I’m visiting my son Kai in Seattle. He’s a carpenter and currently building a
basement apartment in his house. While
I’ve been here, we’ve been installing kitchen cabinets together.
IKEA cabinets are, apparently, of good quality and
relatively inexpensive … but you have to assemble and install them
yourself. IKEA sells internationally and
has chosen to obviate the need for translation by creating assembly
instructions comprising only pictures and diagrams, no words at all. The instructions are very clever, walking you
through complicated procedures one small step at a time. They are thorough and accurate, but they are
Since Kai’s the carpenter and it’s his kitchen, I’ve
been the assistant, deferring to him in interpreting the diagrams. Yesterday, however, Kai asked me to attach a cabinet
door. The assembly was a little
different from the others we’d done, but not particularly complicated. On my own, however, I was completely
flummoxed. The two of us had previously
put one small part of the drawer together, but I couldn’t even find the place
in the instructions where we’d stopped.
I looked for ten or fifteen minutes and just couldn’t figure out where
to begin. I told Kai, he took over, and
we got the job done.
Afterwards, we watched football together, went for a
long walk and picked up a pizza. On the
way home, I asked him whether he had noticed any impairment in my cognitive
capacities, anything other than my reports of what I was experiencing. He pointed to the difficulties with the IKEA
diagrams. He told me that that’s the
kind of thing you used to do better than I could.
That kind of capacity to translate diagrams and interpret the proper sequence
of steps to complete that task had always been a strength. I’d enjoyed similar tasks and would have
looked forward to it as a challenge, knowing that if I took my time, I’d get it
done. But that’s changed.
Kai and I talked about it later, and he asked if such
impairment is frustrating for me. I
would have thought so, too, but, in fact, it hardly bothers me at all. I’m cognitively impaired, I understand I’ll be
increasingly limited and, importantly for me, that I am not to blame, so it’s
been easy to let it go. I remain
surprised by such equanimity, which had previously not been my forte, to put it
mildly. I’m very grateful.
In diagnosing cognitive impairment, there are several
different domains. Most common in
Alzheimer’s is problems with memory, the so-called “amnestic” type. Non-amnestic symptoms include limited
abilities to make sound decisions, judge the time or sequence of steps needed
to complete a complex task, interact socially, or translate visual cues. In addition to a dominant impairment in
memory, a second, lesser impairment in another of these domains is additional
evidence for Alzheimer’s.
What surprises me is how symptoms can be so
specific. Despite my inability to
assemble the door to the cabinet, I was able to analyze several single-step
problems that initially confused even Kai.
Also surprising is how sporadic symptoms can be. On another day, I could probably have gotten
the cabinet door assembled.