She's Not There, She's Here

My mother suffers from dementia. Over the past nine years—since she turned 80 years old, in fact—her mind’s ability to function has deteriorated. Wikipedia describes dementia as a “serious loss of global cognitive ability.” There is much truth to the description: the woman who looks at me from across the table does not think as did the woman who raised me. Or so I think. I refer here not to the nature of her thoughts but to the very thoughts she utters and the capacities that produce them. They are in serious decline. Yet . . .

            There resides in my mother’s face a peacefulness that I don’t think she ever knew in her life. She experiences at this time no visible sign of anxiety, no sense of unhappiness or displeasure. She is thoroughly content in her present moment. As we sit at a restaurant where I eat a meal and she barely tastes her cup of chicken noodle soup, a smile remains almost permanently on her face, and it seems to me as I look at her looking at me that the smile she shines on me wholly expresses her. My mother is more than content: she is happy.

            Dementia affects the ability to understand and to produce language. Of course, dementia affects memory, and language depends very much in its functioning on the basic powers of memory. Though it seems automatic, the production of even the very grammar of the sentence has to derive from memory’s awareness of structures essential to meaning making and to the production of a vocabulary that communicates. My mother cannot construct a simple sentence: either the grammatical forms lack the ability to make meaning or the available resources of vocabulary elude her. And yet . . .

            Though I comprehend almost nothing that she says, there seems to run through her head a series of scenarios that she means to report to me in her talk. It is not conversation she intends because she makes statements of fact that do not require response. “This is,” she means. I know this, I think, because of her use of pronouns. She struggles to find the grammar to express what she must be seeing, and because she sees something and assumes her hearer knows of whom she is speaking, she employs the pronoun (it is almost always the masculine form) to refer to the subject of her sentence. “He always says this . . .” she says simply, smiling knowingly. This sounds to me like a trace of the mother I remember: always certain and never to be questioned. Authoritative. Somehow, I wonder, is she still there (where is there) but now can’t be here (but where is she now here?).

            It is the struggle of any writer to get the ideas and pictures in her head into a language that someone who resides outside of her head will be able to comprehend. Language to make sense of. Language to play with. But my mother will not be able to achieve this again because she is not aware that she is incommunicative. She struggles for words and form, as do we all, but once she chooses she assumes she has achieved her purpose. And I say to her as I sit across the table from her, I say sotto voce “What do you see, Mom? Of whom do you speak? Is it someone we know together? Tell me!” I am in this questioning engaged in the same wonderful effort that an adult makes with every child learning speech, the pretense of comprehension and the evocation of sense and the teaching of new forms in the serious attention to developing the ability to intelligently converse. And the terrible sadness as I look into her face is that my mother will never again achieve the ability to speak and to communicate no matter how I respond to her pseudo-sentences. She is trapped in the mind that suffers from the steady process of debilitating dementia.

            Nevertheless, I smile as I would for the learning child, and I nod affirmatively to my mother as if we were in perfect sympathy. But I don’t know to what she refers; I don’t know what she means. Of whom does she speak? To whom does she think she speaks?
            And when I stand up and give her a kiss goodbye, she smiles to me, and it is I who feel a deep sorrow at my leaving. She has immediately returned to the present, and in that present I have not left and I am not there.