[this was a tough one to write; almost did not post it. there are, in
fact, glimpses and periods of joy and humor in our situation; I will write
about those someday. this is not that writing]
---------------------------------------------------------------------------
“Do not lie to one another, seeing that you
have put off the old self….” Colossians
3:9
Confabulation: the automatic, subconscious fabrication of
experiences or situations, often recounted in a detailed and plausible way to
fill in and cover up cognitive impairment or memory loss, which may be caused
by alcoholism; head injuries; dementia; or lead poisoning. Mosby’s
Medical Dictionary, 8th ed.
“What are you looking for?” I ask Karen as she rummages through the
refrigerator. “Nothing”, she replies, “I was just checking to see if we had
enough drinks for today”. Sounds plausible, but it is 6:30 a.m., she has her
standard yogurt cup in one hand, a spoon in the other, and is obviously trying
to locate the dry cereal that she has put in her yogurt every morning for five
years (it is in the cupboard adjacent to the fridge, its usual location). I silently
point to the cupboard, she gets the cereal, fills her cup, and sits down to
start eating breakfast. There was no prior “Where do we keep the cereal?”, no subsequent
“Thank you”, and certainly not the rarely heard “I have forgotten where the
cereal is; will you help me?”
Karen trusts that God knows what He is
doing even in her illness, and in any group situation when it may simplify things if
we tell others about her memory problem, she is always willing to do so, and
usually makes a comment affirming that “God is in control”. But one-on-one, if
someone asks her directly any question that would require memory access
(doesn’t make any difference how far back or how recent; “What did you guys do
last night?” is no more accessible than “How long have you guys been
married?”), and if I am not immediately there to answer or clarify, she will
provide an answer. The answer almost always sounds rational and believable, so
there is no way for the hearer to know that it may be completely fabricated. In
the now-almost-eleven years of our slow journey through the land of dementia, I
have never heard her answer anyone’s question with “I can’t remember”; she has
only done so with me three times in those years (I shouldn’t keep count, but
the occasion is so rare that I recall each one in detail) unless I ask her
first, “Do you remember…?” This is
confabulation, the mind’s automatic effort to contrive artificial information
rather than face the reality of not being able to retrieve accurate data.
We pledged early on in our marriage ( and
long before I had any spiritual reason to do so) to never lie to each other. Thus it was so devastating when the
conflicts began to arise where Karen would recall or report things one way and
I had totally different perspective or information; we personalized it: she
called me a liar more times than I can recall, and I know I responded in kind.
Things got so bad about five years ago that I obtained my own
neuropsychological assessment, checking on my own memory capability or lack
thereof; after all, “he said; she said” conflicts when they only involve
perception and memory with no actual record of the event could be evidence that
either one (or both) had faulty recall of which they may not be aware, and if I
was the one having problems then I had no business practicing medicine. There
was some internal relief when I passed my tests, but it had no impact on
Karen’s belief that she was right and I was wrong. The problem, of course, is
that her confabulation is subconscious, unintentional, and serves to protect
her awareness from the pain of the reality of not being aware. She isn’t lying
in the true sense, in that she completely feels that the answer she gives is
100% accurate; at that moment, it is what she remembers.
So why does this bother me so much?
- simple logistics, for one: one can never trust the information,
so one must be very, very careful about acting on that information. And, it requires me to be within earshot of
anyone who is asking Karen a question, as she may answer with something that if
not corrected can lead to rather interesting conclusions or subsequent plans on
the part of the naïve inquisitor.
- male pride, for another: I want my wife to trust me, enough
to tell me that she doesn’t remember something, to ask for my help, to lean on
me so we can get through this together. If she acts like she doesn’t need me,
becomes angry if I have to correct information (which I have learned to never
do unless absolutely necessary to avoid adverse outcomes), or seemingly is
ungrateful for my running interference, it hurts.
- I can’t shake the theological implication of the reality of lying, regardless of the
etiology. God says we shouldn’t, and when we do, we are violating his
commandment.
But, that probably isn’t why this lack of
honesty, for whatever reason it may exist, is so problematic for me. Karen has a recognized cause that at
least explains, if not excuses, her lack of truthfulness. Yes, she hates not
looking competent in the eyes of others, and no, she has never been comfortable
accepting any form of correction; those are flesh patterns that plague me more
than her. But in her case, some rogue
amyloid protein has damaged the part of her brain that would call spiritual
awareness of one’s own behavior into play, to draw one toward honest
recognition of difficulty and away from a need to deny or hide a problem. I
don’t have (yet?) such a convenient biomechanical explanation for why I still
try to look better in the eyes of others, still try to minimize my own
complicity in life mistakes, and would even write such a polemic as this to
shift attention away from my own shortcomings.
Even as I am preparing for my next presentation as co-teacher of
our adult Sunday School class, doing an overview of Genesis 12-45, I am reminded of how disingenuous any of us
can be. Abraham lies by saying that his wife Sarah is his sister, later his
son Isaac repeats the same offense with Rebekah, and his son Jacob by his deception and
conniving behaviors lives down to the meaning of his own name (“supplanter;
deceiver”). And these are the Patriarchs
that God chose as the initial instruments of the process of restoration of his
people to himself.
This has been a week when I wish I were in
different circumstances. It is wearying to have to anticipate potential trouble
areas that might arise, confusion generated by confabulation. I wince when
others write to tell me that I am some form of role model in how I am caring
for Karen; I know within my own heart that being here is not always where I
want to be. We found out earlier this week that the experimental drug Karen has
been receiving for the past two years does not appear to have any significant
hope of reversing the damage of Alzheimer’s, but then were also told that there
is some evidence it may slow the progress of the disease, so they are keeping
her in the “open label” study to see if it does in fact grant us more time. And
therein lays the challenge: things will not get better, but they may not get
worse, at least not for some time to come. The confabulation, the lack of
trust, the reminders of my own heart issues, may go on, and on, and on.
As I am going deeper into my study of the
Old Testament, I see
how the character of God is so vividly and repetitively revealed, over months,
over years, over millennia: He keeps His promises. His word is truth. He chose
the Patriarchs, in spite of their dishonest tendencies. He chose me, and Karen,
to be His children before either of us ever had a chance to utter our first, or
last, lie. I do not like where we are. But I like, a lot, this aspect of God’s
unchanging character. In spite of our confabulations or any other of a
multitude of sins, He has promised us something so very much better. And He keeps His promises. He tells the
truth, He will not lie. There is hope.
So, be honest with each other this week. Be honest with yourself this week. Be
honest with God, although He already knew about it anyway. And when someone is
honest with you, cherish the moment…
It is the stuff from which hope arises….
Barney
No comments:
Post a Comment