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Losing It Staging the Cultural Conundrum of Dementia and Decline in American Theatre Dorothy Chansky
Losing It “Losing It is a comprehensive, interdisciplinary, and evocative look at representations of dementia on the American stage from the early 1900s to today. Chansky demonstrates how the stories and characters onstage evolve alongside the medical research, making the stage a place to think with the changing conceptions of cognitive impairment.” —Amy Cook, Associate Dean for Research and Innovation, College of Arts and Sciences, Stony Brook University, USA “Dorothy Chansky, one of the foremost historians of modern American drama, demonstrates once again her ability to work at the cutting edge of the discipline, bringing her considerable skills and insight to bear on the ways that theatre – and the society around it – struggles to comprehend the phenomenon of cognitive decline.” —Henry Bial, Professor and Chair, Department of Theatre and Dance, University of Kansas, USA “Losing It exemplifies the best of contemporary theatre scholarship, advancing the study and practice of theatre while offering profound implications for society at large. Its authority stems from Chansky’s broad and deep knowlege of her subject, keen critical insight, aesthetic training and gifts, communicative skill, and lived experience. It is a clarion call, not only to theatre-makers, but also to all human beings to think and act differently about living with dementia and caring for those living with dementia.” —Cheryl Black, Curators Distinguished Professor Emerita, University of Missouri, USA “This masterwork integrates deep discussions of plays about dementia, their historical contextualization, and research on views of these illnesses, including discussions of current work (and arguments) about treatment. Chansky’s interweaving of the research with meticulous investigations of the plays and how they “work” not only illuminates the plays themselves, but also, possibly more significantly, reframes how we might understand dementia and its meaning for those experiencing it and their loved ones.” —Rhonda Blair, Professor Emerita, Meadows School of the Arts, Division of Theatre, Southern Methodist University, USA “Dorothy Chansky presents a well-researched, meticulous argument. A play about dementia needn’t be a horror story. Instead, it can amplify a simple truth about living with dementia – in order to be our individual selves, as person or caregiver, we need each other – and then generalize that truth to the lives of vast audience of the not-yet-ill and not-yet-caregivers. Writers, directors and actors – heed this compelling call to action!” —Jason Karlawish, author of The Problem of Alzheimer’s: How Science, Culture and Politics Turned a Rare Disease into a Crisis and What We Can Do About It, University of Pennsylvania, USA
Dorothy Chansky
Losing It Staging the Cultural Conundrum of Dementia and Decline in American Theatre
Dorothy Chansky Professor Emerita, School of Theatre and Dance Texas Tech University Lubbock, TX, USA
ISBN 978-3-031-20901-7 ISBN 978-3-031-20902-4 (eBook) https://doi.org/10.1007/978-3-031-20902-4 © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Cover credit: The painting is Fading by Terry A. Bennett This Palgrave Macmillan imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
In loving memory of Terry A. Bennett
Acknowledgements
My debts are many; my words will be few. This book was completed thanks to a yearlong fellowship at the Penn State Humanities Institute. The fellowship came about through the recommendations of Jeanmarie Higgins and Bill Doan, to whom I will always be grateful. Genevieve Durham DeCesaro, Interim Dean of Texas Tech University’s J.T. & Margaret Talkington College of Visual and Performing Arts, helped facilitate my being approved for the yearlong leave. Additional financial support for the fellowship year came from Texas Tech’s Office of Research and Innovation and Vice President Joseph Heppert. As well, I thank the Office of the Provost at TTU for an earlier one-semester faculty development leave and W. B. Worthen of Barnard College for recommending me for Visiting Scholar status at Columbia University, which enabled me to use that institution’s library resources during summers and breaks over a two-year period. As I have said in the acknowledgments of other work, “I have always depended upon the kindness of librarians.” For this project, these include John Calhoun, Jennifer Eberhardt, Sarah Finn, Daniel Lee, Juli McLoone, Jeremy Megraw, Rob Weiner, and Kevin Winkler. I also thank indexer extraordinaire Brian M. Benoit for locating more newspaper articles, photos, reviews, and squibs than I could ever have imagined were out there and for cheering me on as I used them. Many people shared resources with me, read and commented on parts of this work, and otherwise offered information and support.
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ACKNOWLEDGEMENTS
Thanks to Sara Back, Maralyn Billings, Cheryl Black, Sam Burstein, Edward Chansky, John Christman, Amy Cook, Thierry Dubost, Ted Dykstra, Margaret Elbow, Helene Foley, Rabbi Deborah Goldmann, Bruce Hermann, Emeline Jouve, John Macdonald, Scott Magelsson, Steven Mancuso, Sarah Clark Miller, Cory Norman, Veronica O’Keane, Cecelia Riddett, DayDay Robinson, Cindy Rosenthal, Carol L. Shapiro, Magdalena Szuster, Noam Tirosh, Sarah Tracy, Alec Lee Williams, and Steve Wood. The Translation, Adaptation, and Dramaturgy Working Group of the International Federation for Theatre Research was a valuable forum for presenting and getting feedback on portions of this work. My graduate research assistant, David Priebe, did major heavy lifting with endnotes and the bibliography, and his software abilities saved the day (mine) more than once. Lionel Zevounou, my officemate at the Penn State Humanities Institute, talked to me about dementia treatment in Africa and was always a wonderful interlocutor about all things citational and archival. Foremost, he helped me up my French game. That celebratory dinner in Paris awaits when both of us see our projects in print. An earlier version of chapter four appeared in Modern Drama in Volume 65, Issue 1 (Spring, 2022) as “Alice Brown Takes on Social Insecurity: Joint Owners in Spain.” Finally, I will never be able to repay my debt to my late husband’s extraordinary caregivers. They made it possible for me to continue to work in the face of his dementia and they opened my eyes to the reality of their work. Thank you, Maribel Mosquera DeLeon, Piedad Graciano, and Jayne Rogers.
Contents
Part I Orientation 3 9
1
Introduction Organization of the Book
2
Dementia, Alzheimer’s, Age: Intersectionalities and an American Context
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Bodies in the Audience/Bodies Onstage: Intersectionalities
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3
Part II Social Insecurity 4
Walk-On: Joint Owners in Spain Joint Owners: Dramaturgy and Depictions Dementia In Situ Critical Reception(s) Ladies First. Or Last.
55 56 59 62 66
5
Supporting Role: All the Living The Moment/The Medicine/The Men Dramatization and Its Discontents Reading Embodiment The Next Steps
77 79 83 89 95
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CONTENTS
Willy Loman Center Stage Doctors’ Dilemmas Seeing Is Believing/Believing Is Seeing Home. Free.
105 107 111 120
Part III Taking It Personally 7
From the Inside Brain Crash “I Am an Archive”
129 131 142
8
Inside (and) Out: “Who Exactly Am I?”—The Father
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Part IV Human. Resources. 9
Memory. Loss. Or, Understanding Memory (for Dummies) Understanding Memory (for Dummies)
171 175
10
Family Affairs Sign on the Dot(ty)ed Line Brief Me on This
187 187 200
11
Ready for Prime Time: Marjorie Prime
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12
Cellular Data Cellular Data on the Public’s Radar
225 228
13
No. Regrets. Wav(erly)ing Goodbye Humans. Resources.
241 241 255
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Who Cares?
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Works Cited
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Index
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List of Figures
Fig. 4.1
Fig. 4.2
Fig. 5.1
Fig. 6.1 Fig. 7.1
Fig. 7.2 Fig. 8.1
Fig. 10.1
Fig. 13.1
Joint Owners in Spain, Chicago Little Theatre, 1913 (Photo courtesy of the Special Collections Research Center, University of Michigan Library) Joint Owners in Spain, Drama League of Milwaukee, 1932 (Photo appeared in the Milwaukee Journal, March 29, 1932. Courtesy of the Milwaukee Public Library) All the Living, 1938. John McKee as Old Man Adams (Photo courtesy of New York Public Library, Lincoln Center Branch for the Performing Arts) Death of a Salesman, 2022. Sharon D Clarke, Wendell Pierce, and Khris Davis (Photo © Joan Marcus) Constance Cummings in Wings, 1978 (Photograph by Bill Smith. Courtesy of New York Public Library, Lincoln Center Branch for the Performing Arts) Peggy Shaw in Ruff at LaMama (Photo © Lee Wexler) The Father, Texas Tech University School of Theatre and Dance, 2019. Kaylee Underwood as Laura and Justin McKean as André (© Allison Roberts) Dot, Vineyard Theatre, 2016 (Pictured, left to right, Marjorie Johnson [Dot], Finnerty Steeves [Jackie], Sharon Washington [Shelly], Michael Rosen [Fidel], Stephen Conrad Moore [Donnie], and Colin Hanlon [Adam]. © Carol Rosegg) The Waverly Gallery. Josh Hamilton as Daniel and Eileen Heckart as Gladys, 1999–2000 (Photo © Carol Rosegg)
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134 145
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197 244
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LIST OF FIGURES
Fig. 13.2
Fig. 13.3
The Humans, Pittsburgh Public Theatre, 2017 (Pictured, left to right, Valeri Mudek [Brigid], J. Tucker Smith [Erik], Cecelia Riddett [Momo], and Charlotte Booker [Deirdre]. © Michael Henninger) The Humans, Pittsburgh Public Theatre, 2017 (Cecelia Riddett as Momo. © Michael Henninger)
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PART I
Orientation
CHAPTER 1
Introduction
Theatre has been presenting characters in varying stages of cognitive decline as far back as the fifth century BCE, when Sophocles penned an Oedipus starting to lose it at Colonus, displaying frailty, inattention to personal hygiene, querulousness, anger, suspicion, imperiousness, and dependence.1 Any study of dramatic depictions of slippage in memory and reasoning inevitably includes more than a passing glance at King Lear, whose questionable judgment, stubborn refusal (or inability) to recognize changed circumstances, tantrums, and puerile selfishness constitute a checklist of signs of early dementia. Lear is an obstreperous example of a prelude to the last of Shakespeare’s seven ages of man, “second childishness and mere oblivion.”2 The eponymous Everyman (late 1400s) offers a clear roadmap of steady decline. First, he is unable to hold on to friends or property; later phases include loss of youthful or even just healthy appearance; finally, he is bereft of his “five wits,” stepping into the grave as an embodiment of the extreme end of Shakespeare’s seventh age, “sans teeth, sans eyes, sans taste, sans everything.”3 At least one scholar has pointed out that three of the four characters in Waiting for Godot suffer from memory impairment, noting that although “Beckett never specifically identifies Estragon’s cognitive impairment, his depiction of early to mid-stage Alzheimer’s disease is accurate.”4 Willy Loman, the salesman who takes his own life so his heirs can cash in on an insurance policy, is probably the twentieth century’s best known dramatic exemplar of a © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 D. Chansky, Losing It, https://doi.org/10.1007/978-3-031-20902-4_1
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condition that today might be identified as Mild Cognitive Impairment (MCI), broadly defined as “an intermediate state between normal cognitive aging and dementia.”5 In all of these instances, however, the “it” being lost is not only some combination of cognitive and physical functioning; it is also the person as s/he was known to society and family and who is seen increasingly as not just ill, but even gone. It is also the capacity of onlookers to cope or sometimes even to imagine what coping would look like. This book proposes to do three things. Foremost, it historicizes representations of dementia and decline on the mainstream (with a couple of exceptions) American stage, connecting a little over a century’s worth of plays featuring characters in cognitive decline to the medical, social, and legal aspects of healthcare and elder care that made and make them legible to audiences whose metric for theatrical appeal has largely been realism, acknowledging that realism is a capacious category.6 The cultural milieu in which a particular play is written and presented is crucial to its power as a piece of theatre. This history, however, is not only a chronicle of what came before us; it is also meant as a guide to the cultural DNA that is our legacy and is still discernable in our policies and attitudes concerning dementia. Second, the book considers links between dementia—a neurological but also a social condition—and age, with a focus on how these are presented onstage. Most but not all people who suffer from dementia are what are politely called senior citizens, hence arguably doubly stigmatized, both for their debilitating disease and for their culturally “dissed” stage in life. But ideas about age and aging can also be historicized. If a seventh decade of living was once a relative rarity, and one often spent with little help for health developments now recognized and often easily manageable, recent decades have spawned phrases such as “sixty is the new forty.”7 To concretize the presence of seniors under discussion throughout this study, in 1910 people in the United States sixty-five or older represented just 4.3% of the population; by 1970 that percentage had grown to almost 10%; in 2016 over-sixty-fives were 15% of the populace, and the Population Reference Bureau projected a rise to 23% by 2060.8 Numerically, this means going from fifty-eight million seniors in 2021 to eighty-eight million by 2050.9 Finally, Losing It insists on the importance of bodily presence in theatrical representation. The bodies in question are those of both actors and audience members. On each
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side of the footlights, the collections of bodies are typically multigenerational (“multitemporal” is the term proposed by narratologist Peter J. Rabinowitz) and sometimes multi-class; they are also multi(ply)-abled.10 Occasionally they are multi-ethnic, but, importantly, they are often pointedly not so. Whose sympathies are being solicited, by what means, and to what political ends? And whose stories are not being told? As the Baby Boom generation—those born between 1946 and 1964— travels through its senior years, it is unsurprising that plays about dementia, decrepitude, post-stroke disability,11 caregiving, and identity as inflected by some instance of one or more of these have become an increasingly significant presence on the American stage, although this book also discusses plays from earlier eras. Recent plays speak to the anxieties Boomers experience as many become caregivers for their parents, most of the latter born in the 1920s and 1930s. One 2016 source notes that “the number of Americans older than eighty-five has risen more rapidly than any other demographic.”12 In a phenomenon dubbed “boomerang seniors,” people who are themselves seniors—some even in their eighties—are having to care for parents in the category called the oldest-old.13 And Boomers, who constitute the rising cohort of elders, may recognize signs of dementia in themselves. Almost without exception, dementia is greeted with fear. A 2007 essay baldly labels Alzheimer’s disease, the best known of the dementias, “the most dreaded condition that faces the aging population in the twenty-first century.”14 A nuanced discussion of the current fear of Alzheimer’s (really any dementia) is presented in Jason Karlawish’s 2021 The Problem of Alzheimer’s in a chapter called “Existential Dread.”15 Although Alzheimer’s accounts for a majority of all dementia cases, it is neither the only cause of cognitive decline nor itself fully understood either in the worlds of medicine or social work, much less in the minds of the general public.16 It is also sometimes erroneously used as a catchall for dementia, a phenomenon that points to the ignorance surrounding most iterations of the portmanteau condition. In other words, “dementia” is the umbrella term for a “syndrome that can arise from many causes.”17 Other causes of dementia include head injury, stroke, diseases besides Alzheimer’s, extreme misuse of drugs or alcohol, or a brain tumor. I return in the next chapter to discussing dementia as a capacious category and to historicizing Alzheimer’s, the Goliath of its constituent disease causes. I also discuss below, in Chapter 3, and throughout the book, the grounds on which audiences, as culturally and historically situated
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subjects, understand or misunderstand and accept or reject what they are offered onstage about any dementia. Mainstream plays presenting characters in cognitive decline do so via scripted relationships generally featuring conflict and as products intended for consumption in a social context, i.e., typically in a playhouse in the presence of others. Hence, probable public awareness—distinct from medical or scientific expertise—on the part of playgoers experiencing these works inflects my analyses of them just as it inflects said playgoers’ reception strategies, strategies shaped by playwrights, directors, actors, designers, and publicists, among others. Some of the recent plays motivated by the experience of and/or anxiety about dementia depict helplessness, incontinence, pressures on middleaged family members, and dottiness in the elderly. Indeed, one such play—Colman Domingo’s 2016 Dot (discussed in Chapter 10)—puns on the very word, via its common use as a nickname for Dorothy. As these plays become more common, variations on the theme open new ways of theatricalized seeing. In 2016 alone, besides Dot, at least four other plays featuring people with dementia, their family member caregivers, and their challenges played on major New York stages. The “family caregiver play” came in several styles and colors, although nearly all feature spouses and children whose own problems and frustrations usually upstage those of the character with dementia.18 The needy, depressed caregiver might be a description of the adult daughter of a soon-to-die octogenarian in Marjorie Prime (by Jordan Harrison, discussed in Chapter 11); the twin adult children in Our Mother’s Brief Affair (by Richard Greenberg, also discussed in Chapter 10) are self-absorbed caregivers; the daughter in The Father (by Florian Zeller, translated by Christopher Hampton, discussed in Chapter 8) is a beleaguered, frustrated caregiver; the sixtyish couple in The Humans (Stephen Karam, discussed in Chapter 13) are resigned caregivers. Neediness leads to suicide; self-absorption means wanting—or trying—to rewrite the elder’s own story to better jibe with the Boomers’ view of their own world as well as of their parent; beleaguered is presented more than addressed in a play about the “tragedy” of the never-very-nice father; resignation yields stasis, and it is a tossup whether this stuckness is acceptance or denial.19 Kenneth Lonergan’s 2000 (publication date) The Waverly Gallery (running in New York in 1999–2000 and again in 2018–2019 and discussed in Chapter 13) pulls no punches in depicting an octogenarian sliding from forgetfulness to panicked incoherence, as her family feel helpless, resentful, and lost. Here the family member caregivers combine self-absorption, impatience, financial concerns, beleagueredness,
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and resignation, all in the context of having been written as very recognizable stand-ins for a particular New York theatergoing demographic: educated Manhattanites with successful careers, large apartments, vacation homes, and a sense of themselves as sophisticated. In the plays described above, the characters who suffer from dementia are depicted in ways that focus largely on the sadness or frustrations of their families and perhaps on their past glories rather than on their present experiences. Two of the plays I discuss, Arthur Kopit’s 1978 Wings and Peggy Shaw’s 2013 Ruff (both in Chapter 7), address cognitive decline from the perspective of a post-stroke patient undergoing cognitive and physical disruption necessitating hospitalization. (Stroke is the second most common cause of dementia, after Alzheimer’s Disease.)20 Not all strokes lead to dementia. This is discussed at greater length at the start of Chapter 7. Zeller’s The Father is a hybrid, with a deceptively straightforward story problematized by introducing the perspective of the character who is living with rapid cognitive decline. Furniture disappears. Multiple actors play the same characters. The dementia-ridden André fails to recognize his daughter or her fiancé. The play anticipates audience confusion, withholding any direct explanation for the “replacement” actors. Theatre lags behind the novel and the memoir in showing us dementia from the inside.21 All genres mostly give short shrift to the perspective(s) of paid caregivers, who can either be left in the margins or offstage, presumed to be satisfied (because paid?) or emotionally relatively untouched (because professional?) or simply overlooked by family members absorbed in their own woes. Two crucial relational axes—one between paid carer and person cared for and the other between paid carer and private payer— too often disappear as the worries of family members take center stage and the ill character becomes an object of pity or a blocking agent. An exception to this is the 1938 All the Living (Chapter 5), which is set in a state hospital, giving central narrative importance to the doctors, nurses, and administrators tasked with negotiating ideas about up-to-speed care while trying to placate elected officials and a largely uninformed public. A key supporting character with dementia has not only his own (brief) story but is an agent of change for another character with a different kind of mental health problem. If the symptoms and behaviors of dementia have been long as known as there has been a forum in which they might be depicted, why zero in on the past century’s American depictions? For that matter, why zero in on plays, when, as performed instances of narrative representation, movies
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have jumped into the fray, arguably with more detail and in greater closeup?22 The answer is not entirely about the quality of any of the plays in this study as literature, although a number are moving, poetic, and memorable, and several have won major prizes for their playwrights and actors in New York productions. Rather, it requires an interest in particular audience(s). Plays succeed because certain people want to see or read them, even if the works have short shelf lives. Thus, they are both conservable artworks (published texts, recorded performances, archived photos) but also consumer goods subject to the same fickle changes in style and taste as other products with price tags. This book, then, considers the social, medical, legal, and cultural conditions that have given rise in the United States to an interest in plays depicting dementia, decline, and caregiving. It also considers the cohort who pays money to see these plays and finds the depictions to speak to—and sometimes about—them. Thousands more people saw Julianne Moore portray a rapid slide into the throes of dementia in the 2014 movie Still Alice than collectively probably saw all of the plays about dementia that ran in New York between 2015 and 2019, but, while people who saw any of those plays may well also have seen movies depicting dementia, this study considers only staged plays. So, why claim that category as significant? Playgoers—an American minority since the days when movies took over from theatre as cross-class popular performed narrative entertainment23 —might be seen as models of American success and cultural desirability. When the American Dream, a slippery and complex idea, but the label for a perceived desideratum nonetheless, is proposed and marketed as an ideal, it is a dream already being lived by many in the theatergoing population.24 This status as a role model of sorts is not owing to any profound aesthetic wisdom or moral superiority to which theatregoers may or may not lay claim. It is ascribed because playgoers as a cohort or imagined community are more formally educated and have more disposable income than most demographically “average” citizens in the United States.25 They are frequently among the influential members of their communities—whether as teachers, so-called “professionals,” or even just people with more financial and material assets than others, who therefore receive attention and service. They are more likely than others to read the print publications that still publish theatre reviews (meaning they probably also read other parts of these publications, including advertising and editorials); it is reasonable to think that they are predisposed to send their children to college, support other arts, read serious literature
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and non-fiction, and possibly to run for and hold office. None of this is to say that they are deeply knowledgeable about what they consume at the playhouse, although many are, nor that insider knowledge possessed by what might be called theatre mavens makes those possessing it either farsighted or even adventuresome in their tastes. It is to say that American audiences for dramatic theatre are, for hegemonic reasons, a group taken seriously by educators, writers, artists, non-profits seeking thoughtful and influential supporters (ideally with money, although also as volunteers), and politicians seeking same, and whose opinions and values have leverage regarding what ends up being culturally canonized, hence included in curricula and often encoded as law.26 In the context of plays about or deploying situations inflected by dementia, anticipated—or at least hoped for—possible action on the part of anticipated possible playgoers is, I suggest, one of the things driving productions. On some level, one could say that all of the plays in this study are or were when they were new “political” in the sense that they have texts and production strategies that aim to spark thinking and/or challenge a way of seeing or understanding and thereby possibly lead to action, even if that action starts out simply as a shift in one’s own way of seeing.
Organization of the Book The three succeeding sections in which the book is organized are roughly (although not entirely) chronological and definitely thematic. The section following this one, Section II, “Social Insecurity,” features three plays written before 1950; it explores the world of caregiving before the advent of such governmental assistance programs as Social Security, much less Medicare and Medicaid, nor widespread Alzheimer’s awareness. The earliest play, Joint Owners in Spain (1913, Chapter 4), offers a character in the early stages of dementia as a walk-on, albeit one crucial to setting the plot in motion. The second, All the Living (1938, Chapter 5), needs its dementia-afflicted character to play a significant supporting role in its “how will it turn out?” activist plot. The final play, Death of a Salesman (1949, Chapter 6), puts the character who is losing it front and center, side by side with the one-woman support system on whom he depends. While the characters with dementia are on display in these three plays, acknowledgment of their condition by their playwrights is brief and circumspect, and it gets little attention as a medical issue. It gets no real attention as a public health issue. Although the characters with dementia
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might be regarded as unfortunate, their situations are accepted, perhaps because fewer people lived past what is now known to be the common threshold for developing dementia (sixty-five) and because most people with any kind of ailment were generally cared for at home. The second and third sections of the book present plays written after the arrival in the 1970s of the Alzheimer’s awareness and activism movement, dedicated primarily, although not exclusively, to raising money to combat dementia as a biomedical condition. The lead-up to and start-up of this movement is presented in Chapter 2 of this preliminary section of Losing It. Dementia moves away from being the disease that dare not speak its name. Two things are largely unspoken givens in these more recent plays. One is that dementia is an individual and not a public health issue; personal (or family) and private travails take center stage. The second is that caregiving remains a tremendous strain on families and that those who can afford help avail themselves of it, even as the “help” remains largely offstage or appears either as impersonal, although not unkind, employees in an institution that is the last stop in a slide into irrelevance, or as sometime assistance, but never as “enough” nor as experienced professionals outside a fully medical(ized) context. In Part III, “Taking It Personally,” I look at three plays whose optic is that of the character who is “losing it.” In the 1978 Wings (Chapter 7) the perspective for most of the play is that of a female stroke victim— a former aerial performer—whose aural and temporal reception are, one might say, scrambled, but no less potent than what is proffered intermittently as “normal” narrative. Ruff (2013, also discussed in Chapter 7) was performed and co-created by Peggy Shaw of the company Split Britches in the wake of her own stroke. Chapter 8’s The Father (2012 in France and 2016 in the United States) is a hybrid. It mimics a realist, observational, let’s-solve-the-problem-and-get-closure play but is troubled by the increasingly kaleidoscopic perceptions of its protagonist, whose grip on what is too often unproblematically called “reality” is shifting, as reflected in changing scenery and characters who may or may not be the people the main character says they are. While the script starts with the protagonist’s behavior leading his daughter to look for care solutions, and the final two scenes depict him in a nursing home, at least one production set the entire piece in the nursing home, suggesting that reading the not-always-logical action in a linear fashion might be an a priori category mistake.27
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Part IV, “Human Resources,” treats five twenty-first-century plays (although one opened at the end of 1999), all of which, in one way or another, present a personal “rock and a hard place.” Attempts at a solution appear in more than one of these plays, but they are temporary ones involving preserving the autonomy of a dementia sufferer in the early-to-middle phases of her illness. The plays offer a snapshot of how contemporary American theatregoers and critics understand and are willing to engage with representations of dementia. Chapter 9 discusses the workings of memory from both popular and medical perspectives and serves as an introduction to the analyses of the three plays in the following two chapters. The plays in Chapters 10 and 11, “Family Affairs” and “Ready for Prime Time,” try to answer characters’ questions about living with dementia; they make their cases both via their textual argumentation and via their status as blueprints for performance, and all three have been professionally produced. In Dot , Colman Domingo limns an upper-bourgeois African American woman holding on to her dignity as her dementia worsens. I mention her race because, for better or worse, this is the only dementia play I have found that ran in New York (among other places), got mainstream press, and features a specifically designated person of color as the character with dementia and rather than as a caregiver. I stress “designated” to head off at the pass the idea that some of the plays in this book could not be played by nonwhite actors even if their original casts were white. Domingo’s eponymous heroine lays out precisely the way she wants to be regarded and treated (“remember,” in this play, is an imperative or admonition) so that the people around her who wish her well and who visit will understand her terms for living meaningfully with her disease. And this play identifies her dementia specifically as Alzheimer’s Disease. While chatty and engaging, the play is ultimately didactic. Our Mother’s Brief Affair is almost a kind of “what really happened?” play. The adult children of a woman with what they think maybe Alzheimer’s (it is never named as a diagnosis and they speculate casually without ever investigating) try to piece together the “truth” of what went on in an affair she had decades earlier with a man who may or may not have been directly involved in the trial of Ethel and Julius Rosenberg. The frustrated siblings seek a definitive answer; the mother—whose memory may or may not be accurate—needs to tell her story her own way, a need that may, fifty years after the fact, be more important than her children setting to rest the question of whether her lover was a stooge, thereby gaining mastery over her story. Here, memory
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is a frustrating question of “accuracy” that does little to improve understanding or family relations even as it inspires interaction. Marjorie Prime is set in a future that looks like the present except for the presence of humanoids crafted via Artificial Intelligence and called Primes, which can be programmed and purchased to “bring back” a deceased person. The play opens with a dementia sufferer in her eighties chatting with a Prime in the form of her late husband. She has selected to have him programmed to be as he was in his thirties. This play uses dementia as a springboard to investigate how we regard, value, and use memory, with memories here being mostly the directly retrievable and rarely the inchoate or surprising. Again, these three pieces are united by their discursive power as texts, although in Dot especially, embodied behavior designed to elicit somatic, empathetic response is built in. Excepting in Dot, there is an absence of any discussion of policy or procedure for dealing with dementia as a culture-wide phenomenon and no engagement with public services. Chapter 12 provides an up-to-date but lay-friendly understanding of cultural and financial issues around dementia care in the United States. Chapter 13, “No. Regrets.” features two plays that put characters in the full throes of dementia center stage. In this sense, these plays differ from the three in Chapters 10 and 11 in that they cry out for performances and anticipate that the texts alone cannot do the heavy lifting. The Humans was a finalist for the 2016 Pulitzer Prize for Drama and won the 2016 Tony for Best Play as well as best performer awards for Jane Houdyshell and Reed Birney from the Drama League, the Outer Critics Circle, and (in the “featured” actor and actress categories) the Tony committee. The Tony Awards, established in 1947, are named for producer-actress Antoinette Perry and honor excellence in musicals and plays produced on Broadway each season. The Humans offers a rare look at the constraints of caregiving in a lower-middle-class family whose adult children with aspirations have no sense of how to help, nor, perhaps, any inclination to do so, even as the financially strapped parents lay out clearly the monetary situation in which they, and many Americans, find themselves. Both parents are working for low wages (in the father’s case hourly pay and not a salary) and between them they are unable to pay for eldercare, hence picking up the hands-on caregiving slack themselves. They are about to lose a house with enough room for a mother/grandmother who cannot care for herself. They patch together a life driven by necessity. This couple would be part of the American cohort who in 2019 gave 18.6 billion hours of care—worth $470 billion—to their families
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and friends with dementia.28 The fact that the generations in this play are on such different wavelengths may make it the most polyphonic play in the book, although the stipulated (scripted) literal overlap in dialogue is limited. In The Waverly Gallery (1999–2000 and 2018–2019), the unproblematized stance that loss of the kinds of skills and autonomy that underwrite upper-bourgeois status is a big part of the “tragedy” of dementia had audiences gasping and in tears. The play’s power comes in part from a narrative strategy that puts focus on family dynamics and the clear journey of a vibrant heroine from independent gallery owner to shrieking, frightened, ungroomed “lost soul.” The “guide” to the play is the heroine’s grandson, who breaks the fourth wall to relay both information and updates on his own feelings, thereby further putting the focus on personal anxiety. If too few of these plays feature non-white, non-middle-class characters or give serious stage time to paid caregivers outside of doctors and nurses (again, there are exceptions in The Father and Dot and, perhaps, one of the patients in All the Living who cares for one of the others), I hope the American theatre can anticipate new plays exploring new perspectives. Lorraine Hansberry’s A Raisin in the Sun broke ground in 1959 not only because it depicts Blacks as “real people” (clearly this was a need only for non-Black audiences), but also because it depicts underpaid domestics as having lives, points of view, strategies, and needs influenced by but well beyond the realm of their jobs. Caregivers deserve something analogous. The narratives of each of the case study plays are unpacked in the following pages, but the book as a whole is my own narrative. I close here with the impetus for researching and creating it. Toward the latter part of the five years during which my late husband lived with dementia (his was Progressive Supranuclear Palsy, but the diagnosis matters little in this context), a friend expressed to me his intention to take his own life should he ever reach “that stage.” Loss of hearing, he said, could still allow for music in one’s head, just as the loss of sight could leave the art in the mind’s eye, but the loss of memory would leave one bereft of anything recognizable as relationship or meaning. This did not sit well with me, but it took a day before I could collect my thoughts. My friend, like many of us, I suspect, seemed to see life in terms I regard as those of a sort of nineteenth-century novel, having discrete characters, each with a purpose, the whole possessed of an overarching morality, explainable via causality; relationality defined by categories (parent/child, clergy/ parishioner, teacher/student, employer/employee, etc.); a clear past/
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present/future; and ultimately characterized by meaning and closure, all driven—or at least subject to interpretation—by words. This is life conceived as a traditional narrative. What if, I thought, life was not like a novel at all but was more like a Picasso painting?29 For me as the spouse of an artist whose métier was abstraction and whose favorite play was Waiting for Godot, coming to embrace this optic was not such a rational stretch, although it took practice. As Janet Gibson observes, “the ‘truth’ of dementia... may lie in overlooking memory and notions of literal truth, and instead lie in looking to the symbolic.”30 The hardest lesson for me to learn—ironic because I have labored to craft the best book I can—is that “productivity is not the essence of humanness.”31 Recognizing this is, I believe, the challenge presented by every single play in this book.
Notes 1. See Michael Mangan, Staging Ageing: Theatre, Performance, and The Narrative of Decline (Intellect Books Ltd., 2013), Chapter 3 “On Liminality and Late Style: Oedipus at Colonus ). For a description of symptoms of dementia clearly displayed by Oedipus, see Stephanie M. Woo and Caroline Keatinge, Diagnosis and Treatment of Mental Disorders Across the Lifespan (Hoboken, NJ: John Wiley & Sons, Inc., 2008), Chapter 7 “Cognitive Disorders,” especially page 341 regarding emotional changes in dementia and 343 regarding agitation. 2. As You Like It, act II scene 7, line 164. 3. Ibid., line 165. 4. Briege Casey, “Dementia and Symbiosis in Waiting for Godot,” 36–52 in Dementia and Literature: Interdisciplinary Perspectives, ed. Tess Maginess (Abingdon, Oxfordshire and New York, 2018), 37–38. 5. Definition is from Blossom C. M. Stephan, Tobias Kurth, Fiona E. Matthews, Carol Brayne, and Carole Dufoull, “Dementia Risk Prediction in the Population: Are Screening Models Accurate?” Nature. https:// www.nature.com/articles/nrneurol.2010.54.pdf?origin=ppub (Accessed 5 July 2023). MCI does not always lead to dementia but it is considered a good predictor. There are multiple possible causes for MCI, which is a clinical diagnosis. When the cause is early Alzheimer’s, a positron emission tomography (PET) scan or spinal fluid test can confirm the diagnosis. See Alzheimer’s Association, “Mild Cognitive Impairment (MCI)”. https://www.alz.org/alzheimers-dementia/what-is-dem entia/related_conditions/mild-cognitive-impairment (Accessed 23 March 2023); and Seema Y. Pandya et al., “Does Mild Cognitive Impairment Always Lead to Dementia? A Review,” Journal of the Neurological Sciences
1
6.
7.
8.
9.
10. 11.
12.
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Vol. 369 (15 October, 2016): 57–62. MCI can also be a forerunner of Parkinson’s Disease. See Irene Litvan, Dag Aarsland, Charles H. Adler, Jennifer Goldman, G. Kulisevsky, et al., “MDS Task Force on Mild Cognitive Impairment in Parkinson’s Disease: Critical Review of PD-MCI,” Movement Disorders, Vol. 26, No. 10 (2011): 1814–1824. See William W. Demastes, Beyond Naturalism: A New Realism in American Theatre (Westport, CT: Greenwood Press, 1988); Demastes, “Preface: American Dramatic Realisms, Viable Frames of Thought,” Realism and the American Dramatic Tradition (Tuscaloosa: University of Alabama Press, 1996); Pam Morris, Realism (London: Routledge, 2003); and Dorothy Chansky, Kitchen Sink Reaslisms: Domestic Labor, Dining, and Drama in American Theatre (Iowa City: University of Iowa Press, 2015), especially Chapter 1. Regarding changes in life expectancy over the past century plus in the United States, see https://www.seniorliving.org/history/19002000-changes-life-expectancy-united-states/ (Accessed 1 April 2022). There is a range of opinions on the “wisdom” of the 60/ 40 catch phrase, but its status as indicator that Americans are living longer and healthier lives is indisputable. See https://www.huf fpost.com/entry/is-sixty-the-new-forty_b_8531980 (Accessed 23 March 2023); https://www.cbsnews.com/news/is-60-the-new-40-or-is-40-thenew-60-02-05-2007/ (Accessed 23 March 2023). Peter J. Whitehouse with Daniel George, The Myth of Alzheimer’s: What You Aren’t Being Told About Today’s Most Dreaded Diagnosis (New York: St. Martin’s Press, 2008), 93; and Fact Sheet: “Aging in the United States,” the Population Reference Bureau, https://www.prb.org/agingunitedstates-fact-sheet/ (Accessed 1 April 2022). Alzheimer’s Association, 2023 Alzheimer’s Disease Facts and Figures: The Patient Journey in an Era of New Treatments (Alzheimer’s Association, 2023), p. 20. https://www.alz.org/media/Documents/alzheimers-factsand-figures.pdf. Peter J. Rabinowitz, “Sedimental Education; or, Reading as We Age.” PMLA, Vol. 133, No. 3 (May, 2018): 661–666. Cognitive impairment following a stroke is categorized as dementia. Multi-infarct dementia is caused by a series of small strokes—events that impede blood flow to the brain. See James B. Pinkston, Hadejda Alekseeva, and Eduardo González Toledo, “Stroke and Dementia,” Neurological Research, Vol. 31, No. 8 (October, 2009): 824–831. Rachel Aviv, “The Cost of Caring,” New Yorker 11 April 2016: 60. Ai-jen Poo (written with Ariane Conrad) notes this more than once in The Age of Dignity: Preparing for the Elder Boom in a Changing America (New York and London: The New Press, 2015), 3 and 24.
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13. Bayshore Healthcare, “Aging Together: ‘Boomerang Seniors’ Are Caregivers for Their Parents.” 16 November 2020. https://www.bayshore. ca/resources/aging-together-boomerang-seniors-are-caregivers-for-theirparents/ (Accessed 23 March 2023). 14. Pia C. Kontos, “Self, Senility, and Alzheimer’s Disease in Modern America: A History.” Journal of the History of Medicine, Vol. 61 (April, 2007): 268. 15. Jason Karlawish, The Problem of Alzheimer’s: How Science, Culture, and Politics Turned a Rare Disease Into a Crisis and What We Can Do About It (New York: St. Martin’s Press, 2021), 243–248. 16. Gaynor Macdonald and Jane Mears, ed. Dementia as Social Experience: Valuing Life and Care (London and New York: Routledge, 2019), 1, 2, 8, 11, and 15. For an excellent extended discussion of how Alzheimer’s Disease is variously and multiply (mis)understood by medical experts, see Margaret Lock, The Alzheimer Conundrum: Entanglements of Dementia and Aging (Princeton University Press, 2013). 17. Woo and Keatinge, 338. See, too, Pam Belluck, “What is Alzheimer’s Disease?” New York Times, 30 April 2016. https://www.nytimes. com/2016/05/02/science/what-is-alzheimers-disease.html (Accessed 23 March 2023). 18. At least three plays about caregivers for people with conditions other than dementia opened in New York late in 2017. See Jonathan Mandell, “Caregivers on Stage: Mary Jane, The Treasurer, The Cost of Living.” HowlRound.com. 5 October 2017. http://howlround.com/caregiverson-stage-mary-jane-the-treasurer-the-cost-of-living?utm_source=HowlRo und.com%27s+Email+Communications&utm_campaign=9ee00fe3a7DAILY_RSS_EMAIL&utm_medium=email&utm_term=0_9ac5709e389ee00fe3a7-53631065&ct=t(RSS_EMAIL_CAMPAIGN)&mc_cid=9ee 00fe3a7&mc_eid=b2172f8660 (Accessed 23 March 2023). 19. High points of reviews of The Father are in “The Father on Broadway Reviews” All originally appeared on April 14, 2016. http://www.broadw ayworld.com/reviews/The-Father (Accessed 23 March 2023). “Tragic” is from Ben Brantley’s New York Times review. Other examples, although not discussed in this book, include Tina Howe’s 2017 Singing Beach, featuring a poet losing his ability with words, based on the playwright’s experience with her husband’s Alzheimer’s Disease, and putting climate change into the conversation; Taylor Mac’s Hir, with an abusive stroke victim whose wife strikes back; and Jesse Eisenberg’s 2019 Happy Talk, in which an unpleasant woman with dementia remains offstage while her notgenerally “relatable” sixtyish daughter tries to control or one-up everyone
1
20.
21.
22.
23.
24. 25.
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else around her, battling her own fears and demons. Max Posner’s The Treasurer (2017) depicts chatty spendthrift in major cognitive decline whose youngest son reluctantly assumes responsibility for her finances. James B. Pinkston, Hadejda Alekseeva, and Eduardo González Toledo, “Stroke and Dementia,” Neurological Research, Vol. 31, No. 8 (2009): 824–831. https://doi.org/10.1179/016164109X12445505 689643. See, too, WebMD, “Stroke Related Dementia,” 2019. https:/ /www.webmd.com/stroke/guide/stroke-related-dementia (Accessed 23 March 2023). See Sara Falcus and Katsura Sako, Contemporary Narratives of Dementia: Ethics, Ageing, Politics (New York and London: Routledge, 2019). This excellent study delves into books of many genres, including memoirs, novels, detective fiction, biographies, autobiographies, and graphic narratives. Drama does not make an appearance. Likewise, Rebecca A. Bitenc’s fine Reconsidering Dementia Narratives: Empathy, Identity and Care (Routledge, 2020) looks at novels, films, graphic narratives, and autobiographies but deliberately avoids drama, the author declining to categorize it as narrative (4–5). A very short list of mainstream movies in English includes Still Alice (2014), starring Julianne Moore; Iris: A Memoir of Iris Murdoch (2001), with Judi Dench as the title character; Away from Her (2006) featuring Julie Christie; and The Savages (2007), starring Philip Seymour Hoffman and Laura Linney. Film versions of The Father and The Humans were released in 2020 and 2021 respectively. Movies portraying dementia and its challenges in many other countries are discussed in Raquel Medina’s Cinematic Representations of Alzheimer’s Disease (London: Palgrave Macmillan, 2018). For an in-depth look at the changed role theatre came to play in American culture at the point when movies superceded stage plays as mainstream popular entertainment, see Dorothy Chansky, Composing Ourselves: The Little Theatre Movement and the American Audience (Carbondale, IL: Southern Illinois University Press, 2004). See Jim Cullen, The American Dream: A Short History of an Idea That Shaped a Nation (Oxford and New York: Oxford University Press, 2003). See, for instance, Paul DiMaggio, Michael Useem, and Paula Brown, Audience Studies of the Performing Arts and Museums: A Critical Review. Center for the Study of Public Policy (National Endowment for the Arts, 1978). https://www.arts.gov/sites/default/files/NEA-Research-Report9.pdf. The report mentions at least four times that the single biggest factor in identifying audiences for the arts is educational attainment
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26.
27. 28.
29.
30. 31.
(pages 2, 18, 21, 33), also noting that occupation was the secondbest predictor of arts attendance. The survey refutes the idea that arts patrons are wealthy but does state that “live performing arts audiences have considerably higher median incomes than the population at large” (28). The National Endowment for the Humanities’ 1988 report, The Arts in America, notes of theatre audiences (12% of Americans) that “participation rates generally increase with both income and education levels” (117, 118). American Participation in Theater, Research Division Report #35 (Santa Ana, CA: National Endowment for the Arts, Seven Locks Press, 1996) https://www.arts.gov/sites/default/files/AmericanParticipation-in-Theater.pdf again cites education as the biggest predictive factor for theatre attendance, with income right behind (2). The more general “Share of adults attending an arts activity in the U.S. 2012, by family income” (https://www.statista.com/statistics/381471/arts-act ivity-attendance-rate-in-the-us-by-family-income/) does not differentiate among “benchmark” arts activities; it does make clear that 16.3% of adults with an income of less than $20,000 attended an arts activity in the year prior to the study’s release, while 62.3% of households with an annual income of $150,000 or over did so. Figures are for adults. Fay Lomax Cook and Rachel L. Moskowitz marshal research to show that “the preferences of high-income Americans are much more likely to be reflected in policy outcomes than are those of lower-income citizens.” See Cook and Moskowitz, “The Great Divide: Elite and Mass Opinion About Social Security,” in The New Politics of Old Age Policy, ed. Robert B. Hudson, third edition (Baltimore: Johns Hopkins University Press, 2014), 69–96, 92. They clarify that this wealthier demographic comprises the top 10% of American earners (70). That production was mounted at Texas Tech University under the direction of then-MFA candidate DayDay Robinson in 2018. Alzheimer’s Association, “2020 Alzheimer’s Disease Facts and Figures,” https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1002/alz. 12068 (Accessed 23 March 2023). Janet Gibson’s Dementia, Narrative and Performance: Staging Reality, Reimagining Identities (Palgrave Macmillan, 2020) challenges the value of narrative in dementia care and theatrical representation, arguing that such projects as “Life Review” not only privilege linear recollection, but they situate meaning for people with dementia in their pasts, denying their needs and experiences in and of the present. As well, she points out that hegemonic ideas of narrative privilege certain ways of constructing experience as valid, natural, and organized while obliterating or denying others. Gibson, 118. Macdonald et al., 18.
CHAPTER 2
Dementia, Alzheimer’s, Age: Intersectionalities and an American Context
Dementia, which the World Health Organization estimated in 2017 affected around fifty million people,”1 is most simply definable as an “umbrella term for diseases which produce cognitive decline.”2 Indeed, as sociologist and dementia studies scholar Christopher Johnson points out, dementia constitutes a cluster of about eighty diseases and is more than just the “Alzheimer’s stereotype.”3 The persistent conflation of the two, however, arises from the visibility of Alzheimer’s—the most commonly occurring form of dementia—and from the activism, publicity, and research dollars in the United States in the last quarter of the twentieth resulting from organizing and lobbying by families of people affected and by scientists and pharmaceutical companies with an interest both in finding a possible cure and in selling palliative drugs. Alzheimer’s accounted in 2018 for an estimated 60%–80% of dementia cases4 ; it affects about one in ten American adults over the age of sixty-five.5 Researchers at Brown University anticipated that in 2050, on its current trajectory, Alzheimer’s will affect fourteen million people in the United States.6 The 2019 World Alzheimer Report projects 152 million people, globally, living with dementia (of any sort) in 2050.7 Age is the single biggest risk factor for developing dementia, so as Americans live longer, a heftier percentage of the populace develops dementia.
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 D. Chansky, Losing It, https://doi.org/10.1007/978-3-031-20902-4_2
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Few plays in Losing It actually name the dementia from which characters suffer, except when it is the result of a stroke. For audience members or readers who are knowledgeable about even a handful of dementias other than Alzheimer’s, this is a good thing, as it enables “relatability” and does not lump all dementias together (mistakenly) as Alzheimer’s. A 2006 study of 539 caregivers revealed that people who experienced a cognitive decline (either those with an illness or their family members) waited an average of 39.5 months to receive a diagnosis,8 meaning that people perceive and grapple with symptoms long before they get a diagnosis—if they ever do. Dementia presents in three stages. In the mild phase, people may need only minimal assistance with daily tasks. This is the phase most frequently depicted in present-day advertising for drugs or home-based care to help people maintain autonomy. In the moderate phase—most common in recent dramatic representations—more care is needed, as those with a developing condition may experience “hallucinations, delusions, insomnia, and agitated behavior.”9 In the severe phase, the person with dementia is typically much more subdued and maybe wheelchair-bound or bedridden.10 The Father and The Waverly Gallery both feature a character who traverses the three phases. Since no diseasecaused dementia yet has a cure, although there are drugs to alleviate or slow temporarily some kinds of symptoms of some kinds of dementia, the diagnosis itself may matter less than figuring out and living with care and coping strategies. Nonetheless, the science of Alzheimer’s still drives much popular thinking about dementia, especially among non-specialists. The observable characteristics of a spectrum of dementias in the elderly have been present as long as humans have existed, and these have been written about for millennia.11 The salient feature of all forms of dementia, particularly as described by medical personnel, is typically memory deficit.12 “Dementia” was used in the eighteenth and nineteenth centuries “to name any state of psychological dilapidation associated with chronic brain disease.”13 Until the 1860s, as G. E. Berrios and H. L. Freeman write in Alzheimer and the Dementias , what was known about dementia came from clinical observation (i.e., in-person examination of patients or inmates); by the latter third of the nineteenth century, advances in the laboratory study of diseased organs and tissues (morbid anatomy) led to new kinds of research. The catchall term for what would later be differentiated as a variety of neurological disorders was, at the end of the nineteenth century, “senile dementia,” used in the popular press and denoting something normal,
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although hardly inevitable or ubiquitous. Carole Haber notes that, prior to the nineteenth century, “senile” just meant old; it had little connection to abnormality or scientifically diagnosable illness.14 By the end of the nineteenth century, owing largely to medical research in Europe, the term had become linked to disease, although sometimes only to a disease occurring in an older rather than a younger person. In Geriatrics: The Diseases of Old Age and Their Treatment , published in 1914 by I. L. Nascher, the father of gerontology, a host of ailments that might affect young or old are preceded by “senile” in their descriptions when occurring in elders (e.g., “senile constipation,” “senile bronchitis,” “senile gangrene,” and “senile pruritis”).15 Also, as Martha Holstein observes, “in what may seem contradictory to modern readers, turn of the century investigators often described ‘normal’ aging somewhat quixotically as pathological….”16 Senile dementia was seen as incurable.17 For that reason, the elderly demented in the United States, whether they were regarded as victims of a condition that was normal or one that was pathological, were warehoused in almshouses (“poorhouses,” typically run by local communities and often requiring inmates to work, with an eye to their “rehabilitation”), where administrators “sometimes acknowledged the difficulty of distinguishing between normality and pathology….”18 Around the turn of the twentieth century, the elderly (American) demented were (strategically) regarded, or (firmly) recategorized, as mentally ill and sent to mental institutions (if they were not already there). A partial reason for the reclassification is that states assumed responsibility for the mentally ill, meaning that it was financially advantageous to local welfare officials to designate their demented almshouse inmates as insane.19 Mental hospitals came into being in the United States on a small scale in the first four decades of the nineteenth century; the earliest ones were small and as likely to be called “asylums” as hospitals, although psychiatrist superintendents fought for the latter designation.20 There was a major uptick in the creation of statesupported mental hospitals starting in the mid-nineteenth century, largely due to the activism of Dorothea Dix, whose reports on conditions in the almshouses and jails that had previously warehoused the “insane” shamed legislators across the eastern United States, starting in Massachusetts, into building specialized medical facilities. Although people with dementia can also have other mental illnesses, the fact that dementia brought on by disease (e.g., Alzheimer’s or Parkinson’s or Creuzfeld-Jakob Disease) or by, for instance, a vascular incident is incurable boded ill for the elderly
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demented in mental hospitals, as these institutions staked their hopes and some of their claims on curing their patients, making it easy to give minimal attention to those seen as losing it (and not expected to recover it) because old.21 Institutions and institutionalization figure prominently in the first two plays I discuss, Joint Owners Spain and All the Living . The Father depicts a nursing home—albeit what seems to be an expensive and genteel one with highly individualized care—as a last resort: the final setting in the decline narrative. It is also worth noting that, although the print record suggests American judges, lawyers, doctors, and lay people thought they recognized senile dementia when they saw it, it was not clear that there was an agreement where, on a continuum, normal aging yielded to a disease that rendered its sufferer “insane.”22 As one physician wrote in 1909, “No sharp line can be drawn between ordinary senile dotage and senile dementia…. The normal mental deterioration incident upon old age is itself early senile dementia.”23 If a spectrum from normal deterioration to an illness that is dementia remains forgivably hard to mark with milestones (absent, perhaps, strokes, and head injuries), it is far more frightening to consider a world in which “no distinct line separated the forgetful old person from the insane.”24 Newspaper articles and squibs published between 1895 and 1915 containing the paired words “senile dementia” sometimes described people who, aged sixty-five to one-hundred-plus, manifested behaviors that might today be understood as resulting from severe depression and not necessarily progressive disease or a stroke or head trauma. Moreover, declarations of mental incompetence—frequently resulting in the person so “diagnosed” being sent to a public asylum—were often made by judges based on testimony by family members seeking property or money.25 “For all the clarity with which they stereotypically represented senility,” writes historian Jesse Ballenger with careful restraint, “medical experts of the nineteenth century stressed the difficulty of recognizing it.”26 The discovery of Alzheimer’s Disease (AD) and the trajectory of research on it are important for understanding the evolution of dementia achieving widespread public awareness. Alois Alzheimer (1864–1915) was a German research physician who specialized in neuroanatomy. The case he described at a medical meeting in 1906 was one of what would now be called early-onset dementia. The patient he treated was 51 when she was admitted to a psychiatric clinic in Frankfurt at the end of 1901. The clinical symptoms Alzheimer outlined were no different from those of what was then called senile dementia; only the relatively early age at which his
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patient’s condition emerged was unusual. Moreover, the brain changes he observed in his laboratory after the patient’s death would turn out to be no different from those observed in the postmortem brains of older people with (senile) dementia. When, in 1910, Alzheimer’s colleague Emil Kraepelin (1856–1926) proposed naming the presenile dementia described by Alzheimer after the latter researcher, two things happened. Alzheimer’s Disease became a diagnostic category, and it was understood as a disease of the young, which for Kraepelin meant those who experienced onset before ages fifty to fifty-five27 (Kraepelin gets a worshipful shout-out in All the Living; his work as a classifier of mental diseases based on prognosis, not just symptoms in isolation, made him a game changer). Again, although the symptoms and progression of the illness were no different in young victims from what they were in older ones, its appearance in the elderly was regarded as too ordinary to warrant any attempts at treatment, not to mention research. Hans Förstl notes, in retrospect, “it probably was a clever political decision to extend the concept of AD from the presenile into the senile area instead of surrendering to senile dementia and ending up with no disease at all, but with a senile or presenile aging process that would have been outside the realm of medicine.”28 Most American dementia sufferers in the early part of the twentieth century likely didn’t receive the same kind of treatment stateside as they might have in Europe. One reason was the distance of many American psychiatrists from research; the other was the tacit acceptance, even among the medically advanced, of senile dementia—contra its presenile doppelgänger—as incurable (Again, neither iteration yet has a cure when caused by a disease). Holstein observes that American psychiatrists with an interest in recent developments were “particularly receptive to the discoveries of Alzheimer and his colleagues” starting around 1910—in no small part because they themselves had become discredited among American physicians—but their receptivity did not result in any immediate change in methods of treatment. The discrediting, and concomitant awareness of being out of touch, arose because of American psychiatrists’ primary affiliation in the nineteenth century with state institutions for the mentally ill, where they served largely in administrative functions,29 outside the realm of laboratory research. (This exact situation and the tensions around it figure in All the Living ). In 1894, H. Weir Mitchell, a prominent American physician, gave an invited talk to the American Medico-Psychological Association in which he lambasted its members for
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“their lack of scientific rigor, for facility to study the psychology and pathology of their patients, and for their ‘want of competent original research.’”30 While the date of this talk preceded by over a decade and a half the precise designation of Alzheimer’s Disease, even after Kraepelin’s 1910 beachhead, the vast majority of work published about AD appeared in German,31 and, of course, the disease had been identified as afflicting under-fifty-fives, allowing psychiatrists—and it is unlikely that every dementia sufferer had the benefit of a psychiatric evaluation—to “explain signs and symptoms somatically—but only in presenile patients— without disrupting commonly accepted … explanations of dementia in older patients … and the familiar but not universally held view that senility was a part of ‘normal’ aging.”32 Before sketching the trajectory of dementia research and popular awareness in the United States over the rest of the twentieth century, I note, as Sarah Falcus and Katsura Sako make clear in their study of dementia and narrative, “it is impossible to disentangle the discourse of dementia from discourses of ageing [sic].”33 The discourse of aging has long been a depressing one. In recent decades, scholars and activists from fields as diverse as social work and literature have begun to resist and rewrite the narrative of decline and attendant ageism that is so ubiquitous as to seem inevitable. The failure to officially differentiate the “senior,” who may be as young as 55 or 60, from the “oldest old,” who may be pushing 100, is as senseless as conflating all pediatric patients, who range in age from newborns to high school students. Who, exactly, is “old?”.34 Theatre began asking this question only relatively recently. Elinor Fuchs threw down a critical gauntlet in 2014, when, regarding dramatic theory, she asked in print, “how is it possible, after more than thirty years of identity theory…that we have largely ignored the vast undeconstructed binary of youth and age?”35 Other disciplines—notably literature, sociology, and psychoanalysis—arrived at the table several decades ago. Margaret Morganroth Gullette published Declining to Decline: Cultural Combat and the Politics of the Midlife in 1997.36 Gullette names culture (read: language, advertising, literature, film, television, pop psychology) as the culprit in instilling fear of aging in even our youngest citizens, concluding with her own challenge:
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[H]ow can we better theorize ‘aging’? As we tie it more and more to culture, how fast can we change our speech? Can we write about it without recourse to the master narrative’s assumptions that ‘changes’ are natural, prediscursive, and unwanted, and without falling into positive aging’s simplicities?37
“Positive aging” is the term Gullette applies to the kind of upbeat acceptance promoted by women’s magazines and some novelists and feminist theories. She eschews it not exactly because it is false thinking, but because it is a simplistic, wishful, unrealistic form of response to the master narrative of decline that she wishes to contest.38 She would prefer a narrative that includes decline but resists either unproblematized loss or stigma. Anne Davis Basting articulates the problem with “positive aging” in what might be the earliest book to put aging discourses in conversation with theatre—one somewhat recently rediscovered and praised more widely than when it was published in 1998 (Basting won a MacArthur “genius” Fellowship in 2016): Anti-ageism advocates aimed to replace the negative images of aging with “positive” images—a move that ultimately fails to question the strict division between these two poles (successful and unsuccessful aging), and which fuels a denial of physical and psychological changes in the aging process.39
In the master narrative these (among other) theorists seek to overturn, the journey of aging is seen and accepted as a fateful descent into uselessness and emptiness—the latter a description driven by capitalism’s focus on youth (a lucrative market) and youthfulness (a marketable product). Sociologist Mike Featherstone and cultural historian Andrew Wernick point specifically to how, in the United States, capitalist industrialization transformed domestic production and consumption, idealizing in advertising the youthful female body “while fundamentally weakening the value of accumulated life experience both in itself and as a marker of social status.”40 Psychoanalyst Erik H. Erikson reminded readers that only a few decades prior to publication of his The Life Cycle Completed in 1982, “[o]ne could still think in terms of ‘elders,’ the few wise men and women who quietly lived up to their stage-appropriate assignment and knew how to die with some dignity.” His worry—only exacerbated in the intervening decades—is that these have been replaced by “mere ‘elderlies.’”41
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American drama has more or less complied with and reflected a belief in this master narrative—particularly for women—since the advent of the Little Theatre Movement of the 1910s. The “failing” characters in most of the twenty-first-century caregiver plays discussed briefly at the opening of the Introduction are women.42 The dementia character in Joint Owners in Spain is a woman, as are the two stroke victims whose interior lives are explored in Wings and Ruff . While it is impossible to generalize about why this might be, casual speculation cannot ignore the simple fact that, demographically, women live longer than men (recall that age is the single greatest risk factor for developing dementia) nor the possibility that male playwrights might arguably be less likely to want to present men losing their grip on power than to present women in that situation, perhaps because the former has historically been considered threatening or catastrophic while the latter emerges as sad or regrettable. Women’s power has “traditionally” lain in housekeeping and childrearing and outside the “public” sphere of politics and work for pay.43 I think it is no accident that the two plays in this study for which “tragic” is hardwired into our understanding feature men with dementia. Arthur Miller famously justified his position regarding Willy Loman as an icon in “Tragedy and the Common Man,” and Florian Zeller specifies the genre of The Father as “tragic farce.”44 In both sexes, though, cognitive decline is solidly figured in drama as loss or burden—indeed, as loss of personhood—whether the dementia is understood or not. Understanding increased, but it did not reach all people at the same time or in the same way. Dementia was solidly “medicalized” starting in the 1970s, the change accelerating in the 1980s, which “transformed what was previously considered a natural part of ageing [sic] into a pathology of the brain and led to the conflation of dementia and Alzheimer’s disease in much public discourse.”45 As Basting explains, the National Institute on Aging, founded in 1974, had an investment in this medicalization, as it could now “vie for research funds with other National Institutes of Health players.”46 This did not yield much of a shift in the loss/tragedy perception; it did provide a mission for any who cared to take up arms. It also put dementia and Alzheimer’s on the public radar. On the way to focusing on hard science as the white knight on whom salvation depended, an interim attitude toward the imbrication of aging and dementia gained traction for about three decades. Put crudely, a midcentury mode of thinking arose in which dementia was viewed as having a social and personal component (a sympathetic view) but also as something
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to which the sufferer contributed by failing to stay active and engaged (a punitive view). Between 1937 and 1952, American psychiatrist David Rothschild published a series of articles in which he rejected biological pathology as the sole explanation for dementia in the elderly. He looked to personality and to life changes that induced what today might be called extreme stress as major contributors to “senile dementia,” arguing against “focusing attention solely on the impersonal tissue process”47 and for the value of considering the latter’s relation to personal experience and outlook as therapeutically key. This approach arguably had a positive effect on some elderly people who were healthy enough in all ways to push back and resist what Robert Butler in 1968 named “ageism,” but for those not fortunate enough to have the genetic makeup, the money, the leisure, or the lifetime of healthful living and social advantages to take up younger lifestyles, the “the attack on ageism … cannot shake the accusation that it simply demands old people to be young.”48 Jesse Ballenger characterizes the 1940s and 1950s as decades in which failure to achieve “successful aging” was construed by many as the result of either individual or social neglect. He describes beautifully a trajectory at whose focal turning point Death of a Salesman’s Willy Loman might be caught in the crosshairs: …from the late nineteenth century on, the dullness found in the senile, their isolation and withdrawal, their clinging to the past and lack of interest in worldly affairs were characteristically represented as the symptoms of senility—the social stigmata of the inevitable deterioration of the brain. Following World War II, gerontological discourse typically represented these as the causes of senility. The locus of senile mental deterioration was no longer the aging brain but a society that, through mandatory retirement, social isolation, and the disintegration of traditional family ties, stripped the elderly of the roles that had sustained meaning in their lives.49
Willy, born in the late nineteenth century and losing it in the midtwentieth, is pinioned between a diagnostic rock and a socially hard place. Were Willy Loman an actual person, however, even one alive as late as 1970, the difficulty of properly recognizing his condition would still plague medical science, not to mention non-specialist family members trying to navigate the changing (personal as well as scientific) waters. Recall Ballenger’s and others’ observation about how medical experts
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of the latter part of the nineteenth century had difficulty of recognizing senility even as they blithely went about representing it. The 1970 (fourth) edition of the Psychiatric Dictionary published by Oxford University Press50 confusingly (to this reader) defines senile dementia both as “simple senile deterioration” and as a category of senile psychosis, noting that it is characterized by shrinkage of the brain but then stating that symptoms may appear even in the absence of the plaques that are “always present” (in senile dementia) adding that, among several types of senile psychosis is “simple senile deterioration,” (italics mine) explained elsewhere in the Dictionary as characterized by behaviors that would nowadays be easily recognized as belonging, among other places, to people suffering from depression or displacement, or even being overor under-medicated. These include “sluggishness of thought … defective orientation, hoarding, inattentiveness except to immediate personal wants, apathy, [and] irritability.”51 Plaques are, indeed, frequently present in the brains of people with AD. Brain shrinkage is common in AD. But the combination of unilateral insistence on these things (even while noting that dementia can appear absent the presence of plaques), the conflation of any or all diseases under one kind of rubric, and the use of multiple definitions that are applied both to decline due to dementia and to conditions that have other causes than dementia reads a little like medical waffling. Eight years later, Arthur Freese’s book The End of Senility (whose subtitle promised to “make old age obsolete”) did not deny the existence of irreversible neurological brain conditions.52 Rather, its purpose was to point out that “senility” was a usually punitive—or at least dismissive—diagnosis easier to dole out than one requiring investigation into the possibilities of depression, overmedication, or other health problems (e.g., a mild heart attack or undiagnosed stroke) that could lead to observable changes in behavior but be waved aside owing to ageism. The sensationalist title aside, the book argues persuasively for proactive investigation by elders and their families, particularly regarding the choice of a physician who will not write them off and who, ideally, has some knowledge of (the then rare specialty) geriatrics. In 2008, Peter Whitehouse published a book with the provocative title The Myth of Alzheimer’s. Whitehouse is a geriatric neurologist who, at the time the book appeared, had not only spent thirty years working with patients but had also been a consultant for many multinational drug companies and had worked on numerous medical research projects, perhaps most notably in the 1980s at Johns Hopkins University, where he
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contributed to the development of the first drugs used to treat symptoms of Alzheimer’s disease.53 He was aware that physiological, anatomical, and genetic research yielded evidence of the existence of a condition that could legitimately be called a disease. But he wanted to push back against the ways popular narratives about AD contribute to patients’ and families’ terror, shame, and feelings of helplessness, thereby worsening a situation that could be far better handled.54 Whitehouse’s two themes are that the medicalized vocabulary of a “war” on Alzheimer’s does nothing for the people who live with cognitive impairment nor for those who care for them and that “cognition and rationality must not be equated with personhood.”55 Invoking T. S. Eliot, he asserts that asking how we are going to “fix” Alzheimer’s is to ask the wrong question. Rather, we need to be asking how we are going to behave in the face of the inevitable rising number of cases of cognitive impairment when nearly twenty percent of the American population (70 million people) will be sixty-five or older by 2030.56 While more than a third of his book discusses the brain biology of Alzheimer’s and the myriad studies, drugs, and proposed routes to a cure proffered by various pharmaceutical companies and scientists, the takeaway is that, rather than defaulting to the search for a cure, we need a cure for the (hurtful effects of) apotheosizing that search. “Our attention must begin shifting from mythical cure to hard-earned prevention,” he writes, advocating healthful behavior on all fronts. But he also argues against denying the personhood of those who experience cognitive decline by writing them off (or avoiding them) when we see AD as the “never-ending funeral” or the “slow death of the mind.”57 Perhaps unsurprisingly, Whitehouse praises the decades-old work of David Rothschild for its emphasis on seeing the cognitively impaired as “living, mentally functioning persons” rather than easy acquiescence to a “bleak neuropathologization of aging.”58 In the twenty-first century, anyone who reads mailers from Alzheimer’s Disease Research (a project of BrightFocus Foundation) knows that, while the organization gives lip service to the importance of the “combination of social, mental, and physical stimulation” as “the best hope for living a healthy life,” printed requests for contributions still call AD a “mind-stealing” and “terrifying” disease that “cruelly robs those afflicted of their precious memories.”59 The plays I treat in Chapters 8, 10, and 13 rightfully anticipated audiences still living with the myths and fears, and probably some unspoken hope that the medical world would discover a “cure” in their lifetimes. Yet none of the plays is about medicine per se;
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all deal with relationships, coping strategies, feelings of anger or helplessness, financial worries, and isolation, as our culture has yet to devise a widespread policy for the care of the cognitively declining that might mimic, for example, our policies regarding free, public kindergartens or publicly funded special education.60 Recent writing from both the fields of literature and sociology stresses that those with dementia and those who care for them are people and always exist in relationship(s). “[D]ementia as ‘catastrophe’ can be reframed as ‘biographical disruption’, requiring adjustment, accommodation and reconciliation on the part of others,” argue a team of writers in Dementia as Social Experience: Valuing Life and Care.61 People with dementia suffer the loss of cognition; they do not cease to be humans with feelings, perceptions, and, yes, memories. The “personhood movement” of the 1990s “stresses the individual and social experience of the person, and therefore relationships with others, social context and personal history all become relevant to the care for someone with dementia,” argue the co-authors of Contemporary Narratives of Dementia: Ethics, Ageing, Politics .62 Whether the characters who have dementia in the plays discussed in this book are granted personhood has much to do, of course, with how they are scripted. But the presence of an actor who will, almost inevitably, drop the symptoms of illness in the curtain call invites viewers to consider the very real personhood of the individual before their eyes—an actual, physical human simultaneously losing it (in character) and keeping it together (in performance). I discuss the actor’s dual bodyings in the next chapter.
Notes 1. Sarah Falcus and Katsura Sako, Contemporary Narratives of Dementia: Ethics, Ageing, Politics (London: Routledge, 2021), 1. 2. Gaynor Macdonald, Jane Mears, and Ailin Naderbagi, “Reframing Dementia: The Social Imperative,” in Dementia as Social Experience: Valuing Life and Care, ed. Gaynor Macdonald et al. (London and New York: Routledge, 2019), 1. 3. Laura Rice, “Why the U.S., and Texas, Need to Catch Up When It Comes to Dementia Care.” https://www.kut.org/post/why-us-and-texas-needcatch-when-it-comes-dementia-care. The URL includes a link to a radio interview with Dr. Johnson broadcast on The Texas Standard on 20 March 2019 (Accessed 23 March 2023). According to scholars Blossom Stephan and Carole Brayne, over two hundred subtypes of dementia have
2
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5.
6. 7.
8. 9.
10.
11.
12.
13. 14.
