THE METAPHYSICS OF DEMENTIA

This blog piece is difficult because the subject of dementia is so personal and so vast. Those are only several reasons why one might defer writing about them. But it is because of those reasons that the blog piece seems compelling and necessary. It is a piece that I couldn't avoid writing but that could be interpreted as whining self-service. That is not my intention. I have thought about not publishing it but then wanted to have it available for someone who might be facing something similar and is equally confused about its meaning. Perhaps it could be of some help. Everything about dementia in here is based on my own experience and so my experience might be very different from that of someone else caring for a loved one with some form of dementia, of which there are many causes and conditions. And it must also be said that the mapping of my experiences with someone else's dementia might, at some future time, be the mapping of my own. Knowing how to segment off pieces of the experience is a challenge but it seems to me that the best way is to consider dementia from the inside as well as the outside of the phenomenon.

Trying to look inside dementia from the standpoint of the patient suffering with it is like trying to get some hold on what happens after we die. There is no available language that can be called up to describe the state and no one able to testify. Without language the experience can't be shared and all the observer can do is notice how another person is changing and attempt to translate that into the language we do have at our disposal to describe a mysterious state of mind, body, and soul. I am aware that there are numerous causes of dementia and that what I am working with here is Alzheimer's disease but using the larger category of dementia as a final common pathway of experience, a condition of the brain/mind that is chanelled through common neurologic pathways. This piece is not an attempt to describe what neuroscience has offered us as evidence of the changes in dementia or to highlight the first descriptions of the condition by Alois Alzheimer (1864-1915). This is a piece about fitting dementia into a larger space of understanding from a personal perspective and from accumulated daily experiences.

I notice a tendency here of distancing myself from “the patient” as a way of describing my experience but in truth it has not been that easy living the experience with someone with dementia. In this case, my wife, M, is the patient. It is because we have been married for fifty years that trying to separate myself from her life and experiences is nearly impossible. We are bound together in so many obvious and also subtle ways, as two people become over so long a period of time. Still, it is the distancing that has carried me over the shoals of frustration and sadness to see her changed world in a different way. I am not sure that distancing is a healthy approach, as it creates separation. However, without it there is no way to discern the details of the two lives involved and to preserve the obvious separation of two different worlds in a way that supports both of them as healthfully as possible. It has been most difficult to pull myself away from the idea (and assumption) that we grew together as a single unit over so long a period of time. It was a pulling away from the myth of romantic absorption that brought me to a state of existential despair. I had invested heavily over the years in the idea that we were a fusion of selves, that different as we were we “completed” each other. Looking back on such an assumption, I see that this was a disservice to her and to me in that I never saw us as separate beings with different wants and needs. This is hard to write because our relationship evolved in this way over many years and those years might have been more valuable if I had freed M from my own constraints. Whatever was laid down in her psyche and that now surfaces without filters must be an element in how she is processing her world. With time, perhaps, I will understand more fully the entanglement of the lives of two people in a complex relationship. What follows, then, is an attempt to describe my experience with as little clinical coldness as possible and to reflect along the way on how I was able to eventually understand M more deeply and to accept the changes in her without being with her inside her world.

What is possible to notice in the patient with dementia is an evolution of expressions that is manifested in the middle to late progress of the condition. It has been impossible for me to locate the beginning of the process as I think back on when it might have begun its slow walk. It is not uncommon as one ages to have situations and periods in which there is forgetfulness and to wonder about dementia but still be able to move ahead with the routines and activities of daily life, one's usual life. This includes quirks and habits all of us have as well as memories and interactions with one another and the world around us. We are who we are, all built up over a lifetime of experiences. It is these things that are laid down into the bedrock of who we are and give us a foundation for identity. This is what the philosopher Arthur Schopenhauer (1788-1860) refers to as the world of phenomena. As time goes along, it is these parts of us that are exposed when the veneer of adaptation and all its filters and social niceties is peeled back in dementia. It seems there is always something of who we are and who we have been that emerges to carry us and act for us. Again Schopenhauer uses the term “will” to designate a force or energy that is life, not the source of life but life itself that is manifested in every aspect of the cosmos but which is not accessible to us as something that can be separated or analyzed. It is life or the life impulse. So it seems with the patient with dementia. In very general terms, as described by Iain McGilchrist (b. 1953) in his book The Matter with Things, this represents an emerging dominance of left brain hemisphere functions such as analysis, organization, planning, language and others that represent a static and fixed approach to experience (maybe the place where the ego is located). This is contrasted with the right hemisphere in which there is located facility with metaphors, art, imagination, creativity in general, curiosity, a relationship with another, an expression of affection, and a sense of the sacred, among others. Because of the dysfunction of disease (stroke, trauma) or inhibition of the right hemisphere by the left hemisphere, the resultant effect is what one can notice in a patient with dementia. In other words, the left hemisphere functions seem to predominate with all of its organizational and structural parameters.

