Pink Elephants on the Wall

I was reminiscing this morning about medical school and some of my psychiatric training.

I clearly remember the first day of my psychiatric rotation in medical school. It was my last rotation in my final 4th year. and knew by that time that psychiatry was the field for me. I felt anxious and excited when I walked into the hospital that morning. I met the attending psychiatrist who was assigned to me. Without further ado, we immediately went onto the locked ward to make morning rounds. He said, “Don’t worry. You’ll be fine. You’re training starts now. You’ve learned a lot of theory in the books, but this is where it’ll start for you.” I never had been on a locked psychiatric unit before. I felt apprehensive but not totally frightened. Short of 5 minutes on the unit, we discovered one of his patients sitting in a wheelchair in the middle of the hall. She looked to be in her 70s. Well made up. Hair curled. And pretty. She was energetic and animated given my internal concept of what “old” people were supposed to be like.

The Dr. began to speak with her. She smiled warmly and it appeared that she totally understood him. Then she spontaneously looked over at the right side of her to the wall and stated, “Oh, yes. I totally understand what you mean. Aren’t those pink elephants up there on the wall pretty? I think they are playing. Let’s go over and look at them.”

I began to feel up with tears not knowing exactly what I was feeling. Being an astute man, the Dr. took me into a side staff room and sat down with me. He said, “I can already tell that you are going to be an excellent psychiatrist just by your reaction. But, I need to remind you of something. You’re going to see, hear, feel and experience more things in this field than you ever imagined—more than most people could ever dream or think of during their entire life. So, you can either laugh or cry. One of the two. For your own insanity during your career, you must learn to laugh. Otherwise, you’ll burnout and never last. It’ll take some time to learn to laugh but it will protect you in the long run. (And, yes. Humor is the 2nd best defense mechanisms out of over 30 of them. I don’t think we use it enough with patients with dementia and their caregivers.)

As I ponder this now, I would be highly convinced that she suffered from Lewy Body Dementia (LBD) since seeing non-existing animals and people can be a pleasant experience. This is one of the features that is different than Alzheimer’s disease.

Just think. Few people know about Lewy Body disease now in 2009. Imagine the little information that even neurologists knew back in 1977!

As I type this, I am reminded of how I saw pleasant flying peace doves, my dog, and other playing animals at the bottom of my bed last at the end of 2007 while in the hospital being evaluated for LBD.

So let’s use some humor. I laughed a lot when I tried to answer these questions…………I hope you do too!

Take the test presented here to determine if you’re losing it or not. The spaces below are so you don’t see the answers until you’ve made your answer. OK, relax, clear your mind and begin.

1. What do you put in a toaster?
Answer: “bread.” If you said “toast,” give up now and do something else. Try not to hurt yourself.. If you said, bread, go to Question 2.

2. Say “silk ” five times. Now spell “silk.” What do cows drink?

Answer: Cows drink water. If you said “milk,” don’t attempt the next question. Your brain is over-stressed and may even overheat. Content yourself with reading a more appropriate literature such as Auto World. However, if you said “water”, proceed to question 3.

3. If a red house is made from red bricks and a blue house is made from blue bricks and a pink house is made from pink bricks and a black house is made from black bricks, what is a green house made from?

Answer: Greenhouses are made from glass. If you said “green bricks,” why are you still reading these??? If you said “glass,” go on to Question 4.

4. It’s twenty years ago, and a plane is flying at 20,000 feet over Germany (If you will recall, Germany at the time was politically divided into West Germany and East Germany). Anyway, during the flight, two engines fail. The pilot, realizing that the last remaining engine is also failing, decides on a crash landing procedure. Unfortunately the engine fails before he can do so and the plane fatally crashes smack in the middle of “no man’s land” between East Germany and West Germany . Where would you bury the survivors? East Germany, West Germany, or no man’s land”?

Answer: You don’t bury survivors. If you said ANYTHING else, you’re a dunce and you must stop. If you said, “You don’t bury survivors”, proceed to the next question

5. Without using a calculator – You are driving a bus from London to Milford Haven in Wales . In London, 17 people get on the bus. In Reading, six people get off the bus and nine people get on. In Swindon, two people get off and four get on. In Cardiff, 11 people get off and 16 people get on. In Swansea, three people get off and five people get on. In Carmathen, six people get off and three get on. You then arrive at Milford Haven.What was the name of the bus driver?

