I saw my grandfather tonight. This doesn’t happen often—it’s a long way from Texas to Nebraska. He’s 94 and doing pretty well for that age. My dad picked him up from the assisted living facility where he is currently living and we had a nice Christmas Eve dinner as a family.
I watched him make his way in. A walker now, and each step labored, each foot placement the potential for a catastrophic fall. Made it to the chair, a gradual, trembling unwinding so he could safely sit.
He’s struggling with the beginnings (or perhaps the middle) of a combination of Alzheimer’s and dementia—he can follow the conversation sometimes, and sometimes not. He wasn’t sure that he wanted to come over—too many people, too much hubbub. But I think he was glad that he did. We all shared favorite Christmas stories as he enjoyed his pecan pie.
Here’s the thing though. I remember him sharp as a tack. One of the sharpest men I’ve ever met. Always ready with a quip and a good-natured barb. When I say to people that my dad was a professor, his dad was a professor, and his dad’s dad was a professor, and that’s why I had to be one, he’s the one in the middle of all of that.
I still remember a conversation that we had more than 30 years ago. We were sitting in his kitchen on the old family farm. He was listening to a classical Spanish guitarist—I believe it was Segovia, considered the father of modern guitar. Someone brilliant and talented. I, in my 17-year-old glory and brilliance, wandered in and explained how the guitarist in the latest metal band I was listening to was clearly more talented than whoever this character was. And, like everyone at that age, I was sure I was right.
But here, instead of the quick barb, he was kind. Yes, he advocated for Segovia, but gently. I’ll never really forget this moment. It has basically made it on to my Mount Rushmore of “moments that should keep you humble and allow you to be kind to others instead of feeding your big dumb ego.” It might seem silly, but I think about this small moment often. I’m still, all these years later, a bit embarrassed by it.
What I saw tonight made me incredibly sad. Others said, “Oh, he is on the ball tonight.” “Oh, he’s doing well.” Not me. I did get to share that moment from 30 years ago with him. I’d never been able to apologize—to own up to my hubris. I tried to tonight, but I could tell that he wasn’t completely following. At least, the words have been said.
I saw the diminishment. I saw the loss. I wish I didn’t. I’d like to understand better the folks who see what is left and can treasure it and appreciate it. I’m uncertain as to my feelings. Am I mis-calibrated? I just ache for what is gone. What does that make me?
The experience made me think harder about what it means to be made in the image of God (Gen 1:26–27), to truly be imago Dei. What does Christian theology have to say about diminishment, loss, and dignity?
This led me to perhaps one of the seminal works on this topic, John Swinton’s Dementia: Living in the Memories of God.[1] In it, he argues that regardless of whether we remember, God remembers. In the Old Testament, God is constantly remembering his people: God remembered Noah (Gen 8:1); God remembered Rachel (Gen 30:22); God remembers his covenant with his people even in their disobedience (Ps 106:45). He knows us literally before we existed: “Before I formed you in the womb I knew you” (Jer 1:5, NIV). He clearly and emphatically does NOT forget his people: “Can a mother forget the baby at her breast and have no compassion on the child she has borne? Though she may forget, I will not forget you! See, I have engraved you on the palms of my hands” (Is 49:15–16). This carries on into the New Testament—we are “known by God” (Gal 4:9). This is an encouragement to me—our memory is not the critical one, God’s is. And God is good.
I came to faith at a later age than many, and for me it was an intellectual journey—Tim Keller’s analytical framework and C. S. Lewis’s philosophical and logical underpinnings were crucial in the wrestling that brought me to faith and belief. So, the life of the mind is no small thing for me. I’ve written in other places that the faith had to be intellectually coherent to me before I could come all the way in the door. “I think, therefore I am.” I’ve referred to this myself. Swinton argues that this simply goes way too far, coining the term cortextualism to describe the modern belief that the cerebral cortex is the seat of personhood.
Are we only our cerebral function, or are we something more? Swinton argues personhood has five elements—dependency, embodiment, relationality, woundedness, and love—and that none of them depend directly on our own memory. What does Swinton mean by these five elements? Dependency challenges our culture's worship of autonomy—to be human is to need others, and my grandfather’s increased physical dependency doesn’t diminish his personhood, it reveals what was always true. Embodiment means personhood isn’t trapped in cognitive function—it’s expressed through the entire organism interacting with the world. My grandfather’s trembling unwinding into the chair, his careful navigation with the walker, these aren’t signs of diminished personhood but of embodied personhood adapting. Relationality insists that personhood exists in relationship—when he sat with us enjoying pecan pie, sharing Christmas stories, he was still relational even if he couldn’t always follow the conversation. Woundedness acknowledges we’re all broken and living in a fallen world; dementia is one form of the vulnerability we all share. And love—the capacity to love and be loved persists even when cognition fails, visible in his gladness at being with family despite the hubbub he feared.
This resonates deeply with me. I’ve spent the last several years of my career arguing for an approach to engineering that incorporates relational skills and Christ-centered purpose. In other words, that the Greatest Commandment (Matt. 22:37–39)—stated simply, to Love God, Love People—is integral to engineering. And here Swinton is arguing that these things are in fact the fundamental markers of personhood itself—this is familiar and comforting ground to walk on.
I’ve used language in the past such as “He isn’t really there anymore.” This dive has led me to the firm conviction that I must stop doing this—it is harmful to me and to my grandfather. He is there, whether cognitively diminished or not. He is God’s child and always will be, and will always be fully formed in the mind of God, even if the dust of which he is made in the brokenness of creation is beginning to blow away. Rather than an either/or framing, I think a more helpful posture, as in so many other aspects of my Christian walk, is the both/and framing. Yes, I can and should lament the loss of some of his God-given intelligence, wit, and sharpness. This grief is real and can be holy. But his worth, his dignity? Those are unchanging, unshakable.
This has powerful implications on how we make end-of-life decisions, advance directives, even how we structure assisted living. This cuts away arguments such as those by Australian bioethicist Peter Singer, who defines personhood as requiring rationality and self-consciousness—leading him to argue that severe dementia removes personhood and can morally justify euthanasia. This seems to be the endpoint of cortextualist thinking. My grandfather needs to be cared for as a precious child of God, and our family needs to plan for this. If assisted living is necessary, we need to select a facility that can meet him where he is—in his embodied state, in his dependency—while nurturing relationality. That can view dementia as one more form of woundedness rather than pure deficiency. That treats him with love.
So, the next time I see my grandfather, I’ll be keeping these thoughts top of mind. Perhaps I’ll be better able to see in him the image-bearer: to relax into the relational, to treat him with love while honoring the grief that I carry for some of the intellectual might that is gone.
References
[1] John Swinton, Dementia: Living in the Memories of God (Eerdmans, 2012).