What I also notice over time is a simplification of word choices and language in general. Conversations have become simpler and silences more prevalent. There has been a loss of eye contact, of appetite at times, of body weight (associated with a phobia or fixed idea about gaining too much weight when all the evidence points to serious weight loss), loss of personally directed intimacy and affection. The range of expressions is narrowed and there has been a loss of personalization. In the latter, I no longer seem to be a unique someone to her, a husband or confidant, and what I do around the house is just what someone contracted to do the work would do. There are other manifestations of loss almost every day and it is a challenge to keep up with them with the intent of making the environment safe and comfortable. Her personal responses are often argumentative or critical and are expressions of some lack of trust with resultant resentment and anger. Once again, I think these responses are emanating from a place deep inside her psyche based on a lifetime of similar responses. It has taken me a long time to understand how all of these pieces fit together to explain what I observe daily because so many of the realizations have been accompanied with emotional turmoil on my part. Having fixed ideas about order around the house or shopping lists or media news stories become redundant certainties. Changing these ideas with reminders or rational conversation is not possible.

What the above descriptions document are the very sources of the turmoil I experienced as the dimensions of dementia unfolded. In general, I had made many assumptions over the years that covered all aspects of our relationship and those were placed squarely in front of me as I stumbled through a growing realization of what was happening. At first, it never crossed my mind that what was occurring was a process of loss of cognitive function. I personalized acts and events as if our relationship was what it had been over the fifty years of our marriage. When I experienced depersonalization in her eyes I was thrown into an existential crisis, not understanding who I had become to her and who I actually was. I think this is probably my own singular experience and I can't speak for anyone else working with a loved one's dementia. And I am guessing that experiencing dementia in an aging parent or sibling might be different based on different life contexts and relationships from that of a spouse. My life has been constructed from the bricks that society and culture have provided for me. I built up an inner life that was based on those bricks. Some of the bricks also came from assumptions I had made about our relationship over the time of our marriage that turned out to be unstable. What happened with my crisis was that I felt my heart breaking for the two of us and what I thought we had together as well as a shattering of the pieces of my identity. This was the beginning of my “dark night of the soul,” as described by St. John of the Cross. In part, my identity had depended on the long-term relationship with a spouse as well as other relationships (with children, for instance) and from the cues absorbed from social structures (relationships with my profession and hospital staff and patients I treated) that included whatever a changing world delivered to my consciousness. How the pieces were gathered back is a later part of this story.

What has helped me in the process of reconstruction has been a reliance on metaphors and what they have revealed about what I know and don't know about disease/dementia. One of my guides along this path has been Susan Sontag (1933-2004) and her book Illness as Metaphor. In it she describes the many ways metaphors of illness have shaped our thinking about disease in general (even though her focus was on cancer and tuberculosis, fertile diseases for metaphorical assignments). I want to highlight some of them as a way of attesting to my own thinking about disease and what repercussions they have had in my personal experience with dementia. It is clear to me that metaphors are powerful references that shape how we think. As with almost anything one might mention or think of, metaphors can be useful in harmful as well as beneficial ways. One of the tasks of dealing with dementia is to study the harmful ones in order to construct ones that are beneficial and support whatever healing there can be in one's own life and in the life of the patient with dementia. My experience is that metaphors are powerful ways in which to understand pieces of the phenomenal world. Lakoff and Johnson in Metaphors We Live By emphasize that the metaphors that saturate our everyday lives are largely unnoticed. I think that is the case for my background shaping of what dementia is. It is instructive to substitute “dementia” for Sontag's examples of cancer and AIDS and to see to what extent deconstructing the metaphors helps understand my own experiences with dementia. What follows are reflections on the metaphors she writes about in her book. I will be substituting dementia for the illnesses she discusses.

