I’ve been on service a week, and I’ve already seen quite a range of presentations and stages of Alzheimer’s. I had no idea there was such variety.

The first patient, diagnosed at the young age of 57 , had deteriorated rapidly. She was very aphasic–meaning she couldn’t find the words she wanted, nor could she understand some of the things I asked. She scored a 3/30 on the MMSE , a quick test of one’s cognitive functions. This is very poor. Often I would ask a question, and she would respond with “Well, I… you know, I am… and so, it is, because, you know, it… is. And it’s okay, because what it is… is.” It was very difficult emotionally to continue; I felt really uncomfortable asking her more questions. This was complicated by the fact that her partner was in the room, a psychiatrist. He looked like he was on the verge of tears with every question I asked. I asked him how he was doing, if he might like some help caring for his wife, but he said he was fine.

On the exact flip side, I met another woman who has Alzheimer’s and was very happy-go-lucky. Maybe her disease had just progressed less. She still recognized her children, but didn’t know much else. Besides that, she seemed content. When I asked her the year, she smiled and replied, “Oh, I don’t keep up with that.” What an outlook. Her children, who were at the appointment with her, seemed to have accept their mother’s illness. They smiled and joked with their mother, and tried to make the best of the situation.

Sometimes, I guess all you can do is laugh.

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