The Impact of Dementia

Emma Healey’s debut novel, Elizabeth is Missing, deals with the issue of dementia. The protagonist, Maud, forgets the simplest of details. She writes things down that she does not want to forget and then stuffs those notes into her pocket where they become crumpled. Her daughter comes over every day to help out, plus there is a part-time hired assistant who arrives in the morning.

The effects of aging concern all of us who have reached a certain age. We have relatives who have dementia or other forms of cognitive deficits and worry that the same thing will happen to us. We see them struggling with basic tasks such as feeding, toileting and self-care. They lose their driver’s license and eventually can no longer live alone. They wear diapers, become confined to wheelchairs, cannot walk and lose the ability to recognize people that once were important in their lives.

Dementia is a frightening affliction as there is no cure. Drug companies are test-marketing medications that might slow down the process, but none can stop the progression of the disease.

We live in an instant-gratification world. When we want something, we can find it online if we can’t get to a store. Food, electronics, books, clothing, shoes, music are all available with a click of the mouse. But what happens when our memory fails and we can’t remember what we want, what we already have, what we have dreamed about?

In the novel, Maud is obsessed with one worry: she believes that her friend of many years is missing. She cannot remember what she has been told about her friend and so goes about pestering people with her concerns.
Spotty recall is one of the indications of dementia. Initially short-term memory is affected. The individual cannot remember what he/she just ate, who called or visited, what she watched on TV or whether or not he had a bath. Yet for some reason, he remembers the names of his children, but not grandchildren, where he lived as a young man, and even when he bought his television and computer. She isn’t able to turn on the computer or operate a remote, and following a conversation is nearly impossible. The only possible blessing is that dementia destroys so many connections in the brain that the individual eventually loses herself in the fog of the disease.

Of course there are other afflictions that are equally disabling. For a lover of books and movies, there is the loss of sight. Those inspired by music fear deafness. The physically active are troubled by impairments that leave them unable to walk without assistance. For the ones who cherish independence, the inability to drive and to live alone are profound.

Maud is a sympathetic character. We expect our protagonist to experience change in response to the plot, and are most pleased when the change leaves our character better off then when the story began. Unfortunately dementia has no happy ending.

The Final Test

Every summer hordes of sweaty children crammed into cars and headed into downtown Dayton, Ohio, where the nearest public pool was located in order to participate in lessons. Suits and frilly caps were donned, and then swimmers, dragging towels, paraded onto the deck. Blue-suited instructors sorted the swimmers by skill level, with the least talented in the shallow end, the more competent ones down by the diving board and all the in-between ones in groups along the deck. The smallest kids generally fell into the first group, while the taller ones stood proudly in the second.

When I was nine years old my mother decided that it was time for me to learn to swim. She was tired of my floundering around whenever we went to Indian Lake and so had decided that only a proper instructor could teach me. After purchasing a proper one-piece suit and gathering needed supplies, the day arrived when our family joined the others heading into town. I was extremely nervous. Terrified, really.

Now you have to understand that I was fat. There is no kind way to phrase it, for my legs were puffy pouches even at that tender age and my belly jiggled like Santa’s when I walked. Putting on a suit that showed every bodily flaw was not my idea of fun.

On top of that, I was deathly afraid of the water. Not all water, mind you. I could happily sit in my neighbor’s baby pool and splash in the six inches of water for hours at a time. I could even walk around the edges of a lake or river, feeling the gentle pull of the water against my ankles. When forced to go into deeper water, I could float on my back for the briefest of moments, until I felt some imaginary “thing” brush against my tense body and then I would flounder from panic. But I could not swim and so the thought of getting into that large pool filled me with fear.

After demonstrating my total lack of skill when asked to tread water or swim the crawl stroke, I was assigned the “baby” group for my two weeks of lessons. I was the oldest and the fattest student in the group. Because of these two conditions, I believed that the instructor hated me. I was the antithesis of everything she stood for: fitness, image, skill, and self-confidence. She was young, slim and oozed a certain degree of arrogance. In my mind, she was going to pick on me, humiliate me, and cause me to do things that I would never have done on my own.