Sontag writes about the romantic myth that people are made more interesting by their disease. This was so with those suffering from tuberculosis and how the characters of the patients were thought to be results of the disease. In this sense they were thought to be caused by a mental state or personal dispositions or character flaws. This metaphor is part of descriptions of dementia and especially those forms that result from assumed alcohol abuse or addictions or lifestyle (as in AIDS). It is an example of blaming the patient for her dementia when, in fact, there may not be any evidence that the dementia is caused by anything other than the aging of yet another organ system. An offshoot metaphor of this tendency to blame the patient is to think that the patient is the subject of “divine wrath” and is being punished for transgression. Blaming and shaming are all part of this metaphorical entanglement.

There is a tendency to use the disease as evidence of identity. I think this results, in part, from categorizing dementias as diseases rather than as what might otherwise be a state of the normal aging process. This results from the common practice within and outside medicine to brand a person based on the disease. It is to diminish the whole person by separating the person from the disease. The result is to depersonalize someone. This practice has become so widespread and acceptable that we see it repeated in the wider culture(s) in which the “other” is identified by a habit or trait or conviction, often pejoratively. It establishes a prejudice that becomes infectious. As much as these metaphors are intended to publicly identify someone, they also hide the whole person and a whole identity that is obviously more complex than a stigmatizing label.

Separating the physical body's manifestation from the whole person is often seen as self-betrayal of the body as it breaks down. Once again, this seems to be an effort at blaming and I think many patients feel this way about their conditions. I don't know if this is how a demented person thinks about her condition because that seems to be a state that is beyond articulation. But, once more, it is often seen as a failure of moral character as well as a shameful physical deterioration. It seems there is an unspoken hope that somehow the dementia patient will pull back from the effects of the condition, discover insights, clear away self-deceptions and assumptions—come back to their “right mind.” Here the metaphor implies that the cognitive decline is a choice and a form of self-expression. I think this is an impression early in the process of decline and I have been subject to this thinking, also. A thought was: If only my spouse could see how she is acting and change. Looking back, this thinking was a subconscious way for me to overlook changes that were already part of the dementia process and a source of my own guilt in not being more astute and caring.

Sontag discusses the idea that there are often gender differences in how metaphors of illness are assigned. She says that women have often been viewed as “weaker” than men in a culture in which men are dominant. They have been viewed as more frail and with delicate dispositions and this metaphor of “weakness” because of gender spills over to how ill women are seen as victims or as deserving of their illnesses. Thinking of patients as victims or losers or as evil is common and to assume that they are responsible for falling ill (as well as getting well). This has not been part of my metaphorical usage. Interestingly, Sontag says that thinking of patients as weak or culpable in the larger setting of the social world is projected onto uncountable others who appear weak and, therefore, diseased and subjects to be feared and blamed (I think we saw this during the Covid pandemic when the then president blew his dog whistle in calling the corona virus the “Asian flu,” thus blaming an entire population with his metaphor).

With all of this there are assumptions of contamination, premeditated threat, strengths and weaknesses, and more high-flying notions of insults to the “natural order.” Patients who experience this (and maybe not patients with dementia) might also experience paranoia, thinking that they are targets of criticism, hate, or isolation (violence?). Perhaps in the early phases of the illness there is recognition of outside control of freedoms when others are seen as controllers or police. I do think there has been some of this in my own experience.

The language of warfare is a common metaphorical network to apply to disease. Terms such as battle, victim, invasion, campaign, and survivor are all meant to further separate a patient from the reality of disease as a part of a whole person and not as an object of threat or encroachment. It is my experience with dementia that this metaphorical network does not apply very often to these patients because of the often very slow progress of the condition and the loss of agency. Not only do the metaphors separate a person from the disease but they also separate individuals from others. There is the problem of the self-assignment of metaphorical gloom and shame and the problem of bearing the implications of the metaphors others assign to the patient.

Some, but not all, of the active metaphors mentioned above have been a part of my experience with someone with dementia but not always consciously. How I have viewed dementia from the outside of the condition has tended to separate the living whole person from me. It is said that we can trace this duality of mind separate from the body to Rene Descartes (1596-1650), a separation that our culture/society now embraces with its embrace of science and technology at the expense of the holistic experience of being a human being. The former is variously referred to as the world of phenomena (Schopenhauer) and as left brain hemisphere dominance (Iain McGilchrist in his book The Matter with Things). The latter, holistic being, is couched in the concept of will and the noumenal (Schopenhauer again) and the neuroanatomic dominance of the right brain hemisphere as emphasized by McGilchrist. So, the phenomenal and the noumenal are aspects of a whole world consciousness, separable for the purposes of describing human behavior and the human approach to what we know of the wide world and of our own personal experiences.

