Cushion?

Washington DC

I’ve begun to read Daniel Kuhn’s Alzheimer's Early Stages.  The book is directed toward “care partners” (his word, as opposed to “caregivers”) and not particularly toward the people with Mild Cognitive Impairment (MCI) themselves, but my reading has so far stimulated my thinking.  He writes about hearing the diagnosis:

 [T]he person with the disease usually receives the diagnosis with little or no emotion and few if any questions. … Those with AD [Alzheimer's disease] seldom grasp the full implications of the diagnosis.  Even those who are well aware of their symptoms ordinarily do not appear overwhelmed by the news.  It seems that the ability to understand the magnitude of the situation may be blunted by the disease itself.  Those with AD typically do not share the same perceptions of the disease as others close to them.  In a sense, the disease is often accompanied by a cushion that softens its meaning for the affected person.

 This raises the question, of course: Where does this cushion come from?  Kuhn suggests that it’s because the person with Alzheimer's does not grasp the full implications of the diagnosis as well as a person without impairment might receive a diagnosis of, say, terminal cancer.

In my case, at least, I would argue the point.  It’s certainly true that upon receiving the diagnosis I showed little emotion and had no immediate questions.  It’s true that I didn’t share the same level of grief as others close to me.  But I don’t think it was because I failed to grasp the “full implications” of the diagnosis.  No one really understands the full implications, of course, until he or she begins to experience them.  But I knew what was coming as well as anybody!

So what does explain why the diagnosis caused me so much less shock than it seemed to cause others around me?  I don’t have a good answer.  I suppose it could be that my deep introspection precipitated by my previous depression and consequent decision to leave medical practice left me more prepared for an overwhelming diagnosis like Alzheimer's.  Perhaps it had to do with my history of meditation and the recognition that as long as I was able to remain in the present, I had no reason to fear.  Perhaps it was because I hadn’t experienced anything frightening yet, and was more interested in the diagnosis than afraid of it.  Perhaps I realized subconsciously that the experience of the disease is worse for others than for the affected person.

Or perhaps I’m just an inexplicable exception.  That seems unlikely, so I wonder if others have had similar experiences of a cushion upon hearing their diagnosis. 

I would like to hear from you, either as a comment or in an email (see “contact me” above.  What was your reaction to finding out?  If it was similar to mine, do you have an explanation for the cushioning from the shock that you experienced?