Memory in the Margins
As I close out my first year of medical school, I find myself less captivated by lectures and more enthralled by moments of clarity on the dementia floor: a woman’s eyes brightening as jazz music crackled from our old boombox; a Huntington’s patient’s shoulders loosening as she followed the slow rhythm of our seated arm exercises; an Alzheimer’s mind pausing over a familiar photograph. Dementia, Alzheimer’s, Huntington’s are often reduced to broken circuitry, but I see real people craving dignity and connection.
My fascination began back when I worked as a CNA, feeding residents, helping them shower, changing them, and learning to recognize the person behind the diagnosis. I remember one resident in particular: she would scratch or claw at most of the staff, but whenever I came in to feed her she would settle quietly, almost as if she knew I was there to care, not just to complete a task. The nurses made it a running joke between them, telling me I was the only CNA she did not try to push away. In those moments, I felt not only useful but deeply connected, like I could reach someone where words and memories failed. When I learned to interpret her nonverbal cues, I realized that patients often speak through their posture, facial expressions, and small gestures, and that recognizing these signals is just as critical as any history I’ll take as a doctor.
There was also E, a sweet woman with no family who always sat in the corner of the dayroom, close to the sink. She never let go of her robotic therapy cat, one of those models that meowed when you pressed its button, and she would pet it and meow right back. When I offered her coloring sheets and crayons, her eyes would glisten as she filled every page perfectly within the lines. I often found myself wondering if she had once been an artist or had another creative career. Though I never asked, in those quiet moments I felt we shared something meaningful.
And then there was P, a Spanish-speaking resident who greeted me with “Hola, niña linda” every time I walked through the door. I would reply in my shaky high-school Spanish, sometimes leaning on Google Translate, with “tú linda,” and her grin would fill the room. We would spend unhurried minutes trying to solve a puzzle and trading simple phrases in Spanish until she drifted back into her afternoon routine. My exchanges with P reminded me that connection does not require perfect language, only genuine warmth and curiosity.
These experiences taught me that treating people with dementia is not just about managing symptoms or prescribing medications but also about finding small ways to light up their world. Whether it be playing a familiar song, creating a structured routine, adjusting lighting to calm sundown confusion, or handing residents a simple coloring book, these small acts bring flickers of recognition. While my interests may evolve as I progress through my medical training, the lessons I’ve learned from these early encounters, about dignity, patience, and presence, will remain central to the physician I hope to become. Right now, I feel most drawn to working with geriatric patients living with dementia and learning how to bring light to their world, one small gesture at a time.