A disserting sketch….
After a series of unfortunate events, the Energetic Brain Club (a dementia prevention club) changed locations and met at Mrs. Takiguchi’s home, just a few doors down from Mrs. Ishikawa’s creaky house. But this too turned out to be a temporary arrangement. After an extended period of forgetfulness, mild enough to let pass, Mrs. Takiguchi’s decline into dementia became too great a barrier to overcome. Although her sharp wit and opinions remain intact, dementia removed much of her ability to forge new memories. Even frequent repetition rarely made things remain in mind. The signs were clear enough. Two copies of the same book of Japanese and Chinese proverbs, bought on different days from the same store, sat in her living room. “This book looked interesting when I was shopping,” she said, handing me one volume. I flipped through the pages and found a Chinese proverb a doctor had used to describe the nurses when they were teasing him:
四面楚歌 (shimen soka). “In four directions, the songs of Chu.”
[Meaning] An expression of loneliness when one is surrounded by enemies.
[Origin] At the Battle of Gaixia, Xiang Yu of Chu was surrounded by Gaozu’s (Liu Bang) forces. When night fell, Xiang Yu heard the Han soldiers riotously singing Chu songs from the four directions and fell into sorrow, believing that the Han had already conquered the people of Chu.
Now juxtaposed with Mrs. Takiguchi’s diagnosis and her decline, the sorrow and inevitability of Xiang Yu’s situation acquired a new meaning. I kept proverb to myself and willfully ignored the second copy on a cluttered table.
“There’s a lot to be learned. Don’t you agree?” Her ensuing description of the book was nearly word for word what it would the following month when the Energetic Brain Club met again. The turns of vocabulary and pithy expressions appeared like fixed rails. You only had to nudge Mrs. Takiguchi for her to traverse the same pattern of thought. And each time she was delighted to talk about the proverbs and wisdom they bear.
I had learned patience with dementia while preparing food at Persimmon Center. Each time I participated, a man, Mr. Wakaume, came around from the elderly daycare center wing with two elderly women and a care worker. Every time he saw me, there was a profound look of surprise. The following conversation ensued, nearly verbatim if I chose not to deviate from the well-trodden path:
“Where are you from?” Mr. Wakaume inquires.
“I’m from America, and you?”
It is an absurd question. In line with common beliefs, Mr. Wakaume’s appearance, language, and cultural appropriateness would undeniably mark him as Japanese from Japan. But it always makes him chuckle, so I repeat the question each time. He replies, “Japan, Japan, yes I’m from Japan. What are you doing here?”
“Volunteering and learning about Persimmon Center.”
“Are you a student?”
“Yes. What about you?”
“I am mechanic for airplane,” he forces out the sentence in English.
“That sounds quite complicated. You must be very skilled.” Each time Mr. Wakaume smiles with a hint of humility at the praise.
“Do you like living in Japan?”
“Yes I do.” (Sometimes I return the question to him, continuing the absurdity that gives him smiles. But on most days, I let him move unimpeded to the next question.)
“What about nattō [納豆]?” asks Mr. Wakaume, referring to fermented soybeans that have a very distinct odor. Foreigners are not supposed to be able to handle nattō.
“I had some this morning—over rice with a raw egg on top,” I reply. It’s usually true, but always gives Mr. Wakaume another smile. The conversation may linger with other foods that are notoriously difficult for foreign palettes, but eventually their walk must continue, and I need to return to cooking.
“Enjoy your morning,” I say.
“Do your best for cooking!”
“I think we’ll continue our walk,” Mr. Wakaume concludes.
The care worker and the attendees of the elderly daycare give smiles and words of thanks and go on their way. For more than a year, this episode repeated in nearly identical fashion at 10:30 am on the first and third Thursday of each month. For Mr. Wakaume, each time was novel experience. But as his dementia progressed, he became more difficult for the care workers. Mr. Wakaume often overflowed with frustration when he could not comprehend what was going on. The care workers appeared as enemies to him and he often attempted to leave the daycare wing. The Persimmon Center employees at the front desk were ready and found gentle ways to delay him. Usually, they would listen to his complaints. Yet this too was simply a stage. As neural connections in his mind further atrophied, Mr. Wakaume’s coordination weakened. Walking became a struggle and his escapes slowly came to an end.
Once dementia progressed beyond a far buoy for Mrs. Takiguchi, time distorted. She began to live in a mottled state of remembrance of years long passed, imagination of the future, and the singularity of the present. But the latter dissolves in minutes, as do recollections of any new plans. Remembering to look at the calendar in the morning is now of little help since its contents vanish as though her mind were exhaling thoughts back into the atmosphere. At the same time, old memories are losing distinctness and growing confused. What has become most potent is the immediate present. For one club meeting, Mrs. Terao was the first to arrive. She rang the doorbell and waited. She rang it again, and after a time Mrs. Takiguchi appeared, somewhat flustered, and inquired, “Hello, what business do you have here today?” This left Mrs. Terao confused. Had she come on the wrong day? Was the meeting supposed to be held elsewhere? Soon enough, though, Mrs. Yamada arrived alleviated the confusion. Mrs. Takiguchi could only laugh and say, “I can’t remember anything, but welcome! Welcome!” The next meeting, Mrs. Yamada arrived just as Mrs. Takiguchi was leaving for an errand. Apparently, a sudden urge to buy food had overcome Mrs. Takiguchi, but she could not recall what, exactly, she needed from the store.