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been defined. See Stephan and Brayne, “Prevalence and Projections of Dementia,” 2010, 11. https://citeseerx.ist.psu.edu/viewdoc/download? doi=10.1.1.598.9059&rep=rep1&type=pdf (Accessed 23 March 2023). Alexandra Sifferlin, “A Beast with Many Heads,” 19–25 in TIME The Science of Alzheimer’s, 20. July 8, 2019, 19–25 (New York: Time Inc. Books, 2018), 20. Markham Heid, “Alzheimer’s: A Tutorial,” 9–13 in TIME The Science of Alzheimer’s, 8 July 2019 (New York: Time Inc. Books, 2018). The Science of Alzheimer’s, 9. Maura Sullivan Hill, “Battling Alzheimer’s,” 22–27 in Impact: Research at Brown (Brown University, 2020), 27. Alzheimer Disease International, World Alzheimer Report 2019: Attitudes to Dementia (Alzheimer’s Disease International), 8. https://www.alz. co.uk/research/WorldAlzheimerReport2019-Summary.pdf (Accessed 23 March 2023.) Anne Davis Basting, Forget Memory: Creating Better Lives for people with Dementia. (Baltimore: Johns Hopkins University Press, 2009), 28. Stephanie M. Woo and Caroline Keatinge, Diagnosis and Treatment of Mental Disorders Across the Lifespan (Hoboken, NJ: John Wiley & Sons, Inc., 2008), Chapter 7 “Cognitive Disorders,” 341 and 343. Ee Heok Kua, Emily Ho, Nong Hee Tan, Chris Tsoi, Christabel Thng, and Rathi Mahendran, “The Natural History of Dementia” 196–201 in Psychogeriatrics, Vol. 14 (2014): 198–199. Woo and Keatinge describe seven stages of dementia due to Alzheimer’s (346–347); the final three map perfectly onto those of Kua et al., Ai-jen Poo (with Ariane Conrad) succinctly parses three phases in her highly readable The Age of Dignity: Preparing for the Elder Boom in a Changing America (New York and London: The New Press, 2015), 26. See Jeffrey Kluger, “Through the Millennia” in The Science of Alzheimer’s (New York: Time Inc. Books, 2018), 26–29; and François Boller and Margaret M. Forbes, “History of Dementia and Dementia in History: An Overview,” 125–133 in Journal of the Neurological Sciences, 158 (1998). G. E. Berrios and H. L. Freeman, “Dementia Before the Twentieth Century,” 9–27 in Alzheimer and the Dementias, ed. Berrios and Freeman (London: Royal Society of Medicine Services Limited, 1991), 27. Berrios and Freeman, “Introduction,” Alzheimer and the Dementias, 2. Carole Haber, “From Senescence to Senility: The Transformation of Senile Old Age in the Nineteenth Century,” in The International Journal of Aging and Human Development, Vol. 19, No. 1 (1984–1985): 41–45. I. L. Nascher, Geriatrics: The Diseases of Old Age and Their Treatment; Including Physiological Old Age, Home and Institutional Care, and Medico-Legal Relations (London: Forgotten Books, 2018. Original published in Philadelphia by P. Blakiston’s Son & Co, 1914), ix, x.
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16. Holstein, op. cit. In the first chapter of his 2021 study of Alzheimer’s disease, Jason Karlawish repeats his oft-given answer to many patients’ present-day question about the difference between normal aging and dementia. He says that the former basically involves predictable slowing down in many areas with the latter indicating the arrival and progression of serious decline in the ability to perform ordinary mental and physical tasks (Karlawish, The Problem of Alzheimer’s, 10–11). As recently as 2013 medical anthropologist Margaret Lock wrote that “the question of the relationship of ‘normal’ aging to dementia has never been satisfactorily resolved” (Lock, The Alzheimer Conundrum, 27). Karlawish clearly begs to differ. 17. Regarding incurability, see Jesse F. Ballenger, “Beyond the Characteristic Plaques and Tangles,” 83–103 in Concepts of Alzeimer [sic] Disease: Biological, Clinical, and Cultural Perspectives, ed. Peter J. Whitehouse, Konrad Maurer, and Jesse F. Ballenger (Baltimore and London: Johns Hopkins University Press, 2000). 18. Thomas R. Cole, The Journey of Life: A Cultural History of Aging in America (Cambridge and New York: Cambridge University Press, 1992), 200. 19. Ballenger, “Beyond the Characteristic Plaques and Tangles,” 85; and see David Gollaher, Voice for the Mad: The Life of Dorothea Dix (New York: The Free Press, 1995). Leland E. Hinsie and Robert J. Campbell assert that the term dementia “was once synonymous with madness, insanity, and lunacy” (Psychiatric Dictionary, Fourth Edition [New York: Oxford University Press, 1970], 193). 20. Gerald N. Grob, Mental Institutions in America: Social Policy to 1875 (New York: The Free Press, 1973), 140. See especially Chapter 3, “The Growth of Public Mental Hospitals.” 21. For an excellent and highly readable assessment of both the idea of “curability” and the career of Dorothea Dix, see Albert Deutsch, The Mentally Ill in America: A history of Their Care and Treatment from Colonial Times (New York: Columbia University Press, 1946, originally published in 1937), Chapters 8 and 9. My use of scare quotes around the word “insane” is owing to the fact that many people so designated were not suffering from neurological or chemical problems but were victims of extreme poverty, malnutrition, severe depression, or a host of other things that were, indeed, “curable” via such things as adequate food, shelter, cleanliness, and a modicum of humane treatment. 22. Indeed, as my study of Death of a Salesman (Chapter 6) shows, plays with characters suffering from dementia are regarded in new lights if their host dramas endure long enough to be revived following shifts in the cultural and scientific world of production and reception. 23. Dr. W. H. B. Stoddard quoted in Haber, Beyond Sixty-Five, 75.
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24. Haber, 78. 25. See, for instance, “Sanity of Testatrix,” Washington Post, 30 March 1899, p. 9, in which Dr. E. L. Tompkins “an expert in nervous diseases,” testified that “moral shock” could produce a “paralytic stroke” in the elderly. My thanks to Rob Weiner for locating twelve apposite pieces from the Chicago Tribune, seventeen from the Los Angeles Times, and twenty-two from the Washington Post. 26. Jesse F. Ballenger, Self, Senility and Alzheimer’s Disease in Modern America: A History (Baltimore: Johns Hopkins University Press, 2006), 28. 27. Daniel A. Pollen, Hannah’s Heirs: The Quest for the Genetic Origins of Alzheimer’s Disease (Oxford and New York: Oxford University Press, 1993 and 1996), 27. 28. Hans Förstl, “Contributions of German Neuroscience to the Concept of Alzheimer Disease,” 72–82 in Concepts of Alzheimer Disease: Biological, Clinical, and Cultural Perspectives, 78. Details of how AD is understood to work in terms of biochemistry and information available via tissue samples from brains at autopsy and from spinal fluid samples in the living is unpacked (in lay language) in Part IV. 29. In his biography of Dorothea Dix, David Gollaher points out that most superintendents of facilities for the insane—a category into which many dementia sufferers were lumped—were reluctant to give up on the idea of “moral treatment” and kindly care as possible cures, even as the progressive among them were moving as early as the middle of the nineteenth century “increasingly toward trying to find a somatic case for mental illness. If one could look closely enough through a powerful microscope, according to this school of thought, mania, dementia—all forms of madness—would be seen to have an observable pathophysiological basis.” (Gollaher, Voice for the Mad, 379, 381). Grob (my Chapter 4) also discusses the connection between nineteenth-century psychiatrists and their institutional affiliations reflecting their sense of responsibility to the communities that supported them, with both driven by middleclass, white, mainstream Protestant values and both seeing the mentally ill as suffering largely from the effects of bad environments and, therefore, recuperable with the proper discipline and treatment. Clearly this was irrelevant for the severely demented. For an excellent study of late nineteenth-century psychiatric training, institutionalization for people suffering myriad kinds of mental disorders, and the professional preference for disregarding fine-tuned diagnoses, instead accepting simply that “the patients were ‘insane,’ that is all,” see Richard Noll, American Madness: The Rise and Fall of Dementia Praecox (Cambridge, MA: Harvard University Press, 2011), Chapter 1. Quote is on page 26. 30. Holstein, op. cit.
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31. 32. 33. 34. 35.
36.
37. 38. 39. 40.
41.
42.
43.
Förstl, 72. Holstein, op. cit. Falcus and Sako, 5. See Louise Aronson, Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life (New York and London: Bloomsbury, 2019). Elinor Fuchs, “Estragement: Towards an ‘Age Theory’ Theatre criticism,” 69–77 in Performance Research, Vol. 19, No. 3 (2014): 69. This essay won the Best Article award from the Association for Theatre in Higher Education in 2015. Margaret Morganroth Gullette, Declining to Decline: Cultural Combat and the Politics of the Midlife (Charlottesville and London: University of Virginia Press, 1997). Ibid., 220. Ibid., 66–67. Anne Davis Basting, The Stages of Age: Performing Age in Contemporary American Culture (Ann Arbor: University of Michigan Press, 1998), 14. Mike Featherstone and Andrew Wernick, “Introduction” to Images of Aging: Cultural Representations of Later Life, ed. Mike Featherstone and Andrew Wernick (New York and London: Routledge, 1995), 7. See, too, Chapters 1 and 2 in William Graebner’s A History of Retirement: The Meaning and Function of An American Institution, 1885–1978 (New York and London: Yale University Press, 1980). Older workers in the mid-to-late nineteenth century had been valued less for their output than for their knowledge and advice. The latter became expendable as “expansion, commercialization, urbanization” became “the central missions and concerns of the society” (Graebner 11) leading to a new century in which “consumption replaced production as the most important solution to the nation’s economic problems” (15). Erik H. Erikson, The Life Cycle Completed (New York and London: W. W. Norton & Company, 1982), 62. From a psychoanalytic point of view, he notes that “old age was ‘discovered’ only in recent years” (9) Erikson’s first book on the life cycle, Identity and the Life Cycle, was published in 1959. I am including The Waverly Gallery here because I assess its 2019 revival; I am not counting the wife in The Height of the Storm, as it is the husband who appears most confused and whose demise seems to be the one motivating the couple’s daughters to consider how to deal with his legacy and estate (although we are meant to wonder which of the couple is really losing it). See Ballenger, Self, Senility, 59 and 63–64, concluding with the author’s assessment that the focus in the late nineteenth and early twentieth centuries on older, “senile” men’s problems was “an indication of how much of this discourse was driven by anxiety about masculinity.” Eight
2
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45. 46. 47. 48. 49. 50. 51. 52.
53.
54. 55. 56. 57. 58. 59.
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of the ten twenty-first century plays mentioned in this book were written by men, as were Wings, All the Living, and Death of a Salesman. Joint Owners in Spain and Ruff are by women. Arthur Miller, “Tragedy and the Common Man, New York Times 27 February, 1949, Section X, Page 1. Florian Zeller, The Father in The Mother and The Father, trans. Christopher Hampton (London: Faber and Faber, 2015), 75. Falcus and Sako, 9. I expand in Chapter 13 on the history of medicalizing dementia in the United States. Basting, Forget Memory, 33. Ballenger and Karlawish discuss this phenomenon/campaign at length in their respective books. Quoted in Ballenger, Self, Senility, 49. Ballenger, Self, Senility, 79. Ibid., 58. Hinsie and Campbell, Psychiatric Dictionary. Hinsie and Campbell, Psychiatric Dictionary, 693 and 208. Arthur S. Freese, The End of Senility: A Factual Break-Through Guide to the Prevention and Cure of Senility—The Book That Makes Old Age Obsolete (New York: Arbor House, 1978). Peter J. Whitehouse with Daniel George, The Myth of Alzheimer’s: What You Aren’t Being Told About Today’s Most Dreaded Diagnosis (New York: St. Martin’s Press, 2008), xiv. Whitehouse, 16, 221. Ibid., 106. Ibid., 34, 107. Ibid., 98, 220. Ibid., 92. Alzheimer’s Disease Research, 2017 mailer. ADR is a project of BrightFocus Foundation. A 2019 mailer from the same organization repeats the “terrifying disease” tag, adding that “new research into the complexities of Alzheimer’s is our only hope for saving our loved ones from this uncertain fate.” I would suggest that it is, at present, a certain fate and that many will need to spend their precious dollars and time on care and coping, causes not mentioned in the fundraising campaign as worthy of research or support. This standoff is discussed in some detail in Part IV of this book. In early 2021, President Joe Biden proposed including expanded benefits for home health care workers; in the United States, some fifty-three million adults serve as “informal caregivers” for family members with illnesses and these carers are predominantly women who make an average
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of $12 an hour. See Nicole Goodkind, “Biden’s infrascructure plan sets out to expand how America looks at eldercare—and who gets paid,” Fortune, 8 April 2021. https://fortune.com/2021/04/08/bidens-inf rastructure-plan-elder-care-homecare-healthcare-medicaid/ (Accessed 29 March 2023). 61. Macdonald and Mears. 62. Falcus and Sako, 17. An early and oft-cited work in this movement is Tom Kitwood’s Dementia Reconsidered: The Person Comes First (Berkshire, UK: Open University Press, 1997).
CHAPTER 3
Bodies in the Audience/Bodies Onstage: Intersectionalities
I’ve sketched in brief in the opening chapter a simple portrait of the theatregoing audience who might be expected to see or have seen the plays discussed in this book. From the earliest studies of American theatre audiences—in the late nineteenth and early twentieth centuries, not always rigorously conducted—to the current emphasis on quantitative as well as qualitative data, the origins of which might be traced to William Baumol and William Bowen’s seminal 1966 study, Performing Arts: The Economic Dilemma, scholars, critics, journalists, arts administrators, and demographers of various stripes have identified theatregoers as educated and possessed of disposable income.1 This sledgehammersubtle description may be useful in the pursuit of ticket sales, but one might ask what “educated” means beyond specialist credentialling when there is a comprehensive cultural context that the “educated” share with the “uneducated.” The STEM major who endures the minimal undergraduate university requirements in arts and humanities is no more or less “educated” than, say, the Classics scholar who has mastered four or five languages by junior year and eschews STEM subjects, except, again, as required, feeling free to proclaim “I’m no good at math” when confronted with balancing a checkbook. Both or neither may embrace theatre for any number of reasons, and what they do not share may inflect their experiences as much as what they do.
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 D. Chansky, Losing It, https://doi.org/10.1007/978-3-031-20902-4_3
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The above notwithstanding, theatregoers sharing the experience of a performance also share a zeitgeist. It is this widest of contexts that must be considered in any responsible analysis of an aesthetic phenomenon, no matter how rarefied, and Losing It depends on the wide context to situate its discrete case studies. Educated Americans buy their gasoline, charge their phones, procure packaged snacks, and rely on public snow removal in the same capitalist landscape as their fellow citizens who have marginal formal education. Here I want to use a relatively recent example of a widely recognized cultural phenomenon to point to a kind of understanding or awareness that emerges within a society and affects a broad swath of people on many points along the spectrum from specialists to the un(formally)educated. As a single index, I turn to network television for an example of both influencing and reflecting the mainstream understanding of a medical condition and phenomenon. Consider two episodes of the popular NBC police detective series Law and Order: Special Victims Unit (which started its twenty-third season in fall 2022). In 2006, eighty-year-old Jerry Lewis made a guest appearance as a homeless man whose obsession with a rape-and-murder case helped solve the episode’s crime.2 At one point, as Lewis’s character starts to lose coherence under questioning, the police squad’s psychiatrist notes that the man is sundowning. The lead detective doesn’t understand, and the psychiatrist explains to her that this is the term for what happens to many dementia sufferers toward the end of the day, as their abilities to focus and remember dwindle. Five years later, in an episode featuring a retired, legendary fictional football player arrested for soliciting sex from a fourteen-year-old, legal experts see the only chance of a “not guilty” verdict depending on the fact that the defendant is not responsible for his actions, due to repeated head injuries that have caused chronic traumatic encephalopathy (CTE), a degenerative disease that is a form of dementia.3 This time, the lead detective refers to sundowning herself, persuading the district attorney to keep the injured player on the stand late enough into the day to get him acquitted for lacking the capacity to remember or know what he did. Five years meant the distance between needing a pop culture footnote and the confidence to assume mainstream familiarity with a very ordinary facet of dementia that, nonetheless, could pass as irresponsibility or insanity absent the medical understanding that had seeped into the wider culture. I will be mining both medical/specialist and popular culture sources to build my arguments about the plays in this book. I should also point out
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that, as noted immediately above, public awareness shifts, which means that plays in revival are greeted by audiences whose worlds are not identical to the worlds of the audience(s) anticipated when the plays were new. This comes into play, particularly, in my analyses of Death of a Salesman, The Waverly Gallery, and Joint Owners in Spain. As Christopher Balme makes clear, theatre audiences “cannot be coterminous” with the wider public in whose name theatre sometimes claims to speak because theatre since the rise of modernism has the privileged experience that is “predicated on intensified absorptive attention usually in darkened spaces to enable a primarily aesthetic experience but which is seldom conducive to social or political debate.”4 In The Theatrical Public Sphere, Balme makes short work of relegating the contemporary (“serious”) theatre to “a place of concentrated aesthetic absorption,” removed over the course of the past century and on the back of Modernism from “a rowdy, potentially explosive gathering” and generally implying an audience “more or less intense, corporally immobilized … in a darkened auditorium.”5 The abolition of censorship laws in Europe and the United Kingdom signals, for Balme, “a gradual recognition of theatre’s increasing marginality as an agent in the public sphere.”6 Indeed, Balme invokes Dennis Kennedy’s 2009 dig at the theatre as a “cultural cul-de-sac off the Infobahn.”7 Liz Tomlin, on whose work about audiences I draw in Chapter 13, notes that present-day theatregoers with an interest in political and/or activist theatre manifest their separateness from some citizens of communities in which they live by often sympathizing with “others” who live beyond their immediate reach (geographic or social) while turning up their noses at people in their communities whose values differ greatly from their own.8 Think liberal or progressive Democrats in the post-2020 United States for whom BIPOC lives matter but anti-vaxxers can be regarded as dangerous Neanderthals. None of this is to say that all members of the theatre-going public are uninvolved in political debate or activism. Indeed, following and discussing unusual theatre work is a form of social engagement for many, yet it is as much this investment in the newest, arguably experimental or potentially offensive facet of theatre that makes its followers out of touch with some of the political or religious interests of a wider public. It is primarily to say that an interest in theatre as a locus of personal experience and coterie knowledge often trumps any interest in theatre as a way of reaching a wider public—a public that may (and does) include people wholly unlike the usual theatre-loving suspects. Again, this is not to say
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that those who regularly can be expected to be part of a theatre audience are impotent or uninterested in the public sphere in other contexts. But Balme’s focus, and mine, is the intersection of theatre, cultural knowledge, and audience around a particular issue, in this case, dementia in the United States of the past century and up to the early 2020s—an issue whose theatrical response has generally not focused on activism or a sphere wider than the family, the individual, or personal life in an institution. As W. B. Worthen so succinctly puts it, theatre can be “a device for claiming and legitimating a certain kind of interpretive activity,” one valued because of its basis on “precisely the freedom not to see.”9 On the other hand, as Janelle Reinelt cautiously asserts, theatre can be “a possible worksite for democracy and citizenship” but its “contribution to the public sphere is limited to its local impact,” although plays and productions that travel can have a broader reach. Nonetheless, despite theatre’s capacity “to modify or challenge” other forms of information, it only does this “alongside of but also in tension with other nodes in a communications network.” I deliberately foreground a kind of backand-forth here, as it has become a shopworn truism that theatre can be a driver of social impact but that its far-reaching effects can rarely be quantified, especially in the short term. Reinelt also clear-sightedly reminds her readers that “the insistence that art can only be transgressive and individual seems like a legacy of romanticism.”10 The plays in this study both support and challenge the status quo, sometimes doing both, depending upon a critic’s or an audience member’s point of view, and sometimes doing one at the time of initial production and another later in revival(s). How theatregoers make sense of performances is the product of both what they bring to the table and what the artistic personnel place there. Marco De Marinis calls spectators’ interpretive response activity to theatre productions “controlled creative autonomy.”11 Artists can lead audiences to aesthetic water but can neither force them to drink nor control the specific way or amount they swallow if they do choose to imbibe. Importantly, audience response does not occur in a vacuum. Maaike Bleeker underscores “the necessity of locating vision within a specific historical and cultural situation.”12 Within that situation, though, theatregoers’ attention is structured by such things as seating configuration; lighting and positioning of actors onstage (focus is rarely determined randomly by viewers); and, predictably for most of this book, the “privileged status of the verbal text in the Western theatrical tradition.”13 For De Marinis, disruption and surprise are key to spectatorial engagement. He quotes
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a favorite Italian director who believes that “there are two aspects to the enjoyment which theatre can give: surprise and the joy of finding the same thing over again.”14 This “dialectic between the frustration and satisfaction of expectations”15 is, in the aggregate, what the plays in Losing It offer. The more dramaturgically traditional works satisfy expectations for narrative closure, although they may frustrate expectations of or hopes for answers to, or even deep discussions of, social (in the sense of public or culture-wide) problems. Some of the less traditional have satisfied some audience members’ expectations of novel perspectives or forms of theatrical treatment while perhaps frustrating the expectations of others who had hoped for traditional narrative or for familiar (maybe safer?) character types. Frustrated expectations come into play in published audience responses to The Humans , discussed in Chapter 13. This dialectic can be unpacked with regard to Joint Owners in Spain and Death of a Salesman across decades. The dialectic is important in considering revivals, both on Broadway (e.g., The Waverly Gallery) and, of equal significance, in amateur or regional contexts, where local interests cannot be ignored. While it is impossible to get inside the head of every individual within a single night’s audience—much less the cumulative audience for the full run of any production—it is worth keeping in mind Bleeker’s caveat that, in addition to (shared) cultural situatedness, what is put in front of audiences is not merely “there,” but is “in fact, rerouted through memory and fantasy, caught up in threads of unconscious and entangled with the passions.”16 At the very least—and I acknowledge up front and in full that the concession is minimal—audiences fracture along lines of generation(s) and/or personal (lack of?) connection to the individual or people with whom any of them is sharing a theatre experience. Audiencing is both a communal and solitary activity, always already inflected by personal psychology and experience on top of broad cultural as well as immediate social situatedness. As a final area to consider regarding American audiences for plays about dementia, they are, if we are to believe the scholars who study manifestations and representations of dementia, composed of anxious bodies. Ballenger argues forcefully that, regarding the terror that came to surround dementia in America starting around the end of the nineteenth century, contra conceptions of the self that had once been based on the place in family, community, or the eyes of God,
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broader changes in American culture associated with modernity … made the symptoms of senile dementia more frightening. In the antebellum period, hierarchical social relations eroded with the market revolution and the triumph of a liberal social order. Since then, the notion of selfhood has grown increasingly problematic for all Americans. Selfhood was no longer an ascribed status but had to be carefully and willfully constructed by every individual.17
Indeed, not only symptoms of senile dementia, but ordinary signs of aging provoked anxiety under the new Victorian code of self-control, a code whose rules stipulated that “the decaying body … came to signify precisely what bourgeois culture hoped to avoid: dependence, disease, failure, and sin.”18 This American anxiety can be situated in a larger Western context, one described by Rebecca Bitenc as “hypercognitive,” and in which “selfhood is seen to depend on cognitive functioning alone,”19 but I want to put pressure here on its American iteration, if for no other reason than because the care of people with dementia remains influenced ideologically and financially by national values and specific laws governing health care. I discuss this in Chapters 13 and 14. So-called rugged individualism exacts a toll. It assumes identity must be achieved and maintained, the latter threatened by a lessening of the cognitive capacity to “get ahead” in the world of work. A superb argument for the Americanness of this anxiety in a late twentieth-century context is made by Kathleen Woodward in her examination of literature treating dementia.20 Analyzing Marion Roach’s 1983 article in the New York Times Magazine, in which Roach describes in the first person her journey with her mother’s early-onset Alzheimer’s, replete with references to hopelessness (Roach’s) and loss of personhood (her mother’s),21 Woodward writes, “the disease … in the course of the essay is reified.”22 By contrast, Yasushi Inoue’s (Japanese) novel Chronicle of My Mother, while never denying the profound changes in the person at its center, offers a cultural perspective in which loss is not ignored, but emotional continuity is honored, as are a relation to landscape and a shared investment in “traditional rituals that enable one to meet death with dignity.”23 To the extent that Inoue and Roach likely see a future self in the parent, one writer knows that past, present, and future will fuse, albeit not in a linear way, and that “answers” are not the point, while the other imagines “tragic fate.”24 Woodward wants readers to widen their theoretical lenses
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beyond “the American tradition of ego psychology.”25 She invokes Beckett’s Krapp’s Last Tape, in which the play’s protagonist fails to remember past events that once seemed indelible to him, yet whose fragmented experiences, as Woodward points out, can be read simply as a display of what might be called “the way it is,” rather than as the sort of loss that would underpin romance, a genre with an investment in meaning that “seldom occurs in our everyday lives…. [T]his is one of the reasons we are drawn to such fictional narratives: they offer fulfillment of our wish that our lives end with a certain poise and balance.”26 Why, Woodward asks pointedly, “should integration and reconciliation necessarily be valued or prized? … is the continuity of the self itself a fiction?” Such searches for meaning can, she argues, make us “blind to the plenitude— however mundane—of the present.”27 Picasso rather than George Eliot, indeed. I have reiterated a few times that audience engagement with plays about decline and caregiving are inflected by considerations of other plays, television shows, books, publicity, journalism, and films that tell us much about what audiences bring to the playhouse by way of popular knowledge and, perhaps, expectations. What they see in any single playgoing experience in turn also inflects their understanding of dementia and its social challenges. And what they literally see, of course, are actors playing roles, not actual dementia sufferers (Peggy Shaw’s Ruff , which is about her own stroke, was an exception). These bodies with whom spectators share space are the living conduits of authorial ideas. Performers’ mimesis and semiosis inevitably speak across the footlights. Embodiments of decline sometimes undercut even as they support the ideas embedded in playtexts. Quite typically, for instance, actresses significantly younger than their characters portray “old” (itself a flexible and changing notion) women onstage. Does this practice offset the resistance producers imagine would be engendered by the appearance of actual “old” women (other than stars) onstage? Valerie Lipscomb points to this conundrum in Performing Age in Modern Drama. “The apparently successful casting of actors whose ages differ significantly from those of the characters they play returns us to a consideration of age not only as performance, but also as performative.”28 One might substitute “cognitive capacity” for “ages,” but Lipscomb’s argument here is not so much about the credibility or persuasiveness of any actor’s impersonation (“it’s called acting, stupid”) as it is with audience desire in the form of “the longing for an essential, stable self, one that remains constant throughout
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the years…. Perhaps then, … [the phenomenon at work is] the longing for—and continuous attempt to construct—an integrated, unchanging self.”29 To stave off their own fears, perhaps audiences want to believe that characters in decline retain the wholeness that can be attributed to the actors who portray them. Or, in a related vein, the assurance of mental “wholeness” in the actors—likely evident at the curtain call—erases the frightening specter of the (persuasive?) character losing his or her independence and/or grip on “reality.” Yet this desire is linked to a belief that the “self” comprises consciousness, memory, and cognition above all. I discuss the slipperiness of equating self with a common idea of memory in Chapter 9. When it comes to dementia, the problem of an age/actor/self/ character package is both obvious and tricky. An actor needs to be able to deliver a reliable performance, so the idea of typecasting an actor with dementia to mesh with some of the more obvious (and arguably naïve) facets of realism is problematic. My discussion of this problem draws on what Anne Davis Basting calls “complex and even contradictory descriptions of age. To be old might now refer to one’s chronological age (number of years), biological age (rated according to one’s health), social age (determined by social roles), or personal age (self-selected).30 “Biological age” allows for a chronologically youngish person with dementia to be figured as old since the disease almost inevitably hastens death. Three ideas underwrite many of my considerations of how actors’ bodies speak to and about experiencing dementia and decline: the body in-depth, ghosting, polyphonism. Basting’s 1998 The Stages of Age— arguably the first book to put aging discourses in conversation with theatre—offers the rich concept of “the body in depth,” which figures in portrayals that show dramatic characters declining over a period of time or dramatic characters performed in a single play by more than one actor: Simply put, to see the body in depth is literally to see time across space. It is to witness the event of aging, to anticipate the changes the body will produce, and to remember changes already passed. To see the older body in-depth is to recognize the wrinkles and age spots while also seeing the thick, pliant skin of a child. To see a younger body in depth, on the other hand, is to imagine the uncharitable changes that the body will produce … the important thing is not to polish the details, but to acknowledge the almost certain (barring tragedy) links between youth, adulthood, old age, and all categories in between.31
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To cite a single, but very potent instance of a body staged in-depth, David Lindsay-Abaire’s Kimberly Akimbo, staged in New York in 2003 and reworked as a musical in 2021, features a sixteen-year-old living in the body of a sixty-four-year-old due to an unusual genetic condition that causes her to age four biological years for every one chronological one.32 The playwright stipulates that Kimberly should be played by an actress in her sixties or seventies. While the play is solidly a wacky family comedy, the staging of the body in-depth is at the heart of the cultural work it does. The mashup of body and actions keeps at bay a spectator’s full identification with either old age or youth while insisting that the two are imbricated rather than entirely discrete. When Kimberley suffers a heart attack at chronological age sixteen during a family birthday party, the imbrication is brought home to roost. I would argue, however, that audience members are aware of bodies indepth even when a single actor plays a single character in decline, by virtue of the fact that the actor is not (cannot be) in severe decline if s/he is to learn lines and repeat performances over a period of time, thereby offering simultaneously illness and not-illness, often figured as age and not old.33 Consider, as one iconic example, Lee J. Cobb, the actor who originated the role of the sixty-something Willy Loman in 1949, when Cobb was thirty-seven. Cobb, not yet a star, offered viewers a chance to see an older man in the body of a younger one, and possibly the presence of (performatively obscured) youth in the defeated and declining protagonist. At the other end of the spectrum, Lois Smith originated the eponymous octogenarian of Marjorie Prime in New York just after she turned eightyfive; Elaine May earned a Tony Award for Best Actress in a Play in 2019 at age eighty-seven for her performance in the revival of The Waverly Gallery. Here, two perspectives present themselves. One, and perhaps the most obvious, is that these eighty-somethings are exceptional personifications of positive aging, continuing to excel at physically and mentally demanding work as they travel toward the end of their ninth decades. The other is the phenomenon Marvin Carlson calls ghosting, something that arises whenever we see an actor whose work we have previously experienced undertaking a new role.34 Past characterizations “ghost” the present one, frequently bringing to mind youthful work that somehow still clings to the older body. Certainly this phenomenon was at play for some audiences watching the now-iconic May, who made her Broadway debut in 1960 with her comedy partner, Mike Nichols, in An Evening With Mike Nichols and Elaine May Ghosting is also at play when amateurs
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who are known in their communities for their “real life” roles take on dramatic parts and the two characters/characteristics are imbricated, a phenomenon I explore in my discussion of Joint Owners in Spain. Polyphonism is the noun form I proffer for what Sarah Falcus and Katsura Sako describe as “polyphonic narrative” (68). They use this term parsing the work done by a comic book (their label for one iteration of “graphic life writing”) based on Y¯ uichi Okano’s 2012 Pecross’ Mother and Her Days . Falcus and Sako identify this work as a somatography, a category of text about dementia written by carers and/or family members … [that] offer intimate and affective insights into the relational context of dementia and its effects on those trying to care for someone whose perceptions of the world and of time are undergoing radical change [and] … are about people with late-onset dementia. (68)
Graphic life writing interests Falcus and Sako for its capacity to “depict dementia in the context of care relationships” (57), serving to “produce … a hybrid form able to represent narrative and [italics in original] materiality simultaneously and “indicating the possibility of an understanding of selfhood that is ‘embodied’” (58). Cartoons allow for gaps and jumping in time and place, therefore effortlessly forcing—or at least inviting—shifts in reader perspective. For once, it is narrative/literary theory that is late to the party, as theatre has been precisely this hybrid at least since the first performance of Oedipus at Colonus (which also threw gender impersonation into the mix). For audience members attuned to the utterances of dramatic characters with dementia in the context of other characters’ concerns with the dementia characters embodied by actors who may well be channeling age as well as bringing onstage ghosts of their earlier performances, oscillations between blending and clashing can be deeply revealing. This phenomenon comes into strong play in my analysis of The Father and The Humans . Audiences are presumably expected to identify with the characters who drive the narratives of the plays I examine, as these characters give voice and face to the fears and challenges experienced by those who witness, deal with, and are able to articulate the effects of dementia. Among these characters, it will be unsurprising to most readers that the ones
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who deal with hands-on care are primarily women.35 Dara Horn pointedly expressed the ubiquity—even the naturalized expectations—of this phenomenon: Only for a nanosecond of human history have men even slightly shared what was once exclusively a woman’s burden: the relentless daily labor of caring for another person’s body, the life-preserving work of cleaning feces and vomit, the constant cycle of cooking and feeding and blanketing and bathing, whether for the young, the ill or the old. For nearly as long as there have been humans, being a female human has meant a daily nonoptional immersion in the fragility of human life and the endless effort required to sustain it.36
Since roughly the 1970s, when middle-class American women began to enter the workforce as a matter of course (working class and poor women had already been there for a long time), the economics of this gendered expectation has taken some eldercare out of the hands of family members, outsourcing their labor to underpaid, almost universally female caregivers who are often undocumented, foreign-born workers.37 Economist Nancy Folbre points out that this outsourced labor makes possible, among other things, dual-career households (of the sort that often domicile people who can afford theatre tickets), but that, while this labor is regarded as useful to the individual, it is not factored as a societal good.38 It is useful to point out that the preponderance of American theatregoers (one source claims 70%) are women.39 It is impossible to know whether, with regard to gendered expectations that still prevail in American culture, the pleasure women audience members take in watching plays about dementia, decline, and caregiving constitutes instances of Worthen’s freedom not to see (the reality of the paid caregiver, when applicable?) or of recognizing personal truisms, or neither, or both. Whatever optic is at play, gender is on non-neutral display, if one knows where to look, on both sides of the footlights for dementia plays, even if simply in economic terms. And, to return to the handful of twenty-first-century caregiver plays discussed briefly at the opening of the Introduction, in which five of six dementia sufferers are women, not one features a male solo caregiver, while all six feature women providing care. When men do perform caregiving, they are part of a dyad that includes a woman, something that gets closest to being egalitarian in The Humans. In Dot , two adult daughters of the
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character with dementia have part-time help from a hired male caregiver; their brother offers no help. The bodies of actors—including both those who play people with dementia and those who play people otherwise dealing with the illness and its imperatives—and the bodies of audience members meet in the playhouse, joined together via narrative and performance. As Falcus and Sako underscore, “narrative is central to the public debate over, and understanding of, dementia.”40 The nature of the encounter is, of course, inflected by the nature of the theatrical work, and the pieces in this book run the genre gamut from lightweight comedy (Joint Owners In Spain) to “tragic farce” (The Father) to one-woman autosomal (having to do with living in a particular body—typically an anomalous one—rather than with living as a particular ideological “self”) show (Ruff ) to near-plotless, real-time depiction of an everyday that veers close to naturalism (The Humans ) to a kind of detective story that does not fully solve the crime (Our Mother’s Brief Affair) to iconic memory play (Death of a Salesman) to abstract expressionist, nonlinear explosion of sensibility (Wings ) to activist pièce-a-thèse melodrama (All the Living ). A frequent somatic bid at the end of a pre-show announcement in the theatre is to “sit back, relax, and enjoy X,Y,Z .” If this is not how you (choose to) experience this book, feel equally free to sit forward, tense up, and argue in your mind with Losing It. Or oscillate among positions. Changing seats/optics is free.
Notes 1. William J. Baumol and William G. Bowen, Performing Arts: The Economic Dilemma: A Study of Problems Common to Theater, Opera, Music, and Dance (New York: Twentieth Century Fund, 1966). It is beyond the scope of this study to go into detail on this phenomenon, but its early years are discussed in Chansky, Composing Ourselves, passim, with a brief nod to further reading about recent values on page 218. See, too, Dorothy Chansky, “Burns Mantle and the American Theatregoing Public,” Theatre History Studies, Vol. 31 (2011): 51–66. 2. The episode is the 2006 “Uncle,” first aired in October, 2006. 3. The episode is the 2011 “Spiraling Down,” first aired in October, 2011, and featuring Treat Williams as the ex-NFL quarterback. American sports fans may have learned about C.T.E. in 2021 when retired National Football League player Phillip Adams, then thirty-two, shot and killed six
3
4. 5. 6. 7. 8. 9. 10.
11.
12. 13. 14. 15. 16. 17. 18. 19. 20.
21.
22. 23. 24. 25. 26.
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people before dying himself by suicide. A post-mortem examination of his brain revealed severe, advanced C.T.E. Christopher Balme, The Theatrical Public Sphere (Cambridge: Cambridge University Press, 2014), 13, 14. Ibid., 3 and 13. Ibid., 16. Kennedy quoted in Balme, 14. Liz Tomlin, Political Dramaturgies and Theatre Spectatorship: Provocations for Change (London and New York: Methuen), 16–19 and 129–157. W. B. Worthen, Modern Drama and the Rhetoric of Theater (Berkeley: University of California Press, 1992), 53. Janelle Reinelt, “Performance at the Crossroads of Citizenship,” 34–50 in The Grammar of Politics and Performance, ed. Shirin M. Rai and Janelle Reinelt (London and New York: Routledge, 2015), 42 and 43. Marco De Marinis, “Dramaturgy of the Spectator,” 100–114 in TDR (The Drama Review) T114 (Summer, 1987), quoting Franco Ruffini on p. 101. Maaike Bleeker, Visuality in the Theatre: The Locus of Looking (Basingstoke, UK: Palgrave Macmillan, 2008), 2. De Marinis, 108. Luca Ronconi, quoted in De Marinis, 112. De Marinis, 112. Bleeker, op. cit., 2. Ballenger, Self, Senility, and Alzheimer’s, 9. Cole, The Journey of Life, 231. Rebecca A. Bitenc, Reconsidering Dementia Narratives: Empathy, Identity and Care (Routledge, 2020), 135. Kathleen Woodward, in “Reminiscence and the Life Review: Prospects and Retrospects,” 137–161 in What Does it Mean to Grow Old?: Reflections from the Humanties, ed. Thomas R. Cole and Sally A. Gadow (Durham, NC: Duke University Press, 1986). Marion Roach, “Another Name For Madness,” New York Times Magazine, 16 January 1983. https://www.nytimes.com/1983/01/16/mag azine/another-name-for-madness.html (Accessed 1 April 2023). Woodward, 140. Ibid., 141. Ibid., 142. Ibid., 144. Ibid., 151.
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27. Ibid., 156, 160. 28. Valerie Barnes Lipscomb, Performing Age in Modern Drama (New York: Palgrave Macmillan, 2016), 42. 29. Ibid. 30. Basting, The Stages of Age, 17. 31. Ibid., 141. 32. Lindsay-Abaire may or may not have been inspired by HutchinsonGilford progeria syndrome (HPGS), a rare genetic condition that produces rapid and premature aging in children. See Jason Horowitz, “Living With Gusto Despite a a Rare Fatal Disease,’ New York Times (2 April 2022). https://www.nytimes.com/2022/04/01/world/europe/ scientist-patient-progeria.html?campaign_id=2&emc=edit_th_20220402& instance_id=57450&nl=todaysheadlines®i_id=23019177&segment_ id=87328&user_id=1dbf70b423f43b29db1b038801e53866 (Accessed 1 April 2023). 33. Noah Haidle’s play Birthday Candles features a central female character who goes from age seventeen to age 101 over the course of a ninetyminute play. The piece premiered in Detroit in 2018 and opened in New York in 2022. 34. Marvin Carlson, The Haunted Stage: The Theatre as Memory Machine (Ann Arbor: University of Michigan Press, 2003), Chapter 4, “The Haunted Body.” 35. Husbands in Marjorie Prime and The Humans are exceptions, as are medical doctors in All the Living. The grandson/narrator in The Waverly Gallery spends time with his grandmother and her certainly cares about her, but he is not a primary caregiver in the hands-on sense and, indeed, narrates at the end of the play that he was out of the caregiving world for the final two years of his grandmother’s life. 36. Dara Horn, “The Men Who Want to Live Forever,” New York Times, 25 January 2018. https://www.nytimes.com/2018/01/25/opinion/sun day/silicon-valley-immortality.html?emc=edit_th_180126&nl=todayshea dlines&nlid=23019177 (Accessed 1 April 2023). 37. On changing economics, see Nancy Folbre, The Inivisble Heart: Economics and Family Values (New York: New Press, 2001). On foreign-born and underpaid caregivers, see Rachel Aviv, “The Cost of Caring,” The New Yorker 11 April 2016: 60; and Miriam Jordan, “When the Elderly Call for Help, a ‘Chain’ Immigrant Often Answers,” New York Times, 25 March 2018. https://www.nytimes.com/2018/03/25/us/immigrationlabor-trump.html (Accessed 1 April 2023). 38. Folbre, 66–67.
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39. Lauren Gunderson, “Theater’s Audiences are Mostly Females: Why Not the Roles?” https://www.huffpost.com/entry/theatres-audiences-arema_b_1388150?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ2 9vZ2xlLmNvbS8&guce_referrer_sig=AQAAAJUsSzUs1NRucnQnsKzX 8shQWLJ2BXft8tj0rR3sz3A4rqSe3a5p7OtusPglqdfyW9Kj6gatocLZq 9IiHmQ6bFvajQf2U3heGhMDn3iXPSxgzadruPrBrppXLcyWwvSJmuJ hOG_CrfFkynJ56KN0YJfeFigJXz0xnQHsP3zWNsSq (Accessed 1 April 2023). This is not a new phenomenon. For a consideration of women as audiences for American theatre in the Progressive Era, see Chansky, Composing Ourselves, Chapter 4, “Woman and/as Audiences.” One 1913 article reported that 80% of American theatre audiences were women (107). 40. Falcus and Sako, 3.
PART II
Social Insecurity
CHAPTER 4
Walk-On: Joint Owners in Spain
This chapter offers a new reading of Alice Brown’s dramatic legacy by situating her best known play, Joint Owners in Spain, as the earliest American realist play to feature a character—albeit a minor one—with dementia, absent any ridicule or bathos. It is also a piece of feminist resistance that enjoyed production long after its initial splash in a context where its materiality was widely familiar to audiences. Hence, dementia as a women’s problem was made public in a palatable yet straightforward way to thousands of theatregoers who might not otherwise have seen cognitive decline presented publicly and without shame. New England writer Alice Brown (1857–1948) is remembered today, if she is remembered at all, as a nineteenth- and early twentieth-century regionalist with a penchant for dialects, moralizing, close-ups on material culture, “mid-Victorian optimism,” sympathy for women misunderstood by their men, and a love of nature.1 She published seventeen novels, three volumes of poetry, nine collections of short stories, and five volumes of non-fiction, including studies of Mercy Otis Warren and Robert Louis Stevenson.2 In 1914, however, she was for a brief moment a darling of the theatre world, when she won the $10,000 prize offered by Little Theatre producer Winthrop Ames for “best American play,” with Children of Earth, one of 1646 eligible submissions, all submitted under pseudonyms.3
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 D. Chansky, Losing It, https://doi.org/10.1007/978-3-031-20902-4_4
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Brown’s 1914 prizewinner, Children of Earth, is set in a small New England town—the author’s choice of milieu for most of her work. The play follows an unmarried woman, Mary Ellen, who finally has the chance to wed upon the demise of her father, for whom she has been the primary caregiver. Both the father and her brother want her to marry in the interest of acquiring property via a particular union. She prefers a different suitor—one she has long genuinely loved and admired—but he is already married, albeit unhappily to an alcoholic. Our heroine sacrifices the pleasure that might have been for the propriety she knows. The play opened at the Booth Theatre on Broadway, garnering at best lukewarm reviews, with one representative writer calling it “an unconvincing story of middleaged romance…filled with pretty sentiment which fails merely because it lacks that elusive something which producers nowadays term ‘punch.’”4 It closed after thirty-nine performances. Shortly before winning the prize, however, Brown saw the opening of one of her plays that was to have shelf life of over three-quarters of the twentieth century with descendants in the twenty-first, whether their immediate progenitors recognized ancestral dramaturgical DNA or not.
Joint Owners: Dramaturgy and Depictions Joint Owners in Spain features two old women in an “Old Ladies Home”5 both of whom have caused every roommate they’ve ever had to tear out her hair. Finally, the Home’s director throws the duo in with each other to sort it out, which they do. The play definitely does have “punch,” in the sense that its point of attack is a problem that has reached an impasse; it features the conflict between two strong, individualized characters; it builds to a crisis; and it is resolved in a creative, even inspiring, and touching but not sappy way, when one of the women hits upon the idea of drawing a chalk line down the middle of the room and getting her counterpart to agree that the line is an imaginary wall offering privacy to both. Living into old age in the absence of wealth or a willing (usually female) caregiver could spell upheaval, insult, embarrassment, malnourishment, precipitously reduced living circumstances, disgrace, disorientation, and depression for the elderly in the days before Social Security, Medicare, and Medicaid offered Americans at least a modicum of financial support. The earliest of these, initiated with the Social Security Act of 1935, was part of Franklin Roosevelt’s New Deal, created in response to widespread recognition of the dire needs of older Americans that became painfully
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apparent during the Depression.6 The program offered financial resources to people sixty-five or older who met certain criteria; it excluded farm workers and domestics, among others. Because Social Security was predicated on recipients having earned wages and contributed to the program, women were generally only eligible if they were widows of qualifying male participants. In Joint Owners in Spain, neither federal aid nor any of the varying (and few) pension plans of the early twentieth century—some offered by unions, some by states, some by private employers, but none far-reaching—is even a gleam in the eye of the rural women who find themselves in the Home. The primary characters in this play crave and privilege privacy and autonomy; their ability to perform separate domiciles and neighborliness restores their dignity. Joint Owners is both unusual for its time and prescient. It features a cultural conundrum produced by characters representing a demographic in decline (they seem to be in their sixties or seventies, although no ages are specified7 ), two of them querulous and eccentric, another one definitely in the mild to moderate stage of dementia8 (although it is not named that way), and determination on the part of three characters to work within a problematic system. Brown’s insights into eldercare remain timely; her focus on the gendered nature of both prejudice and persistence in the key of the everyday are handled with wit and nuance. Her willingness to include without ridicule or comment a minor character— the “walk-on” of this chapter’s title—who today would be recognized as having dementia was bold and unusual without being offensive or outré. The play’s premise and set-up were recently revisited in Tina Howe’s 2009 Chasing Manet and David Lindsay-Abaire’s 2015 Ripcord, each play featuring a pair of women with wildly differing temperaments sharing a room (at first reluctantly) in an assisted living facility. Part of my project here is to show the social policy and feminist forests too easily obscured by the local color trees in stage representations of dementia, decline, and caregiving. J. Samaine Lockwood offers a useful way of thinking about Brown’s “local color” work that is germane to appreciating and unpacking Joint Owners. Troubling simplistic notions of regionalism, Lockwood zeroes in on New England women writers who resisted heteronormativity both in their lives and their writing to insist that the independence they claimed for themselves and for their characters implied that precisely such nonconformity “was essential to democratic life, that so-called old maids were representative of a not yet realized democratic state, or better put,
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given New England regionalists’ decided critique of the nation, a not yet realized free community of white, cosmopolitan dissenters.”9 The “old ladies” of Joint Owners, then, far from being quaint relics of smalltown life in arguably the oldest (settled by white, non-Spanish Europeans) region of the (originally constituted) United States, are models of what a civilized democracy needs to recognize and address. Elders, especially women, without immediate family or pensions still crave dignity and some independence, even if they also require assistance in their day-to-day lives and even if they are beginning to “lose it” cognitively. The characters in this play also model a bootstrap, collaborative method of problem-solving. Blindness to racial privilege is neither confirmed nor denied; as Lockwood suggests, it is on display as both part of the problem and a platform for proposing a solution. The play’s efficient dramaturgy pares down to a single extended scene with four characters in one room an earlier iteration of the narrative—the short story—that covers two weeks and features several additional minor characters in other locales within the home. At the play’s opening, Mrs. Fullerton, who is described as “very delicate, old and shaky, and more than ever ‘faded in her wits’ because dazed by impending change”10 is being ushered out of the room by Mrs. Mitchell, the home’s director, described as “a kindly, prosperous and energetic lady,” while Miss Dyer looks on. In both the short story and play, we see that it is Mrs. Mitchell who has decided to put the two problematic women together. Miss Dyer is the room’s other inhabitant—one of the troublesome two. Mrs. Blair (read “blare,” as she is “‘highspirited’ and overbearing”)11 is brought in to meet Miss Dyer (read “die-er,” as she claims she “ain’t a well woman and … ain’t been this twenty year”12 ), after Mrs. Mitchell informs Miss Dyer that she will have a new roommate, owing to her impossible disposition having worn out all previous—and mild-mannered—roommates via endless cantankerous (a word Mrs. Mitchell uses in her explanation) complaining. Indeed, Mrs. Mitchell notes, “There are just two of you in the Home that are impossible to live with—you and Mrs. Blair.”13 While nearly all of the dialogue in the play is lifted right from the short story, and, as I mentioned, several minor characters have been eliminated from the drama, Mrs. Fullerton is an addition. Certainly, her meekness and seemingly total harmlessness pave the way for the assertion that Miss Dyer would try the patience of a saint, making Mrs. Fullerton an ideal embodiment of the impetus for the play’s action. Her sleeplessness and being “scared out of her wits” by Miss Dyer constitute the inciting
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incident for the play. But this character also fleshes out in a small but significant way the picture of the world of eldercare and understanding of what was at the time called senile dementia (discussed in the Introduction) that were being negotiated in the first two decades of the twentieth century. Joint Owners in Spain, then, presents at least two reasons for scholarly attention. First, although its plot has been described as “melodramatic,”14 it can be read as a naturalist snapshot of a turn-of-the-century charitable project in New England, colored by regional as well as national values but also highly local in its materialist details. In this way, it is of historic interest, particularly regarding what sort of play appealed to its original producers and audiences and why a play about old women would fit that bill. Second, however, it portrays a rock-and-a-hard-place situation still alive and well in the first half of the third decade of the twenty-first century. Namely, while the science of understanding aging and various dementias has made great progress, and while a far greater percentage of American senior citizens has some kind of health insurance than ever before (primarily owing to the creation of Medicare in 1965), the fear of living in a facility and the absence of a safety net for all (something that might perhaps be analogous to public school for children) remain palpably present.15 In this way, Joint Owners is of transhistorical interest, telling much about what sort of play appealed in an ongoing way to various kinds of audiences, albeit largely in amateur contexts, over a wide swath of geography and several generations of theatregoers and theatremakers, and, I would argue, continuing to tell us something about ourselves a century plus after the first opening night. If the specifics of its institutional structures are superficially antiquated and its material world perhaps quaint, its emotional and interpersonal characteristics remain “relatable.”16
Dementia In Situ The home in which Joint Owners is set would have had a specific meaning for readers and theatregoers at the end of the nineteenth century and into the twentieth. A telescoped history of care for the destitute elderly and demented would begin with colonial-era laws stipulating that adult children were responsible for the care of their needy elders.17 The colonies modeled their governance in this area on English Poor Law. For people with no immediate family, local public officials offered assistance, but
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eligibility had stiff entry requirements, including proof of residency within a community (often for several years) and being “worthy” of relief, i.e., unable to work, but the descriptor sometimes carried moral overtones. By the early nineteenth century, almshouses (“poorhouses”) became the trend. Here the idea was that discipline—even punishment—as much as charity or care was of great importance, predicated on the idea that the indolent could be rehabilitated via strict rules and work (despite the frequent entry requirement of being unable to do so). People relegated to almshouses, however, included not only those who might work, but also “the vagrant, the orphan, the mentally and physically ill,” and, of course, “the unfortunate elderly.”18 Over the course of the nineteenth century, municipalities created specialized institutions to address the needs of specific classes of people requiring particularized care. Orphanages, homes for the deaf or blind, and reformatories were created; the acutely ill were sent to hospitals; those deemed insane were sent to asylums focused on their category of disability. This left garden-variety elderly people—including those with some kind of emerging dementia—to become an ever-more-significant presence in poorhouses. Indeed, the “percentage of almshouse inmates above the age of sixty grew from 33% in 1880 to 53% in 1904 and 67% in 1923.”19 By the 1880s, fear of dying in the poorhouse was so great, that Will Carleton’s popular ballad about this had become a musical hit. That the speaker/singer is a woman should not be lost on readers: Over the hill to the poor-house I’m trudgin’ my weary way— I a woman of 70 and only a trifle gray— I, who am smart an’ chipper, for all the years I’ve told, As many another woman that’s only half as old… What is the use of heapin’ on me a pauper’s shame? Am I lazy or crazy? Am I blind or lame? True, I am not so supple, nor yet so awful stout: But charity ain’t no favor, If one can live without Over the hill to the poorhouse—my child’rn dear, goodbye! Many a night I’ve watched you when only God was nigh: And God’ll judge between us; but I will always pray That you shall never suffer the half I do today.20
The home in which Joint Owners is set is not a poorhouse, but an “institutional alternative, the private old-age home.”21 Such private homes were products of motives that could be characterized as a hybrid of
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generosity, guilt, and xenophobia, as reformers and city elders feared relegating members of their own ethnic group (typically white Protestants) to spending their final days in the indignity of being housed with vagrants and/or racial or ethnic “others.” These homes had entry requirements, including a notion of respectability; they also typically included an admission fee. In the short story “Joint Owners,” Mrs. Blair, thinking she’d rather leave the home than another roommate, says “she’d like to know what had become of the hunderd [sic] dollars her nephew Thomas paid down in bills to get her into the Home,” wishing she “could board somewhere decent till’t was gone and then starve if she’d got to.”22 Understanding then-contemporary views of the continuum from old age to old age with querulousness to being “‘faded in [one’s] wits’ because dazed by impending change” is a challenge. As Martha Holstein observes, physicians of the Progressive Era use moral, hereditarian, anatomical, and physiological explanations to account for the behavioral changes they often witnessed in older patients,” underscoring that “interpretation of disease and conceptions of what is to be done about it, especially psychiatric disease, cannot be separated from the cultural milieu in which it takes shape,” and concluding that even by 1920, “there was still uncertainty about the relationship of senile dementia to ‘normal’ aging,” something evidenced by the “because” in the characterization of Mrs. Fullerton’s state of mind.23 If physicians did not share definitive answers, we cannot expect theatregoers or readers of The Atlantic to have known more than the experts, even as we can fully expect them to have shared points on a continuum of received opinion(s), prejudices, as well as an interest in whatever emerging scientific research findings were available to them. The original audiences for Joint Owners in Spain were Little Theatre aficionados, who can be broadly characterized as educated progressives who believed in the power of drama and performance to provide both meaningful social commentary and self-expression.24 Progressives were not necessarily all what we would today call liberals; their belief in the value of education and “uplift” did not mean an absence of socially exclusionary practices.25 Progressives were, however, greatly interested in the social challenges of their time, including women’s rights, poverty, provincialism, access to education, immigration, American involvement in overseas wars, and workers’ rights. So, what, exactly, would an educated public in the early twentieth century in the United States have known (and/or believed) about
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dementia as a facet of aging? The observable characteristics of a spectrum of dementias in the elderly have been present as long as humans have existed, and these have been written about for millennia.26 Neurologically inclined scientists, nearly all in Europe, were starting to locate the somatic roots of cognitive decline via laboratory examinations of brain tissue. Americans outside the medical professions, however, knew little about the details of what caused any of the (only much later-to-be-differentiated) sources of senile dementia. (See Chapter 2) Psychiatrists affiliated with state mental institutions, even if they were interested in experimental therapies (and many were not),27 were expected to heal as many patients as possible and knew that curative endeavors would be wasted on the elderly demented, who were not expected to “recover.” Any kinds of publicly supported institutions— whether called hospitals, asylums, or homes—were subject to fear and suspicion on the part of even marginally privileged Americans, who, if they could afford them, preferred private facilities.28 Recall, too, from Chapter 3, the fear of loss of self and identity that Jesse Ballenger parses as a singularly American and, in the latter part of the nineteenth century, a newly emergent anxiety that seeped into the consciousness not only of the elderly but into the awareness of younger people responsible for eldercare and/or cultural policies. These garden-variety worries and prejudices were a kind of default setting for the reception context of the initial production of Alice Brown’s now-canonical one-act.
Critical Reception(s) Joint Owners in Spain premiered at the Chicago Little Theatre in 1913 (Fig. 4.1).29 The CLT was one of the five most-publicized—and now most lionized—of the early Little Theatres. The other four were the Boston Toy Theatre, the Washington Square Players, the Neighborhood Playhouse, and the Provincetown Players. Both the Boston and Washington Square companies hosted the Chicago production, suggesting the play’s power and popularity with insiders when it was new. The CLT— nearly all of whose other productions were of plays by European male playwrights (favorites included Yeats, Schnitzler, Ibsen, and Euripides)30 published Joint Owners in 1914, and shortly thereafter the play was published by the Walter Baker Company of Boston. In 1921 it became even more widely available, when Brown’s collection, One-Act Plays , was published by Macmillan. But the piece, which Brown’s biographer calls
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a “little masterpiece [that] might stand as a memorial to her talent as a playwright” and that Brown herself acknowledged brought “if not all her bread, the ‘butter and jam,’”31 had clearly gone, to use an encapsulating anachronism, viral by 1917. That year, Brown wrote to the editor of the Bulletin of the Authors’ League of America, complaining that a typed excerpt of the play was being sold by the Nebraska Wesleyan School of Expression, violating her copyright and depriving her of the (modest) royalties payable for purchases of the Baker edition.32 “Going viral” is not an exaggeration, albeit not necessarily something that happened in one fell swoop. A search for “Joint Owners in Spain” full text in Readex’s America’s Historical Newspapers database yielded 1359 results in the years between 1910 and 1982, nearly all of these references to or reviews of productions of the play, offered in cities large and small, including not just Chicago, Boston, and New York, but other major cities such as Seattle, San Diego, Omaha, Milwaukee, Dallas, Cleveland, and Providence, as well as smaller cities such as Stamford (Connecticut), Norfolk (Virginia), Trenton (New Jersey), and Quincy (Massachusetts), among many.33 Unsurprisingly, most productions were by amateurs, both because this is how Little Theatres were constituted in their heyday, but also because the one-act form has never been a staple of commercial theatre. Why, though, has this particular play had such shelf life? Why and how did it speak to its audiences, and perhaps by association, to those who chose to produce it? What can it tell us about performative embodiments of dementia, both casually and perhaps clinically recognized? Reviews for the seven decades considered here are brief, in part because they often appear in the Society section of newspapers as “shout-outs” more than assessments. Most have no bylines. They reveal that the play has given pleasure over the years but also suggest that this pleasure need not be linked to a play’s status as the latest thing or as dramatically innovative, but rather for the opportunity it offers both for a (shopworn?) idea of “self-expression” and, more importantly, a way of recognizing a cultural wolf wrapped in the sheep’s clothing of “fun.” The first review of the end-of-1913 Chicago production lays the groundwork for how to appreciate the play in the theatre. The unattributed review in the Chicago Daily News describes the text as “a rollicking bit of naturalism … candidly drawn in the matter of theme and form from Lady Gregory’s irresistible story of the two old Irishmen in the same ward of the poorhouse. Miss Brown uses two characteristic
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Fig. 4.1 Joint Owners in Spain, Chicago Little Theatre, 1913 (Photo courtesy of the Special Collections Research Center, University of Michigan Library)
old women with wild fantasies, feverish imaginations, grumpy donations to opinion’s wake, and much mental activity of conversation …. It is a delicious piece of truth …[a] classic.”34 But the review also situates the reviewer (and presumably their readers) in a very particular place with regard both to women and to theatregoing. In the former vein, s/he assures readers that the play is “not in the vaguest manner carrying a message from militant femininity,” while “the strength, superiority, durability, and charm of the livelier, least accounted sex is vividly accentuated.” Women are morally superior and charming; they also need to behave decorously and not expect to usurp male privilege, although it is fine for them to appear “strong”—just so long as this does not become “militant.” In the latter vein, the writer flatters readers, informing them not only that the (Chicago) Little Theater is “one of the greatest advances in art Chicago can claim,” but also promising readers who attended or might attend a CLT production of “the delight of being in close touch with sincere, sane, and unusually desirable people,” a company who “bestow
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upon its gatherings and performance an altogether excellent effect.” The “company” here might refer equally to people on either side of the footlights. The way in which one might consider this play a classic shifted over time. Lady (Augusta) Gregory was, with William Butler Yeats, a cofounder of the Irish National Theatre Society and instrumental in that group purchasing the Abbey Theatre, where nationalist plays were staples for decades. The Irish Players of the Abbey Theatre had toured the United States in 1911 with Lady Gregory as an accompanying spokesperson, so forging a connection with the then au courant entity would have appealed in 1913 to readers with an interest in new art movements, also merging the ideas of timelessness and timeliness. By 1940, Joint Owners, while still much in production, could be described as “a quaint study full of humor,” although quaintness did not obviate either its timeliness or its timelessness.35 “Humor” and “comedy” would be the most frequently used words to describe the play, likely because the publisher (Baker) described the play as a comedy in its catalogues. Certainly, the materialist aspects of the play (the bonnets, flannel petticoats, novelty of photographers) would become (“charmingly?”) oldfashioned. More revealing, at least regarding being a “piece of truth,” something usually associated with “classics”—i.e., an idea of timelessness—is the linking of pathos with humor, something mentioned in three extant reviews from the early 1920s.36 The oxymoronic yet frequent linking of opposing yet simultaneously accepted stereotypes about women would fit a vernacular definition of “classic.” Miss Dyer is, in 1919, variously described as “sour, suffering” and a “‘gabby,’ crabbed old spinster.”37 “Disagreeable” is applied to both main characters in 1926, while “irritable” describes the duo in 1933.38 Yet the characters certainly display the original review’s strength, durability, and liveliness. They unquestionably represent the “least accounted sex.” The plight of the characters is assuredly one with which audiences were (and are) meant to sympathize. The unparsed stance, then, is that old women are unpleasant when they are querulous but that the circumstances provoking these two—real, acknowledged, legible, and justifiable provocations—just can’t be helped. Presumably, audiences “get it”; we just don’t want to gloss it or (don’t know how to) change it. A 1911 description of a septuagenarian crafted by the father of modern geriatrics lays out the dilemma in terms still legible a century-plus later. I.L. Nascher described a seventy-six-year-old woman’s “behavioral
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changes as her hearing, memory and reasoning power became impaired as a ‘garrulous dement.’”39 In his 1914 Geriatrics , Nascher unambiguously proclaimed that “mental changes in the female generally include all the intellectual faculties and proceed to the extent of complete dementia far more often than in the male,” although he adds that vanity drives female efforts to conceal decline, while religiosity means greater acceptance of “the inevitable.”40 Are the resourceful Mrs. Blair and Miss Dyer “demented?” Should that term be reserved for Mrs. Fullerton? Was Alice Brown unintentionally prescient in staging a continuum of behaviors that were not easy to categorize or differentiate with certainty at the time the play was new and perhaps for many decades to come?
Ladies First. Or Last. Assessing not just the impoverished, newly restricted social status of Joint Owners ’s characters but the very question of how “demented” any of them is is not simply a neutral medical question; it is also a gendered one. Evidence suggests that Progressive Era ideas of senility were figured in terms of middle-class males, whose intellectual failures could be attributed to overtaxing their minds with work.41 For lower-class men not engaged in “brain work,” it was underuse that caused them to “lose it.” Women, however, were (mis)understood as homebodies, whose post-menopausal years might appropriately be spent sewing or knitting by the fire, imparting salutary domestic values to their juniors. Nascher’s observation above indicates that if an “old lady” strayed from this stereotype to become garrulous, querulous, or confused, she was a “dement,” no matter that she may have been stripped of hearth, home, and family— anyone to whom she might impart much of anything and anyplace she might have recognized as welcoming or familiar. Moreover, the elderly person on a continuum of decline must, if s/he is to remain at all identified with the society in which s/he seeks acceptance, continue to identify with the values of that society.42 So, Mrs. Blair and Miss Dyer, and even Mrs. Fullerton, to some extent, continue to be concerned about having the right bonnet, the right petticoat, and the right pastimes and values, even as they have no pecuniary or service need for preserving or pursuing activities such as quiltmaking—the project in which Miss Dyer is engaged. Rationalizing social prejudices, which manifest, among other places, as laws or medical diagnoses, leads to compulsive repetition of the only activities available to the woman seeking agency on
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the only terms she is permitted. Crabbiness, bossiness, ongoing expressions of misery, then, might be acts of “force of will,” by means of which “middle-class … women who were confronting the age line could differentiate themselves from the decrepit, senile Other.”43 Cue Blair, Dyer, and Fullerton. I want to make a small leap to the assertion that productions of Joint Owners over a seventy-year period could be read as a culture-wide iteration of repetition and stuckness undertaken as a means of asserting agency in one of the few sanctioned outlets for middle-class women in search of self-expression: amateur theatre. Many of the organizations that produced Joint Owners were women’s clubs. Unsurprisingly, a play requiring no men in the cast would hold appeal, if only for reasons of expedience. High schools, too, were frequently producing entities for Brown’s play. Obvious reasons for embracing the play include the fun of dressing up in old-fashioned clothing, putting on character makeup and perhaps wigs, and mastering a dialect (Fig. 4.2).44 But many other Little Theatre oneacts offering analogous features fell quickly by the wayside after the Little Theatre heyday of the 1910s and 1920s. What kept this one in circulation? The imbrication of pathos and humor in the context of gender coding suggests that this little play offers a chance to laugh while uneasily confronting possibilities for one’s (or members of one’s community’s or family’s) future self. Indeed, humor itself is a way of making the feared or fearful seem harmless.45 The combination and its possibilities persisted over a period of seven decades, because, although local color fiction, poke bonnets, and rural poorhouses became relics of a generation gone by, women’s relative irrelevance as citizens outside an imagined middle-class home persisted as stereotypes and legally enforceable position at least into the 1970s.46 Therefore, the plight and the pluckiness of the Joint Owners sparring partners remained simultaneously recognizable, anxiety-provoking, and laughable.47 For most of the twentieth century, historical processes continued to leave women out of the best spots (or even equal pay) in the workplace; in government; or with regard to reproductive rights, concurrently allowing their grounding ideological context to remain unyieldingly stuck in place.48 Yet, even as incarnations of Mrs. Blair, Miss Dyer, and Mrs. Fullerton yielded easily to scenery chewing (many reviews nod to robust and sometimes over-the-top amateur acting), they also continued to provide places in which to inhabit future possibilities. Historical processes left the exteriors of these characters’ lives behind while allowing the internal(ized)
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Fig. 4.2 Joint Owners in Spain, Drama League of Milwaukee, 1932 (Photo appeared in the Milwaukee Journal, March 29, 1932. Courtesy of the Milwaukee Public Library)
and culturally shared realities of their age and gender status to remain stubbornly intact. Indeed, the play in production invites readings subject to understanding (possibly critically but possibly indirectly or intuitively) Anne Davis Basting’s body in depth, the optic or phenomenon in which one sees “time across space” when one recognizes in an older body a younger self, or the future self in a youthful one. It is, one might say, a palimpsestic reading of embodied presence.49 Watching one’s child or niece or friend or neighbor “play older” means the possibility of seeing
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that person’s future (or one’s own) on the palimpsestic body that is the actor imbricated with character. I have written elsewhere about amateur theatre being experimental theatre not in the sense of working with something unknown, untested, and perhaps falsifiable, but in the sense that, say, chemistry lab undertakings in high school are called “experiments.” The results of these undertakings are known in advance by the professional community; they are, however, first times for the students experiencing them, making them not new information for scientists, but, rather, “aha” moments of enlightenment for the student/amateur.50 The context of the experiments also speaks to their value. Audiences for plays presented by amateurs comprise people far more likely to know each other than audiences at commercial productions. For one thing, amateur productions do not have long runs. They sometimes have very limited seating. Interested spectators very often have a personal relationship with performers, either because they are related to the latter or because parties on both sides of the footlights are members of the same group or club. In this case, “ghosting”51 occurs not (only) because of other roles in which an (amateur) actor has appeared and that are remembered, but because of other contexts in which the actor is recognized as a participant or active group member. Therefore, reception of such a production does not only reflect one’s membership in what Stanley Fish calls an “interpretive community” nor contextualization within what Hans Robert Jauss calls a “horizon of expectations.”52 Here, primary keys to audience response to productions of Joint Owners rest not only on the textual or even performance elements subject to semiotic or cognitive unpacking. Rather, in line with Frank Coppieters’s thinking, the social event and context of theatregoing can have a large effect on one’s experience of a play. Coppieters cites, as two key elements in theatrical perception, “one’s attitude toward/perception of/ relationship with the rest of the public” and “social interaction” as ways to understand perceptual processes in the theatre.53 Both these things work very differently within a social group whose members are largely known to each other from how they work in the far more impersonal environment of, say, a Broadway theatre visited well into the run of a settled-in hit. Each type of audience might be seen as a social entity confirming itself to itself, but even a person who might elect to be party to both kinds of theatre experiences is unlikely to be confirming the same self in both contexts. As Dennis Kennedy notes in his study of spectators and
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performances, “If we can admit that an audience is a public assembly for an event larger than the performance, we should see that spectation is about more than reception.”54 In other words, seven decades of audiences—and performers—eager to embrace Joint Owners in Spain may say as much about the public that self-selected to witness communally gendered bodies in depth portraying the sheep’s clothing of a quaint past concealing the spectral wolf of a bleak possible future as promised by the terms of an ongoing capitalist present as they say about the dramaturgy of Brown’s modest gem. The life or death of a play cannot be divorced from the care and attention provided by its audiences, and for Joint Owners, the play was able to persist because its supporters did. And what of Alice Brown in the years after Joint Owners debuted? Like many Americans and Europeans, Brown experienced a distinct “before and after” with regard to the First World War. She had been a pacifist, but, as Ellen Langill explains, an “emotional attachment to Britain”55 moved Brown towards an almost strident pro-war stance. Following the war, the modernism that was to define the literature of the 1920s marked Brown’s work as out of sync with the times. As she wrote in her 1919 novel The Black Drop, reeling from the effects of a war that failed to be the holy crusade she had imagined it would be: Since the war has knocked out from under us the foundations of old conformities, it is difficult to decide whether to write the story of those men and women who walk the pages of that reality called fiction before 1914 or after. For they would be found, if they are malleable enough to be worth writing about at all, distinctly different people before and after that date.56
Distinctly different, yet she persevered. Brown continued to write well into her eighties. Despite a steep decline in her reputation, she published several books in the 1930s, although her longtime publisher, Macmillan, dropped her in 1932. She was a prolific correspondent, and her identity as well as her sense of self meant that it was largely unthinkable that she would cease writing. “[I]f you write books and plays there is only one happiness you can expect: that of the hourly enchantment of the writing itself, for then you are living in your dream.”57 Following the stock market crash, the death of her longtime friend and housemate, Maria Gilman Reed, and in the face of a world and politics at odds with her personal values—she favored community caring and
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charity over mass government projects and disliked both Franklin and Eleanor Roosevelt—Brown suffered a nervous breakdown. She recovered, however, and continued not only her writing and enjoyment of time in the country and walking in Boston; she also pursued interests in spiritualism, the supernatural, and Catholicism. She refused any specific creed, however, rather, comfortably calling herself a “pagan.”58 Her final book, Pilgrim’s Progress , was written in 1944, when she was eighty-eight, and the pilgrims whom she was thinking were the other young women with whom she traveled to England and Europe in the late nineteenth century. Brown asserted in the latter third of her life, “I have a talent for writing what nobody wants,”59 Yet one of her works remained very much in demand, and in a 1945 letter to a friend she wrote, “The only thing that exists for me now in that line is a little play called ‘Joint Owners in Spain’ which probably lived because it was so well fitted to amateurs.”60 If Brown’s career overall ceased to run in the fast lane of the marketplace, Joint Owners in Spain did what she claimed she wanted her work to do. It spoke, over the years, to people interested in the things that amateur theatre privileges: a willingness to slow down, to ingest and digest text in the interest of an embodied experiencing of selves in relation to each other, and a joy in communal support. If these are not descriptions of how a person with dementia is (or is able) to live, it is surely a decent recommendation to their friends, families, and caregivers. Mrs. Fullerton, for all her importance to the action of Joint Owners in Spain, is, in the final analysis, an enigma. We never learn how long she has been at the Home nor how she came to be there, or anything of her life before she became “faded in her wits.” Her dramaturgical purpose fulfilled, this walk-on walks off. Thirty-five years later, Old Man Adams, the dementia character in Losing It ’s next case study, would have been left to his own devices, despite his memory loss and delusions, had he not become a disturbance and possibly a danger to his neighbors. The institution to which he goes is publicly funded; it is a hospital for the mentally ill and most assuredly not a private “home.” Advances in neurology and psychiatry, as well as input from the newish field of social work coalesced to yield laws and policies whose goal was medical care rather than mere warehousing—much less punishment—for those deemed mentally ill. Where people with senile dementia fit within this broad category, however, remained unclear. And the fact that Adams is a supporting character with a backstory, a significant role to play in the life
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of another hospital patient, and a narrative arc, invites readers to consider both the advances and the blind spots in representing dementia onstage a third of the way into the twentieth century.
