Going Downhill

April 2nd, 2026

I’m old enough to have had friends and family members die from chronic debilitating diseases. A sudden death is traumatic. I know this because one of my younger brothers died in a car wreck at the age of twenty-eight. But a slow death, one in which there is a gradual disintegration of mind or body, is agonizing. It’s like watching a slow-motion train wreck. The progress of the disease seems to be inexorable, and human efforts to stop or even to slow it down are often futile.

My mom died from Alzheimer’s disease. I have close friend whose father is suffering from the same tragic ailment. My friend’s father used to be a brilliant mathematician. Now he’s not. Now the man has great difficulty with walking up stairs and performing a number of other everyday tasks. The father, oddly enough, can still improvise music on the piano, but his other mental faculties are slipping away. My friend tells me that sometimes his dad is okay, meaning that his father hasn’t gotten any worse. The disease plateaus for a while and then continues on its negative path. There is not a smooth downward trajectory. The disease attacks the brain in fits and starts, but the overall direction is always clear.

I had two friends from work, both of whom died from cancer. One of them suffered from a type of blood cancer. The other had a brain tumor. Both of them received treatments, chemical and/or radiological. Each of them rallied for a while. I remember in visits with each of the two men how their wives would light up at any good news. The wives encouraged their partners and told them that they were getting better and it would be okay. My two friends did get better, but that was only a brief interlude, and eventually they both succumbed.

I had another brother who died from complications of alcoholism. Officially, he died of a heart attack, but it was more than that. He didn’t take care of himself, and I don’t think he wanted to live. His mental and physical decline were in many ways similar to that of somebody with Alzheimer’s. My brother would have a severe medical crisis, then he would recover, but he never quite recovered to the previous level of health. He always dropped down a step. I, along with many other people, hoped that he would turn things around one day. Other folks with addictions have been able to do that. My brother didn’t.

I sometimes speak of watching somebody else slowly die. I don’t think anybody actually just “watches” somebody whom they love die. To me, it is impossible to simply observe the destruction of someone else in a disinterested way. It’s not like going to see a Greek tragedy in a theater or binge watching a slasher movie on Netflix. The person who cares about the individual who is desperately ill is not just a spectator. That person is also a participant in the drama.

I am currently a participant in the struggle of a young person who seems to have the same disease as my brother. I love the person and I cannot separate myself from their suffering. I hope for their recovery, but I often feel completely helpless. I know I cannot save the individual.

So, what is left? There is hope. It is perhaps a forlorn and irrational hope, but it’s all I have. I cling to that hope despite all evidence that it is pointless.

That’s what I do.