Rating: 3.5
Fifty-six-year-old Wendy Mitchell was out for her usual jog when she fell, badly banging and bloodying herself. After seeking medical attention, she returned to the place she’d stumbled, expecting to see a pothole or uneven ground. There was neither. A few days later while out on another run, she fell yet again. Aware that she’d been excessively fatigued and had been experiencing a persistent “sensation of a head half-full of cotton wool”, Mitchell visited her GP. A few weeks later (perhaps)—after she’d been slurring her words at work one day—she checked herself into the local hospital to undergo diagnostics. There was vague talk of a stroke, but test results were basically normal. A neurologist sent her to a clinical psychologist for cognitive testing, who suspected incipient dementia, and, some months later, confirmed it.
For some time Mitchell was off work. At the National Health Service, she had been known for the encyclopedic memory and superior organizational skills she brought to the job of scheduling nursing staff at a large hospital in Leeds. When she did finally return to work, she was stymied by her deficits: the computer programs that were the crux and core tools of her work seemed utterly foreign to her. The phone calls from other NHS staff and administrators—a regular part of her work, easily and automatically managed in the past—were completely discombobulating. Often callers did not identify themselves; they spoke too fast, and rarely supplied context details, assuming that Mitchell already had them at her fingertips. Eventually, of course, she told her supervisors and then her colleagues about her diagnosis. Her team attempted to make work accommodations for a time, but these were insufficient to compensate for the cognitive losses. Mitchell was forced by her disease into early retirement.
Written mostly in the first-person present tense, apparently to underscore Mitchell’s living day by day with the disease, the main text of SOMEBODY I USED TO KNOW is occasionally broken up by italicized letters written to her former self. These elegiac letters are addressed to “you”—another person, not herself— someone she was once intimately acquainted with, now gone. “I know life wasn’t easy for you,” she begins one of these messages; “I know life was lonely. I know you worked hard to hide these things from the girls [Mitchell’s daughters], painting a smile on your face and being determined not to let it slip.I remember that even if you did a good job of hiding it from others by making a joke, too proud to let it slip, and never in front of the girls, life was difficult.” While I understand the author and co-writer Anna Wharton’s desire to communicate Mitchell’s sense of the loss of her former self as well as some of her backstory, I found this authorial device contrived and tedious. People don’t address themselves in this artificial way. I also dislike present-tense tellings, which I understand are intended to bring immediacy to a narrative, but which often end up sounding forced and unnatural. Extraneous details are inevitably included, apparently to bring a novelistic quality to the text or to help readers better visualize scenes. More often than not, though, the details turn into text filler and padding. For example, on page 67, we read: “my eyes fall on . . . a Post-it note: Book dentist appointment. I sigh and roll my eyes” and on page 68: “something inside goes cold, a worry starts to whittle away. I feel my eyebrows knit together into a question mark . . .” Really? I don’t think many people notice the movements of their eyes and the “knitting” of their eyebrows. Imagining the latter as a punctuation mark was a bit too fanciful for me. Unfortunately, these unnecessary bodily play-by-plays populate the book. They are silly and detract from an important narrative that would be better served by a simple, plain telling.
Mitchell’s memoir is valuable in that it gives readers a good sense of the feel of Alzheimer’s as it encroaches. I was not surprised to read of Mitchell’s sense, before the diagnosis, of there being something “not quite right”, a general, inexplicable cognitive clouding. What was surprising and alarming to read about were the times in which she would completely blank out. At work one day, for instance, she was, for a short period of time, completely engulfed in a fog. Panicked “by a brain gone AWOL”, she moved through a corridor to the bathroom and sat on a toilet seat “Waiting for the world to clear. Waiting for time to pass.” Until I read this book, I was also unaware of the clumsiness and incoordination associated with the disease and the visual hallucinations that can occur.
Mitchell describes how she tries to find meaning after her devastating diagnosis. (She bakes cakes for a homeless shelter—until she can no longer follow recipes; she writes a blog; she rides a bright pink bike along a special route that includes none of the right turns that appear to hijack her brain.) A great deal of meaning is found in advocacy work and participating in research, which “means I’m contributing to changing the future for my daughters . . . so that one day a diagnosis won’t be filled with emptiness, but with hope of a cure and better understanding and conditions in care homes.” Life is oddly “busier now, more varied and challenging than it ever was when I was at work”, she observes at one point. To Mitchell’s surprise, she quite suddenly overcomes a lifelong fear of animals (cats and dogs), recognizing that her life has become more like theirs: lived in the present moment. She also finds that positive transformation, even personal growth, can occur in those diagnosed with dementia. For example, for most of her life, she had been “an intensely private person”: retiring, shy, a listener. However, as she begins to attend support groups and involve herself in Alzheimer’s organizations, she discovers a new, more open, and social self. About her meeting Julianne Moore, star of the film STILL ALICE, Mitchell writes: “for a moment, I have that strange feeling again, as if Alzheimer’s is a gift, as if we could all learn something from the harsh lessons it teaches.” I admit that I was sometimes skeptical of this kind of gratitude. Maybe, though, as Mitchell herself notes, there is “nothing wrong in making a list of the advantages of having Alzheimer’s. Perhaps it might even help.”
Other topics addressed in the memoir include the medical profession and the media’s negative and limiting language about dementia and the effect this kind of language has on patients; the care-givers’ burden, including resentment and guilt; the impact of dementia on friendships; medications; challenges the cognitively impaired experience in the home (mirrors, TV screens, cupboard and closet doors are particularly problematic); how modern technology (i-pads and cell phones) can assist; and finally, the awkward but important discussions with family about what the future will inevitably bring. Mitchell emphasizes throughout that her daughters are her great loves and that she never wants them to become her caregivers. In some respects, however, they already are—though at the time of the book’s writing, at a distance.
The only other memoir I’ve read from the point of view of a person living with dementia is Gerda Saunders’s MEMORY’S LAST BREATH—a very different book from Mitchell’s, and one in which the author attempted to address the nature of memory itself, how recollections are transformed, remade, each time we retrieve them. Really, when you think of it, it’s a pretty amazing thing that a memoir of any kind can be cobbled together when an author’s brain is failing. As people live longer, more and more of us are likely to face a diagnosis of dementia—a terrible, sobering thought. Personal accounts like those of Mitchell and Saunders put a human face on a devastating disease. Although I do have some reservations about the writing in SOMEBODY I USED TO KNOW, I still found this memoir an illuminating and worthwhile read.