Say (Play) That Again?

     The polite term is cognitive decline; but most people know that we're just slapping a coat of paint on naming this blatant form of losing our minds, in a sense.  Alzheimers, dementia, memory loss, however you describe it, most of us will know immediately what you're describing without the specifics.  Wrote AARP: By 2030, 8.5 million older Americans are projected to have Alzheimer’s.  A half-million of us will develop it this year.  Once it begins, there's no way to halt it.  As brain cells die, connections between them wither and the brain itself shrinks, memory worsens, thinking skills decline and navigating everyday life becomes less and less possible.  At least a third of people with early-stage Alzheimer’s slip into a more severe stage in about three years.  But with all of that being said, the article added: A surprising and mysterious trend has arisen in recent years that may help point us toward a cure for dementia.  Rates of Alzheimer’s disease in the U.S. are actually dropping.  Indeed, your risk may be lower than that of your parents or grandparents.  The percentage of Americans aged 65-plus with dementia, including Alzheimer’s, fell 30 percent from 2000 to 2016, a 2022 Rand Corp. study found. 

     Losing cognition must be especially difficult for those who practice what most of us would picture as more complicated skills: a surgeon, a pilot, a mathematician, and many others.  It's what I thought of as I watched a 2002 performance of Grammy-winning vibraphonist Gary Burton perform with his one-time student, the jazz piano prodigy, Makoto Ozone, at the Montreaux jazz fest.  Watching these two, their hands and fingers flying across their instruments as their bodies pulsed with the music, I was reminded of the words of saxophonist John Coltrane: Between what I think and what you hear, there's this damned instrument.  Watching such playing, where the physical act of playing an instrument almost seems secondary, one has to wonder what is going on in their heads?  Almost beyond the creative spark, you wonder if they're grasping at something more, a euphoria that seems to surpass what they are able to express. 

     I was fortunate enough to catch Burton in concert when he played with Chick Corea in 1979.  They were celebrating their Duet album winning a Grammy (Corea remains the jazz player with the most Grammy awards at 27).  During the show, their playing was both frantic and penetrating, at times each player walking off the stage to let the other play solo.  Such performances mesmerized me: Rudolph Nureyev's last tour, Yngwie Malmsteen (another Grammy winner), Bette Midler (early in her career when she was The Divine Miss M).  For some reason, I attended most of these concerts alone, as if the random variety of talent which I found thrilling seemed to have little interest to my friends.  But no matter for I would watch and wonder just what these performers were tapping into, what world, what source?  There was something more out there, and these performers were evidence of that. 

     Reading also seems to find me on a solo path for while I hear neighbors and friends share their enthusiastic thoughts about a recent bestseller or a book club pick, the titles I tend to mention seem to float in and out of their memory like hummingbirds.  Perhaps reading nonfiction is just not as popular, or just a sort of NY Yankees vs. NY Mets sort of thing.  But then James Patterson put together a collection of testimonials from librarians and booksellers in his recent book, and opened with this: If you live in America, you're among only one in five who can read a book and are actually in the habit of reading books...in America we urge everyone over the age of eighteen to vote, but only 15 percent of voters read books.  Only 15 percent of us perform the life-affirming, sanity-bolstering, empathy-forming act of spending time inside someone else's brain.  Fortunately --in spite of cell phones, in spite of video games, in spite of online gambling and pork, in spite of the current storm of shortsighted politics-- the habit of trading books is not yet on the brink of extinction.  Not yet. 

     So what happens when something begins to slowly drift away, a talent or memory noticeably diminishing or fading away each day?  Dr. Jerome Groopman reviewed the book, The Country of the the Blind by Andrew Leland, in the NY Review and started with this: As a physician, when I care for patients I often wonder what thoughts and feelings I'm not hearing from them.  What inner dialogue is running, what worries do they have, not only about the present and the future, but about how their illness will unfold and change their lives?...James Joyce, whose vision was impaired, required an operation to rescue one eye from going blind.  Facing this uncertainty, he nonetheless kept working on Finnegans Wake, writing to a friend, "What the eyes bring is nothing.  I have a hundred worlds to create.  I am losing only one of them."  Leland [author of the book being reviewed and now going blind] embraces Joyce's words: This comment, for all its bravado, still captures, I think, the reality of vision loss; one is indeed losing an entire world, a planet's worth of images, all those dioramas plunged into darkness.  And yet the worlds that persist after blindness --in the remaining senses, in the imagination, and in the depths of feeling that has nothing to do with visuality-- far exceed what's lost.