Notes 1. Quote is from Emily Levine, “Alice Brown,” Boston Athenaeum, June 2016. https://www.bostonathenaeum.org/library/book-recomm endations/athenaeum-authors/alice-brown (Accessed 30 July 2018). See also Susan Allen Toth, “Alice Brown (1857–1948),” American Literary Realism, 1870–1910, Vol. 5, No. 2 (Spring, 1972): 134–143; Dorothea Walker, Alice Brown (New York: Twayne Publishers, 1974); and Beth Wynne Fisken, “Legacy Profile: Alice Brown (1857–1948),” Legacy, Vol. 6, No. 2 (Fall, 1989): 51–57. 2. Lists are from Walker, 171–173. 3. “Alice Brown Wins $10,000,” Dramatic Mirror, 3 June 1914. See, too, Ellen Detering Langill, “Alice Brown: A Critical Study,” unpublished doctoral dissertation (Madison: University of Wisconsin, 1975), 194. 4. “…Well Played But Unconvincing Story,” “from a Globe-Democrat Staff Correspondent.” St. Louis Globe Democrat, 25 January 1915. Walter Prichard Eaton published a scathing critique of the play’s negative reviews, in which he called Children of Earth “on the purely literary side, perhaps the most significant American play since ‘The Great Divide,” the latter, William Vaughn Moody’s 1906 hit in which New England Puritanism is pitted against frontier independence, the latter winning the heroine and winning over her stuffy family. Eaton’s real plea was for standards of dramatic criticism that recognized more than immediate box office appeal. 5. This is how it is designated in the 1895 short story, by Brown, on which she based her play. In the play, it is simply “the Home.” Alice Brown, “Joint Owners in Spain,” Atlantic Monthly Vol. LXXV, No. 447 (January 1895): 30–38; and Joint Owners in Spain in One Act Plays by Alice Brown (New York: The Macmillan Company, 1921), 161–176. Page numbers from the script are noted as “Play.” Although unexplained in the play’s text itself, the title may refer to the common Spanish practice whereby homeowners jointly purchase real estate in shares, which serves as an analogue to the splitting of the apartment within the play. 6. See W. Andrew Achenbaum, Old Age in the New Land: The American Experience Since 1790 (Baltimore and London: Johns Hopkins University Press, 1978), Chapter 7, “Social Security: A Novel Solution for the Problem of America’s Aged.” 7. The clearest indicator of age is Mrs. Blair’s recollection of going to Sudleigh fair at age twenty “in my changeable [refers to fabric that changes
4
8.
9.
10. 11. 12. 13. 14. 15.
16.
17.
18. 19. 20. 21.
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color in light] visite [a short cape or cloak worn in summer] an’ leghorn hat [a stiff straw hit with a flat crown]” to have her picture taken with Jonathan—presumably her fiancé—in “the brocaded weskit [waistcoat] he stood up in the next week” (story 34; and play 168). The styles she describes would have been ordinary around the middle of the nineteenth century, making her likely birth date some time in the 1830s. This reasoning would put Mrs. Blair in her mid-sixties when the story was published, in 1895. For the stages of dementia, see Ee Heok Kua, Emily Ho, Nong Hee Tan, Chris Tsoi, Christabel Thng, and Rathi Mahendran, “The Natural History of Dementia,” 196–201 in Psychogeriatrics, Vol. 14 (2014): 198–199. J. Samaine Lockwood, Archives of Desire: The Queer Historical Work of New England Regionalism (Chapel Hill: University of North Carolina Press, 2015), 11. Play, 161. Ibid., 164. Ibid., 169. Ibid., 164. Dorothea Walker, Alice Brown (New York: Twayne Publishers, 1974), 76. Regarding present-day fear of life in a facility, see as a single example, Beth Teitel, “An age-old question on housing,” Boston Globe, 6 August 2018: A1/A6. The headline on the page where the article continues is “Seniors’ decision on leaving home is fraught with concern.” Clearly, the perception is that a “home” is not or cannot be accepted as home. Concerning elders and some kind of health care insurance, according to the Director of New York’s Morningside Retirement and Health Services, “only 2% of elders lack health care coverage today.” Ronald Bruno, “Director’s Column,” MRHS Newsletter, Vol. XLII, No. 8 (1 August 2018): 2. In 2018, the state of Maine placed on its November election ballot an initiative to provide care to the elderly and disabled by taxing wealthier Mainers on their income. The initiative was defeated, 63–37%. Material in this paragraph is drawn from Carole Haber and Brian Gratton’s Old Age and the Search for Security: An American Social History (Bloomington and Indianapolis: Indiana University Press, 1994), especially Chapter 4, “The Threat of the Almshouse” and from David Wagner’s “Poor Relief and the Almshouse,” VCU Libraries Social Welfare History Project. https://socialwelfare.library.vcu.edu/issues/poor-reliefalmshouse/ (Accessed 1 April 2023). Haber and Gratton, 121. Ibid., 123. Quoted in Wagner. Original source is W. Carlton in Farm Ballads (New York Harper and Brothers, 1882). Haber and Gratton, 129.
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22. “Joint Owners” story 31. The hundred dollars of 1895 would have a relative inflated worth of $33,606 in 2022. https://westegg.com/inflation/ infl.cgi?money=100&first=1895&final=2021 (Accessed 1 April 2023). 23. Martha Holstein, “Alzheimer’s Disease and Senile Dementia, 1885– 1920; An Interpretive History of Disease Negotiation,” Journal of Aging Studies, Vol. 11, No. 1 (Spring, 1997). http://eds.b.ebscohost. com.lib-e2.lib.ttu.edu/ehost/detail/detail?vid=3&sid=fbb5af59-5d9c4b2c-9df5-01a10a47d870%40sessionmgr120&bdata=JnNpdGU9ZWhv c3QtbGl2ZQ%3d%3d#AN=9704114281&db=a9h (Accessed 18 August 2018). 24. See Dorothy Chansky, Composing Ourselves: The Little Theatre Movement and the American Audience (Carbondale, IL: Southern Illinois University Press, 2004). 25. See Peter G. Filene, “An Obituary for ‘The Progressive Movement,’” American Quarterly, Vol. 22, No. 1 (Spring, 1970): 20–34. 26. See Jeffrey Kluger, “Through the Millennia,” in The Science of Alzheimer’s (New York: Time Inc. Books, 2018), 26–29; and François Boller and Margaret M. Forbes, “History of Dementia and Dementia in History: An Overview,” Journal of the Neurological Sciences, Vol. 158 (1998): 125– 133. 27. Albert Deutsch notes the nineteenth- and early twentieth-century “mutual distrust, suspicion, and hostility” between neurologists—those interested in laboratory research into the nervous system and its diseases—and psychiatry, which, although its practitioners were medical doctors, focused on studying and treating personality disorders, when “studying” was possible at all, as many were consumed with the organizational task of running state facilities. (Deutsch, The Mentally Ill in America: A History of Their Dare and Treatment from Colonial Times [New York: Columbia University Press, 1946, originally published in 1937], Chapter 14, “Psychiatry Emerges from Isolation.”) 28. Deutsch, 278; and Achenbaum, 80. 29. The play opened to the public for review at the end of the year, but an earlier production, featuring a different cast in three of the four roles, was presented briefly in February 1913. 30. See Stephen Watt, “Modern American Drama,” 102–126 in The Cambridge Companion to American Modernism, ed. Walter Kalaidjian (Cambridge and New York: Cambridge University Press, 2005), 110. 31. Walker, Alice Brown, 78. 32. “Another Form of Piracy,” The Bulletin of the Author’s League of America, Vol. 5, No. 5 (August 1917): 8. 33. My thanks to Brian M. Benoit for doing the extensive search and providing links to all hits.
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34. “Little Theater Plays,” The [Chicago] Daily News 4 December 1913, p. 16. Although the Chicago reviewer made the connection with Lady Gregory’s work, Dorothea Walker, Alice Brown’s biographer, recalls a tour of the town next to the one where Brown grew up and being shown a house that had been occupied by two sisters who, “after a severe quarrel, had divided the house right down the middle with a piece of chalk, each one respecting the privacy and ownership of the other, ‘even down to the fireplace’” (Walker, Alice Brown, 164). 35. “Graham School Gives Plays at Little Theatre,” Norfolk Virginia-Pilot, 2 June 1940: Part 2, Page 9. 36. “Peggy Passe Partout’s Letter,” New Orleans States, 6 February 1921, page 30, Sunday morning edition; “Business Women’s Club to Present Plays,” The Evening News (San Jose, CA), 18 March 1922: 10; and “Amusements,” The [Washington] Evening Star, 15 March 1923, Financial section, p. 23. 37. “Stage Society Gives First Play,” The State (Columbia, S.C.), 10 October 1919: 5; and “Horner Students in Plays,” Kansas City Star, 8 March 1919: 6. 38. “Douglas Church Play Captures Kieft Trophy,” Illinois State Journal, 22 June 1926: 10; and E. de S. Melcher, “From the Front Row,” The Evening Star (Washington, D.C.), 20 February 1933, B-5. 39. I. L. Nascher quoted in Martha Holstein, “Aging, Culture, and the Framing of Alzheimer Disease,” 158–180 in Concepts of Alzheimer Disease, ed. Whitehouse, et al., 162. 40. I. L. Nascher, Geriatrics: The Diseases of Old Age and Their Treatment (Philadelphia P. Blakiston’s Son & Co., 1914, reprinted in 2018 by Forgotten Books), 16, 17. 41. Ballenger, Self, Senility, 25–28. 42. See Sander L. Gilman, Disease and Representation: Images of Illness from Madness to AIDS (Ithaca and London: Cornell University Press, 1988), 5 and passim. 43. Ballenger, Self, Senility, 30. 44. Production photos are almost nonexistent, but a 1932 picture in the Milwaukee Journal (March 29, Picture Page, local section p. 4, shows a finger-pointing Mrs. Blair (Charlotte Culbertson) hovering over a weeping, seated Miss Dyer (Edith Reichhardt) in a Drama League production staged—at least for the photograph—in front of a simple curtain. 45. Gilman, 3. 46. When Working Woman Magazine was founded in 1979, the two-earner family was rapidly becoming a norm, but women remained responsible for most housework and caregiving in a phenomenon Arlie Russell Hochschild would name The Second Shift in her 1989 study of working
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47.
48. 49. 50. 51. 52.
53. 54. 55. 56. 57. 58. 59. 60.
mothers in the United States. I am aware, too, that these shifts affected white and moderately-to-well educated women. Minority and poor white women had been going to work for decades. It would likewise take a while for the mainstream (white and middle-class) women’s movement to recognize the sisters they had been excluding. As reception theorist Justin Lewis notes, “Cultural forms do not drift through history aimlessly; they are grounded in an ideological context that gives them their historical significance ….[M]eaning is neither fixed nor transcendental but the production of historical processes.” Lewis, “The Meaning of Things: Audiences, Ambiguity, and Power,” in Viewing, Reading, Listening: Audiences and Cultural Reception, ed. Jon Cruz and Justin Lewis (Boulder, CO: Westview Press, 1994), 20, 21. American women, regardless of their income, could not apply at a bank for credit without a man as a a co-signer on the application until 1974. Anne Davis Basting, The Stages of Age: Performing Age in Contemporary American Culture (Ann Arbor: University of Michigan Press, 1998), 141. See Composing Ourselves, 185. See Marvin Carlson, The Haunted Stage: The Theatre as Memory Machine (Ann Arbor: University of Michigan Press, 2001). See Susan Bennett, Theatre Audiences: A Theory of Production and Reception, second edition (New York and London: Routledge, 1997), 40–52. Frank Coppieters, “Performance and Perception,” 35–48 in Poetics Today, Vol. 2, No. 3 (Spring, 1981): 47. Dennis Kennedy, The Spectator and the Spectacle: Audiences in Modernity and Postmodernity (Cambridge: Cambridge University Press, 2009). Langill, 209. Quoted in Langill, 217. Ibid., 233, from a 1928 Autobiography published as a pamphlet by Macmillan. Langill, 245. Ibid., 231. Quoted in Langill, 201.
CHAPTER 5
Supporting Role: All the Living
A non-medical specialist interested in the psychiatric, social, and institutional understandings of “senile dementia” in the latter half of the 1930s could do worse than to triangulate readings of Albert Deutsch’s The Mentally Ill in America—A History of Their Care and Treatment from Colonial Times (1937), Victor R. Small’s I Knew 3000 Lunatics (1935), and Hardie Albright’s All the Living (1938). Deutsch’s thorough and highly readable tome considers the evolution of medical and institutional treatment for people often lumped together over the course of several centuries as “insane.” It concludes with an on-the-ground section containing a brief sketch of how and why dementia sufferers were then diagnosed (if they were).1 Small’s chatty memoir-cum-exposé is based on the years he spent as a physician at the Dorothea Dix State Mental Hospital (then called Dix Hill) in Raleigh, North Carolina.2 One historian of mental illness, writing in 2011, calls Small’s “the most vivid and detailed memoir of an assistant physician” in his position, written when the vast majority of assistant physicians in mental hospitals in the United States “chose not to belong to the only existing national organization of psychiatrists,” and when most who entered the field of psychiatry had few if any lectures on insanity during medical school or had never examined an insane person.3 Small’s genuine interest in patients as individuals and his recognition of the governmental constraints placed upon personnel in
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 D. Chansky, Losing It, https://doi.org/10.1007/978-3-031-20902-4_5
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publicly funded mental hospitals is laced with lay-friendly explanations of the latest medical science in psychiatry. All the Living, Albright’s play based on Small’s book, shows behaviors manifested in a variety of mental disorders while also dramatizing the challenges of practicing medicine in a state hospital. Significantly for my purposes, the play gives its single elderly dementia character a crucial role in its story.4 All the Living was clearly written to reveal performatively the symptoms and desperation of underserved, overmedicated patients in the hands of complacent and overworked medical personnel beholden to largely uninformed state officials (themselves beholden to powerful blocs of largely uninformed voters) for support. The title points to hope and to advocating curing, not just warehousing, the mentally ill. “For to him that is joined to all the living, there is hope” is drawn from Ecclesiastes (IX– iv). The play’s major dramatic question is whether an idealistic researcher will be able to pursue his experimental work in psychiatric neurology in this context. All the Living ran for fifty-three performances on Broadway, earning respectful mainstream reviews but then sinking from sight. While much of the medical thinking in All the Living now appears hopelessly wrongheaded even to a lay reader, it is important to remember that its source text and that text’s author (Small advised Albright on the script) represented the work of research and psychiatric physicians of the day.5 The 1938 Broadway production yielded publicity, criticism, and some very limited archival material belonging to its producer, Cheryl Crawford, and its director, Lee Strasberg—obviously useful materials for the theatre historian. But I am also interested in entities that are tangential yet revealing in understanding this singular theatre representation of an unnamed form of dementia as one of a family of medically incurable mental illness(es): the Group Theatre and the Federal Theatre Project (FTP). Both the Group and the FTP were driven by idealism; arguably, the power of the former’s members brought the play to life in production, while common attitudes on the part of workers for the other regarding audiences outside New York let it sink. In the Depression years of the 1930s, idealism and solutions to social problems were important to a broad swath of Americans. All the Living is driven by an investment in both, but what might be called its failure to thrive says a great deal about audiences (actual and anticipated) of the time and the critics who purported to speak for them while definitely speaking to and sometimes just about them. How audiences viewed, shrugged off, shrank from, or
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screened out Albright et al.’s (I include the production team here) representation of dementia will never be known definitively, but assembling the many pieces of the reception puzzle to which we do have access yields, if not answers, then perhaps an opening to more nuanced questions and informed speculation about how such representations were read and what these might say to us today.
The Moment/The Medicine/The Men Albert Deutsch was a self-educated social historian and journalist who specialized in health care, psychiatry, and Veterans’ Administration hospitals. He was a columnist for the New York Pos t from 1941 to 1947, was regarded as an advocate for the ill and disabled who lacked a policy voice and won numerous prizes for his writing.6 The Mentally Ill in America starts with the faux diagnosis of witchcraft in the seventeenth century. A small number of “lunatic asylums” were established in the early nineteenth century. By the middle of that century, almshouses/poorhouses (labeled “catchall” institutions) packed sick and healthy, young and old, “feebleminded” and otherwise mentally troubled, sometimes two to a bed, into rooms frequently lacking heat. They were expected to work unless they were wholly incapacitated.7 A network of kinder, gentler state and county mental hospitals was the result of the activism and indefatigable lobbying of reformer Dorothea Dix. Deutsch also chronicles the history of psychiatry in the United States. Public mental institutions created as a result of Dix’s labors were dedicated to “curability,” which was predicated on the idea that routines, cleanliness, adequate nourishment, moral instruction, and discipline were the best means to eliminate irregular, erratic, socially unacceptable behavior marked as “insanity.” Of course, neither dementia nor epilepsy nor intellectual disability (formerly called mental retardation and, until well into the twentieth century, “feeblemindedness”) can be “cured” via kindness and routine. People with any of these conditions were classified, sometimes interchangeably, as mentally ill or insane, as were those suffering from “senile dementia” or now-treatable (if not curable) illnesses, such as schizophrenia or bipolar disorder, among others. Moving into the twentieth century, Deutsch sheds light on the plight of people with neuroses (defined in one medical history of that era as “‘functional’ nervous diseases ... conditions that had signs and symptoms that seemed neurological but that did not make medical sense
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physiologically”8 ), who might be incarcerated in mental hospitals where patients were “treated as sub-humans.” They were “often expected to act like perfectly rational beings and were meted out swift and humiliating punishments for failing to do so.”9 The Mental Hygiene Movement, a project of the first decade of the twentieth century, lobbied for the reform of the treatment of the mentally ill, for research “into the causes, nature and treatment of mental disorder; and finally, for the creation of services directed toward the prevention of mental maladies.”10 Unsurprisingly, perhaps, the movement’s basic idea—that mental illnesses, whether or not they had evident physiological bases, should be studied and treated like other illnesses—did not infiltrate the popular mind, which still feared and recoiled from the mere presence of mental maladies, regardless of cause. Psychiatrists were not all on the side of the angels. Deutsch makes clear that the Association of Medical Superintendents of American Institutions for the Insane (AMSAII) demonstrated “unremitting antagonism” to the exposure of “prevalent asylum evils,” a conflict brought to the fore in All the Living.11 Despite opposition from the superintendents, the trend in the early twentieth century was toward attempts at medical cures rather than mere custodial care. Emil Kraepelin, a German neurologist, named as a discrete disease the underlying cause of the symptoms identified by Alois Alzheimer in Alzheimer’s case studies of the first decade of the twentieth century. Kraepelin’s great contribution to psychiatry was a classification system derived from laboratory research. His system, which, like earlier ones, was based on symptoms rather than causes, was revolutionary because it linked diagnosis to course and outcome and “discarded the notion that mental diseases formed syndromes (a cluster of signs and symptoms that would remain consistent, regardless of outcome.)”12 For Kraepelin, mental illness was not a static condition, and disease progression was an important part of what he studied. Deutsch credits Kraepelin with helping “to shift the emphasis in psychiatric research from the pathological laboratory to the clinic—from the dead to the living.”13 The intersection of laboratory research and actual, living patients in a clinical situation is precisely where All the Living is ideologically as well as literally set. The play’s conflict arises because the ideals of its protagonist threaten the entrenched practices of the hospital superintendent (and vice versa). Its argument is leavened by the clear way in which overcrowding, understaffing, overwork, and political negotiating inflect the three activist
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characters’ ability to do the best work of which they are capable while also suggesting that “public” inevitably means compromise. Albright’s play, like Small’s book, focuses on the behavior and treatment of patients with bipolar disorder, then called manic depression, and “dementia praecox” (which would now in most circumstances be called schizophrenia14 ). “Dementia praecox” covered a multitude of symptoms and behaviors that might begin with confusion or depression, then progress to incoherent speech, and end with cognitive disability and little hope of recovery. It often affected adolescent males.15 Manic depression and dementia praecox were the two disease concepts for which Kraepelin’s diagnostic work made psychiatric history; in the mid-1930s, people suffering from these accounted for about one-half of the total number of patients in mental hospitals.16 A smaller but clearly identifiable percentage of new admissions to mental hospitals in 1934 was diagnosed with “senile psychoses” (8.4% of new admissions) or “psychosis with cerebral arteriosclerosis” (9.4%).17 “Senile psychosis” described the appearance of strange, anti-social, hostile, aggressive, or paranoid behavior in an older person whose dementia-with-a-modifier could not be attributed alone to “old age” or “forgetfulness” or “dotage.” “Psychosis with cerebral arteriosclerosis” was a blanket term for dementia resulting from the thickening of the walls of arteries that supply blood to the brain, which can lead to strokes. “Hardening of the arteries” (other arteries) also restricts blood supply to the heart. The character Old Man Adams in All the Living manifests the former (some aggression, some paranoia), which may or may not have started in the wake of a stroke. Adams is also diagnosed with a weak heart, which is the cause of his eventual death. Nothing is specified in All the Living about Adams’s earlier medical history, and the language about this character in I Knew 3000 Lunatics, discussed below, is confusing. Either way, Adams represents some facet of the just-undereighteen percent of new admissions to state mental institutions in 1934 who were seniors with some iteration of dementia. Victor Small, whose first-person I Knew 3000 Lunatics was the basis for All the Living, was born in Kentucky in 1888; the family moved to Ohio when he was a child. His rural origins and attendant racism that permitted Blacks and whites to work and live cheek by jowl while maintaining (then) commonly accepted hierarchies, is evident in 3000 Lunatics, as is an unquestioned sexism. (He describes women—both patients and nurses—almost salaciously in terms of appearance, favoring the slim and curvaceous and making note of long hair, while men’s
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appearances are generally just noted with regard to such things as hair color and approximate, uncriticized size.) Small graduated from the Ohio State University medical school in 1916; he honed his neurological skills during a residency at the Ohio Hospital for Epileptics in Gallipolis and took a position at Raleigh’s Dix Hill in 1920. Neurology was a newish branch of medicine, having emerged as a specialty in the 1870s. Psychiatry and neurology—two distinct areas of medicine that formally split into discrete board-certified entities in 1934—deal respectively, in crude terms, with functional problems, and with physiological ones. Psychiatrists saw patients; neurologists worked in laboratories. Or, as one historian succinctly summarizes it: What the early researchers “could find under their microscopes they declared ‘neurology.’ What they couldn’t find was psychiatry.”18 Small had an investment in both. In a 1921 article about epilepsy published in Southern Medicine and Surgery, Small made clear that, while the symptoms of epilepsy were familiar, its causes were unknown; its manifestations made it nearly impossible for most sufferers to live normal lives outside of an institution; and paraldehyde—a sedative no longer much used in American medicine—was an excellent means of controlling symptomatic convulsions.19 Indeed, “two drams of paraldehyde” becomes almost a mantra in All the Living. It is what the harried doctors in the play routinely tell nurses to administer to agitated patients; the phrase’s repetition signals to audiences the generic nature of treatments meant to stave off institutional chaos rather than to address individual patient needs. It is worth noting that Small at one point believed the probable causes of epileptic seizures to be underlying psychoses, and that a patient’s “convulsions are manifestations of this psychic disorder, rather than the results of some definite anatomical lesions.”20 Here psychoses are considered as perhaps one step up from neuroses (the latter with no discernable physiological cause), yet still not so important as mental ailments resulting from “some definite anatomical lesions,” suggesting that lab results take precedence over clinical symptoms in real people regarding the importance of a disorder. Small also wrote poetry and had an abiding interest both in the outdoors and in the arts. He moved to Clinton, North Carolina, where he established a private medical practice and bought a large Classical Revival house, residing there until his death in 1971.21 Small unabashedly calls his loosely novelistic tale of the people at the state hospital “a play being enacted on a gigantic stage,” where he saw “comedy, tragedy and melodrama” but finally realized that what he
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had first perceived in his actual experience as “the enactment of a story without meaning” was in fact not a single epic drama, but rather “three thousand dramas.”22 The brief write-up given I Knew 3000 Lunatics by Kirkus Review encapsulates the focus and tone of the book: Vivid presentation of the daily life, the social aspects, the professional side, even to the point of indicating symptoms so that the layman will feel an intelligent familiarity with the distinctive features of different forms of insanity. Interesting reading, for anyone concerned in mental hygiene.23
This source material for All the Living devotes individual chapters to case studies that elicit sympathy, are prone to othering, and provide what actors consider great possibilities for character work. The cases include a nymphomaniac (“she’s not insane; smart as a whip”24 ), two schoolteachers who are manic-depressives allowed to go home when not in the grip of agitation or suicidal thoughts, several “epileptics” (identified only by virtue of having seizures), a teenager diagnosed with dementia praecox, an old man with senile dementia (Old Man Adams in both the sourcebook and the play), and a criminal who fakes insanity to escape jail time and be remanded to the hospital, a less violent and punitive place. Small devotes one chapter to various categories of intellectual disability (“feeblemindedness”), a few “psycho-neuroses,” and one chapter to a man who might today be described in amateur terms as suffering from a combination “Napoleon complex” and “persecution complex.” As late as 1935, senile dementia is still described as something simultaneously characteristic of the elderly and a syndrome necessitating institutionalization—the Escherlike “which is it, normal or not?” described in Chapter 2 of Losing It.
Dramatization and Its Discontents Hardie Albright, né Hardie Hunter Albrecht, born in 1903 to vaudevillian emigrés from Europe, was primarily known as an actor. His first stage appearance was at age seven in his parents’ act. He graduated from Carnegie Tech (now Carnegie Mellon) with a major in theatre, then enjoyed regular work on Broadway, in stock, later in film (including as the uncredited voice of the adolescent Bambi in the 1942 cartoon), and on several television series. He retired from film acting after World War II, was briefly an instructor at the University of California Los Angeles,
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and wrote respected books on both acting and directing.25 Albright died in 1975. All the Living telescopes the episodic sprawl of 3000 Lunatics into a play with conflict and resolution, conflating key characters for the sake of focus, and providing a lot of medical, research, and funding information both in the dialogue and, for readers of the published text, in parenthetical notes. It retains an array of colorful characters, some of whom are mostly walking packages of symptoms. Albright combines three characters into the sensitive researcher, Dr. Gilbert Kromer, the hospital’s “star pathologist,”26 played on Broadway by Sanford Meisner. Pathologists, who worked in laboratories, had a lower status than assistant physicians in the asylum pecking order, but Albright blurs the jobs and gives Dr. Kromer access to patients.27 One of the three source characters for Kromer is the “I”/observer/author of 3000 Lunatics; the second is Dr. Gilbert, who both loves and secretly marries the “pretty nurse” (Miss Stalling) in the book; the third is a self-admitted patient named Ashley Kell, described as nervous, small, and wearing heavy glasses. In the play, Kromer is described as sensitive, occasionally wearing glasses, and nervous—indeed, others fear he may have a breakdown. Kromer is on a quest for a medicinal cure for dementia praecox via something the play calls Sulphur X. In All the Living, the new arrival (Small himself in the book) is the handsome Dr. Merritt, who in the end spirits away Nurse Stalling, with whom Kromer is in love and who is his staunch supporter and research assistant. Wholly invented by Albright, Merritt proves worthy of his name, continuing Kromer’s experiment while the latter is emotionally paralyzed by despair. Merritt secretes a copy of Kromer’s much-rejected research paper to and then summons Vogel, the medical authority from Baltimore, who arrives just in time to offer Kromer a research laboratory and to request three copies of Kromer’s paper. Baltimore is code for Johns Hopkins University. Its highly selective medical school opened in 1893, followed by the Phipps Psychiatric Clinic in 1913. Vogel is doubtless based on Adolph Meyer, who headed the Phipps Clinic from 1913 until 1941, and who was believed, “at one point or another ... [to have] personally trained almost every psychiatrist who rose to senior institutional positions of power in American institutions in the first half or the twentieth century.”28 Vogel invokes Kraepelin as a forerunner to Kromer in working in a laboratory as well as with patients, which was still not common practice at the time.
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The springboard to Albright’s writing the demand-to-be-takenseriously All the Living may have been his affiliation with Eva Le Gallienne’s Civic Repertory Theatre, which he joined shortly after finishing college, in 1926, as leading juvenile, and where he appeared in Chekhov’s Three Sisters, Ibsen’s John Gabriel Borkman, and Shakespeare’s Twelfth Night. Albright left the classics-focused company in 1928 for Broadway opportunities. One might see his script for All the Living sitting at the intersection of show business (his vaudeville origins), idealism and respect for weighty, canonized art (LeGallienne’s company), and the imperatives of the Great White Way (its dramas commonly flatter the intelligence of its audience and generally embrace linearity and causality). His script cannily takes the high road, values what passed then for a kind of photorealism in theatre, delivers a moral “message,” and packages all of this in a melodramatic plot complete with a love triangle and deus-ex-machina rescue at the end. Albright presents dementia without judgment or apology. Producer Cheryl Crawford was his ticket to ride. Crawford is well known for her independent Broadway productions of Brigadoon (1947), the 1942 revival of Porgy and Bess, and, in the non-musical realm, four Tennessee Williams plays on Broadway (The Rose Tattoo, 1951; Camino Real, 1953; Sweet Bird of Youth, 1959; and Period of Adjustment, 1960), as well as Yentl (1975).29 She was also a cofounder of the famed Actors Studio. All of this work postdates what put Crawford on the theatre history map: her years with the Group Theatre. While Crawford was, as her biographer puts it, “[a]s a commercial producer … apolitical, practical, and sanguine,” she also set her sights on being “at the center of a theatrical enterprise that spoke to the social conscience of America.”30 The Group, whatever its members’ internecine frictions, is inextricably linked with the “social conscience” Depression-era plays of Clifford Odets (most famously the 1935 Awake and Sing, which proclaimed that life should not be printed on dollar bills) and Sidney Kingsley’s 1934 Pulitzer Prize-winning Men in White, a searing drama recognized as a cry for legalized abortion. Both plays were produced by Crawford. The Group was started in 1931 by Crawford, Harold Clurman, and Lee Strasberg. Besides their dedication to plays of social significance, the Group sought to establish a tight ensemble of actors who would train and experiment together in the interest of work predicated upon truthfulness, as they understood it, using techniques based broadly on the work of Konstantin Stanislavski. Sanford Meisner and Stella Adler were among its storied actors who, like Strasberg, would become known as
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acting teachers and theorists. Men in White was directed by Strasberg; Meisner was in the cast. They teamed up again in 1938 in All the Living, the year after Crawford and Strasberg left the Group.31 Crawford later wrote that one of the Group’s “chief failures was our inability to find or develop enough good plays to reflect what we wanted to say about life in America.”32 That she maintained this ambition can be seen in All the Living as well as, in the 1940s, her joining American Repertory Theatre, formed by Le Gallienne and Margaret Webster (known for her New York productions of Shakespeare) to unite the high-mindedness of classical repertory with the ensemble idealism of rotating rep within a Broadway environment. That the grafting was financially unsustainable led Crawford to depart the project, but she continued to associate with other independent-minded idealists—who, perhaps hardly coincidentally, were (as was she) in the (largely closeted in the public eye) LGBT New York theatre community of directors, producers, and writers of their day, which included Carson McCullers and Tennessee Williams, as well as Strasberg, Le Gallienne and Webster. While much of the medical thinking in All the Living now appears hopelessly wrongheaded even to a lay reader, it is important to remember that its source text and that text’s author (Small advised Albright on the script) represented the work of research and psychiatric physicians of the day.33 The patients who enable Kromer’s journey in the play and help the audience understand that what’s commonly referred to as “an insane asylum” is, in fact, a hospital are Old Man Adams and Alec Jenkins. Alec, seventeen, has been rendered wholly uncommunicative, with causes attributed to the double traumas of his father abandoning the family years earlier and the recent death of his beloved uncle, who was struck by lightning. Alec lives on a dilapidated farm with his mother, who is struggling to make ends meet. Shorthand diagnoses proffered when Alec first arrives are aphasia and Dementia Praecox. Just after his arrival, Old Man Adams (“gnarled and weather-beaten and past ninety”) is brought in by an attendant. At this point in the play, Adams is walking and talking, and Alec takes immediate notice of him. Caring for Adams and providing support for the old man’s obsession with the crows that used to eat his crops will give Alec the proverbial reason to get up in the morning. Adams is, in terms of plot as well as theme, a very helpful device, offering at least three things. First, the script indicates that Kromer immediately notices “the effect that ADAMS has on ALEC. The OTHERS are
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concentrated on trivialities.”34 Adams is, therefore, a means of adumbrating Alec’s as well as Kromer’s perspicacity. This legibly conveyed ability to notice is the sort of thing a Method actor like Meisner would have relished performing. So, Adams is good for Alec and for Kromer—two characters about whose fate the playwright wants us to care. Second, Adams’s first spoken words are, upon seeing Dr. Grosh— Kromer’s primary blocking agent—“Here’s that damyankee doctor,”35 pointing specifically to Grosh as an antagonist. Grosh repeatedly demeans Kromer, telling newcomer Merritt that Kromer’s work is “a ridiculous lot of nonsense,” and telling Kromer himself that “a doctor can have too much science.”36 Kromer writes Grosh off as “a country doctor.”37 So, when Adams snorts derision at Grosh, we are meant to grasp that the old man can see through pretense, regardless of his age or folksiness. Finally, Adams provides an opportunity for explaining dementia, in a way that is sympathetic but offers no hope for treatment beyond the custodial. “His mind is clear as crystal on early events of his life. It’s only the present that bothers him.”38 Adams recalls the Centennial (1876) and the crows that attacked his crops, but he has little idea where he is, nor why he can’t have his rifle to drive away the now imaginary birds. Grosh explains that, while most old people remember the past better than they can deal with the present (which is not a universal truism), Adams also suffers from hardening of the arteries, as a result of which, according to set-in-his-ways Grosh, “the brain starves. They get childish—prowl around in the middle of the night—that’s what Adams did—only he carried a gun” (Fig. 5.1).39 So, major memory loss requires neither diagnosis nor research, nor even care. A “starved brain” is also more rather than less unremarkable, until a senior’s acting out becomes threatening. When Old Man Adams returns in the second act in a wheelchair, Alec is pushing him and has attached to the back of a chair a broomstick that he gives to Adams when the old man wants to “shoot” at crows. This meager form of “care” (not from a medical professional) is arguably the best offered in the asylum. The boy is crestfallen when the old man, for once, recognizes the broomstick for what it is and insists he needs his rifle. Here, Grosh reveals the problem with being a(n out of step/ uninterested in research) “country doctor.” He is kindly in his explanation to Nurse Stalling that Alec wants to help Adams, even as he recognizes there is nothing to be done for the old man. But he also believes that the staff have done all they can for Alec via what sounds like a “talking cure” in combination with regular routine, adequate food, and fresh air. Stalling
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Fig. 5.1 All the Living, 1938. John McKee as Old Man Adams (Photo courtesy of New York Public Library, Lincoln Center Branch for the Performing Arts)
gently wonders about the possibilities of Kromer’s Sulphur X for Alec, and this is where Grosh refuses to help, noting that a State Hospital is not the place for experimenting with unauthorized drugs on humans . At the end of the first scene of Act II—about two-thirds into the playing time of All the Living —Adams, who has been left alone onstage for the entire scene and is now enfeebled and covered with a blanket—dies. Suddenly, the faint sound of a crow is heard, and Alec utters his deceased friend’s mantra: “Caw, caw—Goddam you, caw,” adding “You wait till Old Man Adams gets his gun!!”40 Curtain.
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With the hope that Alec’s speaking indicates he has been cured (via secret injections of Sulphur X), the curtain rises on the remainder of the play. In the final act, however, just following Old Man Adams’s burial, we learn that Alec has not spoken again. The Superintendent has extracted a promise from the Governor to support a bill for the appropriation of hospital building funds; Merritt has left the hospital; and Alec’s mother is told that there is nothing more the doctors can do for her son if he lacks a will to get well. In the final rush of showdowns, Nurse Stalling challenges Dr. Grosh, asserting that the injections of Sulphur X were what allowed Alec to speak; Grosh attributes the momentary speaking to “a mental treatment” and taunts her with “Why hasn’t Alec spoken since?”41 Kromer stands up to Grosh, defending research against mere warehousing; Merritt returns with Vogel in tow, Vogel praises Kromer, and Alec speaks again. Although a senior with dementia, for whom no treatment is proposed, is not the main character in this play, he is not hidden and he serves a crucial dramaturgical purpose. All the Living is a play of social significance, treating a major health concern that receives some level of public support. But this support—a necessity for the impoverished (among others)—is hampered by public ignorance. For example, Alec’s mother fears ridicule rather than anticipating sympathy from the neighbors if she takes him home in his near-catatonic state. (“Message” to audience: “So, what are you going to do about it?”) Why the Broadway production limped to a closing night and was neither embraced later by the idealistic, democratic Federal Theatre Project nor for a London opening is not clearly spelled out in the archive but is not impossible to ponder. I return to this question in the penultimate part of this chapter.
Reading Embodiment Pre- and post-production articles and reviews in daily papers and weekly magazines offer not just a look at publicity strategies, reportage, and “response.” They are guides for anticipated playgoers as well as being “for the record.” The mixed reviews for this play especially are unusually opinionated—even didactic—and frequently take an advisory, perhaps paternalistic tone regarding actual and anticipated audiences. New York (and a few out-of-town) critics saw themselves not just as experienced and knowledgeable, but also as superior to their readers, for whom they
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perhaps saw themselves running interference. Many reviewers saw the All the Living ’s script as hackneyed while praising the production’s acting and directing. A number of reviewers vociferously warned about what a “downer” the play was, even as they lauded its intentions. Most presumed to have a definitive, monolithic idea of what a theatre audience was, what it expected, and why it would likely not “like” All the Living. Some said the play offered a salutary evening of instruction. Even while anticipating “dislike” or discomfort, critics wagged their fingers at laughter (you should appreciate it; you won’t like it). John Mason Brown, a critic for the New York Post, came close, two weeks into the play’s run, to recanting his opening night review, in no small part owing to pushback from a reader/ actual audience member. Although the latter did not come right out and say that he was insulted and felt looked down upon by the initial review, he did provide his own stance regarding both audience acumen and the value of the production.42 Brooks Atkinson’s New York Times review offers a look at a moderate iteration of the “mixed” balancing act, calling the play’s narrative “poorly proportioned” and “in need of a little mental therapy itself,” while lauding the acting as “one of the foremost achievements of the new theatre” and praising “sheer perfection in stagecraft.” Atkinson warned in a teacherly vein that “those of us who go to the theatre must live and learn,” encouraging any possibly reluctant potential ticket buyers via his opinion that “although it may sound morbid, it is vibrantly, clinically real.” The normally gentle, middle-of-the-road Burns Mantle led with the observation that “naturally, a play reporter’s first reaction to ‘All the Living’ ... is one of rejection on the grounds of unpleasant subject and a questionable appeal as entertainment of that character to which the theatre is presumably dedicated,” thereby pitting the play a priori against the norms of theatre tout court. Later, he allowed that “once past these objections there is much to be said in the play’s favor,” but then chided director Lee Strasberg for being “so concerned with the realistic and technical movement of his play that he has permitted the story to become pretty badly confused a good part of the time,” something “not likely to help with its popular reception.” In the most extreme push/pull review, John Anderson, writing for the Journal-American, went from respectful to hateful in his two-sided response. While he called All the Living “frankly and honorably a thesis play” possessed of “high purposes,” allowing that he did “not always expect the theatre to be amusing,” he
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leveled a one-two punch in this conclusion: “I was reminded of what Mr. Benchley said as he quit ‘Mourning Becomes Electra.’ It was nice to get back to the depression. It was, in fact, quite a big step up.” A few critics noted the similarities to Men in White (Mantle, Pollock), while one writer pointed out that critics missed similarities to Yellow Jack, a 1934 play about Yellow Fever in Cuba between 1898 and 1900, featuring doctors determined to find a cure and patients participating in an experiment.43 Three critics lambasted the opening night audience for laughter the writers saw as wholly inappropriate. Anderson “found it the most depressing play I have seen in years. Its little note of hope at the end had about the same lifting power on my spirits that a hummingbird would have on the Empire State Building.” In their (self-adopted?) positions as bearers of expert, beyond garden-variety knowledge, critics sagely let readers know that absent a certain superiority of their own, they need not bother with this play. Mantle offered middlebrow comfort in a review for a western Massachusetts paper: “Leaving the theater, you might decide that you did not want to see that play again, but you would probably be well pleased that you had seen it once, and proud of such added knowledge of a hidden phase of life as it had given you. The educational drama has a place. The playgoer’s rightful quarrel with it is that it too often is deceitfully exploited.”44 The “it was good for you” tone pats the skeptical on the back if they endured a performance, although it is not particularly inviting to any who had not. No reviewer mentioned dementia as probably a not-so-unrecognizable facet in the lives of many. Publicity outside of reviews encouraged potential New York playgoers to feel sophisticated, not only because of the high-mindedness of the subject and excellence of the acting, discussed below, but also because of a not-so-subtle strain of hauteur regarding the U.S. South. An article about set designer Harry Horner describes the play as set in “the Solid South” (capitals in original), mistakenly calling the hospital building an “ancient Southern mansion, renovated for the treatment of patients, yet retaining something of its ante-bellum flavor.”45 The published text of the play makes clear that the setting is a dedicated hospital built in 1868, which predates the actual institution on which Small based his book. Journalists ignored the distinction when the goal was to forge a rhetorical “we” with New York readers. (Production photographs make clear that this facility is too large ever to have been a single mansion.) A Journal-American article pulled no punches in saying that, without naming names, “the play script makes it clear that this hospital is situated in one of our more backward
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States.”46 Columnist Tom Vernon wrote a revealing piece about Victor Small’s visit to New York to see All the Living, crafting a kind of “aw, shucks” country doctor persona, and focusing on the city being “all right for a visit—provided it is a short visit,” adding that Small tried “practically every restaurant that advertised Southern cooking and was bitterly disappointed”; stayed at the same hotel as Albright and his wife, because “he knew he’d be lonely if he were surrounded by strangers”; and “went to ‘Tobacco Road,’ looking for something to remind him of home.”47 Tobacco Road, still one of the longest-running plays in Broadway history, opened in 1933 and closed in 1941. Based on Erskine Caldwell’s novel of the same name, which argues for the sterilization of Georgia’s poor whites, it features a destitute family of sharecroppers whose morality— sexual and other—is on full display for derision and/or headshaking. Vernon admitted that the play did not remind Victor Small of home, “exactly,” but the linkage of Deep South, small town doctor, salacious play, and All the Living was presumably intended to boost ticket sales among audiences who, whether they had an interest in social reform, might respond to titillation and an editorial wink. The audience member, John Coffey, who pushed back and wrote to John Mason Brown asserted that All the Living “credit[s] the audience with imagination as well as conscience,” chastising Brown and asking whether such a “rare accomplishment as this in the theatre [is] to be called punishment, less than entertaining?” He praised the play for “awaken[ing] disused, long overdue, sympathy for the insane. It challenges to action.” Here is a playgoer for whom author, producer, and artistic personnel intended their product, and he notes that All the Living “will attract enough others not to need the attendance of mentally shorn lambs who must have the winds of relevant truth and reality tempered to them,”48 which is to say that, while he was an actual theatregoer who resented being pandered to, he, too, disdains those who are not up to the requisite task of imagination, challenge, sympathy, and possibly action, writing them off as “mentally shorn lambs.” Like the critics, he does not mention that a nonagenarian with memory loss might be more familiar to audiences than they cared to admit and that “insane” may not be the right word for him. The single point on which almost all reviewers agreed is that the acting in All the Living was noteworthy. Praise for Sanford Meisner as Dr. Kromer includes “tops” (Brown), “keeps splendidly in character,”
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(Mantle, Daily News ), “earnest” (Benchley), “superb,” (Whipple), “presents a vivid portrait” (Anderson), “moving, passionate” (“Asylum Play”), and “an extraordinary performance that translates pride and torment into a living design” (Atkinson). These are certainly ringing endorsements; they are not descriptions. In the interest of assessing just exactly what audiences who attended All the Living might have experienced regarding the bodies and techniques of actors onstage—distinct from the words of the script—I want to posit a kind of acting dialectic that may have been perceivable between the work of Meisner as Dr. Kromer and John McKee as Old Man Adams, the character with dementia. McKee was in his sixties when he played Adams. He was born in Belfast, sometime in the 1870s.49 After emigrating to the United States, he trained as an actor with the legendary Joseph Jefferson, making his stage debut in the latter’s storied Rip Van Winkle, which Jefferson performed in the United States for forty years, starting in 1866. Jefferson, born into a theatre family in 1829, would have trained McKee in nineteenth-century techniques predicated on embodying recognizable character types via a standardized movement repertoire and on projecting and performing in large houses without electric (or, in many instances, even gas) lighting, necessitating gestures and inflections today considered stereotyped and possibly even phony. McKee went on to work for New York producer Charles Frohman, then spending eighteen years working for Boston-based producer Henry W. Savage, primarily as a director.50 A 1908 article detailing Savage’s modus operandi tells much about how McKee would have understood actors, acting, and directing. The article reports on Savage forming seven companies simultaneously to perform a play called The Devil in various U.S. cities, suggesting the kind of work probably performed by McKee: The rehearsals are now, it appears, a simple matter because, after one company has been broken in the stage manager [the term of the era for what is now called director] learns just how to break in another, and he can go at it in such a way as to bring results in less time than it takes to build the scenery.
McKee cut his teeth, in other words, on acting and directing now readily understood as Taylorist or Fordist, with an emphasis on immediate legibility, speed, repeatability, and interlocking parts. He largely disappeared as an actor between 1910 and 1936. Resurfacing in Three Wise Fools,
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followed by his stint as Old Man Adams in All the Living in 1938, he worked steadily in very small roles until his death, frequently playing clergymen or doctors. Production stills for All the Living, while they suggest poses and large gestures, cannot be said to depict actors in performance, as most were staged to highlight key moments in the script or to showcase actors to advantage. Nonetheless, McKee’s heyday—as with Old Man Adams’s—was in the past, and audiences could see that this actor did not need prosthetic makeup to play old. Recall Brooks Atkinson’s praise for All the Living the best of “new theatre.” This was the terrain occupied by Meisner and Strasberg. Sanford Meisner was still a member of the Group Theatre when he appeared in All the Living. He had been teaching acting at the Neighborhood Playhouse since 1935. Unlike Strasberg, although both drank from the well of Stanislavski, Meisner’s means of achieving truth onstage was not about dredging up personal memories, but about living in the moment and reacting honestly both to one’s imagined circumstances and to one’s acting partner. The primary record of his teaching and philosophy, Sanford Meisner on Acting , relentlessly returns to ideas such as “the practitioner is somebody who is learning to funnel his instincts, not give performances”; “all good acting comes from the heart ... there’s no mentality in it”; “you cannot escape the impact of emotion”; “character comes from how you feel about something”; or “the best way to act well is live truthfully, and don’t create a phony situation.”51 Audiences who remembered his (then recent) appearances might recall the intense young man in his 1935 performance in Awake and Sing as the lovestruck nebbish Sam Feinschreiber, who is duped into marrying the pregnant (by someone else), beautiful Hennie, who cares not one whit for him. The intensity was Meisner’s stock in trade, truthfulness his métier. The “new theatre” of which he was a pathbreaker sought to overturn everything in which McKee had been trained, something entirely clear in Meisner on Acting. It would be wholly unfair to call McKee’s style (which we cannot know, as no film of the production exists) hammy or sclerotic or stuck in a time warp. It would be equally wrong to say that the realm in which Meisner was credible would seem subtle to us today. But in performative terms, audiences who saw All the Living witnessed a doctor character embodied by an actor taking the bit in his teeth with the new and an actor trained in the previous century embodying a dementia character stuck in the past, playing and replaying the same repertoire of resenting Yankees and crows
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while unable to leave his restricted environs. In Mieke Bleeker’s terms, what is put in front of audiences is not merely “there,” but is “in fact, rerouted through memory and fantasy, caught up in threads of unconscious and entangled with the passions”52 ; memory here might refer to spectators’ own memories, e.g., of family members with dementia, or of having seen McKee onstage in the early part of the century, which raises the specter of Marvin Carlson’s concept of ghosting (discussed in Chapter 3). Audiences might also see bodies in depth, both in McKee and in Meisner, seeing Anne Davis Basting’s “time across space,” witnessing the event of aging (in McKee), anticipating the changes the body will produce (in Meisner), and remembering changes already observed—in themselves, in McKee during his career, or even in Meisner in his still young career.53 It is hard to write off an actor who is actually there in front of an audience as “gone” or “missing” or “already dead.” I want to suggest that McKee’s two bodies—his own and that of Old Man Adams— could strike a chord of recognition. Adams is still possessed of feelings and needs (including the need to relate to others). Spectators might pay attention to being “blind to the plenitude—however mundane—of the present.”54 Beyond scripted assertions, the live actions of these two actors might put simply, have contributed to an unspoken appreciation of the relative normalcy of dementia. Adams’s presence does not argue for a cure so much as it demonstrates the need for the recognition that he is still there, still has feelings, still counts. It is, ironically, not the researcher who is able to offer succor.
The Next Steps Shortly after All the Living closed on Broadway, applications for further productions were received and assessed both in London and by the (United States) Federal Theatre Project (FTP). In London, Britain’s Office of the Lord Chamberlain (OLC)—the gatekeeper for any and all productions until the office was abolished in 1968—objected in a report of April 29, 1938, to lines in the script that seemed offensive (including “sons of bitches” and “my fanny”) and to a reference to Queen Victoria that does not appear in the published version of the play. The reader characterized the play as “long and troublesome.”55 A second reader for the OLC, in a statement dated May 2, was even more corrosive, saying “it is a nasty play, it will offend and hurt many and give pleasure only
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to those who ought to be inmates of institutions in which the action of the play takes place.”56 The application was submitted to the OLC by Jack Buchanan (1891–1957), a Scottish performer who started his career as a music hall entertainer and then went on to years of playing debonair men about town. Buchanan owned the Leicester Square Theatre in London, the venue he proposed for All the Living. He did not pursue the requested revisions. The Federal Theatre Project story is different. The FTP was national in scope and created deep into the Depression (in 1935) specifically to put theatre artists back to work and to provide quality, low-cost entertainment to other Americans. The FTP, headed by Hallie Flanagan, was part of the Works Progress Administration, which also included relief for other creative workers in the form of the Federal Music Project, the Federal Art Project, and the Federal Writers’ Project. Performing arts professionals who were put to work under FTP auspices included not only actors, but vaudevillians, circus performers, minstrel performers, and puppeteers. Their work was offered in churches, on rafts, in tents, in schools, in parks, and, of course, in “legitimate” theatres, in languages including French, Spanish, German, and Yiddish, as well as in English. The project was shut down in 1939 when a campaign mounted by the House Un-American Activities Committee attacked the FTP’s work as Communist. In fact, the bulk of FTP productions—those that could be characterized as theatre, rather than vaudeville, circus, puppetry, minstrelsy, etc.—were musicals or classics and not social protest dramas, although the famous Living Newspapers addressed social ills head on and in a clearly leftist way. Early in the existence of the FTP, a clearinghouse, ultimately called the National Service Bureau, was created to disseminate information to the public about FTP activities; to assemble and house a national production archive; to assess original scripts submitted to the FTP for possible production; and to assist theatres around the country in need of production guidance and play suggestions. All the Living was submitted to this bureau.57 It received two readers’ reports in mid-September of 1938, and these suggest what George Kazacoff labels the “subjective and uninhibited” nature of the work undertaken by readers who were largely writers themselves and whose assessments reveal “through their candor, naivete, and subjectivity much about the dramaturgy, social issues, politics, and the mores of the time.”58 A reader named H. Kline titled his report “Men in white in the state lunatic asylum.” He recommended rejecting the script, calling its science “far-fetched” (although admitting he knew
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little of scientific procedure), adding that this might be forgiven if the play had anything else to recommend it. The most impressive thing about it was, for him, the fact that it had been produced. Reader Harold Callen was more forgiving, although still on the fence. He recommended it with reservations, admitting that he was “visualizing the production I have seen rather than the script as it reads. What in the reading appears to be gruesome, statistical facts was on the stage given some action and dramatic effects. It’s not a play for a pleasure bent crowd—but it’s a play, and a good one.” He also compared reading the text to “reading a patient’s chart in a hospital, it’s absorbing and yet fearful.” Like some of the critics, Callen believed the production he’d seen was, in some ways, superior to what could be appreciated by the audience whose tax dollars were paying him. Democracies—including the theatrical endeavors they support— cannot be better than the people who step up to make them work. In an eighteen-month period, readers for the FTP had read and analyzed four thousand plays. While one director of the Bureau described the type of plays being sought as “alive to the problems of today’s world,” with “no taboos on subject, form, or theme,” she also said that the FTP would “work through accepted tastes of the community, rather than attempt to foist our opinions of plays upon them.” The fact was that overworked readers were based in New York and were rendering opinions on behalf of regional directors who often preferred the “tried and tested.”59 Also, New Yorkers’ opinions of “the community,” when that meant something outside a major metropolis, were then, as they can sometimes be now, biased and even condescending, as evidenced by the reviewer in JournalAmerican writing that All the Living was set in a “backward state” in the South. Despite the ardor of the playwright and Crawford’s goal of being “at the center of a theatrical enterprise that spoke to the social conscience of America,”60 critics and FTP readers, even when they acknowledged what might be called moral or ethnographic value in All the Living, could recognize ideologically “wholesome” fare but not be forced to partake. Moreover, they took for granted that most theatregoers would, if given the choice, eschew basic nutrients in favor of something sweeter or fattier. In the case of the Federal Theatre Project, the two readers’ reports pretty well guaranteed that the public would not be given a choice. Farm support, poor housing, and syphilis were “problems of today’s world” that the Federal Theatre Project addressed.61 Mental illness was perhaps
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too shameful and dementia too ordinary to be acceptable subjects for theatricalization. In 1938, Pic Magazine ran a feature headlined “The Group Tackles the Abnormal.” The focus of the piece, which is heavily illustrated with photographs, is actors using Stanislavskian methods to portray various kinds of mental illness. Six pictures show Alfred Ryder, the young man who played Alec in All the Living, preparing to go onstage and in performance. Captions describe him performing symptoms of the “catatonic form of dementia praecox caused by a severe shock,” which include an inability to speak, being in a daze, and “blinking helplessly.”62 Other photos show Sheila Trent in the role of Hazel, the nymphomaniac, with one depicting her collapsed in a chair, as a doctor and nurse look on anxiously. The doctor (the script suggests this is Kromer) has one hand on her head, perhaps as if to indicate “there, there.” Stage directions do not stipulate the gesture, much less suggest its meaning. Three years later, Pic ran an article titled “Are You Mentally Disabled?”63 The same photo of Hazel is captioned with “note the handon-head fakery portrayed in scene from ‘All the Living.’” The thrust of the article (after listing various kinds of diseases and offering thumbnail descriptions for anxious readers interested in possible self-diagnosis) is that mental illnesses deserve the same attention and serious consideration as physical ones. But disease names and categories shift, and nowhere is this more evident than in the sentences describing “the schizophrenic, or what is sometimes called Dementia Praecox.” Now unable to decide which it is, the popular journal leans toward Freudian (psychological/ functional) rather than Kraepelinian (biological/neurological) explanations, concluding that most schizophrenics’ “failure to adjust themselves to life is the cause of the deterioration of the personality.” All the Living ’s science is passé (or outright fakery); adjustment is the new angle. After 1948, the designation “dementia praecox” vanishes from medical literature.64 Regarding senile dementia, the “adjustment” angle would take hold full force. In 1937, David Rothschild published the first of several articles that would wield tremendous influence on psychiatrists who “increasingly thought of modern social relations as the pathology of senility.”65 Rothschild’s modest but forceful conclusion in “Pathologic Changes in Senile Psychoses and Their Psychobiologic Significance” is that patients are not merely “anatomic specimens,” but “living persons who are growing old and who are struggling to adjust to personal problems.” He names their
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inability to make adjustments as a crucial factor in the decline, noting that his attitude is not new but that psychiatrists have not applied it to this particular category of mental incapacity. It would be decades after its 1949 opening before the evergreen Death of a Salesman would be considered a play about a character in the early throes of dementia. The fact that no one read protagonist Willy’s situation as illness for many years tells much about popular views toward dementia at mid-century. Those educated in psychiatry were turning from biological to psychological therapies. Those wholly outside any facet of the medically or psychoanalytically informed loop could continue to shrug or sigh or throw up their hands or weep at some facet of “the normal course of things.” Those looking for a roadmap of how theatre portrayed dementia should turn off at the next exit.
Notes 1. Albert Deutsch, The Mentally Ill in America: A History of Their Care and Treatment from Colonial Times (New York: Columbia University Press, 1946 [third printing; originally published in 1937]). For senile dementia, see 488 and 491. 2. Victor R. Small, I Knew 3000 Lunatics (New York: Farrar & Rinehart, Inc., 1935). The hospital closed permanently in 2012. 3. Richard Noll, American Madness: The Rise and Fall of Dementia Praecox (Cambridge, MA: Harvard University Press, 2011), 295 (note 20), 21, and 19. 4. Hardie Albright, All the Living (New York: Samuel French, 1938). 5. In addition, three other doctors were called in as consultants on the play and two of these attended rehearsals to advise on the behaviors, gestures, and walks of people with particular mental disorders. See “Psychiatrists Give Pointers to Cast of ‘All the Living,’” New York Post, 19 March 1938 (n.p.) and “Va. Doctor Asked Advice in Hit Play,” Richmond (Virginia) News Leader, 4 April 1938. 6. Kenneth J. Weiss, “Images in Psychiatry: Albert Deutsch, 1905– 1961,” American Journal of Psychiatry, Vol. 168, No. 3 (1 March 2011): 252. https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp. 2010.10101491 (Accessed 1 April 2023). Also https://en.wikipedia.org/ wiki/Albert_Deutsch. 7. Deutsch, op cit. “Catch-all” is on page 130 in a chapter called “Retrogression: Over the Hill to the Poorhouse.” 8. Noll, 16. 9. Deutsch, 304.
100 10. 11. 12. 13.
14. 15. 16.
17. 18. 19.
20. 21.
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Ibid., 309. Ibid., 313. Noll, 60 and 66. Ibid. The importance of using standard diagnostic terms was recognized beginning in the 1920s by a plethora of committees of several national medical and psychiatric organizations. Multiple non-congruent nomenclatures were in use; finally, in the wake of World War II, the first volume of The Diagnostic and Statistical Manual of Mental Disorders (DSM I) was published in 1952. Tellingly, DSM I addresses dementia only in what now seems like a vague way: as “Chronic Brain Syndrome associated with senile brain disease” or as a syndrome with a hereditary cause or the effect of another disease. (Diagnostic and Statistical Manual of Mental Disorders [Washington, DC: American Psychiatric Association, 1952], introduction and pp. 4, 22, and 23.) Shared nomenclature facilitates communication across specialists and disciplines, but categories are still determined by socially situated individuals, which means that they are (necessarily) subject to revision in the face of ongoing research. As Rachel Cooper summarizes, “D.S.M. is shaped by pressures emerging from the various ways in which it is used in practice.” (Classifying Madness: A Philosophical Examination of the Diagnostic and Statistical Manual of Mental Disorders [Springer, 2005], 76.) DSM is in its fifth iteration, which was released in 2013. For a comprehensive history of dementia praecox, see Noll. Noll, 3–4. Deutsch, 465–466. This total number in such institutions would have been in excess of 200,000, representing a dramatic rise over the course of a half-century, as the number of patients in public mental hospitals went from 41,000 in 1880 to 403,519 in 1935; in fifty-five years it increased eightfold, while the population of the nation had merely doubled (Deutsch, 487). Deutsch, 486. Noll, 17 and 83, the latter with a quote from Edward Shorter. Victor R. Small, “Treatment of the Epileptic Insane,” Southern Medicine and Surgery (May 1921): 196–201. Noll notes both the frequent use and the foul odor of paraldehyde in mental hospitals in the 1890s (26). Small, “Epileptic Insane,” 197. Material in this paragraph is also culled from The Ohio State Medical Journal (March 1920): 222. https://archive.org/details/ohiostatemed ical1619unse/page/222 (Accessed 9 April 2023); Report of the State Hospital for the Insane at Raleigh, NC (Year ending November 30, 1920– June 30, 1922). https://archive.org/stream/reportofboardof00stat/rep ortofboardof00stat_djvu.txt (Accessed 1 April 2023). “About Victor R. Small,” https://sampsonarts.net/about-dr-victor-r-small (Accessed 1
5
22. 23.
24. 25.
26. 27. 28. 29.
30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42.
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April 2023). My thanks to Dr. Sam Burstein for insights about paraldehyde. Small, 3000 Lunatics, v, vi, and vii. Kirkus Review of I Knew 3000 Lunatics, 8 April 1935. https://www. kirkusreviews.com/book-reviews/victor-r-small/i-knew-3000-lunatics/ (Accessed 1 April 2023). 3000 Lunatics, 44. Hardie Albright Obituary, Variety, 24 December 1975, p. 46; “Eva Le Gallienne Gave Juvenile First Chance,” The Philadelphia Ledger, 24 November 1928 (n.p.); Cynthia Jobin, “Acting Texts: A Review and an Argument,” Dramatics Curtain, February 1981, p. 13; Trav S. D., “Hardie Albright: From Vaudeville to the Voice of Bambi,” Travelanche, 16 December 2018. https://travsd.wordpress.com/2018/12/16/hardiealbright-from-vaudeville-to-the-voice-of-bambi/ (Accessed 1 April 2023). All the Living, 84. See Noll, 25 and 42 re: lower status of pathologists. Noll, 37. Material about Crawford is drawn from her autobiography, One Naked Individual: My Fifty Years in the Theatre (Indianapolis and New York: Bobbs-Merrill, 1977) and Milly S. Barranger’s A Gambler’s Instinct: The Story of Broadway Producer Cheryl Crawford (Carbondale, IL: Southern Illinois University Press, 2010). Barranger, 48, 125. Barranger cites Crawford’s complaint of (male) “chauvinism” in the Group (124). Crawford, 100. See note 5 above. All the Living, 29. Ibid., 28. Ibid., 11, 56. Ibid., 38. Ibid., 30. Ibid., 30. Ibid., 96. Ibid., 130. John Mason Brown, “Mr. Albright’s ‘All the Living’ And Some Questions It Raises,” New York Post, 9 April 1938 (n.p.). Brown’s opening night review is “Cheryl Crawford Presents ‘All the Living,’” New York Post, 25 March 1938 (n.p.). Other reviews consulted and quoted below are Brooks Atkinson, “Mental Therapy and State Hospitalization in Theme of Hardie Albright’s ‘All the Living,’” New York Times, 25 March 1938 (n.p.); Richard Watts, Jr., “The Theaters,” New York Herald Tribune, 25
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March 1938 (n.p.); Richard Watts, Jr., “Madhouse Is Setting for Two Plays,” The Sunday Star (Washington, DC), 3 April 1938, Section F first page; John Anderson, “‘All the Living’ Clinical Study of Insanity: Honest Play Shuns Tear-Jerking,” New York Journal-American, 25 March 1938 (n.p.); Sidney B. Whipple, “Engrossing Drama in ‘All the Living,’: Deals with Two Worlds, That of the Same and the Unreal, and Is Finely Directed and Splendidly Acted,” New York World-Telegram, 25 March 1938 (n.p.); Robert Coleman, “‘All the Living’ Limns Science and Love,” New York Daily Mirror, 25 March 1938 (n.p.); Arthur Pollock, “‘All the Living,’ Presented With Astonishing Realism and the Fulton Theater. Is Something of a Phenomenon,” Brooklyn Daily Eagle, 25 March 1938 (n.p.); Arthur Pollock, “Science and Love: ‘All the Living,’ an Extraordinary Realistic Drama, Blends Romance With Argument for the Proper Treatment of Insanity,” Brooklyn Daily Eagle, 10 April 1938 (n.p.); Burns Mantle, “‘All the Living,’ Drama of the Asylums, Is Skillfully Staged,” New York Daily News, 26 March 1938 (n.p.); Burns Mantle, “‘All the Living’ Best of Recent Play Crop,” Springfield (Massachusetts) Sunday Union and Republican, 3 April 1938 (n.p.); Richard Lockridge, “‘All the Living,’ Descriptive Drama, Opens at the Fulton Theater,” New York Sun, 25 March 1938 (n.p.); Richard Lockridge, “Hardie Albright’s ‘All the Living’ as an Example of the Descriptive Drama,” New York Sun, 9 April 1938 (n.p.); “Mr. Albright’s ‘All the Living,’” New York Herald American, 3 April 1938 (n.p.); Louise Mace, “Here and There in the Theatre,” Springfield (Massachusetts) Sunday Union and Republican, 10 April 1938 (n.p.); Robert Benchley, untitled review; The New Yorker, 2 May 1938 (n.p.); “Mr. Albright’s ‘All the Living,’” no author, New York Herald-American, 3 April 1938 (n.p.); “Asylum Play Wins Applause Despite Its Melancholy Theme,” Sunday Times-Advertiser (Trenton, NJ), 3 April 1938. The remarks of the resistant audience member’s, John Coffey, remarks are quoted in Brown, 9 April 1938. “Mr. Albright’s ‘All the Living,’” New York Herald-American. Mantle, Springfield Sunday Union and Republican. “But Ignorance is an Excuse in Some Cases,” New York Herald-Tribune, 27 March 1938 (n.p.). “Vital Problem Presented,” New York Journal-American, 3 April 1938 (n.p.). Tom Vernon, “Broadway Has No Thrills For ‘All the Living’ Creator,” New York World Telegram, 9 April 1938 (n.p.). Quoted in Brown, 9 April 1938. McKee’s longest obituary puts him “in his eighties” when he died in 1953. See “John M’Kee, Actor and Stage Director,” New York Times, 29 December 1953 (n.p).
