As Time Goes By

It's still the same old story.....

You lose yourself, you reappear

You suddenly find you got nothing to fear

Alone you stand with nobody near

When a trembling distant voice, unclear

Startles your sleeping ears to hear

Someone thinks they really found you

Bob Dylan

It's All Right, Ma (I'm only Bleeding)

Dear friends,

I am raising funds for the National Brain Appeal, more of which I will explain later.

The reason I wish to do this is personal, and twofold.  My mother, Anna, once McMullin but latterly Gibbs, died recently after a long and lovely life, but her last years and especially the last months were afflicted by an undiagnosed dementia which ultimately robbed her of speech, and understanding, and life.

When I took her to see a specialist, a while after my father, her husband of 64 years, had died in 2010, I was told that she had dementia but that it would be difficult, and ultimately of little purpose, to test her further to determine exactly what nature of dementia she had.  And so, conveniently, she was said to have Alzheimer's disease.

What difference it makes I cannot tell, but I am inclined to a different diagnosis, which is that she had Dementia with Lewy bodies, the very same that may have stolen Lear's sanity in the mists of Shakespearean tragedy.

Why do I think this?  My mother heard voices, thought people were there when they weren't (including my father).  She got up too early and then was confused that the shops/church/market stalls were not open. She was unsteady, unbalanced, and fell.  

I was called early one day, not very long after her ninetieth birthday, when her neighbours had found her bleeding from the head having fallen against a radiator in her bedroom and bursting her right eye. She had thought that someone was there.  She never lived alone in her own home again.  The operation at Moorfields, (following admission to the Accident and Emergency unit at Watford General) with anaesthesia and trauma, at the age of ninety, left her unable to reason or to look after herself.

That was over six years ago.  Her decline was steady, from smiling and talking she reduced, gradually, and, I hope to think, painlessly, to a gaunt frame in a wheeled chair, still able to chuckle and say thank you, but usually grinding her teeth and holding on, as if the world was spinning too fast.

Now she is at peace, and I am sure she is relieved.  

I am hoping, attempting, to raise funds for the national Brain Appeal.

Another reason, personally, why I wish to do this, is that my wife, Amanda, the mother of our two girls, is also affected by dementia.  This time it is a type of dementia known as Semantic Dementia.  This, as the title suggests, affects words and understanding, and now, about eight years since the symptoms became concerning, verbal communication is almost beyond us..... 


Bit by bit she declines…..

Initially Amanda was diagnosed with Early Onset Alzheimer's, and spent a year ingesting Donepezil Hydrochloride (which can cause stomach upset, cramps and sleep disturbances) as if it might make a difference. 

We don't know if it made a difference. 

There was no controlled experiment, and, as we discovered following my insistence that I didn't think this was a correct diagnosis, she didn't/doesn't have Alzheimer's.....  So the drug (at whatever cost) was useless (but at what cost?)

No, after brain scans, neurological examinations, extensive, exhausting testing, and lots of anxiety, the diagnosis was amended to Semantic Dementia, sometimes referred to as Primary Progressive Aphasia (though that, in itself, is a form of Fronto-temporal Dementia and an umbrella for more than one form of dementia.)

And these terms mean little, or nothing, to me and her, us, the family, the patients, the sufferers, the public.  They mean nothing, because there is nothing, currently, that can be done about it, and nothing, currently, that any government will do about it.  

It is a road sign.  It says One Way Street.  This way to decline and death.  

Well.  We will all die.  Yup.  And we don't exactly know when, or how.  But, for some it is unannounced, so the life flutters on until it flutters off.  As Dylan sang, 

He not busy being born, is busy dying......

But it's alright, Ma, I can make it

In Amanda's case, it has been announced, and the brain is shutting down.  

Anyway, 

there is a reason for this subdued story telling.

I have been supporting the Alzheimer's Society for years now (and still am) but have recently found that The National Brain Appeal has a direct link with the Dementia Research Centre at University College London Hospital (UCLH) where Dr Jonathan Schott is overseeing Amanda and the progression of her disease. The specialism  here is in the rarer types of dementia, such as Dementia with Lewy bodies (as my mum probably had) and Semantic Dementia (as Amanda securely has.)

And so I want to raise money for them....

Which is where you come in.