     To be honest, I'm not really sure why I find myself reading about these topics, about loss and death, and even how we view death here in the U.S.  Okay, I'm growing older (fortunately) but there also seems to be more and more books and articles about what most of us would consider a morbid subject (thus the word, morbidity).  Yet death is something most of us have encountered at some point in our lives, even if was our first experience of finding a baby bird that had fallen from its nest; and if not the loss of a parent or relative or friend, we've generally experienced the sadness of having to put down our cats or dogs ("putting down" being a euphemistic term if ever there was one).  And of course there are the nebulous, almost unreal number of deaths that barrage us nightly from wars or shootings or car accidents.  So I wasn't that surprised to pick up another book by the sociologist, Stefan Timmermans, titled Postmortem.  Now I have to admit that I've never seen such television shows as Quincy, M.E., or Bones, or any of the dozen or so CSI shows (that said, I did enjoy the Australian character of Harrow, perhaps because of his wicked sense of humor); but reading Timmerman's book caused me to be even more skeptical: Coroner's are now public officials, appointed or elected.  They do not necessarily have medical backgrounds or training in death investigation...In some counties, anyone can become a coroner, so that the post has been held by tow-truck drivers, paramedics, plumbers, bar owners, nurses, carpenters, police officers, and funeral directors.  Frontline did an investigation with the same title (Postmortem) and added: An 18-year old made headlines when she was elected deputy coroner in Jay County, Ind. while still in high school.  But to make matters worse, Frontline threw in this bit of history: Introduced to the colonies by early settlers, the role of coroner dates back to English common law.  King Richard I developed the system in the 12th century, partly to fund the expensive Crusades.  "Crowners" as they were then known, conducted inquests on the king's behalf to identify the deceased and investigate how they died, but more importantly, to collect death taxes on their estates.   The bottom line: death and taxes have been linked together for far longer than we thought.

     Which brings me to one of those two things we know for certain, and it's not those dang taxes.  For starters, when I finished the book by David Giffels, the subject was about his making his own casket, which led him to wonder why some areas would call it a casket and some would call it a coffin.  As to the latter, picture Wyatt Earp and his brothers at that shootout at the OK corral (who knew that they were actually the good guys); in that and other similar situations, the slower and unlucky gunslingers would be laid to rest in a coffin, a simple box with a simple lid, one made slightly larger near the top to allow for the shoulders, as well as the arms being folded over as if "resting in peace."  Back then, the doc was usually the undertaker, a term as strange as corral (and not chorale).  But did that name come up because such a person put people "under" the ground, and if so, why the word "taker?"  Certainly he "took" your body away but why not "burial taker" or "grave carer?"  Turns out that the word goes much farther back, as if meant more for anyone who would undertake such a job or task.  Said this in Grammarphobia: The earliest published reference for “undertaker,” dating from 1382, refers to a helper or an assistant, according to the Oxford English Dictionary.  Over the years, the word has been used to mean a businessman, a writer, a lobbyist, a contractor, a tax collector, a scholar, and an impresario, among others.  Wait, did that say "a writer?"   And if the term was destined for someone taking a job nobody really wanted, why not a garbage collector, or a strawberry picker, or even a hitman (or perhaps a politician)?

     The checkered history of burials and undertakers and how both of those evolved to become funerals and morticians is perhaps a glimpse of our efforts to hang onto the past.  The average age of that gunslinging Westerner was 37 years and if you managed to survive the bullet wound, you likely soon succumbed to being poisoned from the lead in the bullet.  Grainy photos along the lines of Butch Cassidy (daguerrotypes, although in later years, poor inventor Louis Daguerre would find people remembering only part of his name and calling his photos simply garrotypes) were often taken after death, perhaps because subjects needed to remain still for a long time exposure.  And because people didn't want dead bodies in coffins leaving through the front door, they were usually displayed then taken out via a separate window or door in the parlor, which was an old term for a sitting room.  All of that,  of course, led to the business of funeral parlours.   And a business it is...

