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Tuesday, 6 March 2018

Book review: Somebody I Used to Know, Wendy Mitchell (2018)

This knowing memoir represents something of a watershed for people living with dementia, but even more so for their carers and other family members, and most especially for policymakers. Covering a lot of fresh ground in an engaging way, it is the second book by a person living with early-onset dementia I have read, following Christine Bryden’s 2015 ‘Before I Forget’, which I reviewed in April 2016.

Mitchell finds her memory deteriorating around 2014, a year after experiencing a stroke from which she recovered. She is diagnosed with dementia, specifically Alzheimer’s disease, aged 58. Her children had both left home by this time (in fact, one of her daughters was due to move out of the family home the day the diagnosis arrived) but she continues to go to work in the publicly-funded hospital where she is employed in administration. You wait for news announcing some sort of related disaster, but it never comes.

The author deploys her knowledge of craft competently although at times you get the merest intimation that she lacks a certain quantity of critical distance. When she has an idea for which she clearly sees the merits she follows it doggedly and might from time to time betray it somewhat with a stronger dose of enthusiasm than is absolutely necessary, but enthusiasm and self-reliance characterise her personal response to her disease as well as being also integral to her literary style. She is gung-ho for the rights of people living with dementia and this is why she is chosen by dementia peak bodies to be an ambassador in so many instances.

On the other hand, her expression is exemplary and she gives the reader a rich variety of small details that describe the scenery within which the drama plays out. This is a trick of the novelist. It is in the play of small details that plot in novels is developed or their important characters are delineated. The author uses the same techniques to create a sense of dramatic tension, and to keep the reader engaged. Her pacing is very fine, with each new episode entered into confidently and with major set-pieces serving to punctuate the narrative at critical moments.

When Mitchell buys a bright pink pushbike to ride because jogging has become impossible, to cite one memorable example, she finds that she is unable to turn right. Every time she tries to turn right while she is out riding, she falls over onto the pavement, hurting herself. Instead, she decides to only turn left, and goes about her business normally once this this decision is behind her. Small stories like this one punctuate the narrative. Another clever vignette plays out through the dynamic between Mitchell and Billy, her daughter’s cat, who she feeds again and again when she is called upon to be cat-sitter because she always forgets that she has already done so. Billy gets fat.

Near the end, Mitchell goes up in a glider with her daughters’ support and experiences the world from such heights that you regretfully suspect she will never experience again. This is a fitting metaphor with which to close the book.

The book is filled with a number of clever improvisations designed to outflank the cognitive effects of the degenerative disease. And cups of tea (a very English thing that Mitchell is aware of as a comic foil to use to offset the grave nature of the wider narrative; the book mostly takes place in Yorkshire with occasional trips to London to attend events organised by dementia peak bodies). She also sets alarms on her iPad for a range of things such as meals and medication. The device turns out to be a saviour in other ways, too, because it gives her the ability to use FaceTime. Telephone calls she finds too difficult to make sense of because she can’t see who she is talking with and because the thread of the conversation gets disrupted by the process of verbal communication.

A common theme for the two books is marriage breakdown but another is a strongly-expressed call for society to adjust itself to the needs of people living with dementia, which is set to become a bigger and bigger challenge for all of us as time inexorably rolls on. Housing people in nursing homes is, we know, expensive, and the government already goes out of its way to keep people living at home. Many people would often choose not to go into a nursing home if given the choice. But attitudes in the broader community need to adjust as the population ages.

Six percent of Australians living with dementia have an early-onset form, which means that they are diagnosed with one of the relevant diseases in their 50s, 40s or even as early as their 30s. As well as showing how she individually copes with the changes her disease brings, Mitchell also shows how cities need to change: at one point after her retirement she sells her house in York and moves to a small town nearby where one of her daughters lives because the city’s streets are simply too noisy and disorienting to comfortably deal with.

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