I have produced two calendars for 2020, and I know you would love to buy one and to contribute to this worthy cause.  Both calendars are simple A4 page-to-a-month,  though they are slightly different formats and slightly different papers.  One is made up of  landscape photographs taken in the UK; the other consists of photographs taken in mainland Europe.  Either will look impressive on your wall for an entire twelve months, or would make a wonderful Christmas present, so please don't hold back.....

Each calendar cost me around £6 to produce (I am afraid I cannot compete with mass production) and there will be postage involved, so I am asking for a contribution of £10 per item, but that's a notional figure.  Any contribution (more or less, depending on what you can afford) will be acceptable (either direct to me or to my JustGiving page) in aid of: 

The National Brain Appeal

Rare Dementia Support

So, to put it simply, if you send me £10 and your name and address I will send you a calendar (indicate which one, if you have a preference)

My address is:

Richard Gibbs

75 Coleswood Road

Harpenden

Herts

AL5 1EG

and, since this is only a limited run (these are collectors' items), it will be on a first come first served basis.

So don't fear if you hear

A foreign sound in your ear

It's alright, Ma, I'm only sighing

Bob Dylan

It's all right, Ma (I'm only bleeding)

Thanks

Richard and Amanda

The National Brain Appeal raises funds for Queen Square

We help to provide much-needed funds to support The National Hospital for Neurology and Neurosurgery and the UCL Queen Square Institute of Neurology – together known as Queen Square. This is one of the world’s leading centres for the diagnosis, treatment and care of patients with neurological and neuromuscular conditions. These include stroke, multiple sclerosis, brain cancer, epilepsy, Parkinson’s disease, and dementia.

You can help Richard GIBBS raise money for this great cause by donating directly to their fundraising page - https://www.justgiving.com/Richard-GIBBS13?utm_source=Sharethis&utm_medium=fundraisingpage&utm_content=Richard-GIBBS13&utm_campaign=pfp-email&utm_term=YMN76m3aw.

JustGiving sends your donation straight to The National Brain Appeal so that they can put your generosity to good use!

Thank you for your support! 

Richard

The National Brain Appeal

Box 123

Queen Square

London

WC1N 3BG

020 3448 4724

info@nationalbrainappeal.org

The Madness of King Lear

Dementia, by any other name.....

At the end of Act three, Scene six of King Lear, Shakespeare's most abstract and extraordinary tragedy, Edgar, the legitimate son of the Earl of Gloucester, who has been driven to assume the cloak of insanity by his half brother Edmund's scheming, makes this pronouncement:

When we our betters see bearing our woes,

We scarcely think our miseries our foes.

Who alone suffers, suffers most i'th'mind,

Leaving free things and happy shows behind.

Edgar has witnessed Lear's dementia, through the eyes of Poor Tom, but he momentarily steps out of his own disguise to comment to the audience on the loneliness of madness.

We two alone will sing like birds i'th'cage.....

Almost two years ago I watched Simon Russell Beale as Timon of Athens, at the National Theatre, while Andy Murray was beating Federer on Centre Court. For some reason that combination of events caught my imagination and I included it in my blog piece on Timon. This Wednesday, at the National Theatre, I watched Simon Russell Beale descending into hell and oblivion as Lear, while simultaneously Andy Murray's lack of aggressive forehands led to his downfall against Grigor Dimitrov in Wimbledon's men's quarter-final match, IBM analysis has suggested (as quoted in The Daily Telegraph).

I won't pursue the links between these late eclipses - I will simply take them as circumstantial turns of Fortune's Wheel, though I cannot help but think of Gloucester's words:

As flies to wanton boys are we to th' gods;

They kill us for their sport.....

Anyway.....  in 1967 I studied King Lear and still have my Cambridge University Press copy, much annotated under the guidance of the terrific John Davison, a teacher who not only would chase his class around the school to refresh them halfway through a double lesson, but who would then fold his almost seven foot frame into a Porsche 911 at the end of the day to disappear in a dust of latin phrases as we wearily wandered home.....