But I had no choice. My mother had paid for the lessons. She had given me firm instructions to pass the first level so that I could progress to the next. And so when told to get into the water, I complied. I clung to the side of the pool with a death grip and only let go when held by the instructor.

Day after day we blew bubbles, bobbed our heads under water, floated on our backs with the aide of the teacher, and learned a rudimentary form of crawl stroke. Being a relatively intelligent child, I quickly mastered blowing and bobbing, keeping my eyes tightly closed the whole time. Floating was the one skill that I could demonstrate with some prowess, and so I willingly flaunted my ability whenever the opportunity arose. Coordinating arms, legs, and rhythmic breathing however, was not even in my vocabulary and so the crawl stroke was out of the question.

Nevertheless, every day I put on a determined face and gave it my best shot. My teacher was encouraging for the most part, although she sometimes lost patience with me, especially when the tiny kids mastered skills that I still could not. Surprisingly enough I did show slight improvement over time despite my continuing fear of the water. Some days I could swim a few feet before panic set in and I flipped onto my back to float.

Most days I could put together about eight strokes before I began to sink. Even at my best, the distance from wall to wall was as insurmountable as climbing Mt. Everest.
The last day of lessons everyone had to demonstrate their skills, and if they passed, they earned a coveted certificate that allowed them to go on to the next level. In order to advance, I had to dive in the deep water and swim the width of the pool and back. There is no way in God’s watery world that I stood a chance of passing this test. In fact, I was convinced that I would drown.

One other thing that you need to know; I was a master at excuses. I could drum up the crème de la crème of stories in seconds, without much thought required. Give me a scenario, and my creative little mind went to work. So it should come as no surprise that on test day, I came up with a list and plied them all.

Before lining up to take the test, before putting on my suit and cap, even before we parked in the lot, I began to plead in earnest. I told my mother that I was feverish and had the chills. She rolled up the windows of the car, creating a stifling situation for the entire family. Then I told her I was going to throw up; she rolled the windows down and told me to stick my head out. As the air rushed by, it stole my breath away. My hair flicked into my eyes, so I cried in pain, declaring that my eyes had been injured, so I couldn’t swim as the chlorine would seep into the cuts and blind me. My mother said that chlorine is a disinfectant, and so it would kill any germs that might have blown in with the wind.

When we arrived at the pool, I suddenly remembered that my suit was still at home. “No worry,” my mom said as she pulled it out of a large bag in the trunk. “Now get in the locker room and get dressed.”

Off I went sulking. While in the dressing room, my intestines did a mighty jump, sending me rushing into the bathroom where I sat as everything I had eaten for days gushed out. Convinced that I really did have the flu, I stayed close to the toilet, waiting for the next attack. Unfortunately, my mother appeared and unsympathetically dragged me to the poolside, towing me like a tugboat pulling a recalcitrant ocean liner.

After depositing me with my teacher, my mother joined the expectant parents in the bleachers. I sat on the deck, wrapped in my towel, nervously waiting my turn. I watched the all the little kids jump in and swim to the far wall and back. I saw the smiles and heard the applause, knowing all along that none of that praise would be for me.

My arms and legs morphed into molten rubber and my head pounded with the intensity of a jackhammer. I truly believed that I had lost the ability to stand, let alone walk to the edge of the pool and jump.

When I was the last one left, the instructor smiled. “It’s your turn,” she said.

“There isn’t enough time,” I offered. “I’ll try next session.”

“Move to the edge of the pool.” She smiled encouragingly as she pointed to the red tile border.

“I’ll do it next week.”

“There isn’t a next week,” she said. “Come on now. Everyone is watching.” Again she smiled, although this time her teeth did not show.

“I have to go to the bathroom really bad.” I stood and adeptly performed the ‘bathroom dance.’

“You’re wasting time. Get up there and do your test!” Her eyes narrowed and her lips formed a tight line.

“Please don’t make me! I’ll drown! I know I’ll drown!”

“No you won’t,” the instructor stated. “Put your toes on the edge, right there.” She pulled on my ankles until I had no choice but to step forward. “Good. Now bend over and jump.” I bent over, but did not jump. “I said, jump!” The instructor hit the back of my legs with her metal whistle.

