Dottie (not her real name) is in her 80’s, weighs less than her age and resides in a nursing home. She is confused and has difficulty completing her sentences. Dottie will hold her head and say, “My thoughts are lost”. When she first became our patient, she was very articulate and enjoyed conversing about her life. We felt her sadness and grief as she realized her loss.
Dottie’s daughter found a journal written by her mother and she wanted me to read it in the hope to understand her mother better. I didn't realize at the time, just how valuable this journal would become. The journal begins in January 1998 and includes writings over a four-year period. Her writings are reflections about her life, the meaning behind her beliefs and actions, plus insight into weaknesses. After reading and glancing through a few pages, I realized how tragic it was for her to lose her thoughts; It was clear that they were extremely valuable to her. I knew that I would use the journal during my next visit.
During the visit, Dottie held the notebook in both hands and caressed it as though she was getting acquainted with an old friend. “May I open it?” she asked. As she turned to the first page, she began to read out loud. After a few sentences, she asked, “Did I write this?” As she continued, she flipped through pages, reading randomly. “Did I write this?” she asked several times. Dottie had been an avid reader but had lost the ability to focus and reading was no longer an enjoyment. But here I was, witnessing her read page after page of her deepest thoughts. Dottie became the teacher when she read a section out loud and then asked, “What does this say to you?”
As the visit came to a close, Dottie said very clearly and with a tear in her eye, “I hope you don't mind if I tell you that I think I have a new dear friend.” She asked if she could hug and kiss me goodbye. Dottie is not usually one to show such affection and this behavior is evident of how deeply moved she was by the experience. Dottie’s ability to express herself became more fluent, though she remains confused. The journal seems to ground her and take her to a place and time where her thoughts are clear.
I received a wonderful gift that day. It wasn't the beautifully written journal or that the daughter had the foresight to offer it to me. The gift was when I was able to use it to help Dottie find her thoughts once again. The joy she experienced, was the most precious gift I could ever receive.
Excerpt from Dottie’s journal 2/5/99
“…I think I am grieving the last phase of my life. I can accept change but this will take some time.”