Page 6 - Mecklenburg_Medicine_April-2018

Feature

Denial

WBy Jessica Schorr Saxe, MD my family and that it begets suffering, I see now that denial has been a
hen I started practice, I had never experienced stubborn undercurrent in my life.
a serious illness. My family members, even
the aged, were healthy. I considered myself an At 54, when called to follow up on a mammogram, I ignored the first

exceptionally compassionate family physician. I two messages. My diagnosis of breast cancer shocked me. In the right

was the healer, and illness was for others. I secretly felt my healthy demographic and without risk factors for heart disease, I had figured

lifestyle and general virtue were an amulet against misfortune. My cancer was probably in my future — but my distant future. I knew that

stethoscope and white coat served as accoutrements of invincibility. no one is ever ready, but I did not find this consoling. My head told

Then my mother got lost. me I should ponder my confrontation with mortality but by the third
early-morning radiation treatment, I could focus only on getting out to

I had called to tell her I was going to stop by. “I’m some place,” she get to work. After weathering surgery and radiation, I resumed my roles

answered, her voice low, rough, panicky. “I don’t know where.” as mother, wife and doctor as if serious illness were a mere ripple in my

“Inside?” I asked. “Outside?” She couldn’t say. I kept her on the line, identity as the healer.

probing for clues. Finally, in the background, I

heard a kind neighbor offering to help. When I

arrived, they were seated on my mother’s favorite

earth-toned sofa, her friend soothing her; my

mother staring ahead, stunned that she had

gotten lost one floor below her own apartment. Where is the
mother we knew…
Although she had been diagnosed with
Alzheimer’s disease a year earlier, this was the first
time I absorbed how terrifying it could be. Not only

for her, but for me as I contemplated this unfamiliar who could do everything
person in my mother’s body, so lost, so childlike. — cook, clean, garden,

In 34 years of family practice, I had many

patients with cognitive impairment. I had friends knit, coordinate her
whose parents had dementia. How had I not children’s activities
realized how much pain it caused? Or that I

someday would know that pain? and work full time?
Once orderly, my mother now scatters

clothes across her room as she compulsively

“organizes.” My siblings and I have watched

our mother be transformed into a fragile,

bewildered old woman, adrift in a vast sea

without landmarks or time pieces.

Where is the mother we knew, who rose

through pure grit from dire poverty in the hinterlands of Argentina Five years later I had bladder cancer, discovered incidentally at

after her family escaped Eastern Europe? The mother who could the end of pelvic reconstruction surgery. I was in the entirely wrong

do everything — cook, clean, garden, knit, coordinate her children’s demographic for this one — wrong gender, wrong age, wrong smoking

activities and work full time? The mother who even recently was an status, no occupational hazards. “Why?” I asked. “You’re an outlier,”

indomitable force, insisting on directing my father’s care and resisting my doctor said. It was a doctor kind of reply that, as a patient, I found

help for herself? neither enlightening nor comforting.

As I busy myself making sure her needs are met, sometimes At times, I felt intensely vulnerable. I agonized while waiting

simmering beneath the surface, sometimes screaming its way into my for biopsy results that would determine my fate. Results often

consciousness, is a searing pain. were excruciatingly late, and I realized they did not have the

How did all this come as such a surprise? My grandmother had same urgency for those who controlled them as they did for me.

Alzheimer’s disease in her early 80s, but my mother passed that age A doctor’s casual aside, which barely hinted of some ominous

intact. In their mid 80s, my parents had rich intellectual and social lives. possibility, could leave me fretting for days. With both cancers,

Dementia, I thought, happened to other people’s parents. I experienced profound fatigue that rest did not relieve. I started

No longer able to hide from the dual realities that dementia has struck taking walks immediately after my pelvic reconstruction and

6 | April 2018 • Mecklenburg Medicine