Losing her mind…

She was one of my first patients.  She was tall, strong, witty and kind…and had a gentle touch. They had married for 50 years, never had children.  They were an exemplary example of a loving, respectful partnership.

Unfortunately, Louis had delayed her first appointment with me, as she had experienced an “episode” and had been hospitalized for a mini-stroke work up.  When we finally met, she had been discharged from the hospital, as she was now stable, and was being followed by the neurologist and cardiologist for a full battery of tests.

We sat and chatted, reviewed her results, and got to know one another.  I immediately felt close to her.  I was not surprised that although they did not have their own children, Louis and her husband had an extensive network of support.  They were very active. We joked, we laughed and we bonded.  They were coming back to my office the following week for a health review for her husband and to follow up some of her pending results.

A week later her husband was concerned.  She was frustrated he was smothering her.  This time, she spoke a little slower, her hands trembled. She didn’t seem as strong.  She was not as confident.  She was seeing her neurologist again.

I called Louis a few days later to update her on some of her results.  She answered the phone but couldn’t complete a sentence.  I was worried. Very worried.  I asked her husband to bring her in.  I trembled after I put the phone down.

The woman in front of me now was not recognizable. She was holding her hands together to stop them from moving.  She could not even open her lips to make a word.  She could only nod her head for yes or no.  I panicked.  She tried to smile, as tears flooded her eyes from frustration.

I called her neurologist and she was hospitalized.  Her CT scan showed inflammation of her brain-cause unknown.

Her husband called me every other day for an update.  At first he seemed positive–he had not understood the initial results.  I tried to explain, tried to brace him.  Very soon, she was deteriorating.  Her husband said she refused to eat, refused to get up.

We discussed death softly.

What to expect, how to prepare for that which one cannot prepare.

He felt she was suffering, she was losing her mind.

One day she didn’t make eye contact with him.  She didn’t hold his hand. She only cried.

A week later she was gone.

Her husband had called the clinic and left me a message.  When my receptionist told me, I thanked her and closed my office door.

I wept. Wept for the lovely, active, charismatic and smart woman who I only had the joy of knowing for less than a month.  A strong, independent woman who had to live her final days trapped in her body, unable to express herself, unable to communicate.  Only able to cry.