I physically couldn’t do it, but the instructor didn’t know that. I was frozen in a bent over position, arms glued to the sides of my head and legs straight as rods. My eyes glazed over and my breathing became shallow. A cold sweat covered my entire body, and speckled spots appeared before my eyes. Not only did time stop, but also did sound and sensation.

I would have stood there forever if it weren’t for an unexpected push from behind. As I flew through the air, I broke out of my cement-like stature with the wide-eyed look of a startled hare. With arms and legs akimbo, I hit the surface of the water with the mightiest belly flop. Gasping for breath, I floundered like the breached whale that I resembled at the moment, my eyes searching for anyone empathetic enough to rescue me.

“I can’t swim,” I gasped. “I’m drowning!” Another gasp. “The water’s too deep!” Yet another strategically timed gasp accompanied my frantic thrashing of arms and legs.

“Quit whining and swim!” The instructor hollered from the safety of the wall.

“I can’t do it! I can’t!”

“I won’t let you get out until you swim to the other side! Now, go!” She pointed to the far wall with a sharp finger.

“Please! Please,” I pleaded as my arms and legs began to tire.


With tear-filled eyes and a rapidly beating heart, I turned toward the opposite wall, and began to swim. Because of a combination of exhaustion, fear and incompetence, my legs didn’t kick in a coordinated way and my arms barely skimmed the surface of the water. Breathing rhythmically was out of the question. I was at the point of sink or swim. Choosing swimming over sinking, I tried my best.

That’s all anyone can say about my effort. I’m sure that my mother was humiliated. After all, here was the oldest kid in the group performing like an injured baby whale, putting on one of the greatest whining shows ever seen. Instead of a coordinated crawl stroke, I floundered about, flinging my arms in a wild show of effort that barely kept me afloat.

As my arms grew ever more tired, I began to sink. Even as I felt myself going under, I continued to fight. I thrashed about, waving arms and kicking legs, all the while holding my breath. Unfortunately the fatigue that overwhelmed my body combined with my lack of skill added up to drowning.

You might have thought that panic would set in and give me the strength to rise to the surface. That was not to be. Despite all my efforts I slowly sank to the bottom of the pool. Sound became muted and my vision blurred. As I held my breath, suddenly all fear left. I was filled with an unexpected peace, so I quit moving my arms and legs and simply sat on the bottom of the pool. I looked around.

I wasn’t scared, even though I should have been. Time had no meaning, nor did drowning. Happiness grabbed hold of my heart and caressed me with a comforting gentleness. I was resigned to my fate, expecting nothing, receiving nothing in exchange.

It was then that I became aware of a presence: an “Other” who floated beside me, offering a gentleness that I had never known in real life. I was not afraid, for this was not a ghost but a mystical sense of well-being. I felt safe; that everything was going to be fine, and that there was no need to be afraid. This “Other” told me that she would take care of me as she wrapped her arms about me. I smiled, believing that all would be well.

I was not aware of being rescued, but I must have been, because when I awoke, I was on the deck of the pool surrounded by a group of concerned-looking faces.

“Why didn’t you swim? I told you to swim,” my instructor screamed as she shook my shoulders. Spittle sprayed my cheeks.

I watched helplessly as the other faces slowly moved away, leaving me alone with my torturer. I tried to speak, but water bubbled out of my mouth as coughs racked my body.

“It’s your fault,” my instructor screamed as she shook my shoulders. “You are an embarrassment.”

“I told you I couldn’t swim,” I coughed out.

“You have failed the course,” the teacher said as she slammed my shoulders onto the pool deck. “You are a danger to yourself. You can never come back for lessons again. Now go find your mother and tell her that you are finished.” She walked away, leaving me lying on the wet concrete.

That’s when I really began to panic. My mother had spent hard-earned dollars on my lessons and I had wasted them all. I knew that she would yell at me, probably even spank me, and her words and her hands could really hurt. Fearing that I might throw up in front of the crowd, I pushed off the deck and ran into the dressing room. Thanks goodness I made it to the toilet in time. I did not need further humiliation that day.

