What's Good About Alzheimer's

Today there were three patients with back pain, three patients with Alzheimer's, one patient with severe neuropathy and weakness and one patient with neuropathy and carpal tunnel syndrome (both have diabetes), two patients with stroke (but one of them is also getting Alzheimer's and has migraines as well), one patient with migraines (she is actually doing quite well, right now) and two new patients, which I'm actually not sure what either one has.

Mrs. S is in her mid-seventies, and she is English. She met me when she had her stroke, about four years ago. She had never seen a doctor, because she was "deathly afraid of them." I sent her to a very gentle primary care physician who I knew would be able to handle her. And she is doing very well. We had to treat her hypertension, her chronic anxiety, her high cholesterol, and her irregular heart beat. She takes her medications, and she is able to see physicians now. She has about a thirty point increase in blood pressure when she sees a doctor, but she doesn't go into a total panic. At one point, I told her I didn't think she needed me. I don't think she does. I called her primary care doctor, and I told her I'm not doing very much for her at this point, except giving her Paxil prescriptions. She was OK with me not continuing to follow her. But she made an appointment anyway in three months. She just likes to come in here. She always tells me that I've been a great help to her. I like her and her husband very much. Although she is very impressed with the help that she got from me, it wasn't anything very dramatic, from my point of view.

I had another three of the really great patients today. So there were four of them. That is always wonderful. I count how many "great" patients there were each day. Sometimes there isn't even one for the whole day. That's not a good day. Four is extraordinary.

There was a lot of Alzheimer's today. Alzheimer's used to depress me. Now it doesn't. I've come to accept its purpose and see its goodness. We are all so excited about intelligence. But it's actually just another attribute. The issue is whether you truly believe that all people are equal or not. Alzheimer's really pushes the envelope on that issue. Is a person who is smart better than a person who is dumb? If the answer is no, then when we lose intelligence, we don't lose any value. If we're not losing value, then what are we really losing? People with Alzheimer's are generally very nice and very happy. These are good qualities, which are often not present with high intelligence people. People like to think that they are better than the other people. They like to think that they're smarter than the others. When that's gone, from Alzheimer's, they accept just being people. Just being people is really good enough. It's actually very complicated, how Alzheimer's is good. We don't see very much of that, because in our culture we only focus on the bad part of it.