Advice From A Poet About Memory Loss
She was a friend. Other people sometimes live their entire lives in one place and keep friends for life, but she was more distant, clinging to me loosely, trying to live off free advice. Like almost all the friends I have in one particular region, she was a therapist. Not a bad thing to be, and I believe her to be a competent therapist. But she had the same problem most people in my age group have. She wanted help fighting it.
I suppose the name for it these days is “cognitive loss for age.” Not Alzheimer’s, that “presenile” (the earliest cases described by Kraepelin himself was in mid-fifties) dementia, but getting older.
Mainstream medicine comes up with names and categories and prescriptions, that may or may not offer significant clinical improvement. The human spirit comes up with, well, at least a little good anger. If there is one piece of poetry I quote more than any other, it is Dylan Thomas “Do not go gentle into that good night/Rage, rage, against the dying of the light.” Of course this brilliant Welsh poet, the way I heard it, died of alcohol poisoning in New York; not exactly how I plan to rage against the dying of my light. Oh, how many people who have tried to feed me alcohol I have told I cannot afford to lose any brain cells by that method. I need everything I have to continue to live by my wits.
My friend may have been a little bit ahead of where her age (68) would land her on graphs, but she was actually doing pretty good in life. She was taking a lot of vitamins and minerals which is good. She had no interest in prescription drugs, which is never a problem for me. Most prescription drugs purported to help cognitive loss are “anticholinesterases.” Acetylcholine is generally believed to be the primary neurotransmitter of memory, so if you take something to stop it from breaking down, it can sometimes stop things from getting worse.
Silly Americans; run for a pill. I love a natural solution; the natural anticholinesterase best studied to my knowledge is huperzine A. Over the counter here, from a particular kind of club moss.
OK. So people need a workup. There are genotypes for Alzheimer’s; lab tests you can take to determine how likely you are to get it. I have never found a patient who wanted this.
The program is not just nutrition here, although it is pretty clear that Omega 3s are good, and the “Mediterranean” diet, and I think even those who seem to be at genetic risk can probably rig up their lives so this cognitive slide does not come, at least until other things have started to move you into your next existence. (You die of something else.). Staying in good physical health is heavily recommended. But wait, there’s more.
The most important thing to do is another thing I never get anyone to do. It is expanding mental horizons. Learning new things. I remember suggestions made in France to older folks to start memorizing their shopping lists, and expanding their lives. Everyone I know who is aging (except for my husband and me, but we are generally regarded as eccentric, aren’t you surprised?) does not seem to start anything new. My friend had the same hobbies she had forty years before. Fitness, yes; some conferences in the community, yes, but all consistent with her political views that had not changed.
I suggested a new or different sport. A musical instrument. Dance or a different sport from her beloved hiking, studying the arts, or a language. She was nonplussed. They seemed so “impractical.” She had been a practicing therapist for so long that patients started to look more alike than they did different. She had that skill nailed. She did not have new skills, nor the drive to acquire them.
She is doing pretty well nutritionally and physically. But the idea of “use it or lose it” is a hard one for people to believe or prioritize. Me, ever since my mother of blessed memory told me as a child that I would never be pretty enough to get along on my looks alone–well, it may not have been a terribly nice thing to tell me as a child, but it really was not bad, because it kept me valuing schoolwork. From that, for me at least, it is not difficult to conceive that stretching my mind will help it keep growing. I cannot and will not narrow my intellectual interest. I am having too much fun.
I have heard little from my friend. I think the effort to change her life would be worth it, but would be hard. I suspect she has done little or nothing on this front.
The key in the Dylan Thomas quote is the “rage.” I mean, after my health crisis, it took me a couple of years to lose about 150 pounds and become a dancer of sorts, but my rage to live is great. More to give patients I may never meet, by writing and reading. More for me to enjoy exploring. I need to be alive to hold my husband’s hand as we stare into the future, trying to figure out what happens next. That is my great motivator for all things.