S was a lovely man who moved to the United States in his early adult years with his wife and two small sons. He brought a few random heirlooms, hopes for a better life, and a coin collection that had been handed down from his grandfather to his father to him. Each coin was in a box with a clear lid, sealed and pain-stakingly labeled in small dark print. S added to this collection throughout his life. He wanted his sons to have it – part old-world and part new. His wife showed me the drawers where the coins were stored, neatly in rows.

When I first met S he could tell me stories about each coin and where the coin had come from and who had collected it. His memories were rapidly failing though. But he remembered the coins. He could not tell me his name or where he lived. He could not remember the month or the year. But he could remember the coins. He told me stories surrounding the engravings and images on each small piece of metal. He loved his coins. They were a connection to where he came from and to his family now. They were something he remembered.

But his memory got worse as it does with dementia. And some days, he would not remember the coins but he would look at them. He would hold the boxes, study the writing, then put the boxes away.

His memory failed more. Over time bits and pieces cracked away. Lost. Most days it was very slow and almost imperceptible, then suddenly one day a large chunk would be missing. Unpredictable and heart breaking and inevitable with the dementia.

Then there was the one day I came to visit. The day when his wife opened the door and she was crying. Expecting the worst I entered the house to find S wearing a robe, sitting in a chair surrounded on the floor and desk by coins and coins and coins. And hundreds of open boxes with small, dark writing scattered about him. Never to be put right again.

And I had not realized how much I hated the disease that is dementia until that moment. I had also not realized until then, that sometimes “the worst” is not always death. There are a lot of really awful diseases out there that cause a lot of suffering. But dementia, I think, deserves a special circle in hell.

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