Answer: Oh, for crying out loud! Don ‘t you remember your own name? It was YOU driving the bus.

If you’d like to receive an email whenever I publish a post on the blog click here: Get an email to “A Diary of a Psychiatrist with Lewy Body Dementia (LBD)”



A Serious Comment along with some Dementia Humor

I noticed this in the comment section. It’s from Hope Stewart in Petaluma, CA. I am deeply touched by Hope’s courage and strength for reaching out for help and advice. I, alone, feel that I would be doing her a disservice by trying to answer this. Yes, I know all the textbook things to say. However, I think she needs some real practical advice and suggestions from other caregivers at this crucial time in her life…………to all my readers. Please read her comment seriously and then contribute your thoughts and advice at the bottom of this post where it either says, “NO COMMENTS” or “3 COMMENTS“, etc. Click on that button and go to the end of all the comments and post some pearls of wisdom in the REPLY box. On behalf of Hope, I’m thanking you in advance.

Well, I want to test your resolve and see if you will respond to my email.I have e mailed you privately in the past and now ask for your advise on how to accept this disease. My husband Gordon is in an Altzeimer’s study at UC Davis and was diagonsed with Lewy Bodies 5 years ago. His evaluation yesterday gave me sad news. He has deteriated greatly in the past year. (poor executive skills, cognitive skills, no adl’s. They told me that usually a persons rate of deteriation is a predicter of what is to come. They said his is in the moderate/severe stages of Lewy Bodies. I’ve been going along with acceptance of “what is”. but now I’m sad and crying and scared. Any words of advise from you, a psychiatrist?

So glad your new year is starting off with good news.

Best, Hope Stewart

To the best of my knowledge, no one chose the correct answer from this block puzzle the other day. If anyone did, they didn’t make a comment on it.

One of the best ways to deal with the painful reality of dementia is to use some humor. If anyone gets angry with me, that’s OK. I did horribly worse when I took my first neuropsychological test! I can laugh at myself even though it is sad.

Three older men are undergoing a memory test at the doctor’s office.

The Doctor asks “What is three times three?”

The first man answers “274.”

The second man answers “Tuesday.”

The third man answers “Nine.”

The doctor pleasantly surprised at the third man’s
correct response, inquires “Great! How did you get that

“Simple. Just subtract 274 from Tuesday.”

Someone wanted me to post a picture of me after my comment yesterday about trying to visualize people. If you look under the comment sections of some of the posts, there should be a small picture of me when I’ve made a comment.

Warmly………….David Thomas

Using Laugher and Jokes to Cope with Forgetting and Confusion

I had to laugh at myself the other day. Pam and I came home from grocery shopping. I went to the mailbox for the mail. I remember saying, “Oh, Chad got a movie today from Netflix. I had the mail in my hand and began to unload the groceries bags from the trunk. I brought them all into the house and put them in the kitchen. Pam put the groceries away without further ado.

Later that day, Pam asked me where I put the mail. I remember looking at her strangely and having a disconcerted and stupefied feeling. “I don’t know. I had it in my hand. I remember telling you that Chad’s movie came.” She agreed. But where was the mail? I had a total loss of memory. It was a different feeling than when I normally forget something and know that I’ll eventually find it. Different that a temporary thought block.


We searched and searched. I went outside in the blowing wind and snow to recheck the mailbox. I looked in the car. Trunk, front seats, back seats, under the seats, in the glove department. Perused the driveway and front walk tracing my tracks I used when unloading the groceries. We looked at every possible place that we could think of when we bring groceries into the house. In cupboards, in the garbage, in the refrigerator. I felt guilty. A bad boy. My fault. I deserve to be punished. And I’m not even a Catholic!  icon_lol1


I won’t hammer the point. Finally Pam checked the spare bedroom. There was a WalMart bag with some candy tins she bought but never took them out of the bag. Bet you can’t guess where I put the mail?!?!


To this very moment, I do not remember placing the mail into any bag! It’s been bothering me since if feels like an alcoholic blackout — never to be retrieved from memory again. But I have to laugh about it. I can write a blog on the computer and navigate websites but yet had a moment of forgetting and confusion. It surely doesn’t make any sense. At this point, I am not even going to try to analyze it.


Speaking of humor……………here’s a cute one.