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50. John McKee, program bio, Romeo and Juliet, Broadway 1951. Accessed in John McKee clipping file (T-Clipping, John McKee), New York Public Library, Lincoln Center branch for the Performing Arts. 51. Sanford Meisner on Acting, Meisner, 37, 87, 96, 123. 52. Maaike Bleeker, Visuality in the Theatre: The Locus of Looking (Basingstoke, UK: Palgrave Macmillan, 2008), 2. 53. Anne Davis Basting, The Stages of Age (Ann Arbor: The University of Michigan Press, 1998), 141. 54. Kathleen Woodward, in “Reminiscence and the Life Review: Prospects and Retrospects,” 137–161 in What Does It Mean to Grow Old?: Reflections from the Humanties, ed. Thomas R. Cole and Sally A. Gadow (Durham, NC: Duke University Press, 1986), 156, 160. 55. H.C. Game, Reader’s Report for All the Living, 29 April 1938. LCP Corr WB 1938—All the Living. 56. “All the Living.” LCP Corr WB 1938—All the Living. 57. See Arena, 261–267 and George Kazacoff, Dangerous Theatre: The Federal Theatre Project as a Form for New Plays (New York: Peter Lang, 1989), Chapter 1, “The National Service Bureau.” 58. Kazacoff, 32. 59. Ibid., 34, 35, 42. 60. Barranger, 48. 61. These were the topics of the Living Newspapers Triple-A Plowed Under, One-Third of a Nation, and Spirochete. 62. “The Group Tackles the Abnormal,” Pic Magazine, 28 June 1938, p. 11. 63. “Are You Mentally Disabled?” Pic Magazine, 29 April 1941, pp. 10–11. 64. Noll, 262. 65. Jesse F. Ballenger, Self, Senility, and Alzheimer’s Disease in Modern America (Baltimore: Johns Hopkins University Press, 2006), 55.
CHAPTER 6
Willy Loman Center Stage
In 1999, a Seattle-based doctor wrote a terse twenty-word letter to the editor of the New York Times. “Willy Loman has Alzheimer’s Disease,” declared George B. McDonald, M.D. “All of the signs. All of the symptoms. I wonder if Arthur Miller knows that.”1 That a doctor could render a diagnosis absent an actual patient points to two phenomena that make Death of a Salesman a rich site for examining dementia’s appearance on the American stage. First is that decades’ worth of people have believed in Miller’s iconic character as an entity they can recognize and discuss as a person. As Amy Cook notes, humans understand ourselves, other people, and fictional personages via the same cognitive processes. “The process of building character—our own and those of the figures we see on stage, screen, and life—is one in which human beings ‘cast’ information from one domain to the other, building up layers of meaning in a networked assemblage of bodies, histories, biases, actions, and words.”2 That process, moreover, involves embodied knowledge and experience, not just intellectual, informational processing and/or semiotic analysis, something explored in greater depth later in this chapter. The second phenomenon is that, precisely because this play has been front and center on U.S. stages, in classrooms, and in scholarship for seventy-plus years, it offers a prime site for considering how popular views of dementia shift over time, even regarding the same dramatic text. Here, of course, the “same” written text yields myriad new performance © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 D. Chansky, Losing It, https://doi.org/10.1007/978-3-031-20902-4_6
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texts, the latter witnessed by assemblages of bodies situated in times and venues yet to come into existence when the play first opened. This chapter (1) historicizes representations of dementia and decline on the American stage—in this case in decades’ worth of productions of Death of a Salesman—linking these to medical and social aspects of health and care that made (and in this case, make) them legible and of interest to theatergoers; (2) considers links between dementia and age in Miller’s play, as both have sociological as well as medical and psychological ramifications and challenges for those experiencing them in tandem; and, (3) insists on the importance of bodily presence—that of actors and of audience members—in understanding, or at least interpreting, theatrical representation. Since McDonald threw down his diagnostic gauntlet, reviews of many productions of Salesman have mentioned dementia or Alzheimer’s. But even prior to either of these words appearing in reviews, critical responses make clear what is hiding in plain sight. In saying this, I am not claiming that seeing the character Willy Loman as having dementia is the sole, “accurate” way to understand his character, nor that it is the heretofore missing key to parsing the play’s themes. I am saying that this piece of the complex character puzzle can add greatly to our thinking about a figure that so many believe(d) they knew, even to the point of weariness or boredom. One scholar wrote that even “in 1948 or 1949, everyone felt Willy Loman was like someone they had known: a father or an uncle, a failure in the great age when all Americans had to succeed.”3 A quarter of a century on, in 1974, a reviewer for the Boston Phoenix complained that “English teachers have spent so many monotonous hours jawing it to death, that the whole idea has come to seem stale—‘Oh Jesus, Willy Loman again?’”4 In his 2015 Theatre of the Unimpressed, in a section of the book called “Boredom,” Jordan Tannahill uses Willy Loman as shorthand for the sort of character appearing in the predictable, box set, middlebrow drama typical of many North American regional theatres that has turned many of his Gen X (and younger) friends against theatergoing. Tannahill writes, “I practically feel obligated now to send old Willy Loman a Christmas card, as if he were a distant great uncle I see every couple of years at a family reunion. And like strained conversations at a family reunion, my encounters with Willy invariably feel like duty.”5 But whatever the unimpressed were seeing, or failing to see in Death of a Salesman, scholars at least kept going back for more; a 1999 interview with Miller includes the fact that between 1963 and 1999, Salesman had
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been the subject of four hundred thirteen scholarly books, articles, and doctoral dissertations.6 In mining largely journalistic sources—those putatively reflecting the experiences and values of theatregoers—my project here is to show how the language used to describe actors’ performances in the role of Willy Loman matches the language used to describe symptoms of various kinds and stages of dementia. Putting these two things together suggests how words and gestures are part of what Cook calls an “ecology” of characterological recognition, even when the descriptions summon one kind of understanding prior to their writers having a rubric under which to unite and another interpretive possibility once that rubric is established.
Doctors’ Dilemmas In 1944, five years before the opening of Death of a Salesman, William Mayer-Gross declared in The Journal of Mental Science that “our knowledge of the pathology of senile psychoses and dementia has made little progress in the last five years.”7 Mayer-Gross’s article is entitled “Arteriosclerotic, Senile, and Presenile Psychoses,” and in it the author parses the three major categories of what we would now call dementia as these were grouped and studied at mid-century. Alzheimer’s Disease makes an appearance in the senile and the presenile categories, but the former contains almost no other specifically named diseases. What is both fascinating and frustrating is to read a list of behaviors associated with “functional psychoses.” Functional psychoses, considered as distinct from “organic” psychoses, were not regarded as biological in origin. Organic psychoses are “characterized by the presence of physiological or anatomical changes to the nervous system, [and functional psychoses] by their absence.”8 Items on Mayer-Gross’s list map neatly onto behaviors that today would most likely lead to an immediate consultation with a doctor on the part of a patient or a representative of the same worried about dementia but that in 1944, with what today might seem hedged bets, were not linked to organic disease and, therefore, not subject to the same kinds of (urgent?) research as psychoses with organic origins, even if, as we have seen and will see further below in the findings of other mid-century medical researchers, symptoms and behaviors overlap. Behaviors listed by Mayer-Gross describe the Willy Loman familiar even to people who may not have (re)read Death of a Salesman recently: “anxiety, depressive and paranoid reactions … confusion, peevishness, resentment … narrowness
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of interests, lack of plasticity, rigidity of the ageing personality and feelings of insecurity,” also adding “dramatic emotional reactions coloured [sic] by anxiety.”9 The question of whether these behaviors result from organic or from psychological causes was not dropped by medical researchers after 1944, although any definitive answer (much less a cure) remained elusive. Indeed, twelve years later, Drs. Naomi Raskin and Ruth Ehrenberg reiterated that the reasons for some people aging “gracefully” while “some become psychotic” could not be answered by “anatomo-pathologic studies alone,” while also offering what—at that point after the fact of the play’s newness—might have been two possible medical (organic, physiological, anatomic) reasons for Willy’s behavior. Stating that the “difficulties of clinical differentiation between psychosis with cerebral arteriosclerosis and senile brain disease” were well known, they nonetheless spell out how these show up and play out. One occurs suddenly, while the other unfolds over time. “More or less sudden onset of the disease, impairment of memory, poor emotional control, confusion, exacerbations and remissions … put the patient in the group of cerebral arteriosclerosis.” (135). Has Willy had a small stroke (formally called a transient ischemic attack) Or a series of undiagnosed strokes? The accepted criteria for senile brain disease comprise “gradual loss of memory, disorientation, poor judgment, and deterioration of personal habits,” but, the authors add, “overlapping of symptoms [between arteriosclerotic and pathological psychoses] is common.” Our hero might, then, be a victim both of stroke (the results of which today, if they are cognitive, fall under the heading of dementia) and of a dementing disease. These kinds of diagnoses, however, were not front and center on the part of psychiatrists and psychologists—both professions that gained in numbers and in visibility after World War II10 —dealing in the 1940s with an increasing population of elders in distress. Laboratory science was not offering a silver bullet, but meanwhile, a growing number of seniors grappling with a host of symptoms cried out for treatment. What would that treatment be? David Rothschild’s 1937 article, “Pathologic Changes in Senile Psychoses and Their Psychobiologic Significance,” cited at the end of the previous chapter, concludes that patients are not merely “anatomic specimens,” but “living persons who are growing old and who are struggling to adjust to personal problems.” Rothschild’s way of thinking would undergird the psychodynamic approach to dementia, the central tenet of which was that social and
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psychological factors were the major contributors to the sorts of behaviors in senior citizens (although that term was not yet in use) described above as hallmarks of functional and organic psychoses, recommending that the struggling, living person should be treated as just that—not as a lab specimen. This school of thought would hold sway in the United States for roughly two decades.11 Until at least the middle of the 1950s, psychiatric journals would publish work featuring laboratory findings as well as studies of hospitalized patients, but they would use the inconclusive or repetitive or contradictory nature of these findings to argue against “therapeutic nihilism” in the face of laboratory question marks and in favor of “therapeutic efforts.”12 The efforts they supported were what today might be (too) simply understood as psychotherapy of the “talking cure” sort. Matthew Ross, in a highly readable article aimed at doctors who were not psychiatrists, declared in 1954 that “any physician” should be able to follow his guidelines: the doctor must “listen, listen, listen to what the patient has to say … reassure the patient … [and] convince him that use of mind and body encourages development while disuse fosters atrophy.”13 It is also worth noting that most articles citing studies of the elderly demented (or those with presenile dementia) were based on studies of people who had been hospitalized. Not only were many people then (as now) not hospitalized for psychiatric reasons; many of the studies involved autopsies to study brain tissue—something clearly not useful as a diagnostic means in living people. This hardly renders such studies wrong; it does mean that they are demographically skewed and limited. The importance of demographics regarding the elderly emerged in full force in the years during and immediately following World War II. In 1942 the American Geriatrics Society was founded; 1945 saw the arrival of the Gerontological Society of America; by 1950 the National Council on Aging joined the field, sponsored by the federal government.14 Broadly defined, geriatrics deals with the aging process and gerontology is its medical branch. But, as Richard Calhoun notes, by 1945, gerontology, an area that had been jealously guarded by a cadre of medical specialists, was joined by sociologists, economists, social workers, and psychologists.15 To be fair, gerontologists did not fully restrict themselves to the laboratory or the hospital. E.J. Stieglitz, in his chapter in Edmund Cowdry’s landmark Problems of Aging, made clear that the science of gerontology comprised three strands: the biological, the clinical, and the socioeconomic.16 Whether or not an actual doctor might
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have diagnosed an actual Willy Loman with a biological dementia, a clinical examination (talking with and examining a patient in person, and not only dealing with tissue or fluids in a laboratory) would reveal, among other things, depression, anxiety, confusion, and difficulty adapting to the present. The socioeconomic component of precipitating causes—in Willy’s case, his being demoted from salaried employee to, in essence, freelancer on commission—was an iteration of a source of anxiety (being fired or pushed into involuntary retirement), not to mention actual financial hardship, for an increasing number of American men in their sixties. As one source notes, “the percentage of gainfully employed American males over the age of sixty-five had steadily declined from 62.8 percent in 1900 to 42.2 percent in 1940.”17 A small boost in senior employability occurred when younger men were drafted into the military during the years of American involvement in the war, but men in their sixties were being eased—or pushed—out of the work force. Pensions and Social Security, the latter signed into law in 1935, helped some, although not every industry offered the former and not every kind of work was covered by the latter.18 Also, of course, not every worker sought retirement even with a pension. Clearly Willy Loman believes/d in the importance of continuing to work. William Graebner makes clear the singular place of the salesman, “the foremost occupational symbol of the twentieth-century economy of consumption, distribution, and mass markets,”19 within the population of aging, and possibly ill, employees seen as increasingly undesirable because too slow or too intractable or, one way or another, losing it. Neither an executive nor a member of the working class, the salesman remained outside the corporate and union bureaucracies, which by 1920 were beginning to protect minimal number of workers from unemployment and old age. He was uniquely vulnerable to changes in fashion and consumer taste, to the competitive markets of the early twentieth century and the business cycle. Although the salesman’s skills would seem to have been relatively easily transferable from one industry or firm to another, this aspect of the occupation was circumscribed by the increasingly sophisticated nature of products and sales training.20
A year after the opening of Death of a Salesman, Drs. Edward B. Allen and Hollis E. Clow published “Paranoid Reactions in the Aging,” in
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which they spell out that over-sixties lacking adequate outlets for “instinctive drives” manifest “anger, irritability, fear, apprehension, suspicion, and self-pity.” Leaving aside the question of whether Willy’s hurt pride and anxiety about the uselessness and being loved by his sons are scientifically verifiable as facets of “instinctive drives,” it is not hard to see that his refusal or inability to recognize his limitations lead him to “project these limitations outward, with a delusional formation of fear of hostility and persecution on the part of others toward them.”21 One of the possible causes for this paranoid lashing out is “associated with organic brain disease where the prognosis precludes complete recovery.”22 As the authors go into greater depth about this category of cause, they name the “organic psychoses … [of] this age period, namely cerebral arteriosclerosis or senile dementia.”23 Willy Loman checks all the symptomatic boxes, but absent a brain to dissect postmortem, no definitive diagnosis can be made. Yet doctors studying hospitalized patients were outlining symptoms and behaviors with which many nonmedical specialists would be familiar because of having neighbors or family members manifesting the same characteristics. Who, then, was the character Willy Loman? How did audience members understand him and how did critics—often speaking not only to but about audiences—characterize him? I lean heavily here on iterations of “character” to return to Amy Cook’s ideas of how humans “cast” fictional figures as well as real people. Or in this case, a fictional figure as a real person. Was Willy read as experiencing normal aging under personal pressure, or might there be neurological misfiring at work? While I am not insisting on the latter, I bring it to the fore, as the evidence is too great to ignore.
Seeing Is Believing/Believing Is Seeing Even before Death of a Salesman opened in New York in February 1949, notices from out-of-town tryouts had primed audiences for a play that was, according to a Philadelphia review, and despite the reviewer’s resistance to using the words “great” and “superb,” about to emerge as just that.24 Critics for New York papers the day after the Gotham opening, whose assessment would, of course, influence audiences seeing the play after its first night, invoked classical tragedy, spoke of emotional power, took in stride that the father/son conflict is a worthy and recognizable subject, nodded to the long-suffering but determined and supportive wife, pointed out that the profit motive and industrial capitalism gobble
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up and spit out ordinary workers when they are no longer useful to companies or shareholders, and generally agreed with the New York Times ’s Brooks Atkinson that “Miller has looked with compassion into the hearts of some ordinary Americans and quietly transferred their hope and anguish to the theatre.”25 A 1951 review shorthanded Willy as “a kind of latter-day Everyman in Babbitt-land.”26 But both critics and other audience members were materially situated individuals, who, as Cook reminds us, understand what they saw in terms of categories, which are “based on prototypes,” also noting that “spectators do not take in information independent of context, speaker, background, facial expressions, physical gestures, and prosody.”27 Certainly Greek tragedy, neoclassical dramaturgy, the background of the Depression, and the anxiety and tension expressed in the dialogue were ingredients in the play’s theatrical reception, something that, as Marvin Carlson explains in such detail, cannot help but take place in a context— the performance of a play in a theatre—that is always already “haunted” by known narrative traditions, roles in which performers have previously appeared, recognizable settings, and even the familiar experience of being in a theatre and having an emotional and social experience there.28 Regarding the character Willy Loman, what, exactly, did audiences see? The sixty-something drummer who, at the start of the play, returns to his modest Brooklyn bungalow after nearly driving off the road while attempting to visit his formerly profitable sales territory, vents his frustrations, remembers his past, and attempts to reconcile with his two sons, both in their thirties, and the elder of whom, Biff, arguably the apple of Willy’s eye, has been a disappointment since flunking one final high school course and, therefore, not being able to attend college and continue what Willy imagines would have been a stellar athletic career. Willy’s older brother, Ben, wanders in and out of the salesman’s thoughts, as do the two sons in their teenage iterations. Ben left home for Africa at age seventeen and made a fortune in diamonds, that fortune leading Willy to think that Ben has “answers.” Biff has been working agricultural jobs in the West and his younger brother, Happy, has been womanizing and failing to advance as an employee in retail beyond low-level positions. When Willy and Biff finally square off, we learn that Biff caught Willy in a Boston hotel room with “another woman” during that fateful senior year of high school and that this has shattered his confidence both in his father and himself. Willy, elated to learn that his 34-year-old son still loves him, decides that the only way he can aid his offspring and put the
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younger man back on the road to success (on the profit and power über alles plan) is by killing himself so Biff can receive the proceeds of a life insurance policy. It is worth noting here that Miller’s earlier title for the play was The Inside of His Head, which is where one might find organic signs of dementia. This is not, of course, what was portrayed onstage. But both words and actions led decades’ worth of writers to use descriptive language that in every way suggests dementia, even absent that label. Reviews of Death of a Salesman in productions starting with the 1949 opening and taking place over a period of fifty years are rife with language indicating that reviewers (lay people by medical standards) witnessed behavior and understood language that fits with psychiatric descriptions of dementia, whether arteriosclerotic (the result of lack of adequate blood supply to the brain, frequently due to a stroke) or due to “senile brain disease.” Howard Barnes used the words “disintegration” and “starts to lose his grip” in his opening night review and nine days later wrote that Willy “cracked up.”29 William Hawkins wrote that “Willy’s mind wanders”30 ; while an anonymous writer for Cue simply said that Willy “cracks.”31 A New Yorker review situated Willy in “a strange borderland of sanity” where “his health and his mind are failing.”32 A 1963 revival at the Guthrie Theatre in Minneapolis featuring Hume Cronyn describes the performed Willy as “cocky and distracted like a confused bantam. He shades from euphoria to despair, from belligerence to defeat….”33 Another review of this production cited “Willy Loman’s lightning changes of mood … his defensive rages, his self-contradictions….”34 A 1980 review of a London revival at the National Theatre described how Willy’s “mind hops, terrified or hopeful, from one subject to another. It is impossible to hold a coherent conversation with him”35 ; and in 1984, Lloyd Rose, in anticipation of Dustin Hoffman’s taking on the role of Willy on Broadway, referred to the character’s “madness,” although he added in parentheses “which made no clinical sense,” offering an instance of clear observation absent up-to-the-minute (or even vaguely recent) medical knowledge to interface with same.36 Recall that Alzheimer’s research advocates put that iteration of dementia on the popular map in the mid1970s. A 1996 review of yet another London revival has Willy “struggling for dignity”37 ; and a 1997 review of a Canadian production starring Judd Hirsch describes Willy as “deluded and defiant.”38 Responses to the 1999 Broadway revival starring Brian Dennehy include that of a priest who saw Willy “gradually losing touch with reality”39 and a New York Times
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reviewer, who, in an interview-cum-essay, referred to the character’s “disabling mental problems.”40 Consider how these descriptions mesh with the clinical terms used by researchers in the 1940s and 1950s to describe “senile psychoses”: anxiety, depressive and paranoid reactions, confusion, peevishness, resentment, narrowness of interests, lack of plasticity, feelings of insecurity, dramatic emotional reactions, poor emotional control, confusion, disorientation, poor judgment, depression, difficulty adapting to the present, anger, irritability, fear, apprehension, suspicion, self-pity, and a delusional formation of fear of hostility and persecution on the part of others. If reviewers and psychiatrists had consulted each other or combined efforts to write a thesaurus of Willyisms, the results could not have been more congruent. As it was, though, at least in 1949, the word “dementia” appeared in only one review that mentioned Death of a Salesman. In advising people who couldn’t immediately get tickets for Miller’s hit, Joy Carmody called dementia a “sheer delight” in The Madwoman of Chaillot, whose crazy-like-a-fox eccentric heroine, stuck in a kind of Miss Havisham time warp, figures out a way to destroy the “money-mad, war-mongering” capitalists who are liberal playwright Jean Giraudoux’s toxic power brokers of the twentieth century.41 By the time Philip Seymour Hoffman played Willy on Broadway in 2012, enough was known about dementia to add a new dimension to the actor’s comment in an interview that “The whole point is to think: ‘This is what life is really like. This is my family.’”42 Americans had become more aware that their own families include(d) people with dementia, whether or not Hoffman used that word. Dementia was in Salesman, as it had been for decades in much of the United States outside the theatre and outside medical laboratories. Reviews—theatrical and literary—that characterize Willy’s situation as the result of dementia do so as matter-of-factly as did earlier reviews that used language descriptive of dementia symptoms but not precisely naming them as such. Some of the more delineative reviews of performances, however, go beyond labeling or synthesizing to spell out actors’ gestures and movements that lend somatic weight to what audiences experienced, and, therefore, to how audiences could use their own and the actors’ bodies as a means of recognizing dementia when it was performed. In the former camp (reviews that name dementia but do not describe precise onstage behaviors), a 2003 article about an Atlanta theatre’s season, suggested that August Wilson’s Fences “resonates with the same blooming dementia … as Death of a Salesman.”43 A 2015
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review of a London production featuring Anthony Sher says that both Salesman and the concurrently running The Father, discussed elsewhere in this study, “are about dementia.”44 A 2019 “Critical Review of ‘Death of a Salesman’ challenges Miller’s claim that Willy’s internalization of the dysfunctional values of American society killed him,” offering the “interesting alternate theory … that Willy Loman suffered from dementia. He exhibits many of the symptoms of Alzheimer’s.”45 A 2011 literary analysis begins with the idea that “Miller makes Willy suffer from dementia” as a springboard to parsing the temporal and spatial “how” of this “why.”46 A review of a 2012 production of Salesman in Albuquerque asks “What exactly is happening to Willy’s mind? It’s obvious that he’s ‘losing it,’ but why? Is he in the early stages of dementia?”47 A 2012 review in Britain’s Economist starts with “Willy Loman is a delusional fabulist with signs of senile dementia and possibly bipolar disorder.”48 In the most detailed and scientific of arguments—one that also marshals the greatest number of textual references to the play—three neurologists propose in no uncertain terms that the most likely cause of Willy’s “striking cognitive features, comprising fluctuating attention, visual hallucinations, and functional decline” is Dementia with Lewy Bodies (DLB).49 Of course, a literary scholar might scoff at the idea that characterological time travel constitutes “hallucination,” but the writers make a compelling case beyond this possible category mistake (it’s dramaturgy, not a clinical examination of a real person), citing “difficulty managing finances at home, visuoperceptual dysfunction in Loman’s recent difficulty with driving,” and “dialogues … characterized by dramatic variations in attention, including clear episodes of transient unresponsiveness.” The authors’ message is to physicians, warning them that DLB is the second most common neurodegenerative dementia, spelling out its symptoms, and underscoring that as few as one third of cases of DLB are identified routinely, with the most common misdiagnosis being Alzheimer’s. Here, the question is not whether a plausible Willy Loman has dementia. The question is which one. How and why audience members who are not medical doctors or researchers would identify dementia and why their focus might be on Willy as a person more than on the capitalist cruelties the play is so frequently cited as indicting suggest two things, one embodied and one textual. In the latter vein, within a scant year of Salesman’s opening, Luke P. Carroll would write in the New York Herald Tribune that Miller
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“was able to arouse feelings of sympathy, sadness, fear and possibly selfidentification by establishing Willy as a man with an indecent hunger for material success who lavished adulation upon two worthless sons and who, all in all, had nothing more than a flimsy attitude toward life.”50 Miller himself, in a 1999 interview, claimed that he wanted the play to be “an emotional rather than an intellectual experience, a play basically of heart with its ulterior moral gesture integrated with action rather than rhetoric.”51 His rhetoric, accordingly, plays on feelings more than on logic. One reason that audiences and critics have been able to focus on feelings and to identify with Willy over the years is the actual paucity of social grounding for the play’s characters. The sixty-something Willy, who would have been born in the late 1880s or in 1890 if he were an actual person, does not seem to have any thoughts about, much less to have served in, World War I. His thirty-something sons, who would have been born in 1915 (the year of Miller’s birth) and 1917 or 1918, reveal not a hint of awareness of World War II. If they served in the military, they manifest neither psychological effects nor any interest in the financial benefits available to G.I.s. Some spectators in 1949 might have recognized the implausibility of the mortgage that is announced as paid off at the play’s end, as the terms of actual mortgages available to actual Americans at the time the Lomans would have gotten theirs (the boys were teenagers in the house, so the family has owned it for at least 20 years) do not jibe with the length of time it took for them to pay off the loan. The typical mortgage available between 1915 and 1935 had a five-to-tenyear maturity, usually required a thirty percent down payment, was only offered for 50–60% of the cost of the house, and might have an interest rate as high as eight percent. The short lifetime of the mortgage was not enough time to pay off the principal, necessitating another loan (like today’s balloon mortgages), typically offered at a higher rate and payable in full in three years.52 Likely Willy has refinanced as a beneficiary of the 1934 Federal Housing Administration, implemented shortly after the creation in 1933 of the Home Owners Loan Corporation, which favored what Dolores Hayden calls the haven strategy (freestanding, single-family, often suburban or rural houses rather than anything communal, either in the form of apartments or dwellings clustered around some kinds of shared facilities such as laundries or kitchens) as the cure for what ailed anxious America.53 HOLC supported uniform national appraisal methods throughout the real estate industry. FHA insured long-term mortgages. Neither entity lent money directly to individuals, but both were solidly
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aimed at making possible home ownership. The year that Salesman opened was also the year that William Levitt’s company, developers of the now iconic Levittowns, stopped building rental houses and turned their full attention to mass-producing the houses and neighborhoods for which they would become famous.54 They benefited from FHA financing, and buyers took advantage of mortgage subsidies and tax deductions for homeowners. Levitt and other FHA clients hewed to FHA guidelines, which explicitly discriminated against non-whites. Two other groups were excluded from home ownership in the 1940s: white women of all classes, who were expected to gain access to private homes through male relatives, and the white elderly working- and lower-middle-class, “who were no longer wage earners in the prime of life, [and] were left behind in the old inner-city neighborhoods.”55 The Lomans are financially trapped in the last category, although they do own their house. From a sociological perspective, it is the above overall package of elements that makes no clinical sense. From a somatic and emotional perspective, something else is going on. A key part of the ecology cited by Amy Cook in her analysis of how people build and understand the characters of others—fictional or actual—works because “our experience with and through our own bodies not just informs our reading of character but in fact is [italics in original] our experience of character.” (55) Here we have evidence of audience response that is concrete—not abstract or metaphorical or speculative. “‘Strong men wept’ was the hallmark of the [Elia] Kazan [original 1949] production.”56 In 1999, an interview with Brian Dennehy reports that “he looks into the audience at the men, crying.”57 Another article about the same production asserts that “on any given night at the Eugene O’Neill Theatre, you are likely to hear a sound that has become rare in American theaters: unabashed weeping.”58 Crying is nothing if not a somatic response, here a somatic response to experiencing the characterological, situational, and narrative. But, more than these responses resulting from scripted dialogue or relationships as depicted in the text, I want to pursue the idea that actors’ actual gestures yield both audience response and possible recognition of signs of dementia. As Cook notes, “How the character moves … may register in the spectator’s motor system and generate assumptions or predictions about the character even if the spectator is not consciously aware of the physical response or its consequences.”59
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A 2014 review of an amateur production on Long Island describes a moment when the “weary … delusional” Willy’s “hopeful countenance deteriorates into an abysmal blank—convincingly evoking, perhaps, the onset of Alzheimer’s.”60 (The actor was Scott Hofer.) This is the only physicalized facet of the play that merits description in the review; the rest of the analysis comprises things globalized or generically labeled (“haunted,” “unfulfilled,” “agony”). What did that deterioration—an observable, physically performed event and not a thematic conclusion— summon in the reviewer’s cognitive and perceptual apparatus—his “motor apparatus?” James Wolcott’s review of Dustin Hoffman’s 1984 Willy Loman notes that the actor “frequently raises his arms in a protective spasm, as if warding off blows from tall phantoms.”61 Victims of strokes or Parkinson’s sufferers (among others with other dementias) can be seen experiencing spasms, and hallucinations, as discussed earlier, are not unusual in people suffering from Dementia with Lewy Bodies. In a richly evocative and articulate review of London’s 2019 production of Salesman, directed by Marianne Elliott and Miranda Cromwell, critic Matt Trueman blends interpretation with specific description to laud Wendell Pierce’s performance of a Willy that Trueman calls anything but “a self-mythologizing mediocrity,” noting that the man has bought a home, lasted 34 years in a job, and put two kids through high school. “Pierce makes the mechanics of Willy’s mental breakdown abundantly clear. With the onset of dementia, his mind ties itself in knots … Pierce doesn’t play his dementia so much as fight it off, squeezing his eyes shut with every mental glitch as he struggles to tame his misfiring synapses.”62 Pierce’s Willy is not being chewed up by what John Lahr calls “the barbarity of American individualism” (48) nor what Michiko Kakutani summarizes as “the bankruptcy of the American dream of success.”63 Or at least this is not all that is at play. Something else is going on. Pierce performs it and Trueman sees it (Fig. 6.1). Suggesting a Willy who is not a loser is no small feat. In an exhaustive review of the literature positing Miller’s salesman as an icon for all kinds of negatives in American culture in the popular press from 1993 to 2013, Susan Harris Smith concludes that the name “Willy Loman … as a term for failure … still resonates powerfully and ubiquitously in the culture at large,” adding “if we need a word for male failure, we have ‘Lomanism.’”64 Trueman can lean on the success that he sees Pierce perform because Pierce and his Willy are Black, and this Willy’s achievements in white America (recall the discriminatory mortgage laws)
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Fig. 6.1 Death of a Salesman, 2022. Sharon D Clarke, Wendell Pierce, and Khris Davis (Photo © Joan Marcus)
are just that: achievements. Trueman’s—and arguably Pierce’s and his directors’—insights are, like the awareness of dementia in Willy, newly coming into focus, although Pierce is not the first Black man to play Willy or a member of his family. In 1996, André DeShields played Willy at Buffalo’s (New York) Oases Theatre, supported by a white actress as Linda, with one Black and one white son. A 1977 production at Stamford’s (Connecticut) Hartman Theatre featured African American Earle Hyman as Willy’s brother, Ben. A 1991 production at Minneapolis’s Guthrie Theatre featured an all-Black Loman family with Mel Winkler as
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Willy, for which there was pushback from people who felt that this “politically correct” instance of colorblind casting “was somehow a betrayal of ‘the black experience,” something Winkler viewed as “myopic, parochial [and] confined” thinking.65 Journalist M.S. Mason agreed that nontraditional casting “deepens the play because our expectations are jolted” but concluded that the key thing the production facilitated was helping us “understand how wrong Willy was and how defeating materialism is.”66 Unless one is shut out of material opportunities because of racism or is unable to provide for material needs due to creeping dementia coupled with ageism. A 2013 production foregrounded precisely such questions by having six actors share the role of Willy, including Korean, Indian, and African American men and women.67
Home. Free. Willy Loman, the bellicose, confused man who cannot seem to remember precisely what he owes his creditors is, despite his slipping grip on what might be called reality, still neatly dressed, well fed, emotionally supported, encouraged, listened to, and domiciled in a clean house. Unsurprisingly, the source of his care is his wife, Linda. Feminist criticism has dealt harshly with this character, the only one who in the course of the play never leaves the house or the yard until the final scene at the cemetery. One of the pithiest and most pointed critiques labels Linda a “two-dimensional pseudomasochist … some kind of gendered service station.”68 (One review of the Wendell Pierce/Sharon D Clarke production after it transferred from London to Broadway avers that Clarke “turns what is usually portrayed as unshakable loyalty into a kind of heedless comorbidity.”69 ) But if Linda is unusual for her willingness to stand up for Willy at all costs, her providing home care for a family member who may have dementia was not unusual for its time, nor is it wholly unusual now. Willy is, if he does have dementia, in its first phase, which is to say that, although confused and frightened, he can still walk, talk, and feed himself, as well as find restaurants, offices, and subway stops. It may be time to take away the car keys, but “assisted living” is a concept that had not yet taken hold in the United States, while hospitalization would— had Miller not scripted Willy’s suicide—have been far down the pike, if the family ever sought help at all. Home care provided by a wife (or mother or daughter or sister) was the predominant model for dementia care. Whether the play is primarily about the brutal indifference of the
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capitalist machine to the hard-working individual or about the grip that individual is losing on his mental and emotional world, the individual is male. Yet Linda is a piece of the dementia care and the capitalist mosaic. The care she provides is free and her own financial situation depends wholly on family members. (One of her lines is “I live from day to day,” and I do not think it is at all unreasonable to see two meanings here.70 ) A 1984 writer for The Sunday Oregonian did with Linda what the “Willy has dementia” writers discussed earlier in this chapter did for Miller’s protagonist: he speculated about her situation as if she were an actual person, in this case, a socially situated American. Ray Jenkins imagined a future for Linda in the years following Willy’s suicide. She starts with a deadend job (“tedious drudgery at low pay, commensurate with her lack of education and skills”), gradually slipping into “welfare subsistence, finally becoming an invalid in the back bedroom in the home of her insensitive son, Biff.” When she becomes “a quarrelsome old nuisance” (shades of I.L. Nascher’s description of a “garrulous dement?”), she is sent to a nursing home, where she expires a little past the age of seventy. Jenkins’s purpose is to point out that American women’s life expectancy exceeds men’s and to call for government policy to address “the longevity gap.”71 Meanwhile, back in the play, a possibly dementia-suffering Willy is buffeted about by children, employer, and neighbor, who find him pathetic, annoying, past his prime, embarrassing, and basically in the way. Dramaturgically, of course, all of these readings are justifiable. Miller seems to suggest that a proper piece of meaningful work coupled, perhaps, with a decent pension could keep Willy afloat, although the peace of mind he seeks in his relationship with his elder son might still elude him. But if this is a person in the throes of dementia, he will have to stop working and driving, and the modest pension may not be enough to provide the care that even the best of gendered service stations cannot. What then? In the “Willy has dementia” interpretation of Salesman, as in many other readings of the play, Linda’s most famous line points us to the thing from which we cannot turn: “He’s a human being, and a terrible thing is happening to him. So attention must be paid. He’s not to be allowed to fall into his grave like an old dog. Attention, attention must be finally paid to such a person.”72 The attention paid to dementia by Americans in the succeeding decades began with a sharp turn (back) to biomedicalization and away from the idea that adjustment, attitude, and the like were the answers
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to the personal social affliction that manifested as cognitive loss. The Alzheimer’s movement that gained serious traction in the 1980s was underwritten by what historian Jesse Ballenger calls a “renaissance of pathology.”73 As I discuss in the final section of this book, plays created under this aegis feature characters who largely see dementia as a personal tragedy waiting for a science solution and perhaps only secondarily as a culture-wide problem in need of a social science strategy, although this is almost never discussed outright in the plays. Only recently have issues of supporting family carers in the here and now and considering the woeful underpayment of professional carers begun to show up with any frequency on the radars of anticipated theatregoers. (For instance, in 2018, the average hourly wage for a home caregiver was $13.50, which is $540 for a forty-hour week and just over $28,000 for a fifty-two-week year.74 ) The average price of a Broadway theatre ticket to a play (not a musical), in the 2018–2019 season was $116.12, although premium seats could command much more.75 The next chapter considers something offered by very few pieces of theatre: staged renditions of the experience of cognitive loss from the inside. Like all the other works in this book, these are aestheticized, framed representations that do not pretend to be the results of funded medical studies. They do, however, invite spectators to witness and to some extent experience the disorientation of sensate beings whose capacity for speech, memory, and judgment of others’ perspectives and actions are changing but who nonetheless have feelings, emotions, and the capacity for human relationships. “Imaginative phenomenology” is the name Rebecca A. Bitenc gives to such works, reminding us that the “experiencing-I,” even if s/he seems to be incoherent, is nonetheless present and not an empty shell.76
Notes 1. George B. McDonald, “‘Death of a Salesman’: Doctor’s Diagnosis,” New York Times, 28 February 1999, Section 2, p. 4. 2. Amy Cook, Building Character: The Art and Science of Casting (Ann Arbor: University of Michigan Press, 2018), 2. 3. David Thomson quoted in Susan Harris Smith, “Who Was/Is/Are Willy Loman?,” 43–56 in The Arthur Miller Journal, Vol. 8, No. 2 (Fall, 2013): 43. 4. Carolyn Clay, “Theatre: Too Young for Death,” Boston Phoenix, 30 July 1974, Section 2.
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5. Jordan Tannahill, Theatre of the Unimpressed: In Search of Vital Drama (Toronto: Coach House Books, 2015), 59. 6. Paul Lieberman, “Life of a Salesman,” Fan Fare, Newsday, 7 February 1999. 7. W. Mayer-Gross, “Arteriosclerotic, Senile and Presenile Psychoses,” Journal of Mental Science, Vol. 90 (1944): 316–327. 8. Jesse F. Ballenger, Self, Senility, and Alzheimer’s Disease in Modern America: A History (Baltimore: Johns Hopkins University Press, 2006), 210, Note 2. 9. Mayer-Gross, 316. 10. Andrew Scull, “Contested Jurisdictions: Psychiatry, Psychoanalysis, and Clinical Psychology in the United States, 1940–2010,” Medical History, Vol. 55, No. 3 (July, 2011): 401–406. 11. See Ballenger, Chapter 2. 12. Matthew Ross, “Some Psychiatric Aspects of Senescence: A Review of the Literature,” The Psychiatric Quarterly, Vol. 28, Nos. 1–4 (January, 1954): 93–112. Quote is on 105. 13. Ross, 106. 14. See Richard B. Calhoun, In Search of the New Old: Redefining Old Age in America, 1945–1970 (New York: Elsevier, 1978); and Ballenger, Chapter 3. 15. Calhoun, 73. 16. Edward J. Stieglitz, “The Social Urgency of Research in Ageing,” in Problems of Ageing: Biological and Medical Aspects, ed. E. V. Cowdry (Baltimore: Williams and Wilkins, 1942), 890–907. 17. Calhoun, 38. 18. See Calhoun, Chapter 2; and William Graebner, A History of Retirement: The Meaning and Function of An American Institution, 1885–1978 (New Haven and London: Yale University Press, 1980). 19. Graebner, 44. 20. Ibid., 44–45. 21. Edward B. Allen and Hollis E. Clow, “Paranoid Reactions in the Aging,” Geriatrics, Vol. 5 (March, 1950): 66–73. Quotes are from pages 66 and 67. 22. Allen and Clow, 68. 23. Ibid., 71. 24. Waters, “Plays Out of Town: Death of a Salesman,” unsourced clipping dated 22 January 1949. New York Public Library Lincoln Center branch for the Performing Arts. Filename is Death of a Salesman Clippings. 25. Brooks Atkinson, review of Death of a Salesman. New York Times, 11 February 1949. 26. K., “‘Death of a Salesman’ at the Gaiety,” Irish Times, 3 April 1951. 27. Cook, 29, 122.
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28. Marvin Carlson, The Haunted Stage: The Theatre as Memory Machine (Ann Arbor: University of Michigan Press, 2003). 29. Howard Barnes, “A Great Play is Born,” New York Herald Tribune, 11 February 1949; and “‘Death of a Salesman’ Sets the Pace for Broadway,” New York Herald Tribune, 20 February 1949. 30. William Hawkins, “‘Death of a Salesman’ Powerful Tragedy,” New York World-Telegram, 11 February 1949. 31. “New Plays on Broadway: Arthur Miller Writes a Splendid Play,” Cue, 19 February 1949. 32. Wolcott Gibbs, “Well Worth Waiting For,” New Yorker, 19 February 2019. 33. Howard Taubman, “Theater: Willy Revisited,” New York Times, 20 July 1963. 34. John H. Harvey, “Guthrie ‘Salesman’ Called Blockbuster,” St. Paul Pioneer Press, 17 July 1963. 35. Robert Cushman, “Triumph of a Salesman,” London Observer, 23 September 1980. 36. Lloyd Rose, “Lost in America,” The Atlantic Monthly, April 1984. 37. Matt Wolf, “Death of a Salesman,” Variety, 11 November 1996. 38. Mira Friedlander, “Death of a Salesman, Variety, 3 March 1997. 39. Father Robert Lauder, “Breath of a New Life in Current ‘Salesman.’” The Tablet, 26 June 1999. 40. Bruce Weber, “Opposites Attracted to Heat Onstage,” New York Times, 22 February 1999, E6. 41. Joy Carmody, “Dementia Is a Sheer Delight in Gotham’s French Fable,” Washington D.C. Evening Star, 10 May 1949. 42. Charles Isherwood, “Making ‘Salesman’ His Own, Despite the Shadow of Kazan,” New York Times, 8 March 2012. https://archive.nytimes. com/query.nytimes.com/gst/fullpage-9F0DE7DA1438F93BA35750C0 A9649D8B63.html (Accessed 2 April 2023). 43. Tom Sabulis, “True Grit: Despite Risks, Kenny Leon Shows His Theatrical Colors,” The Atlanta Journal-Constitution, Arts, 5 October 2003. 44. David Ralf, “Death of a Salesman,” Exeunt, 18 May 2015. 45. Wade Bradford, “A Critical Review of ‘Death of a Salesman’: Is Arthur Miller’s Classic Play Simply Overrated?” ThoughtCo, 27 October 2019. https://www.thoughtco.com/critical-review-death-of-asalesman-2713672 (Accessed 2 April 2023). 46. Georgiana-Elena Dila, “Willy Loman’s Tormenting Time and Space Hallucinations,” 477–481 in Language and Literature: European Landmarks of Identity, Vol. 8 (2011): 477. 47. Dean Yannias, “Regional Reviews: Death of a Salesman, The Vortex Theatre. Talkin’ Broadway, 13 September 2012. https://www.thoughtco. com/critical-review-death-of-a-salesman-2713672.
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48. “We Are All Salesmen Now,” Books and Arts, The Economist, 17 March 2012. https://www.economist.com/books-and-arts/2012/03/ 17/we-are-all-salesmen-now (Accessed 2 April 2023). 49. Conor Fearon, John-Paul Taylor, and Sean O’Dowd, “‘Can’t Seem to Keep My Mind to It’: Did Arthur Miller’s Salesman Have Dementia with Lewy Bodies?,” Journal of Neurology, Vol. 266 (2019): 1806–1808. https://doi.org/10.1007/s00415-019-09343-8 (Accessed 2 April 2023). 50. Luke P. Carroll, “Birth of a Legend: First Year of ‘Salesman,” New York Herald Tribune, 5 February 1950. 51. John Lahr, “Making Willy Loman,” New Yorker, 25 January 1999 (42– 49): 49. 52. Harvey Green, The Uncertainty of Everyday Life 1915–1945 (New York: HarperCollins, 1992), 94; and David M. Kennedy, Freedom From Fear: The American People in Depression and War, 1929–1945 (New York and Oxford: Oxford University Pres, 2005), 370. 53. Dolores Hayden, Redesigning the American Dream: Gender, Housing, and Family Life (New York: W. W. Norton & Company, 2002, 1984). 54. Prospective buyers began lining five days before Levitt opened the sales office for the first of his cookie-cutter two-bedroom houses. When he did open for business, he sold $11 million worth of houses in three-and-a-half hours (Hayden, 23). 55. Hayden, 74. 56. Helen Dudar, “A Modern Tragedy’s Road to Maturity,” New York Times, 25 March 1984, Section 2. 57. Paul Lieberman, “A Willy Loman for the ’90s,” Fan Fare, Newsday, 7 February 1999, D28. 58. Matt Zoller Seitz, “Why ‘Death of a Salesman’ Lives On,” Newark StarLedger, 21 February 1999, Section 4. 59. Cook, 55. 60. Steve Parks, “Studio’s ‘Salesman’ Palpable, Relatable,” Newsday.com/ Entertainment, 30 October 2014. https://www.broadhollow.org/wpcontent/uploads/2014/11/Death-of-a-Salesman-Review.pdf. 61. James Wolcott, “Hoffman’s Break-Acting,” Vanity Fair, May 1984. 62. Matt Trueman, “London Theatre Review: ‘Death of a Salesman,’” Variety, 13 May 2019. https://variety.com/2019/legit/reviews/deathof-a-salesman-review-london-wendell-pierce-1203213082/ (Accessed 2 April 2023). 63. Michiko Kakutani, “A Salesman Who Transcends Time,” New York Times, 7 February 1999, Section 2, Page 1. https://www.nytimes.com/1999/ 02/07/theater/a-salesman-who-transcends-time.html (Accessed 2 April 2023). 64. Susan Harris Smith, “Who Was/Is/Are Willy Loman?,” 43–56 in The Arthur Miller Journal, Vol. 8, No. 2 (Fall, 2013): 52.
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65. M. S. Mason, “The Guthrie’s Shows Tap Many Cultures,” The Christian Science Monitor, 27 August 1991. 66. Ibid. 67. The adaptation was called The Great Country. See Frank Scheck, “Getting the Willys,” New York Post, 6 July 2013. https://nypost.com/2013/07/ 06/getting-the-willys/ (Accessed 2 April 2023). 68. L. Bailey McDaniel, “Domestic Tragedies: The Feminist Dilemma in Arthur Miller’s Death of a Salesman,” in Arthur Miller’s “Death of a Salesman”, ed. Eric J. Sterling (Amsterdam: Rodopi, 2008), 21–32, quotes on 23, 27. 69. Jesse Green, “In a New ‘Salesman,’ the Lomans Look Like All of Us,” New York Times, 9 October 2022. https://www.nytimes.com/2022/10/ 09/theater/review-death-of-a-salesman.html (Accessed 2 April 2023). 70. Arthur Miller, Death of a Salesman (New York: Penguin, 1958), 68. 71. Ray Jenkins, “Sad Widowhood of Linda Loman Spotlights Longevity Gap,” The Sunday Oregonian, 19 June 1984, B5. 72. Miller, 56. 73. See Ballenger, Chapter 4. 74. John Leland, “She Had to Choose: Her Epileptic Patient or Her 7-YearOld Daughter,” New York Times, 22 March 2020. https://www.nytimes. com/2020/03/22/nyregion/coronavirus-caregivers-nyc.html (Accessed 2 April 2023). 75. Statistica, https://www.statista.com/statistics/198306/average-paid-adm ission-at-broadway-shows-since-2006/ (Accessed 2 April 2023). 76. Rebecca A. Bitenc, Reconsidering Dementia Narratives: Empathy, Identity and Care (Routledge, 2020), 63, 72, 92.
PART III
Taking It Personally
CHAPTER 7
From the Inside
In 1983, President Ronald Reagan signed a resolution declaring November National Alzheimer’s Disease Month. It was an idea with traction; decades later, November is going strong as the slightly renamed National Alzheimer’s Disease Awareness Month.1 It is worth yet another reminder at this point that Alzheimer’s Disease is only one of many possible causes of dementia—one useful blanket definition of which is “problems in focusing the will, attention, memory, thinking, language, and so on,” or more simply “cognitive defect.”2 Well into the twentyfirst century, it remains not unusual to have people assume or even assert, upon hearing that someone has dementia, that the person has Alzheimer’s Disease. Nor is it unusual, as Lynn Casteel Harper writes in the 2020 On Vanishing: Mortality, Dementia, and What It Means to Disappear, for dementia “[r]ather than [being] one condition among others, [to] take ... on apocalyptic overtones of annihilation,” a mindset that enables the neuronormal to freely describe people in dementia’s throes as “purg[ed] ... of meaning or of any potential for meaningful existence,” and confident that a person so afflicted is “just a ghost in clothes ... absent, gone, empty, unaware.”3 Personhood would continue to be twinned with cognition and “productivity” on the capitalist model, a phenomenon both confirmed and contested in the works in this chapter and the next.
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 D. Chansky, Losing It, https://doi.org/10.1007/978-3-031-20902-4_7
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Despite the conflation of dementia and Alzheimer’s, increased awareness about the single illness did lead to a gradual uptick in the literature of various sorts exploring the experience of dementia across causes and perspectives. Caregivers contributed their often-autobiographical stories. Advice manuals appeared, the most famous of these perhaps being The 36-Hour Day by Nancy Mace and Peter Rabins, published in 1981, its seventh edition issued in 2021, and still in print as of this writing.4 Described on the Amazon.com site as an “indispensable guide,”5 the volume features everything from coping strategies for family member carers to information about Medicare to making the home safer for people beginning to lose some of their cognitive and/or physical abilities. Among genres in which dementia writing was undertaken is what Rebecca A. Bitenc parses in the category of “autopathography,” a term denoting work in which a writer conveys the experience of having dementia from an embodied, first-person perspective and not necessarily in a linear form.6 People with cognitive impairment do not cease to have emotional and relational lives; their points of view can be ignored or elided in stories told by harried and/or emotionally overwhelmed outsiders, including outsiders who are with them daily, hence the particular, although not exclusive, value of the first-person voice. The plays in this chapter and the next consider the reality of cognitive impairment from the inside, a perch that even on the page in nondramatic genres depends much on embodied phenomenology. Embodiment in Losing It involves, of course, not language descriptive of such things as physical manifestations of disorientation and anxiety (e.g., noting elevated heart rate or sweating), but the corporeal presence of performers undertaking via their interpretive choices the representation of confusion and shifting emplacement. Embodiment touches as well on the somatic experience—to the extent it is documented or can be tentatively extrapolated from documentary evidence—of people in audiences for these productions. Only one of the plays discussed in this section, Peggy Shaw’s Ruff , is a bona fide autopathography. The other two, while they operate with views from the inside, are fictional, although the first one, Wings, was based on research done by playwright Arthur Kopit in an actual rehab facility and involved extensive interviewing and observation of real patients and medical personnel. Also, both Wings and Florian Zeller’s The Father (Chapter 8) feature scenes depicted from the outside. These works are perhaps hybrids that oscillate in perspective, inviting
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readers and/or theatregoers to assemble the pieces of a performative puzzle in multiple possible ways, but avoiding wholly ceding dominance, authority, or the final word to the outsider characters.
Brain Crash7 Arthur Kopit’s 1978 Wings depicts the occurrence and aftereffects of a stroke in a seventy-ish woman.8 Stroke is the second most common cause of dementia (after Alzheimer’s Disease).9 Not every stroke leads to dementia, but experiencing a stroke doubles a person’s chance for developing dementia, and fewer than 50% of people who suffer a stroke will return to independent living during the following year.10 Dementia resulting from a stroke is called vascular dementia, and the latter may be associated with up to 80% of all dementia found in old age.11 The simplest definition of a stroke is an event occurring when blood flow to the brain is interrupted either due to a hemorrhage or to impeded blood flow in an artery.12 The aftereffects of a stroke may be so mild as to go unnoticed, but the event frequently causes an immediate loss of some part of the victim’s ability to function physically (e.g., impaired gait), and/or aphasia (loss of ability to understand or express speech), and may include or lead to impaired memory.13 While many dementias, and notably Alzheimer’s, progress slowly, a stroke typically occurs suddenly— hence the vernacular term for such an event, as the victim is “struck.” An earlier word for what is now called a stroke is apoplexy, which was replaced by “cerebrovascular disease.”14 The word dementia does not appear in Wings, but the protagonist’s severe aphasia, which is scripted as a disconnect between the recognizable (to the audience) language of the medical personal in the play and the scrambled but intelligible-to-herself language of the main character, conveys part of the experience of this condition. Aphasia is one of Alzheimer’s known possible cognitive deficits, another of which is apraxia, a term denoting problems in planning and carrying out purposeful tasks or movements owning to brain damage, which also shows up in the play. The protagonist, Emily Stilson, experiences memory loss as well. This play, then, zeroes in on a world heard, seen, and felt by an over-sixty-five in the throes of cognitive interruption. Kopit got the idea for Wings when he received an invitation to write a radio play in 1976 shortly after his father suffered a stroke that rendered the elder Kopit incapable of speech. The playwright’s lengthy and informative preface to the published version of the play states that Wings is
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“essentially about language disorder and its implications.” Other observations and reviews, though, make clear that readers and theatregoers may well and legitimately find it to be “about” other kinds of deficits. Kopit asserts that the locus of his protagonist’s ailments is brain damage; he also states outright that his overriding question, feeling as he did that his father was “there” even if unable to speak, was “What was it like inside?”15 This view from the inside, rendered sonically, scenographically, and kinesthetically, is what makes Wings singular in its scripted insistence on multi-faceted depiction of the experiential, with dialogue being only one strand of meaningful representation. The play remains unusual among representations of dementia on the American stage, as most plays focus on loss and family conflict. The protagonist in this play has an adult son, but he never appears as a character. Kopit created Emily Stilson as a fictional composite of two patients he encountered on a regular basis— two women who had suffered brain damage but could still speak—during his visits to his father at the Burke Rehabilitation Center in White Plains, New York. This playwright’s apologia for this drama encapsulates what is true of most of the plays in Losing It: it is “a work of speculation informed by fact.”16 Wings is in four parts. The first, “Prelude,” is the shortest and has no spoken lines. It depicts the moment of Emily’s stroke. A clock, a lamp, and the book Emily is reading respectively skips a beat before getting louder and then stopping; disappears after a couple of blackouts; and drops to the floor. In the second, longer section, “Catastrophe,” Emily’s words constitute one of three scripted simultaneous tracks (appearing on the page as parallel columns) of experiential material. Another track is visual, representing what Emily perceives. The remaining track is aural, comprising sounds originating outside Emily’s brain but filtered through it. The visual track, positioned on the left-hand side of the page, has ten prompts, or descriptions, to which the aural and verbal tracks are connected. But Kopit makes clear that there is no reason for these units to be performed in any particular order, as they are “components” that can be “repeated, spliced, reversed, filtered, speeded up or slowed down,” reminding readers that “the question of whether we in the audience are hearing what is actually occurring or only hearing what she believes is occurring is unanswerable.”17 This description and unanswerable question might underwrite the unscripted subtext of most of the dementia characters in this book. Here, though, they take center stage. Obviously, this is a blueprint for production and performance, as anything one might
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construe as “dialogue” in this section is almost meaningless absent its sensory and spatial correlatives. “Unanswerability” did not prevent critics and scholar from trying to provide explanations for what they witnessed in the original production, which, directed by John Madden, opened at the Yale Repertory Theatre in March 1978 with drama students in supporting roles, then transferring to the New York Shakespeare Festival’s Public Theatre for a limited run. The play re-opened on Broadway in January 1979, with Constance Cummings remaining as Emily (Fig. 7.1), along with the designers of the evocative set, lighting, and sound: (Andrew Jackness, Tom Schraeder, and Tom Voegeli respectively). Reviews for the three iterations of this original production did little to explore in much meaningful detail the essential performance (I use the both words intentionally) of the design elements, with one critic simply reporting speech “booming into our ears ... over loudspeakers, along with electronic beeps and thunderclaps and Ella Fitzgerald scat singing”18 and another shorthanding the visual as “an arresting assortment of mobile scenic effects, depicting in exhaustive detail the fumbles and pathos of an apoplexy patient.”19 This latter critic’s invocation of “pathos” showed up in other reviews written by people who saw the narrative of Wings as “terrifying”20 or depicting a “devastating illness.”21 Most wanted to find hope in the therapy that slowly restores much of Emily’s speech and memory, and universalizing seems to have been the salve that took the sting out of the clinical for several. Richard Eder wrote of the heroine’s “battle to speak [that it] is the image for what is tongue-tied in all of us,” and Howard Kissel praised Kopit’s “forcing us to recognize the wonder of the human mind.”22 Still, the clinical was toored meat for some. UPI’s reviewer Glenne Currie was not content with “not a pleasant play,” feeling the need to call it “almost unbearable to watch grey-haired Emily on the knife-edge of becoming a vegetable.”23 William Glover’s concession to “pathos” was preceded by an opening paragraph that concluded: “Go to see it only if monotonous morbidity is your bag.”24 One senses, across these reviews, not only a nervous fear, but a barely concealed acceptance that failure to recover and be as one was prior to a stroke or before dementia advances means to be no longer human. A vegetable. Monotony. As Harper writes pointedly, “Brain death ... does not resemble dementia, even advanced dementia. A palpable life force abides in persons with dementia—sometimes a discomforting life, but a life to encounter, engage, and know nonetheless. They make motion and express emotions; they act and attempt to act. Personal expressions
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endure, however subtly. Their highly symbolic language requires sensitive interpreters and compels creative response.”25 And if this is so for people with dementia, how much more is it so for those who suffer a stroke that impairs traditional communication but does not lead to dementia. The third of the play’s four sections is, although critics did not spell this out in terms of specific dramaturgical units, the one that caught much of their attention, probably because it depicts Emily’s inner experience while in the presence of others with whom she interacts. In “Awakening,” Kopit offers a four-part guide to Emily’s consciousness and speech. It is here
Fig. 7.1 Constance Cummings in Wings, 1978 (Photograph by Bill Smith. Courtesy of New York Public Library, Lincoln Center Branch for the Performing Arts)
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that the human in the stroke victim is most specifically honored, albeit by “translating” what she speaks. The most obvious set of pointers has her using standard English vocabulary but delivering utterances in a kind of word salad that conveys her sensory acumen filtered through scrambled executive functioning: There I go there I go hallway now it’s screaming crowded pokes me then the coolbreeze needle scent of sweetness can see palms flowers flummers couldn’t fix the leaking sprouting everywhere to save me help me …26
Stage directions indicate that doctors and nurses are also onstage prior to and during this speech, so references to needles, pokes, leaking, and the cry to be saved may be linked to things an audience posits as “real” based on the presence of the medical personnel and their activities to reach and resuscitate Emily. Soon, when Emily’s panic abates, her syntax is passable, but some words seem to be gibberish, and this is what she speaks: Haptst aporkshop fleetish yes of course it’s yes the good of times when we would mollis I mean collis all around still what my son’s name is cannot for the life of me yet face gleams smiles as he tells them what I did …27
The clearest signposting to the outside/inside disconnect has doctors pelting Emily with questions, asking if she can hear them and, if she can, requesting that she nod. Emily, played now to show coherent inner thoughts, is scripted to reply to a shouted “CAN YOU HEAR ME!” with “Don’t believe this—I’ve been put in with the deaf!”,28 offering spectators the comfort of knowing that her consciousness is intact even if her ability to vocalize/verbalize is not. In the fourth facet of her imagined experience of communicating (still in “Awakening”), as Emily begins to work with doctors, nurses, and one particularly sympathetic therapist, we witness her struggle to answer questions (e.g., how many days there are in a week) or to coordinate hand movement with object recognition (what do you do with a toothbrush?). Although she becomes agitated, slips back into gibberish, is sedated, and may or may not suffer a second stroke, her memory starts to return, and a photograph of her in her aviatrix clothing from forty-five years earlier prompts fragmented recollection in which we learn of her youth as a wing-walker, a kind of aerialist barnstormer whose daredevil stunts were popular in the 1920s.
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The final of the play’s four sections, “Explorations,” takes place in a rehab facility where we meet other characters with Emily in sessions intended to improve their speech. Stage directions state that Emily “is unable to keep outside images and inner thoughts going simultaneously.”29 At least one reviewer saw the scene with the other patients as “unnecessary” and “obviously inserted to provide relief and open up the play a bit.”30 In the very final scene, the playwright uses Emily’s inner thoughts to reveal details of a dangerous flight in a snowstorm, during which, decades earlier, she had to navigate her bi-plane to a safe but unplanned landing, making clear—if it was not before—whence the most obvious basis for the title Wings. The biggest complaint was that the play is too abstract,31 even as a sense of nervous squirminess/squeamishness suggests the opposite, evidenced in the peppering of reviews with words such as “terrifying”32 or “an expressionistic ride through an impaired mind.”33 Critics, perhaps in their own collective expressionistic ride, invoked poetry or the poetic34 or metaphor,35 the gracious or generous counterparts to an underlying, lurking “less than a fully dimensional drama,”36 “barely a play,”37 or outright declarations that the production was too technical or clinical to garner much emotional engagement.38 To be fair, given that the play was both representing a previously almost wholly unmentioned subject on the American stage (severe cognitive impairment) and doing so experientially rather than via a drama recognizable in terms of Aristotle’s or Gustav Freytag’s familiar-to-the-point-of-naturalized structural elements, as well as the absence of a ready-to-hand critical method for approaching the sort of work that would not become even remotely common for at least twenty years (e.g., the 1999 Waverly Gallery, explored in this book’s penultimate chapter), reviewers’ efforts are indicative of how critical optics emerge—sometimes awkwardly or sporadically or via trial and error— within a larger cultural context. Here that larger context was, of course, both non-theatrical (“everyone” fears loss of “selfhood” as understood in the vernacular) and theatrical (concern for emotional engagement and dramatization of “relatable” conflict, even several years in to the off-off Broadway movement). Two people intimately involved with the original production—Kopit and Cummings, who won a 1979 Best Actress Tony Award for her performance as Emily—shed light on the anxieties and the somatic experiences surrounding the play. In his preface to the published play, Kopit asserts that brain damage is “terrifying to behold … [but] also alluring. One feels the need to avert
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one’s eyes and hide, and the equal if not greater need to keep looking. It is a very scary business, this job of exploring who we are.”39 While the media was not yet trumpeting the fact that age is the single biggest risk factor for developing dementia, in the context of considering audience response to Wings, these remarks are prescient, as growing old is a common if not done-deal-for-everyone experience, hence part of “who we are.” But Kopit was also very savvy regarding how much an anticipated theatre audience would tolerate. Not only his inability to separate enough from his father to feel he could use the latter as a protagonist, but actual medical prognosis guided the playwright’s strategy: “his case was too severe, too grim, my audience would turn away.”40 During the Boston previews of Wings, Kopit spoke specifically about audiences to an interviewer from Harvard (his alma mater) Magazine. …what about the audience? Audiences seem to divide into three groups. People in the medical profession are enthusiastic. Several doctors have said that the play has helped them to get closer to their patients. They began to think about the effects of stroke on a human level instead of a purely medical one. It’s years since some of them have even thought about what it’s like to be in a hospital. Is there anybody who just can’t— Watch it? Oh, sure. That’s true of other plays, too. Some people can’t watch Death of a Salesman …. But a number of people who’ve recovered from strokes have told me that Emily Stilson’s experience has somehow clarified their own. Then there’s what I call the naïve audience: students, young people— Who are so far from such a calamity that they’ve— Never addressed the possibility. And they’re turned on by it. For them the play opens up the workings of the mind, the tricks the mind can play. And a damaged mind … can nevertheless function in oddly beautiful ways ….41
One can envision embodied behaviors in these three groups: the MDs eagerly turning to each other in the dark to whisper observations to colleagues, leaning in to watch more closely, nodding in recognition; those who “just can’t” recoiling or shrinking in their seats or looking for a literal escape route, perhaps (uncomfortably?) in the company of friends whose breathing quickens as they identify with and feel validated by seeing themselves represented as never before; and the “turned on” students maybe feeling hip or even smug and nodding approval while
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accepting what they do not fully understand but are willing to contemplate from the secure perch of imagined infallibility, perhaps leaning back with crossed legs and nodding, too. Cummings related her reluctance, in preparing to play Emily, to visit and observe patients at the rehab center where Kopit had done his own research. She worried that the role might prove too depressing (Mildred Dunnock, the original Linda Loman in Death of a Salesman, had turned down the part in Wings as “too arduous”42 ) and thought the research visit “would be like going to Bedlam to look at the ‘loonies’ for a ‘funny’ afternoon.”43 Cummings, who was close to seventy when she played Emily and who had started her career very young as a Hollywood starlet, might, in retrospect, be forgiven for her reluctance to engage in the sort of work that any student now trained in any iteration of Stanislavskiinflected acting would take as an obligatory first step in researching a role. Certainly her initial response was, if not fully “professional,” to some extent in step with popular impressions. (“A vegetable.”) Her director’s prompting prevailed, however, and after the visit she declared “it hadn’t been depressing, but uplifting. Those weren’t helpless, quiescent hospital patients but people struggling against this blow that had befallen them, fighting to overcome adversity. That’s not depressing, it’s inspiring.” If these are emotional opposites, they also suggest informal derivative readings with bodily implications: being physically pressed upon, perhaps imagining a weight on one’s chest, versus being filled with confidence— something expressed via a word that literally means characteristic of inhalation. Cummings made a connection—in articulating the difficulty of learning her lines in Wings—with the work of Samuel Beckett. “His ‘Not I,’ for example. You just have to learn it, the way you master the multiplication table.”44 Critics outside the rehearsal process also made the connection, although with a less procedural, technical slant, noting, for instance, the play’s “Joycean-like passages of wordplay”45 or “moments when Emily is just a disembodied mind trickling out its thoughts, in a manner much like Joyce’s Ulysses, or Beckett’s characters.”46 The latter comparison is, of course, carelessly conceived at best, cruel and wrong at worst, as no mind is disembodied, and an onstage character being depicted by an actual actor is living proof of the human flesh and presence giving rise to the non-quotidian language.
