Who is left, when illness takes away your mind or body?

A neurologist reflects on the sense of self and how it can drive survival or live on in memories.

- Crystal Jing Jing Yeo

She was a lively middle-aged woman, a mother and grandmother who loved to cook, garden and laugh. One day, she began to forget things.

She repeated questions, misplaced objects, grew anxious and withdrawn. Within weeks, she started having seizures and jerks. She lost the ability to speak.

Brain imaging showed she had Creutzfeldt-Jakob Disease (CJD), a rare and severe degenerative brain condition caused by an errantly folded protein called a prion.

Now she lies in bed at home, fed through a tube, her eyes wandering without focus. Her husband still talks to her softly, describing the garden she once tended. Sometimes he wonders if it is kinder that she no longer knows what is happening - that her mind, in retreat, has spared her the grief of her own decline.

At the National Neuroscience Institute, many of us care for patients living with severe, disabling conditions. For me, this always raises the same question: Who are we when the brain or body changes?

We spend our lives building who we are - through memories, relationships, work and hopes for the future. Yet, sometimes without warning, something in the brain changes, and all we take for granted begins to slip away.

Each time I see this happen, I find myself asking: What makes us who we are? Is identity rooted in the past we remember, the person we are now, or the future we still hope for?

EXISTING, IN OTHER WAYS

Take CJD. It is cruel and fast, erasing memory and meaning in a matter of months. For loved ones, the grief is not just for a life lost, but for continuity broken.

The woman who once told gently teasing family stories, tended roses with quiet pride, and seasoned soup by instinct, can no longer reach that past. The thread linking her yesterday to her today has snapped.