“Matter of Fact”: Neurology

[This is a poem about dealing with the diagnosis of dementia.  I can’t get this blog to make it look  quite right, so please go to the citation at the end to see how it appeared in print, in the medical journal Neurology.]

Matter of Fact

Ron Louie, MD

 

Her face was matter of fact when she heard the pronouncement.  

The neuropsychologist was her colleague; he remained professional,

but slipped in some sympathy with the data, which I could not appreciate.

 

She didn’t display a mask of depression, or Parkinson disease. 

Her face remained pliable, not pleased, but neither terribly pained,

no exhibition of perplexity, or petulance, or surprise, a pensive look,

retaining its complex grace, a quiet reserve, a solemn alertness, 

the beauty of humane consciousness, with no further expectations.

 

In her own practice, she had encountered early Alzheimer disease first hand: 

that wonderful younger woman, whose baby she had delivered, 

working in accounting until the numbers became exotic, then alien; 

she had told me about that patient, with shock, sadness, and resignation.

 

But I didn’t understand this. I wouldn’t. It was the guy, his tests, the setting.

At home, I made her try to draw a clock, count backward, recite words, and

copy intersecting rectangles.  She tried, this good doctor who had always 

bested me in calculus, organic chemistry and marriage.  She wasn’t angry. 

 

So how could I be mad? She was setting the example, as she had done

her whole life, her whole career, without pessimism or regret, or fanfare,

just ready to go on, even though her words and steps might mutate,

unpredictably, ever aware of the possible endpoints, with each of us

now grappling this present moment, trying to recognize its identity.

 

Dedicated to IRJ, MD; suggested by Meryl Comer

 

Citation:  Louie R: Matter of Fact, Neurology 2018; 90:139.

DOI:10.1212/WNL.0000000000004841