My own experience with dementia incorporates not only Christian mysticism but also Zen Buddhism. It is interesting to me that Schopenhauer's philosophy and McGilchrist's incorporation of formulations of philosophy and neuroscience that each has borrowed a great deal from Zen Buddhist thought. I will reflect more on this later in this piece. For now, it is important to this story that I highlight some of the assumptions that were broken apart not too long ago with my experience with dementia. The path through the demolished assumptions really began when it was made clear to me that the person I assumed myself to be was not the same person experienced by my spouse. Her experience was of someone who had intimidated her and annoyed and controlled her for almost the length of our fifty year marriage, it seemed. I had made the assumption that each of us had adjusted to one another, accommodating each other's quirks and habits and that we had a stable understanding of each other. She did not feel that way at all. What I had assumed about myself and who I was was immediately fractured and shattered. This was the beginning of my existential crisis, my “dark night of the soul.” This was described by St. John of the Cross (1542-1591) and I related to his descriptions but could not see how to emerge from this character breakdown. Because my identity was laid bare and in pieces, it had the effect of raising questions about who I was in relation to not only my wife but also our children. Was I who I thought I was all the years of raising four great people? It raised questions about who I had been as a physician (I was informed that I was viewed similarly by the operating room staff as being distant) and what I thought I had accomplished through my work. Everything about my conscious identity was up for scrutiny without any visible supporting structure with which to manage sweeping up the shattered pieces lying all around. This experience lasted for many weeks and the cloud of depression hovered over me all the while I was attempting to understand how my relationship would be with M. She could not perceive my emotional pain and, as with my previous experience with depression, it is not possible for someone who has not experienced depression to comprehend what that dark world is like. Within this there was a very deep sense of pain and loneliness and sadness. This is not unlike what a person suffering from dementia must suffer in the absence of being able to articulate the decline early in the process.

I stumbled about for weeks knowing full well how my body was responding to these stresses. Sleep was disordered and my appetite fell off. I lost all concentration but managed by dint of habit to keep the household tasks from failing. I think it was just the habitual tasks themselves that gave some order to my disordered life. I reacted in ways that didn't seem to be me, but what was I all about anyway? I was intermittently angry and resentful and fearful that I would not be able to pull myself together. My history with depression contributed to this sense of devaluation and failure and disorder. I had failed someone else (maybe lots of people) as well as myself. That is a very perilous place to be emotionally.

So, how did I begin to emerge from under the dark cloud of what seemed like identity dispersal and dissolution? I had some feeling that how I was reacting was not my “true” self, whatever it amounted to. It was a sense more than a decision about what to change. I knew that whatever I did would be “radical” in the way that it would be countercultural, a response that would not depend on all the ways present day culture advertises the manufacture of identity. I read two stories about the life of St. Francis of Assisi (1181-1226) in which he lived a life of “radical love.” It was radical for him because he was alone in his mystical visions of a God that was not always present to him. Even with this realization and the sadness it created, he continued to do only what he was capable of doing and prayed and shouted and went without sleep and ate very little—many of the same experiences I had had. I was able to relate deeply to his whole body life in pursuit of a visionary love in the face of abandonment. My experience was a feeling of being abandoned by whatever spirit had been incorporated within me to make me who I was. I could see from the life of St. Francis that I had to respond to my world of fragmentation with the same radical love, to love in the face of disdain, indifference, affirmation, or outright abandonment. This was the only way I would be able to begin the healing process necessary for my identity reconstruction.

Very slowly more light entered my world. By permitting radical love to motivate me, other very strong impulses began to stir and to contribute to a more stable emotional life. I found myself falling back into the strange world of Zen Buddhism I had experienced at Upaya Zen Center during my chaplaincy training but I had not embodied it. The experience of being embodied had always puzzled me and I did not feel I had imbibed the essence of what it was. But as I returned to the teachings of Zen I could see that they were finding solid places in my consciousness and that I could call them forth in my experiences with dementia, experiences that sometimes changed every day (an “every day is the same and every day is different” sort of experience). It was this embodied application of Zen precepts and ideas and spirit that became my emotional structural support and continues to be just that today. I suppose my subsequent reading about neuroscience and philosophy corroborated the strength of what Zen provided me, wisdom that stretched back in time over two thousand years. I just knew from an embodied sense that I had this support all along, something along the lines of Schopenhauer's “will,” a life force that remains inaccessible to our consciousness but which animates all that is in the cosmos. It is this force, this energy, that precedes all that now exists in our lives (maybe a philosopher's version of the Big Bang). It is the energy that implies motion and this motion describes the actualization of the unknowable in what we perceive. This is very Zen in its flavor and it is the presence of the energy and the motion that I know in an embodied way is what animates my life and the life of the cosmos. So, it is a cosmology that makes “sense” to me in all its impermanence, unknowability, interdependency, interpenetration, with all things in infinite contexts and relationships with everything that is and dependent co-arising of all phenomena. It is Indra's Net that Buddhists refer to as the binding network in the cosmos.

