The Insistence of Hope

My old friend the deity I named George decided to pay me a visit today, either to distract me from the serious business of Carol’s seizure or to just pile on, I’m not sure which.  Either, no doubt, would amuse him.

When I saw the message from eBay in my inbox, I recognized George’s hand, for that message informed me that my recent order had to be canceled because of a problem with the shipping address.

Yes there was a problem, but not with the address.

I hadn’t ordered the item.  When I went to my eBay account, I saw the recent history of items I had checked out.  But, of course, I didn’t recognize them, for I had not trafficked on eBay in quite some time.

Most of my morning was thus spent, all the while keeping one eye on Carol, doing the protect the security of my account dance, the steps for which I am now familiar with from previous experiences with Amazon and my email account.

I finished all that just in time to give Carol lunch before the aide came, releasing me to go to town for my weekly shopping.  So here I am at the end of a very long day, trying to pick up where I left off concerning the seizure.

The nurse practitioner came out within an hour or less from the onset of the seizure.  She checked Carol’s vitals, and looked to see responses to visual and audio stimuli.  She snapped her fingers near Carol’s eyes or asked her to move her head toward the right.  Carol’s responsiveness was limited.  She then, with my help, took a blood sample, which she would drop off at the hospital in town to see if a cause for the seizure would be revealed.  Her best guess is that the seizure was just a product of the progress of the disease, and probably not caused by stress as had been suggested when she had the first seizure in December.

Today, the lab test results reported nothing that would have caused the seizure, and Carol seems mostly recovered.  Last night, she had trouble eating because of her injured tongue, and would tolerate only cottage cheese.  But today, she had her usual breakfast, and half a sandwich for lunch.  The aide reported that Carol resisted a full bath, permitted some washing, and went back to sleep.  She roused for a full supper, including a large cookie for dessert, and then went back to sleep.

I’m assuming that tomorrow, she will be fully back to what I now know as her normal state.

Lost in all of this is the fact that yesterday I had to cancel the first visit of the highly recommended physical therapist. He had scheduled two visits this week, and said that unless I otherwise advised him, he would keep tomorrow’s appointment.

I hope Carol is up to it.

I hope he is as good as advertised.

I know both hopes are fingers in the dyke of Carol’s disease.

We are now three days past the seizure and things seem to have settled back down into our regular patterns.  I had lunch today with two of my usual group, one of the others now in Hawaii visiting his son, and the other off on some domestic errand.  I left Carol in the care of a new aide substituting for the one on vacation this week.  She worked out just fine.  Because Carol slept most of the time after eating lunch this aide looked for things to do, to the extent of cleaning windows inside and out.

Carol would surely have appreciated that.

Yesterday, the new therapist arrived.  He is as advertised.  We agreed on setting both unrealistic and more realistic goals.  The former would be success in getting Carol back on her feet, confident enough perhaps, to again use a walker.  The latter started at enabling her to sit up.  That simple fact would facilitate my dealing with her change of clothes.  More ambitious progress would extend that sitting up to a stand and sit transfer into the transport chair so that I would be able to wheel her to the table, and maybe even outside, although that latter would involve figuring out how to navigate steps.

Besides setting these goals, we also discussed strategy of treatment. I was delighted to discover that he believed in going very slowly.  The implementation of that strategy during this first visit centered on his establishing a level of rapport through a lot of conversation.  He did a little bit of range of motion exercises, but mostly talked.  Every once in a while, I would add a comment to his patter, just to keep it moving along.

All in all a very good start.

I will end this writing session on that happy note, for if I continue I will no doubt feel compelled to state the usual cautions.

They can wait.

Good Friday night and also first night of Passover.  Carol is asleep, and I am snatching a little writing time away from watching the Dodger game streaming on MLB network.  This will be a short session, perhaps developed at greater length over the weekend.

If we were still in New York, or if Carol were still well here in Michigan, I would nod my head toward my holiday by having matzohs and macaroons in the house and perhaps cook up a brisket for us and a couple of friends.  That would be my substitute for a full dress seder, which I haven’t really experienced very often in my adult life.  In New York, I don’t recall us doing much more for Easter than getting some chocolate bunnies.  Here in Michigan, we would usually be invited to a family celebration of the holiday, which when the kids were young on at least one occasion included an Easter egg hunt.  More recently, as Carol’s siblings would sometimes attend holiday activities at spouses’ houses, we might go out with sister Jane and family to a buffet in town.

In short, neither of us were seriously invested in holiday celebrations, and left to our own devices would pay minimum attention to them.

