Every once in a while, a patient will say or do something that makes me stop and think, “There you are.”
I work primarily with older adults who are in their 60s to people over 100. Many of them have dementia to varying degrees.
I often see them at their worst. They’re sick, in an unfamiliar environment surrounded by unfamiliar people, and they sometimes don’t understand what’s happening. They’re confused and scared. Some are easily agitated or combative.
It’s easy to think that this is simply how a person is because those are the behaviors we see the most. And because these patients are often new to me, that may be my first impression of them too.
But these behaviors are often manifestations of a disease affecting their brain. They don’t tell me who a person is.
Sometimes, though, I get to see another side.
A patient who has been irritable or combative will suddenly look at me, smile, and respond to my greeting. They might make conversation and tell me about their life. They’ll say thank you when I hand them something.
Sometimes their entire demeanor changes. They’re calm. They make eye contact. Their voice has a different cadence.
And I think, “There you are.”
I get glimpses of the person who existed before dementia became such a significant part of their life. The person who was there before I knew them.
You were someone’s mother or father, someone’s grandparent, someone’s spouse or friend. You had a job and a life full of experiences, relationships, emotions, and stories all before you ever became my patient.
I see it when a patient with dementia offers me their meal and her son tells me, “That’s how she’s always been, looking out for others first.”
Or when a patient tells a joke and his daughter says, “He’s always had a good sense of humor.”
Or when a wife shows me a picture of her husband from 40 years ago, when he had a head full of brown hair, a light in his eyes, and a smile on his face.
For a moment, I get to see you as someone’s mother, father, husband, wife, and friend. I get to see the person beyond the illness.
There’s so much more to you than what I see in a hospital room.
Sometimes I can see the discomfort in my patients when they recognize that their minds are changing. Other times, I don’t know whether they recognize the difference between how they are now and how they used to be.
But I notice.
And when I get those little glimpses of the person beneath all the confusion, I try to remember that no one should be defined by their illness.
Sometimes, for just a few minutes, I get to see another part of you.
And I think it’s worth noticing that there you are.