The Caregivers Notes

Grappling with hallucinations, as Oliver Sacks examines in his new book Hallucinations, can be a nightmare. Hallucinations take many forms and have powerful effect and alter a perceived reality in a snap and suddenly there is committment to a new reality. Witness  how quickly we are moved to another realm by a synapse barely discernible but deep and real, tangible, probably, if the brain could be scanned, and we are embedded in this new reality. The collisions of constantly shifting realities is what constitutes life but in a hospice house it is compressed, it’s a caldron of colliding realities, life and death and purgatory and heaven and hell, and hallucinations, all mixed together. The Caregiver attempts to control these forces, usually unsucessfully, especially when dementia and drugs are involved, as they often are. Who can say what is safe and fair and sane and compassionate when, as a Caregiver, you are pushed beyond what you think you can bear and by osmosis the plight of the dying becomes yours, by necessity, if you’re doing your job and survive. Others, most, turn away, simply don’t deal with it. Lester makes a committment to the dying in an attempt to purge his past sins and failures. He freely embraces various hallucinations, battles others. Within the confines of the hospice house, stretching his imagination, he flits in and out of various worlds. Is this what we all do to survive day by day? And if there is no accepted reality is life an endless series of colliding hallucinations, especially with the old and the dying? From the write-up in the Sacks book:

Have you ever seen something that wasn’t really there? Heard someone call your name in an empty house? Sensed someone following you and turned around to find nothing?

Hallucinations don’t belong wholly to the insane. Much more commonly, they are linked to sensory deprivation, intoxication, illness, or injury. People with migraines may see shimmering arcs of light or tiny, Lilliputian figures of animals and people. People with failing eyesight, paradoxically, may become immersed in a hallucinatory visual world. Hallucinations can be brought on by a simple fever or even the act of waking or falling asleep, when people have visions ranging from luminous blobs of color to beautifully detailed faces or terrifying ogres. Those who are bereaved may receive comforting “visits” from the departed. In some conditions, hallucinations can lead to religious epiphanies or even the feeling of leaving one’s own body.

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