So, I do not mind that we will pretty much ignore both holidays this weekend.

The game calls and will not be denied.

It is Sunday night approaching midnight.  As expected the holiday weekend passed quietly.

And that suits me just fine.

 I did a little book business, and attended to a broken string on one of the blinds in the living room.  I arranged for it to be picked up today by the woman from whom we bought these blinds years ago and who repairs them when necessary.  She has family on the Peninsula and offered to pick up the blind today after visiting her relatives.

Winter decided to inform us that it was not done yet, offering some snow and wind on Saturday, followed by dropping temperatures today.

As I was thinking about what I could prepare for supper, the doorbell rang, and there stood Brad from next door, accompanied by Marty, two of my lunch companions.  Brad had plastic containers in his hands, which he offered to me, saying that he was aware that it was Passover but Amy had prepared an Easter dinner for us.

Lovely people, dealing with their own problems but thinking of us.  Brought a smile to my face and lifted my spirits.

Tuesday afternoon in the library.  Lots of noisy chatter from some kids.  Although it is again snowing so far the predictions of a serious accumulation have not occurred.  Roads are still clear.  Snow is anticipated through the night.

We shall see.

An April snow is not particularly unusual hereabouts as the Facebook You Have a Memory on this Date reminds me by reposting images from years back showing the property around our house beneath a white blanket.

But this year, perhaps because of my circumstances, and because as well, Easter occurred two days ago on April 1st, and not because income tax returns are due in twelve days, this snow, this year, puts me in mind of the provocative opening of T. S. Eliot’s “The Wasteland,” to wit, “April is the cruellest month….”

The poem is famously difficult, and this is not the place to even begin to suggest what that line leads into.  Rather, I choose to look at it, more or less, out of its context to see what thoughts it leads me to consider.

First  this five word declarative sentence just seems wrong.  In the northern hemisphere where Eliot spent his entire life, April is the doorway to spring, to life returning from the dead cold of winter.  It is no accident that Easter occurs in the beginning of spring.  Its message of overcoming death would not play well in winter, but it fits the warming season.  If vegetation can return from a dead like state, then so can people who have died.

Of course, Eliot is well aware of these associations of religious belief with the annual cycle of seasons.  What he is offering is a paradox, a seemingly contradictory, even absurd, statement, which nonetheless is true.

April can only be seen as cruel if its promise is not realized.  Because we respond so strongly to the promise of revival, to the prospect of life returning with its usual vigor, we are that much more distressed when that doesn’t happen.

The rest of the poem, built on this paradox, explores it with a wealth of erudite details drawing on anthropology and comparative literature, all of which make it the bane of any undergraduate student who is asked to deal with it.

I, though, will simply take that paradox and apply it to our experience with dementia.

First, complete Eliot’s basic point.  As the title of this poem suggests, he does not see the promised revival as arriving.  Therefore, the hopeful expectation is not, and perhaps will not, be realized.

From there, it’s an easy transference of terms.  Just take every instance that seems to promise a positive outcome and equate it to the disappointment April presages.

Library now quiet, kids gone, but I have to get home.

Late at night.  Wind howling.  Forecast still predicting significant snow through the night and into the morning.

OK, let’s make the connection.

During the course of this disease, this dementia, at least as I have been experiencing it, there have been numerous little aprils, the lower case beginning letter being deliberate to indicate the difference with the month, and the quantity, many more than a mere one a year.

But the similarity with the poet’s month remains.  These little aprils raise expectations that are routinely disappointed.  One would think that this repetition would by its very nature diminish the expectation that the promise will be realized.

But it doesn’t any more than the annual arrival of April does not produce the hoped for conquering of death that Eliot has in mind.  True, the weather does warm, nature springs back to life, only to be followed by the inevitable death of winter.  Again, of course, Eliot is probing for deeper meanings beyond seasonal cycles, but it is enough in this context to say that just as the hope of the season of April inevitably gives way to the winter, the hopes raised by the lower case aprils during the course of the disease will yield to the reality of the dementia’s crushing power.

What brings all of this into the present moment is the arrival of the most recent physical therapist who again raises the possibility that as good as he seems to be he will be able to make some progress toward modest goals, such as enabling Carol again to sit up, and perhaps even, with enough assistance, again sit comfortably in the transport chair.

It is not much, and it may not happen.

The lower case april might well emulate its larger sibling.

But if nothing else it is better to live with realistic hopefulness than wallow in despair.

I’m sure Carol, if she were able, would agree.

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