#3
The hits keep coming.
December 2021
Right around Christmastime we received unsettling news from my mother-in-law. Something unexplainable was wrong with my husband’s father. He was behaving strangely, speaking abnormally fast and incoherently. I overheard him on the phone with my husband talking for two straight hours late one night; I later asked my husband if his father hadn’t gotten enough social interaction during the day because he sounded so wound up.
We went to visit my in-laws for a few days over New Year’s and witnessed firsthand what appeared to be a manic episode. As we pulled into the driveway late at night, we found him sitting under the massive tree in their front yard staring up at the Christmas lights, holding a stuffed dog and rambling. It was disconcerting, made more so because this man is a top doctor in his field, a brilliant researcher with countless awards and achievements to his name. His typical demeanor is thoughtful and controlled. Witnessing him in this reduced state was very troubling – and scary.
The very next day his behavior was nearly normal again. We toasted the new year and stayed up late making jokes, laughing, talking about everything from science, medicine and academia to politics, sports, and weather. These were the conversations I always enjoyed with him. His breadth and depth of knowledge on a variety of topics always made for interesting talks and thought-provoking questions.When his behavior didn’t revert to a consistent state of normal over the next several weeks, we embarked on a journey to find help. Crisscrossing the state to meet with renowned specialists, everyone seemed short on answers. An initial diagnosis of dementia was walked back after imaging returned clean brain scans. Our family tried to adjust to this version of him, offering support and encouragement as he cycled through several medications and tried different therapies to help him both physically and mentally.
The sudden, mysterious onset of his condition was extremely stressful for my mother-in-law. Just like us, her life was turned upside down with no warning. The man she married and raised three kids with had disappeared. In his place was someone unrecognizable, unpredictable. Not only did my father-in-law change intellectually but he lost a significant amount of weight. He admitted to feeling self-conscious and insecure, two traits he has never, ever been. His face was mostly expressionless, void of smiles. He seemed older, frail. My mother-in-law no longer had a partner to take walks or ride bikes with, accompany her to the theater on Sundays, go out to dinner with friends, or travel, one of their favorite things to do. For a period of time, she was unable – and uncomfortable – leaving him alone at home only to get her hair done or go to the grocery store.
After New Year’s, he was in and out of the ER. One morning, my sister-in-law found he had pulled his mattress on to the floor, ripped off all the sheets and blankets, and thrown the pillows off. He was sleeping on just a mattress on his bedroom floor. My mother-in-law had been staying in the guest room because he hadn’t been sleeping and was waking her. That morning my father-in-law shredded his bed, his wife and eldest daughter insisted he be examined at the hospital. He was having bouts of catatonia, was agitated, uncooperative, refusing to take his medications or eat.
He was admitted to the ICU (the very same weekend my mom was also) quietly for privacy protection, given that he practices at the hospital. A week-long stay ensued, a slew of tests were ordered, and he was monitored for erratic behavior or mental status changes. He had a temporary feeding tube inserted to prevent him from losing any more weight. Once released from the hospital, he was very weak and went home with an aide. He did physical therapy for several weeks and got strong enough to again walk on his own, though eating still posed problems.
Retirement was inevitable and appeared on the horizon by Spring. To practice medicine again would require passing a neuropsychological exam and unfortunately, he was nowhere near capable of doing so. Coupled with his age – 72 – and the doctors’ inability to predict improvement, he was forced to acknowledge that his office needed to fill his position and he needed to focus on his health. This was a devastating decision made worse because it was made for him. He thought he’d work another ten years, though was planning to cut back to part-time. In fact, everyone teased him that he would never actually retire… it was his biggest fear. His parents suffered from Alzheimer’s dementia and he has always been terrified of losing his mind. His attempt to ward off the same fate was by keeping his brain active, engaged in the topic he’s most passionate about: medicine.
He’s seeing a psychiatrist and his internist and they’re trying to find an effective medication regimen. So far, nothing has fully eliminated his symptoms, though thankfully, he hasn’t had any more manic episodes.
I miss our conversations. I miss his distinctive laugh where he would slowly close his eyes and throw his head back, smiling with his mouth closed. While I continued to grieve November’s losses, I was unprepared for yet another one. The sadness compounded. The small bits of anger and disbelief that had dissipated came surging back ten-fold.