At one of the final meetings Mrs. Takiguchi was present, the women discussed an upcoming friendship association luncheon to be held at the clinic. Mrs. Takiguchi spoke up, “That sounds wonderful. I haven’t been to a luncheon in such a long time.” Mrs. Fujii took Mrs. Takiguchi’s hand in her own and invited her. Soon the room was lively as Mrs. Yamada and the women worked out how to bring Mrs. Takiguchi to the clinic and see her home afterwards. An extra meal needed to be prepared. Mrs. Fujii kept Mrs. Takiguchi’s hand in hers for the entirety of the conversation, the same way schoolgirls 80 years their junior show friendship.
On the day of the luncheon, Mrs. Yamada arrived at Mrs. Takiguchi’s home at 11 a.m. as she had promised and penciled in on Mrs. Takiguchi’s large calendar hanging on the wall beside the refrigerator. The luncheon was scheduled for noon, so they had plenty of time. But when she entered Mrs. Takiguchi’s home, Mrs. Yamada found Mrs. Takiguchi in pajamas on the couch with the television blaring and her daughter trying to coax her into getting dressed for the day. Mrs. Takiguchi was in no mood to leave her couch, let alone change and travel the short distance to the luncheon, which she had forgotten. And so Mrs. Yamada took leave of Mrs. Takiguchi and her apologetic daughter, and went to the luncheon alone.
The Energetic Brain Club met at Mrs. Takiguchi’s home the following month and all was normal. No one spoke of the luncheon and Mrs. Takiguchi passionately described toiling in a factory to make flares and parachutes during the war. It was a story we had heard before, but most of the members had forgotten and listened closely. Some asked the same questions they had during the first telling months before. With or without dementia, minds appear to ply the same routes, evincing the same curiosities and emotions. In one sense, people are freed to feel the fascinations wholly fresh and anew; from another angle, humans appear to be much more like Rube Goldberg machines or even simple windup toys. The mechanisms pushing forward are not always clear, but individuals trod along the same paths.
This was the final meeting at Mrs. Takiguchi’s house. Summer and its long, hot days were coming. Mrs. Takiguchi’s daughter was worried about her mother’s safety. If she was unable to complete the normal routines of dressing and eating by herself, long periods unattended in the heat could bring harm. Judging by Mrs. Takiguchi’s difficulty with remotes and forgetting to turn off the television, she could not be counted on to use the air-conditioning when necessary. Her life could slip away. With reluctance and after absorbing more than a few sharp words, Mrs. Takiguchi’s daughter brought her to short term facility. It was just for the summer, she told her mother. Mrs. Yamada visited on a few occasions, but it was obvious that there would be no return home. Mrs. Takiguchi, for her part, was fascinated by all the people around her—and unconcerned about returning home. As she had done with the Energetic Brain Club, she regaled Mrs. Yamada about the others in the facility, their interesting lives and accomplishments. Perhaps some of her stories were stitched from older memories and then knotted upon the newer relations, a confused assemblage of recollection and imagination. Mrs. Yamada was not sure. In any case, everyone at the Energetic Brain Club agreed that the facility suited Mrs. Takiguchi. It wasn’t too far from home and her daughter visited often.
The conclusion of Mrs. Takiguchi’s residence at home is an example of things working out. Her daughter was near and engaged; friendship association members checked up on her with regularity. The support and attention Mrs. Takiguchi likely allowed her to maintain a residence, even if somewhat lonely, in the place that she desired. In all the conversations in the Energetic Brain Club, she never expressed a wish to leave. In this regard, she differed quite a bit from Mrs. Ishikawa. Solitude brought loneliness to both, but Mrs. Takiguchi was content at home with the quiet hours as her companion. And so nearby friends and kin, along with a small squad of home helpers and regular visits to elderly daycare, enabled Mrs. Takiguchi to squeeze two years of life at home following a diagnosis of dementia and a failing ability to walk. Her outlook remained oriented toward future pursuits. In May, shortly before her entrance into a facility, she heard that I would be giving a lecture on my research. Without hesitation, Mrs. Takiguchi promptly found a pencil and a piece of paper. “Please do tell when and where it will be,” she requested formally. “I would very much like to hear what you have learned.” Her clouded eyes fixed on mine. A second passed and a few women began to speak about difficulty and distance—it would be arduous a trip for Mrs. Takiguchi, who needed a wheelchair for anything further than 50 meters—but Mrs. Yamada swiftly shushed them. This was a matter of dignity rather pragmatic concerns. Feelings, from moment to moment, took precedence. I gave Mrs. Takiguchi the details and she wrote them down dutifully. With an unsteady hand, she placed the small slip of paper on the crowded table, in with other short notes, notices, and one of her two copies of the book of proverbs.
 According to the historical records, Xiang Yu managed to slip out of the trap set by Gaozu. However, he escaped only with a few hundred soldiers out of a hundred thousand, the rest deserting and abandoning the conflict with the Han. After a long and bloody pursuit, Xiang Yu committed suicide rather being taken alive by the Gaozu’s forces. The demise of Xiang Yu was a major turning point in the Chu-Han conflict that would result in the establishment of the Han Dynasty with Gaozu as the emperor of China.