Harvey

Finally, in keeping with the title of this blog, I visited on a Monday!

I arrived mid-afternoon and Mother was seated at a table in the dining room. I came in and said hello. She made no response. I gave her a kiss and she looked at me with a blank look. I sat down at the table, glad no one was there to ask who this was that was visiting. One woman was across from her, but soon she had a visitor and they moved to another table.

Mother had an empty glass in front of her. Would you like more to drink? I asked her. "No," she said, "but you're welcome to if you want." Lucid but cold. It was almost the last thing she said in our visit.

Seated at another table was a woman with long, straight gray hair and a straw hat. A walker stood beside her chair and on her lap was a large...and I do mean large...stuffed pink rabbit. I watched her trying to feed her cookie to the rabbit and dribbling milk on its fur as she tried to get it to drink.

In the meantime, I tried to engage Mother in conversation. It was extraordinarily difficult. I asked questions and made comments but it was like the words were never spoken. She stared at something unseen in the kitchen. I began to think she was losing her hearing until I said in the same voice, "I have a new job." Instantly she turned and looked at me with interest. "Oh?" So I told her about being the new Executive Director for the Massachusetts Bible Society and said that Easter would be my last Sunday in the church. I told her about being in the Boston Globe and my trouble trying to find a place to live, but she was back to examining the finer details of her napkin.

The woman with the rabbit was hugging him close and I found myself growing envious. I wanted to hug a rabbit, too, and make the terrible distance between me and my mother go away.

"I'm taking a trip at the end of the month," I said. Nothing. "I'm going to Israel." She turned and looked at me with interest. She still knew of that ancient land of the Bible. It was still there. For a second. Maybe her own travels passed through her mind in that moment...Russia, Morocco, Alaska, Hawaii. Or maybe she struggled to determine whether Israel was a place or a food.

We sat quietly for a time. The woman with the rabbit got up and hobbled over to our table, trying to cling at once to both rabbit and walker. In quite clear terms she told us how her "baby" was growing up. How he managed to pull himself up and that his legs were getting stronger. She showed us. She told how he was learning and how he was a pain sometimes, but that was all part of it. She loved him. It was obvious. Then, selecting the rabbit as the most important support, she put her walker against the wall and hobbled into the TV room.

Mother continued to observe the design pattern on her white paper napkin. I told her that Rob was no longer commuting so far to work because they put the radio station in his attic. Again, nothing. Soon it was time for me to head south. I kissed mother goodbye. As I did so, she looked at me and laughed. She didn't laugh at all during the visit before that. She is no longer on antidepressants.

Driving home I thought of the rabbit--and of course thoughts of large rabbits turn my mind to Jimmy Stewart and Harvey. Of course this woman's rabbit was quite visible, although just as fictional in its own way. It had an imaginary life as an infant boy struggling to take his first steps, and there was nowhere that the woman went where he did not go. After all, you can't leave an infant boy on his own, now can you?

And Mother, too, had her Harvey. Whatever it was, it was in the kitchen for quite some time. It was reflected in the embossed lines on a paper napkin. An alternate reality...or perhaps simply a new mental interpretation of what was really there. It called to Mother. Called her away from a world where your children are making major changes in life, away from a world that exists on the outside to a world that exists only on the inside of each individual mind.

And I had Harvey, too. I was talking to someone who wasn't there, a figment of my imagination by all signs, but one that seemed for all the world to be sitting in front of me.

And I wished I had a large pink rabbit to hug.

From a visitor

I'm always grateful when I hear from those of you who drop by this blog. I don't always respond because time is tight, but I appreciate your e-mails, comments, and posts.

Recently I had a response from a colleague, now retired, who left New England at about the time that I came back. So we have never met in person. But, as is the case with many of you, we have "met" through this blog and through the experience of seeing a loved one through the agony of Alzheimer's.

My colleague, the Rev. Richard Lee Evans, has written a book entitled Senior Moments: Reflections from the Third Trimester of My Life, and in the book he has a segment about his mother-in-law's battle with the disease and the miracle of grace that often occurs at the border of this life and the next. I have asked his permission to print it here, since I have heard others relate similar experiences--not as many times as this, but still significant. I'd be interested to know if others of you have anything similar to share. Here it is:

2000

Out of the Fog—For a Moment or Two

During the final years of her life, Lillian Monsen was enveloped in the fog of Alzheimer’s disease. Yet there were three times we know of, during the last year of her life, that the fog lifted and for a few minutes she became “herself” again. These three experiences indicate to me that Lillian was on the edge between the physical body (with its disintegrating brain) in which she was trapped and the spiritual body in which she would be free and whole again.
The first incident occurred early in 2000. Lillian was in the dayroom of the Alzheimer’s Unit at Evanswood Nursing Center in Kingston Massachusetts. Suddenly she fell from her chair and hit her head. A nurse came immediately and found her unconscious and with no pulse. Several attendants helped lift her into a wheel chair so that they could return her to her bedroom, where they assumed she would be pronounced “dead.” On the way, she revived and looked at the nurse walking beside her. “I died, didn’t I, and you brought me back,” she asked? “Yes,” the amazed nurse responded.
The staff notified her family and soon her daughter and granddaughter arrived. Lillian knew them both immediately and wanted them to stay with her. She was fully lucid with no sign of the disease that had invaded her brain. She laughed and joked with Barbara and Diana and was full of life—just as she was years before. After about 20 minutes, the fog began to descend again and all of the Alzheimer’s symptoms returned.
The second incident occurred about six months later—again in the dayroom. Lillian passed out and staff members returned her to her room and to her bed. She regained consciousness and then passed out a second time. The family was notified and when Barbara arrived, her mother was awake and said: “I’ve been with Arvid (her late husband) and mother, but I’m not ready to stay with them.” Barbara tried to assure her that it would be OK for her to “stay with them.” Then after 15 or 20 minutes, the fog descended once again.
The final incident occurred the day before she died in February 2001. A staff member found Lillian on the floor of her room where she had fallen, near her bed. She sustained a severe head laceration. Staff members got her up from the floor and laid her on the bed where they stopped the bleeding and called for an ambulance for transfer to a hospital. She began to talk and said that her head “hurt a lot.” She carried on a lucid conversation with the EMTs while they placed her on a stretcher and wheeled her down the hall. After passing the nurses’ station, the supervisor asked an assistant who it was that was being wheeled out. “Lillian Monsen,” the woman replied. “Oh no,” said the supervisor, “that couldn’t have been Lillian. She was talking too rationally.” She talked rationally all the way to the hospital where, later that afternoon, she suffered a cerebral hemorrhage. Lillian remained comatose until she died the following day.
These three stories—taken together—have become a source of amazement and comfort to members of her family as we watched Lillian “teeter” on the brink of death and even glimpse a bit of that heavenly realm before her final journey into the eternal presence of God. “So we fix our eyes not on what is seen, but on what is unseen. For what is seen is temporary, but what is unseen is eternal.” II Corinthians 4:18 (NIV)

October 2004

Broken

Not a great picture, I grant you. But, yes, that is a sling around Mother's arm. I've actually been up to visit three times since my last posting. There has been a lot going on, and I haven't had the emotional energy to post. I find that writing this is both quite therapeutic and quite difficult--I guess all therapy is difficult, no matter what form it takes.

Writing about visits is a re-living of sorts and visits are a complete mixture of emotions. As I found back when Mother first entered The Birches, I find that I want never to leave and never to return all at the same time. A part of me wants to stay and never leave her side. The other part of me wants to play ostrich and pretend that this isn't happening, which is much easier if I just go about my daily life and don't visit.

But the pull to stay away vanished instantly when David called the week before Christmas to say that Mother had broken her arm and had pneumonia. I was up there within 24 hours. We still don't know what happened. The aides and nurses on staff don't think she fell, since her mobility is now impaired enough that she couldn't get herself up if that happened, and no one found her down.

What they did notice was a bruise on her upper right arm. It began, they said, as a straight line across her arm and didn't look like much. When the bruise got larger, they did an x-ray in-house. Not liking what they saw, they took her down the road to the hospital, where they confirmed a fracture. While waiting at the hospital, the nurses there noticed her wheezing and decided to do a chest x-ray. That's when they discovered she had pneumonia.

They decided to try just a sling rather than a cast for the fracture and sent her home with pain meds and antibiotics. So, when I saw her the next day, she wasn't very engaged. But she wasn't in bed either. I found her sitting up in the dining room with Narissa and Gloria.

Gloria was distracted by the blazer she was wearing. One of the extra buttons that come with most jackets was sewn on the inside down near the hem. For someone whose brain isn't connecting properly, this can do a number on you. She saw the button there on the inside and determined that her jacket wasn't on properly. But, of course, if she turned it around to try to make that button connect with a buttonhole somewhere, that wasn't working out either. Gloria wasn't able to focus on anything else and after a bit one of the aides took her to her room to get things sorted out.

If Mother had wanted to engage conversation, she would have had a hard time getting a word in edgewise. Narissa still has a lot on the ball and when I sat down, she wanted to talk. And talk she did. She told me a lot about her life, asked questions, and waxed wistful about the circumstances of life that landed her at The Birches. Like I remember from a similar conversation with Frances and Russell, the basic sentiment was that if you had to be somewhere, The Birches was as good as any; but the pain of not being at home and whatever knowledge she had of the road ahead was evident. She said what a nice lady Mother was. Mother stared into her cranberry juice. I said my goodbyes when it was time for supper.

I was, of course, up for Christmas Day with the immediate family and then again the day afterward when the extended family also came for a visit. It's time to head up again.

The pneumonia seems to have cleared up. Thankfully they caught it early. She has always been prone to that and I remember her having walking pneumonia several times when I was growing up. The bone-breaking, however, is new. She never broke a bone in her life until she was well into her sixties and broke her pinky finger on a spiral staircase. While I'm glad to know she didn't fall, if she fractured her arm just by walking into furniture or something (which seems to be the consensus...especially given the straight-line bruise), bigger issues loom. It seems we now must add osteoperosis into the mix. The doctor has confirmed.

And so life goes on...break by break. It strikes me that Alzheimer's is kind of like having your brain in a sling. It's still there, but you can't really use it and it seems to only get in the way.