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The script of Wings does lend itself to rich textual interpretation, but the work of literary critics undertaking such explication invites questions about the implications of their arguments when considered outside the realm of critical/scholarly citationality and in the compass of the everyday, here particularly in the context of dealing with people—or being a person—suffering the effects of brain damage. Suzanne Burgoyne insists that the central focus of Kopit’s plays is their work as “a mirror of modern culture and the ways in which it imprisons us.”47 For her, the primary quest in Wings is Emily’s “search for freedom, a search which leads her on a journey into the recesses of her own mind and from terror to a transcendence of fear.” Burgoyne contrasts the “almost mystical freedom” of Emily’s “inner flights” with “the voices of the doctors vainly theorizing about what is wrong with her.”48 Margot Anne Kelley pushes this theory even further, arguing that the medical staff are “symbolic of a number of social conventions, including linguistic ones” and that “Emily’s rejection of ordered discourse in favor of babble or silence becomes ... [an] indication that Kopit is searching for and advocating alternatives.”49 Kelley concludes that Wings presents “the stroke as a metaphor for a system in which meaning is not achieved exclusively through difference,” allowing readers to see “ways to circumvent imprisoning forces—whether those forces are biological, social, or literary-theoretical.”50 While a neurologically intact writer may choose to “reject” ordered discourse or to opt for “sound and fury” in the name of metaphor or postmodernity or existentialism, a person with dementia whose verbal expression is non-normative is not making the same kind of cognitive decision in the interest of philosophy or aesthetics. Reading Emily’s struggle in terms of metaphor can be a convenient way to look away from the character’s embodied self and a way to forget Bitenc’s reminder that “a person with dementia is not ‘self-free’ but remains a person with unique characteristics, needs, and emotions.”51 While it is wrong to suggest that a person attending a live performance of a play may not also be parsing a script in his or her mind (or that s/he may not have done before or may not do so after going to the theatre), witnessing an embodied version of a phenomenon ups the phenomenological ante in a way suggested millennia ago by Aristotle. In Poetics , the philosopher observes that humans delight in witnessing imitation, even when the object being imitated might be painful to behold in real life. If the imitation depicts a known object, the witness takes pleasure in recognition; if it depicts something previously unknown, the
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witness is supposedly fascinated and eager to learn.52 Kopit’s three kinds of audience members map onto Aristotle’s categorical terrain, experiencing fascination and satisfaction in their recognition (doctors and stroke survivors) or in their lack thereof (young people and students). Certainly imitation is not the province alone of performance, but in the case of this particular play, with its descriptive text, sometimes garbled dialogue, the relative absence of inter-character conflict, and insistence on physicalized actualization (and here I include realization of the mise-en-scène and soundscape as well as the actors’ playing), I believe imitation may safely be assigned in large part to theatrical production. It is also worth noting that the scene in which Emily experiences her movement into memory and inner peace is scripted as the recounting of a dream. In the dream, she not only re-experiences her dangerous flight in the snowstorm, she has also been visited by a stranger and has envisioned herself outside of and looking down upon her own body, suggesting that she dies at the end of the play. The speech, while occasionally fragmented, can easily be followed and contains no garbled words. Here, then, the view from the inside is clear enough, although the playwright is offering it in what might be interpreted as a linguistic translation. This view from the inside is part of a tradition going back at least as far as the Old Testament’s Joseph and going strong as recently as Freud’s work: a tradition in which dreams speak truth about bodies. Was Constance Cummings as Emily Stilson luminous and compelling (the Tony award) or “technical” and “boring?”53 Is the play in production off-putting or something from which one cannot turn away? Is a brain-damaged self in a hypercognitive society no longer really a self? The person issuing observations and responses from the inside is not writing critique (although she may be cranky or critical); she is living in the moment and communicating her experience of same. Wings had a handful of productions outside New York between 1979 and 1981, including in Seattle at A Contemporary Theatre (ACT); at the Cleveland Playhouse; in San Diego; in Victoria, British Columbia; and in London. Press releases for the first two productions recapitulated the split positions of New York reviewers, with ACT describing Wings as a “battle … back from the strange, isolated world of aphasia … [and] the horrifying frustration of [a] mysterious experience,” while Cleveland’s press contact promoted a “sensitive play … [d]ramatizing the miraculous workings of the human mind,” this depicted with “clinical accuracy” based on Kopit’s research and interviews.54
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In the 2000s, Wings enjoyed a flurry of revivals, with reviews reflecting a changing reception climate. A production in the metropolitan Denver area in 2000 garnered a review with the familiar categories of “terrifying” coupled with “courage and indomitability.”55 Perhaps inadvertently recapitulating Kopit’s own recipe for witnessing the effects of a stroke, reviewer Dianne Zuckerman summarized the work as “often riveting, always moving.” She also allowed readers a peek at actress Martha Greenberg’s physicality, observing the performer’s “laboring on stiff legs” as Emily. In 2008, a revival at a small theatre in Ft. Collins, Colorado, was reviewed by John Moore for the Denver Post.56 Again, the balancing act of “fractured gibberish” with “the miracle that is the human brain” showed up along with a nod to actress Wendy Ishii’s “physical work— the shuffling gait, the trembling hand … the simultaneous look of terror and sadness … in [her] eyes.” Moore, however, also pointed to a reason why the effects of a stroke on speech and the body might be more ordinarily present on Americans’ popular culture radar at the time of the Fort Collins production: a 2005 episode of the television medical drama E.R. featured Cynthia Nixon as a thirty-five-year-old mom who suffers a stroke and whose interior thoughts—delivered with complete clarity and wit as a voiceover—contrast with her debilitated physical condition, the latter replete with a drooping eye, immobilized right side, and face bruised from the fall she suffered when she collapsed.57 The E.R. episode treated viewers to a scan showing the clot that had lodged in the heroine’s brain as well as a description of the risky procedure that might (and, of course, does, as this was prime time television) dislodge it and lead to instant recovery. The horrors of being incapacitated are obliquely suggested by having Nixon’s character briefly share a room with an elderly woman who is incontinent, unable to speak, and unable to turn over by herself, as well as a visit from Nixon’s character’s estranged husband who fears that without the risky procedure, his wife may end up “a vegetable,” something her interior thoughts make clear would not be the case—at least so far as maintaining an interior life goes—but that, from the outside could be (ignorantly) read that way. Moore posits that Wings informed the script of the E.R. episode. The E.R. episode includes not only Kopit’s script’s interior clarity contrasted with the physical/neurological inability to speak trope. It also features something else borrowed from Wings: a tear trickling down the heroine’s cheek that catches the attention of a nurse and is pointed out—a means of indicating the ongoing selfhood of the person with brain damage.
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A 2010 New York revival with Jan Maxwell as Emily ran off-Broadway at Second Stage. The mainstream New York Times recapitulated responses of the late 1970s, finding the production “elegant but uninvolving,” and complaining that Maxell’s Emily was “too vibrant, even in distress, to generate feelings of pathos,” and, while noting the “chic, polished minimalism of the production,” immediately chiding that “it’s not a good sign when you are fully conscious of such effects.”58 The reviewer for Vulture offered something more attuned to the purpose of both the text and the production. By “purpose,” I do not mean any kind of ultimate intended “meaning” or “message,” but rather underlying strategy or impetus or even simply topic created with an eye to stimulating engaged response on many levels. Scott Brown identified the show’s “reeling, refracted carousel-of-consciousness,” played out as the protagonist sits and is buffeted by “gales of sensory confusion—cacophony, yammering, all dangerously unmediated, and disordered” from all sides. The website on which Brown’s review of Wings was posted is a project and property of New York Magazine. It is, however, a web publication, and an explosion both in web presence and in critics who may or may not be paid and who bring multiple new perspectives to their work had changed the world of theatre criticism, although this presence had hardly unseated the power of the New York Times. Brown, rather than looking for universals or clinical accuracy or a need for emotional buy-in, read Maxwell’s Emily emanating “animal fear and heroic ecstasy in nearly equal proportions,” with the production overall “deliver[ing] a tremendous theatrical head rush, and a priceless inverted view of consciousness itself.”59 Impaired cognition is no longer the disease that dare not speak its name. It may speak in tongues, but in the new millennium savvy listeners could no longer pretend to be deaf.
“I Am an Archive”60 The impetus for Peggy Shaw’s 2013 one-woman show Ruff was the stroke she suffered in 2011. Obviously, the piece offers the “inside” perspective of brain damage that is the umbrella for this chapter. Ruff is, however, a unique production in the context of Losing It, for several reasons. It is definitely comedic, with video clips of actual performances in front of live audiences making clear that the latters’ laughter is uproarious at points.61 Ruff is also performance art as much as it is a play, in that it does not privilege text over the occasion of the embodied event. Indeed,
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given Shaw’s status in the world of resistant, insouciant, “downtown” New York performance, a text extracted from her own performance would at best yield readings no more than a remove or two from the meaning immanent in the creator’s embodiment.62 When Ruff opened, Shaw was what critic Jill Dolan called “the doyenne of the downtown lesbian/ feminist/trans/butch performance scene for the last 45 years”63 ; she had won three Obie Awards (Off-Broadway’s analogue to Broadway’s Tonys); and she was the subject of a substantial introductory essay to an anthology of her plays.64 It is unquestionable that the artist’s fan base and reputation were crucial to the success of the piece. This “success,” however, is not merely about positive reviews or even full houses. It is very much about the palpable synergy between artist and public when the former can command attention even in the context of what otherwise might be a “downer” subject. Ruff delivered a first-person account of the experience of brain damage—both the event that caused it and the actuality of living with it in the aftermath of the event—in real life and real time via the persona that Peggy Shaw developed over her career. In this section, I braid (1) Shaw’s own words in Ruff itself and in interviews about her performance work and her brain damage with (2) Philip Auslander’s understanding of performer persona and Anne Davis Basting’s concept of the body in depth in the context of Marvin Carlson’s “haunted stage” with (3) published critical response and my own reading of the live event(s) of performances of this show as evidenced in publicly availably clips (although I also saw it in a theatre). Peggy Shaw (b. 1944) co-founded the feminist performance troupe Split Britches in 1980 with Lois Weaver and Deb Margolin. The company started the (largely lesbian) WOW (Women’s One World) Café, a New York Theatre venue still in operation. Margolin left the trio to work solo; Weaver and Shaw continued to collaborate. Weaver both co-wrote and directed Ruff . The company’s website describes their aesthetic as “DIY” (do it yourself), further explaining that [w]e create new forms by exploiting old conventions. Our work borrows from classical texts and popular myths, but its true sources are the details of everyday life. We use popular culture as a mode of communication, like the vaudevillian comedy double act or the relationships in A Streetcar Named Desire, taking existing forms and cracking them open to queer and personalize them. The work is personal, bordering on the private. It relies on moments rather than plot, relationships rather than story. As we’ve
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aged, our work has focused on tapping into the unexplored potential in elders and people with disabilities.65
Shaw, a native of Massachusetts from a working-class Irish family, earned a Bachelor of Fine Arts degree in painting and printmaking, gave birth to a daughter, and moved to New York City in 1967. She became intrigued with the performance work of Hot Peaches, a drag company with whom she then worked, starting as a scenic painter, in the 1970s. While on tour with the company in Europe, she met Weaver. Both were taken with the work of Spiderwoman, a Brooklyn-based feminist company with an intentionally “messy” aesthetic, deploying storytelling, music, dance, and an unabashed willingness to look “amateur” in the interest of speaking truth to power. Shaw became known for playing butch and some male roles, perhaps most notably Stanley Kowalski in Belle Reprieve, the mashup/ takedown of A Streetcar Named Desire jointly created by Split Britches and a British male drag duo, Bloolips, in 1990. The piece is both an homage to Tennessee Williams and a sendup of Streetcar’s heteronormative archetypes. It concludes with a tirade against the representational disservice done by traditional realism to gay and lesbian people. The ensemble won an Obie for the show that year. Shaw’s first Obie had been for her work in Dress Suits to Hire in 1987. She would win her third in 1999 for Menopausal Gentleman, a work whose title suggests the unusual contours of Shaw’s persona. She is recognized for appearing as a kind of 1950s hipster man in a blazer, tight pants, and a skinny tie, often with a fedora, sometimes crooning songs, always butch, never losing her cool, and never letting us forget that this gentleman is a lady. Or that this lady is a gentleman. Ruff puts brain damage on full display. Shaw can no longer memorize lines, so in the production she is accompanied onstage by three video monitors to which she refers for prompts or even whole sections of text throughout the one-hour-plus piece. At the start of the performance, she tells the audience that she now coughs with regularity,66 and she asks an audience member to hold the water bottle she knows she will want at some point (Fig. 7.2). She jokes about her immediate feelings while having the stroke, saying she imagined that being felled with vomiting and then passing out were either cosmic punishment for having lived as a butch outsider for decades or the effects of the ham sandwich she shouldn’t have eaten earlier the day of the stroke.
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The joking is punctuated, however, with observations such as remembering the feeling that “an icicle was falling into the ocean bottom of her mind.”67 She goes on to deliver a “public service announcement,” riffing on a message circulated by the Centers for Disease Control and the American Stroke Association about recognizing symptoms, and explaining with a mnemonic acronym how to tell one is having a stroke and what to do about it.68 FAST = Face (if you smile and one side is drooping, you’re having a stroke); Arms (if you try to raise them and one won’t cooperate, you’re having a stroke); Speech (if it’s slurred, you’re having a stroke); and Time (as in “to call the ambulance”). While these are indeed the terms of the medical advice/announcement, Shaw’s delivery— especially the second person admonitions—make the lesson her own, her authority the product of her neurological experiential status in tandem with her downtown star status. Also, the recipients of the information are present in person and engaged in the close embrace that characterizes the audience/performer’s pas-de-deux in a successful theatre encounter.
Fig. 7.2 Peggy Shaw in Ruff at LaMama (Photo © Lee Wexler)
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What personalizes Ruff overall is Shaw’s ruminations on her own brain and her actual past, destabilized present, and potential future delivered in words uttered by the body that suffered the stroke. Ruff is then, with its nonlinear form, in part a somagraphy: something that “considers anatomical knowledge and its relation to textual form.”69 Shaw tells us that she’s missing half her brain. She went into the hospital, she relates, as a queer woman generally mistaken for a man (frequently Sean Penn, but she deadpans that she doesn’t believe she looks like him; rather he looks like her). Following the stroke, minus half her brain (as she experiences herself), she tells us she emerged from the hospital as a straight white man. The heart of the show, so to speak, is Shaw’s putting her sensate and conscious self in conversation with imaging (all meanings intended)—described in words and on a greenscreen that suggests but doesn’t literally show her brain as a physical organ whose effects are mysterious. The brain can be studied via magnetic resonance imaging (MRI); the mind cannot be captured, yet it is the essence of what makes us human. Or, as Shaw relates, “you can’t photograph a thought or take a picture of what you believe in. Stephen Hawkings [points out that] a map of the brain can tell us no more about the mind than a terrestrial globe can show heaven or hell.” If ever there were reminders of the self that is present whether or not one suffers from dementia, these are they. Shaw gently chides anyone who associates self with cognition that the latter isn’t necessary to feel desire, any more than the presence of an actual supernatural being is necessary for a person to feel haunted.70 Shaw’s performance in Ruff was haunted in many of the senses theorized by Marvin Carlson in The Haunted Stage: The Theatre as Memory Machine. The venues in which Ruff was presented—first at Dixon Place (January 2013) then the following year at LaMama (January 2014)—are known for hosting experimental, often queer, ordinarily nonlinear works, so, by Carlson’s criteria, these houses are haunted by ghosts or audience memories of these previous productions.71 Reviews for Ruff were written by critics who experienced the work in these venues with the audiences who frequent them. Numerous Split Britches works have been presented at LaMama.72 The presence of Shaw on LaMama’s stage in Ruff would be a summoning of remembrance of performances (hers) past. For many, these performances were part (ghosts?) of spectators’ own pasts73 ; for some—younger people who had first encountered Shaw’s work in their academic studies—Ruff would be a kind of initiation, yet an initiation into the actual of something formerly known to the new initiates via
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academic mediums. For both categories of audience member, however, two things would heavily inflect the experience of watching Shaw cope with losing it. One, as discussed in Chapter 4 (Joint Owners in Spain) is the particular communal event that is witnessing a piece of theatre with a known group of co-viewers. While an excursion to a large theatre to see a hit is, of course, an occasion, a visit to an out-of-the-way, small theatre (Dixon Place can not only be a little difficult to locate on a first visit, but the stage on which Ruff was presented required negotiating a steep, narrow stairway) frequented by one’s familiars is, possibly, as much pilgrimage or ritual as it is “an evening at the theatre.” Young spectators encountering Shaw’s work in the flesh for the first time would know, if only by looking around but also from the audience “vibe” that they would be sharing the experience with seasoned fans. I want, briefly, to consider Shaw as an icon to be sought out by the community of followers and then to consider a contingent of those followers as people themselves invested in information or inspiration or creative guidance regarding undertaking the rest of their lives’ journeys with an increased awareness of the possibility of impaired brain functioning. Shaw speaking in the first person from the inside delivered her performances largely to bodies of what could be called fellow travelers. At the very least they recognized whence she had come and were invested in her charting of the terrain traversed. At a 2014 Montreal conference featuring Shaw and Weaver and devoted, among other things, to discussing methods of archiving performances, Shaw declared, “I am an archive.”74 To be an archive is arguably to be haunted by the past, as the word denotes a repository for items intended for preservation and not to be abandoned; it is also arguably to be a special destination for people seeking knowledge. The knowledge Shaw proffered in Ruff is both discursive and embodied. In an article entitled “Embodied Memory: Again, Neuroculture and the Genealogy of Mind,” Stephen Katz historicizes and challenges how “western thought has … individualized memory as the guarantor of civilized personhood” (2), Katz cites John Locke’s work as a beachhead for the common idea that personhood inheres in a coherent, consistent identity and notes that for Locke, the person who cannot recollect or remember experiences is therefore not the same person who had the experiences in the first place. In this way, the Lockean diagram of personhood, memory, and consciousness
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is a philosophical underpinning of modern frameworks of the aging mind, self, and dementia. (4)
If Shaw’s cognitive memory loss precludes her learning lines; if she moves more slowly and awkwardly and with less range than in the past; if she requires assistance from both her audience (whom critic Benjamin Gillespie calls “her continual collaborators”75 and something to which Weaver nods in an interview conducted in England before a performance of Ruff 76 ), is she the same person she was before the stroke? Anne Davis Basting’s idea of the body in depth, discussed in Chapter 3, is informative here. In Basting’s words: to see the body in depth is literally to see time across space. It is to witness the event of aging, to anticipate the changes the body will produce, and to remember changes already passed. To see the older body in-depth is to recognize the wrinkles and age spots while also seeing the thick, pliant skin of a child. To see a younger body in depth, on the other hand, is to imagine the uncharitable changes that the body will produce … the important thing is not to polish the details, but to acknowledge the almost certain (barring tragedy) links between youth, adulthood, old age, and all categories in between.77
Here, the changes the body produced include cognitive, memory, and physical change. Shaw cannot remember all she once could (lines, among other things), yet her body remembers—something evident both in her nodding to ongoing desire but also in her outright statement that remembering where to move while onstage is not so difficult.78 Indeed, Rebecca Bitenc points out “the extent to which memories are embodied (consider, for instance examples of procedural memory such as the capacity to ride a bike, dance, or knit) and may thus persist even when verbal communication disintegrates.”79 I discuss various kinds of memory, including procedural, in Chapter 9. The body one sees—Shaw’s body—is not anyone else’s body. If it has aged, it still carries genetic and performative material from its/her past and, if one refuses the thrall of the hypercognitive imperative, one might see both a physical and perhaps a mental palimpsest. The body one sees also conveys—literally, physically—the star persona that makes Shaw an icon and attracts audiences. “Persona” is the term Philip Auslander uses to denote a version of a performing artist’s self that is defined through social interaction more than it is a reflection or extension of the performer’s personality (although
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it may be that, or built on that).80 Persona is a form of self-presentation; it may or may not be personally “expressive.” The persona delivered (embodied?) by a performer “will reflect the priorities of the performance context,” argues Auslander,81 further reminding his readers of two things. First “aesthetic performances … are set apart from the flow of ordinary life by means of signs that indicate their special status” and second, “in performance art, life is often integrated into art rather than the other way around.”82 Shaw’s decades of performances in New York’s East Village and in other venues receptive to work built with a downtown, resistant, queer aesthetic, meant that she arrived at the moment of performing Ruff with an outsize, recognized, beloved persona. Auslander makes clear that, despite some of the vicissitudes of individual performances, “audiences expect performers whose work they experience more than once to maintain relatively consistent personae.”83 What happens, then, when an iconic performer’s brain suffers damage? Can she maintain the persona for and by which she is known? To some extent, of course, the answer in the case of Ruff must be “yes,” else it is unlikely that Weaver and Shaw would have chanced putting Shaw in a potentially very embarrassing situation. But Auslander tellingly, and importantly here, asserts that “it is the audience that produces the final construction of an identity from the impressions created by the performer”84 (114). It is worth quoting his expanded argument here at some length: [T]he performer’s persona is precipitated by the interaction with an audience and is, in that sense, a social construct, not simply an individual one…. [There is an] investment audiences have in the performance personae they help to create. This investment is not purely economic; it is also cultural, emotional, ritual, sometimes political or even spiritual. Audiences try to make performers into who they need them to be, to fulfill a social function. A successful working consensus means that such a relationship has been achieved.85
Shaw’s post-stroke success in continuing her status as the “doyenne of the downtown lesbian/feminist/trans/butch performance scene” is as much about audience acceptance of change as it is about her own ability to “overcome” some of the effects of brain damage. In this sense, the view from the inside is one of hope, buoyed by a combination of humility, bravery, and confidence—confidence not just in herself, but in
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the support of her community. It is precisely this community acceptance that is missing from many dementia narratives, which reflect the fact that more than a third of people with dementia reported losing friends after receiving their diagnosis86 ; as dementia advances and/or as people move to care facilities, the absence of visitors typically rises precipitously.87 Recall Weaver’s assertion in the quote earlier in this section from the Split Britches website, that the duo’s current projects focus on working with older women and people with disabilities and doing so in the spirit not of therapy or recreation, but of exploration and the future. The 2018 Unexploded Ordnances ,88 which I saw at its world premiere at LaMaMa as part of New York’s Under the Radar Festival, revealed not just a less-agile-than-in-her-heyday-post-stroke Shaw, who was cast as an army general and directed to execute a minimum of staged moves. It revealed a loyal, longtime, and invested following of women willing to face our own mortality. Weaver, sitting at the head of a conference table in a faux global situation room, asked for audience volunteers to serve on her council of advisors. Criteria included at least remembering the Cuban Missile Crisis (1962) and extended to being born prior to World War II. Women who stepped forward fit a profile shared by most of the audience. In 2022, among the top ten causes of death in the United States, stroke ranked fifth and Alzheimer’s Disease seventh, with third and fourth places held by Covid-19 and preventable injury respectively.89 Heart disease is first. It is a fair bet that any theatre audience comprises people who will have, have had, or know people suffering the effects of either stroke or Alzheimer’s.90 Shaw performs something her audience accepts: there is life with brain damage. Her audience performs a (minoritarian?) willingness to accept and embrace her ongoing personhood, perhaps because of their own recognition—even if driven by anxiety—of their own mortality. One could say that they meet I to I.
Notes 1. Of course, this disease strikes humans beyond the borders of the United States and Alzheimer’s awareness is an international concern. September 21 is designated World Alzheimer’s Day. 2. Richard Noll, American Madness: The Rise and Fall of Dementia Praecox (Cambridge, MA and London: Harvard University Press, 2011), 62, 69. 3. Lynn Casteel Harper, On Vanishing: Mortality, Dementia, and What It Means to Disappear (New York: Publisher’s Group West, 2020), 84, 88.
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4. Nancy Mace and Peter Rabins, The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer Disease, Other Dementias, and Memory Loss, seventh edition (Baltimore, MD: Johns Hopkins University Press, 2021). 5. https://www.amazon.com/36-Hour-Day-sixth-Alzheimer-Dementias/ dp/1421422239 (Accessed 7 April 2023). 6. Rebecca A. Bitenc, Reconsidering Dementia Narratives: Empathy, Identity and Care (London and New York: Routledge, 2020), 4, 35, and Chapter 3. 7. Gerald Clarke, “Brain Crash” (review of Wings ), Time Magazine, 3 July 1978. 8. Arthur Kopit, Wings in Three Plays by Arthur Kopit (New York: Hill and Wang, 1997). 9. James B. Pinkston, Hadejda Alekseeva, and Eduardo González Toledo, “Stroke and Dementia,” Neurological Research, Vol. 31, No. 8: 824– 831. https://doi.org/10.1179/016164109X12445505689643. See, too, WebMD, “Stroke Related Dementia,” 2019. https://www.webmd.com/ stroke/guide/stroke-related-dementia (Accessed 7 April 2023). 10. Pinkston et al., 824. 11. Ibid., 825. 12. Impeded blood flow may be the result of either arteriosclerosis or atherosclerosis. In arteriosclerosis, arteries become stiff and are no longer pliant, thereby losing their ability to carry blood (and oxygen) as freely as needed; in atherosclerosis, a build-up of fats or cholesterol impedes blood flow. For the difference between strokes caused by blockage and those caused by hemorrhage, see “Types of Stroke,” American Stroke Organization. https://www.stroke.org/en/about-stroke/types-of-stroke (Accessed 7 April 2023). 13. Americans may have become aware overnight of aphasia and its symptoms when movie actor Bruce Willis was diagnosed with this form of cognitive impairment in 2022. In this case, aphasia is an illness and not only an effect. See Maya Salam, “Bruce Willis Has Aphasia and Is ‘Stepping Away’ from His Career,” New York Times, 30 March 2022. https://www.nytimes.com/2022/03/30/movies/bruce-willis-aph asia.html (Accessed 7 April 2023). 14. Pandora Pound, Michael Bury, and Shah Ebrahim, “From Apoplexy to Stroke,” Age and Aging (1997): 331–337. See, too, William S. Fields and Noreen A. Lemak, A History of Stroke: Its Recognition and Treatment (New York and Oxford: Oxford University Press, 1989). 15. Kopit, 179, 180. Italics in original. The phrase “from the inside” appears in Richard Eder’s review, “Theater: ‘Wings’ By the Yale Rep,” New York Times, 22 June 1978; and in Sy Syma’s untitled review for WNYC-TV, dated 1 January 1979.
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16. Kopit, 187. 17. Ibid., 201, 202. 18. Douglas Watt, “Cummings’ ‘Wings’ soars,” New York Daily News, 22 June 1978. 19. William Glover, AP Drama Critic, type text, 22 June 1978, New York Public Library Lincoln Center for the Performing Arts [need call number for the correct folder]. 20. Frances Herridge, “‘Wings,’ Terrifying Story of a Stroke,” New York Post, 22 June 1978. 21. John Beaufort, “Constance Cummings in Yale’s ‘Wings,’” The Christian Science Monitor, 28 June 1978[ 22. Eder, “‘Wings’ By the Yale Rep,” and Howard Kissel, “‘Wings,’” Women’s Wear Daily, 23 June 1978. 23. Glenne Currie, “Constance Cummings Takes Flight in ‘Wings,’” Typescript, New York Public Library Lincoln Center for the Performing Arts [need call number for the correct folder]. 24. Glover, op cit. 25. Harper, 86. See Heidi E. Hamilton, Language, Dementia and Meaning Making: Navigating Challenges of Cognition and Face in Everyday Life (Cham, Switzerland: Palgrave Macmillan, 2019). 26. Kopit, 218. 27. Ibid. 28. Ibid., 221. 29. Ibid., 245. 30. Watt. 31. Kissell and Beaufort. 32. Clarke. 33. Syma. 34. Herridge, Clarke. 35. Glover, Beaufort. 36. Beaufort. 37. Eder. 38. Kissel, Beaufort, Currie. 39. Kopit, Three Plays, 179. 40. Ibid., 180. 41. Judith Parker, “Arthur Kopit Says ‘A Play Has to Breathe,’” Harvard Magazine (March–April 1979): 90. 42. Robert Berkvist, “Constance Cummings—‘Wings’ Lifts Her to Stardom,” New York Times, 28 January 1979. https://www.nytimes.com/1979/ 01/28/archives/constance-cummingswings-lifts-her-to-stardom-consta nce-cummings.html (Accessed 7 April 2023). 43. Ibid. 44. Ibid.
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45. Watt. 46. Syma. 47. Suzanne Burgoyne Dieckman and Richard Brayshaw, “Wings, Watchers, and Windows: Imprisonment in the Plays of Arthur Kopit,” 195–207 in Theatre Journal, Vol. 35, No. 2 (May 1983): 205. 48. Ibid., 206, 207. 49. Margot Anne Kelley, “Order Within Fragmentation: Postmodernism and the Stroke,” 383–391 in Modern Drama, Vol. 34, No. 3 (Fall 1991): 387. 50. Ibid., 390. 51. Bitenc, 144. 52. Aristotle, De Poetica, translated by Ingram Bywater, in The Basic Works of Aristotle, ed. Richard McKeon (New York, Random House, 1941), Chapter 4, p. 1457. 53. Syma. 54. ACT press release for Wings, 7 August 1980 and The Cleveland Playhouse, New Release, 2 July 1979 [GET FOLDER AT NYPL-LC]. 55. Dianne Zuckerman, “Into the Wild, Dark Yonder ‘Wings’ Depicts Life, Courage After Stroke,” Denver Post, 3 March 2000. https://extras.den verpost.com/scene/wings0303.htm (Accessed 7 April 2023). 56. John Moore, “Inside the Mind of a Stroke Victim: ‘Wings’ Is Harrowing, Revelatory Theater,” Denver Post, 10 April 2008. 57. “Alone in a Crowd,” E.R., script by Dee Johnson, episode first aired 17 February 2005 (season 11). 58. Ben Brantley, “The Shadows of an Airborne Life,” New York Times, 24 October 2010. https://www.nytimes.com/2010/10/25/theater/rev iews/25wings.html (Accessed 7 April 2023). 59. Scott Brown, “Theatre Review: Wings Soars With Jan Maxwell,” Vulture, 25 October 2010. https://www.vulture.com/2010/10/theater_review_ wings_soars_wit.html (Accessed 7 April 2023). 60. Peggy Shaw quoted in Alexis Clements, “How Split Britches Joined Lesbian Performance With the Avant-Garde,” American Theatre, 16 January 2014. https://www.americantheatre.org/2014/01/16/peggyshaw-lois-weaver-leave-their-mark-on-new-york-avante-garde-theatre/ (Accessed 7 April 2023). 61. Peggy Shaw, Ruff . Video edited by Victor Bautista. Hemispheric Institute, Concordia University, Montreal, 22 June 2014. https://hem isphericinstitute.org/en/enc14-performances/item/2347-enc14-perfor mances-shaw-ruff.html (Accessed 7 April 2023); “Split Britches Ruff : Science Stroke Art 2014,” http://www.split-britches.com/greenscre ening (Accessed 7 April 2023). The latter video includes both a part of the performance and an interview with Shaw and Weaver. 62. For a view of experiencing performance art in mediated form, although generally via a representation of the work’s originator,
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64.
65. 66.
67. 68.
69.
70. 71.
72.
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see Amelia Jones, “‘Presence’ in Absentia: Experiencing Performance as Documentation,” Art Journal, Vol. 56, No. 4 (Winter 1997): 11–18. http://links.jstor.org/sici?sici=0004-3249%28199724% 2956%3A4%3C11%3A%22IAEPA%3E2.0.CO%3B2-O (Accessed 7 April 2023). Jones’s interest is in the representational and not the ontological status of the performer’s self as soon as s/he engages in performance as a framed event. My concern is with the particular body and persona in the performance. Shaw in Ruff to some extent is Ruff , which would mean and speak quite differently in the body of a different performer undertaking but not having lived through the first-person event. Jill Dolan, “Peggy Shaw in Ruff,” The Feminist Spectator, 22 January http://feministspectator.princeton.edu/2014/01/22/peggy2014. shaw-in-ruff/ (Accessed 7 April 2023). I question the 45-year attribution, as Shaw’s New York onstage presence as a “fixture” really dates to the starting of Split Britches in 1980, which would make an approximate 35 years more likely at the time Dolan wrote this review. Peggy Shaw, A Menopausal Gentleman: The Solo Performances of Peggy Shaw, ed. and introduction by Jill Dolan (Ann Arbor: University of Michigan Press, 2011). http://www.split-britches.com/about (Accessed 7 April 2023). Brendan Macdonald, “Review: Ruff at the Barbican,” Exeunt Magazine, April 2016. http://exeuntmagazine.com/reviews/review-ruff-at-the-bar bican/ (Accessed 7 April 2023). Dolan, “Peggy Shaw in Ruff.” “Stroke,” Centers for Disease Control and Prevention.” https:/ /www.cdc.gov/stroke/signs_symptoms.htm (Accessed 7 April 2023); or SCAI, “Act Fast to Identify a Stroke in Progress.” 18 May 2016. http://secondscount.org/heart-condition-centers/info-det ail-2/act-fast-to-identify-stroke-in-progress#.XqXTTpNKjok (Accessed 7 April 2023). John V. Nance, “Gross Anatomies: Mapping Matter and Literary Form in Thomas Nashe and Andreas Viselius,” 115–134 in The Age of Thomas Nashe: Text, Bodies, and Trespasses of Authorship in Early Modern England, ed. Stephen Guy-Bray, Joan Pong Linton, and Steve Mentz (Surrey, England and Burlington, VT: Ashgate Publishing Co, 2013), 117. Peggy Shaw, Ruff . Video edited by Victor Bautista. Later performances were presented in Montreal at the Hemispheric Institute, at the Barbican Centre in London, and at the University of Manchester. The duo’s Last Gasp, described as “a call and response to the precarities of again and of our age” was slated for production until the Covid-19 pandemic closed New York theatres in spring 2020. Print advertising, author’s collection.
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73. For snapshots and history of 1980s downtown performances by, for, and about lesbians who were both the original audiences for Split Britches’s work, some of whom were also performers, and for a sense of spillover among audience, community, and artists in the East Village (where the WOW Café, Dixon Place, and LaMaMa are located), see Jill Dolan, “Carmelita Tropicana Chats at the Club Chandalier,” TDR (The Drama Review), Vol. 29, No. 1 (Spring 1985): 26–32 and Alisa Solomon, “The WOW Café,” TDR (The Drama Review), Vol. 29, No. 1 (Spring 1985): 92–101. 74. Alexis Clements, “How Split Britches Joined....” 75. Benjamin Gilllespie, “Review of Ruff ,” Theatre Journal, Vol. 65, No. 4 (December 2013): 576–577. 76. Split Britches Ruff : Science Stroke Art 2014. http://www.split-britches. com/greenscreening (Accessed 7 April 2023). 77. Anne Davis Basting, The Stages of Age: Performing Age in Contemporary American Culture (Ann Arbor: University of Michigan Press, 1998), 141. 78. https://vaudevisuals.com/category/vaudevisuals-interview-with-peggyshaw-ruff-a-solo-performance-dixon-place-coil-festival-2013/. 79. Bitenc, 26. 80. Philip Auslander, “Musical Personae,” The Drama Review, Vol. 50, No. 1 (Spring 2006): 100–119. 81. Ibid., 103. 82. Ibid., 105. 83. Ibid., 113. 84. Ibid., 114. 85. Ibid., 115. 86. Harper, 87. Those unafraid to confront who they are as they live with dementia following a diagnosis may resent the thinking not only of frightened and uninformed friends, but also of therapists who advise secrecy and pretending. See N. R. Kleinfield, “Fraying at the Edges,” New York Times, 30 April 2016. https://www.nytimes.com/interactive/2016/ 05/01/nyregion/living-with-alzheimers.html?action=click&pgtype=Art icle&state=default&module=styln-alzheimers&variant=1_show®ion= MAIN_CONTENT_1&context=STYLN_TOP_LINKS_recirc (Accessed 7 April 2023). 87. Janelle S. Taylor, “On recognition, Caring, and Dementia,” Medical Anthropology Quarterly, Vol. 22, No. 4 (December 2008): 313–335. 88. https://www.broadwayworld.com/off-off-broadway/article/Split-Bri tches-to-Tackle-Aging-Anxiety-Desire-in-UNEXPLODED-ORDNAN CES-UXO-at-La-MaMa-as-Part-of-Under-the-Radar-20171204 (Accessed 7 April 2023) and https://www.nytimes.com/2018/01/08/theater/ unexploded-ordnances-uxo-split-britches-under-the-radar.html (Accessed 7 April 2023).
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89. Centers for Disease Control and Prevention, https://www.cdc.gov/nchs/ fastats/leading-causes-of-death.htm. Data are from 2021; last reviewed by the CDC in 2023 (Accessed 7 April 2023). 90. It is unclear whether the designation “Alzheimer’s” includes all dementias.
CHAPTER 8
Inside (and) Out: “Who Exactly Am I?”—The Father
If one were to imagine, perhaps cynically, a play sitting at the intersection of a first-person roller coaster experience of dementia and the cold but familiar comfort of a weepy decline narrative, Florian Zeller’s The Father might be that play. Readers now have additional experience with Zeller’s work on account of the 2021 film version of the piece, for which Anthony Hopkins won a Best Actor Academy Award for his performance as the titular character. In fifteen short scenes and with a playing time of ninety minutes, the play follows the upper middle-class, urban octogenarian André in his journey from crotchety, resistant, independent bully in natty clothes and denial to cognitively unmoored denizen of a nursing home living in his pajamas and crying for his mother. The play’s conceit is that it braids André’s perspective with those of his daughter and her boyfriend, leaving the audience to parse which perspective is “accurate” and/or when either is so. Le P ère opened in 2012 in Paris, where its author lives and works as both a novelist and a playwright. That production garnered three Molière awards (Paris’s most prestigious theatre award): for Best Play, for Best Actor in a Private Theatre (Robert Hirsch), and for Best Actress in a
Florian Zeller, The Father in The Mother and The Father, trans. Christopher Hampton (London: Faber and Faber, 2015), 153. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 D. Chansky, Losing It, https://doi.org/10.1007/978-3-031-20902-4_8
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Private Theatre (Isabelle Gélinas). In Christopher Hampton’s translation, it opened as The Father at the Ustinov Studio of the Theatre Royal, Bath, England, in 2014, with Kenneth Cranham in the title role; the production moved to the West End at Wyndham’s Theatre in October 2015, returning to the West End at the Duke of York’s Theatre for a month in early 2016. Cranham won Britian’s Laurence Olivier Award for Best Actor. Other productions followed in Australia, Singapore, New Zealand, Canada, Brazil (where lead actor Fúlvio Stefanini won the Shell Best Actor award for his performance in the title role in 2017), and in Capetown, South Africa (garnering a 2017 Fleur du Cap Best Actor award for Marius Weyers). The American premiere took place on Broadway in a Manhattan Theatre Club production in 2016 with Frank Langella in the title role, for which he garnered a Best Actor Tony. In 2020, a Pasadena Playhouse production starred Alfred Molina and the feature film with Anthony Hopkins debuted at the Sundance Festival in advance of its commercial release. Other American productions have been mounted in St. Paul, Washington, DC, Pittsburgh, and Chicago. This list is partial but representative. Additional American productions were offered by amateurs and by university students. The latter two categories include a brief run at the remote, privately owned, Unadilla Theatre in Marshfield, Vermont, and a Master of Fine Arts thesis production at Texas Tech University, both in 2019. Zeller’s dramaturgical strategy in The Father involves more than scripting the work to articulate confusion and conflicting accounts of the same event in conversations among characters. The playwright also stipulates that this multiplicity unfold phenomenologically by noting that, between scenes, furniture moves and disappears and also by indicating that some characters be played by more than one actor. Realizations of these extra-verbal maneuvers are meant to create for audiences the experience of the eponymous protagonist: non-recognition, even when the person standing there insists s/he is one’s nurse, daughter, son-in-law, or daughter’s partner, and disorientation with regard to locale (am I not in my own apartment of thirty years? What do you mean, this is your home? Who took the furniture?) as well as time (how long have I been here?). In constructing his text this way, Zeller sets up expectations of what is “real” and then invites us to look via an alternate optic. Whether that optic is the metaphorical result of faulty vision or of failing to realize that one’s glasses need cleaning or of peering through a kaleidoscope (perhaps mistaking it for a spyglass intended to facilitate close-up viewing) or of
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being offered a stance with a partially obstructed view or of losing an electric (or electronic or cellular) connection at one or more crucial moments in an encounter, the script clearly expects audiences to realize that, while the play’s major dramatic question may be “where will the protagonist end up?” its major philosophical question is “what is reality?” The first and the final two of the fifteen scenes in The Father are anchors and the events depicted in them are not meant to be contested with regard to whether they are reliably related. The play begins in the upper-bourgeois apartment of André, which his middle-aged, professionally dressed daughter, Anne, enters in frustration, confronting her parent about the bad behavior that has just driven a part-time caregiver to quit. André has supposedly verbally abused the carer and threatened her with a curtain rod. André denies the curtain rod and insists he needs no assistance; his daughter believes he does and that she can no longer provide it at the level she thinks he requires, even if only for shopping and cleaning. In the play’s penultimate scene, she takes him to the nursing home to which she is moving him and where we will see him in the final scene, several weeks (or months?) later, not remembering his name nor how long he has been in the institution he mistakes for his apartment denuded of furniture and whence he wishes to depart. The twelve intervening scenes cover just a few weeks, but parts of them are replayed with different outcomes, foci, and actors, allowing audiences simply to consider multiple perspectives or to experience André’s anxiety from the inside or to witness how Anne and her live-in partner Pierre’s decision-making is both responsible and selfish, gentle and cold, careful or desperate, or all of the above. The three key events in the dozen scenes comprise hiring a new caregiver, Laura; having a dinner for three (André, Anne, and Pierre) right after Laura is interviewed and hired; and Laura’s first day on the job, the following morning. The pre-, during, and post-dinner encounters between combinations of characters are cut up, replayed, and re-ordered. In the first of the non-bookend scenes, which is the play’s second scene, a man enters the apartment. André doesn’t recognize him and is incensed that a stranger is in his home. The man explains it is his home, which he shares with Anne and where André is now staying until a new caregiver can be hired. The audience hears this explanation and only later sees the live-in partner played by the “regular” cast member who is listed in the program as playing Pierre, retrospectively figuring out that the first performer who has appeared as Anne’s partner is “Man.” When a woman arrives with takeout food, we, like
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André, are meant to wonder who she is, until dialogue reveals her to be daughter Anne, played by a different actress (“Woman”) from the one who established the father-daughter relationship in the opening scene. André’s fear, disorientation, and defensiveness mount. On the day of Laura’s interview, occurring roughly ten days after the play’s opening scene, he is in his pajamas in the middle of the afternoon. In the dinner scene, when he learns it is eight o’clock and nearly time to eat, he is confused that it is not eight o’clock in the morning. He belligerently asks Laura on what may be her first day of work whether she is a nun, a question that confuses her until he explains that she is talking to him as if he were “retarded”1 —something he dislikes intensely. Is she merely pleasantly cajoling him to take his pills? On what is definitely her first day of work, he fails to recognize her when she walks in, saying “it’s not her” and asking for “the one I like.”2 In this brief part of a longer scene, Laura is played by the actress listed in the script and program as Woman, and whose presence here, as was her presence earlier as Anne, is intended to offer an André’s-eye-view of people who become unrecognizable to him (Fig. 8.1). The most extreme instance of this “whose-reality-is-itanyway?” world involves a scene between André and Pierre—someone André finds “unsympathetic”3 and who frightens him—that starts with Pierre asking André for an honest answer to the question of how long he is going to hang around “getting on everyone’s tits?”4 When the scene is replayed, but not immediately, with Man as Pierre, it goes further, and André’s interlocutor strikes the old man three times, leaving him cowering and in tears. Does Pierre really hit André? Is André hallucinating? When Anne later admits to Pierre that she herself is frightened of him, André’s perspective (or experience) is given additional weight. Whether or not Pierre really hit André is surely less important than the presence of fear and dislike in an obviously ill person whose primary carer, his daughter, sees his tears and hears his words yet chooses to decamp to London with her (unsympathetic? frightening?) partner. The script tells us just enough to allow us to question her behavior (why does she “need” to work, or need to work full time, when both she and her father own large apartments? Why does she choose to stay with a man who frightens her and has little patience for her father?) but also enough to enable us to sympathize with it. (She is divorced and now newly involved with another man after five years of being single; her father has always preferred her younger sister, who died in an accident that he seems to have forgotten, and he makes no bones about this preference nor much effort to avoid calling
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Fig. 8.1 The Father, Texas Tech University School of Theatre and Dance, 2019. Kaylee Underwood as Laura and Justin McKean as André (© Allison Roberts)
Anne stupid; there is enough money for private care; she is high enough on the employment food chain to be able to work from home in London for a company that is based in Paris and may enjoy both perks and the work itself.) In the play’s first two scenes, close to a hundred of André’s lines end with question marks. Some “mns?” are social covering; some questions are simple requests. Most are bids for clarification or reassurance about something that seems wrong or impossible, such as when he says, “this really is my flat, isn’t it?”5 Some questions are uttered in the face of panic or upset, such as when a Woman enters, calls André Dad, and receives the reply, “Where’s Anne?”6 Other uses of questions, however, put the audience in André’s shoes. In the opening scene, Anne tells her father that one reason she will not be able to care for him any longer is that she is moving to London to live with a man with whom she has fallen in love. When we meet Man in the second scene and he identifies himself as
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Anne’s husband (although she is divorced from a man named Antoine), André spills the beans about the move to London, but Man-callinghimself-Pierre, nonplussed, says he knows nothing about this. In scene six, Anne reassures André that she is not moving to London, that she is not married, and that Pierre is her boyfriend. By the play’s final scene she has moved to London. What, exactly, is the audience to think along the way? When caregivers in two different scenes repeatedly ask André “don’t you remember?” an outsider with any knowledge of dementia would respond that they are unkind, unprofessional, or untrained—something on which a few reviewers remarked.7 But what if the caregivers have asked only once and the repetition is a kind of echo chamber of escalating fear in André’s mind—a hallucination of assault? Who is the reliable narrator here? Reliable with regard to what, exactly? The Father is clearly at least in part an exercise in what Rebecca Bitenc calls imaginative phenomenology, which she defines as fiction that “provides the possibility of exploring the experience of living with dementia within a particular physical environment and sociocultural context.”8 Certainly the playwright intends an oscillating inside/outside experience for his audiences, perhaps the back-and-forth between what it feels like to be André living with dementia and what it feels like to be Anne dealing with André living with dementia. But there is a subtle trap—or at least a problem—here. Bitenc comments on the “double perspective of seeing with but also knowing more than the protagonist [which] allows readers to engage with the character with dementia while remaining aware of their own perspective.”9 What is the reader’s—or in this case the audience member’s—perspective? The ur-perspective is that of Florian Zeller, and his modus operandi seems to be to keep audiences off balance and not necessarily possessed of greater knowledge than the protagonist. The play is imaginative phenomenology, but it is not an autopathography. The playwright is present, and his perch, that of what we might call a puppeteer pulling the strings, is anything but naïve. Critical response recognized what Zeller was up to, but some reviewers found his strategy obvious, slick, schematic, sterile, or gimmicky—“more interested in theatrical trickery than psychological insight or emotional depth.”10 One or two nodded to his operating in territory explored by Harold Pinter.11 For the reviewers who were unimpressed with the play’s construction, looking under the hood meant that the ride could not be (fully?) enjoyed, or at least fully immersive. They seemed to want more emotion, with one reviewer declaring of the New York premiere that it
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“exudes a cool clarity that borders on the clinical”12 and another labeling it “a chic arrangement of diminishing effects.”13 (Recall complaints in Chapter 7 about things clinical capsizing sympathy or psychology or what is now called “relatability” regarding Wings.) For others, however, the descent and ending were devastating, one audience member writing that the play in Los Angeles hit her “like a ton of bricks”14 and a New York reviewer declaring not only that “say[ing] the play is hard to take is a cruel understatement” but going on to suggest “there should be a nurse stationed in the lobby to revive the more sensitive patrons in the audience.”15 Here was, perhaps too much emotion. Or perhaps the anticipated emotion accompanying a decline narrative. Comparisons were made with King Lear—textual ghosting, and also in at least one case performance ghosting, as Langella had played the royal role not long before undertaking André. By the time The Father opened in North America, dementia was openly on the table for discussion, and numerous critics nodded to having parents with dementia. The play never uses that word, but most reviewers did. A few jumped to a diagnosis, with one calling the play an “Alzheimer’s-palooza.”16 Reviewers who commented on Pierre/ The Man not being likable (André’s POV?)17 weighed in alongside those who found André unlikeable or unkind (Pierre’s?).18 Also by this time, online reviews—both those created for web-only sites and those that appeared both in print and online—had grown greatly in number, as had the complement of reviewers who are women. How, then, to parse the dual (or multiple) realities in this play? Or is there only one reality but seen from a few perspectives? Is the latter a more realistic view of reality (or at least of Zeller’s representation of it), if I may be excused for framing it in this vernacular, tautological, hall-of-mirrors way? The Father achieves what Pam Morris, in her study Realism, calls the empirical effect: “all those techniques by which realist writing seems to convey the experiential actuality of existence in physical space and chronological time,”19 something that sounds nearly the same as Bitenc’s imaginative phenomenology. We know where we are in this play because we recognize the physical setting, furnishings, other accouterments, clothing, food, descriptions of work and travel, and the stated needs and anxieties of the characters coming from the same zeitgeist as our own. Yet clearly what is or was “real” for some observers was clinical or strategically Pinteresque for others. Certainly The Father relies on what Roland Barthes calls the cultural code (deployment of recognizable referents from the worlds of author and potential reader) as well as what
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he calls the code of actions (the means by which people read or hear texts with an eye to trying to put events in proper chronological order, thereby satisfying the desire to have expectations fulfilled).20 Were the former not in effect, we might not care or at least care to try to care. Were the latter not in effect, neither those in sympathy nor those crying “gimmickry” would have a methodology on which to hang their critical response hats. Yet familiar dependence on these codes can stifle readings that would challenge a view of the play as one in which social stigma and loss trump expanded notions of the fully human. The play insists on accepting confusion, arguably as it asks for a definition of realism perhaps more (Bertholt) Brechtian than (Gyorgy) Lukácsian—demanding an inclusion of today’s (neuro)science and intertextual pastiche in our arsenal of reception tools rather than settling for the comfort of positivism and closure.21 Brecht asserts that “Realism is not a mere question of form,” but the genre par excellence for representing the true “relations between appearance and essence without the need for any external commentary.”22 How might we think—via this representation—of dementia not as a total loss, but as what Christopher Johnson calls “a disability with abilities?”23 As the dramaturg’s note for Texas Tech University’s 2019 s production of The Father suggests, “The world of this play is entirely real, but we invite you to think about the nature of its reality. The main character belongs to a population that is alive, although not necessarily entirely well, in our midst. Any one of us could be a member of that population in the future.” (Italics in original.)24 Popular discourse causes many to believe they would rather die than be a member of “that population.” Yet the relational, emotional, tactile, olfactory, and musical (among others) pleasures still enjoyed by people in neurological decline suggest that not everyone on the dementia spectrum would rather be dead. Ted Dykstra, who directed The Father at Toronto’s Coal Mine Theatre in 2019, stated firmly that he believes the play is about what it’s like to have dementia—about what is in André’s mind. “You think you’re in a Pinter play and he thinks he’s being gaslighted.”25 Dykstra sees all of the play’s events and all of the characters’ assertions as questionable so far as verifiable occurrences go yet entirely “accurate” so far as André’s mind goes. At Texas Tech University, director DayDay Robinson set the entire play in the nursing home, suggesting that the events unspooling before our eyes are unquestionably happening as André sees, (re?)experiences, or recalls them. The hospital bed and nurse in scrubs did not emerge until
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the final scene, but the scenic crew for the many furniture rearrangements and removals were attired in scrubs. A video in the lobby that welcomed patrons to (a wholly fictional) Riverhaven Home, could easily have been read by audience members (if they chose to watch it at all) as vaguely, generically informational rather than as being part of the production itself, so the conceit was fully present and available but not “in your face.” Dykstra was firm in saying “I think the audience should be devastated at the end and indeed they were.” He was equally firm in insisting that he never wanted André’s reality to be his own “I can’t imagine losing grip on the only people in your life and not knowing where you are.” Yet André’s reality and the neuronormative imagination here are two distinct things and writing memory loss off as terrifying or unimaginable does nothing to aid understanding the full experience—and the relational and sensory possibilities—of people living with dementia. Robinson’s production was unlike Dykstra’s or those featuring Langella or Molina in that its final moment was not played with André either immobile (Toronto) or weeping in his nurse’s arms (Los Angeles) or curled up in a fetal position on the floor (New York). After the nurse’s scripted bid to go for a walk in the park prior to having a snack, a nap, and then the possibility of another walk, André’s response to her “come with me” was to do just that. Robinson’s simple but boldly unusual thought was to depict a man living with dementia, not dying of it. In asking “who am I?” Zeller’s character does, indeed, need to be told the name on his birth certificate. But he does not need to be told that fresh air, lunch, company, and a nap sound good. And likely are.
Notes 1. 2. 3. 4. 5. 6. 7.
Zeller, 130 and 132. Ibid., 146. Ibid., 118. Ibid., 117. Ibid., 100. Ibid., 96. See Jesse Green, “The Father’s Frank Langella Is at a Peak as a Proud Man in Humbling Decline,” Vulture.com, 14 April 2016. https://www. vulture.com/2016/04/theater-review-the-father.html and Lynn Slotkin, “Review: THE FATHER,” The Slotkin Letter, 25 February 2019. https:// slotkinletter.com/2019/02/review-the-father. Slotkin reviewed a production in Toronto (Both accessed 8 April 2023).
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8. Bitenc, 63. 9. Ibid., 66. 10. “Sterile” is Joe Dziemianowicz, “Frank Langella Returns to Broadway in ‘The Father,’ a Compelling but Sometimes Slick Show,” New York Daily News, 14 April 2016. “Slick” is both Dziemianowicz and Elisabeth Vincentelli, who also uses “gimmicky” in “Amazing Frank Langella Saves Another Mediocre Show,” New York Post, 14 April 2016. https://nyp ost.com/2016/04/14/amazing-frank-langella-saves-another-mediocreshow/. https://www.nydailynews.com/entertainment/theater-arts/the ater-review-fran-langella-returns-father-article-1.2600959 (Both accessed 8 April 2023) and Christopher Kelly, “‘The Father’ With Frank Langella: A Sour Look at Old Age,” NJ Advance Media for NY.com, 15 April 2016. https://www.nj.com/entertainment/2016/04/father_broadway_ play_frank_langella_review.html (Accessed 8 April 2023). I realize that the critics whose work I have examined saw various productions, but those in New York, Los Angeles, Chicago, Toronto, and Washington, DC are all North American, in keeping with the focus of this book. 11. Barbara Mackay, “Studio Theatre Introduces Washington, DC, to a New French Play,” TheaterMania, 16 May 2017. https://www.theatermania. com/washington-dc-theater/reviews/the-father-studio-theatre_81103. html and Ben Brantley, “‘The Father’ Examines the Lion’s Mind in Winter,” New York Times, 14 April 2016. https://www.nytimes.com/ 2016/04/15/theater/review-the-father-examines-the-lions-mind-in-win ter.html?_r=0 (Accessed 8 April 2023). 12. Brantley. 13. Jesse Green, “The Father’s Frank Langella ….” 14. Leslie Saeta, “Understanding Alzheimer’s from a Different Viewpoint,” Los Angeles Theatre Reviews, Undated. https://www.los-angeles-the atre.com/theaters/pasadenaplayhouse/the-father-customer-reviews.php (Accessed 8 April 2023). 15. Marilyn Stasio, “Broadway Review: ‘The Father’ Starring Frank Langella,” Variety, 14 April 2016. https://variety.com/2016/legit/reviews/thefather-review-broadway-frank-langella-1201753769/ (Accessed 8 April 2023). 16. Ed Rampell, “Molina on El Molino in a Meditation on Dementia,” Hollywood Progressive. https://hollywoodprogressive.com/the-father/ (Accessed 8 April 2023). 17. Robert Kahn, “Volatile Langella Loses Grip on Reality in MTC’s ‘The Father,’” NBC New York, 13 April 2016. https://www.nbcnewyork. com/entertainment/the-scene/new-york-live/broadway/review-langellathefather/2027181/ (Accessed 8 April 2023) and Harker Jones, “THE FATHER at Pasadena Playhouse Florian Zeller’s Brilliant Play THE FATHER Plumbs the Idea of How Memory Makes Us Who We Are,”
8
18.
19. 20. 21.
22. 23. 24. 25.
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Broadway World, 17 Feburary 2020. https://www.broadwayworld. com/los-angeles/article/BWW-Review-THE-FATHER-at-Pasadena-Pla yhouse-Florian-Zellers-brilliant-play-THE-FATHER-plumbs-the-idea-ofhow-memory-makes-us-who-we-are-20200217 (Accessed 8 April 2023). Brantley; Linda Winer, “Frank Langella Scratches the Surface,” Newsday, 13 April 2016. https://www.newsday.com/entertainment/theater/thefather-review-frank-langella-scratches-the-surface-1.11688469 (Accessed 8 April 2023) and Chris Jones, “In ‘The Father,’ Remy Bumppo Explores the Agonies of Dementia,” Chicago Tribune, 16 February 2019. https://www.chicagotribune.com/entertainment/theater/ct-entfather-remy-bumppo-review-0216-story.html (Accessed 8 April 2023). Pam Morris, Realism (London: Routlege, 2003), 101. Barthes in Morris, 105–106. Bertholt Brecht, “Against Georg Lukács,” in Aesthetics and Politics (London: NLB, 1977), 81, 82. Brecht famously insisted that “petroleum resists the five-act form,” shoring up his assertion that present-day realism (whatever present) cannot be held to standards that prevailed several generations earlier. He was specifically eschewing the realism favored by Lukács, which was that of the mid-nineteenth century European novel. Georg Lukács, “Realism in the Balance,” in Aesthetics and Politics (London: NLB, 1977), 34. Laura Rice, “Why the U.S. and Texas Need to Catch Up.” I was that dramaturg. Ted Dykstra, interview with the author 13 May 2020.
PART IV
Human. Resources.
CHAPTER 9
Memory. Loss. Or, Understanding Memory (for Dummies)
Memory loss is arguably the most salient feature of dementia and, as noted in the Introduction, “the only intellectual function whose measurement had reached adequate development [by] the 1880s.”1 The plays introduced here and discussed at length in the next two chapters deploy dementia to explore different questions about memory. In none of the dramas is dementia in and of itself the playwright’s primary concern, although the characters living with dementia—one in each play—have awareness of their situations and are far from passive, much less complacent, which is to say that they are fleshed out personages with some agency. All three plays depict adult children facing the challenges of caring for a parent with dementia, but memory is put to more complex use than just as a motivation to figure out “how am I going to deal with my parent in cognitive decline in the context of my own woes and needs?” (which is hardly to say that that thorny question is absent). Dementia in at least two of these plays is not really what David Mitchell and Sharon Snyder call a “narrative prosthesis”—a “discursive dependency upon disability,”2 familiarly functioning to enable self-discovery on the part of the “real” protagonists in a work of fiction or by working as a kind of analogy or allegory or prompt. Rather, in these plays, all the main characters grapple with the myriad effects of dementia, but the playwrights train their spotlights on memory, with its particular power and mysteries. (Dementia takes its toll on more than just memory, something explored in earlier © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 D. Chansky, Losing It, https://doi.org/10.1007/978-3-031-20902-4_9
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chapters and again in the final section of the book.) These playwrights pose questions about memory that are philosophical, social, psychological, and existential rather than medical or neurological. And, while one might say the same thing about most of the plays in Losing It, the three in this unit use the words “memory” or “remember” to a greater extent than most of the others.3 The characters with dementia cause other, neurotypical characters to come face to face with beliefs or desires they might prefer to avoid, some of which concern their parent but many of which concern themselves and their own capacities to remember. Audience members may or may not see themselves in the cognitively declining characters; they are, however, almost explicitly exhorted to consider the questions that plague the other characters or that the playwright tosses more or less directly into their laps via any or all of the characters, as these questions are not only about how memory works (or fails) but about how we use it, value it, and, in some cases, abuse it. The characters living with dementia also invite us to think about how we use, value, and abuse the memories and/ or memory functioning of their real-life counterparts. The vernacular understanding of “memory”—thoroughly overturned decades ago but still on the loose at large—is “archival,” i.e., that “our memories exist in some sort of mental library, as literal representations of past events.”4 This view of memory as a kind of file cabinet containing well-organized, reliably incontrovertible records of happenings or people (perfect videos or maybe photocopies) persists, even as a far more nuanced, reconstructive understanding of memory is now widely accepted by scientists and psychologists. “Memories,” explains psychologist and author Charles Fernyhough, “are mental constructions, created in the present moment, according to the demands of the present... [This] is quite a different concept from the idea that memory is a static, indivisible entity, an heirloom from the past.”5 He underscores that “memory is about the present as much as it is about the past.”6 As Daniel Schacter elaborated in 2001, “we bias our memories of the past by attributing to them emotions or knowledge we acquired after the event.”7 The needs of the present, which are not necessarily consciously applied needs, determine the construction of the memory. One might say that the building blocks of past events and people are inside the person, but the way a collection of impressions will be constructed as a bona fide memory—at least the kind of memory having to do with selfhood and events—depends on the moment at which they are tapped. Perhaps one might think of these building blocks as a private Lego set. In an overly
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simple observation, this is why two (or more) people can have radically differing recollections of the same event, no matter how closely the fundamental sensory elements of their respective building blocks might match (although they probably don’t, since both emotion and attention play a role in what gets uploaded in the first place to be remembered later on). Memory is, moreover, as Sven Bernecker argues, adaptive. The needs of the moment at which a memory is summoned shape it—and may even reshape it for future recall.8 As sisters Hilde and Ylva Østby explain, using a metaphor particularly vivid in the context of my study: Our memory is reconstructive and elastic. It is not a PDF we open and reread on a computer, or a camera filled with high-definition images. Memory is more like live theater, where there are constantly new productions of the same pieces…. Each and every one of our memories is a mix of fact and fiction. In most memories, the central story is based on true events, but it’s still reconstructed every time we recall it.9
It is worth noting that once a memory has been summoned, it can ossify into something less like personal recall than like recollection of data, especially with retelling. It can also, of course, continue to be shaped. The remainder of this chapter following the lead-in offers a simplified and preliminary guide to the hard science and some of the social science of memory in the interest of providing usable tools for parsing some of the underlying assumptions and arguments in the plays that are the subsequent chapters’ backbones. If most of the explanations account for the workings of the neurotypical memory, they are also keys to areas of misfiring or failure on the part of characters with dementia(s) in the plays that puzzle or frighten or otherwise challenge most of the scripted characters—those with and without dementia—and probably many audience members encountering them in the experiential or informational dark. The use of memory differs greatly among the next two chapters’ three plays, regarding both questions/conundrums (the “whats”) and themes/dramaturgy (the “hows”). Colman Domingo’s Dot (2016), the only play in this book that features an explicitly African American person with dementia (although, as is clear in my examination of Death of a Salesman, characters in other plays often taken for granted as “white” can be performed by and as African Americans or people of other races or ethnicities in ways that open up additional meanings), features a comfortably middle-class Black woman, Dotty Shealy, transitioning from an early
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middle to a later stage of dementia. Her adult children, the spouse of one, and a longtime neighbor appreciate her, visit her, enjoy her company, and to some extent depend on her—a least emotionally—but it is not clear that most of them are fully aware of either her situation from the inside or the speed at which her decline is on the verge of beginning to snowball. Memory in this play is not simply something the title character is losing; its deliquescence with attendant symptoms is something that she wants her circle to know in a sensory, kinesthetic, personal, concrete way. “Encode this,” she seems to say, regarding her reality. “Fix it in your minds in an unshakeable, indelible way that you can and, ideally, will be activated when you think of me and that will underpin how you treat me going forward.”10 The play takes place at Christmas, and three lines before the curtain line, “Merry Christmas,” Dotty’s oldest child hits “record” as she starts making a tape for her nine-year-old son so he will be able to know and recall the last Christmas the family spent in grandma’s house. “Remember this,” she says. “Remember all of this.”11 In Our Mother’s Brief Affair by Richard Greenberg (2016), the adult children of a woman living with dementia press her to find out “what really happened” one autumn decades earlier during her son’s weekly viola lesson at Juilliard, when she had a fling with a man she had not previously known. The play is constructed as a quest for “the truth,” with the children questioning their mother’s capacity to remember even as they depend on her to fill in gaps in their own understanding. The play leaves open the question of what constitutes accuracy in memory, and it places front and center the overlapping roles of past and present in constructing memories. Is the mother lying (to her children) to conceal something? Is her memory actually faulty (something that some theorists of memory would claim is an impossibility, as a memory that does not reflect objective reality can nonetheless be recalled by a remembering subject)?12 Do the children, twins in their forties, believe they have incontrovertibly proven their mother “wrong” when they find information about her putative lover in a book published long after the affair? How might they understand her own truth (not the same as “the” truth they think they can verify with something like a Google search) better if they were more sympathetic to her present-day needs? This play traffics in the most basic, and arguably banal, understanding of memory—one that regards past events as verifiable and singular even if perspectives on the event(s) differ. Jordan Harrison’s 2014 Marjorie Prime is the most philosophical and subtle of the three memory plays. It is certainly the least realistic,
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as it is set in the future and features human-like entities serving as companionship for their owners and that can be made to look like any deceased person their owner desires at any age the owner elects. While the playwright’s given circumstance for introducing such a non-human companion is the decline of an octogenarian in the late-middle stage of dementia, Harrison poses questions that go well beyond what it feels or looks like to experience problems with recall. Are some things better forgotten? Can memories be rewritten? Are there things we remember but wish we didn’t? Will pretending that something didn’t happen eventually make it fade from memory? And, perhaps most importantly, what quintessentially human things about memory are more nuanced than the accuracy of recall?13
Understanding Memory (for Dummies) Early in Marjorie Prime, the adult daughter of the octogenarian living with dementia confesses “I don’t know how memory works. I think of it like sedimentary layers in the brain.”14 Readers and viewers may draw a similar blank if pressed to explain their own understanding of memory and its operations. The character may be invoking the “xerox”15 understanding of memory destabilized at the start of this chapter, although the playwright may cagily have given her a line with some claim to accuracy, albeit via metaphor. Sedimentary rocks often look like firmly in-place layer cakes of sorts, but there are multiple kinds of sedimentary materials, and sediment is defined in a basic way simply as “material deposited by water, wind, or glaciers,”16 leaving the door open for an interpretation of the character’s loose figurative language that allows for multi-sourced, multisensory material to be deposited by various means without any orderly plan for (re)assembly and not necessarily layered with seeming coherence. The following material provides some basic tools for thinking about memory and its workings, many of which have precisely to do with assemblage. Discussions of the three plays in the next two chapters use versions of these tools. Ultimately, however, the plays are of social and artistic interest not for “getting the science right” (although most of what is depicted can be parsed via medicine and neurology) but for what they posit and/or leave open to interpretation about how we (here meant to encompass non-specialists in neuroscience or neurology) use what we think we understand about memory, especially but not exclusively regarding dementia.
