ARTICLES / General /
We are Not in Kansas Anymore... /
“There is no place like home; there is no
place like home.” We can all relate to
Dorothy’s sentiments. She was surrounded
with enchantment—talking animals and vivid
colors—yet she still longed for black and white
Kansas. In Kansas lived the people she knew and
loved; things were familiar and predictable, and
Dorothy knew where she fit in. Her eyes
were filled with joy and relief when she saw
Auntie Em, Uncle Harry, Hank and Zeek.
Now consider this scenario: Dorothy’s shoes
suffered a technical difficulty and she had to stay
in Oz for 40 or 50 years before she is able to
return home. When she opens her eyes, she discovers
that the farm was repossessed by the bank in the
Dust Bowl, and the house has been moved to town. Oh,
and by the way, her body was repossessed as well and
was replaced with a smaller, weaker version.
Auntie Em and Uncle Henry are dead and the farmhands
are long gone. Dorothy recognizes the house, and
yet, nothing is the same. She longs for the
familiar—the smell of Auntie Em’s cooking, the sound
of pigs grunting in the yard, and the voices of the
farmhands talking and laughing. She wants to go sit
on the fence and watch Zeek feed the pigs, but there
is no fence, no pigs and no Zeek. And she couldn’t
climb a fence if she tried. Dorothy is lost
once again and she cries to go home to Kansas.
She is told over and over again, “This is your home,
Dorothy.” But she knows in her heart that she
is not home.
MGM would never have ended a movie on such a
hopeless note. But life is a different story.
Alzheimer’s and other forms of dementia play a cruel
trick on their victims. The memories of rich,
full lives are slowly and insidiously stolen from
them. Alzheimer’s attacks the short-term
memory first. An individual may, in the
process of driving to the bank to make a deposit,
forget halfway there why they are going. She may go
to the grocery store and see a friend of many years
and be unable to call her name. He may ask the
same question over and over again.
Entire passages of time may be erased in the last
stages of Alzheimer’s. “Joe” lives in a
nursing home and worked as an accountant for many
years, yet he tells people he is a mechanic.
His family wonders, “Where did that come from?” and
Joe receives the label “confused.” Yet,
looking into his history would have revealed that he
worked his way through college as a mechanic. He
really isn’t confused; he is just living within the
confines of his own memory. The disease has
eroded the past 45 years of his life and he does not
remember being an accountant or getting married or
having children. Thus, when his son Tom comes
to see him, he decides this familiar looking man
must be his younger brother Jimmy. When his
wife comes to see him later, Joe tells her that
Jimmy came to see him today. His wife knows
that Jimmy died in an accident several years ago and
she tells the nurse that Joe is having another bad
day. The nurse then tries to explain to Joe that it
was his son Tom that was here to see him earlier.
Joe argues angrily with the nurse; he does not
remember having a son, so the nurse must be either
stupid or a liar, and he proceeds to call her both. The scenario above explains why it is fruitless to
try “reality therapy” on an Alzheimer’s patient in
this stage of the disease.