A psychiatric nurse once relayed an observation to me that I
have been pondering for the last decade.
We were working together in an inner city “dementia unit,” populated
with patients with end stage Alzheimer’s, vascular dementias, and brain
disorders of unclear etiology.
Individuals were parked in geri-chairs in institutional hallways, others
were in bed in 4 point restraints for their own protection, still others were
muttering to themselves in wheelchairs.
We were discussing the case of a particularly unpleasant
patient – he would swing at people as they got near him, trying to hurt them –
scratching, punching, even biting if you got close enough. His favorite thing was to grab nurses’, or
other female staff’s, breasts or crotches. He rarely succeeded at this, since most staff
were aware of his tactics, though he sat in his chair nearly motionless, like a
Moray eel in a reef cave, small eyes and snaggle teeth, mouth open slightly at
all times, taking slow deliberate breaths as he waited for an unsuspecting ocean
dweller to wander inadvertently into his reach.
I asked the nurse how she thought he had gotten to be so
rotten. She replied simply, “When people
get older they become more like themselves.”
That one sentence has fascinated me ever since. Could it be that as we age (and our minds
lose their ability to maintain the social graces we were taught), we slip into saying
things in an uncensored manner, and behaving the way we truly want to? Or is the difference between “sweet little
old ladies” and “mean old biddies” a matter of how much damage there has been
to their frontal lobes?
The scientist in me would like to explain away all agitation
as an organic brain disorder. But I just
don’t think we can reduce human behavior to neuroanatomy. The complexity of a lifetime of circumstances
and individual choices – and their interaction with personality – are soul-defining.
Perhaps age brings wisdom and life experience… or maybe it
unveils the truth about who we’ve been all along. Either way I have a feeling that when the time
draws near for our bodies to give up our souls, we can catch a glimpse of what people
are “made of” in their final words and deeds.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.