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Simple definitions of memory include, perhaps most succinctly, Paula Droege’s “the present use of past experience.”17 Sarah K. Robins offers the dry but clear “diachronic capacity—the acquisition of information, ideas, or experiences at one time, which is then available for recall at a subsequent time.”18 Psychiatrist Veronica O’Keane proffers “the infinitely complex neural representation of sensory information that has been carried to the brain.”19 O’Keane’s careful articulation of the roles played by both input acquired through the senses and by the brain that processes the input bespeaks the biological emphasis that the newest science uses in understanding memory. And dementia(s). Acting theory has recognized a mind–body continuum for generations.20 The above definitions serve more than one category of memory. One remembers how to do such things as sit, stand, walk, use a knife and fork, drive a car, or play the guitar via the retention of motor skills. This kind of memory, to whose neurological origins people generally do not have conscious access is called “procedural.” Think of the shopworn “it’s like riding a bicycle.” Procedural memory stands in contradistinction to “declarative” memory, which involves cognition (its contents can be articulated) but which itself comes in two forms.21 These two—semantic and episodic—were first defined and explained by experimental psychologist Endel Tulving in 1972.22 Put simply, semantic memory is a memory for terminology or facts or data. Tulving called it “a mental thesaurus,”23 which he further defined as “a system for receiving, retaining, and transmitting information about the meaning of words, concepts, and classification of concepts.”24 The contents of semantic memory comprise anything from vocabulary to mathematical formulae to names of state capitals to the elements in the Periodic Table, and these contents exist outside the person recalling or using them. Episodic memory, in contrast, is biographical and records some facet of the remembering subject’s experience. It is “memory for personal experiences and their temporal relations.”25 Tulving points out that retrieval of semantic information does not alter the remembered information (even if it was erroneous in the first place), while “retrieval as feedback into the episodic system [which itself becomes an episode in the subject’s experience] may lead to changes in the contents, and the retrievability of these contents, of episodic memory.”26 Generally speaking, plays represent characters in cognitive decline losing or scrambling their episodic memories, although the characters in the final chapters of Losing It are also losing semantic and even some procedural ground. Readers with a vernacular understanding of memory have likely encountered such terms as implanted memories, repressed memories, and
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suppressed memories. Many know that people living with dementia often, although not always, have better recall of events or input of any sort from the past (episodic memories or even popular music) than they do of more recent input. Questions about all of these, and more, occur in the plays discussed below, although the concepts are not always directly named, much less defined and unpacked by the playwrights. Also, using only the three broad categories explained in the previous paragraph, one can see how dramas in performance multiply the memory phenomena at play on stage in real time. Actors have to memorize lines (semantic uptake?) and may also create fictional autobiographies, which, even if they don’t constitute events and memories that happened in the past in a real place to an actual human with a birth certificate and blood type, may feel quite authentic to the actors who generated them, which is an argument for a kind of two-tiered actorial episodic memory: the real actor really is likely to remember the events of developing her character (I read three books; I interviewed my aunt; I watched six movies online; I looked at ads in magazines I thought my character might have perused if she were an actual person; I generated a journal), even as the events underpinning the real-time life of the character in performance and in relation to others are events invented (and possibly believed in) by the actor. (When I read that second scene with X, I suddenly grasped why our characters were continually at loggerheads, but it’s not spelled out in the script; we realized it as we embodied and gave life to our characters in rehearsal and explored the relationship in tandem; the emotional experience was palpable and I remembered it thereafter. After we did that rehearsal exercise, I could no longer look at X in character without certain feelings about our fictional shared past.) And, to the extent that actors generally become secure enough in their blocking, physicality, learned dialects, etc. to stop thinking about them consciously in performance, there is procedural memory at work, too. Dual consciousness, Diderot’s paradox of the actor, is largely baked into a well-prepared actor’s conscientiously developed ability to function onstage. So, Actor A has no problem investing in showing love for Actor B (both of them in character and even if they are indifferent to each other off stage), even as Actor A takes the initiative to pick up the pieces of a vase knocked over by Actor C during a performance and having nothing to do with the relationship(s) between the characters (in any configuration of A, B, C) nor with the scripted contents of the scene at hand.
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I have not forgotten the terms introduced at the start of the previous paragraph (and probably neither have you, although they may be in your longstanding semantic memory and available for recall more than they immediately come to mind when I invoke the previous paragraph). They are useful tools in thinking about the three plays discussed in the next two chapters. Implanted memories are memories of events that never happened but are presented as true to people (often subjects in psychology studies) who then claim to recall them as actual events. Sometimes these are simply called false memories, although the latter term may also refer to memories generated by a subject herself based on any number of factors other than externally verifiable events and which might include dreams, reading, imagination, desire, the conflation of a few actual events that were not related at the time they occurred, etc. (This is a key issue in Our Mother’s Brief Affair.) For this reason, I use “implanted” memories for one kind of memory of a fictional event and “false” memory for the other. Implanted memories were a bit of a cause célèbre in the United States in the 1990s, when it was revealed that they were the basis of the testimonies of numerous young children against putative pedophiles who were found innocent of the crimes of which they were accused.27 The children were, arguably, pawns of other adults with an interest in bringing down the accused. Psychologist Elizabeth Loftus incurred the wrath of other psychologists, feminists, and at least one person believing herself to be the (not definitively proven) victim of childhood sexual abuse, for her (Loftus’s) work on such memories.28 Put (overly) simply, our brains absorb, distribute, and create memories from all kinds of input, but they do not instantly know whether the input is “accurate” or not.29 Loftus explains that “there are different ways to store information depending upon the length of time we want it remembered” and that it is necessary to “rehearse” (her word) items in short-term memory— perhaps especially quotidian things—if we want to be sure they are to go into long-term memory.30 Indeed, willing ourselves to remember things is a recognizable memory activity—the sort actress Constance Cummings invoked with regard to learning the “garbled” language in the lines spoken by her character in Wings (Chapter 7)—an endeavor she likened to mastering the multiplication table by rote. Encoding memory this way is, roughly speaking, a matter of repetition combined with focused attention.31 Whether things memorized in this manner obviate or obliterate other things is another question—a question having as much to do with
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the nature of the “things” themselves as with anything else. For instance, if one has been taught that the American Civil War ended in 1935 and then learns that it really ended in 1865, the new information might easily replace the old, at least for purposes of public use, if for no other motivating reason than to avoid embarrassment. Or perhaps the two might co-exist as true and false cousins concerning the same datum. If, on the other hand, one learns late in life that one’s father’s alcoholism was motivated by his physical pain resulting from an accident in his youth, it may be hard to will that information to replace one’s deep-seated recall of the parent as abusive, insulting, and irresponsible. In Freud’s famous phrase, “I know very well, but all the same….” False memories in the realm of the episodic, which may involve other people, can have grave implications, especially in such circumstances as police lineups or courtroom testimony. Repressed memories and suppressed memories are concepts indebted to Freudian thinking—concepts Veronica O’Keane points out receded in credibility “when brain science began to come of age” toward the end of the twentieth century.32 Suppressed memories are those supposedly pushed out of consciousness by a subject wishing to avoid them, while repressed memories are pushed away via an unconscious process. While these are neurologically/scientifically outdated ideas, they are workable fictions in the context of thinking about literature, and they can guide readings of Our Mother’s Brief Affair and Marjorie Prime. Regardless of the type of memory (short term, long term, repressed, episodic), it is important to lay out briefly what should be obvious but often is not: memory is a function of the body, since the brain is part of the body and the brain both receives and then processes the sensory input that provides the initial building blocks for any memory. Memory is wholly dependent on brain function (hence brain impairment on account of dementia is a cause of memory impairment), but memory function can go awry for myriad reasons, including other illnesses, trauma, or injury. Even a well-functioning brain does different things when encoding short-term memory from what it does when it is generating long-term memory. In my off-the-cuff invocation of two people witnessing or experiencing the same phenomenon but remembering it differently on account of putting together their respective memory traces (changes in the brain resulting from something stored/ encoded) in different ways, I did not then but will now add the possibility—hardly an unusual occurrence—of the observed phenomenon being life-altering for one and completely forgotten by the other. (Movie
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fans may recall the moment in 1997 The Turning Point , at which Shirley MacLaine, playing a character who, decades earlier, gave up a ballet career to have children but who has always wondered whether she might have been cast in the leading role that went to her rival, comes face to face with the artistic director who cast the rival in the role. She has thought of the event regularly for years and musters the courage to ask him about it; he says he doesn’t remember it at all.) Using material intended for lay readers by research psychologists Loftus and Schacter and psychiatrist (also a researcher) O’Keane, one can grasp that even a healthy, fully functioning brain is an elaborate—indeed a delicate—kind of mechanism with millions of interrelated parts that can feel to a non-scientist like an endlessly complex Rube Goldberg machine with heart and soul and (perhaps redundantly?) the occasional mind of its own. Input to the brain—the initial components of memories—arrives via the senses (sight, hearing, touch, smell, and taste), with each sense having its own devoted destination area in the cortex, which is the outer layer of the brain. The sensory input travels from the parts of the cortex dedicated to receiving the input to the hippocampi (we have one on each side of our heads and they are located roughly over our ears), where they are put together to form “memory codes.”33 O’Keane explains, however, that information stored in the cortex that never makes it to the hippocampus constitutes memory for many kinds of routine functioning, even though it does not make the grade as material needed for episodic memory. In other words, much of what we need as semantic memory lives in the cortex, and these cortical bits are “difficult to change or rearrange... relatively resistant to... damage.”34 These cortical items serve facets of semantic memory, e.g., knowing words or colors, but they do not in and of themselves build episodic memories. Memories in the hippocampus— the area that processes the input for episodic use—are more or less recent memories; the ones that will become “longterm” go to an area of the brain called the prefrontal cortex, where they come to include concepts of before and after as well as emotional components, i.e., biographical features.35 But short-term memory has limited storage capacity; memories can only stay there for up to twenty seconds.36 This is where we solve immediate problems or store phone numbers just long enough to dial them. As the Østby sisters explain, “it provides only temporary storage. It’s like a mail shelf, where employees are supposed to pick up today’s mail so there’s room for new deliveries. The only difference is that on this mail shelf, if you don’t pick up your mail on time, someone throws
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it out. It is normal to forget in this way. It’s a natural part of having a human brain.”37 The hippocampus—the place where multiply sourced sensory input is put together as a memory—is, along with its adjoining parahippocampal gyrus (brain tissue which surrounds the hippocampus and plays a role in spatial memory and navigation) “among the earliest affected and hardest hit by the senile plaques and neurofibrillary tangles of Alzheimer’s disease, which probably explains why affected patients have such great difficulty remembering recent experiences.”38 If this sounds straightforward (sensory input→cortex→hippocampus →prefrontal cortex = securely created memory for the long haul), why don’t we remember in perfect detail everything we see, hear, taste, touch, or smell? What’s wrong—sort of injury to one of the sensory organs or to the brain—with the Xerox model of memory? (Again, this is a question regarding a neurotypical brain.) For one thing, as Loftus explains, we may fail to create a memory for such reasons as the following: “The thing we wish to remember didn’t last long enough for us to absorb it; it lasted long enough but we didn’t notice it; or we noticed it but didn’t pay sufficient attention to ensure it would make its way into long-term memory.”39 Both Marjorie Prime and Dot take up questions of what we might call attentive encoding. Our Mother’s Brief Affair could be read as a cry of frustration for the very human failing to accept that memory is mutable in myriad ways, even if we wish that the one person who was, regarding an event in the past, “really there” could settle for us once and for all what truly happened. She may be able to settle it (at least for herself) from her own perspective, but what she offers may not be what would be understood to have occurred had there been something like footage from multiple security cameras to record the event(s) in question. Or she may confess what really occurred and yet leave her interlocutors unsettled or angry or confused or wishing they had never asked. The Primes (the human-like entities available for purchase and programming) in Jordan Harrison’s play do have the perfect ability to absorb on first encounter exactly what their surrounding humans tell them. Yet they are only repositories of the past to the extent that the humans talking to them are. Which is to say that the Primes can record anything (including items fed to them that may not objectively reflect what happened) but they can judge, feel, or infer next to nothing. And if the data fed to them in conversation is itself faulty or incomplete, they encode it that way (to perfection) anyway.
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Memory is, of course, recall, but it is not a singular thing and most certainly not a tidy compilation of “accurate” factoids. Dementia invites thinking about what is lost and what remains for people who live with any one of the cognitive decline’s iterations. If neurotypical theatregoers or readers equate being human with having infallible gigabyte memory storage coupled with flexible thinking, these plays ask us to rethink what we think about memory (the above sequenced equation being, of course, wholly wishful thinking and therefore, maybe the first thing needing to be overturned). They also serve as prompts to contemplate the connections between the importance of forgetting and the healthy functioning of memory.40 In the previous paragraph, I quoted the Østbys’ mailroom shelf analogy. There’s just so much room in short-term storage and if we don’t forget some things, we would be overwhelmed by the glut of nonstop everyday input (every billboard, every car that goes by, every overheard utterance, every advertising jingle, the details of every news broadcast, every item on the shelves in the bathroom, the contents of every meal, every pair of socks encountered in the drawer whence we pull out just one for the day, etc., etc., etc.) that we would be unable to function. But in a more ruminative sense, forgetting certain things— generally painful personal memories or events—can be restorative. In this sense “forgetting” may or may not mean total erasure from recall. It may mean a kind of minimizing or backburnering or resituating or recalibrating, a notion Lewis Hyde explodes and explores in A Primer for Forgetting.41 When we use the commonplace “forgive and forget,” we are not necessarily (or not literally) advocating the complete erasure of a memory, but perhaps more its defanging and placing out of immediate sight. Consider the fairly ordinary instance of people with a loved one living with dementia who say they prefer to “remember them as they were.” Is this not a kind of self-willed erasure of short-term memories? Of course, whether it serves the person living with dementia in the present is a wholly different question. I recognize that I have combined a very small amount of biology and neurology with an equally small amount of knowledge in experimental psychology and tried to make this material intelligible via the philosophy, arts references, and analogy that will likely be more familiar to my readers. One of the three plays that follow, Dot, does name its character’s dementia as Alzheimer’s. To date, Alzheimer’s can still only be definitively diagnosed in an autopsy, although the most recent forms of testing can help physicians rule out other illnesses, but the combination of specific episodic
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memory and navigational/spatial problems (damage in the hippocampus and parahippocampal gyrus) mean that a nexus of recognizable symptoms can prompt an informed medical (clinical) opinion for which the formal clinical diagnosis—the one given to living patients and their families— is typically “‘possible’ or ‘probable’ dementia of the Alzheimer type.”42 The other two plays—like those in the rest of this study that depicts cognitive decline resulting from disease and not strokes—do not specify a diagnosis. For purposes of examining the boots-on-the-ground experience of dementia and the many ways we think about memory, a particular diagnosis is largely unimportant.43
Notes 1. G. E. Berrios and H. L. Freeman, “Dementia Before the Twentieth Century,” 9–27 in Alzheimer and the Dementias, ed. Berrios and Freeman (London: Royal Society of Medicine Services Limited, 1991), 27. German philosopher Hermann Ebbinghaus first demonstrated in 1885 that most forgetting happens after something is first input to memory and slows down as time passes. 2. David Mitchell and Sharon Snyder, Narrative Prosthesis: Disability and the Dependencies of Discourse (Ann Arbor: University of Michigan Press, 2000), 47. 3. Wings may be an exception to this statement, but it differs from the plays in this chapter in that it is almost relentlessly focused on the medical journey of a single character, albeit a journey involving her memory. In no way is Wings a family drama. Regarding the use of the word “memory” (or its derivatives), The Father has an almost annoying number of imperatives to “remember” or “don’t you remember” questions directed at its title character. These are blunt-edged, often self-serving, even naïve uses of “remember” and not in the same register as the uses of memory in the plays in the next two chapters. 4. Rachel Aviv, “Past Imperfect,” 28–39 in The New Yorker (5 April, 2021), 28. See, too, Daniel L. Schacter and Donna Rose Addis’s, “Constructive Memory: The Ghosts of Past and Future,” in Nature, Vol. 445, No. 7123 (4 January, 2007): 27. https://doi.org/10.1038/445027a. 5. Charles Fernyhough, Pieces of Light: How the New Science of MEMORY Illuminates the Stories We Tell About Our Pasts (New York: HarperCollins, 2013), 5. 6. Ibid., 7. 7. Daniel Schacter, The Seven Sins of Memory: How the Mind Forgets and Remembers. (Boston: Houghton Mifflin, 2001), 9.
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8. Sven Bernecker, “Memory and Truth,” 51–62 in The Routledge Handbook of Philosophy of Memory, ed. Sven Bernecker and Kourken Michaelian (Abingdon and New York, 2019). 9. Hilde Østby and Ylva Østby, Adventures in Memory: The Science and Secrets of Remembering and Forgetting (Vancouver: Greystone Books, 2018), 63. Ylva Østby is a clinical neuropsychologist who researches memory; Hilde Østby is a journalist and novelist. Both sisters live in Oslo. 10. For encoding and a discussion of the items or bits or images that are knit together to yield later memories, see Sarah K. Robins, “Memory Traces,” 76–87 in The Routledge Handbook of Philosophy of Memory. 11. Colman Domingo, Dot (New York: Samuel French), 106. 12. Jordi Fernández states that “strictly speaking, there is no such thing as a false, or incorrect, episodic memory [the kind of memory involving recall of past events in the life of the one remembering]” (“The Intentional Objects of Memory,” 88–99 in The Routledge Handbook of Philosophy of Memory, 90). Psychiatrist Veronica O’Keane asserts unambigously that “‘true’ event memory is a contradiction in terms” (A Sense of Self; Memory, the Brain, and Who We Are [New York: W.W. Norton & Company, Inc., 2012], 207). See my brief discussion of implanted memories and items in endnote 17. 13. Daniel Schacter’s Seven Sins of Memory, a synoptic exploration of how memory both serves and frustrates us—an exploration intended for lay readers—might answer yes, yes, yes, maybe, and that our species-specific hardwiring to forget, to transpose, to misattribute, to adapt, to revise and to blend fact with imagination as the normal course of things is what separates us from databases. 14. Jordan Harrison, Marjorie Prime (Samuel French, 2016), 18. All page numbers are from this edition. 15. Bernecker, 60. 16. https://www.merriam-webster.com/dictionary/sediment. 17. Paula Droege, “Memory and Consciousness,” 103–112 in The Routledge Handbook of Philosophy of Memory, 104. 18. Robins, 76. 19. O’Keane, A Sense of Self , 25–26. 20. See Joseph Roach, The Player’s Passion: Studies in the Science of Acting. 21. See Markus Werning and Sen Cheng, “Taxonomy and Unity of Memory,” 7–20 in The Routledge Handbook of Philosophy of Memory. 22. Endel Tulving, “Episodic and Semantic Memory,” 382–402 in Organization of Memory, ed. Endel Tulving and Wayne Donaldson (New York: Academic Press, 1972). 23. Ibid., 386. 24. Ibid., 402. 25. Ibid., 401–402.
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26. Ibid., 391. 27. Schacter devotes part of The Seven Sins of Memory to this in a chapter on suggestibility, which he defines as “an individual’s tendency to incorporate misleading information from external sources—other people, written materials or pictures, even the media—into personal recollections” (113). The section is “Suggestibility in Preschool” (130–137). 28. See Rachel Aviv, “Past Imperfect”; and Cara Laney and Elizabeth Loftus, “Traumatic Memories are Not Necessarily Accurate Memories,” The Canadian Journal of Psychiatry, Vol. 50, No. 13 (November, 2005): 823–828. 29. The Østby sisters report in their study that MRI scans show that “when we imagine something, the activity in our brains is similar to what it would be when we experience the same thing in real life. Imaginings, memories, and false memories actually behave quite similarly in our brains,” adding that “it is only how our brain sorts things under the labels of ‘true’ or ‘not true’ that determines what’s what. A real memory is a form of imagining— an imagined reconstruction. False memories make use of memory’s natural laws, however irrational they seem. A false memory moves, in some way, from imagination to memory and is suddenly seen as something real. It steals a label that says ‘true’” (64). 30. Elizabeth Loftus, Memory: Surprising New Insights into How We Remember and Why We Forget (Reading, MA: Addison-Wesley Publishing Company, 1980), 13, 16. 31. In a phenomenon one team of researchers calls “inattentional blindness,” we often fail to remember in any detailed or specific way items that we encounter daily, such as the images or words or the placement thereof on coins or banknotes, or, for that matter, perhaps the faces and other personal characteristics of the barrista at the local coffee shop or the man who delivers the mail. (See Alan D. Castel, Michael Vendetti, and Keith J. Holyoak, “Fire Drill: Inattentional Blindness and Amnesia for the Location of Fire Extinguishers,” 1391–1396 in Attention, Perception, and Psychophysics (Vol. 12, 2012). See, too, Adam B. Blake and Alan D. Castel, “Why We Can’t Remember the Things We Most Often See,” Psychology Today, 3 March, 2015, where the authors introduce the catchy term “attentional saturation.” https://www.psychologytoday.com/us/ blog/metacognition-and-the-mind/201503/why-we-cant-remember-thethings-we-most-often-see (Accessed 6 June 2023). 32. O’Keane, 209. 33. Ibid., 54. 34. Ibid., 60. 35. Ibid., Chapters 2–4. 36. Østby and Østby, 107; Schacter, 27–28.
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37. Ibid., 108. “Working memory” and “short-term memory” are sometimes used interchangeably. In a 2018 article, three neuroscientists differentiate the two, with working memory involving more than short-term storage. Rather, working memory “is a multicomponent system that manipulates information storage for greater and more complex cognitive utility” and involves interplay with longterm memory to get immediate things done. (Wen Jia Chai, Aini Ismafairus Abd Hamid, and Jafri Malin Abdulla, “Working Memory From the Psychological and Neurosciences Perspectives: A Review,” in Frontiers in Pyschology [27 March, 2018]. https:// www.frontiersin.org/articles/10.3389/fpsyg.2018.00401/full) (Accessed 8 April 2023). 38. Schacter, Seven Sins of Memory, 24. 39. Loftus, Memory, 74. 40. Schacter posits, in the final section of The Seven Sins of Memory, that types of forgetting are essential to our functioning and well-being and have evolved in the interest of survival. His is a neurological, or at least a biological, argument. 41. Lewis Hyde, A Primer for Forgetting: Getting Past the Past (New York: Farrar, Straus and Giroux, 2019). Hyde’s argument, in contrast with Schacter’s, is about the importance of forgetting as a socio-cultural and individual psychological facet of creating communities, nations, and sometimes just functioning selves. 42. Marianne Boenink, “Biomarker for Alzheimer’s Disease: Searching for the Missing Link Between Biology and Clinic,” 63–82 in Emerging Technologies for Diagnosing Alzheimer’s Disease: Innovating With Care (London: Palgrave Macmillan, 2016), 70. See, too, Anna Laura van der Lann’s, “Emergent Biomarkers and Good AD Diagnostics,” 103–122 in Emerging Technologies, especially pages 103 and 107–108. 43. In my personal experience, reactions to my husband’s cognitive decline fell into some repeated (predictable) categories. Nearly everyone wanted to know a diagnosis. (It was very late in the game before we had one, but it made zero difference in terms of experience in the trenches or possible medical relief.) If I could not confirm that he had Alzheimer’s (he did not), some people assumed that, well, it couldn’t be that bad. (It was.) Once we knew that it was Progressive Supranuclear Palsy, some either lost interest, registered confusion, or, again, figured that it wasn’t Alzheimer’s, and nothing could be worse than Alzheimer’s. (For a personal story—not mine—about Progressive Supranuclear Palsy, see Tom Coughlin, “Nothing Could Prepare Me for Watching My Wife Slip Away,” New York Times, Opinion guest essay, 25 August 2021. https://www.nyt imes.com/2021/08/24/opinion/tom-coughlin-wife-psp.html [Accessed 8 April 2023]).
CHAPTER 10
Family Affairs
Sign on the Dot(ty)ed Line Colman Domingo’s play Dot takes place in the West Philadelphia house of African American, widowed mother of three—Dotty Shealy—in the forty-eight hours that conclude on Christmas morning. The time is presumably the present (2015), with the world of the play anchored by such references and objects as pinging cell phones, YouTube fame, Craigslist, Skype, and the decline of print journalism. Dotty has been diagnosed with Alzheimer’s disease the previous year, but we are not immediately told this directly. Rather, as the play opens, we see her at the breakfast table with her frazzled eldest daughter, forty-five-year-old Shelly, who is drinking watermelon vodka at ten a.m., frustrated by her mother’s endlessly repeated questions. Shelly is a lawyer, a single mother by choice, and the only one of three adult siblings who seem to grasp— or at least acknowledge—the extent of her mother’s decline. She hopes that her brother, “golden boy” Donnie, will participate in their mother’s care, at least financially, but he has not taken her phone calls of late, which portends a confrontation when he arrives for Christmas. In this opening scene, Shelly begs her mother to sign a document and says twice “on the dotted line.”1 Another character, Jackie, is a forty-year-old white woman who grew up with Shelly and Donnie, has moved to New York, and is visiting her childhood home (although her parents are deceased) as she re-assesses her life and options in the face of a dead-end career and © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 D. Chansky, Losing It, https://doi.org/10.1007/978-3-031-20902-4_10
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an unwanted pregnancy by a married man. She provides motivation for the revelation of the diagnosis when something about Dotty seems “off” and she initiates the gentle questioning that prompts the conversation in which Shelly admits to giving her mother sleep medication when the situation is too much for her to handle and that she has hired a part-time caregiver who is an undocumented immigrant from Kazakhstan. Jackie dated Donnie in high school. She has long since known he is gay and married to someone else, but her questions to Shelly about other details of his life function for the audience as a source of backstory about him. Donnie and his husband, Adam, who is white, arrive late that night. They are doing a juice cleanse, but Donnie is ravenous and sneaks food from his mother’s refrigerator. In various groupings of characters, Donnie makes clear that his career as a music critic for print outlets is evaporating, that he cannot help with his mother’s care financially, isn’t willing to move back to Philadelphia, and that he and Adam are quarreling about their future together. Shelly explains the extent of their mother’s illness and proposes looking into a care facility, something Donnie resists. The end of the first act is punctuated by the arrival of the third and youngest sibling, Averie, who is loud, vulgar, and did not go to college; was briefly a YouTube sensation; is living in her sister’s basement; and currently works as a grocery store cashier. In the second act, which takes place the day before Christmas, we meet Fidel, the caregiver from Kazakhstan, who is solicitous of “Mrs. Dotty” and is possibly the only character who meets her where she is and with empathy. Dotty is looking at old photographs and confesses to Fidel that she is scared. She also tells her version of her life with her husband, Richard, who insisted on a honeymoon in England and sending the three children to private schools. Dotty seems to have worshipped Richard, but she believes private school made the kids “uppity,”2 noting that she herself went to public school and turned out fine. She refers to her immediate family as “working-class people”; she got Shelly to school at seven a.m. because the family depended on the school’s free breakfast program. We learn that Dotty was a powerful and respected community activist and started her working life as a cashier in a university cafeteria. She also notes the decline of the neighborhood, where she has lived since the 1950s and which suffered “white flight” in the 1970s. When Jackie arrives later on Christmas Eve day, Dotty confesses in a scene between the two to the Alzheimer’s diagnosis and Jackie says she is “so sorry.” Dotty replies: “This is EXACTLY why I don’t tell people.”3 This is arguably a
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clue to something the playwright would like us to think about, but none of the two dozen reviews I read of productions in five cities took note of this reference to stigma. At the end of Act One, Averie bursts in with a bucket of chitlins to add to the Christmas dinner menu.4 The penultimate scene of the play takes place on Christmas Eve. Although Shelly and Donnie have put the kibosh on Adam’s suggestion that they open just one present on Christmas Eve to lighten the mood, it turns out that Dotty has gifts she would like her children to open right then. While she exits to retrieve them, Shelly engineers a family meeting among the siblings (and Adam). Averie insists that while white people put their elders in assisted living, “WE DON’T DO THAT!”.5 Dotty returns with Fidel and hands out gifts that surprise the children: goggles, pebbles, latex gloves, headphones, and tape. She and Fidel have found a dementia simulation game, and Donnie agrees to play. When wearing the goggle, headphones, and latex gloves with his fingers taped together and with pebbles in his shoes, he finds himself unable to retrieve a few items (a sweater, a Christmas ornament), to put some wrapping paper on a table, and to pour a glass of wine, as he stumbles, cannot see clearly where he is going, and can’t think with the persistent noise in his head. This is what Dotty wants her children to grasp and remember: her existence is proscribed by diminished sensory capacity (because of diminished brain function), but it is still their mother who is there with them. At the end of the scene, after he calms down a bit, Donnie fulfills his mother’s request to play the piano, something he claims he didn’t remember how to do. Donnie also claims to have forgotten the upcoming holidays when he agreed to a juice cleanse on the dates proposed by Adam. These two instances of a neurotypical character forgetting things of two different sorts are subtle reminders that while dementia indeed affects memory, memory is always what we might call mischievous or capricious, or simply not wholly predictable or programmable. In the final scene, on Christmas morning, the Shealy sisters finally pay a little attention to Fidel and grasp the implications of his undocumented status. He has been unable to return to Kazakhstan for nine years because of his history of political activism. Averie announces that she will move out of her sister’s basement and into her mother’s house to provide caregiving and assistance. Shelly begins recording for her nine-year-old what she calls “our last Christmas all together as the family that you know.”6 (106). She whispers, “remember this” into the machine, before everyone yells “Merry Christmas” and curtain falls.
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The two instances of a character insisting that one or more other characters “remember” are, obviously, the game of “virtual dementia experience”7 and starting the Christmas morning audio tape. Before I unpack how these particular moments do their work, I want to talk briefly about how the play overall does its work and how critics read that work. Domingo’s depiction and discussion of Dotty’s Alzheimer’s are credible. The character is confused about what day and time it is; she leaves food to burn on the stove; her daughter has taken away the car keys. She misrecognizes her son-in-law, Adam, taking him briefly for her late husband. Clinical tests for dementia can measure recall and recognition.8 Dotty’s confirmation of the effects on Donnie of using the prescribed items in the purchased virtual dementia experience kit suggests that balance and spatial orientation have also become issues. All of this jibes with the damage to the hippocampi and parahippocampal gyrus that are regularly seen in Alzheimer’s. Dotty has been prescribed Donepizil (often sold as Aricept), a drug that postpones the symptoms of Alzheimer’s but neither cures the disease nor prevents its progression. (Some see this drug as merely staving off the inevitable, arguing that the money spent on it— especially at government or insurance company expense—would be better spent on caregiver support or patient services.9 ) The play tells us nothing about medical follow-up or advice. Anna Laura van der Laan discusses two schools of thought regarding diagnosing Alzheimer’s (with implications about follow-up). One, which she calls “pulling out all the stops,” aims to get close to a high level of etiological (denoting a cause) accuracy in a living patient. It involves a lot of testing, which, for a patient with resources and willingness, can nowadays include brain scans and even an analysis of cerebrospinal fluid. The other school of thought, which she calls “holding back,” is often used by general practitioners (also by neurologists) who focus on articulating care needs and do minimal testing.10 Dotty seems to be experiencing a little of both kinds of assessment and treatment. It is worth repeating that a definitive diagnosis of Alzheimer’s is at best highly informed speculation. This character certainly has dementia, but the playwright is not interested in the method of diagnosis or in medical follow-up.11 “Alzheimer’s” provides a recognizable placeholder guaranteed to elicit shock or sympathy or fear. Dotty’s older daughter is the one who has taken her to a doctor and has probably filled the prescriptions. Averie’s insistence that Black people care for their own at home and that a facility is out of the question meshes with research suggesting good
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reasons for African Americans to distrust dementia assessments. These too often largely rely on instruments developed for and by whites, frequently with insufficient adjustment for racial and socioeconomic differences.12 For audience members with even minimal knowledge of dementia, either from first-hand experience or from the media, the setup—including the opposing approaches of the two daughters—is relatable. African Americans have a higher prevalence of dementia than Caucasian American elders; they also have a higher incidence of comorbidities (other diseases along with dementia), such as diabetes or hypertension.13 We learn that Dotty needs to watch her cholesterol to preserve her heart health. Poor nutrition in childhood and/or lack of financial resources can contribute both to developing dementia and, in the case of African Americans, to being misunderstood or written off, and therefore misdiagnosed. Here the playwright seems to want to have it two different ways. Dotty is listed in the script as being sixty-five. If the play is set in the present— roughly 2015—she would have been at most in grade school when she and her husband supposedly moved to this house “in the fifties,” and ten years old when she became politically active, if, as Shelly says, she “campaigned for every primary since 1960.”14 Domingo combines a past of extreme material and nutritional deprivation—something often starkly (although not inevitably) typical of an African American born in the 1930s or earlier, often (but not exclusively) in a rural location—with a present that allows for references drawn from popular culture and that situates Dotty in a relatively comfortable urban world, especially as the wife of a doctor. It makes a kind of “if you don’t look too closely” sense as a patchwork of familiar African American cultural history commonplaces.15 Again, though, “relatable.” I would argue that Domingo is also canny about addressing both Black and white audiences. Averie’s key scene is titled Sl(Averie) in the script, and the playwright uses it to underscore a heritage of eating slave food (the chitlins; there is also a reference to collard greens) and of understanding slavery and its legacies not from studying in school, but “from LIFE! From LIVING.”16 In a spat between Shelly and Donnie about who is more traumatized, Donnie wins the argument with “I’m a black man in America. I OWN trauma” (49). Some of the fast-paced humor, recognizable tropes (widowed matriarch, domestic setting, adult children home for Christmas, money problems, absent fathers, “come to Jesus” moment) call to mind the sort of theatre that populates the Chitlin Circuit. Taking its name from the slave food, the Chitlin Circuit, possibly the context in
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which theatre followers unfamiliar with the food know the word, was a touring route of music and theatre venues set up in the 1920s, in the age of Jim Crow segregation, and frequented for many decades by African Americans seeking material that spoke to them, “sophistication” be damned. It was for years ignored by white theatre critics and scholars even as it turned a profit for its producers and delighted audiences.17 Actor/writer Tyler Perry got his start writing highly profitable plays for these venues. His movie character Madea exemplifies the stereotypical but recognizable strong Black woman with an impoverished background and a badass attitude who anchors plays featuring drugs, guns, unplanned pregnancies, and young grandmothers raising their children’s children. Chitlin Circuit audiences simultaneously judged and forgave, laughed, and cried.18 At the same time, Domingo is sure to make a typical white audience (educated, upper-middle-class) comfortable, limning the Shealys as a family whose paterfamilias was an M.D., his widow a liberal political activist, their two eldest children an attorney and a musicologist, the son having been accepted at the prestigious Wharton business school of the University of Pennsylvania. Donnie and Adam have regularly rented a summer house on Fire Island, all of these shoring up the family’s liberal and financial bona fides. Shelly’s and Donnie’s given names are Michellene and Donatello. Donnie had piano lessons, Shelly had ballet. The living room boasts a baby grand piano and the ceiling is high enough to accommodate a nine-foot-tall Christmas tree. Domingo also indirectly suggests that Dotty is not only a mother to her three Black but a mother figure to the three White adults in the play, as Adam is present at the family meeting (Dotty calls him “my Adam” and he calls her “Momma Dotty”), Jackie is invited for Christmas Eve dinner (a meal her family has always shared with the Shealys), and Fidel—who is the young adult Dotty appears to trust the most—is spending Christmas Eve and Christmas with the family, even though he is only paid to work alternate days of the week. Presumably, everyone can relate. Dot had productions in Philadelphia, Baltimore, St. Louis, Atlanta, New York, and Austin (Texas) following its premiere at the Actors Theatre of Louisville in 2015. Few reviews address the script’s intellectual or philosophical challenges, although all reviewers responded to emotional effects, albeit not uniformly. In referencing reviews of productions in several cities, I avoid detailed analyses of directorial issues regarding such things as pacing or vocal cadence or stage pictures or even casting. Rather,
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I focus on structure, events, dialogue, setting, characters, topic(s), and specifically scripted behaviors such as dancing, whispering, stumbling, working hard on concentrating, etc. Most reviews fulfill the not inaccurate but sort of flatfooted headline of Charles Isherwood’s review: “In ‘Dot,’ A Fading Matriarch Brings a Family Together,”19 or the slightly livelier headline of Frank Scheck’s: “A family copes with its matriarch’s worsening dementia in this comedydrama written by ‘Fear the Walking Dead’ actor Colman Domingo.”20 Most read the play as a decline narrative with a flourish of uplift at the end. Several use the word “sitcom,”21 with one laying out why this mode does not serve the presumed purpose of the play: “much of the power and poignancy are lost in the layers and layers of jokes, and some over-the top characterizations evoke a TV show requiring a laugh every 20 seconds.”22 Countering this, at least five reviews are anchored by “authentic,” “realistic,” or “real,” with one calling Dot “a middle-class, African American slice of life.”23 Several reviewers straddled the fence with an iteration of “uses comedy and pathos.”24 Words such as “tragic”25 vie with “farce.”26 Sometimes both seemingly oppositional descriptors appear in the same review.27 One reviewer politely observed that the “blend between the broad comedy and the moments of poignancy... isn’t a smooth one.”28 A few found the plot “messy,”29 objecting that Dotty’s story gets sidelined or lost in the many subplots,30 with one complaining that the play “feels too long and too diffuse,”31 and another noting narrative “shagginess.”32 Regarding dramaturgical “clutter,”33 four writers wondered why Jackie was in the play at all.34 One reviewer found the second act (Christmas Eve, the dementia simulation game, Averie taking responsibility) “superior,”35 while another found the simulation game the “nadir” of the play’s scenes.36 Two reviewers and one study guide provide information about African Americans and about Alzheimer’s (and about African Americans and Alzheimer’s).37 Most writers saw some iteration of “a familiar kitchen sink drama,”38 with the presumably scary label of Alzheimer’s and the need for the adult siblings to be honest with each other foreclosing the possibility of discussing pretty much anything else that might be packaged in an embodied rendition of this script. One simply (or simplistically?) concludes that the play “shows the strength of family—and ultimately how love is the cure all.”39 Is there anything the reviews ignore? I return here to the two moments of “remember” to say that there is, that these moments deal with specific kinds of memory, and that it is possible to parse and value the work these
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moments do in terms of affect and effect, even if (one thinks) they traffic in “sentimentality.”40 In the final moments of Dot , Shelly starts the tape recorder and speaks to/for the sake of her nine-year-old son Jason, saying that this is “the moment before you come down on Christmas Day. Our last Christmas all together as the family that you know.” She underscores her point by saying “Remember this. Remember all of this.” The imperative she utters is a bid for a prospective memory, a term used “to describe remembering to do things in the future.”41 Or, whether or not Jason will “do” anything with these proposed memories, his future thoughts regarding the tape and the day are, for good or for ill, instances of “episodic foresight.”42 What is deceptive here is that “this”—the Shealy family gathering of matriarch, adult children, family-like guests, and a grandchild—will almost certainly not look to nine-year-old Jason the way it does to his mother, either now or in the future. Importantly, since the curtain drops on an increasingly foggy Dotty (“the look on her face is uncertain,”43 says the stage direction, and she has mistaken Jason a page and a half earlier for the boy who delivers her newspaper), it may turn out to be an upsetting day for the child and a potentially weepy one for the adults. Shelly wants him to encode a lasting memory of the day; there is no assurance either that he will or that if he does, it will constitute the memory she wishes. That Jason never actually appears in Dot is significant. If one interprets children in a play as embodiments of a future, their absence can be read as trouble or death or stasis for the characters or social world being depicted. Shelly may be speaking to herself as much as she is to Jason, but, again, what she tapes and what she remembers may be two different things. She is also speaking to the audience—a point to which I return at the end of this section. I read this scene as the play’s denouement. Its climax is the “virtual dementia experience,” set up by Dotty, administered by Fidel, involving Donnie as a voluntary participant, and observed by all the others. Characters and audience alike are enjoined to witness, and in Donnie’s case to inhabit, the bodily, sensory, and emotional experience of living with dementia. The scene is noisy, fast-paced, and tense. It creates a mess of dropped, spilled, bumped into, and knocked over items on the stage. It shuts down the festivities, as Donnie panics and then abandons the accoutrements of the game, traumatized, and Dotty says “you see?” shortly before the stage directions say she “just smiles and stares off into space.”44
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The purpose of the scene is to force both characters and audience to understand what Dotty is living with. Its method is not discourse or argument, but rather embodiment. The understanding for which it aims is affective, not verbal or cognitive. As Erin Hurley succinctly observes in Theatre and Feeling , “the whole enterprise of theatre is geared to the perceiving body.”45 The scene is constructed to arouse response at a somatic level, the body and its sensory abilities being the source of emotions and memories. The play is tasking its characters and its audience with recognizing and honoring bodily remembering, which might emerge as procedural memory (I know how to navigate this because I’ve done it and laid down the neurological tracks for it, which means I don’t have to think about it, and which is what we now see is fading for Dotty46 ) or a semantic memory (I know and can identify the list of symptoms and characteristics; I’ve seen them, memorized the list, and can readily recall what’s on it, which is what Dotty would like the others to do and perhaps what Domingo would like us to do); or an episodic memory (I remember the time when …). The scene uses simulation to create new knowledge. In his study Simming: Participatory Performance and the Making of Meaning , Scott Magelssen looks at participatory events created to “produce a new narrative or experience, versus simply reproducing an original.... [S]immings [his term for such events] reflect intended perceptions of a time and space more than they can promise to ‘capture’ any of its true contours.”47 One of his chapters investigates projects that allow participants to experience the aging body via weighted garments, filmy or otherwise blurred glasses or goggles, and pads that restrict joint mobility. Magelssen, then in his thirties, tried out several of the prosthetic impediments and found himself sweating, anxious, and awkward as he attempted to undertake some ordinary tasks while so accoutered, observing that “the body itself is the very site of these meaning productions.”48 The outcome of such experience, however, may or may not be positive empathy—the presumed desideratum. Some young people exposed to the experience of elders vowed that they never wanted to be old.49 Embedding the simulation in a play adds personality and narrative investment to the experience. The “virtual dementia experience” in Dot is based on an actual simulation project that was the subject of an ABC news story. A female reporter and a middle-aged man dealing with his mother’s dementia donned the same goggles and headphones as Donnie, and their rubber-gloved fingers were taped together. They were then to perform
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five very simple tasks within a set time while being bombarded with highvolume cacophony through the headphones.50 (Simulators have their tactile, aural, and visual sensory capabilities restrictively adjusted; and the pebbles Donnie puts in his shoes create not just pain but imbalance.) While the ABC participants’ frustration and panic are credible, viewers don’t “know” the middle-aged Texan being profiled or the reporter, and the Texan’s confused mother is not coiffed, made up, dancing, possessed of an enticing backstory revealed in the proceedings, or cracking jokes as the character of Dotty is. How does the dementia game in Dot do its work? Scholars investigating the efficacy of watching bodies in motion and thereby gaining new understanding(s) or awareness or perspectives use the concept of “kinesthetic empathy” to explain how bodies act on other bodies, especially when the ones doing the acting are unusual, either differently abled or trained as dancers or acrobats or athletes or actors in performance. One definition of kinesthetic empathy is “the feeling of sharing another person’s movement, or vicariously experiencing another person’s movement simply by watching,” or more succinctly, “automatic, involuntary, kinesthetic response of one body to another.”51 Dee Reynolds argues that. it is more appropriate to think of empathy in ‘affective’ rather than emotional terms. Affect … can be understood as embodied and as preceding the kinds of cognitive differentiations that separate out emotions into distinct and identifiable categories (such as happy, sad et.). Affect denotes a stage where emotions are still in the process of forming and have not yet taken on a definable identity; indeed, they resist such definition. In terms of embodiment, affect refers to that point at which the body is activated, ‘excited’, in the process of responding; but this process has not yet reached consciousness to the extent of producing cognitive awareness that can be translated into language.52
Donnie has had an opportunity to watch his mother, but either because of what she is successfully hiding or because he is unable to recognize the limits of his own kinesthetic empathy when not forced to pay attention (much less get his senses and body directly readjusted and focused— recall the phenomenon of inattentional blindness noted in the previous chapter), Dotty decides it is necessary to up the stakes by forcing him into a collection of restraints to which he must submit corporeally (Fig. 10.1).
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Fig. 10.1 Dot, Vineyard Theatre, 2016 (Pictured, left to right, Marjorie Johnson [Dot], Finnerty Steeves [Jackie], Sharon Washington [Shelly], Michael Rosen [Fidel], Stephen Conrad Moore [Donnie], and Colin Hanlon [Adam]. © Carol Rosegg)
The restraints in the simulation are neither metaphorical nor ideological. He learns what it feels like to have noise in his head, aching feet, poor balance, and an inability to remember a series of simple assignments (executive functioning). Kinesthetic empathy proposes that, even as we watch Donnie, “we are always limited by our own first-person experience.... When we watch another’s movement, what we simulate is our own experience of the movement, not the experience of the other.”53 We might wince, as people often do when watching others fall or cut themselves or bump into things. But we might need an extra step in achieving empathy rather than ignoring what is before us. Our own experience of walking to a closet to retrieve a garment or to a Christmas tree to pluck off an ornament is presumed to be, whether accurately or not, pain-free and unimpeded by such things as mistaking the front door for the closet door or being unable to distinguish a blue sweater from a black jacket. As Donnie stumbles, opens the wrong door, throws the wrong garments
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on the floor, and nearly knocks over the tree, we understand his pain and frustration both because his experience is like ours and because it is not. As Wanda Strukus notes, “the automatic experience of kinesthetic empathy is very likely a factor in how we understand and experience both physical difference and physical similarity.”54 But “pivotal to empathy,” writes Amy Cook, “is not a merging of self and other but the recognition of separation.”55 The moment is both illusionistic and distanced, Stanislavskian and Brechtian. It works either way, if we are paying attention, because “we understand others’ bodies and their actions through our own bodies... [V]iewing actions of others resonates in the areas of our brains that create our own actions,” as psychologist Barbara Tversky explains.56 The bodily discourse of the “dementia experience” is deployed along two axes. Borrowing from narrative theorist James Phelan’s idea of unresolved or discussed differences in a piece of literature, the terms “instabilities” and “tensions” denote, respectively, “unstable relations within story” and unstable relations “in discourse.”57 In other words, here Dotty (within the play) is addressing her children in the interest of getting them to walk a mile in her shoes; the characters’ differing perspectives are instabilities. Dot (the play as a whole) is addressing its spectators to get them to recognize for themselves exactly what it takes to walk that mile; the discourse of the play is the source of tensions between its ideas in to and the reception strategies activated by audiences. Dot, I argue, refuses narrative prosthesis—a metaphysical dependency on disability deployed for thematic purposes but indifferent to the lived experience and perspective of living with a disability—to grant its disabled (because of dementia) character agency.58 Dotty’s embodied reality is, at her behest, simmed by Donnie and, in performance; this uncomfortable experience forces, or at least works to force, an embodied response in the audience. David Mitchell and Sharon Snyder suggest how this encounter might leave its mark. At this moment in the play. …the terror of the challenge to the self’s boundaries, which are believed to be more or less absolute, suggests that the spectacle of the extraordinary bodily difference upsets the viewer’s faith in his/her own biological integrity. The viewer of the freakish spectacle does not experience a feeling of superiority in his or her closer proximity to the normal ideal, but rather
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senses his or her own body to be at risk. The power is in the challenge of the self’s stability rather than in its security.59
“Viewer” is a doubled category, here encompassing both Donnie (and his siblings, ex-girlfriend, and spouse) on one side of the footlights and the theatre audience on the other. And theatre—the play in performance—has made it possible to begin to overcome one of literature’s shortcomings with regard to illness or disability, as articulated by Mitchell and Snyder: “If the body is the Other of text, the textual representation seeks access to that which it is least able to grasp.” (Italics in original.) Texts, lacking opposable thumbs (to use a metaphor about corporeality), may have trouble grasping things in non-metaphorical ways. Bodies in performance have more tools at their disposal. I return now to the final scene—the denouement—with the same idea of dual axes of address. At the very last moment of the play, not only is the character Shelly speaking to her offstage son but the playwright is surely speaking to the audience as well. “Remember what you’ve seen here.” Ideally, if the experience has not been one of overkill or triteness, remember what you felt.60 Recall the notion of “attentive encoding” and Elizabeth Loftus’s pointing to the importance of noticing and paying attention to things that will go first into short-term or working memory and then perhaps into long-term storage. This is not to say that experiences don’t force themselves into our memories whether we want to remember them or not. It is to say, regarding the character-to-character axis, that a rush of food and gifts and wrapping paper and chitchat can go by in a blur or be indistinguishable from other such blurs of Christmases past if the participants are not attuned to paying special attention in order to remember this one. Likewise, perhaps, this emotionally engaging evening in the theatre (if it was that) can conclude and evaporate— discarded like pretty wrapping paper—if we don’t really bother to attend to its specifics. So, as theatregoers or readers, we have more possibilities regarding “remember” than to speculate on the (nonexistent) future lives of characters who are not actual people. Of course, as Averie says, “It’s alright because things never stay the same, and we gotta roll with the punches” (106). How might memories “roll” for characters, readers, or theatregoers regarding the final scene? Will anyone in the audience remember that despite Averie’s volunteering to move in with her mother and provide care and Shelly’s agreeing to assist Fidel with his citizenship application (we assume she will continue
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to pay him and some of her mother’s other expenses), Donnie has agreed to do nothing save to recognize the embodied and cognitive package that is his mother’s plight? He claims he cannot provide money and he will not move back to Philadelphia. We might also remember, although it is not spelled out in the script, that there is neither in this play nor in the real world of the United States in the third decade of the twenty-first century any significant government program to assist with custodial caregiving. That keeping a person with dementia safe, fed, clean, and cheered up falls to families—which usually means women—may be the biggest thing to remember after stepping off any emotional roller coaster ride this play has offered.
Brief Me on This Richard Greenberg’s play Our Mother’s Brief Affair ran for fifty-three performances in New York City between December 2015 and March 2016, after a short run in Los Angeles at South Coast Rep in 2009. Critics in both cities were largely underwhelmed by the script, describing it as “wafer-thin,”61 “sluggish,”62 “lazy,”63 “unsatisfying,”64 “a snooze,”65 and “unfocused, anemic and astonishingly trivial,”66 with one calling its major plot surprise “strained.”67 The New York critics, however, lavishly praised Linda Lavin’s performance as the mother, who has dementia. Five reviewers called the play a “memory play.”68 For American theatre devotees, that label may call to mind Tennessee Williams’s Glass Menagerie. Greenberg’s play, like Williams’s, starts with the first-person reminiscence of a gay man in early middle age (in Greenberg’s play, he is either forty-two or forty-five, by estimates in the dialogue) recalling his mother. In both plays, the mother is a compendium of neediness, narcissism, grit, pathos, faded glory, independence, investment in glamor, and arguably coercive and unsympathetic parenting. In both plays, the fathers are gone. In Greenberg’s opus, to be fair, when Anna—the mother—carps about her husband failing to visit her in the hospital, her son Seth replies, “Yeah, well, he’s a shit... [ellipsis in original]. Being dead might count as an extenuating circumstance.” Anna, after the stage directions indicate “thinks a bit,” replies, “That happened, didn’t it?”69 At a few other moments, Anna of the (almost) present (information is given that she has died, but she is given the final word in the play) is depicted as a bit foggy. This is as much as the audience is allowed to see of a named and presumably enacted, but never diagnosed, nor otherwise disabling, dementia that
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is indistinguishable from what might be another illness or might be aging with depression or might be hypochondria. Also in both plays, we see the past performed, although in Brief Affair, rather than past dominating the proceedings and the present only a framing device, past and present take turns, with Seth and his twin sister interacting with their hospitalized mother in 2003, while the affair referenced in the title, which took place in 1973, is presented in what three reviewers called “flashbacks.”70 (I am calling 2003 the present, although the quick allusions to Anna’s death suggest that there may a time following the moment that precipitates the action and show-and-telling of the past in 2003.) As the play starts, we learn that Anna has been on her (putative) deathbed many times, but the adult children believe the current crisis may be “it.” Before Seth’s sister Abby arrives, we learn about Anna from Seth’s perspective, and what we hear is both informative and uncomplimentary. “As the senility ripened, you’d see the same acetate-wrapped library copy of Mary Higgins Clark over and over again. ‘But you’ve read this!’ you’d say” (10). When Anna, who interacts with Seth during his exposition, asks if she ever told him about her affair, he tells the audience “I could only think it was some kind of etherized fantasy, a bit of mental mayhem natural to someone who’d had too many operations, and way too much anesthesia, and was rising dotty to boot” (11). Later, in the initial scene with his sister, after her arrival from California, he diagnoses the situation as “seventy years of bad novels meet a squadron of frizzled synapses. And... she just goes on and on as if nothing else is happening in the room. Believing herself.” 71 When Abby asks whether their mother goes into detail about the affair, Seth replies “Invented demented clouds of it. I should google Alzheimer’s, I suppose.”72 In the first ten pages of the play (about ten percent of the script), Seth has used the words “senility,” “fantasy,” “dotty,” “frizzled synapses,” and “demented.” There is no indication that he has any awareness of Alzheimer’s as a specific illness, much less any interest in caring for or about a parent who may have it, which might include accompanying her to a doctor for an examination and maybe a diagnosis with a follow-up care plan. He continues to deride his mother’s estimation of what counts for good writing, her respect for the New York Post of the 1970s, and even her “mind, softened and sweetened by TV shows, by Big Band music and shoddy novels” (59). In a head-scratching moment with his sister, he asks, “Can you be totally delusional and still be trusted to feed yourself and use the toilet and refrain from driving?” When Abby asks “How do you mean: ‘totally
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delusional?’” he names “this fantasy of a lover she’s concocted.”73 Anna’s ability to feed herself and care for herself at home is not seemingly being questioned (whew—the kids are within their rights to fail to step in— how truly, medically bad can it be?). Enjoying the popular music of her youth and reading best sellers are for Seth grounds to find the relatively youngish Anna (seventy-three) to be losing it—if Seth thinks she ever had anything to lose. Abby confirms that there was a lover, and she has seen the three letters he sent, which their father showed her. This is news to Seth. The major dramatic question is not whether Anna actually had an affair, but whether the lover was who Anna claims he was. Right before the Act I curtain, a little bomb goes off. Anna’s lover, who has introduced himself to her as Phil, comes out after a few trysts as David Greenglass, brother of Ethel Rosenberg. At that point, the script states that the lights come up, the twins face the audience, and Abby announces to those “who know who David Greenglass is or was, we congratulate you on your historical memory.”74 One critic summed up the effect this way: the “flashy development feels tacked on, a piece of trickery….In addition, the play … slithers off the track and midpoint…[and] goes dead in the water when Seth and Anna explain to the audience who Greenglass was.”75 Phil’s confession in Act I opens the door for Anna to make one of her own in Act II. When she was sharing a bedroom with her younger sister as pink-collar working women while living at home with their widowed mother in a lower-middle-class tenement in the 1940s, she was too selfabsorbed to honor the terminally ill sister’s request for a glass of water in the middle of the night. Anna pretended to be asleep as she reveled in the pleasure of fantasizing about her looks and suitors. Three days later the sister, remembered as sweet and uncomplaining, was dead of lupus. Anna posits that she married her husband because she deserved to be unhappy. We already know that her birth family was not nurturing. Her mother was “bitter... grateful to no one,” but expected her daughters to support her.76 After the end of act one reveal, the second act builds first to Anna’s own confession and then moves to the lead-up to the present— her going to an assisted living facility after her older sister moves in to care for her and then dies, the twins selling the childhood house that they suddenly see as tacky, the discovery among Anna’s possessions of a biography of David Greenglass, Seth’s confronting her with the book and insisting she claimed him as her lover in her confusion, and Anna’s
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basically disowning Seth for refusing to validate her as a person who was— even if only briefly—“someone.” Reviewers appear as befuddled as Seth about Anna’s mind. No medical information or personnel appear in this four-hander (the lover is the fourth character, and this actor also doubles as the father in a characterologically unflattering monologue). For two critics she was on the verge of senility,77 two opted for dementia,78 one had her “battling senior citizen dysphoria,”79 and another sat on the fence with “either dementia or Alzheimer’s,” proclaiming that these are two completely separate things.80 That any fact checker for a major New York paper let the latter go by is somewhere between discouraging and unconscionable, though this misunderstanding, in 2016 and now, is common enough. We may know that “chest pain” is not synonymous with “heart disease” (it could be COPD or a pulled muscle, among other things), yet many are still baffled about the difference between “dementia,” a blanket category indicating cognitive decline, and Alzheimer’s, a specific disease that is one among many possible causes of dementia. Perhaps the bigger question is not whether the character suffers from dementia, but why dementia is necessary to the play. Is it a narrative prosthesis par excellence—a device that allows an unhappy son to criticize his mother’s ideas and habits on account of there being a “medical” reason for her withholding information and possibly conflating events, people, and secondary sources? Is the disability of dementia used as “a crutch upon which [a] literary narrative… lean[s] for [its] representational power, disruptive potentiality, and analytical insight”?81 Is the device necessary to enable a play about generational discord, adults disappointed by both their parents and their offspring, with dementia as the excuse for fighting over “accurate” memory—that fight itself dependent on limited understanding of what memory is in the first place?82 Scholarship about memory—briefly introduced in the previous chapter—suggests that whatever is going on in Anna’s mind meshes to a great extent with the workings of memory even in the neurotypical. Daniel Schacter’s Seven Sins of Memory includes three types of outright forgetting (omission), ranging from a total absence of recall of an event years earlier to the “tip-of-the-tongue” phenomenon of momentarily being unable to recall a word or name and four types involving a kind of retrofitting (commission). In the latter category, Anna’s biggest memory issue may be what Schacter calls “persistence,” the involuntary and intrusive recollection over time of painful or traumatic events
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one might be better off forgetting, as they often lead to depression and lashing out. Schacter articulates the “primary territory of persistence: disappointment, regret, failure, sadness, and trauma.”83 A vernacular, probably dated explanation might be that Anna is suffering from the failure of a suppressed memory (ignoring her sister’s simple request) to stay suppressed, although one might argue that she benefits more from keeping the “bad” source event around for justification to herself than she needs to get it out of everyday consciousness. Again, these phenomena occur in the neurotypical as well as in people living with dementia. We find out that they underwrite Anna’s desperation and probably her coming across as “bitter,”84 “sharp-tongued,”85 and “deeply unpleasant.”86 If the question on which the play wants to focus is not “does she remember this?” but rather, “is what she remembers something that could be verified by an independent source?” one might wonder whether suggestibility and confabulation might not be forgiven were Seth and Abby scripted to care about their mother’s present-day well-being more than they seem to care about how they can interrogate her story with an eye to fact-checking. Rebecca A. Bitenc, in Reconsidering Dementia Narratives: Empathy, Identity and Care, defines confabulation on the part of a person with dementia as instances in which they “tell stories or make comments about a situation or a memory that do not align with the way others perceive or remember it... but with no intention of lying.”87 (Seth describes his mother at the top of the play as “an average situational liar but not at all a maker of fables.”88 ) Psychologist Richard Cheston and gerontologist Gary Christopher note that confabulation is an attempt on the part of a person with dementia to “do something positive—to grapple with their illness and to make sense out of their world. It tells us (and themselves) something about the sort of person they take themselves to be.”89 Cheston and Christopher situate this behavior within what neurotypical people do, too. [W]e all buffer or protect ourselves against the anxiety that being aware of the inevitability of ageing, illness, and death generates…. [R]esearch in psychology suggests that we protect ourselves through creating worldviews that provide us with a sense of transcending death in some way: these provide us with narratives of our lives and our place in the world that are full of meaning … they provide the basis for us to feel good about ourselves.90
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At the end of the play, Anna, still insisting that her lover was David Greenglass and that she did not decide on his identity as the result of reading a book published twenty-eight years after the affair, answers Seth’s question as to why she told the story about Phil/David: “I was giving you the information you’d need … [ellipsis in original] to write my obituary.... Because I want to be known” (91). Seth, who writes obituaries for a living (one might guess for the New York Times, based on where he lives and his cultural prejudices), informs her that people like her “don’t generally get obituaries” (91). Anna finally says she wants to be left alone and that she is nobody’s mother anymore. Who, then, is she? “I’m a woman who had a moment…. And if that moment was with David Greenglass... [ellipsis in original] so be it”91 (92). A paid obituary is an option, and a kinder Seth, scripted by a playwright with a different thematic motivation, might have acquiesced to one. Or even told a white lie. “Who was she?” is the question with which the play starts and “who are you?” is the question with which it ends, both asked by Seth. Anna does not appear to have gotten much of what she desired in life, appearing in the play as both disappointed and needy. We are told she has dementia. Seth is scornful of her tastes and values. Her own mother was bitter. She harbors guilt. She was embarrassed by having twins, she tells Phil/David. She still wishes Seth were not gay. She never loved her husband. Other than the dementia label as a kind of tacked-on factoid, Anna and Seth are a nearly stereotypical Jewish mother and son in a nearly stereotypical play about a Jewish mother and son. Critic Terry Teachout, writing for the Wall Street Journal, said in the final paragraph of his review that “Mr. Greenberg might have done better to scrap the reveals (as well as several dozen of the quips) and concentrate instead on Seth’s unhappy relationship with his mother.”92 This relationship is the most complex, troubling, and thought-provoking of the human linkages dramatized (rather than narrated) in the play. But my project is not to suggest that Greenberg should have written a different play, although critics point out what might be said to be missing, the presence of which might have kept them more engaged and/or less alienated. My goal is to point out something missing in the critical response. If we accept that Anna does have dementia, however, minimally limned and however glibly dismissed by her uninformed children, where are the critics who might see her confabulation not as a prosecutable offense, but as one facet of what Cheston and Christopher call “terror management”— the means by which, whether suffering from dementia or not, we keep
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the awareness of our mortality at bay? While those living with dementia may lose cognitive skills, short-term memory, and executive functioning capacity, they still have consciousness and, if one believes in it, souls. Perhaps, in order to understand behavior like Anna’s, one needs to experience the fears, desires, and needs of a person who is “losing it” but knows it on some level. The characters in the next case study, Marjorie Prime, do get it, and terror management is a project undertaken in that play by the two neurotypical adults caring for the octogenarian with dementia who gives the play its title.
Notes 1. Colman Domingo, Dot (New York: Samuel French, 2016), 8. Page numbers are from this edition. 2. Dot, 65. 3. Ibid., 62. As noted in Chapter 7, more than a third of people with dementia reported losing friends after receiving their diagnosis, according to Lynn Casteel Harper in On Vanishing: Mortality, Dementia, and What It Means to Disappear (New York: Catapult, 2020), 87. See, too, See N. R. Kleinfield, “Fraying at the Edges,” New York Times, 30 April 2016. https://www.nytimes.com/interactive/2016/05/01/nyregion/livingwith-alzheimers.html?action=click&pgtype=Article&state=default&mod ule=styln-alzheimers&variant=1_show®ion=MAIN_CONTENT_1& context=STYLN_TOP_LINKS_recirc (Accessed 8 April 2023). 4. Chitlins (chitterlings) are hog intestines. They are frequently sold in grocery stores in African American neighborhoods around Christmas, Thanksgiving, and New Year and are associated with poor southern (most often Black) food. Averie points out that slaves had to eat what the masters discarded (many parts of the pig) and makes much of how completely she has washed her basic ingredient. She tells her siblings that she has heard Dotty say how much she misses her own mother’s chitlins. 5. Dot, 79. 6. Ibid., 106. 7. Ibid., 90. 8. See Rita Hargrave, “Dementia Assessment in African Americans,” 91– 107 in Ethnicity and the Dementias, for brief explanations of multiple non-invasive, non-chemical clinical kinds of clinical tests and diagnostic methods. 9. See Ingunn Moser, “Making Alzheimer’s Disease Matter; The Politics and Interferences of Different Practices Concerning AD,” 165–184 in Emerging Technologies for Diagnosing Alzheimer’s Disease: Innovating With Care (London: Palgrave Macmillan, 2016), especially 175–179 in the
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sections subtitled “The Promise of the Drug: The Solution That Excludes, Disarticulates, and Makes Care Alternatives Invisible” and “A Gathering Around the Doctor’s Desk: The Pill Meets Lived Reality in Clinical Practice.” See van der Lann’s, “Emergent Biomarkers and Good AD Diagnostics,” especially 110–112. See J. Wesson Ashford, Frederick A. Schmitt, Carr J. Smith, Vinod Kumar, and Nusha Askari, “Assessment of Cognitive Impairment, Alzehimer’s Disease, and Other Forms of Dementia,” 41–68 in Ethnicity and the Dementias, ed. Gwen Yeo, Linda A. Gernder, and Dolores Gallagher-Thompson, third edition (New York: Routledge, 2019). Hargrave, op cit. In March 2022, a newsletter sent in by the Alzheimer’s Association pointed out that Black Americans are twice as likely as whites to develop Alzheimer’s, with Hispanic Americans one and a half times more likely. The “ask” was that readers contact their government representatives to voice support for means to realize an “increase [in] the participation of underrepresented populations in Alzheimer’s and other dementia clinical trials by expanding education and outreach to these populations, encouraging the diversity of clinical trial staff, and reducing participation burden, among other priorities” via the Equity in Neuroscience and Alzheimer’s Clinical Trials (ENACT). Ibid. Dot, 10, 11. One way to solve the problem might simply be to have made Dotty somewhat older. A sixty-five-year-old who began losing her memory a few years earlier and got a diagnosis at age sixty-four, is on the early end of the dementia spectrum. Audiences may simply choose to read the character as older, since the age stipulated in the script is never uttered as part of the dialogue. Dot, 75. See Henry Louis Gates, “The Chitlin Circuit,” The New Yorker, 3 February 1997, 44 ff. See Wesley Morris, “Black Theater is Having a Moment. Thank you, Tyler Perry. (Seriously),” New York Times Magazine, 9 October 2019. https://www.nytimes.com/interactive/2019/10/09/magazine/tylerperry-black-theater.html?auth=login-email (Accessed 7 June 2023). Charles Isherwood, “Review: In ‘Dot,’ A Fading Matriarch Brings a Family Together,” New York Times, 23 February 2016. https://www. nytimes.com/2016/02/24/theater/review-in-dot-a-fading-matriarch-bri ngs-a-family-together.html (Accessed 8 April 2023). The slightly differing title in the print edition of the Times review is “A Matriarch Starts to Face, and a Family Struggles to Adjust,” 24 February 2016, C1.
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20. Frank Scheck, “‘Dot’ Theater Review: A family copes with its matriarch’s worsening dementia in this comedy-drama written by ‘Fear the Walking Dead’ actor Colman Domingo,” Hollywood Reporter, 23 February 2016. https://www.hollywoodreporter.com/news/generalnews/colman-domingos-dot-theater-review-868718/ (Accessed 7 June 2023). 21. Frank Rizzo, “Off Broadway Review: ‘Dot’ by Colman Domingo,” Variety, 26 February 2016. https://variety.com/2016/legit/reviews/ dot-review-play-1201714882/ (Accessed 8 April 2023); Stanford Friedman, “Dot,” New York Theatre Guide.com, 24 February 2016, https://www.newyorktheatreguide.com/reviews/dot (Accessed 8 April 2023); and Hilton Als, “Dot,” The New Yorker, 7 March 2016, 9; as well as Isherwood and Scheck. 22. Frank Burd, “People’s Light Presents Colman Domingo’s ‘Dot,’” Broad Street Review, 23 September 2019. https://www.broadstreetreview.com/ articles/peoples-light-presents-colman-domingos-dot (Accessed 7 June 2023). 23. “Slice of life” is Matthew Wexler, “The New Normal? ‘Dot’ Delivers at Vineyard Theatre,” The Broadway Blog (undated). https://thebroadwayb log.com/the-new-normal-dot-delivers-at-vineyard-theatre/ (Accessed 8 April 2023); others include Linda Armstrong, “‘Dot’ Exposes Devastation of Alzheimer’s Disease,” New York Amsterdam News, 10–16 March 2016, 23; Epiphany in Baltimore, “Theater Review, ‘Dot’ at Everyman Theatre,” 14 December 2016. http://epiphanyinbmore.blogspot.com/ 2016/12/play-review-dotthe-dance-at-everyman.html (Accessed 8 April 2023); Cristee Cook, “At Soul Rep Theatre Company, DOT by Colman Domingo Leads With Heart and Humor,” Dallas Art Beat, 9 December 2019. https://www.dallasartbeat.com/post/at-soul-reptheatre-company-dot-by-colman-domingo-leads-with-heart-and-humor; Dennis Bloh, “Theatre Review: DOT at People’s Light,” Philly Life & Culture, 23 September 2019. https://phillylifeandculture.com/2019/ 09/23/4691/; and Rizzo. 24. Mark Bretz, “‘Dot’ Uses Comedy to Depict a Family’s Plight with Dementia in Black Rep Production,” Ladue News, 13 September 2017. https://www.laduenews.com/arts-and-culture/features/dot-uses-com edy-to-depict-a-familys-plight-with-dementia-in-black-rep-production-the ater/article_4beb8214-98ba-11e7-a1a5-cb8c6000019d.html (Accessed 8 April 2023). 25. Kelundra Smith, “‘Dot’ at True Colors Brings Vivid Life and Humor to the Tragedy of Alzheimer’s,” Arts ATL, 25 July 2018. https://www.art satl.org/review-dot-at-true-colors-brings-vivid-life-and-humor-to-the-tra gedy-of-alzheimers/ (Accessed 8 April 2023). To be fair, and is obvious in the title of this review, Smith is calling the disease a tragedy and not
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28.
29. 30.
31.
32. 33. 34. 35. 36. 37. 38. 39.