     But picture your body now ignored by all (perhaps you left no contacts or were just lost in the system) and destined for a state burial because you didn't have any assets to cover the cost of a funeral.  Wrote the authors of Unclaimed (mentioned in the previous post) one such burial came to David Grafton Spencer.  The state summed up his costs as reported by one of the contracted mortuaries: an obituary in the paper, $95; embalming, $1,750; dress David in his own clothes, $50; steel casket, $3,000; printing of 100 programs for the funeral, $45; three copies of the death certificate, $45; and flowers for the service, $75.  The total bill was the maximum the state would pay (in this case, out of David's meager assets): $5,495.  The funeral home would also add an additional cost to bury the body: single grave, $3,000; burial cost, $495; concrete vault to hold the casket, $290; and extended care for the graveside, $150.  A bronze flower vase was billed at $45 plus another $10 for its extended care.  Throw in a granite marker and care for it and the additional total upcharge (again the maximum the state would allow) was $4,532.17.   Wrote the authors: After the blessing, for which the clergy received a gratuity of $150, cemetery workers snagged the expensive bouquet on Carmine's 18-gauge steel casket just as it was being lowered into a vault, presumably to reuse for the next funeral.  The funeral director said that in the three years she had been working there, no relative or friend had ever attended a funeral ordered by the public administrator...David's burial was similarly empty -- of people and meaning...[his] headstone was located on a strip of dead grass along a metal chain-link fence, abutting a homeless encampment at the edge of the Interstate.  Such abandonment is not that uncommon, the authors noted.  One man mentioned who detested his sister: ...because she had put him in the "looney bin'" after his Alzheimer's worsened (he'd checked himself out), received half his estate...No one in the family wanted any of [his] belongings...Nor did they have any interest in [his] funeral.  His estate was valued at $750,000...

     So what would you picture was being built if you had these materials: 30 million board feet of hardwoods, 2,700 tons of copper and bronze, 104,000 tons of steel, and 1,636,000 tons of reinforced concrete.  Perhaps an elegant cruise ship?  Or another remote home for Elon Musk?  Actually, if you throw in some 827,000 gallons of embalming fluid, you'd have the annual usage of what we use to bury our deceased, all in the name of hiding that which we don't wish to be reminded of.  All of this has given rise to no-fuss funerals, direct cremations, and even requests for being buried in your own backyard (which is still legal in many areas).  It's all meant to answer a simple question: what if you can't afford a funeral?   

     My goodness, how depressing overall.  But there was more.  Medical examiners (some go on to become forensic pathologists) --and sometimes those tow-truck coroners-- are asked to list the manner of death to put on the death certificate, and there are pretty much only five such categories: natural, suicide, homicide, accidental, or undetermined.  Wrote sociologist Timmersman: Little is known about the initial reasons for asking about the manner of death, but "the assumption of those now working in the National Center for Health Statistics is that the manner box was added as a means of gathering more information on the death certificate regarding the circumstances surrounding death."  It's purpose was to help nosologists in coding and classifying cause-of-death information for statistical purposes.  The manner of death is administratively binding and has great social relevance...Although public health interests mandated a manner-of-death classification, no guidelines were provided to distinguish manners.  The most ambiguous and contested manner of death was, and still remains, suicide.  Timmermans goes on to note, in a chapter he titled "The Perfect Crime," that testing for poison is rarely done in autopsies...

     It is not as if death, specifically premature death, was alien to me, wrote foreign war correspondent Rod Nordland in his book, Waiting for the Monsoon. For nearly five decades I had faced down death, my own or others', covering virtually every war of note from Cambodia in 1978 and on through East Timor, Sudan, Bosnia, Somalia, Chechnya, Kosovo, Iraq, Yemen, and finally Afghanistan.  In total, I reported from 150 different countries -- ten of them in 2018 alone, the year before my disabling tumor struck. (Nordland was diagnosed with a terminal brain tumor and currently writes from his hospital bed)  Psychologists have a term for the fear of dying alone: monatophobia.  Friends and family members and editors have often raised their eyebrows at my frequent assertions that my tumor was the best thing that ever happened to me, a gift that has enriched my life ever since.  They are skeptical about my full embrace of this Second Life.  But I know that I am not alone in this experience.

     We’re all deeply flawed, wounded, selfish, clueless, and mean at different times, wrote Jim VandeHei in his book, Just the Good Stuff.   It does not make us bad.  It makes us normal.  That’s why we need to extend grace to others, and to ourselves...It is nonsense that to shine, you need to go to a fancy school, bootlick bosses, or pay your dues at soul-sucking jobs working for bad people.  You do not need to get 1500 on your SAT or to have a sky-high IQ or family connections.  You don’t even need sparkling talents.  You simply need to want to construct goodness with whatever life throws at you.  This starts by grounding yourself with unbreakable core values and then watching, learning, and copying those who do it—and get it—right.  But it also includes watching and studying those who screw it up.  You need to find your own passions, not have them imposed by others.  Then outwork everyone in pursuit of shaping your destiny—your own personal greatness—on your terms, by your measures, at your pace.  

     For my wife and I, it was also a time to recharge, to return to that childhood home of hers in Cornwall on the southwest coast of England, an annual visit which we had missed last year.  It would be a time of relaxing, a time of reflecting, a time to meet and exude kindness, and smiles, and friendship.  It would be a time which was needed by both of us.  And we were nearly done packing...