I could not have emerged from my darkening gloom without St. Francis and Zen. I am not a hero in this story and my journey has not been a hero's journey as described in many traditions in which individuals experience an identity death and are resurrected (sound like reincarnation?) in a different form with a new and resilient consciousness. I do not expect to emerge as a being from the liminal environment of the cocoon wholly transformed. I still struggle with my identity and I still experience frustration and sadness and guilt as circumstances change. But I do not feel as fragile and fragmented as I once did many months ago. I have no idea where this process of our lives will lead and how it will play out but it no longer matters to me as I move now from the circumstance of today to the circumstance of tomorrow. The radical love I am plumbing every day manifests as compassion, more compassion for myself and for others. The love moves me to compassion and compassion moves in the direction of doing good for others (the third of the Three Pure Precepts in Zen). I cannot do otherwise because the source of love and compassion is an embodied “will” and energy, a force that I cannot control and is not part of what I am able to include or exclude from my life by choice. All of this philosophizing is now the operating system, if you will, for meeting the needs of my loved one with dementia. But the truth is that dementia doesn't have to be the issue for me to have greater self-confidence in my ability to see how love and compassion shape acceptance of changing circumstances in the social order as well as in changing contexts and relationships. This new perspective also enables a more flexible assumption of the uncertainties of life, an assumption that will serve me instead of severing me from what I perceive as realities and truths and that these can be as various as there are circumstances and the perceptions of others, in or out of a world of dementia.

This blog piece began with considerations of what power metaphors have, what power language has. Initially I had thought that the assumptions I had made about my spousal relationship were false. Now, looking more deeply and reflecting on the many aspects of metaphors in general, such as their ubiquitous presence in all of our communications and references, I am drawn to the notion that those initial ones can also be sources of newly worked metaphors that support the relationship (and the identity) I thought had foundered and was lost. Now they read differently: bonding for life, trust at the core, an equality of balance, the value of personal sacrifice, identity based in part on affirmation from the other, mutual goals, love as durable and enduring, life partners to the end of life, a mutual supportive dependency. The assumptions that aren't renewable are: that mental decline won't happen and if it does it will affect both of us in tandem, that diseases will always be corrected and overcome, and that mortality will be avoided because our fifty years will be an investment in the stretching out of time (these assumptions are more along the lines of delusions). What seemed at the outset as detrimental mental formations in metaphorical form can have new faces and new meanings at a deeper level of being, of being with oneself and with another. It has helped me see that the original person is never lost, as the life force is never withdrawn. It has helped me to understand more fully what impermanence means for the body but not the spirit and that the process of aging includes regression as well as progress, but always with evolving change. It seems counterintuitive to think that what we face is death of the body but an eternal embrace into the cosmological force that is life in all its forms. Zen teachers say that with birth nothing is added and with death nothing is lost.

One of my intentions in writing my many blog pieces has been to explore the ways in which different individuals view/viewed the world. I have the same intention with this one. In previous ones I have featured a person whose life has demonstrated a different way of seeing. In this one, I am the subject of it but not to suggest that I have arrived anywhere solid about viewing the world. It is about the process of fitting pieces together into a more meaningful whole. This process has evolved into seeing the world differently and yet not different from seeing through a Zen lens. The Zen lens has been the optic for me for many years, heightened and enlightened by my experiences at Upaya Zen Center. The Zen lens has been not only a psychological heuristic but also a metaphysics, a system of awakening to insights and not necessarily an experience of catharsis or transformation. I do not feel transformed. Instead, I am awakening to the reality of no-self, a bedrock Zen idea about personal identity. I see this as an opening to the idea that all of life is energy and motion and we humans fool ourselves into thinking that the more we focus on the self and chase after things, prestige, power, and profit the more we support our identities. But what I see now is that identity is fluid and flows out from whoever we think we are on a tide of energy and motion to support and express the miracle of our being in the first place. How each of us acts in this cosmological force field emerges from the embedded and embodied core of our own beings. For me that is compassion (more than the too-complex “love”) and what I do with compassion is to do good and do good for others. It is a very simple formulation, a personal metaphysics, that strips down being and doing to their essence. It makes living in the world and my world in particular a determined effort to let go of ego and, thus, the self in the coursing of the stream of my life. The awakening opens up inquiry into assumptions and prejudices and frees me of tangled concepts of “authenticity” and whether or not I am being true to myself, such as I imagine myself to be. Curiosity about my life makes me curious about the lives of others.

