Suddenly found I'd been dreading the birthday visit. Not sure why - too many associations, maybe. Or maybe I had the sense that this year, finally, he wouldn't register much of anything, and that of course would set off a fresh set of associations. And then there's always the question of what state I'm going to find him in...
And the visit was, in fact, difficult. In a strange way, this was a byproduct of good news. His dosages are finally worked out. He's good on the 25mg Seroquel, at least for now, and they've given him a stool softener, which also helps his mood. The result of this is that he was relaxed and loquacious and spent close to five hours talking his way through a series of recursive loops. I couldn't make out most of it but there was the moment when I realized he could no longer remember being in the Coast Guard ("was that after the war?"), and the moment when he discovered that I was his older brother. And there was an Oliver Sacks moment, too. He doesn't produce many of those anymore - the capacity for complex thought just isn't there - but at one point he told me there was a guy he had to introduce me to. I said, "Sure, I'd like to meet him." Whereupon my father rolled up his pants leg to the lower thigh and pointed to the skin above his left knee and said, "Here he is, right here." I said that was a really interesting guy and tried to find out more, but he moved on quickly and we never got back there.
His presents were a contrast to last year's. One way you can track his decline is through his birthday gifts and how he reacts to them. The other day I found myself thinking about his 50th, when my mother and I surprised him by driving him from Atlantic Beach to Lincoln Center to see a revival of Man of La Mancha. He spent the whole trip trying to figure out where we were going to wind up - for example, thought it might be the Mets game 'til we drove past Shea Stadium and kept going...
There's not much to be gained in looking so far back. Closer in... a year ago I was still able to buy him books, but now he can't cope even with picture books - the visual information is too much for him. So this time there were lounging clothes and a small table radio (his stereo is dying and classical music still relaxes him), and Peanuts cards (no recognition of the characters, liked the drawing of Woodstock, could make out a word or two but only with help). And there was a small box of Godiva chocolates, which he liked. But he wasn't sure why there were presents and couldn't hold onto the idea that this was his birthday, and he returned several times to the idea that I was older than he was.
An ongoing theme - he now talks constantly about wanting to move to Washington. The night before the visit I talked to him by phone, and he said he'd had a visit from two women who told him he'd be moving to Washington to be closer to his son. I found out later that the two women were M and E, and he'd talked to M about "moving downtown." Washington came into it later, when he was on the phone with me. The details don't matter as much as the broad outline. According to the broad outline, he wants to be closer to me - me being a significant person who seems to care for him. That's fine - I can work with that, and I don't need him to know the geography or the cast of characters.
The same is true of the birthday itself. It's not important that he knows which birthday is his, or whose birthday is his, or that a birthday is happening, or what a birthday is. It's important that he understands that there are people who care about him and who wanted to do something nice for him. At that level I think we accomplished what we needed to.
There's an article this month in one of the Buddhist rags about the need to root your practice in the body and not have meditation become some sort of intellectual thing. In the course of it the question of dementia comes up and someone asks, doesn't dementia show that the mind is totally dependent on the body, if brain damage can wreck your thinking like that? And someone else answers that yes, that's true, at least about the thinking mind, which is usually what we mean when we talk about the mind. But mind is in fact something bigger than that. I've been chewing over that comment and without going off into Buddhist metaphysics, I'm willing to say that the birthday experience - and also his ideas about moving to Washington - illustrate the point. The details are completely gone (whose birthday? where's Washington?) But there's also the level at which a full set of connections is being made (you did something nice for me. I want to be close to you). If you want to refer to that as mind, well, it might just be. I won't argue. Interestingly, you can even cancel the the individuals out of it and you'll still have something complete - a nice event happened. A connection happened. You could do worse.
The short version is, he had a birthday celebration and it was worthwhile.
As usual, the celebration was early. His actual birthday is tomorrow, the 11th. I'll spend a few minutes thinking about all his other birthdays (among the other meanings of the 11th). Then I'll get back to work on the nursing home move. Then at night I'll call him and he won't remember the date but we'll talk about whatever he wants to talk about, in whatever mode seems to be working right then. The specifics won't register but the broad strokes will, and that'll have to be what counts.