During my early career as a journalist, I had the chance to witness the fragility of life. While making a documentary about the 115 Emergency Center in Saigon, I observed a patient suffer a sudden stroke and pass away alone in the restroom shortly after having lunch. I visited nursing homes where loneliness overshadowed and encountered the devastating effects of Alzheimer's disease.
📌 This blog belongs to the contemplate death series; you can read part one here: 🔗 Life - a journey toward inevitable death
Aging - the decay of the sense of identity
As one grows old, it becomes an intriguing social phenomenon. When you reach the age of 70 or 80, you no longer actively participate in the labor market, and you gradually lose your social standing. External beauty loses its significance, and your body becomes weaker, more prone to illness. Your social relationships diminish, and you have to face the deaths of friends and loved ones. Most of what you strived for in your youth, such as maintaining health, beauty, and status, slowly disappear. You are gradually pushed to the sidelines of society and deepen into the burden of disease and loneliness.
A conversation in Hoàn Mỹ nursing home, in Sai Gon, Việt Nam, from the article Link
Not only socially, but some elderly individuals also suffer from cognitive decline, particularly Alzheimer's disease. This is an incurable condition where all the memories that shape who you are gradually disappear over the years. Biologically, Alzheimer's causes the brain to shrink and disrupts its functions. Patients with this disease progressively lose cognitive abilities, from forgetting everyday objects' locations to losing their sense of self.
Alzheimer’s has five main stages of development over time. You can observe some symptoms in this video.
Preclinical Alzheimer's disease:
This stage has been estimated to begin between 10 and 20 years before a dementia diagnosis and when clinical symptoms are not yet present/overt (Sperling et al. 2011).
Mild cognitive impairment due to Alzheimer's disease.
The symptoms of this stage include forgetting things, such as (1) Losing things often, (2) forgetting about events or appointments, and (3) experiencing more difficulty in finding words compared to others of the same age. However, individuals in this stage have not yet experienced memory decline. Source
Mild dementia due to Alzheimer's disease.
As Alzheimer’s worsens, people experience more significant memory loss and other cognitive difficulties. Problems can include wandering and getting lost, trouble handling money and paying bills, repeating questions, taking longer to complete normal daily tasks, and personality and behavior changes. Source
Moderate dementia due to Alzheimer's disease.
In this stage, damage occurs in areas of the brain that control language, reasoning, conscious thought, and sensory processing, such as the ability to detect sounds and smells correctly. Memory loss and confusion worsen, and people begin to have problems recognizing family and friends. Source
Severe dementia due to Alzheimer's disease.
Brain tissue shrinks significantly. People with severe Alzheimer’s cannot communicate and depend entirely on others for their care. Near the end of life, the person may be in bed most or all of the time as the body shuts down. Source
My grandmother passed away from Alzheimer's. Towards the end of her life, she could hardly take care of herself and constantly needed the presence of family members. Because of the inheritance from my grandmother, I worry about being affected by it in the future. One day, I may not be able to recognize myself when I look in the mirror, and my loved ones will look into my eyes and realize that I'm no longer truly there.
Our team article: Chuyện mùa Vu lan: “Giờ mẹ thường quên cài nút áo, xỏ dây giày. Ăn cơm vãi đầy vạt áo. Xin con nhẫn nại chút và dịu dàng thêm”
(My creative writing excerpt, imagining what would happen when I grow old and discover that I have Alzheimer's): The time machine
The endless dance of life and death
In 2019, our team wrote a long-form article on the 115 emergency centers in Sai Gon during the Lunar New Year. The Lunar New Year is when people usually rest and spend quality time with their families, but 115 emergency staff members continue to fight to save lives from the constant presence of death. The following video and photos capture a glimpse of their experiences with various medical situations they have to face. Our team article: Đêm 29 Tết trong Trung tâm Cấp cứu 115
4:00 PM on the 29th day of the Lunar New Year. A 37-year-old man, who worked for a shop selling ornamental fish tanks in District 3, had just finished celebrating the year-end gathering with his colleagues. A few hours later, he went to the restroom. After a while, a loud crash was heard. It was only then that the people in the shop realized something was wrong and tried to pry open the door. When the emergency responders from the center arrived, the man's limbs were already covered in purple bruises, a sign that the patient had been dead for a long time. His wife had also passed away less than a year ago due to diabetes complications, leaving behind their 7-year-old child. Beside the man's body, his mother sobbed, "I told him, but he didn't listen. He had a stroke once and kept drinking and now he's gone, my child." - Excerpt from the article.
You can watch my documentary video here:
The next day, during the final shift of the medical team, it was already 7 am on the 30th day of the Lunar New Year. In Thanh Da, a woman gave birth to a baby girl inside a restroom. The baby weighed about three kilograms, with a round and rosy face. Resting against her mother's chest, medical staff hurriedly rushed her into an ambulance to be taken to the hospital.
Looking at the baby's face, I understand that death begins right from the first moment of life. The baby's life will have her own path, but she shares the same ending as the man who worked in a shop selling ornamental fish tanks. The welcome to life always comes with a farewell when our time has run out.
Practice: The Clock of Life
Last week, my friend used an analogy to explain the passage of time in our lives. He compared the human lifetime to a 24-hour clock. Suppose you live to be 80 years old; each hour on the clock represents approximately 3.3 years of life.
Here is a little exercise for you: try to calculate at which hour of the day your current age falls on your life clock.
At 3 am, when you're still in a deep sleep, you have lived almost 10 years.
At 6 am, as you begin your day, you reach the age of 20 years old.
At 9 am, you have lived 30 years.
At 12 am, when you have lunch, you turn 40 years old.
At 6 pm, it's dinner time, and by that point, you are around 60 years old, with only 6 hours left on the clock of life.
Doing this exercise may make you realize you still have time to experiment, make mistakes, and pursue your dreams. For example, I have just reached 9 am on my life clock. On a typical day, this is when I start a workday and have plenty of time to tackle the day’s most important tasks. However, the clock is ticking away minutes of life, forcing me to prioritize meaningful tasks before the end of the day arrives.
Thank you for such a great article. It is hard to find someone who can document and give doctors and nurses at emergency centers the praise and appreciation that they deserve for the extraordinary work that they do these days. The part on the elderly are also nice; it mind us of how to live better amid the increasingly busy life in which we often lose sight of what's really important, our parents.