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If you're new to this blog and want some context for it, read this post from the day I announced my Alzheimer's disease and this post about the day I announced I had lost it. For more info, visit my website with my autobiography and all blog entries in chronological order for easier reading to catch up. There's also a sermon on the spiritual lessons I've learned through this journey through my damaged mind.

Monday, July 29, 2013


Washington DC
I’ve written before about privilege and losing privilege.  After I came to Washington thirty years ago and began working in the inner city with impoverished African Americans, I became aware of the social rankings.  Poor, undereducated, African Americans were on the bottom rung of privilege and power.  I—white, highly educated, economically secure, and male—was near the top. 

It’s not possible for me to give up my privilege voluntarily.  I can give my money away, but voluntary poverty is fundamentally different from life-long, imposed poverty.  I can’t give my middle-class upbringing away: In my family I will always have a safety net.  I can’t give my education away or my white skin.  I have had a secure place in our society.  People tend to believe what I say and listen to my opinion.  When I was young, they didn’t perceive me as threatening when I walked down the street or into a store.  As a college kid, I had almost no chance of being imprisoned for the marijuana I smoked.  I was given preference in job selection.  And so on.

I’m not complaining.  Privilege certainly makes life easier.  But I didn’t earn the essentials of my privilege; they were given to me. 

I may not be able to give my privilege away.  But it can be taken away by mental illness or addiction.

Or dementia! 

As we with Alzheimer’s (or other dementias) become increasingly impaired, other people will drop away, embarrassed or afraid.  We won’t be believed or trusted.  We won’t have the power to convince people to do this or do that.  We won’t be able to drive and may have to live in a locked unit. 

Just to state the obvious: On a relative scale, I will still maintain some of my privilege.  African Americans begin with less privilege than I and, on top of that, get dementia, too.  The same is true for the poor of any race: Poor people get dementia and are still poor.  I have dementia and am still relatively wealthy.  Even with Alzheimer's, I still come out better, closer to the top.

These past three weeks, as I have experienced how deeply my African-American friends have been impacted emotionally by the verdict in the Travon Martin case, I’ve been more aware of the privilege I start with.  The verdict didn’t touch me at an emotional level for it doesn’t affect me personally.  I have long known about the vast differences in privilege between blacks and whites: how differently we are treated by the criminal justice system, for instance.  Without having to know the legal details of the Travon Martin case, it has been for me just another example in a long line.

I can’t speak for my African American friends, but for them this is not just another example.  President Obama spoke of the context in which the case has taken place, a long history of African-American oppression.  For African Americans, the verdict is, at the very least, a powerful symbol that evokes their outrage at a lifetime of injustice. 

Dementia is not the same, of course, as the American black experience, not even in the same league.  It’s not based on a lifetime of second-class status.  Only so much will be taken away from me. 

Nevertheless, it’s enough to grieve over.  I will no longer have the privilege that I’ve taken for granted.  I’m not obviously impaired yet, so I haven’t felt the loss of privilege.  But it’s coming, and I will know something of my friends’ experience.  I hope I can be as gracious to the still-privileged as my African-American friends have been to me.


  1. Thank you for this post.

    As I read it, the word that came to me was 'kenosis', a call that some of us receive. Your life seems to be emptied of some of what it was made of. You express it beautifully.

    Blessings and prayers.

  2. This is a beautifully written post, thank you!

  3. Dr. Hilfiker, I cannot thank you enough for this blog and for this post. I am exactly your age and am now dealing with a 92 year old mom who is sliding away with dementia. I have deep-seated fears about my own future based upon what I am experiencing on this journey with her. Thank you for pointing out that there is joy and happiness to be found even in the midst of this long, slow good-bye. Your bravery, your articulate writing style and your openness have meant so much to me. This post is yet another example of your willingness to 'go there' on all kinds of important topics. I am grateful for your presence here. (I am a retired pastor and spiritual director as well as a blog and essay writer. I have chronicled some of my experience with my mom at

  4. You inspire me to be authentic at every stage of life. Thank you for your generosity in sharing these experiences and the lessons learned. Blessings to you and yours.

  5. Dr. Hilfiker, You have expressed such a special perspective on exclusion and privilege and you articulate it in a way that is so, so real and truthful and yes, very sad for all of us as a people. Thank you for sharing your journey with us and the unique insights that are helping us all to appreciate what we have, who we are and, with your help, who we might become.

    1. The other half of this, of course, is that we are always invited downward, even if we don't have Alzheimer's. For me the most important has been face-to-face relationships with those who don't have my privilege.

  6. Anonymous7/30/2013

    *Chuckles quietly* Thanks to mental illness I've been homeless between 3 to 5 times (I've lost track of decades due to lack of treatment, Sir) but there is one bright light at the end of this tunnel- and its something YOU need to be aware of for your own mental health.
    If you're on the bottom, and you've never gotten up very high and you fall its no big deal because you weren't that high to start with.
    In your case you were well within the top 1%- and the social fall from such a great height to the bottom will possibly make you very despondent and depressed and give you a feeling of helplessness. So for your own mental health and well being I suggest you memorize the hardest verse in the bible.
    1st Thessalonians chapter 5, verse 18- "In all things give thanks, for this is the will of the Lord your God"
    I am convinced this is the hardest verse in the bible to live by- when its wet, you're homeless and uncertain what to do next and then you think about those Christians who sang while being executed you cannot help but wonder "Are you people insane?"
    Go in peace, go with my blessing David- that and $5 bucks will get you a cup of coffee at a restaurant...;)

    1. Yes, to the extent that I cannot let go of my expectations, of what I feel I deserve, of who I am ... to that extent I will be very unhappy.

  7. I have wondered, reading through your blog, if the one thing that is more valuable than money or being socially entitled will cause you more problems than anything else. You are a doctor. Doctors have always been the diagnosers, the ones who tell us what to do to get better. We listen to doctors. They have a lot of education and experience. I have wondered if that will be the most difficult for you, the feeling of not being in control, not the one people listen to. I remember in the 80s, a doctor would walk into the nurse's station and a nurse would stand up and chart in the corner standing so a doctor could sit down (remember those days?). By the mid 90s, a Doctor would walk in and say, "where is a chair for me to sit?" And a nurse would say, without looking up, I think you can find one down the hall in 214." I used to take care of a gentleman that had been a pharmacist, and he could read the ingredients on any drink bottle and knew what they were. he had a hard time with people not willing to listen to him. Just a thought, as things change, I guess none of us know how we will respond.


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