On Vanishing. Lynn Casteel Harper

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       Introduction

      WITH VANISHING ON MY MIND, I CROSSED CENTRAL Park to the Metropolitan Museum of Art on a late autumn morning on a sober errand. Ginkgo leaves, freshly fallen, coated my path. My root-word research on “vanishing”—which, like “vanity,” comes from the Latin evanescere (“die away”) and vanus (“empty void”)—had led me to a genre of still-life painting that flourished in the Netherlands in the early seventeenth century.

      The vanitas school of painting takes its name from the Latin version of an Ecclesiastes refrain (“Vanity of vanities! All is vanity”) and it involves carefully juxtaposing objects deemed symbolic of life’s brevity and the evanescence of earthly achievements. Objects such as mirrors, broken or tipped glassware, books, decaying flowers, and skulls are meant to encourage viewers to contemplate their own mortality. Jacques de Gheyn’s Vanitas Still Life, the earliest known vanitas painting, hangs in one of the Met’s seemingly less popular galleries. Most visitors pass through this corridor of dark still-life paintings on their way to lighter, more moving pieces. That autumn morning, I had Vanitas Still Life to myself.

      A modest-sized piece, 32.5 by 24.25 inches, it contains a panoply of vanitas symbols. A thin stream of vapor rises from an urn, an orange flower with browning leaves languishes in another. Dutch medals and Spanish coins glitter in the foreground. Two philosophers—Democritus, the “laughing” philosopher, and Heraclitus, the “crying” philosopher—recline in the painting’s top corners, pointing to the objects below. A large transparent bubble hovers above a human skull. From every angle, the viewer confronts images of life’s transience, but it is the skull that serves as the central reminder of human vanishing. The empty eye sockets locked my gaze, making me think—vainly—of my own future. A hollowed head, more than any other bodily remnant, symbolizes death’s totality, an unyielding force that consumes the entire person, even the ability to think. I guess there’s a reason why the sight of Yorick’s skull, not his rib cage or pelvic bone, occasions Hamlet’s famous lament.

      As a condition associated with the head, dementia—like the vanitas skull—ignites an especially acute awareness of mortality, placing our very selves under death’s scrutiny. In the last decade, I have glimpsed dementia from several different angles. I have seen dementia-related deaths in my own family. I have worked with dementia sufferers day-to-day in my capacity as a nursing home chaplain. I recently discovered that both of my parents carry one copy of ApoE4, a gene variant strongly linked to late-onset Alzheimer’s disease. I have a 50 percent chance of having a single copy of the gene, which doubles or triples my risk of developing the disease. I have a 25 percent chance of having two copies, which elevates my risk by eight to twelve times, giving me a 51 to 68 percent chance of having Alzheimer’s by the time I am eighty-five. My particular bloodlines aside, the chance of getting Alzheimer’s disease, the most common form of dementia, is one in nine after age sixty-five and one in three after eighty-five. Nearly six million people in the United States are living with Alzheimer’s—making it the nation’s sixth leading cause of death. And yet nuanced thinking about dementia is largely absent—perhaps even nonexistent—in public discourse.

      Heart disease impairs circulation. Kidney disease impairs filtration. But brain disease impairs communication. By distinctly and directly impacting our abilities to relate with ourselves and others, it confronts us with the fact of our humanness: to be human is to be limited, even in our most cherished capacities. Perhaps more than other conditions, dementia brings our fundamental lack of ultimate control over our lives, and their endings, to a head.

      Rather than confirming the humanness of sufferers, dementia, curiously, is often viewed as throwing it into question. A gerontologist once told me over lunch that he begins his dementia caregiver workshops by telling participants that their loved ones remain persons throughout their illness. He reminds caregivers that, even as their relatives become more inaccessible, their “core” never leaves. I am glad for his admonition; I am also troubled that it is needed. I doubt caregivers of persons with terminal heart disease need such instruction, or caregivers of infants need reminders that, even though their babies cannot talk or use the bathroom, they remain people.

      That we need reminders that persons living with dementia are “still people” elevates my curiosity and my suspicion about the peculiar burdens dementia-causing diseases bear. We seem to have placed dementia beyond the scope of ordinary human imagining, as if this condition alone reveals some nasty, shameful secret: the ease with which we all may disappear.

      The cultural critic Susan Sontag’s classic Illness as Metaphor emerged from her rage at seeing, after her own cancer diagnosis, “how much the very reputation of this illness added to the suffering of those who have it.” In 1978, Sontag contended with cancer’s reputation as scourge, invader, predator, demonic pregnancy, demonic enemy, barbarian within. Cancer’s roots were then imagined, at least in part, as psychological, resulting from repressed emotion. These metaphoric conceptions of cancer saddled its sufferers with shame and prevented many from seeking proper treatment or even knowing their diagnosis. A decade later, in AIDS and Its Metaphors, Sontag turned her critique