Have You Ever Not Eaten?

Have you ever not eaten?

Of course! You ran out of time to eat lunch before class, you woke up too late to eat breakfast. Maybe you have had the flu so badly that even the thought of a bowl of soup makes your stomach quiver. We’ve all been there.

Have you ever not eaten for weeks? Months? How about years?

No, if you’re reading this, you have likely have not gone quite tat long without eating. But I see people every day that haven’t. I am a medical Speech-Language Pathologist (SLP), and I work in a setting where I regularly diagnose and treat people who, like my title implies, have speech and language disorders. However, an SLP does much more than speech and language; about 75% of my caseload is actually treating swallowing and cognitive disorders. I see people that cannot eat, that have poor memories. I’ll attempt to restore their swallow function, even if that only means they have a few tablespoons of pureed chicken at a time. (I also don’t think I’ll ever be able to look at applesauce or mashed potatoes again, ugh.) Sometimes I’ll see people immediately following an infection, a surgery, or a broken bone, and in a few weeks, they’ve bounced right back to where they were: happy, independent, and ready to go home. More often than not, the people I treat have neurodegenerative diseases. This means that they won’t get better, and the things I do either slow down decline, or establish adaptations and modifications that help them become the most independent as possible. Key words: as possible.

No one thinks that these diseases will find them. No one thinks that. How can you, when at 19 you can stay up all night drinking red bulls and vodkas, but can still rally for that 9am class? How can you think that your body won’t deteriorate when you can log 8 miles on that trail, when you can eat 3 slices of cake and still look fabulous on the beach in that bikini? No one thinks that these debilitating, terrible health problems or diagnoses will happen to them, and trust me, you never want them to. Death is not the worst thing that can happen to a person. Think about that for a while, mull it over. Or better, yet, take a trip to a nursing home, or better yet, a dementia lockdown unit.

As I work with my patients daily, I learn a lot about them. I’ve heard stories about their lives, their pasts, their families. I feel like I’ve spent many accumulated holidays with them, in a sense: I know about the time Joe slid down the banister and needed 6 stitches in his forehead. I know about the time Mary eloped with the man 12 years her senior. I know the color of the dress their granddaughter wore to prom. I know the names of their children, their grandchildren, their pastor. I know the places they traveled to on their honeymoon, although now, somehow 10 years has passed as a widow. “Where does this time go?” I know what crops their daddy raised on that farm in South Carolina; sometimes I can envision those tobacco leaves growing so large and strong, so leafy and verdant that they could wrap around someone like an earthy, flat blanket, tying their body to the land.

I know the stories of the people my patients have loved and lost. My patients have shared family recipes with me, they’ve told me some of the skeletons in their closest.

 “How long have I been here? Is it still 2006?”

“You’ve been here awhile, ma’am”, is now my standard response. No use in breaking their heart. I know they’ll forget new facts, its only a matter of time, but I am convinced that the devastation stays, that it dwells deeply and roots at the bottom tip of the heart, rooting until it becomes a sense of desperate intuition,  a gnawing sense of unease and omniscience. There’s something to be said of where the memory of a feeling is housed.

How can someone not remember the past 7 years of their life, but they can remember the details of a night 40 years ago? Why do they tell me all these things? I still don’t know, but sometimes I feel as if they are trusting their memories to me, using me as some external hard drive, knowing that as their memory fails, mine grows stronger, linking my past experiences to theirs. Linking my current, dynamic,  life into their past, immovable, memories.

I know my patient’s favorite foods, their hobbies, their regrets. I know when they’re going to have a bad day, or even a good day, when who they are (were?) comes charging back to their body so suddenly and brightly, that their new diseased shell seems to fall right off, if only for a few minutes.  One of my patients, a man in his early 40s and former chef, had brain damage so badly that he couldn’t remember how to read, write, or his own address, but when I told him I had been trying to recreate my own Paleo version of Chick-fil-a, he immediately told honed in on the ingredients I had been missing. (He was right.) 20 minutes later he didn’t remember our conversation.

I’ve sat with patients who have a memory of about 10 seconds, where their life resets over and over and over again, day after day:

“What day is it?”

“April 14th”

“Oh, ok. Look at that sun!”

“What day is it?? Wednesday?”

“Its April 14th, and look how nice that sun is”

“Ohh., you read my mind! I was going to say something about the sun!”

………

“What day is it?”

I’ve been in rooms with patients that I’ve treated everyday for months, their mind so eaten away that every time they see me is like meeting a new person. “Hello, its nice to meet you! Where are you from? You look so familiar!” But amidst the memory loss and confusion, my patients still have haunting moments of clarity. I once had a patient, in a lucid moment, exclaim: “I’m tired, dear. Don’t you see? What you’re doing is just prolonging my death, and I know its your job, but I’m going to die. It won’t be now, but I wish I could go. Jesus won’t accept me if I take my own life, so I’ll just wait here and be tired. I’m so tired.”

I’ve been in the room, several times now, where my patients start talking to their dead relatives. I almost feel as though I’m intruding, tiptoeing in on a very intimate moment.

I’ve treated patients who haven’t been able to eat for weeks, months, years, because their stroke has left the nerves and electrical wiring in their body unable to coordinate the muscles to get liquids or foods down. I can’t tell you how many times I’ve been in a room when a patient who is on a feeding tube, unable to eat, begs of me: “just one sip of water. Just one.”

I stand in exact juxtaposition to my patients: I happen to have an amazing memory. What did you have for dinner the night of December 28th, 2001? Chances are, if I was with you and you tell me where we were, I can recall it. What did so and so say to you during history class our Sophomore year? I probably remember that too. That argument we had last week? I can recite both sides. Verbatim. I happen to have a semi-photographic memory. I say semi- because it takes a good amount of effort for me to be able to access this skill, although when I really need to remember something, I can pull up a visual “map” of it, which always leads me to the answer.  Somehow, I didn’t even know that this skill could be further developed, shaped and moveable to help me succeed in other areas of my life. I realized I could manipulate my cognition, to make it more functional powerful, to succeed academically in senior year of college, which, not coincidentally, is the year I became serious about removing toxins, pesticides, and artificial foods from my diet.  I do think these things are linked.

All of these issues I’ve touched on in this post are heartbreaking. They are heart breaking and preventable. Many of our western diet choices result in the presence of these diseases; the foods that we eat are fueling them, planting the seeds in us, even now and 15, 25, 35 years of age, for neuro-degeneration. I fear that our culture is beginning to accept that dementias and Alzheimer’s and memory troubles are just normal aging. They are not. So I am begging of you: please take care of yourself now. Please put down those energy drinks, those fast food burgers, those sodas, and artificial sweeteners. Please stop telling yourself that the Standard American Diet guidelines have your best health interests at heart. Please look at the financial backers of food laws and regulations passed in congress. Please take ownership of what you put into your body: what you choose to either fight disease or enable it. Please, I am begging you, eat healthy, eat whole. Get rid of toxins in your food, and eat cleanly as possible.  

You deserve better, your future deserves better. Death is not the worst thing that can happen to a person.

Doing my SLP thing. 

Doing my SLP thing.