How the past can continue to affect us

Andy Bergman (not his real name) never said a word to me. By the time I first saw him for a hospice assessment at the assisted living facility where he had lived for several years, Alzheimer's disease already had robbed Andy of his ability to speak or to indicate in any other way that he understood what was being said to him.

His pale blue eyes flashing, Andy flailed at me when I put my stethoscope on his chest, making it impossible to listen to his heart and lungs. So I completed my assessment as best I could and ordered scheduled doses of a sedative to calm him and make him easier to care for.

"I know," she said. "He's been getting worse for several years. The Andy I knew and loved disappeared a long time ago. I just want you to keep him comfortable."

AN UNFORGETTABLE EXPERIENCE

I never knew Andy when he was healthy, but I knew of him. He had been a career Secret Service agent and was with President John F. Kennedy that day in Dallas when JFK was assassinated. The Charlotte Observer published an interview with Andy on the 40th anniversary of that awful November day that recounted how he had driven the hearse carrying Jacqueline Kennedy and JFK's body from Parkland Hospital to Love Field, and how Andy had witnessed Vice President Lyndon B. Johnson being sworn in aboard Air Force One. Then after the flight back to Andrews Air Force Base, he had helped carry JFK's coffin from the plane to the ambulance that would take it to Bethesda Naval Hospital.

I wondered whether memories of that day and its aftermath were haunting Andy, even when he could no longer speak or remember what happened 5 minutes ago. Is that why he was so restless and hard to manage?

MY OWN MEMORY LANE

Like everyone else who was alive at the time of JFK's assassination, I remember the disorienting shock of those first news bulletins from Dallas. I was an intern at the University of Virginia, full of youthful optimism about the limitless potential of both medicine and politics to make the world a better place.

As my fellow house officers and I were seeing patients in the medical clinic, someone came in and told us that the president had been shot. Before we knew that his wounds were fatal, I remember grasping the thin reed of encouragement offered by a senior attending: "They've taken him to Parkland. They have good neurosurgeons there."

But there was no remedy for the president's massive wounds, and soon, news came that he was dead. I remember calling and consoling my wife, who was pregnant with our first child, then returning to work, dazed by sadness and disbelief. But I remember even more the weekend that followed, sitting home with my wife and unborn daughter, sobbing uncontrollably as the black and white TV images from Washington and Dallas savaged my emotions with a force that I still feel.