Spirituality and Wholeness in the Context of Alzheimer's Disease: A Vignette

J. Seibyl

On her face she wore deeply furrowed layers of thick yellowish skin which wrapped around two delicate orbs of glistening wet blue and white porcelain.  These eyes feigned connectivity and comprehension, although they were seeing distant lands or a distant past, rather than the two people in her immediate presence.  Her nurse adjusted her frail, lithe body in the wheelchair, as she slumped frequently, as if sitting was a tiresome physical chore and gravity had mystically increased its pull on her, negotiating with her soul to enjoin her body to earth, even as the former yearned for lightness and freedom of the heavens; in a dynamic dance between life and death, the corporeal and the immaterial, of being and nothingness.

Her visitor scanned the day room while she was secured in her chair; a new-bright yellow coat of paint glimmered as it reflected the streaming rays of the morning sun, inundating the room in a warm undulating light. Objects appeared more intensely real; the shadows cast by the crinkled folds of a newspaper, a yellow Ticonderoga pencil with a worn pink eraser left next to the paper, the shiny-luminescent metal sides of her wheelchair.

The visitor was from her church, on a pastoral visit to share, as best she could, her fellowship and a brief lesson using the props and materials from her Sunday school class. The visitor wondered how much she would understand, as Hope, a name most fitting her demeanor in her earlier life, was mute, thereby limiting one’s sense of her sense. As the visitor unpacked the lesson materials she thought of the cruelty of this disease, how it robs one’s Self, leaving a decorticate body- like a slow motion version of a newly beheaded chicken running about the butcher’s yard. But perhaps this was unfair. Perhaps Hope has an internal life, like a dream which provides a solipsistic kind of satisfaction, accessible and real only to her, but a valid kind of reality nonetheless.

The visitor began the Lesson of the Good Shepherd while Hope sat quietly, her eyes now closed. The slow deliberate words of the story echoed through the bright room, like gushing waves of water; rhythmic, repetitive, each fusillade of sound bouncing off the yellow walls. The sounds forming words, the words forming sentences, the sentences, ideas. She wondered, even as each carefully chosen word released from her lips into the room, at what level was Hope hearing? Were the words mere sounds, did the concrete meaning become lost in the disconnectedness of a brain plagued by dementia, or were the words, sentences, and ideas perceived and understood? The visitor watched for signs; a small, wrinkled smile perhaps, eyes opening, nod of the head or shift in posture. Nothing.

The visitor shortened the story and finished her telling, while she thought of a different strategy. She remembered that music encodes and is perceived differently by the brain than the spoken word; a different port, a back-up permitting entrée into Hope’s world. The visitor began singing, “Our Father in Heaven…. “.  Like some miracle, Hope and aide joined in, an unlikely trio of troubadours. Hope’s tiny sparrow voice sang out each word precisely, her whole countenance abruptly changing, now connected with two fellow wayfarers for a brief, but meaningful moment, perfect unto itself, transcendent of Alzheimer’s.

 When Hope finished the prayer, she sighed a breathy “Amen”, closed her eyes, and fell into a deep sleep, perchance to dream.