A new pastor moved into town and went out one Saturday to visit his parishioners. All went well until he came to one house. It was obvious that someone was home, but no one came to the door even after he had knocked several times. Finally, he took out his card and wrote on the back: Revelation 3:20 and stuck it in the door. The next day, as he was counting the offering he found his card in the collection plate. Below his message was the notation Genesis 3:10. Revelation 3:20 reads: “Behold I stand at the door and knock. If any man hear my voice, and opens the door, I will come in to him, and will dine with him, and he with me.” Genesis 3:10 reads: “And he said, I heard thy voice in the garden, and I was afraid, because I was naked.” 
A new word I learned today:

Lucullan \loo-KUHL-uhn\, adjective:   rich; magnificent and luxurious


Quote of the day:

The person who knows how to laugh at himself will never cease to be amused.(Shirley MacLaine)


Saturday November 8, 2008


Dear Blog:


Chad’s been on vacation this past week. The 3 of us took a little out of town daytrip to Western NY yesterday. A nice relaxing fun day. We came home to a large envelope in the mail from Edward G. Rendell, the Governor of Pennsylvania. I had written to him about November being National Caregiver’s Month. He sent a signed official statement Proclamation on parchment paper with an original gold embossed seal. I’m glad he has recognized the need to acknowledge caregivers around the State. My email to him didn’t go in vain.


This morning I learned that the White House is home to a swimming pool, a bowling ally and a movie theater.


I’ve received copious emails from caregivers of friends, family members and loved ones suffering from one type of dementia or another. The positive message from the majority of them is that they’ve been helped from the October 30th blog. I’m going to post that page again today.


Asking for help is a sign of strength, not weakness, because it is an acknowledgement of the difficulty of the situation at hand. Sometimes that is not always an easy thing to do; however, we owe it to ourselves and our families to really try. You will both be better off if you learn to:


  • Put guilt aside.
  • Overcome negative self talk and insecurities.
  • Ask for the help you need and accept help that is offered.
  • Recognize and accept that you have a RIGHT to time off.

It has been said, “It takes a village to raise a child,” the same holds true for family caregiving. It is far too important of a job to go it alone. Reach out and ask for HELP!

National Family Caregivers Month (NFC Month) — observed every November — is a nationally recognized month that seeks to draw attention to the many challenges facing family caregivers, advocate for stronger public policy to address family caregiving issues, and raise awareness about community programs that support family caregivers. It is a time to thank, support, educate, and advocate for the more than 50 million family caregivers across the country.

Top 10 Ways to Celebrate National Family Caregivers Month 2008

There are many ways to celebrate family caregivers and to take action and communicate the important messages of NFC Month. The following are ideas and guides to help you create a successful National Family Caregivers Month in your community:

  1. Offer a few hours of respite time to a family caregiver so they spend time with friends, or simply relax.
  2. Send a card of appreciation or a bouquet of flowers to brighten up a family caregiver’s day.
  3. Encourage local businesses to offer a free service for family caregivers through the month of November.
  4. Participate in the National Family Caregivers Association’s FREE national teleclass to learn how to communicate more effectively with health care professionals. The 2 free one hour sessions will be November 6 and 13 at 2 p.m. ET. For more information Click here.
  5. Help a family caregiver decorate their home for the holidays or offer to address envelopes for their holiday cards.
  6. Offer comic relief! Purchase tickets to a local comedy club, give a family caregiver your favorite funny movie to view, or provide them with a book on tape.
  7. Find 12 different family photos and have a copy center create a monthly calendar that the family caregiver can use to keep track of appointments and events.
  8. Offer to prepare Thanksgiving dinner for a caregiving family in your community, so they can just relax and enjoy the holiday.
  9. Take a few minutes to write a letter encouraging your mayor, county executive, or governor to issue a local proclamation establishing November as National Family Caregivers Month. Contact information for state government officials can be found at
  10. Help a family caregiver find information and resources on the internet or to locate a local support group.

Do you know that family caregivers provided more than 306 billion dollars of caregiving services each year, helping chronically ill and disabled loved ones deal with life’s basic functions? Do you know that 78% of seniors that need care receive it from family members, over 80% of all homecare services are provided by family, and that businesses lose as much as 34 billion annually due to employees’ need to provide care for loved ones 50 years of age and older?

This is the perfect time for a story about family caregivers and the contribution they are making to our community. This story will speak to everyone because today the concerns of caregivers have moved from being a private family situation to a societal issue. Today policy makers, employers, insurers, and healthcare professionals are all addressing these issues.

Use humor with people around you — it will make you laugh and your spirit will bloom!





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