Further Down the Rabbit Hole

"No, I didn't," was the hot denial from a man who cannot remember five minutes ago. I had to assume then that the television remote control had made its way into a sink-full of water at the hands of an intruder or the dogs. As it was a quiet day with no visitors, I highly doubted the former; as my dogs are intelligent canines but do lack the skills to plan such mischief, I ruled them out too. No, it was another of Michael's odd little escapades that I'm sure made perfect sense to him in the moment.

I've learned there is no point trying to find reason in his bouts of madness, nor is there anything gained in reprimanding him or suggesting he not do that again. He will simply forget. Unlike a small child who will eventually remember and learn appropriate behaviour, Michael's mind no longer has the capacity to learn, though he sometimes seems to possess that childlike curiosity that simply cannot resist finding out what might happen if you plunk the remote control into a basin of water.

Lately Michael's dementia has escalated to the point that he can no longer hide it in front of others most of the time. Until recently he could, as do many who are stricken with senility, rise to the challenge of putting on a fairly normal face in front of visitors, reserving the real Michael for me alone. I used to feel that some folks doubted my reports of his extreme behaviour simply because they never saw it, especially those who only saw him occasionally. As recently as last summer I would feel an odd mixture of extreme frustration and delight when I would take him up to the soccer field to socialize with his old buddies. He would be the old Michael, back-slapping and running to retrieve the soccer ball, then slump the moment I got him back into the car; overcome with exhaustion, he would shut down completely. Some of these same men have recently helped me out by spending a couple of hours with Michael to allow me some time off. The look of alarm on their faces upon my return as they reported his bizarre behaviour was strangely satisfying. Ah, at last you are seeing what I see every day.

But his behaviour around me has worsened too, leaving me nervous to take my eyes off him for more than a short while. A few days ago, as he rolled up the living room carpet, he explained incoherently something about the Civil War, soldiers and how he had been killed. Another time, again down on the floor with a carpet, he was apparently looking for a flashlight. Then there was the moment, with wallet in hand, he announced he needed to find his way home. He knew neither me nor who his children are. Indeed, like poor Alice confronting the Caterpillar, he couldn't even identify himself.

A recent conversation with the doctor about what course to take if no infection is found in a urine sample, taken after I discovered clumps of blood, brought us to a new understanding, at least for the doctor. When he asked me if the normal protocol of scans, cystoscopies, and whatever else might be needed to get to the bottom of a possible urinary problem could be followed, I told him I could never see Michael tolerating anything beyond mild procedures that could be performed at home where even collecting a urine sample is now very difficult. I asserted that my concern is to ensure not only his physical wellbeing but also, more importantly, his equanimity. We've had this conversation before even though I have a document stating minimal intervention in the event of a catastrophic episode. The doctor needs to confirm and reconfirm that we are on a purely palliative course now.

It is February, and cold and snowy outside. It is an isolating time, trapped indoors with insanity, but at least he is sleeping through many more hours of the day now, calm and quiet in bed or on the couch to balance out the more manic, delusional times. Television viewing, however, is now slightly more challenging as I wait to see if a dry remote control will still work.

*John Tenniel's illustration from Lewis Carroll's "Alice's Adventures in Wonderland", 1865.