When vascular dementia forced Gerda Saunders to retire as a university director of gender studies in her early 60s, she decided to document her decline. “In it I’ll report my descent into the post-cerebral realm for which I am headed,” Saunders wrote in a 2011 journal entry. “No whimpering, no whining, no despair. Just the facts.”
Her writings have been compiled into an essay published in the Georgia Review and reprinted by Slate, offering insight into the devastating effects of vascular dementia.
Vascular dementia is the second leading cause of dementia after Alzheimer’s, accounting for 20% to 30% of dementia cases, according to the Alzheimer’s Association. This underdiagnosed condition is usually caused by strokes that block brain blood vessels and deprive brain cells of necessary oxygen and nutrients, resulting in a decline in thinking skills.
Saunders intended to focus her writings on “the most formidable issue I face: my ever-changing identity.” The result is a deeply honest and emotional look inside her gradually deteriorating mind. She reveals her hopes, fears, and memories of her mother Susanna, who also suffered from a severe case of dementia and wrote about her condition before her 2006 death.
Saunders’ reluctant acceptance of her own condition begins the moment her neurologist tells her at age 61 that she is “dementing,” a verb she’d never heard before and thought absurd. “But in my heart I already knew: I am dementing I am dementing I am dementing,” Saunders wrote, echoing her mother’s realisation before her.
Saunders’ writings recount a period of many months, marked by grim milestones like the day in 2012 she quit driving after a dementia-induced car accident. She recalled the feeling of losing her identity, since it meant she could no longer volunteer to take her elderly neighbours shopping. “I could not bring myself to tell anyone else,” she wrote. “It wasn’t so much the actual driving, but rather the change in what I think of as a core of my self: helping other people.”
Saunders documented the steady progress of her symptoms — inability to follow her own lecture notes as a professor, susceptibility to getting lost, and difficulty following normal tasks as basic as cleaning the kitchen counter. She was particularly self-conscious that her IQ had dropped by more than 20 points.
After her diagnosis, Saunders wondered why she has still been able to write despite her dementia. She became intrigued by studies suggesting people who spend most of their lives mastering particular skills may maintain those skills long after dementia disrupts their other functions. This gives Saunders hope that she will be able to continue writing, but her deep honesty with herself forces her to admit a harsher reality. “I want to believe this will be my story, too. But in truth writing is getting slower and harder…”
Saunders also expressed her concerns about research conducted at Albert Einstein College of Medicine of Yeshiva University, indicating the memory of a highly educated person may deteriorate much faster than someone with minimal education.
Although hopeful in the short term, Sanders’ long-term outlook is not naive. She has accepted that patients like her, “are always still dementing, never done. Until they die.”
You can read the full essay, reprinted on Slate, here.
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