The bare facts are these:  Lear is King of pre-Christian Britain, and wishes to retire. He divides the kingdom in three parts between his daughters and then expects them publicly to earn their shares by declaring their love for him. The older two women, Goneril and Regan, exaggerate; the youngest daughter, Cordelia, declines to play the game.  In a rage Lear disowns her and splits the kingdom in two, on condition that his older daughters look after him and his hundred retainers. Very quickly, however, this proves too much and both women turn him away.  Losing his sanity Lear spends a night out in a storm, supported by three faithful followers.  War breaks out between the King of France, who has married Cordelia, and Britain. Lear takes refuge with Cordelia at Dover, but her forces are defeated and they are imprisoned. Treachery, which stems largely from the sub-plot, complicates the ending and all the family die, leaving the state to be governed by Lear's eldest son-in-law.

In 1968, prior to our exams, we shuddered in the cavernous Shakespeare Memorial Theatre, Stratford, as Eric Porter stripped to his underpants to rail against the weather and Cornwall shucked oysters out from Gloucester's eye sockets to splat them on the stage.....

I was affected.  The play, never mind the actors, nor directors, had gripped me, and the intense web of theme and nuance has never since left me alone. The profound emptiness of the line Nothing will come of nothing reverberates through the caverns of my hollow mind; the sallow bleat of The gods are just and of our pleasant vices Make instruments to plague us pricks me in my irresponsibilities; and the crushing sadness of I have no way, and therefore want no eyes; I stumbled when I saw.... twists my heart and causes tightness in my chest at times when the cinder path of life seems to burn my feet.....

But my teenage years have long gone, and the clouds of smoking fires' smouldering embers are hazed and dark.  When we discussed Lear and his madness in that temporary classroom, I only partly comprehended, despite the power I sensed that welled up within the play. I grasped, I think, the intricacies of plot and subplot, the parallels of good and evil in the offspring, the paradoxes of sight and sightlessness, the ambiguity of Nature and the complexities of love. But I did not understand the meaning of madness.

But now, perhaps, as I have learned what a poor, bare, forked animal I am, the gossamer veil which fences in the sane has been revealed in all its intricate nothingness.  Be Kent unmannerly when Lear is mad.... See better, Lear, and let me still remain The true blank of thine eye......

From Eisenstein to Bacon, the frightening paradox of spectacles

It is about perception, and sight - insight, foresight, hindsight.  We do not always see the meaning, the importance, the relevance, the joke..... Here below is Lear in confused rage with his daughter Regan (who, although she will not tolerate his excesses, would put up with him alone):

And here is Simon Russell Beale's Lear disrobed, pensive, quiet, discussing dementia with a host of strangers as if it were a game of chess.....

Where is the madness in a quiet mind?  Like the clapping of one hand it is impossible to detect.  Is Lear mad when asleep (the Doctor wisely recognises that rest will cure)?  The word mad derives from the Old English for foolish, though today it has more overtones of rage, as in a mad bull. Insanity and dementia both come to us from Latin, with the first having connotations of an unhealthy condition, and the second implying being out of mind, deranged - out of control.

Just how far Shakespeare intended consciously to depict or explore madness in this play we can only hazard, but it is not incidental that Lear trades quips with his Fool (Prithee, nuncle, tell me whether a madman be a gentleman or a yeoman.  Lear.  A king, a king!) And it is not accidental that in Shakespeare's play Lear travels from apparent control (even if foolishly mistaken) to a complete lack of discipline, made most clear in Sam Mendes's production when Lear suddenly bludgeons his Fool to death in a bath.  

But Lear is not the only one who may be mad....  Why does Cordelia so resolutely defy her father? She is perhaps little more than an impetuous teenager, stubbornly holding principles that will do nobody any good, but the scene rapidly spirals unnecessarily to crazy outcomes (not unlike, incidentally, Juliet's last encounter with her intemperate father, Capulet).  Why do her sisters flatter the King their father so and then turn him out of house and home?  Why does Edmund run so wildly against his brother, and his father, and then play so riskily with Regan and Goneril?  Is Kent not rash and foolish to risk death rather than accept an unjust banishment?  And what need is there for Edgar to mimic a bedlam beggar so vividly?

Simon Russell Beale as Lear, about to banish Kent

What lines can be drawn?  To touch on two quite different stories currently in the news, was Oscar Pistorius mad when he shot Reeva Steenkamp?  And was Rolf Harris mad when he sexually assaulted young women?  What is apparent is that both men behaved aggressively and (seemingly) out of character; there is talk now of Pistorius having a split personality (which I thought was old-fashioned psychobabble for bi-polarity).  But can't the same be said for Harris, who on the one hand sang about two little boys with three legs, and on the other fondled the queen... Or am I confused? At what point is there an excuse for any individual to lose their balance?  Where is there reason for unreason?