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categorizing the play dramaturgically. The study guide can be found here: https://issuu.com/everymantheatre/docs/dot-playguide-vfinal-forissuu (Accessed 8 April). Zachary Stewart, “Dot,” TheaterMania, 23 February 2016. https://www. theatermania.com/off-broadway/reviews/dot_76074.html. Scheck, Isherwood, and Stewart. Stewart and Kelundra Smith are the only two reviewers who spell out both the phenomenon of increasing numbers of cases of dementia as the American (and really global) population ages (including the absence of a safety net in terms of caregiving) as well as the reality that African Americans and central Asian immigrants who get the short end of the stick in medical care (African Americans/Smith) and in dramatic representations (Stewart). These two review(er)s, although working in the realm of popular journalism, bring particular depth to their thinking about what this play presents, at least demographically. Michael Dale, “Colman Domingo’s DOT Mixes Broad Comedy With Family Drama.” Broadway World, 25 February 2016. https://www.bro adwayworld.com/article/BWW-Review-Colman-Domingos-DOT-MixesBroad-Comedy-With-Family-Drama-20160225 (Accessed 8 April 2023). Epiphany in Baltimore. David Roberts, “‘Dot’ at the Vineyard Theatre. OnStage Blog, 24 February 2016. https://www.onstageblog.com/reviews/2016/2/24/rev iew-dot-at-the-vineyard-theatre (Accessed 8 April 2023). Jonathan Mandell, “Dot Review: A Mother With Alzheimer’s by Colman Domingo,” New York Theater, 24 February 2016. https://newyorkth eater.me/2016/02/24/dot-review-a-mother-with-alzheimers-by-colmandomingo/ (Accessed 8 April 2023). Stewart. Bretz. Roberts, Friedman, Stewart, Epiphany in Baltimore. Bretz. Wexler. Kelundra Smith, Stewart, and Everyman Theatre’s study guide for students seeing the play in school classes. Wexler and Als. Tachelle Wilkes, “Colman Domingo’s Dot at the Billie Holiday Theatre Review,” Black Talent Team, 2018. (This production was the one mounted in Atlanta and directed by Kenny Leon. The Billie Holiday Theatre is in Brooklyn.) https://blacktalent.tv/2018/11/01/col man-domingos-dot-at-the-billie-holiday-theatre-review/ (Accessed 8 April 2023). Isherwood. Schacter, 51. Quote from Dot is on 106. Thomas Suddendorf quoted in Østby and Østby, 138.
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43. Dot, 106. 44. Ibid., 90 and 93. 45. Erin Hurley, Theatre and Feeling (Houndmills and New York: Palgrave Macmillan, 2010), 25. 46. Scott Magelssen was reminded by the director of an aging simulation project that “older adults are constantly relearning how to do things as their bodies age.” Magelssen, Simming: Participatory Performance and the Making of Meaning (Ann Arbor: University of Michigan Press, 2014), 153. 47. Ibid., 9. 48. Ibid., 146. 49. See Chapter 7, “Senior Moments,” 138–154. 50. The news story can be viewed here: https://www.youtube.com/watch?v= LL_Gq7Shc-Y (Accessed 8 April 2023). 51. Wanda Strukus, “Mining the Gap: Physically Integrated Performance and Kinesthetic Empathy,” 89–105 in Journal of Dramatic Theory and Criticism (Spring, 2011): 89. 52. Dee Reynolds, “Kinesthetic Empathy and Dance’s Body: From Emotion to Affect,” 123–136 in Kinesthetic Empathy in Creative and Cultural Practices, ed. Dee Reynolds and Matthew Reason (Bristol and Chicago: Intellect, 2012), 124. 53. Strukus, 103. 54. Ibid., 103. 55. Amy Cook, “For Hecuba or for Hamlet: Rethinking Emotion and Empathy in the Theatre,” 71–87 in Journal of Dramatic Theory and Criticism (Spring, 2011): 79. 56. Barbara Tversky, Mind in Motion: How Action Shapes Thought (New York: Basic Books, 2019), 30. It is beyond the scope of this chapter to delve into the phenomenon of mirror neurons, first discovered in macaque monkeys in the 1990s and then capturing imaginations in the humanities and the general public until around 2010. Mirror neurons are brain cells that react both when an action is performed and when it is observed. Such neurons are present in the human brain, but there is some assembly required (i.e., they do not spring full-blown into hardwired efficacy as the result of genetic inheritance; they require sensorimotor learning) and, perhaps most importantly, they are not vehicles for understanding emotions or intentions. See Cecilia Heyes and Caroline Catmur, “What Happened to Mirror Neurons?” in Perspectives on Psychological Science (2021). https:// doi.org/10.1177/1745691621990638 (Accessed 7 June 2023). 57. James Phelan, Reading People, Reading Plots: Character, Progression, and the Interpretation of Narrative (Chicago: University of Chicago Press, 1989), 15.
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58. David Mitchell and Sharon Snyder, Narrative Prosthesis: Disability and the Dependencies of Discourse (Ann Arbor: University of Michigan Press, 2000). 59. Mitchell and Snyder, 37. 60. Als uses “trite” in his review. Four reviewers use “over” in their critiques. Scheck and Burd use “over-the-top.” Rizzo invokes “overlong.” “Overstuffed” appears in John Timpane, “‘Dot’ at People’s Light: A West Philly Family Faces the Terrible Truth of Their Mother’s Decline, With Affection and Authentic Humor,” Philadelphia Inquirer, 23 September 2019. 61. Scott Stiffler, “The Bon Mot Family Slingers,” The Villager, 28 January 2016, 21. 62. Matt Windman, “‘Affair’ has mommy issues,” a.m. New York, 21 January 2016, A16. Windman also uses the word “underwhelming.” 63. Marilyn Stasio, “Our Mother’s Brief Affair,” Variety, 26 January 2016, 87. 64. David Rooney, “‘Our Mother’s Brief Affair’: Theater Review,” Hollywood Reporter, 20 January 2016. https://www.hollywoodreporter.com/news/ general-news/mothers-brief-affair-theater-review-857018/ (Accessed 8 April 2023). 65. Joe Dziemianowicz, “‘Our Mother’s Brief Affair’ Review: Linda Lavin is On Her Game,” New York Daily News, 21 January 2016. https://www.nydailynews.com/entertainment/theater-arts/lindalavin-game-mother-affair-article-1.2503700 (Accessed 8 April 2023). 66. Alexis Soloski, “Our Mother’s Brief Affair Review: A Very Tame Liaison,” The Guardian, 20 January 2016. https://www.theguardian.com/stage/ 2016/jan/20/our-mothers-brief-affair-review-broadway-theatre-a-verytame-liaison (Accessed 8 April 2023). 67. Charles McNulty, “‘Our Mother’s Brief Affair’ at South Coast Rep. Los Angeles Times, 12 April, 2009. https://latimesblogs.latimes.com/cultur emonster/2009/04/review-our-mothers-brief-affair-at-south-coast-rep. html (Accessed 8 April 2023). 68. Ben Brantley, “Considering the Lives That Shape Our Own,” New York Times, 21 January 2016, C4; Rex Reed, “An Affair to (Mis)Remember,” New York Observer, 1 February 2016, 20; Linda Winer, “Viola Lessons While Her Passion Burned,” Newsday, 21 January 2016, B4; Terry Teachout, “Sleeping With the Enemy,” Wall Street Journal, 22 January 2016, D7; Barry Bassis, untitled review of Our Mother’s Brief Affair, Resident Magazine, April 2016, 122. 69. Richard Greenberg, Our Mother’s Brief Affair (London: Oberon Books, 2016), 42. All page numbers are from this edition.
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70. Robert Kahn, “An ‘Affair’ to Remember, Even if Her Kids Would Prefer to Forget,” NBCNewyork.com, 18 January 2016. https://www.nbc newyork.com/entertainment/the-scene/new-york-live/broadway/lindalavin-review-mother-brief-affair/708577/ (Accessed 8 April 2023); Adam Feldman, “Our Mother’s Brief Affair,” Time Out New York, 3 February 2016, 47; and Dziemianowicz. 71. Greenberg, 19. 72. Ibid. 73. Ibid., 36. 74. Ibid., 61. 75. Teachout. 76. Greenberg, 80. 77. Rooney and Teachout. 78. Christopher Byrne, “Starry Nights,” (unsourced but possibly Variety), 26– 27; and Adam Feldman, “Our Mother’s Brief Affair,” TimeOut New York, 20 January, 2016. https://www.timeout.com/newyork/theater/our-mot hers-brief-affair (Accessed 8 April 2023). 79. Reed. 80. Stasio. 81. Mitchell and Snyder, 49. 82. This play calls to my mind a New Yorker cartoon by Zachary Kanin in which two early middle-aged adults, a man and a woman, stand in a doorway looking into a living room or den at an older and clearly unhappy man sitting alone on a sofa and staring at a television. The caption (it’s unclear which of the couple is speaking) says, “I think my dad is losing his memory. He keeps forgetting to say he’s proud of me.” The cartoon appeared in the 28 March 2020 print edition. 83. Schacter, 162. (Chapter 7 is “The Sin of Persistence.”) 84. Rooney. 85. Brantley and Feldman. 86. Stasio. 87. Rebecca Bitenc, Reconsidering Dementia Narratives: Empathy, Identity and Care (Abingdon and New York: Routledge, 2020), 175. 88. Greenberg, 11. 89. Richard Cheston and Gary Christopher, Confronting the Existential Threat of Dementia: An Exploration into Emotion Regulation (Cham, Switzerland: Springer Nature/Palgrave Macmillan, 2019), 69. 90. Ibid., 31. 91. Greenberg, 92. 92. Teachout.
CHAPTER 11
Ready for Prime Time: Marjorie Prime
Marjorie Prime, Jordan Harrison’s 2014 much-produced drama (also made into a feature film) features two generations of unhappy adults who seem to fear living and dying in about equal measure. It is the dementia of the titular character that precipitates the play’s action. Eighty-five-yearold Marjorie’s caregiver daughter and son-in-law have provided her with a Prime—a sort of cross between a chatbot and a robotic human—with the multiple purposes of keeping her company, helping her remember her past, and reminding her that she had an interesting life. Using robots, especially those that simulate pets, to keep lonely elders company, is neither new nor costly.1 Chatbots, which are computer programs that simulate human conversation, are apps that can be downloaded for free and programmed to sound like the person their user would like them to be. They “learn” via user input and algorithms that do for the app things akin to what semantic memory does for humans. Moviegoers may recall the 2013 Spike Jonze film Her, in which a lonely and introverted man falls in love with an artificial intelligence (AI) virtual assistant, personified in a female voice. In Marjorie Prime, Harrison suggests both the appeal of his robotic/chatbotic fictional beings, as they are made to look and sound like a departed loved one, as well as pointing out all they cannot do or be. In this play, perhaps more than in any other in Losing It, the needs and existential awareness of the character with dementia are in sync with those of the neurotypical characters, even if Marjorie is older and cognitively © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 D. Chansky, Losing It, https://doi.org/10.1007/978-3-031-20902-4_11
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impaired. It is awareness of mortality, regret about the past, emptiness in the present, and fear of the future that collectively define the shared humanity of Harrison’s characters. They all struggle with memory(s). Marjorie Prime has eight scenes and can be performed with or without an intermission. It is set in the future, starting roughly in 2062, as the script tells us both that Marjorie was born in 1977 and that she is eightyfive at the start of the play. It proceeds in chronological order and we observe the evolution of the lives of the three main characters over a period of a year or two, concluding with a final scene set far in the future. The piece is, however, light on plot that might be understood as agon seeking resolution via discovery. As one reviewer wrote, “Marjorie Prime [sic] is more interesting as a premise and a jumping off point for philosophical discussions than as a story in itself.”2 At the top of the play, Marjorie is seated in a recliner (described as a “lumpy chair [which] doesn’t go with the rest of the décor”)3 talking to a young man about her past. After a minute or two it emerges that there is something a bit “off” about the young man, Walter, as he announces, when Marjorie accuses him of sounding like her vaguely bossy daughter/ caregiver, that he sounds like whoever he talks to. He is happy to repeat stories to Marjorie about her youth, except when she asks questions to which his reply is that he does not “have that information.”4 Walter is the first of the play’s three Primes and is a fabricated version of Marjorie’s late husband when he was thirty. Theatre critics defined Primes with such words as “computer program,”5 “hologram,”6 “android,”7 “digital companion,”8 “AI,”9 “technological incarnation,”10 “clone,”11 and “subjectively constructed avatar,”12 with Tim Brayton, in his review of the film version, offering the thematic explanation of “a made-up technology to examine modern society.”13 Priming, in psychology, refers to a phenomenon in which words are activated in memory as a result of hearing others use them, with the failure to remember previously hearing the primed word resulting in a subject’s belief “that they are producing it for the first time themselves.”14 A prime number is one that can only be the product of itself and a multiplier of one (e.g., five is a prime number because the only way of writing it—as 5 × 1 or as 1 × 5 or simply as 5 must include the number 5 itself) and the Primes in the play are the products of specific deceased individuals (no other would do; each is arguably only a multiple of its unique model times one) to be programmed with memories those individuals would or could have had. The play’s Primes need only be told something once to store it; they learn from those
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who speak to them, including other Primes. They are masters of attentive encoding. Marjorie’s son-in-law, Jon, approves of Marjorie’s having and interacting with the Prime, since, among other things, “when she talks to it, she’ll remember she had an interesting life.”15 In the second scene, Tess, Marjorie’s daughter, and Jon discuss the Prime, about which Tess has grave misgivings, seeing it as something just there to pacify and distract, and which she may resent (according to Jon), as her mother seems to prefer the company of the “weird fountain of youth version” of her father16 to interacting with her. In this scene, we learn that Marjorie was talking in her sleep about someone Tess thought her mother had forgotten. In one of the play’s few “what was the truth?” bits, we soon learn that contra the first scene chit chat about Marjorie and Walter’s early marriage and letting their first child, Tess, pick out a dog at the pound, there was in fact another child—an older brother named Damian, who committed suicide at age thirteen and who picked out the dog. While Tess thought her mother had forgotten this, it seems Marjorie struggled for decades against the intrusion of this memory, while never truly forgetting at all—merely coping. Still, this spontaneous memory bubbled up unbidden.17 As Jordi Fernández observes, “involuntary episodic memories are generally biased toward negative events, in contrast to the bias toward positive events in voluntary memory recall. Given that most episodic memories are involuntary, the emotional weight of unpleasant events must be useful.”18 Lewis Hyde finds such memories akin to the Furies of Greek tragedy, “embodiments of unforgettable grief and rage.... They harry the sleepless mind, demanding blood for its release.”19 This particular unpleasant event allows Jon in the next scene to “prime” Walter Prime, thinking that the latter should know about the key incident from his model’s (and Marjorie’s) past. Getting the suicide on the table also opens an emotional floodgate for Tess and allows her to confess, later in the play, her true feelings about both her brother and her mother. Her mother was never warm toward her and she felt Damian had stolen that parent’s love. With or without dementia, both women harbor the memory, no matter the attempts to forget or deny. In the third scene, Jon greets Marjorie the morning following a trip to the emergency room in the middle of the night after her having fallen in the bathroom, none of which she remembers. As Jon recounts Marjorie’s flirtatious behavior with the E.R. doctor, he flatters her with recollections of a suitor named Jean-Paul, a world-class French tennis pro and smitten for years with Marjorie, even continuing to write to her after the death
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of her husband, an event occurring a decade before the start of the play. We later learn that Jean-Paul was not European but Canadian, that he only played tennis in college, and that he owned (or may still own—it’s unclear whether he is alive or not) a drywall business. But Jon wants to keep Marjorie happy via flattery and it is easy to see the good cop/ bad cop partnership he has with Tess. This leaves Tess feeling inadequate and unlovable, even though Jon later assures her that it is far easier to be jocular and encouraging with an elder, not the biological parent who brought you up, underscoring that Marjorie always loved Tess. Jon departs after turning on some music for Marjorie—the “Winter” part of Vivaldi’s Four Seasons—which she played long ago on the violin in an orchestra. This is one of several ways in which Harrison makes the family in Marjorie Prime one with which anticipated American theatregoers for this play (middle aged, educated, possessed of disposable income, interested in the arts) are presumably able to identify. Other things include the fact that Jon and Tess have a son who is an investment specialist and another who is a chef at a restaurant with a Michelin star and that their estranged daughter, an aspiring musician, sees a therapist who has advised her cutting off all contact with her mother. When the couple plans a trip in the latter half of the play, Jon suggests Spain, but since Tess has been there, they go with her preference for the as-yetunvisited Madagascar. These are self-described west coast WASPS, one of whom who can afford to spend a year at home dealing with depression, and who can as a family unit afford visits for their mother from a caregiver working for an establishment called “Senior Serenity.” While listening to Vivaldi, Marjorie confesses her fear of death and is comforted by Walter Prime, who knows and teases her about Jean-Paul. Tess and Jon return and Marjorie asks if Damian is asleep (cue a knowing and worried look between the couple), then tells the story of a trip to New York with Walter one winter decades earlier, when they tried to enjoy themselves at Christmastime and she wished she could avoid having to go back to the rest of her life. Jon takes notes on the story, and when Tess escorts Marjorie out of the room for a shower, Jon feeds information to Walter Prime about Damian (whose suicide prompted the trip, as an effort on Walter’s part to ease Marjorie’s pain). Until this point, Walter Prime knows nothing about a son, but Jon says, “if you’re Walter, you would know, wouldn’t you,” adding that, although Marjorie said nothing for fifty years, “she never forgot.”20 Hilde and Ylva Østby point out that a key feature of what kinds of experiences stick as memories is the emotional
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impact of the several factors of the experience.21 The death by suicide of an adolescent son certainly fits Daniel Schacter’s category of “persistence” in memory. It just won’t go away, whether one talks about it or not. At the start of the fourth scene, about midway through the play, Tess is speaking to a cleaned-up and better-dressed Marjorie, now sitting on a more stylish piece of furniture, and actually the play’s eponymous Prime. Marjorie is learning about “herself” via conversation with Tess, who is both eager to have her “mother” with her and frustrated that the Prime is not the real thing, even as she (Tess) felt distanced from and not truly loved by the real thing. “Why is this the Marjorie for me?” asks Tess, knowing that she could have ordered up a younger version of her late mother. “Why is this the way I want to remember her.”22 She adds that she and her mother were never close, although Marjorie was not a bad mom, to which Marjorie replies, “Maybe I’m the Marjorie you still have things to say to.”23 As the Prime asks for more information about “herself,” Tess answers her question about having other children with a lie. She, Tess, was the only one, she says. Conversation about getting a dog reveals that Jon, too, has been talking to Marjorie Prime, as she brings up his preference (a collie), when Tess expresses hers (a Shiba Inu). Tess is angry at what she perceives as programming behind her back, but Marjorie Prime explains that “there’s no ‘programming,’ just talking. Exactly what we’ve been doing.”24 Of course there is some kind of programming, as the Prime can speak English and make grammatical and syntactically felicitous sentences and can also walk, smile, and engage in conversational turn-taking. Syntactical and procedural memories are taken for granted to put the focus on episodic memory and existential musings. We are not meant to think about how the Prime can intuit or deduce that Tess may have unresolved issues with the old Marjorie, although conceivably this, too, resulted from a conversation with Jon. Toward the end of the scene, Marjorie Prime says she wants to know more in order to be more human. Tess asks what humans are like and Marjorie’s reply is “unpredictable.” Tess says she believes herself to be predictable, to which Marjorie’s rejoinder is “You want to be more human too.”25 This is the perfect, albeit somewhat indirect, segue into the fifth scene, which uncovers the ache that has been driving Tess and that has now reached the point of derailing her. This is also a foreshadowing of the final scene’s takeaway, regarding both dementia and humanness. We may or may not “be” our memories, but whatever or wherever they are, they are fallible
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and unique to each of us, and hoping for a file cabinet or Xerox model of memory is to hope to be less than human. In a husband/wife two-hander, Tess admits that she hated Damian, that she feels he took all the love her mother had, that she doesn’t want to go to therapy even though she has basically not left the house for a year, and that the Prime of her mother, although it can sometimes fool her into feeling comforted, is just “a backboard. It can’t be interested or not interested.”26 Jon adds, hopefully, that, since the Prime is made of things they say to her, possibly “the human part” of them has made it in there, too.27 Tess wonders why she is living; she regards the second half of life as the half where one doesn’t live but lives through others. She admits to being scared after Jon says she is scaring him. She feels guilty for having judged her mother rather than just keeping her comfortable. When Jon finally walks away in frustration, Tess agrees to go out to dinner with the friends who have been asking them to do that, but he neither looks at her nor moves. The next scene lasts about thirty seconds and has no lines. Tess sits silently. Jon watches her and then exits. Humans experience stalemate; Primes just wait. In the penultimate scene, it is clear that the Tess of the previous very short scene was a new, silent Tess Prime—possibly so new that Jon was not yet ready to interact with her, even though he acquired her. The actual Tess hanged herself during the trip to Madagascar. Jon has now experienced the programming of two Primes, Walter and Marjorie, and he has a list of items that he wants to convey to Tess Prime about “herself.” He breaks down as he relates the suicide story, ignoring Tess Prime, who tells him not to cry, and talking to his inner recollection of the actual Tess. “You were right. It’s nothing. It’s a backboard. I’m talking to myself.” But this is not the end of the scene. Tess Prime begs Jon to look at her. And he does. “I can help you if you’ll let me.... But first you have to tell me more about myself.”28 Jon, at what is arguably the moment at which he might leave the room, stays, choosing the comfort of a backboard to the emptiness he feels at the death of his wife. The choice of comfort, too, is quintessentially human, even when it means the opposite of acknowledging a truth. The final scene—occurring possibly centuries later—features the three Primes chatting it up in a kind of comfortable limbo. Walter Prime tells the story of proposing to Marjorie in an old movie theatre after a screening of Casablanca, a story the living Marjorie told him in the play’s
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very opening scene one was preferable to the actual story of proposing after seeing My Best Friend’s Wedding. The programmed “knowledge” has become real—an implanted memory there for keeps. Walter Prime mentions their son, Damian, and Marjorie Prime frowns. A son is news to her, as she is only able to remember what she’s been told, and Tess withheld this information from the Prime of her mother. Again, actual humans sometimes have no control over what surfaces in memory; Primes are reliable databases.29 Marjorie Prime says she’ll remember now. Damian is also news to Tess Prime, as is the dog her brother picked out at the pound (she only remembers the second family dog, although both were given the same name). The Primes will go on forever, looping this conversation or other iterations of it, unable to generate or experience anything new, except what one of them might say that exceeds what has been already told to one of the others. The final word is Marjorie Prime’s, as she says how nice it is that they could love somebody. Theatre scholar Sean Metzger has coined the term “digital cohabitation” to mark the new technological relations in which “machines learn from users and users learn from machines.”30 If this is an apt way to describe the relationships in Marjorie Prime—and I think it is—it also marks an uneasy alliance. Marjorie is aware that Walter Prime is not her actual husband, but she clings to him as the best she’ll be able to do in terms of assuaging her loneliness and having someone who will relive old times as frequently as she likes. The Prime is the only character to whom she confesses her fear of dying. Tess hopes that Marjorie Prime will make her feel loved, even as she cannily avoids implanting memories of events that might spoil the chance of closure with the mother to whom she never felt close. Jon knows he is talking to a backboard but cannot face the specter of life without any semblance of Tess at all. These are three humans who cannot live with their memories and cannot live without them. They deceive themselves in order to be (what they want to believe to be) themselves. It is certainly by design that Jon is not in the final scene. At one point in the scene, Walter Prime asks where Jon is, and Tess Prime replies that she doesn’t have that information. The Primes inhabit a kind of endlessly cheery Twilight Zone in which they happily relive the past as it was programmed into them and where nothing will change. Jon’s level of awareness would not have served the scene, but, also, there was apparently no member of the next generation interested
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in having a Prime of Dad. Among other things, we rewrite family histories as we go, and, if we are unable to exert total control over our own memories, we have some say in what to reveal to or conceal from future generations. Two critics offer assessments of Marjorie Prime that might be read as sweet and sour versions of the same thing. Tony Adler, reviewing the 2015–2016 Writers Theatre production in Chicago called the play “basically... a one-act update on the garbage in, garbage out axiom: we may disappear from the earth, but those who replace us will be worse still because they won’t know where the holes are. Indeed, their therapeutic programming will render them horribly banal, if not exactly bad.” Ben Brantley’s conclusion about the New York production at Playwright’s Horizons called Harrison’s creation of Marjorie “a portrait, in short, of an ineffably individual being made of fine gradations of thought and feeling that can never be reduced to formulas or calculations. When the Marjorie of this play’s opening scenes disappears, it leaves an aching void that no Prime could ever replace.... an irrefutable argument for the human factor.” We are our memories in action, so to speak, and it is the action— colored by interaction, among other things—that differentiates us from the Primes, who are far better at encoding and summoning factoids. What makes Marjorie Prime distinctive in the context of this study is not that its senior with dementia declines during the course of the play, nor that memory is relentlessly invoked both in the script and in reviews, although these are both the case and not unimportant. What makes it unusual as a stage(able) representation of dementia is that the character with dementia is one of several people in a family struggling with memories, demons, loneliness, regrets, depression, and fear; all are engaged in terror management. The “accuracy” with which Marjorie can summon items from the past—something I have argued is iffy even among the neurotypical—is of less interest to the playwright than is this character’s situatedness along the spectrum of the fully human. The memories lost, recalled, misremembered, and generated in this part of Losing It by the characters in Dot, Our Mother’s Brief Affair, and Marjorie Prime offer one way to think about how dementia is handled on the American stage and what it invites us to think about. The plays in Chapter 13 up the stakes in terms of lost cognition in that the characters they depict living with dementia experience hallucinations, aphasia, failure to recognize where they are, and a collapse of personal grooming
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skills and table manners, among other things. The questions posed in The Waverly Gallery and The Humans are messier and perhaps uglier than the ones dealt with above. It would not be right to say they are ripped from today’s headlines. The world they depict is more like the stuff of something that might be called the human-interest section of the newspaper. The names and venues and wardrobes and menus change but the situations and events will happen to most of us—or at least to people we know. As Rabbi Bradley Shavit Artson avers, “there are two types of people in this world. Those who have a disability and those who will have a disability if they live long enough.”31 Substitute “memory loss” for “a disability,” and, while profound memory loss is not guaranteed, consider what it means to live a long life, diagnosed dementia or not.
Notes 1. See Katie Engelhart, “What Robots Can—and Can’t—Do for the Old and Lonely,” New Yorker, 24 May 2021. 2. Tom Williams, “Marjorie Prime,” Chicagocritic.com, 29 October 2015. https://chicagocritic.com/marjorie-prime/ (Accessed 8 April 2023). See, too, Elizabeth Broadbent, “Interactions With Robots: The Truths We Reveal About Ourselves,” The Annual Review of Psychology (14 September 2016). https://doi.org/10.1146/annurev-psych-010416043958 (Accessed 8 June 2023). 3. Jordan Harrison, Marjorie Prime (New York: Samuel French, 2016), 7. Page numbers are from this edition. 4. Harrison, 8, 9. 5. Myron Meisel, “‘Marjorie Prime’: Theater Review.” The Hollywood Reporter, 23 September 2014. https://www.hollywoodreporter.com/ news/general-news/marjorie-prime-theater-review-735059/ (Accessed 8 April 2023). 6. Williams, and Paula Citron, “Theatre Review – Coal Mine Theatre/ Marjorie Prime by Jordan Harrison.” PaulaCitron.ca, 5 February 2020. https://paulacitron.ca/theatre/theatre-review-coal-mine-theatre-mar jorie-prime-by-jordan-harrison/ (Accessed 8 April 2023). 7. Lynn [sic, but probably Slotkin], “Review: Marjorie Prime,” The Slotkin Letter, 14 February 2020. https://slotkinletter.com/2020/02/reviewmarjorie-prime (Accessed 8 April 2023). 8. Tony Adler, “Robots Take Over in Writers Theatre’s Marjorie Prime.” Chicagoreader.com, 4 November 2015. https://www.chicagoreader.com/ chicago/writers-theatre-marjorie-prime-jordan-hamilton-karel-capek/Con tent?oid=19885775 (Accessed 8 April 2023).
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9. Ilana Lucas, “Review: Marjorie Prime (Coal Mine).” Mooney on Theatre, 31 January 2020. https://www.mooneyontheatre.com/2020/01/31/rev iew-marjorie-prime-coal-mine/ (Accessed 8 April 2023). 10. Meisel. 11. Alan Bresloff, “‘Marjorie Prime,’” Around the Town Chicago, 2015. http://www.aroundthetownchicago.com/theatre-reviews/marjorieprime/ (Accessed 8 April 2023). 12. Tim Brayton, “Marjorie Prime (2017).” Alternate Ending, 12 January 2018. https://www.alternateending.com/2018/01/marjorieprime-2017.html (Accessed 8 April 2023). 13. Ibid. 14. Daniel Schacter, The Seven Sins of Memory: How the Mind Forgets and Remembers (Boston: Houghton Mifflin, 2001), 110. 15. Harrison, 17. 16. Ibid., 16. 17. “Spontaneous memories” explain Hilde and Ylva Østby and Østby, “are memories that appear on their own, without our consciously searching for them,” in Adventures in Memory: The Science and Secrets of Remembering and Forgetting (Vancouver: Greystone Books, 2018), 39. 18. Jordi Fernández, “The Intentional Objects of Memory,” 88–99 in The Routledge Handbook of Philosophy of Memory, ed. Sven Bernecker and Kourken Michaelian (Abingdon and New York, 2019), 107. 19. Lewis Hyde, A Primer for Forgetting: Getting Past the Past (New York: Farrar, Straus and Giroux, 2019), 155. 20. Harrison, 33. 21. Hilde Østby and Ylva Østby, Adventures in Memory: The Science and Secrets of Remembering and Forgetting (Vancouver: Greystone Books, 2018), 136. 22. Harrison, 40. 23. Ibid., 41. 24. Ibid., 42. 25. Ibid., 43. 26. Ibid., 49. 27. Ibid. 28. Ibid., 57. 29. Jaron Lanier argues that we have all become less human in the presence of the hive mind forced upon us by the ubiquity of all things www in the past few decades, understanding ourselves increasingly as the product of algorithms we neither fully understand nor can readily avoid. Lanier participated in the founding of virtual reality. See You Are Not A Gadget (New York: Alfred A. Knopf, 2010). 30. Sean Metzger, “Editorial Comment; On the Possibilities of AI, Performance Studies, and Digital Cohabitation,” xiii–xx in Theatre Journal, Vol. 73, No. 3 (September, 2021): xv.
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31. Rabbi Bradley and Shavit Artson, email communication via Rabbi Deborah Goldmann, 7 December 2021. Another version of something similar is an oft-quoted mantra of Rosalynn Carter’s: “There are only four kinds of people in the world. Those who have been caregivers; Those who are caregivers; Those who will be caregivers and; Those who will need caregivers.” See https://www.caring.com/articles/rosalynn-carter-caregi ving/ (Accessed 8 April 2023).
CHAPTER 12
Cellular Data
It was the picture of the cookies and the headline stating that “craving this food more often could be a sign of early dementia” that sent me into a “you have to be kidding” frame of mind.1 The cookies, peeking out of the top of a glass jar with a wide mouth, were the small, multishaped, and flavored kind (a few thin and crisp; a few chocolate chips; a few sandwiches with red jam or white cream filling; one or two heartshaped; a couple with chocolate frosting) that look appealing on a party plate. The publication in which the headline appeared is the online version of Woman’s World, a supermarket weekly targeting middle-class women, many of whom are mothers and work outside the home, and featuring light, brief, articles on health, beauty and grooming, home and gardening, and parenting. The article cites a study that found increases in sweets cravings among people with frontotemporal dementia and provides a small number of links to sources, with the most lay-accessible being a piece titled “Could Eating Sweets Be a Sign of Dementia?” in the popular Psychology Today.2 To be fair, the Woman’s World article does specify that the sweets cravings are a result of dementia, not its cause. It also states that such cravings are linked just to one kind of dementia, one different from Alzheimer’s, and one typically affecting people between forty-five and sixty-five, i.e., a cohort younger than those who typically manifest Alzheimer’s. But the
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connection between the image of the cookies and the word “dementia” is a means of creating what Charles U. Larson calls a “nuance of meaning”—here false meaning—via “the brushing of information against other information.”3 The Woman’s World writer goes on to say that craving cookies or a few scoops of ice cream on occasion is no cause for concern; worrisome behavior involves radical personality change, bingeing on sweets, and/or impulsive actions. Still, the headline and that cookie jar play into a present-day fear—one that, for the anticipated audience, exceeds even losing one’s figure or youthful looks—the fear of losing one’s cognition. In the end, the innocuous reminder to pay attention to changes in body and behavior (and maybe to read other articles to which links are provided in this one) is hardly by itself a full-on fright assault, but the verbal/visual come-on is clickbait (to subscribe to the publication or to purchase things it advertises) driven by a presumed anxiety. A later Woman’s World piece with a photo featuring an array of snacks including potato chips, pretzels, and seasoned crackers appeared under the headline “Eating This Popular Food Regularly for Just One Month Could Cause Memory Loss—and Lead to Dementia.”4 “This food” was anything high in refined carbohydrates (add to the list above frozen pizza, Cheez-its, and processed deli meats). Links this time were to a study done at Ohio State University on rats that blissed out on processed foods and gained a lot of weight, although only older rats ceased to be able to perform cognitive tests. Here there is a hint of a cause and effect, although perhaps only clinically proven for rodents. (Don’t enter the maze expecting to get out unless you’re a young rat?). I don’t mean to “bash” Women’s World by itself. Perhaps because I am on a list to receive emails from the Alzheimer’s Association and perhaps just because I’m interested, I frequently see other “be very scared about developing dementia if you do or have or eat (or fail to do or have, or eat) x, y, or z” lead lines and articles. Most exaggerate the danger of foods or behaviors that pose no threat in small or moderate quantities. Many are trying to sell a product as a putative preventive measure or a medical intervention. It’s fun to google the purveyors hawking various “cures”—cures that are often harmless, sometimes expensive, and usually useless. One of the most famous cases of false promises concerning a product promoted to stave off memory loss is that of Lumosity, an online program of braintraining games. While the games are still available (a customer pays for them monthly or purchases a lifetime membership), the parent company, Lumos Labs, paid two million dollars to the Federal Trade Commission
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in 2016 and agreed to stop advertising its product as a means of keeping memory loss at bay. “‘Lumosity preyed on consumers’ fears about agerelated cognitive decline, suggesting their games could stave off memory loss, dementia, and even Alzheimer’s disease,’ said Jessica Rich, Director of the FTC’s Bureau of Consumer Protection …. ‘But Lumosity simply did not have the science to back up its ads.’”5 Is it good to use one’s mind to solve problems, do puzzles, or play word games? Sure. Will such activities keep disease-driven neurological change at bay? No. Cookies and chips don’t cause dementia all by themselves. They certainly do not do so when consumed in reasonable, or even occasionally over-indulgent quantities. Attending to one’s weight, blood sugar, blood pressure, and amount of exercise are advocated by most physicians for most people at most stages of life, and especially beginning in middle age, but even managing one’s vitals to the extent that one can is not a guarantee of avoiding the onset of any number of (especially) hereditary or age- or environment-related diseases.6 On the proactive side, some foods may have some positive effects on brain health, although as Dr. Allison Reiss, a member of the medical scientific and memory screening advisory board of the Alzheimer’s Foundation of America concludes in a measured way, “I don’t think there are miracle foods, but, of course, it’s really good to eat the fruits and vegetables.”7 “Dementia” is a scare tactic that sells in the context of what Stephen G. Post has labelled our “hypercoginitive” culture and society, in which “nothing is as fearful as AD because it violates the spirit (geist ) of selfcontrol, independence, economic productivity, and cognitive enhancement that defines our dominant image of human fulfillment.”8 This might be seen as the updated version of what Jesse Ballenger described in his 2006 study as the anxiety that emerged with new notions of selfhood in the United States around the end of the nineteenth century, when “selfhood [came to be] no longer an ascribed status but had to be carefully and willfully constructed by every individual.”9 (See Chapter 3) By the end of the twentieth century, Alzheimer’s disease—still used frequently at that point as a shorthand stand-in for all dementias—was accepted tout court as a “transgression of core cultural values [including] productivity, autonomy … and cleanliness,” described with such words as “killer, thief , terrifying, ruinous, living death, never-ending funeral, private hell of devastation and destruction,” and accepted as damaging the Alzheimer’s “‘victim’s’ status as an adult, and indeed as a full human.”10
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The two plays in the next chapter—Kenneth Lonergan’s The Waverly Gallery (opening in 1999 and revived in 2018 in New York) and Stephen Karam’s The Humans (2016 in New York and followed by a national tour and numerous independent productions)—are set and were received under the rubric of what Elizabeth Herskovits calls “the current Alzheimer’s construct,” which comprises the terrified and sometimes even contemptuous attitudes thumbnailed above and which remains alive and well in our midst well into the third decade of the twenty-first century. The terror aroused as part of the Alzheimer’s construct, however, exists in the context of far greater public awareness of and willingness to name Alzheimer’s and other dementias as facts of many people’s lives. “Awareness” may or may not mean informed or up-to-date or nuanced understanding. It does mean, among other things, that Americans are no longer afraid to utter the words “dementia” or “Alzheimer’s,” and that movies, television episodes, and stories featuring characters with dementia are, if not ubiquitous, then certainly at large. How this two-pronged situation, made up of awareness cum overwrought fear, came to be the status quo can be historicized. Below I offer a very brief overview of how the “disease of the century”11 came into focus as such.
Cellular Data on the Public’s Radar Research on cognitive decline took a turn toward biology and away from psychodynamics (see Chapters 2 and 6) in the 1960s, in part because of what was facilitated by the development of the electron microscope.12 Alois Alzheimer and others working on brain pathology in the early twentieth century had used dyes to stain brain tissue samples for examination with conventional optical (light) microscopes that used magnifying lenses (One still sees these in high school labs). The electron microscope, which produces higher-resolution images by using a beam of electrons rather than glass lenses to magnify its object of examination, made it easier to see infinitesimally smaller facets of its objects, hence much more of what was occurring in the biopsied samples, and researchers were able to observe regularly occurring phenomena that could consistently be identified in the postmortem brains of people with severe cognitive impairment. The published article that set Alzheimer’s disease research and activism on a new trajectory was not exactly a scientific study, although it was written by the chair of neurology at Albert Einstein College of Medicine in New York, and it certainly depended on science research. Robert
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Katzman’s brief, highly readable 1976 “Prevalence and Malignancy of Alzheimer Disease: A Major Killer” asserted that there was no difference between the disease isolated and described almost three-quarters of a century earlier by Alzheimer, which was said to afflict people too young for what was loosely called senile dementia, and what was still in the 1970s generally called senile dementia itself.13 The designation of “Alzheimer’s disease” had been reserved for an identifiable pathological organic disorder in younger people—basically those under sixty-five. (See Chapter 2) Both iterations, Katzman stated, were the same disease, regardless of the age at onset. That disease, however, was not the same as “benign senescent forgetfulness,” the common memory change(s) seen across older populations. One was a pathology that could be studied qua biology (and then biochemistry) and neurology; the other was a not unusual and not illness-driven possible facet of old age that might also be studied, but not as a disease.14 As I have stated repeatedly throughout this book, Alzheimer’s disease is not synonymous with dementia, the former being a specific disorder and the latter a blanket category for cognitive decline that includes AD as one possible cause. Specifically isolating and naming Alzheimer’s in the 1970s, however, made possible what Patrick J. Fox calls the “diseasespecific approach” to addressing severe cognitive decline as a national “issue.”15 Since the purpose of this chapter is to sketch in broad strokes the main steps of how Americans who are not or were not research scientists came to recognize dementia as a widespread phenomenon that could benefit from federal assistance, social support, cultural awareness, and non-maudlin empathy, and that could be discussed, at least in some ways, without personal shame, the remainder of this evolutionary roadmap is a synopsis/overview, although not an in-depth, blow-by-blow description. In 1979, representatives of seven groups dealing with various problems relating to Alzheimer’s disease and other brain impairments came together to discuss the formation of a national activist organization. Three of the groups had been started by researchers; the other four were lay initiated by “family members whose relatives had AD or a related disorder and who had repeatedly experienced difficulty in obtaining medical, emotional, social, and financial support.”16 The meeting was called by Robert Butler, the first director of the National Institute on Aging (NIA, founded in 1974), who may be best known for coining the term “ageism.” From the outset, there was dissent among the constituent groups, who, in choosing a name for their endeavor, settled on the
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name Alzheimer’s disease and Related Disorders Association (ADRDA). The family support groups were and wanted to continue to be open to people whose struggles were not only with AD; it was, however, the “disease-specific” approach that won out, as the strategy more likely to garner money from the federal government (with the help of the National Institutes of Health, NIA’s parent organization). Two of the original constituent groups—family/caregiver groups—stepped away in 1980. That same year, a letter to the nationally syndicated newspaper advice column “Dear Abby” from someone signing the letter “Helpless in NY” talked about the struggle of caring for a spouse with Alzheimer’s and asking how others coped with the disease. The response from “Abby” was that the writer was not alone and should send a pre-addressed, stamped envelope to ADRDA for more information. This put a common but previously not-much-publicly-discussed problem on the table, and support groups started to be formed around the United States. The outpouring of letters to ARDA yielded “a hundred thousand names for a direct mail fundraising campaign.”17 By 1988, the arguably cumbersome moniker “Alzheimer’s disease and Related Disorders Association” was replaced with the streamlined “Alzheimer’s Association.” The organization remains robust; it has raised millions of dollars; it provides services and support for caregivers and families, many of whom are dealing with people whose dementias or brain damage are not the result of Alzheimer’s disease. But research dollars still go largely toward seeking a cure for that particular disease. As Jason Karlawish, Professor of Medicine, Medical Ethics and Health Policy, and Neurology at the University of Pennsylvania and Co-Director of the Penn Memory Center, sums up the “renaming and publicity” of the 1988 name change, these “sent America a clear message. Chapters’ services were for people with dementia and their families, but the focus of research was a cure for one—and only one—of the diseases that caused dementia: Alzheimer’s disease.”18 While drafting this chapter I received an email from a state chapter of the Alzheimer’s Association. Like most other outreach material from the Association, it nods to work on all dementia, even though close reading reveals its real priority. So, “Our mission is to lead the way to end Alzheimer’s and all other dementia” but the “ask” is to join in advocacy to approach government representatives in Washington for appropriations in the amounts of $289 million for
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Alzheimer’s research activities at NIH and $20 million for the implementation of BOLD act in the FY [fiscal year] 22 budget.”19 The funding was approved.20 The split is approximately 93–7%. Throughout the 1980s, congressional hearings about the need for financial support to address dementia-related needs largely focused on AD and on the imperative for biomedical research. A key argument was that spending in the present to find a cure for the disease would “save untold billions of dollars for long-term care in the future.”21 By one metric—dollars garnered and allocated for research—this strategy was quite successful. In 1979, the NIA spent about four million dollars on AD research; by 1999, it was spending $155 million—“a 37-fold increase.”22 “At least half of the NIA’s budget was directed to Alzheimer’s research” by 1990.23 Politicians in the 1980s were chary of increasing “entitlement” programs. Entitlements (government-funded programs typically available to individuals or families by application and designed to address problems such as food insecurity, crop failures on farms, unemployment, individualized education for children with cognitive or physical or neurological or psychological needs, or insufficient income for basic living expenses after retirement) are, once they have come into existence and reached ordinary Americans, very hard to withdraw or ramp back without incurring major voter backlash. This is what aid for caregiving (either under the rubric of Medicare, a government-sponsored healthcare program discussed below, or via a possible new, not yet existing social insurance program) would have been. Money given for research grants fluctuates based on annual government allotments to the federal agencies that vet and select project applications and generally flies under the radar of average citizens whose household budgets are not immediately affected by such allocations. The NIA was able to apply for, receive, and funnel money to AD research, but money going directly to individuals living with AD and/or their caregivers would have to come directly from the government (as an entitlement) and not via one of its institutes or endowments. The United States of the 1980s was still in the thrall of Cold War thinking that made it easy to portray such programs as incipient socialism, and, therefore, undesirable if not outright dangerous. Although President Bill Clinton, a Democrat elected at the end of 1992, introduced proposals for health care reform that would have included comprehensive long-term care social insurance, any possibility for that going forward was shut down with 1994 mid-term (i.e., in
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the middle of a four-year Presidential term) elections, when Republicans became the majority party in the House of Representatives. The quick response of the Alzheimer’s Association’s first vice president for public policy was that the Association (indeed, American citizenry) was up against “a changing philosophy that stresses a balanced budget, smaller government, lower taxes, less ‘entitlement’ spending [the scare quotes are in the original], a shift from federal to state government, and an emphasis on personal responsibility.”24 (One joke during the Trump years was that according to conservative thinking, the best form of health insurance was “don’t get sick.”) At the start of the twenty-first century, incongruent dyads remained representative of America regarding dementia. From a religious and cultural heritage perspective, there is a “psychological conflict between ‘our’ contempt for the ‘weak elderly,’ who violate Protestant and capitalist work ethic values, and our Judeo-Christian mandate to respect the ‘wise elderly,’” resulting in a conflated “condescending pity.”25 From a policy perspective, the “health politics of anguish” still fails to win financial support for caregivers, continuing to favor, as it does, the hope for a cure.26 Put another way, “our system is designed for the great breakthrough, not the great followthrough.”27 The present (hardly brand new) ironic stalemate features, on the one hand, increased awareness of the normalcy of aging and the fact that most dementias are the result of disease with the greatest risk factor being age, and on the other hand, its doppelgänger that this awareness has “in some ways … actually heightened anxiety about the prospect of losing one’s mind as one grew older. If American culture had produced more positive meanings for old age in the 1980s and 1990s, it was less tolerant than ever of disability and dependence.”28 American culture was and remains also stubbornly unwilling to ask taxpayers (itself) to pick up costs for so-called “informal care,” i.e., assisting with dressing, bathing, cooking, eating, and transportation—the usual requirements of a person with dementia who is not experiencing other needs understood as properly “medical.” Medicare, the federally funded assistance program started in 1965 that is available to Americans sixty-five and older, pays for chemical, surgical, or other professional physical curative, diagnostic, or rehabilitative intervention, including some limited equipment and supplies, but it was not created to include coverage for attending to the quotidian needs of a person living with dementia— needs that do not require anything much beyond what appears on the
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above list of informal care services and that will not go away, no matter how good the quotidian care. Such care nearly always falls to families to provide, either hands-on or via spending money, and the family members providing the care are nearly always women, something that became glaringly evident in congressional hearings of the 1980s,29 although even someone getting their information from theatregoing could have figured this out. (See Death of a Salesman and, later, The Father and Dot, with a modicum of reading between the lines in All the Living.) Alternatives—all requiring financial resources—tend to be individually hired caregivers or residential care homes understood as acceptable if expensive and private while distasteful or even embarrassing if operating under the auspices of the state. (See Joint Owners in Spain, The Father, and Wings for the former and All the Living for the latter. And see, coming up, for a little of each, The Waverly Gallery and The Humans.) Karlawish reports that in 2010, the annual cost of Alzheimer’s disease to the United States was “as much as $215 billion.” What he relates as most stunning is “the breakdown of the components of this total. Costs to Medicare—the tests, repeat visits, and the limited numbers of prescription treatments doctors order—were a small fraction. The costs of informal care drove up a total to rival the costs of cancer and heart disease” (meaning the medical costs of the latter two—not caregiving costs.)30 In 2020, the cost of unpaid dementia caregiving was estimated at $256.7 billion by one office of the National Institutes of Health.31 I return in the final chapter of Losing It to Karlawish’s suggestions for better ways to think about care for elders living with dementia that recognize priorities beyond the biochemical, pharmaceutical, or surgical and that consider better ways to allocate available resources than either to “real” medicine or primarily to laboratory research if the goal is to alleviate culture-wide suffering resulting from dementia. The hope that a medical discovery will put an end to Alzheimer’s disease (other dementias often drop out of the discussion when either the popular press or the Alzheimer’s Association are purveyors of information, although several others have their own organizations, e.g., the American Parkinson’s Disease Association) remains both front and center as the major goal of raising money in the name of dementia, even as no drug has ever done what its developers—much less its users—hoped it would. In a chapter catchily titled “Hope in a Pill,” Karlawish tells the story of the development of donepezil (marketed as Aricept, the pill Dotty Shealy takes in Dot ), a drug that addresses the loss of cholinogeric neurons in the
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brain by increasing the levels of a protein called acetylcholine, which facilitates cell-to-cell communication. Aricept provides some improvement in some cognitive competences for some time (typically a few months) for some (small percentage of) users. It slows the effects of Alzheimer’s by aiding communication between remaining healthy cells in the brain, but it is not only ineffective for most users, it is more importantly not a cure, because cells still die.32 A quarter of a century later, early in 2022, Americans could witness a similar instance of what Karlawish calls “a perverse competition that pits cure against care,” precisely around the issue of paying for a questionably valuable and very expensive drug—the first in eighteen years to address the effects of Alzheimer’s. The approval in 2021 of a controversial drug called aducanumab (sold as Aduhelm and made by the Massachusetts-based company Biogen) raised hackles among experts and lay citizens alike. The drug was approved at mid-year, but the panel of experts assembled to advise the Food and Drug Administration (FDA) the previous year had determined in a ten-to-one nonbinding vote that the drug was ineffective, potentially hazardous to some patients’ health (it caused brain bleeds), and insufficiently tested. One panel member, who was recused from a hearing but submitted a comment in writing said, “Perfection may be the enemy of the good, but for aducanumab, the evidence doesn’t even rise to ‘good.’ … Contrary to the hope that aducanumab will help Alzheimer patients, the evidence shows it will offer improvement to none, it will harm some of those exposed, and it will consume enormous resources.”33 The drug is designed to target beta-amyloid protein—the plaque that accumulates between neurons in the brains of Alzheimer’s sufferers. Such plaque is also found in the brains of older people who never develop Alzheimer’s. Even the Biogen head of neurodegeneration development said that the drug might at best prolong patients’ independence by just a few months. The drug is recommended for patients in the early stage of Alzheimer’s when cognitive difficulties are still mild. It is administered as a monthly intravenous infusion and at first costs approximately $56,000 a year. “Patients’ groups argued forcefully for approval, citing the devastation caused by the disease.”34 It is worth remembering that beta-amyloid can now be detected in the brains of living people, hence people who might be candidates for this drug can be identified via more than interviews or cognitive testing. This is not, however, detection that takes place in a quotidian clinical setting—i.e., the “ordinary” one where a doctor talks with patient and family and perhaps administers tests via games or questions or drawings.
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In other words, even learning that one has the plaques requires testing that, as discussed in Chapter 10, occurs in the context of a type of treatment that Anna Laura van der Laan calls “pulling out all the stops,” and that typically includes brain scans and analysis of cerebrospinal fluid. It requires the time and knowledge to seek it out and the resources to get to a testing clinic, which may be miles away for rural citizens, who, even if interested, might not have a friend or relative with the time or leisure to take off from work to drive them to the test, much less the money to pay for it. The other school of thought, which van der Laan calls “holding back,” centers on articulating care needs and involves minimal testing.35 So, patients whose doctors might be extremely caring and practical but might not advise extreme testing (especially for patients who couldn’t afford it), would simply not be eligible for this drug.36 For a short time, (activist) patients’ concerns seemed to prevail, as Aduhelm was approved and some people began to receive it, but seven months later, in mid-January 2022, the Centers for Medicare and Medicaid Services (CMS) proposed to limit Medicare coverage for this drug only to patients participating in randomized control trials. On the “pro” side of this proposal to limit payments were physicians and others arguing that the drug has much potential for harm and very limited evidence of efficacy. On the “anti” side were patient advocates claiming that the vast majority of people who might benefit from the drug would never get it because they would not be participants in clinical trials. Biogen, the maker of the drug, dropped its cost by half, to $28,000 a year, reportedly in response to weak sales. Meanwhile, “Medicare’s actuarial division, acting without knowing what the coverage decision would be, imposed one of the biggest-ever increases in Medicare Part B [coverage users purchase and that helps pay for doctors and some drugs, distinct from coverage for hospitalization, which is basically free for over-65s who register37 ] premiums for 2022, partly driven by the possibility of Aduhelm coverage.”38 Comments from readers of The New York Times to the story breaking the “only for those in clinical trials” news included, perhaps predictably, a reflection of the two sides of the deadlocked “how can the government help make life better for people with dementia” question. “DS” wrote “Unconscionable spending for a drug that does little or nothing and not a dime for home care. Ask the families which they would prefer?” “Jane” jumped in with “Given that it’s currently believed that hearing aids have beneficial effects against mild dementia, and these cost like $5000
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or less per year (or two or three), wouldn’t it make more sense to cover these instead? Nobody ever developed brain swelling a from a hearing aid (unless they’re hearing too much flattery, and that kind isn’t fatal).” On the other side, “James” asserted that “people paid into Medicare. They should be able to spend the money as they like. Paid Caregivers? They just sit around all day. $30,000 a year is nothing.” “Karen” pointed out that “Pharma companies never charge for clinical trial medications, in large part because most clinical trials are blinded to the participants and involve the use of a placebo for some participants. If Medicare is billed for a trial medication, then the trial isn’t blind and the patient will know their medication status. So maybe this is Medicare’s way of telling Biogen that their drug won’t be reimbursable under any conditions—at least for now.” Most responses agree with “unconscionable” based on the drug being ineffective, unproven, overpriced, and causing a hardship both to people who struggle to pay for their Medicare coverage as well as and for those who would never have access to a clinical trial. (This may reflect the general makeup of the Times ’s readership—liberal, educated, politically astute—more than it does any kind of national consensus.) Reader Eilon Caspi made the argument that this brouhaha ignores the problem of medicalizing aging and argues that the third (typically unmentioned) side of the triangle has been left out of the arguments. Not just Biogen and the FDA are trying to force Americans to look at dementia as a tragedy in search of a medical fix. Caspi names the National Alzheimer’s Association as a player in this expensive game, owing to the “massive campaign and powerful lobby [that] played a key role in the FDA approval of the drug Aduhelm.”39 In July, 2023, the FDA (Food and Drug Administration) gave full approval to lecanemab (sold as Leqembi), a monoclonal antibody that reduces the formation of plaques typically found in the brains of people with Alzheimer’s. The drug is likely to reduce disease progress, but it is not guaranteed to do so and it is not a cure for AD. This approval gave patients and doctors a glimmer of hope, but questions remain concerning the drug’s safety, effectiveness, accessibility, and cost, which is $26,500 a year with no guarantee that insurance companies will pay for it. Ninety-three to seven percent. As Ingunn Moser observes, regarding the search for a silver bullet that Karlawish called “hope in a pill” and that here might be “hope in a fancy infusion,” “clinical medicine and care practice include the pharmaceutical enactment of the disease, but the same is not true the other way around … The pill version of Alzheimer’s is
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built on a disconnection from care-versions.”40 The final two plays in this book offer stances and experiences predicated (one of each) on embracing a concern for these differing views.
Notes 1. Ashley Lall, “Craving This Food More Often Could Be An Early Sign of Dementia,” Woman’s World, 8 August 2021. https://www.womansworld. com/posts/health/sweet-cravings-dementia (Accessed 8 April 2023). 2. Andrew E. Budson, M. D., “Could Eating Sweets Be a Sign of Dementia?,” Psychology Today, 11 May 2019. https://www.psychologyto day.com/us/blog/managing-your-memory/201905/could-eating-swe ets-be-sign-dementia (Accessed 8 April 2023). 3. Charles U. Larson, Persuasion: Reception and Responsibility (Belmont CA: Wadworth Publishing Company, 1995), 18. 4. Elizabeth Laura Nelson, “Eating This Popular Food Regularly for Just One Month Could Cause Memory Loss—and Lead to Dementia,” Woman’s World, 24 October 2021. https://www.womans world.com/posts/health-news/processed-foods-memory-loss (Accessed 9 April 2023). 5. Andrea Peterson and Brian Fung, “FTC: ‘Brain Training’ Brand Lumosity Didn’t Have the Research to Back Up Its Claims,” Washington Post, 5 January 2016. https://www.washingtonpost.com/news/the-switch/wp/ 2016/01/05/ftc-brain-training-brand-lumosity-didnt-have-the-researchto-back-up-its-claims/ (Accessed 9 June 2023). 6. The Alzheimer’s Association announced research showing consumption of olive oil to be linked to lower risk of AD. A mindful reading of both the brief article in the January 2022 newsletter and the USA Today article to which it provides a link reveal the careful wording “could lower your risk” and “suggests the potential.” Nowhere are cause and effect definitively specified. See Mike Snider, “A Life-Enhancing Elixir? Olive Oil Linked to Lower Death Risks from Alzheimer’s Disease,” USA Today, 11 January https://www.usatoday.com/story/news/health/2022/01/11/ 2022. olive-oil-may-lower-death-alzheimers-risks/9170375002/?WT.mc_id=ene ws2022_01_24&utm_source=enews-aff-179&utm_medium=email&utm_ campaign=enews-2022-01-24&utm_content=homeoffice&utm_term= Story1, in Alzheimer’s Association, “Alzheimer’s and Dementia e-news,” 19 January 2022 (Accessed 9 June 2023). 7. Quoted in Amelia Neirenberg, “Can Certain Foods Really Stave Off Dementia?” New York Times, 21 April 2022. https://www.nytimes.com/ 2022/04/21/well/mind/dementia-prevention-food-diet.html (Accessed 9 April 2023).
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8. Stephen G. Post, “The Concept of Alzheimer Disease in a Hypercognitive Society,” 245–256 in Concepts of Alzeimer [sic] Disease: Biological and Cultural Perspectives, ed. Peter J. Whitehouse, Konrad, Maruer, and Jesse F. Ballenger (Baltimore: Johns Hopkins University Press, 2000), 245. 9. Jesse F. Ballenger, Self, Senility, and Alzheimer’s Disease in Modern America: A History (Baltimore: Johns Hopkins University Press, 2006), 9. 10. Elizabeth Herskovits, “Struggling over Subjectivity: Debates about the ‘Self’ and Alzheimer’s Disease,” 146–164 in Medical Anthropology Quarterly, Vol. 9, No. 2 (1995): 153. Raquel Medina points out that these attitudes and attendant negative images in all sorts of representational media have “spread rapidly across Western societies,” so Americans are entrenched but not alone in experiencing their ubiquity. (Medina, Cinematic Representations of Alzheimer’s Disease [London: Palgrave Macmillan, 2018], 22). 11. Ballenger, Self, Senility, 109. 12. Ibid., Self, Senility, Chapter 4, “The Renaissance of Pathology”. 13. Robert Katzman, “The Prevalence and Malignancy of Alzheimer Disease: A Major Killer,” The Archives of Neurology, Vol. 33 (April, 1976): 217– 218. 14. See Jason Karlawish, The Problem of Alzheimer’s: How Science, Culture, and Politics Turned a Rare Disease Into a Crisis and What We Can Do About It (New York: St. Martin’s Press, 2021), Chapter 11, “The Essay Heard Round the World,” 110–118. Katzman nodded to many researchers in making his argument. Especially noteworthy are R. D. Newton and M. A. Neuman and R. Cohn, whose work in 1948 and 1963, respectively, (i.e., long before Katzman wrote his short essay) enabled Katzman to assert that “both Alzheimer disease and senile dementia are progressive dementias with similar changes in mental and neurological status that are indistinguishable by careful clinical analyses”. 15. Patrick J. Fox, “The Role of the Concept of Alzheimer Disease in the Development of the Alzheimer’s Association in the United States,” 209–233 in Concepts of Alzeimer [sic] Disease: Biological, and Cultural Perspectives, ed. Peter J. Whitehouse, Konrad Maurer, and Jess F. Ballenger (Baltimore: Johns Hopkins UP, 2000), 213. 16. Fox, 214. 17. See Karlawish, The Problem of Alzheimer’s, Chapter 12, “A Self-Help Group for the Self-Made Man,” 119–127. Quote is on 127. At the end of the chapter, Karlawish reveals that the Dear Abby letter was staged, as its writer was Jerome Stone, a key player in the formation of ADRDA, a self-made businessman who was at the time the head of a Fortune 500 company, and the husband of a woman with severe dementia. 18. Karlawish, 130.
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19. Vermont Advocacy in Action Newsletter, Vol. 1, Issue 1, January 14, 2022. “The BOLD Infrastructure for Alzheimer’s Act was passed into law on December 31, 2018 (P.L. 115–406) pdf icon [PDF—312 KB] external icon and amends the Public Health Service Act (Section 398A; 42 U.S.C. 280c-3-4). The acronym stands for Building Our Largest Dementia Infrastructure, but as the previous sentence of this note reveals, the 2018 passage was for the BOLD Infrastructure for Alzheimer’s Act (italics mine). The activities outlined in BOLD are designed to create a uniform national public health infrastructure with a focus on issues such as increasing early detection and diagnosis, risk reduction, prevention of avoidable hospitalizations, and supporting dementia caregiving. 20. Alzheimer’s Association, “Congress Agrees on $289 Million Alzheimer’s Research Funding …,” 9 March 2022. https://www.alz.org/news/ 2022/congress-agrees-on-alzheimers-research-funding-inc (Accessed 9 April 2023). 21. Fox, 222. 22. Ibid., 220. 23. Karlawish, 131. 24. Quoted in Karlawish, 143. 25. Herskovits, 151. 26. Ballenger, 145. 27. Atul Gawande, “The Costa Rica Model,” 30–41 in The New Yorker (30 August 2021): 40. 28. Ballenger, 145–146. 29. Fox, 222. 30. Karlawish, 18. 31. “2021 Alzheimer’s Disease Facts and Figures,” March 2021, National Library of Medicine/National Center for Biotechnology Information. https://pubmed.ncbi.nlm.nih.gov/33756057/ (Accessed 9 April 2023). 32. One might expect that some kind of testing for a reliable biomarker in the brain warranting the use of the drug would be the prelude to prescribing it, but one would not necessarily be correct. My late husband was prescribed this drug, but he did not have Alzheimer’s disease. Very late in the game, the revolving door of neurologists who saw him at regular appointments (it was rarely the same doctor twice) accepted that he had Progressive Supranuclear Palsy. I say “accepted” because it was my (not his) eye doctor who told me this had to be the diagnosis, based on a single salient symptom I mentioned in passing at my own annual eye exam; when I passed this on to one of the neurologists, the neurology clinic seemed to start to think differently. My husband had, in fact, had the spinal fluid test that revealed he did not have the clinical marker for AD, but because he had had the test as part of a clinical study, the information could not be released to a personal physician—something that
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34. 35. 36.
37. 38.
39.
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might have aided in a diagnosis, if only by a via negativa. My access to that information about his clinical test came about through cajoling and pushing when he was admitted for a wholly other reason to the hospital (part of a major medical center) where the study was being undertaken and I (admittedly probably a little rudely) pursued the “come on—those records live somewhere in someone’s files in the X office on the Y floor— try asking” route. It worked to a limited extent, which is to say that the doctors treating him at that hospital for the non-dementia related admission saw the results, but I had no access to them and they were not available to the neurologists who saw him in a different context and a different city once the dementia became evident. Pam Belluck, “F.D.A. Panel Declines to Endorse Controversial Alzheimer’s Drug,” New York Times, 6 November 2020. https:// www.nytimes.com/2020/11/06/health/aducanumab-alzheimers-drugfda-panel.html (Accessed 8 April 2023). Belluck, 2020. See van der Lann’s “Emergent Biomarkers and Good AD Diagnostics,” especially 110–112. The bipartisan ENACT (Equity in Neuroscience and Alzheimer’s Clinical Trials) Act of 2021 “Sets out Activities and Requirements to Increase the Participation of Underrepresented Populations in Research and Clinical Trials for Alzheimer’s Disease and Related Dementias,” https://www.con gress.gov/bill/117th-congress/house-bill/3085 (Accessed 9 April 2023). https://www.medicare.gov/what-medicare-covers/what-part-b-covers (Accessed 9 April 2023). Pam Belluck, “Medicare Proposes to Sharply Limit Coverage of the Alzheimer’s Drug Aduhelm,” New York Times, 11 January 2022. https:/ /www.nytimes.com/2022/01/11/health/aduhelm-medicare-alzheimers. html (Accessed 9 April 2023). Ibid. Readers’ responses appear on a link at the end of the article. They continued to be updated for several days after Belluck’s piece first appeared. Ingunn Moser, “Making Alzheimer’s Disease Matter: The Politics and Interferences of Different Practices Concerning AD,” 165–184 in Emerging Technologies for Diagnosing Alzheimer’s Disease: Innovating With Care, ed. Marianne Boenink, Harro Van Lente, and Ellen Moors (London: Palgrave Macmillan, 2016), 181.
CHAPTER 13
No. Regrets.