After my spectacular show of incompetence, and the temper tantrum that I had expected, my mother announced that swim lessons were a waste of money for me. From then on, for the next several years, I spent summers watching my older brother master the fine art of diving off the board and competently performing a variety of strokes as he flew across the pool. Eventually he mastered the program and earned a certificate with a gold star.

Even my sister learned to swim. You would have thought I would be embarrassed as my little sister, seven years younger, accomplished the smallest of tasks that I had been unable to do, all with a smile on her face. I was, but I didn’t let it show. Instead I thought of other things while she dived, swam, and floated on command.

As my siblings participated in this rite of summer year after year, I looked for unusual shapes in the clouds passing overhead. I read a lot of books and wrote my first stories with a pad of paper balanced on my knees. I wondered why birds had different cries and questioned the ability of fish to breathe underwater. Time passed without my learning how to swim, but anyone looking at my enraptured face would have thought I didn’t care.

They would have been wrong, for deep down inside, I really did want to learn. I just didn’t have the confidence to give it another try.

The Journey

The Journey

Jack Swanson was tired of living in a Podunk town south of Dayton, Ohio where the most exciting thing to do on a Saturday afternoon was to watch cows chewing grass. Sure there were other things to do, like playing pickup games of baseball in the early morning before it got too hot and humid, or go hiking through the woods behind his family’s home, but those depended upon weather and other like-minded boys.

Sometimes a kindly parent would drive a few of the guys into town to go bowling or to see a movie, but that was only when they had earned money selling fruits and vegetables out of the family garden. Most days Jack spent lazing about in his room or playing board games with his younger sister, or if he was lucky, watching his allotted thirty minutes of television.

He dreamed of big things. Jack wanted to be an engineer and design machinery that would change the world. He loved to take apart broken appliances, find the problem, and then restore them to working order. It gave him a sense of pride. But living in Beavercreek there were few opportunities for that wanted an escape. Completion of high school meant the end of education for there was no money to spare for what his dad considered frivolity. At eighteen he would be treated as a man and therefor expected to pull a man’s weight. Find a job. Get married. Have kids. Jack wanted none of that. He wanted to go to college.

When his mom developed asthma that was triggered by the humidity, his father decided to sell everything and move to California. One day Jack’s father called together the family and said, “Kids, we’re moving next week, so decide what you want to take with you. And it must be small enough to fit in the car.”

So Jack thought and thought. His mother told him he must pack all his clothes that still fit, so that left room for little else. He finally settled on a couple of models he had yet to build, glue and paint.

When the day came to leave, the back of the family station wagon was stuffed with bags of clothes and other precious junk. Jack had no regrets as he took one last look at the home he had lived in for the last five years. Instead his mind was filled with hopes of adventures he would have in the land of sunshine and community colleges.

Boredom ruled Jack’s days as they drove through endless cornfields and land as flat as the back of his hand. There wasn’t much to do. He read. He counted telephone poles. He kept track of license plates, hoping to see one from each state. He annoyed his sister until told to stop. He stared out the window with a vacant look.

All that changed when they hit Colorado. Off in the distance loomed a blue-gray mountain that grew increasingly clear as they neared Colorado City. Their hotel’s front lawn had a great view of the craggy-looking mountain, especially when the sun began to set and the peaks were outlined by a golden glow. Jack figured there must be a road to the top, but his dad insisted there was no time. Instead they hopped on the highway and headed south, stopping at a river gorge for a much-needed break. Standing at the edge of the cliff, Jack saw miniature train tracks winding along. Over his head, spanning the width of the gorge was a pedestrian bridge. Jack wanted to walk across, but there was no money.

Traveling through the mountains brought a monotony of its own. This time there were endless trees, twisting roads that hung on the side of cliffs and billowing clouds high overhead. Sometime after a roadside bathroom break, the clouds took on an ominous dark blue cast. Huge clouds billowed overhead and the air felt moist, although no raindrops fell. A fierce wind rattled the tops of the trees causing them to bend at rakish angles. Fearing being caught in the storm, the family piled back into the car and hit the road.

Rain fell almost immediately. It began with a roar as sheets of dense rain beat against the windshield, nearly blinding his father, who gripped the steering wheel with whitened knuckles. Up and around turn after turn they went, as roads slickened. Jack noticed waterfalls gushing off the hillsides, burbling with frothy mud that puddled in the ditches bordering the road.

