Going, going, gone

 Illustration of a old man at Main & Broadway

With advancing age comes the justifiable expectation of some form of impending illness. This may appear as cardio­vascular events, malignancy, arthritis, or, worst of all, cerebral dysfunction. Alzheimer disease and other dementias are on the sharp increase, a fact of which I am increasingly aware with no less than five of my friends and acquaintances so afflicted.

It is all too easy to say, “So and so was always a wee bit odd or forgetful, fussy or irritable.” But that would be wrong. For these people are, or were, highly intelligent business and professional people who functioned at a very high level.
The onset of their current condition was usually insidious. Increasing forgetfulness, irritability, somnolence, or insomnia prevailed. 

As time went by, these symptoms often combined and gradually—and sometimes not so gradually—progressed until their impact upon the lives of the afflicted and their families was undeniable and ultimately devastating. 

Although only a friend or acquaintance to these people, I have found these experiences profoundly disturbing, even distressing, to witness. Allied to this is a feeling of frustration. As a surgeon, I want to do something, yet I can’t. 

Of course, visiting, talking, and reading can help on both sides, but the progressive decline, withdrawal, and ultimate functional absence are deeply shocking. The collateral damage is evident in the emotions, physical strength, and even financial resources of the victim’s family. 

However, as in all of life, mental aberrations can have their brighter side. Someone once said that many functioning manic depressives make a good living on stage as comedians. Witness England’s Tony Hancock, who achieved mega-stardom only to take his own life. 

Furthermore, each of us, I am sure, can recall an example when an elderly cerebrally uninhibited person would make some timely remark which we wished we had had the courage to say at the time! 

These people are mirrored by the ingenious frankness of the very young, who produce timely howlers—to their parents’ consternation and embarrassment. 

And so, maybe a little “dottiness” is not such a bad thing in life. If only one could control it, or better, learn how to fake it!
For example, I could say “Shut up, you tedious old bore!” and then look blankly at the stares from my outraged companions. “Oh, did I say that? Did I really? Surely not. No, never.” 

Or, “Waiter, what do you mean I forgot to pay? Certainly not. Perhaps one of my friends can help you.” 

Better still, “What’s that you are saying about my wife? I’ve never seen that woman before in my life!” (Perhaps upon reflection, I’d better not try that one!)

So, sad or amusing, life does go on and we must be grateful and use it to the utmost benefit of others and ourselves. On that rather pompous note, I had better be going. I have to find my car keys.


Dr Fraser is retired from pediatric general surgery at BC Children’s Hospital, where he was head of surgery. He enjoys reading, writing, and erratic golf.

Graham C. Fraser, FRCS, FACS. Going, going, gone. BCMJ, Vol. 51, No. 10, December, 2009, Page(s) 470 - Back Page.

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