“Dan the magic man,” Q replied. Q rummaged through his jacket pocket and pulled out a quarter. A childish smile brought the color back to his face as he attempted to make the coin disappear into thin air and then pull it out from behind my ear. The quarter dropped loudly to the floor as he tried to reach behind my ear in the otherwise quiet ICU room. Q didn’t bother picking up the coin.
Reminiscing can be very useful and validating. People with dementia usually retain their memories from long ago; discussing these memories often provides a sense of security. Security that is quickly eroding away as you lose the momentous gains your brain has made over the course of a lifetime. Suddenly issues with dressing, bathing, and eating become distressingly frequent. Even the concept of time escapes you on certain days.
A once resolute college professor, soft-spoken and decisive, always even-tempered at home and in her class, was now prone to lashing out and making hurtful statements. In a matter of months, Q’s mom had become wheelchair bound and was relying on the nursing home staff for her basic functions. A chronic aspiration risk, she inevitably developed pneumonia, required intubation, and was admitted to the ICU on two vasopressors.
One of Q’s mom’s fondest memories was when her shy son, costumed in an ill-fitting white shirt and cape, summoned enough courage to become the “Amazing Q.” A memory that she kept going back to in the past months. As Q’s mom’s faculties blunted further, she still held on to little Q and his magic.
“Dan the magic man,” a $50-per-hour magic instructor was teaching Q how to do the rubber pencil, the bending spoon, the levitating card and of course the disappearing coin. Little Q was never good at it, older Q was no better, but his mama didn’t care. She loved every moment that Q spent by her bedside fumbling through his tricks. It distracted her, soothed her and validated her.
After the de-escalation of care and extubation, the ICU room fell silent. Q sat by the bedside doing his tricks as we disconnected the last of the monitors. I picked up the coin and placed it into his mom’s hand.