Enter Lear asleep in a chair......

It is Lear's love for Cordelia and her response which provides the counterpoint to the horrors of the play. Having rested and been re clothed, Lear is woken, gently.  He is confused, and initially he protests:

You do me wrong to take me out o'th'grave:

Thou art a soul in bliss; but I am bound

Upon a wheel of fire......

Where have I been?  Where am I?  

And for a moment things look up. There is hope of restoration.  The evils may be past, and the catastrophic falling out, which sparked off so many ills, could be healed. Lear shows humility (I am a very foolish fond old man) but Edmund, Regan and Goneril are still at large, and there are more woes to come.  

Juri Jarvet as Lear in Grigori Kozintsev's 

1971 film

Some years ago, my dear cousin Isobel, then in her early thirties, took her life at Beachy Head. This is one strand that affects me now when I see Edgar lead his father supposedly to the heights of the cliffs near Dover. And then to see the blind man fall, to hear Edgar's wondrous explanation, is to feel those last few moments of a young life slip through the air.

Then, at Putney Vale cemetery, she was laid to rest, and I still see my uncle waving goodbye at the graveside.  Howl, howl, howl! Parents are not meant to bury their children.  This feather stirs - she lives!  

My uncle today, like my mother, is old, and has dementia, perhaps not unrelated to the shock of his daughter's death.  He does not rave, Spit, fire! spout, rain! so we will not proclaim him mad, but his mind wanders, and vague thoughts recur.

My mother, having fallen violently one night and lost an eye (which led then to the trauma of general anaesthesia and the operating theatre), muddles words, and is less than steady on her feet.  Old beyond accurate diagnosis, she may have Dementia with Lewy Bodies, the same possibility that provided Simon Russell Beale with some tics for his Lear, though the name is not important.  The condition will not get better.

The core of the play is dementia. The plot concerns politics, and family strife, love, Nature, and tyranny, but the all-pervasive theme is dementia. What happens when your father becomes demented and his habits are unsupportable?  What happens when you cannot see the mistakes you have made and believe the world is against you?

At the end of King Lear, the dead rise and evil is undone; the cast all appear together, bow, and disperse to their ordinary lives.  We stood to applaud at the end of the final performance of the Mendes/Beale collaboration at the National.  I felt uplifted, catharsised (if such a word is permitted), inspired (and could not give a toss about Murray's eclipse).  But outside the theatre our minds will continue to decay, and many a soul will degrade as dementia progresses.  The tempest of life goes on.

Poor naked wretches, whereso'er you are,

That bide the pelting of this pitiless storm,

how shall your houseless heads and unfed sides,

Your looped and windowed raggedness, defend you

From seasons such as these?

Order is restored - the entire cast take a bow after the last performance

It would be nice to think that at the end of the play, when Edgar re establishes his sanity, his words are optimistic:

The oldest have borne most: we that are young

Shall never see so much, nor live so long.

But as yet we cannot stop the tide. Shakespeare never heard the name of Alzheimer, nor Lewy, nor ever saw a prescription for donepezil hydrochloride, nor had an MRI scan, but he knew too well the distress that visual and audible hallucinations may cause, the difficulties of memory loss, mood swings, confusion, and even perhaps the problems of progressive non-fluent aphasia, or semantic dementia, though,

What’s in a name? that which we call a rose 

By any other name would smell as sweet;

(and will still have thorns.....)

In 2012 in the United Kingdom 800,000 people had some form of dementia.  

One in three people over the age of 65 will develop dementia.  

By 2021 there will be over one million people in the UK suffering from dementia.

And as yet there is no cure.

Lear was not alone.

So, so; we'll go to supper i' th' morning

http://alzheimers.org.uk/site/scripts/documents.php?categoryID=200120

https://www.dementiafriends.org.uk/

http://www.lewybody.org/

If you would like to help support the Alzheimer's Society please go to 
http://www.alzheimers.org.uk/

Please note that many of the pictures above have been borrowed, but borrowed in the hope that their use will be pardoned as illustrative and promotional material.  There is no intent to profit from their use.