I am reminded that a lifeway is a laboratory of sorts. We are performing experiments all the time and it is good for me to remember that many experiments don't end up proving the hypotheses or supporting initial assumptions. Even scientists at their work probe their imaginations and seek insights. It is not always clear that their work separates the phenomenal from the noumenal. It seems to me that the best work any one of us could do would be to explore the overlapping realms of both ways of seeing, not only in our inner world but also in the tumbling world of social events, to see them as mutually dependent aspects of what we are able to perceive of the mystery of the world.

The specificity of the phenomenal world, the world of objects and people and events, calls for responses in a multitude of contexts and relationships. But, as the contexts change and make different calls, responding from an embodied compassion and an intention to doing good and doing good for others brings me into a field of sufficient care and outreach. I don't yet have a full comprehension of the vast stretch of Zen concepts and practices, but what I do have is serving me well in this phase of my life, having emerged from a recent complex and confusing phenomenal world of emotions and assumptions to a newly configured vista of possibilities. The metaphor of a streaming life with its implications of organicity, generativity, progression as well as regression, and growth, helps me see my life more clearly through the Zen lens and even through a more muddled kaleidoscope that it sometimes seems to be. Even with some muddling there is the possibility of clarity and insight as the view is ever-changing. There is no need to invent new worlds or new words. Practicing with what is offered in the present moment is good enough. This is metaphysics for me and does not depend on a fixed philosophy as much as it does on a way of noticing and practicing.

I continue to read and learn and process ideas but my intention is to awaken to new insights that expose new levels of understanding about how compassion can be actualized. There are many aspects of Zen metaphysics that I don't understand and many ways in which metaphors play among Zen expressions and manifestations, such as aesthetics and physics, haiku and ikebana, calligraphy and koans. Buddhism at its inception (the Buddha was not a Buddhist of course) was a foundational change in how to view the world and how humans could interact with it and it is fascinating to me that all that the Buddhist “Big Bang” produced is continually in circulation, streaming in all parts of the cosmos. What we humans do with all of its energy and motion is up to us (some aspect of free will, I suppose) with causes and conditions and ramifications. Are we awake enough to imagine and understand how to use the energy granted to us? Can we look inward deeply enough to discern how to respond to the cries of the world?

In some ways this blog piece is just another example of the solipsism that defines much of 21^st century America (and maybe the world). It is focused on how the ego (and the left brain hemisphere) is fixed in its assumptions and prejudices and prefers to maintain them. But it is also an attempt to rise above the rigidity of the ego and to see the world differently in a more expansive and creative way (the right brain hemisphere world). This may, in fact, be just another delusion but somehow this uplift feels right in an embodied way with compassion at its core. Rather than dwell or wallow in the lower levels of consciousness, this is an attempt at bearing witness, non-duality, and to make an offering to someone who might be experiencing a similar awareness or even crisis. I do not think of it as catharsis or transformation, as I have said, but an awakening to a different way of seeing reality. I am fairly certain that my intended practice of compassion will fall to the demands of the ego now and then but that I will be able to refresh my intentions and, once again, enter the streaming of life. This approach seems right to me as I have worked my way from the turmoil of facing a loved one with dementia to a greater understanding of how dementia alters the phenomenal world in ways that forcefully compel compassion from our hearts. In doing so, I practice offering compassion to many others who suffer and perhaps this includes all of us wounded human beings. Saying “yes” to life invites everything and everyone into one's own big tent and makes room for the rich and famous as well as the poor and unwashed.

Now I find the metaphysical can be the structural approach to using the kaleidoscopic Zen lens. Where do I stand to hold the optics to my eyes? Is there a way to focus? Can I now see more clearly? How do all the pieces fit together? How long will this intention last?