As they climbed higher into the mountains, the sky grew dark as night. The rain fell harder. The waterfalls increased in size. Small creeks ran across the road, flooding sections that, thankfully, were still passable. Until they reached a bend in the road where traffic had come to a complete standstill. As they sat in the car, unmoving, the rain pounded on the roof with such intensity that conversation was impossible. Visibility was nearly zero. All Jack could make out was the vague outline of trees bordering the roadside.

Jack’s dad grew impatient with the delay. He pounded the steering wheel, honked the horn and screamed, “What’s the holdup?” He sat for a few more minutes. His lips became narrow lines, which Jack knew meant trouble. “I’m going out there,” his dad said.

Despite the soaking that would come, Jack’s dad got out of the car and strode over to a cluster of men gathered on the opposite side of the road. There was much gesturing and head shaking and shrugging of shoulders. When his dad returned, he slammed shut the door and pounded the steering wheel. “The road is blocked with a mudslide,” he mumbled between gritted teeth. “I don’t know when the road will be cleared, so we’re stuck until someone fixes it.”

We sat silently. When he was in this kind of mood, Jack’s dad could be dangerously explosive. He was quick to slap and even quicker with hurtful words. Jack held his breath, not wanting to attract unwanted attention.
Minutes passed. The rain poured and mud gushed across the road. The muscles in his dad’s arms flexed into knots.

“Maybe we should turn around,” Jack’s mom said. “We can go back to the last town we passed and spend the night there.”

“We don’t have the money,” Jack’s dad screamed, spittle slapping against his mother’s face. “We have to get through.”

Just then a large truck approached from the other direction, the first vehicle to pass through. Mud covered its sides and tires, but it had made it.

“If that truck can get through there, so can we.” Jack’s dad started the car and pulled out of line into the opposite side of the road. As they went around the bend, the wall of mud became visible. It stretched clear across the road and was easily three feet deep and still growing. Jack’s dad revved the engine and stared forward with eyes blazing. The car jerked forward with a sudden burst of energy. The front end climbed the wall of mud, quickly nearing the crest. All was going well until they crested the top. That’s when disaster hit. Just like that the car bottomed out and sank into the mud. Slowly. Until the car was precariously balanced, front end looking up at the sky while the back faced the group of men still clustered behind.

Jack’s dad floored the engine, but nothing happened. The wheels spun, digging ever deeper into mire. When he realized that no amount of gas would free the car, Jack’s dad turned off the engine and sat, staring glumly out at the line of vehicles on both sides of the mud. Jack’s dad pounded the wheel and his mouth reflected his anger and frustration.

No one approached the car and none of us attempted to get out. And so we sat, deep in the mud.

Eventually a bulldozer came lumbering up from the western side of the road. The driver got out, shook his head, and then climbed the wall of mud to attach a winch to the front of the car. The driver returned to his truck, and as the winch tightened, the car slowly moved down the wall of mud. When the tires hit pavement, there was a jolt, soon followed by a second as the back wheels found purchase. The driver walked up to the car and removed the winch. He approached Jack’s father’s window and knocked.

“What were you thinking?” he asked.

Jack’s dad glared at the man. “I thought we could make it.”

“You’re too low to the ground, carrying too heavy of a load. You didn’t stand a chance.”

“Thanks for the information.”

The man put his hands on the top of the glass. “If there’s a next time think about waiting for the road to be cleared or maybe we’ll just leave you there until the mud hardens.” With that he returned to his truck.

Jack’s dad shook his clenched fist at the man, started the engine, and drove away. Silence reigned in the car. Jack crossed his fingers wishing for good luck, that they’d make it to the next hotel without an explosion from his dad. All would have gone well if his mom had kept her mouth shut.

“What an idiot,” she muttered

“Who’s an idiot?” Jack’s dad shouted. “Are you calling me an idiot?”

“Nothing,” she said. “I said nothing.”

“Good, because I could fix your attitude.” His fist punched the air in front of Jack’s mother’s face, missing by a narrow margin. “Keep your mouth shut, okay?”

The rain continued to pound the roof of the silent car.