Sunday, November 20, 2011

Story # 1.3 Lecture on the Mind

"So today, we're talking about dementia."

Jay began his lecture for class that day. He was teaching a group of fifty women, and a couple of men, in a course called "Beginning the Practice of Nursing." The class was a Junior year course as an introductory to basic concepts in nursing, to prepare the students for what they will be experiencing during their clinicals and once they become fully licensed nurses. Jay loved the interaction with fresh open minds. Some were older, most were younger, as the trade had become a stomping ground for those that had passion in youth or were simply looking for a second career after another became trite. He could see from his students' eyes though, who the ones were that really were devoted to learning about the profession of nursing and those who were just there for various reasons. This class gave the students the nuts and bolts of how the profession works. The class was not nearly as complicated as his other class he taught, Pathophysiology. That class even irritated Jay sometimes due to it's complexity, but it was necessary for Jay's students to understand where the physicians were coming from when it came to a particular diagnoses. But with the discussion today, the diagnosis Jay was covering the basics on was anything but near impossible to understand.

"So what is dementia?"

Silence permeated the room. None of the students, that were paying attention, seemed to know if Jay was asking a real question, or if it was rhetorical. In this case, Jay was hoping for a response.

"Ok, let's try something else. How many of you have ever known anyone with dementia?"

This grabbed the entire room's attention now. Hesitantly, a few hands went up.

"Yes, Jessy," said Jay, pointing to her.

Jessy lowered her hand and began to speak, "My aunt once had dementia, I think."

Jessy was barely twenty-one, and had hardly experienced enough worldly endeavors to fully understand the concept she was discussing. But to Jay, at least she was attempting to try.

"What makes you think she had dementia?" asked Jay.

Jessy took a gulp, still unsure of herself, but answered, "Well, she would talk about things that didn't make any sense to the rest of us. She would act like, you know, people were there that had been dead for awhile. Like one time, she acted like my uncle was still alive who had been dead for years. It was like she just forgot."

Aside from the Valley Girl dialogue, Jay knew Jessy was hitting the nail on the head. He often tried to relate things to real world activities or events his students may have encountered. This was a simplistic one to address and led in to his discussion he wanted to pursue.

Jay smiled at Jessy and looked around at the other students, "That sounds like dementia to me."

Jay could already sense the tension was lessening in the room a bit. He wanted his students to feel at home, but not to control the room. Timidness was normal in a large group of people with little to no experience on a subject, but if no one ever opened the door then Jay would basically just be talking to himself.

"When you're a nurse on a unit, working with a patient that believes whole heartedly that you're trying to kill them when all you're attempting to do is give them a shot to help with their pain can be the most trying moment in your career that you'll ever have. As well as disheartening. One of the most important things a nurse has to do with a patient is develop a sense of trust with them. That's why you address your patients by their name, as mister or misses, as you would anyone you stopped to talk to on the street. As a person, the way you would want to be treated.

"So how then can you develop trust with someone that doesn't even understand who they are, much less you? Who believes something so readily that they can't let go of that belief because it's as if their mind has switched gears on them, completely against their will."

"What do you mean by switched gears?" asked a student in the front.

"Well, let's use this example, Kelly. My wife had a grandmother once that had dementia before she died. Sweetest lady you would have ever met. The prototypical grandmother. She cooked for the family all the time. She still went out and did yard work that even her family felt could be detrimental to her health at her age. But she was a fighter, strong willed, determined. There were subtle hints of dementia propogating because she would sometimes ask you the same questions repeatedly, each time she saw you. But it seemed harmless, just unfortunate."

"Until?" one of the male students spoke up, getting into the story.

Jay chuckled and looked at him, "Until she started telling us one day that she was being visited by...", Jay hesitated for a moment for effect, to get his students complete attention.

All eyes were glued to Jay right now.


There was a murmur around the room now, with a few giggles and chuckles from the class.

"You heard me right. She believed a group of aliens were visiting here routinely, late at night when the family assumed she was sleeping. She described the look of the main alien she spoke with in vivid detail. Her hair. Her eyes. Her skin. Her mannerisms..."

"She called it a her?" asked another student, this time in the back of the room.

"Yes, she did Mary. She believed this conversation took place so much that she even told other people about it outside of the family. You can imagine how my wife's family felt about that."

"What did you do about it?" asked Jessy.

"Well, the only thing we knew to do was to have someone stay with her at night, to help her when she woke up and needed help during the night."

"Did anyone ever see an alien?" the other male student asked.

This got a good laugh from the class.

"No, Jake, no aliens ever showed up. Although I was hoping."

The class laughed again.

"So did you all just go along with the story, or how did you handle it?" asked a student from the middle of the classroom.

"Well, Rebecca, that's the tricky part. When someone believes something others perceive as impossible to be true, you have to handle it with kid gloves or risk your relationship with that person breaking down. So we did have to go along with it. This lead to some stories with vivid details."

"What kind of details?" asked Jake.

Jay was hesitant, he didn't want to make his grandmother-in-law look crazy, nor did he want to get enamored with an off the subject discussion at this point, but he indulged Jake on this. He could tell the class was into it now, and he thought he could spin it into the discussion he was wanting.

"She told us that they never meant her any harm. That they came here in peace and could only go to a select few people here on our planet. The reason for that was that some people might try to hurt them, so they sought out those they could trust to treat them appropriately. They also wanted to attend to those that needed help, like my wife's grandmother."

The class was enthralled now. They were talking amongst themselves as Jay attempted to redirect.

"Now, from a psychological perspective, the physicians that heard this story believed this was her way of reaching out to her family for help. That somehow her mind concocted this story because in some way she knew it would grab their attention, as it has all of you right now. She wanted help, it hadn't been forthcoming, so her mind created a way to make that help arrive. And ultimately she got the help she needed."

Kelly was shaking her head, "But why aliens? Did she like science fiction or something?"

The class, and Kelly, laughed a bit at the question.

"Well, that's a good question, and I'll touch on it then we have to get back on track. We don't know where the alien story came from. Maybe she had seen something on television or in a movie that her mind accessed and pulled back into the reality it had created due to the dementia. Or maybe it just triggered something in her psyche that mistook an earlier encounter that truly did happen, with humans of course, but compiled it in a way that became alien, at least to her. No one really knows how the mind with dementia works once it happens, they just try to treat it as best they can and encourage family and friends not to be argumentative when an episode occurs, but encouraging. When you maintain your cool, and present a person in this state with a person willing to listen, to help, even though they still may be unsure, they will develop some trust with you. But I will say I found this to be an interesting story, because I am a science fiction nut."

The class laughed at the last statement.

Jessy spoke up, "Did you want to believe her, Dr. Trent?"

Jay gave Jessy a look, as if to say, "You would go there, wouldn't you?" The class laughed a bit at Jay's reaction. He paused for a moment, and addressed the question before moving on.

"You know, Jessy, there was part of me that wanted to believe her story was true. That there is something out there beyond all of this that watches over us and maybe even guides us in some way. The part of her story that took me by surprise was how she said the aliens in the story were from another dimension, meaning something like an alternate reality. Now, that's been a recent story idea in a lot of television shows and movies that she could have seen, but she wasn't a big watcher of that kind of stuff. So why did that come into the story? What in her mind trigger that aspect of it? Why would it make that up?"

The class was glued to him now, hanging on his every word. Jay was going to have some fun with it right quick. He had moved into a position putting him behind a podium with a big dictionary inside of it. Jay put his hand on it as he began to talk again.

"Because the thing you might have to ask yourselves, as I did, is this. Do you believe that this elderly woman's mind concocted a story to grab someone else's attention for help in the hopes that someone would respond? Or...", Jay leaned over on the podium, as the class was looking straight at him, completely unaware of him lifting the the dictionary up and pulling it out of the podium stand.

"...was this elderly lady being visted by a group of aliens who truly meant no harm? The story was so vivid, it's hard to imagine it not being real. Like a dream you have one night that seems so real that you almost don't believe you are awake when you finally do wake up. Was it real, or wasn't it? Maybe there really was an alien across the street from my house, visiting my wife's grandmother. She's since passed away, so here are the next questions. If they were visiting, will they ever come back? And if they do come back, what are they coming for?"

At that moment, with the class completely on edge, Jay released the dictionary suspended in air in his hand, and let it fall to the floor, slamming with a pop that echoed through the room. The entire class jumped back in their seats, with a collective screach.

They all began to regroup, laughing, sighing, taking deep breaths as Jay smiled right back at them and began to chuckle.

"Gosh, you almost gave me a heart attack!" yelled Jake.

"All right, so now that we're back to reality, open your books to page 357, and let's learn a little more about dementia."  Jay led the class through the lecture.

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