Wav(erly)ing Goodbye Playwright Kenneth Lonergan dedicated The Waverly Gallery, which was a finalist for the Pulitzer Prize in Drama in 2001, to his grandmother and mother.1 Critics for both the 2000 production, which ran at the off-Broadway Promenade Theatre, and the 2018–2019 production at Broadway’s Golden Theatre, noted that the piece is autobiographical2 — the grandson character, Daniel, a “stand-in for the author.”3 The play depicts the two-year decline between 1989 and 1991 of octogenarian Gladys Green, a talkative, sophisticated, retired activist lawyer, now the owner of a small art gallery—described in one review as “dilapidated”4 — in Greenwich Village (known as a “bohemian” part of New York city since early in the twentieth century). The play’s text is strong on detail but short on plot in the sense of conflict or mystery.5 Gladys gets sicker and deafer and more forgetful; she starts substituting words and repeats questions and observations almost ad nauseum. By the end of the play, she can no longer live safely on her own. Her seeming inability to fully grasp what is happening to her makes for a bit of action and agon, but the primary lens is trained on how Gladys comes to grate on her family’s nerves as she loses cognitive ground, eventually unable to realize exactly where she is or what time it is. She wakes up and knocks on Daniel’s door frequently in the middle of the night, and she manifests paranoia (e.g., yelling that someone has stolen her dog, when she doesn’t have a dog). The family © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 D. Chansky, Losing It, https://doi.org/10.1007/978-3-031-20902-4_13
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loves yet resents her; the characters and the audience are confronted with loss and sadness. By the end of the play, we learn from Daniel’s narration that his mother, Ellen, Gladys’s daughter, has moved Gladys into her (Ellen’s) and her second husband’s apartment, where two caregivers tend to her needs and where she finally dies. Multiple reviewers, both in 2000 and again in 2018, use the descriptor “memory play.” A major difference between the reviews for the earlier and later productions is that in 2000, a few critics used the words “senile”6 or “senility”7 to describe Gladys, while almost none did in 20188 when the favored word had become “dementia.”9 As we have seen with other plays in Losing It, although Alzheimer’s is never mentioned in the script, some reviewers used it.10 Yet increased medical awareness, news coverage, depiction in mainstream Hollywood movies, and advocacy did little to change responses to the play over a two-decade period. How Lonergan writes the situation and the opportunities he affords his actors therein are what is powerful. Critic Leah Greenblatt describes Lonergan as “a sort of master miniaturist, a keenly perceptive chronicler of small, telling moments. His characters rarely live large-canvas lives; instead they talk, meander, and double back, fumbling for ordinary truths and landing, somehow, on the profound.”11 Peter Marks calls “Lonergan’s ear for the crossroads of love and recrimination, of accusation and confession... as fine as that of any American dramatist.”12 One reviewer praised actor Lucas Hedges as Daniel in the 2018 production for being “an excellent, utterly transparent emotional lightning rod.”13 Another noted that “the essence of the play” is summed up by the one non-family member character, an affable but hapless amateur painter who stumbles into Gladys’s gallery and to whom she offers both a show and living space: “‘I tried to get the details right,’ he says, ‘because that’s what you remember when you think about something, so I tried like hell to get them the way they are.’ So did Mr. Lonergan. That’s what makes ‘The Waverly Gallery’ a work of such hard, compassionate clarity.”14 Virtually all critics for both the 2000 and 2018 productions were lavish in their praise for the actresses playing Gladys: Eileen Heckart in 2000 and Elaine May in 2018, both in their eighties at the time they undertook the role. John Simon praised Heckart’s pitch-perfect “spotty mind, wayward hearing, croaking voice, and shuffling walk,” adding that “admirably, she manages to make Gladys as likable as she is irritating.” Linda Winer applauded Heckart’s work in what was possibly “the role of her formidable career,” calling the performance “a massive portrayal of an
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aging woman we have not seen onstage with this depth and devotion.”15 Heckart won both a Drama Desk and a Lucille Lortel Outstanding Actress Award for her work. May won a Best Actress Tony as well as a Drama Desk Award for Outstanding Actress in a Play. One critic wrote that May delivered her Gladys “with a very stealthy command. It is painful to watch. That’s how good she is.”16 Because I am discussing critical responses to two different productions, and because readers or others may choose to mount or see other productions, I will focus on what is textually encoded and more or less by necessity embodied by actors rather than on design or staging choices, although, of course, these are important delivery modes in a live performance, and they figure in major ways in affective response. The play’s opening scene does double exposition duty. As Gladys and Daniel have lunch together in the gallery, she tells him about his father, his grandfather, her past, her family’s wealth, and her love of socializing. Daniel has heard it all before, but the audience gets to learn that Daniel’s father, Mark, left his wife (Daniel’s mother, Ellen, who has remarried a man named Howard); that Gladys’s husband was a doctor with whom she lived in Germany while he was on a research fellowship prior to World War II; that this grandfather paid for Mark’s medical training; that Ellen is a psychiatrist; that Gladys was in the American Labor Party; that her father had “plenty of money”; and that she and her husband bought the building in which she and Daniel live (in separate apartments) after the return from Germany. We also learn that Gladys persists in thinking that Daniel writes for a newspaper, although he clarifies (not for the first time) that he is a speechwriter for the local head of the Environmental Protection Agency. After six pages of this nearly nonstop chatter, Daniel steps forward to tell the audience that he wants to relate the story of what happened to his grandmother at the end of her life, which includes the fact that she ran the gallery off Washington Square for twenty-eight years, that he began to find it hard to visit her because it was difficult to get out once a conversation got going, and that the story will also include Don, the painter from Lynn, Massachusetts (a suburb north of Boston with relatively high rates of crime and poverty), with limited talent but a lot of patience and resourcefulness, who had the last show Gladys offered at the gallery. (Fig. 13.1). In the next scene, we learn from Gladys that Ellen attended medical school in Boston (which meant in the late twentieth century Harvard, Tufts, or Boston University—a kind of name-dropping) and now lives
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Fig. 13.1 The Waverly Gallery. Josh Hamilton as Daniel and Eileen Heckart as Gladys, 1999–2000 (Photo © Carol Rosegg)
on the Upper West Side near Central Park (i.e., in a relatively expensive residential neighborhood with easy access to museums, theatres, Lincoln Center for the Performing Arts, lots of green space, many stylish restaurants, and more Jewish and liberal than it Upper East Side counterpart). Gladys’s interlocutor is the newly arrived Don. She talks about changes in the neighborhood near her gallery and apartment. These include an influx of well-dressed Koreans, unsavory drug dealers, and aggressive muggers. In the third scene, at dinner in the apartment where Ellen lives with Howard, who is also a psychiatrist, Gladys complains that everyone in the bank around the corner from the gallery is Black (“And we wanted that. We fought for that”) but that now no one in there will talk to her. In the same scene, we come to understand both some of the specific manifestations of Gladys’s decline and the family’s frustration with these. We are also introduced to additional facets of their class privilege, including Howard and Ellen’s vacation house in Vermont that they like to visit on weekends to get away from socializing (contra Gladys, who used to own a summer house on Fire Island, where she loved to entertain). Not only
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does Gladys need to be reminded that the name of “where you go” is Vermont17 but she tells the family that Don, the painter, is from the same place. Although his home state, Massachusetts, is just south of Vermont, hence the possibility of confusion if one is drawing on a vague mental map, Don’s hometown is both on the coast (Vermont is inland) and, as a working-class city, hardly possessed of the sort of charm that “vacation home in Vermont” is expected to evoke for New Yorkers. Gladys also makes much of not having learned to cook, reminding Ellen (whose cooking she praises) of the cook they had when Ellen was a girl. Howard is concerned about Gladys allowing Don to move into the back of the gallery before the family has met him, which they plan to do in a few days. When Ellen says Howard needs to remind Gladys of this, he says he’s already told her five times. Daniel says Gladys is driving him crazy, tells his mother that Gladys is definitely getting worse, and leaves the room to “take a break.”18 Ellen mutters in frustration that she is going to blow her brains out. Later in the play, she says that she can’t handle having her mother visit more than a couple of times a week; that if Gladys moves in, she (Ellen) will have to move out; and that if they move Gladys into their apartment, Ellen will have to slit her wrists. Reviews suggest that the play was received almost overwhelmingly as “relatable,” in ways the author likely intended, with few critics pointing out any chinks in the representational armor. In one of the most oftquoted lines from the play, Daniel tells Don: “We’re liberal Upper West Side atheistic Jewish intellectuals—and we really like German choral music.”19 In keeping with the world of the “Alzheimer’s construct,” Gladys’s disease and her family’s feeling of loss—as well as frustration—are understood as depressing, regrettable, arguably frightening, and definitely maddening. One critic noted “audience members at intermission, rifling through their own bad memories of grandparents who kept repeating themselves or overfed the family dog [a Gladys action that irritates Ellen]... with the survivors left to sift through feelings ranging from gratitude to guilt.”20 A second critic reported an audience member behind him “spluttering... ‘When I get like that, just shoot me.’”21 Another reviewer confessed he was, by the end of the play, “ready to sign the dear old thing’s commitment papers myself,” before concluding that the “subject is universally familiar—and therefore inevitably affecting... a heart-tugging little docudrama.”22 Compressed to a succinct description of the play’s optic, one critic wrote that the play views Gladys “with exasperation, frustration, sadness, and love.”23 Another critic described the
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play’s trajectory as “gradual modulation... to searing pathos... [because] there’s only one direction it can go.”24 The climactic moment occurs, from the perspective of the narrator of the memory play, when Daniel tells his mother: “I love you so much I can’t even tell you. I don’t know what I’d do...” (ellipsis in original).25 One critic took issue with the “memory play” category, as there are a couple of scenes without Daniel and that he could not have witnessed. Most reviewers accepted the playwright’s and his stand-in’s tone of sadness—almost nostalgia. As art critic Peter Schjeldahl wrote of audience consensus in another arts context, there seemed to be “assumptions of automatic agreement.”26 In no way do I want to suggest that the decline of a loved one does not cause for reflection that frequently includes sadness, nor that immediate family do not feel impending loss, intimations of their own mortality, pressure, or confusion. And they sometimes experience remorse or helplessness or inadequacy about finding ways to care for elders at the end of their lives. But the play, with its liberal humanist assumptions, produces (or attempts to produce) its audience as what Hana Worthen calls an ensemble: “an audience articulated as a supraindividual humanity prior to consciousness, inherent in the drama-as-word,” contra “its nemesis, the assembly (an audience of rationalized individuals finding independent points of articulation within the liberal event of theatre.”27 The feelings that the writer seems to take for granted will occur in the audience—that he arguably attributes in advance and en masse, as it were—seem to me to represent an assumed consensual emotional response, with critics mostly obligingly going along. Philosopher Sara Ahmed writes that emotions, far from being what Worthen calls “prior to consciousness,” are not psychological states, but “social and cultural practices.”28 Ahmed attributes shared understandings that certain phenomena or people or events certain feelings as products of repetition. “[I]f a word is used in a certain way, again and again, then that ‘use’ becomes intrinsic; it becomes a form of signing.... The resistance to the word acquiring new meaning is not about the referent; rather the resistance is an effect of these histories of repetition of the word.... This repetition has a binding effect.”29 The referent here is the person with or the assumed fear of or the phenomenon of cognitive decline, but the word(s) that have meaning are what constitute the Alzheimer’s construct, articulated by Herskovits: “killer, thief , terrifying, ruinous, living death, never-ending funeral, private hell of devastation and destruction.”30
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Is it possible to resist this reading? Must audience members and readers accept Chris Jones’s assessment that “we John and Jane theatergoers, assuming we’re still vaguely in our right minds, observe with dread that some version of the fate that befalls... Gladys Green is most likely also waiting for us.” Lynn Casteel Harper, whose job title is minister of older adults at Riverside Church in New York City, accepted, in her mid-thirties, in light of her family history, that she herself will likely develop dementia. The penultimate chapter of her 2020 book On Vanishing, is titled “When I have Dementia.”31 No “might,” and not “if,” but “when.” She declares her “will to live with dementia as an act of protest against a dominant culture that wishes not to be troubled by my presence. I pronounce my body deep in dementia a sign of resistance to a society that sees elders, especially elders with dementia, as a burden.”32 Harper’s declaration is not, of course, a review of The Waverly Gallery, although one critic for the 2018 production, hinting at the possibility of more nuanced (dare I say evolved?) thinking, noted that the impact of the play had probably lessened in twenty years, now that “stories of Alzheimer’s patients in movies like ‘Iris,’ ‘Away from Her’ or ‘The Notebook’ were more common.”33 It had not lessened—or at least not by much and certainly not among critics. Still common were assessments such as Adam Feldman’s in Time Out New York, in which Gladys is labeled as someone whose disease “robs her of personhood,” leading her to become “a terrifying burden.”34 Harper notes her own discomfort with a gerontologist colleague beginning his workshops for caregivers with the reminder that “their loved ones remain persons throughout their illness.” She writes in response to this that she is “troubled that... [this] 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....We seem to have placed dementia beyond the scope of ordinary human imagining.”35 I do not wish to place myself beyond ordinary human imagining, but I want to offer a very different response to the final moments of The Waverly Gallery (which I saw in early 2019) from that of most of the critics quoted above and of most of the people sitting around me in the theatre, some sobbing and many at least sniffling at the end of the performance. I’ll start with Daniel’s final speech to the audience, immediately after he tells his mother how much he loves her.
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Gladys moved in with Mom and Howard, where she just got worse and worse. For the last two months of her life, all she did was moan, whether she was awake or asleep. A friend of mine said the whole thing was just unanswerable, and I guess it was. After she moved uptown, I would see her when I went to visit, but I was out of it now. My mother never got out. With the help of Howard, Florence and Marva, she stood by Gladys for the next two years. She took care of her and dressed her and cleaned her up and fed her and watched her fall apart, day in and day out with nothing to stop it and no relief in sight. One night Mom called me up and told me she thought Gladys was dying. I rode my bike uptown and went into the back room where Gladys lived now. By that time she was just this tiny, eight-seven-year-old body, lying in the back of her daughter’s apartment, hanging on with almost nothing, but struggling anyway for one more breath. She finally died around two in the morning. And after that, it was a lot easier to remember what she was like before. But I never want to forget what happened to her. I want to remember every detail, because it really happened to her, and it seems like somebody should remember it. It’s not true that if you try hard enough you’ll prevail in the end. Because so many people try so hard, and they don’t prevail. But they keep trying. They keep struggling. And they love each other so much; it makes you think it must be worth a lot to be alive.
One reviewer who had apparently spent some part of the play as a skeptic was won over by this speech, writing that “Daniel turns to us and delivers what felt to me like a short homily on human perseverance and struggle... all my misgivings about the play’s direct address were forgotten.”36 If one reads it as coming from the limited perspective of a privileged twentysomething who overnight more or less came to be “out of it,” one can accept it at face value. But in light of what we have already learned in the play and what we might know as a culture, it can grate. Or at least fall short. What, after all, would it mean to “prevail?” To cheat death tout court ? One might start with the “out of it”/“in it” observation. Seemingly in one fell swoop, Daniel has gone from caring about spending time with his grandmother (annoying though he finds it at many points) to relegating her to the category of less than human warehoused in the back room and exempting himself from assisting the mother he loves so much. (Visit Gladys to play some music? Bring her an ice cream? Listen to her repeat herself? Give Mom a break? Take her outside, in a wheelchair if need be? He does, to be fair, say he sees her when he visits his mother, but there is
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no indication that visiting Gladys is the, or even a, priority.) Meanwhile, he positions Ellen as the primary caregiver, with “help” from Howard, Florence, and Marva. Howard has revealed himself to be clumsily insensitive in an onstage phone call to his own parents, who are clearly losing cognitive ground and driving each other crazy. (At ninety-three, his father claims that his marriage of sixty-three years was a mistake and that he wants to get a divorce and move to China, leading Howard to conclude that, well, you just get old together and “torture each other to death.”37 ) The two psychiatrists in the play seem both tone-deaf and ignorant when it comes to any understanding of how to interact with elders in cognitive decline. They seem clueless about the pathology of dementia (any dementia), for example, accepting Gladys’s doctor’s statement that Gladys might live another ten years (possible but highly unlikely), and indifferent to such personal discomforts (on Gladys’s part) as fear, anxiety, or paranoia. If they are not indifferent, they certainly seem to be lacking in skills about how to assuage discomfort arising from such states. The play uses the word “analyst” (old fashioned? certainly not the current “therapist”), and at one point we learn that Howard sees patients in an office that is in his apartment. Separate from the medical world? The hip and monied version of the insulation cum arrogance of the psychiatrists in All the Living ’s state hospital? The onstage absence of Marva and Florence troubled me the most. We first hear of Florence about a third of the way through the play, when a frustrated Ellen tells her husband and son, regarding Gladys’s increasing needs, that Florence helps Gladys two mornings a week and that Ellen wants her to learn how to administer the insulin shot Gladys requires for mild diabetes. Later, at the start of the second half of the play, Daniel tells us that his mother hired “a nurse’s aide named Marva” to go to Gladys’s apartment to make breakfast and administer the insulin on days when Florence was not there. Gladys, according to Daniel, “hated it. She said there were these women in the house and they wouldn’t go away.”38 Ellen relates in passing that Florence is “a saint.”39 Since we know nothing about Florence, a common interpretation of this observation might be that Florence is patient and uncomplaining. Is this sufficient qualification for an effective aide? Does she understand or stimulate Gladys? Is she conversational or medically knowledgeable (e.g., about predictable physical and behavioral phenomena that are routine with dementia) beyond being able to learn how to give an injection? Can she handle things in a pinch? Is her primary virtue that she validates Ellen and doesn’t complain?
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In the short story “Coda,” author Tessa Hadley parses the question of caregiver/saint in the voice of a first-person narrator who has moved in to help her ninety-two-year-old mother during the early part of the Covid lockdown. Both mother and daughter, the latter divorced and recently retired from teaching, enjoy some class privilege, although they are not wealthy and the narrator’s stepfather, now deceased, has left her formerly somewhat spoiled mother with very little money.40 Looking out the window, the narrator sees a woman in what looks to her like a nurse’s uniform who steps outside for cigarette breaks, is middle aged with thick ankles, has a snub nose and “scarred, bad, skin” as well as a “stocky build,”41 and who, when the two meet in a grocery store parking lot “seemed to arrange her face... into an expression of guarded minimal pleasantness, appropriate for dealing with someone of the employer class.”42 The narrator discovers that the woman, whose name she learns is Teresa, is a caregiver for the elderly man next door and somehow surmises that Teresa would be a major asset in a time of unexpected need. This moment comes (the narrator’s mother falls and cannot get up) and, when the narrator runs next door for help, Teresa knows how to handle the combination of a fallen elder and panicked family member with courtesy, professionalism, and efficiency. The narrator relates, when she had first suspected Teresa’s competence, that “this gift of caring... had nothing to do with being saintlike. I’d heard this woman on her phone, and she wasn’t in the least a saint: she could be harsh, or shallow. God knows what her politics were. Yet I had a hunch that in a crisis, right down at the bottom of life, where all the trivial judgments about taste and personality and class no longer count for anything, she had the right hands to ease you and comfort you.” This is infinitely more than Ellen tells us about Florence and certainly more than Daniel seems to know first-hand or even want to know about. Indeed, much of The Waverly Gallery is precisely about taste and personality and class (the house in Vermont, the German choral music, a cruise on which Gladys took Daniel as a child, the family cook, the fellowship in Germany). The mother in “Coda” is vain, snobby, and not always polite, but the narrator—whose voice is the important one, as Daniel’s is in The Waverly Gallery—learns a life lesson from even the briefest of encounters with a professional whose skillset is, under the circumstances, precisely what matters most. It may be a little unfair to put all the burden on Daniel for directing audience attitude, as Gladys is a “character” both in the idiomatic sense of being engaging and slightly larger than life as well as in the sense of having
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a lot of stage time and elbow room for an actress in which to maneuver. What can we learn of the caregivers and of caregiving by paying attention to her point of view, which is not always generous nor disinterested? She complains twice to her daughter with specifics. In what might be the less shocking or prejudiced of the things she relates, she says “there’s one woman who comes in and sits there—Hm! (She demonstrates ) And she doesn’t say a word all day long. And I want someone to get rid of her.”43 Whether this is the “saint” or the certified nurse’s aide, the woman in question has not figured out a way to get through to or cajole or possibly even accept Gladys. I imagine the caregiver sitting with her arms crossed and a look of resentment or boredom on her face, although these specifics are not stipulated. Consider what the actress playing Gladys demonstrates. There is interpretive leeway, but whatever the choice, it will suggest something she finds and wants to convey as off-putting or at minimum, indicative of indifference. With money as no object (critic John Simon observed in his 2000 review that the family is “not impecunious” and couldn’t understand why they could not find a “nice old-age home” for Gladys44 ), people with financial resources seeking to hire a caregiver need not settle for the first (or second, or third) person able to give an insulin injection, protect their charge from leaving a pot to burn on the stove, and generally keep an eye out. Parents whose small children express dislike for one particular babysitter or another usually, if they have the means to pay for such help, look for a different one. Where is Ellen? In a more graphic anecdote, Gladys relates an incident in her apartment, saying she found “a woman there who comes in every day... a very good-looking black woman, and I went to the bathroom and she was standing there, standing up, peeing like a man, into the—cup.”45 The scripted pause before the final word and the arguably strange word choice mesh with Gladys’s beginning to lose vocabulary. A couple of scenes earlier, at a family dinner, she has offered Daniel some broccoli (indicated in the stage directions) by asking if he wants “any of this— vegetable.”46 So, with regard to the “woman who comes in every day,” Gladys has probably barged in on the caregiver using the toilet—“toilet” being the word she is not quite able to summon and for which she substitutes “cup.” However, just as Gladys cannot unsee what she thinks is a black woman urinating in a standing position, I could not unhear that. Here I refer not only to the conceivably odd, or at least unusually
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positioned, behavior Gladys claims to have observed, nor to her reference to the woman’s color, possibly mitigated in the playwright’s eyes by adding that the stranger is very good-looking. (This related event is quite possibly one of the things to which one critic obliquely referred in saying that “the show occasionally flirts with tastelessness.”47 ) Gladys expresses herself as well as she can to her daughter, who remains unable to parse her mom’s feelings (despite making her living parsing the feelings of others) and preferences even as she (Ellen) depends upon caregivers to make her own life bearable, at least by assuaging her guilt and tending to Gladys’s bodily needs and corporeal safety. The caregivers’ physical absence struck me, when I saw the play on Broadway, as solipsism on the part of the playwright and his stand-in— treating the women’s existence and work as only of any significance in taking a little pressure off the ongoing emotional burden felt by the family.48 My attendance at the theatre that night was made possible by my late husband’s caregivers (it was an overnight excursion for me, so more than one caregiver was involved). I knew he was safe. I knew they understood his preferences. I knew they talked to him and played music for him, as well as keeping him clean and nourished and turning him over at regular intervals during the night to prevent bedsores. One of them routinely clipped his toenails, after soaking his feet for him and doing all of this while his wheelchair was positioned so he could see the squirrels and birds in the backyard and with some of his favorite music playing softly. It’s hard to tell what, if anything, Daniel knows or knew about Florence and Marva, as he attributes his grandmother’s care to his mother, with “help” from others. What Daniel describes briefly as his mother’s care (feeding, washing, dressing) is what is sometimes called “bed and body” work, contra interactive emotional engagement, response, or stimulation.49 Acknowledging all the pressure and frustration that Ellen experiences, could we read her as failing to see/know/ do/investigate the “best” for her mother? Perhaps not from Daniel’s (sheltered?) point of view, but what about from critics’? What of the two decades’ (at least) worth of thinking about dementia and dementia care that barely showed up in their assessments? The theory of “person-centered care” for people with dementia got traction in 1997, when Tom Kitwood published his book Dementia Reconsidered: The Person Comes First .50 The concept was not new, having been presented in 1961 by Carl Rogers, a psychotherapist.51 It focuses on including dementia patients in decision-making concerning their care
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via careful communication aimed at mutual respect. (Yes, they sometimes resist; no, this is not always straightforward or uninflected by denial or anger.) The goal is to contribute to the dementia sufferer’s wellbeing, with the opposite being a sense of “illbeing,” the latter frequently the result of “malignant social psychology,” or actions that undermine personhood, including not being valued, not being listened to, and not infantilized or bullied.52 None of this is to say that people with dementia are always calmly reasonable and consistent, that they don’t decline, nor that they never experience illbeing. It is to say that they are not empty shells devoid of emotions, preferences, desires, anxieties, and the ability to attempt to express any of these, especially in the early phases of decline. Recall Harper’s pointed observation that “Brain death...does not resemble dementia, even advanced dementia. A palpable life force abides in persons with dementia—sometimes a discomforting life, but a life to encounter, engage, and know nonetheless. They make motion and express emotions; they act and attempt to act. Personal expressions endure, however subtly. Their highly symbolic language requires sensitive interpreters and compels creative response.”53 Lonergan articulates something in this vein in a note near the start of the second act of the play, just before Gladys enters and first speaks. “While Gladys now has a lot of trouble finding the right words, she still knows exactly what she is trying to say, and still addresses herself directly to the others with the same dogged persistence. In other words, she is not lost in her own world, nor disconnected from the others, nor is she talking to herself. She at all times pressures them for answers, and when they ignore or placate her it drives her even harder to get a real response from them.”54 Knowing how to enact person-centered care is a skill that can be acquired with training, but it takes time and it involves more than a long fuse and a big heart (although these may help). Ingunn Moser, in challenging the primacy of science and medicine in Alzheimer’s and other dementia analysis and treatment, asserts that laboratory science and biomedicine see dementia one way, while nurses and family members see it another. Moser discusses the Marte Meo method of working with dementia patients in facilities as one that is primarily concerned with the “nature and quality of the human relations” experienced by those patients.55 Caregivers (typically nurses) using this method, which was developed originally as a means of working with troubled, unruly schoolchildren, do research and analysis to work on “specific material practices and arrangement. These include videotaping, assessing both behavior and observations, experimenting with objects and relations, and
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manipulating these in typically problematic situations.”56 The making and studying of videos sound like the sort of work sports coaches and players do to improve their games, in part by analyzing past maneuvers by means of recording, replaying, and then strategizing. “Marte Meo” means “by one’s own power.” It was developed in the late 1970s and early 1980s. One analysis of its use with children in the Netherlands, Scandinavia, France, Ireland, and India, states “it is often regarded as effective, cheap and pragmatic, which is opposite the viewpoint held by the therapeutic community in the United States, where the method is regarded as too time-consuming.”57 Anne Vittoria further notes that in the nonbiomedicine camp, professional caregivers and family members may also differ regarding what is “good” for a person living with dementia.58 In no way am I suggesting that Lonergan should have written a different play. The one he wrote features the point of view of Daniel, who is sheltered from his grandmother’s care (“out of it now”) and remembers with a mixture of nostalgia, ignorance, and possibly regret how she was before the family decided two years prior to her death, that she, in a way, was no more. His assertion that he is talking about the final years of her life even as he says he basically walked away from the last two is telling. Lonergan’s detailed representation, richly performed by Heckart and May and their supporting casts, provides the sort of pleasure Aristotle claims audiences experience via mimetic imitation, either because as an imitation it confirms what they have previously experienced, or because, if they have not experienced the referent before, it allows them to appreciate the skill with which the imitation is executed.59 Hence, audience nods of recognition or muttering that they’d rather be put out of what they imagine would be their misery than live with dementia (confirmation of the Alzheimer’s construct), coupled with acting accolades for the lead actresses. I am instead interested in what seems to me an almost marching-in-lockstep mindset of reviewers who spoke, of course, for themselves but also presumably to readers who could see the dramatic situation of the play in terms of a particular optic, which turned out to be, using Hana Worthen’s term, an ensemble optic. In a most extreme instance, critic Marilyn Stasio noted “potent” emotions (even if the play’s “poignancy is a bit heavy-handed”), but pressed the point that “if they gave a prize for Most Depressing Play of the Season, this one would win in a walk.”60 In a tarter vein, Tim Teeman noted “all the characters are set on a rinse-and-repeat sequence of impatience and anguish, which is very real when it comes to caring for a loved one suffering from Alzheimer’s
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but adds up to a hollow-feeling act of theatre.”61 Depression, repetition, very real, not enough dramatic tension. Is it possible for a play about a family caring for an elder member with dementia to invite a dispersed, “audience as assembly” response? To be a little more Brechtian or perhaps postdramatic even in the context of Americans’ general preference for realism?62 To be other than a decline narrative? To allow actors to create characters in a mimetic mode but with sufficiently differing perspectives that an audience, in the plural sense, is invited to step back individually from a single assumed response? Yes, yes, yes, and yes.
Humans. Resources. In saying that The Humans invites an assembly response (the assembly being, again, “an audience of rationalized individuals finding independent points of articulation within the liberal event of theatre”), it is important to underscore that the reason Stephen Karam’s play, which was first presented in 2014, offers “independent points of articulation” is not on account of its being fragmented or nonlinear or abstract. The play is hardly anti-realist, either in the construction of its characters or locale or in its language, which is in the realm of the American everyday, although the script’s stipulated noises and erratic illumination (bulbs keep blowing out in the already dark apartment) that characterize its setting allow for an eeriness that might seem a little otherworldly, or at least creepy.63 It is quite readable as a “liberal event of theatre,” inviting recognition of a quotidian and using popular tropes about everything from dating and cell phone reception to student debt, Weight Watchers, expense accounts, big box stores, and specific New York neighborhoods. At least four reviewers used the term “slice of life”64 in their critiques. The play is not, however, driven by a quest for any kind of narrative closure or the solution of any mystery. There is neither an Aristotelean recognition nor a reversal. It is a ninety-five-minute, intermissionless, real-time depiction of an American family gathering for Thanksgiving. Of the six characters, all of whom are onstage throughout, five are related by blood, representing three generations and at least four social classes struggling to get by emotionally and financially and struggling to empathize (when they take the trouble to do so) with the others. The independent points of articulation offered to the audience via text and acting have, as much as anything else, to do with age, profession, education, and place in the capitalist pecking order. In saying this I am not saying that an audience member’s own profession,
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age, etc. will determine their sympathy or point(s) of identification. I am saying that the optic here is multiple, allowing for experiencing one’s own intersectionality, and/or zooming in and zooming out, thereby offering either sticking with one or two characters’ worldviews or hopping from one to another, or pulling back and assessing the group—however, variegated—as a whole. This may, as reviewer and audience member responses show, yield pity, understanding, recognition, boredom, resistance, annoyance, enjoyment, wonder, epiphany, or disengagement—driven by myriad things, including living with dementia. That dementia is woven into the family tapestry rather than its being the central topic of the play is part of what invites an assembled assembly’s varying responses . The Humans was commissioned by New York City’s Roundabout Theatre Company and received its premiere at the end of 2014 in Chicago at the American Theater Company. Eleven months later it opened Off-Broadway in New York at Roundabout’s Laura Pels Theatre with a different company. The Off-Broadway production, directed by Joe Mantello, yielded Lucille Lortel Award Outstanding Lead Actor and Actress awards for Reed Birney and Jayne Houdyshell as the latemiddle-aged couple, Erik (age sixty) and Deirdre (sixty-one) Blake, who are caring for Erik’s mother, Momo (seventy-nine), who has advanced dementia. Three months later, early in 2016, the production transferred— with cast and design intact—to Broadway’s Helen Hayes Theatre. The production garnered Tony awards for Best Featured Actor and Actress in a Play for Birney and Houdyshell and the 2016 Best Play Tony, as well as a Pulitzer Prize nomination.65 The Helen Hayes production transferred after five months, when the building underwent renovations, to Broadway’s Schoenfeld Theatre, where it ran another five months. A touring company performed across the United States in Seattle, Chicago, Minneapolis, Schenectady, Washington, DC, Boston, Dallas, Tempe, San Francisco, and Los Angeles in 2018. Lauren Klein, who was Momo in the New York cast, reprised her role in this company. The Pittsburgh Public Theatre mounted its own production in 2017, as did Portland, Oregon’s Artists Repertory Theatre. Repertory Theatre of St. Louis presented The Humans in 2018. The Dock Players of Sandwich, New Hampshire, did their own production for a week early in 2020. At the end of 2021, The Humans was released as a film, written and directed by. The play was generally received as one to admire and respect, but, as published reviews and audience responses to the New York stage production, the national
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tour, at least one independent production, and the film make clear, not always one to enjoy or even want to put up with. The Blake family’s Thanksgiving gathering takes place in the apartment that Brigid, twenty-six and the younger of two daughters, has just moved into with her boyfriend, Richard. The elder daughter, Aimee, thirty-four, is a lawyer about to lose her fancy corporate job in Philadelphia doing acquisitions and mergers because she has taken too much time off in the past year to deal with her ulcerative colitis. She has also just been dumped by her girlfriend of many years. The apartment is a basement/first-floor duplex in Manhattan’s Chinatown. Its one barred window looks out onto an inner courtyard. To the lower-middle-class baby boomer parents visiting from Scranton, Pennsylvania—a small city with a high poverty rate and low percentage of non-white residents—with wheelchair-bound grandmother in tow, the dark courtyard looks more like a dank alley with a robbery or drug deal waiting to happen. Brigid, a frustrated aspiring composer working as a bartender to pay off student debt, is getting no traction in her career. She is house-proud because of the apartment’s spiral staircase, square footage, and gentrifying Manhattan neighborhood. Erik only sees a flood zone, the slum from which his mother escaped years earlier, and triggers reminding him of having been nearby, not far from the Twin Towers, on 9/11. Late in the play, we learn that Erik has lost his maintenance job of twenty-eight years at a private Catholic school, which also meant losing his pension, as a private religious organization can make its own decisions about severance and beyond. Deirdre has been at the same office job since she graduated high school over forty years ago. She has seen much younger people—men—given authority and high salaries while remaining an office bulwark stuck in a pink-collar ghetto. She overeats to deal with her frustration; she is religious; she has arthritic knees. She happily regards Momo as her own parent. Brigid’s supportive and well-mannered boyfriend is from a much more moneyed family. He is due to come into a trust in two years, when he turns forty. He has taken a few years off from graduate school and work to deal with depression and is now pursuing a degree in social work. His mother, divorced from the father, is a therapist living on Cape Cod; his upbringing included sailing. In the course of the visit, Erik drinks too much; Deirdre eats too much; Momo rants—sometimes in intelligible English and sometimes not—and sleeps; and Brigid never lets her father forget that he would not pay for the private college education on which she insisted (her father believed
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and still believes that a public university would serve her perfectly well) and also that he will not pay for her to go to therapy. Aimee cannot keep herself from telephoning her ex, who has clearly moved on. Rich stays on a genial even keel and offers an audience keys to two features of the play that might otherwise remain headscratchers. First, he had a favorite comic book as a boy in which monsters with teeth on their backs were fearful of humans. The plays’ characters and the audience are, we might surmise, the humans, and we are perhaps being enjoined to fear ourselves and/or each other, or, conversely perhaps to ask ourselves “what do monsters know? They’re not even real.”66 Second, when Erik finally describes to Rich a particular facet of a recurring nightmare involving a faceless woman trying to get him to enter a tunnel, Rich, whose social work program has thus far included one course in psychology, tells him that next time he should “get in it,” since “tunnels can just be,/stuff hidden from yourself/so passing through one... could be... [ellipses in original] a favorable omen... [ellipses in original] you know?”.67 At the end of the play, when all the light bulbs in the apartment have blown out, Erik opens the door to the basement hallway on his way out to the car Aimee hired that will take him, Deirdre, and Momo back to Scranton. In the narrow hallway, seen by the audience across the nowdark apartment, there is, indeed, light, and the script states of this hallway that “it has a tunnel-like quality.”68 Erik enters the hallway, moves ahead, and exits. His entering the light, however, is not the final onstage image. Although not stipulated in the script, both the Broadway production (I did not see it Off-Broadway) and the movie concluded with a small, seemingly elderly Asian woman skittering across the basement hallway pushing the sort of wire cart used for laundry or groceries. Rich and Brigid refer throughout the play to the “older” Chinese woman (they think she is seventy) who lives above them. They say they don’t want to disturb her despite what sounds like a lot of pounding or banging on the floor. They think she speaks only Cantonese. The basement is where the building’s trash compactor and shared laundry room are, so her going to do or retrieve her wash would not be unusual. Speculating about a neighbor and avoiding meeting her because of her assumed, or actual, language and age contribute to underlying strands in the play of classism, solipsism, and some other unnamed behaviors and attributes that belong to the neoliberalism everywhere underwriting this foray into the sort of American family drama undertaken in earlier times, under other dominant social setups, and via other dramaturgies by Thornton Wilder, Eugene
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O’Neill, Sam Shepard, Clifford Odets, and perhaps Richard Nelson. The Humans, however, speaks to today’s times. And today’s ways of dealing with dementia. It is impossible to miss the fact that every one of the characters in this play is beset by some kind of angst and that, except perhaps for Richard, it is related to money. (Rich is rich; Brigid can be rigid; Deirdre is beset by sorrows; Erik is the family’s “one ruler”; Aimee is ironically no longer “beloved” by her ex, but she is “amiable.” Momo repeats syllables and words.) In an oft-quoted line, Erik asks, after saying he just can’t seem to keep up with the cost of a mortgage, car payments, internet access, and now a failed dishwasher (shades of the Lomans’ refrigerator?) “don’tcha think it should cost less to be alive?”69 Surely this is redolent of Clifford Odets’s “life shouldn’t be printed on dollar bills,” the summative zinger of the 1935 Awake and Sing , in which another three-generational white ethnic family struggles to get by, with Mom holding things together, Dad failing to earn enough money, two adult children toiling in lessthan-thrilling jobs while enduring relationship struggles and a beloved grandparent who has reached the point of no longer being able to live alone. For Odets, the implied answer (and one that the adult grandson in the play expresses overtly) is for workers to pull together to make things better all around. In 2014 and beyond, that kind of vaguely Marxist political solution is not what an audience of hundred dollar ticket buyers is lining up to hear—at least by way of solution to their own ennui. I say this not to bash people who go to new American plays with serious themes and who have the disposable income to do so, but to recognize that they/ we are so thoroughly entrenched in neoliberalism, that imagining a way to solve problems of anomie, unease, depression, fear, financial worry, or a host of other things this play brings up does not point immediately and directly to such things as unionizing, going on strike, or waging a major letter-writing campaign, much less anything like overthrowing the government. One reviewer noted that the play’s family had no seeming interest in political involvement that might address their concerns, something she found troubling at this point in American history.70 Another suggested that they might at least extend their conversation into the realm of the political.71 Largely, reviewers saw The Humans as a play about present-day American anxiety, using such phrases as “the American dream fraying in the harsh headwinds of economic stagnation”72 ; “fear: of failure, ruin, loneliness, death;”73 and an “unsentimental look at the way we live
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today – anxiety-ridden, having little control over our environment or bodies, forever stretched and always a step from the abyss.”74 For many the piece seemed almost like an ethnography, with one review titled “A Very Realistic Look at Our Lives”75 and another invoking “wincingly accurate detail”76 as well as the aforementioned uses of “slice of life.” The question of who “we” are was one of a handful of points on which the assembly dis(as)sembled. One reviewer spelled it out this way: “By “we” I mean us non-one-percenters, most of whom are peering around anxiously at the uncertain future and the unsteady world, even as we fight through each day trying to keep optimism afloat in our hearts.”77 An audience member from Connecticut, however, wrote: “ Are the audience the peers of those humans on stage or the class beyond which [sic] can afford the $300.00 date that a night out at the theater is.. unlike the other humans telling their story on stage…whose lives can not be seen as parallel but left to be judged….”78 There were also fault lines—big ones—in how reviewers read the family in the play as a family. For one, The Humans was a “portrait of middle-American family life gone irretrievably sour.”79 Another called the Blakes “the new American family—broken and dislocated, robbed of the American dream, just trying to survive, forget about thrive.”80 But others saw “a family with strong bonds,”81 pointing out that “the members of this family truly love one another” (Fig. 13.2).82 What does The Humans have to say to us (“us” being, in this case, readers of this book with what I might call an interest in “audiencecentered criticism”—perhaps an analogue to the currently popular idea of “student-centered learning”) regarding ways of seeing and representing dementia in the early part of the neoliberal twenty-first century? At first blush, the play offers a caring, person-centered antidote to the declining narrative/family woe of The Waverly Gallery (and, to some extent, The Father). Momo, in an advanced stage of dementia, is included in the family dinner, seated at the table with the others, and not disciplined when, at the end of saying grace, she starts to eat potatoes directly from the serving bowl. (Erik just takes away the serving spoon.) When she repeatedly utters the telling line “you can never come back,” which Deirdre explains as “her latest phrase-of-the-day,” Brigid says, kindly, but perhaps taking the utterance a tad too literally, “Momo, you can absolutely come back, any time you want.”83 The sisters fondly recall and give voice to some of Momo’s Irish blessings and songs. An email she sent to her granddaughters before becoming unable to send emails is read as part of a recently created family holiday tradition. Deirdre states that “having
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Fig. 13.2 The Humans, Pittsburgh Public Theatre, 2017 (Pictured, left to right, Valeri Mudek [Brigid], J. Tucker Smith [Erik], Cecelia Riddett [Momo], and Charlotte Booker [Deirdre]. © Michael Henninger)
her at home with us is, until it becomes too much, it’s a blessing, you know.”84 But the play does much of its work by showing the fissures in the family edifice and in any idea that they have under control Momo’s dementia, the single issue that affects or might affect everyone here. Brigid worries (or claims to) about her parents “burning out” (15), suggesting they treat themselves to a spa day (which they cannot afford), later saying that they are over-medicating Momo, and then proposing that they hire someone to help care for her. Deirdre replies that it would cost one hundred dollars a night. Reaching the end of her generally long fuse, she snaps at Brigid, at which point Erik tries to calm everyone. Deirdre says, “No, she [Brigid] needs to think before she opens her mouth.” (92) Deirdre has also said that if Brigid doesn’t like the way they are caring for her grandmother, she might come home to assist. Brigid has declared in no uncertain terms that she will not move back to Scranton. While neither of the daughters drops so much as a hint that assisting personally might be on the horizon,
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they are aware that their parents are reaching an age when they, too, may need help. After telling his daughters that he lost his Catholic school job because he cheated on his wife with a teacher, Erik informs them that he has no savings and he and Deirdre plan to sell their house and rent a small apartment. His back and Deirdre’s knees cause them a lot of pain. They’re not old enough for Medicare and will not get much from Social Security. Recall that Medicare is a federal health insurance program for people over 65 (with some exceptions for younger people) that generally pays for hospitalization, doctors, medical supplies, and care in a skilled nursing facility, the latter typically if the stay is linked to a rehabilitation program following hospitalization.85 It does not cover everyday living assistance not linked to a medical condition that can be treated by doctors or therapeutic programs. Benefits and eligibility for Medicaid, a program run by individual states with some federal backing, differ across states. Medicaid’s major difference from Medicare is a low-income requirement. Momo qualifies for Medicare to cover medications and doctors’ visits (although coverage for these is not free). She may or may not have Social Security, a fund to which employers and employees contribute, provides monthly income based on lifetime earnings. If Momo qualifies for Medicaid, it would cover a nursing home—the kind of public facility that most Americans fear, with no frills, poorly paid employees, and a high turnover rate—and in order to qualify, any benefits or savings she might have would be assessed and likely “spent down” or put into a trust.86 As Karam modestly said of the situation in the play, “Now that life expectancy is higher, I think it’s incredibly tough to care for aging parents long term.”87 Despite a well-paid lawyer in the family, assisting with eldercare—or interpreting the laws governing financial aid via Medicare, say—is not on the immediate dramaturgical horizon. As we have seen with the family in Dot, having an attorney and a musician as one’s well-educated adult children (or grandchildren) means little when it comes to the assurance of daily well-being with dementia. Reviewers responded to Momo in three contexts. In the first, mimetic credibility, they praised the actors’ achievements in the face of the role’s challenges. In this realm, Karen Topham wrote: As Momo, Klein has an unusual task: her dialogue is, for the most part, a series of repeated mumbles, and her character’s disease keeps her inert for almost the entire proceeding. It would have been very easy to play this in
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a way that slips into caricature, but Klein’s performance is one of the most honest (and wrenching) portrayals of an old woman with Alzheimer’s you are likely to see. Her family are not the only ones in the theatre who want to cheer when she momentarily regains some of her faculties at one point, but it is fleeting. Karam pulls no punches when it comes to the disease, showing it in all of its debilitating, horrifying reality.88
A second category of consideration for Momo’s place in the play articulates that the character herself has anxieties. Here, Momo has agency, and the task of the actress who plays here is not only to convey confusion, aphasia, and difficulty with daily functioning but also to explore and interpret the existential woe of a person whose language is fraying but whose personhood remains. Elysa Gardner put it this way: “Momo... suffers from dementia and says little that’s intelligible. When [she] explodes in a fit of agitation at one point, we wonder if it’s set off by her son, or one of the others, or her frustration at what remains of her lot in life.” In a third category, however, one critic extended her observations from praise for the writerly limning of the role and actorly embodiment to Momo’s thematic possibilities, reaching for political implications beyond the personal sensibilities of either character or spectator (Fig. 13.3): Lauren Klein plays Fiona “Momo” Blake with respectful grace. Momo is a quiet but striking role. She has several severe but life-affirming outbursts that may trigger some audience members. It requires the actor to remain omnipresent in every scene. Her lines are few but effectual and require constant vulnerability. Klein’s staging work with Mantello reminds us of our human fragility. We are all at risk of disability; be it by age or accident. … The Blake family embraces Momo’s frailty when others might put her in hospice. Loving our disabled friends, acquaintances and family is the only option. Fearing their infirmities to the point of alienation is crueler as [sic] ostracizing our disabled community members. Pretending that they don’t exist doesn’t make them go away. It doesn’t lessen our own personal risk.89
If Momo seems to some to be a narrative prosthesis there to facilitate the worries of the others in the gathering (a possible view, although not one with which I agree), she is also a character with her own sensibilities that critic Kitty Drexel reminds us are, for better or worse, “life-affirming.”
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Fig. 13.3 The Humans, Pittsburgh Public Theatre, 2017 (Cecelia Riddett as Momo. © Michael Henninger)
While “loving” people with disabilities are surely the humane option, it does not answer their need for ongoing care that takes time and possibly professionalism. Drexel’s parting observations—primarily her statement that any one of us is or could be one stroke or one neurological misfire or one injury away from life with dementia—are arguably the biggest critical takeaway in Losing It. Turning away from people on the other side of the before and after divide neither takes them out of the body politic nor solves the question of care now that the Linda Lomans of the world have largely joined the workforce. (When Deirdre and Erik are at work, an unseen character named Uncle John, who lives in a trailer and has no money, watches Momo to be sure she neither injures herself nor destroys property. It can’t last.) Lest one thinks that Rich and his trust fund will eventually provide a stopgap, Drexel problematizes his equanimity and assurance that his “issues” are largely behind him. “Richard had depression but he’s okay now. He speaks as if mental health were something that needs healing only the once.... Fear, regardless of its rationality, can break down the mind like disability breaks down the body.”
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I want to return to two words I have used with little explanation heretofore in discussing The Humans —“neoliberalism” and “political.” It is beyond the scope of this book to unpack the former in detail, but it could be briefly defined as an ideology that values market capitalism as the best way for countries, communities, and individuals to enjoy the greatest amount of freedom and wealth.90 Critics of neoliberalism point out that the amount of freedom and wealth one enjoys is almost entirely dependent on the amount of capital one owns or to which they have direct access. In The Humans, those at the top of the neoliberal pecking order (the corporate lawyer, the trust fund perpetual student) might look as though they would be insulated from the destitution facing the lower-middle-class maintenance man and his office manager’s wife, but a single health crisis has derailed each and could repeat itself even as they strive to recover. The baby boomer parents caring for the grandmother with dementia can no longer afford to stay in their house; they struggle with chronic pain; they have no savings and at least one of them will have no pension; they really have no idea how much longer they will be able to care for their elder, much less have any plans for their own care. Brigid, licking her wounds over a lukewarm letter of recommendation that she is convinced has scuttled her chances of getting a grant to support her work as a composer, is living the capitalist dream/nightmare of many wannabe artists. Her education has left her with student debt, no paying work in her field, and no awareness (or seeming concern) that even if she were to get her grant, her success would likely mean someone else’s desperation or failure. It is arguably just the dementia-ridden Momo whose back the system has but in the most minimal, haphazard way. Medicare may cover her drug costs. Medicaid would pay for a bare-bones nursing home if her personal assets (assuming she has any) were virtually depleted. Her son and daughter-in-law (and “Uncle John”) are providing hands-on, uncompensated care for as long as they can. Any government-sponsored care requires reams of paperwork that she would be unable to navigate on her own. Because the characters’ precarity, writ large, is the same as the audience’s (even those with money are not exempt from changes in health or able-bodiedness), I want to assert that The Humans is very much a political play. By this I mean that the play takes up a social problem and asks its audience to think about how the problem might be addressed, or, conversely, what might be at stake if they feel the problem is not theirs
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or, worse yet, doesn’t really exist. I borrow freely from audience theorist Liz Tomlin to posit that the audience for this play, whether asserting its sympathy or turning away in annoyance, is a “spectator of practice,” to the extent that its members recognize ideology—however prismatic the play’s lens may be—at work. Tomlin argues that since the advent of postmodernism and postdramatic theatre, audiences for political theatre have been theorized, understood, and even addressed as operating under either an egalitarian or an autonomous position: The spectator of practice in which the egalitarian logic dominates is offered an egalitarian (and so ideological) view of the world to which they are invited to subscribe and an egalitarian (and so ideological) collective project in which they are invited to participate. The spectator of practice in which the autonomous logic dominates is granted the autonomy of individual interpretation and invited to take precisely what they want from the experience…. I argue that, since the poststructuralist moment, the logic of autonomy has been in the ascendency, and the challenge for contemporary political theatres has been how best to uphold the poststructuralist demands for pluralism and autonomy without necessitating the abandonment of the collective egalitarian imaginary of Marxism.91
Tomlin’s egalitarian and autonomous theatregoers are akin but not identical to Worthen’s ensemble and assembly. Those in both of the first categories are presumed to be thinking and feeling as a group and those in the second are recognized as thinking and feeling individually and not necessarily in quite the same way as anyone else in the audience. There is, however, a difference between what these two scholars posit. Worthen’s audience is one of the liberal humanists whose choice of performance event may or may not be political, either in the eyes of spectators or in the mind(s) of the creator(s). Effect, recognition, identification, and/or mastery may provide a sufficiently satisfying evening from which to walk away. Tomlin’s theatregoers have elected to attend something that wears its ideology on its sleeve, albeit not necessarily in an “in your face” way. Tomlin addresses such issues as the ease of empathizing with an “other” who is perhaps worthy of concern but whose existence is so far from that of the audience member that the empathy need never exact any toll (save perhaps signing a petition or making a monetary contribution). She takes up the question of humans feeling for and ultimately working to protect their own (families, communities, countries) and acknowledges that the “cosmopolitan vision of multiplicity and difference” is one
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frequently shared “among those who might be expected to form a significant majority of those attending politically engaged theatre in the West” but one that depends on “the protection of difference.”92 The Humans, I suggest, does its work by creating a big tent but not insisting on a singular way of entering or experiencing that canvas. It presents a world in which all its audience lives but allows for major differences within that world. For those who imagine that they are free to walk away from or scorn or roll one’s eyes in boredom at this play, it is worth recalling John Dewey’s assertion, made decades ago, that democracy (presumably a system that allows for autonomous responses) “has little content when big business rules the life of the country through its control of ‘the means of production, exchange, publicity, transportation and communication, reinforced by command of the press, press agents and other means of publicity and propaganda.’”93 This list covers the systems under which the characters in The Humans and likely most in the audience experience the anxiety identified both within Karam’s text and by so many reviewers. One might say Dewey nailed neoliberalism avant la lettre. What will happen to Momo? Will Aimee ever get another good job? Will Deirdre be able to work long enough to qualify for the small amount of Social Security to which she will probably be entitled? Will she and Erik be able to hold on long enough to qualify for Medicare? Will they be able to manage the sometimes out-of-control Momo much longer? Will Uncle John up and die or become unable to help out? Will Brigid and Rich stay together long enough for him to finish his social work degree and for her to pay off her student debt? Since they are not married and since she only has access to his money via his largesse, does she have any health insurance? If dementia is the ugliest specter in this play—which it may not be—what does the future hold for any or all of the characters? Shortly after the family arrives at the apartment and the young sisters start to head toward the spiral staircase to descend to the kitchen and dining area for the Thanksgiving dinner, Aimee, who is pushing Momo in her wheelchair, asks her sister how she will get their grandmother down those stairs. Should she just dump her? Oh. Yes, Brigid had forgotten but now points to the elevator in the hallway. At the final moment of the play when the upstairs neighbor scoots silently across the basement floor, one might imagine a whole other play in which her precarity (no family? no English? subsidized rent? food insecurity? rising costs due to gentrification? no pension?) is the subject. Any one of these characters is a car
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accident or a stroke away from becoming a person living with dementia. Except for Momo, who already is. Tomlin concludes her study with the acknowledgment that it is very hard to feel personally in control when one is enmeshed in a world where privilege and power may be presented as desiderata but can disappear or fail to satisfy needs beyond consumerism. It is, she points out, not just easy but even normal to feel that one has no agency beyond going after more money or status (Aimee or Rich or even Brigid) or immersing oneself in art (Brigid, but to bitter disappointment) or religion (Erik and Deirdre, but it provides neither housing nor medical care). In the tension between the audience logics of autonomy, which Tomlin says might better be called libertarianism,94 and egalitarianism, which may feel naïve or coercive, she notes that spectators attuned to this seemingly incongruent balance might at best remember that “their only individual agency lay in the power of the collective and that collective agency was only possible through individual agency.”95 Where can the theatre, and we, its audience, go from here?
Notes 1. Kenneth Lonergan, The Waverly Gallery (New York: Grove Press, 2000). Page numbers are from this edition. 2. David Kaufman, “‘Gallery’ Shows Heckart’s Art,” Daily News, 23 March 2000; Christopher Kelly, “‘The Waverly Gallery’ Returns Elaine May to Broadway, With Mixed Success,” NJ Advance Media for NJ.com, 26 October 2018. https://www.nj.com/entertainment/2018/10/wav erly_gallery_elaine_may_lucas_hedges_broadway_r.html (Accessed 9 April 2023); and Rob Weiner-Kendt, “Kenneth Lonergan’s ‘The Waverly Gallery’ Makes a Belated and Brilliant Broadway Debut,” America Magazine, 16 November 2018. https://www.americamagazine.org/artsculture/2018/11/16/kenneth-lonergans-waverly-gallery-makes-belatedand-brilliant-broadway?gclid=CjwKCAiA5t-OBhByEiwAhR-hmwU9p9Bj HJjLyhBifIQRzhigO6kNHjb_4C11xxs6bm3q0vn3BzSNRhoCQAgQAv D_BwE (Accessed 9 April 2023). 3. Irene Backalenick, “The Waverly Gallery,” Backstage, 24 March 2000. 4. Charles Isherwood, “The Waverly Gallery,” Variety, 27 March 2000. 5. Critic Christopher Kelly calls it “nearly plotless.” 6. D. L. Lepidus, review in The Westsider, 30 March 2000, 8. 7. John Simon, review in New York, 3 April 2000, 57; Isherwood; and Backalineck.
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8. Exceptions include Ben Brantley, “Elaine May Might Break Your Heart in ‘Waverly Gallery,’” New York Times, 25 October 2018. https://www. nytimes.com/2018/10/25/theater/review-waverly-gallery-elaine-maykenneth-lonergan.html (Accessed 9 April 2023). 9. Howard Miller, “The Waverly Gallery,” Talkin Broadway, 25 October 2018. https://www.talkinbroadway.com/page/world/WaverlyGallery2 018.html (Accessed 9 April 2023); Adam Feldman, “Kenneth Lonergan’s Family Drama, Starring the Great Elaine May, is an Indelible Portrait of Loss,” Time Out New York, 25 October 2018. https://www.timeout. com/newyork/theater/waverly-gallery-review-elaine-may-lucas-hedgesmichael-cera (Accessed 9 April 2023); Chris Jones, “‘Waverly Gallery’ on Broadway with Elaine May and Michael Cera: We All Must Come Face to Face With Age,” Chicago Tribune, 25 October 2018. https://www. chicagotribune.com/entertainment/theater/sc-ent-waverly-broadway-rev iew-1026-story.html (Accessed 9 April 2023); Greenblatt; and Kelly. 10. See Kaufman and Teeman. 11. Greenblatt. 12. Peter Marks, “Elaine May Reveals New Depths of Acting Agility in Broadway’s ‘Waverly Gallery,’” The Washington Post, 25 October 2018. 13. Weinert-Kendt. 14. Brantley. 15. Linda Winer, “A Grandmother Failing Unforgettably,” Newsday, 23 March 2000, B9. 16. Tim Teeman, The Daily Beast, 25 October 2018. https://www.thedailyb east.com/elaine-may-endures-the-ravages-of-alzheimers-in-the-waverlygallery?source=articles&via=rss&utm_source=dlvr.it&utm_medium=twi tter (Accessed 9 April 2023). 17. Ibid. 18. Lonergan, 26. 19. Ibid., 35. 20. Christopher Moore, “Heckart’s Last Big Theater Turn,” West Side Spirit, 11 May 2000, 29. 21. Chris Jones. 22. Isherwood. 23. Lyons. 24. David Rooney, “‘The Waverly Gallery’: Theater Review,” Hollywood Reporter, 25 October 2018. https://www.hollywoodreporter.com/news/ general-news/waverly-gallery-theater-1155139/ (Accessed 9 April 2023). 25. Lonergan, 107. 26. Peter Schjeldahl’s review is smartly titled “Who’s We?” It appeared in The New Yorker, 25 October 2021. Quote is on page 70. 27. Hana Worthen, Humanism, Drama, and Performance: Unwriting Theatre (Cham, Switzerland: Palgrave Macmillan, 2020), 2.
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28. Sara Ahmed, The Cultural Politics of Emotion (London: Routledge, second edition, 2015), 9. 29. Ahmed, 91. 30. Elizabeth Herskovits, “Struggling over Subjectivity: Debates about the ‘Self’ and Alzheimer’s Disease,” 146–164 in Medical Anthropology Quarterly, Vol. 9, No. 2 (1995): 153. 31. Lynn Casteel Harper, On Vanishing: Mortality, Dementia, and What It Means to Disappear (New York: Catapult, 2020). 32. Harper, 206. 33. Christopher Kelly. 34. Feldman. 35. Harper, 6. 36. Weinert-Kendt. 37. Lonergan, 74. 38. Ibid., 45. 39. Ibid., 48. 40. Tessa Hadley, “Coda,” The New Yorker, 2 August 2021, 59–68. 41. Hadley, 62. 42. Ibid., 65. 43. Lonergan, 62. 44. Simon. 45. Lonergan, 60. 46. Ibid., 20. 47. Kelly. 48. As reviewer Amy Gamerman wrote in 2000, “it’s her [Gladys’s] put-upon family’s pain that we’re meant to feel,” in a play that “explores the decline of an eccentric and likable character, not so much through the prism of her own experience as through that of her exasperated family.” (“In ‘The Waverly Gallery,’ Senility Generates Tears and Laughs,” Wall Street Journal, 5 April 2000, A24.) 49. See Anne K. Vittoria, Women of Color in a World Apart: An Ethnography of Care Workers and Dementia (New York: Routledge, 2021), pages 21–3, 32, 65–6, and 120–3. The term was coined by Jaber Gubrium (32). 50. Tom Kitwood, Dementia Reconsidered: The Person Comes First (Buckingham: Open University Press, 1997). 51. Carl Rogers, On Becoming a Person: A Psychotherapist’s View of Psychotherapy (Boston: Houghton Mifflin, 1961). Note that the author was a psychotherapist and that his book was published by a major press in Boston. So much for Ellen being informed.
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52. Gary Mitchell and Joanne Agnelli, “Person-Centered Care for People With Dementia: Kitwood Reconsidered,” in Nursing Standard, official newspaper of the Royal College of Nursing (October 2015). https:// www.researchgate.net/publication/283244999_Person-centred_care_for_ people_with_dementia_Kitwood_reconsidered/link/5666aa2508ae192 bbf928b58/download (Accessed 9 April 2023). 53. Harper, 86. 54. Lonergan, 60. 55. Ingunn Moser, “Making Alzheimer’s Disease Matter. Enacting, Interfering and Doing Politics of Nature,” Geoforum, Vol. 39 (2008): 98–110. Quote is on 104. 56. Ibid. 57. https://en.wikipedia.org/wiki/Marte_Meo (Accessed 9 April 2023). 58. Vittoria points out that family members—especially those who may not visit a care facility often—expect more than any caregiver or drug could possibly provide for a person with a fatal, degenerative disease. The nurses of whom Vittoria writes are Certified Nurses’ Aides (CNAs) who provide hands-on care in a dementia facility; family members, who visit only occasionally, frequently fail to grasp the new normalcy of their loved ones’ behaviors, the thing to which the fulltime caregivers are finely attuned. 59. Aristotle, Poetics. Trans. S. H. Butcher. Part IV. http://classics.mit.edu/ Aristotle/poetics.1.1.html. Recall, too, Arthur Kopit’s observations about audience responses to Wings (Chapter 7). 60. Marilyn Stasio, “Broadway Review: Kenneth Longeran’s ‘The Waverly Gallery” With Lucas Hedges,” Variety, 25 October 2018. https://variety. com/2018/legit/reviews/waverly-gallery-review-elaine-may-broadway1202994026/. Stasio is the critic who asserted in her review of Our Mother’s Brief Affair (see Chapter 10) that Alzheimer’s and dementia are two very different things and who wrote in her review of The Father (Chapter 8) that sensitive audience members might like a nurse in the lobby. I would suggest that in the aggregate, this might say as much about the reviewer as it does about the plays on which she reports. Born in 1940, Stasio was seventy-eight at the time she reviewed the Broadway production of The Waverly Gallery. 61. Teeman, The Daily Beast. 62. The term is usually associated with Hans-hies Lehmann and his book PostDramatic Theatre (trans. Karen Jurs-Munby [Abingdon and New York: 2006. First published in German in 1991]) where he describes a postmodern theatre in which the performance may include a script but is not beholden to it for any kind of logical, narrative-driven structure. 63. Stephen Karam, The Humans (New York: Theatre Communications Group, 2016). Page numbers for quotations are from this edition.
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64. Lauren Katz, “Broadway in Chicago Presents the Humans Review: When Family Tensions Bubble Over,” Picture This Post, 2 February 2018. https://www.picturethispost.com/broadway-in-chicago-the-hum ans/ (Accessed 9 April 2023); Jayne Blanchard, “Review: The Humans, Streamed. Olney Cast Excels in Closeup of Stephen Karam’s American Family,” DC Theatre Scene, 15 September 2020. https://dctheatrescene. com/2020/09/15/review-the-humans-streamed-olney-cast-excels-incloseup-of-stephen-karams-american-family/ (Accessed 9 April 2023); Jonathan Mandell, “The Humans Review: A Family’s Everyday Fears Voiced by Off Broadway’s Finest,” New York Theater, 25 October 2015. https://newyorktheater.me/2015/10/25/the-humans-review-a-familyseveryday-fears-voiced-by-off-broadways-finest/ (Accessed 9 April 2023); and Jesse Green, “Theatre Review: The Complex, Funny Sadness of The Humans,” Vulture, 25 October 2015. https://www.vulture.com/2015/ 10/theater-review-the-humans.html (Accessed 9 April 2023). 65. Karam’s play Sons of the Prophet had been a Pulitzer nominee in 2012. 66. Ibid., 73. 67. Ibid., 115. 68. Ibid., 148. 69. Ibid., 40. This line was noted by at least five critics: Michael Schulman, “The Decline of White, Middle-Aged America Onstage,” The New Yorker, 26 February 2016. https://www.newyorker.com/culture/cul ture-desk/the-decline-of-white-middle-aged-america-onstage (Accessed 9 April 2023); Karen, Topham, “A Very Realistic Look at Our Lives,” Chicago Onstage, 1 February 2018. https://www.chicagoonstage.com/ humans/ (Accessed 9 April 2023); Charles Isherwood, “Review: ‘The Humans,’ a Family Thanksgiving for a Fearful Middle Class,” New York Times, 25 October 2015. https://www.nytimes.com/2015/10/26/the ater/review-the-humans-a-family-thanksgiving-for-a-fearful-middle-class. html (Accessed 9 April 2023); Carla Seaquist, “Plays for Our Times: ‘The Humans’ by Stephen Karam,” Huffpost, 11 December 2017. https:/ /www.huffpost.com/entry/plays-for-our-times-the-humans-by-stephenkaram_b_5a2eee95e4b0cf10effbaf94 (Accessed 9 April 2023); and Matt Wolf, “The Humans Review – Staring Headlong into the Abyss,” the artsdesk.com, 10 January 2022. https://www.theartsdesk.com/film/hum ans-review-staring-headlong-abyss (Accessed 9 April 2023). 70. Seaquist. 71. Wolf. 72. Isherwood. 73. Adam Feldman, “Broadway Review: The Humans Reopens at the Helen Hayes Theatre,” TimeOut New York, 18 February
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74.
75. 76.
77. 78.
79. 80. 81. 82. 83. 84. 85. 86. 87. 88. 89.
90. 91.
92. 93. 94. 95.
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2016. https://www.timeout.com/newyork/blog/broadway-review-thehumans-reopens-at-the-helen-hayes-theatre-021816 (Accessed 9 April 2023). Marilyn Stasio, “Broadway Review: ‘The Humans,’” Variety, 18 February 2016. https://variety.com/2016/legit/reviews/the-humans-review-playbroadway-1201709685/ (Accessed 9 April 2023). Topham. Alexis Soloski, “The Humans Review: Thanksgiving Tensions Give Rise to Great Drama,” The Guardian, 18 February 2016. https://www.the guardian.com/stage/2016/feb/18/the-humans-review-helen-hayes-the ater-new-york (Accessed 9 April 2023). Isherwood. Speen (in “reader picks”), https://www.nytimes.com/2015/10/26/the ater/review-the-humans-a-family-thanksgiving-for-a-fearful-middle-class. html#commentsContainer. Schulman. Blanchard. Isherwood. Stasio, “The Humans Reopens.” Karam, 13, 14. Ibid., 15. https://www.medicare.gov/what-medicare-covers/your-medicare-cov erage-choices/whats-medicare (Accessed 9 April 2023). https://www.payingforseniorcare.com/medicaid (Accessed 9 April 2023). Quoted in Schulman. Katz and Isherwood also note Klein’s detailed and credible performance as Momo. Kitty Drexel, “Fear Isn’t Logical: ‘The Humans,’” New England Theatre Geek, 15 March 2018. https://www.netheatregeek.com/2018/03/15/ fear-isnt-logical-the-humans/ (Accessed 9 April 2023). See Noam Chomsky, Profit Over People: Neoliberalism and Global Order (New York and London: Seven Stories Press, 1999). Liz Tomlin, Political Dramaturgies and Theatre Spectatorship: Provocations for Change (London and New York: Bloomsbury Methuen Drama, 2019), 77. The identical wording reappears on page 129. Tomlin, 153. Dewey quoted in Chomsky, 52. Tomlin, 182. Ibid., 175.
CHAPTER 14
Who Cares?
No work of theatre can change the world or force major changes in the laws of a nation or even necessarily change the hearts and minds of all who see that work. What theatre can do is offer various, and sometimes intramurally variegated, ways of seeing a phenomenon or situation, thereby possibly moving the needle in some hearts and minds. As the previous chapters show, American theatre—always created in an actual social moment and milieu—has over the past century depicted dementia in multiple settings and circumstances (urban apartments of upper-middle-class people, suburban bungalows inhabited by middleto lower-middle-class people, privately owned rowhouses belonging to the comfortably middle-class, a state hospital, a private old-age home, various rehab or care facilities), although nearly always with an eye to the syndrome’s effect on individual psyches and/or family relations and certainly with an eye to anticipated legibility for particular, culturally situated, imagined audiences. In the third decade of the twenty-first century, it would be as wrong to say that Americans are blind to the problems presented by dementia as it would be to say that as a nation, we are clear-sighted and farsighted about its challenges and about programs for addressing them. Continuing with these visual figures of speech, I want rather to suggest that as a culture, we see double and/or suffer from macular degeneration (which affects central, or “straight-ahead” vision) or retinitis pigmentosa (which affects peripheral vision and the ability to © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 D. Chansky, Losing It, https://doi.org/10.1007/978-3-031-20902-4_14
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see in the dark), i.e., that our vision is restricted or impaired or discombobulated rather than nonexistent or outright wrong. No one can see everything all the time, but the more we can take in, the more we have to work with as we try to create multi-perspectival big pictures and solve problems. Also, to the extent that visual impairment can heighten awareness via other senses, the restrictions themselves offer theatrical opportunities. What, as a nation, do we put in focus? The National Alzheimer’s Project Act,1 signed into law by President Barack Obama in 2011, has as its primary goal, “to prevent and effectively treat Alzheimer’s disease by 2025.” Clearly, this ambitious agenda situates research and science at the head of the list (and the goal is unlikely to be met). Farther down the list is the vague “expand supports for people with Alzheimer’s disease and their families.” Does “supports” mean financial entitlements? Does it specifically include the creation of memory care facilities? A budget for training caregivers? A minimum wage for those caregivers? On what one might call the opposite side of the world, and certainly coming from the other end of the activist/agenda spectrum, the 2014 Dementia in the Pacific Region,2 published by Alzheimer’s Disease International and an update of the 2004 Kyoto Declaration3 (this latter an advisory roadmap for a region including fifteen countries, with eighteen on the list in 2014), privileged national action plans, community awareness, risk reduction strategies, and services to support family carers. The final item on the Pacific lists, both in 2004 and in 2014, was to support or invest in more research. Clearly, Americans—or at least our policymakers—have a different idea of how to rank priorities. The American way continues to be the lab-and-drugs-trump-the-community-and-bootson-the-ground-challenges of providing care to people who, even as we love them, can be resistant, angry, dirty, obstreperous, selfish, crude, cruel, oblivious, entitled, agitated, violent, and a danger to themselves and others. One thing they are not is likely to recover from their dementia. As a cultural commentator and memoirist, Sandra Tsing Loh wrote of her nonagenarian father in 2021, He is taking everything! He is taking all the money. He’s taken years of my life (sitting in doctors’ offices, in pharmacies, in waiting rooms). With his horrid, selfish, grotesque behavior, he’s chewed through every shred of my sentimental affection for him. He’s taken the serenity I fought for— and won—in 1,000 hours of therapy centered on my family. In fact, he’s destroyed my belief in “family” as a thing that buoys one up…. That’s
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right: my family is throwing all our money away on powdering our 91year-old dad’s giant-baby ass, leaving nothing for my sweet little daughters, with their thoughts of unicorns and poetry and dance, my helpless little daughters….4
One could, of course, say that Loh’s view of family is sentimental, commodity-driven, and entitled, even in the name of her putatively “helpless” children with her strategically chosen fairy-tale descriptors, but the larger question is why she should have to choose between seniors and minors and why one family member’s illness should devour the entire nuclear clan’s resources, with the obligation to do damage control falling on the shoulders of the single “responsible adult” in the room. A cynical reader might say that Loh, writing for major outlets and with a strong NPR (National Public Radio) presence probably has enough money to hire care for her father, but that is to miss the point. Likely she already does do this, but if she had, let us say, a child with a rare disease and/or disability, public funds, and services would likely be available, even though accessing them would require a lot of leg work on her part. The fact remains, that absent what are understood as “medical” needs, people with dementia must depend for safety, cleanliness, and a modicum of dignity and stimulation (if they are fortunate enough to get the latter two) on private funds, family members willing and able to step up, or an eventual trip to a public nursing home after virtually all personal assets have been depleted. Is care for people with dementia a medical issue? It might depend on whom one asks. As Ai-jen-Poo notes, “a fundamental problem with our current health care system is that its measure of success is the delay of death, rather than the quality of life.”5 Poo is a caregiver advocate and codirector of Caring Across Generations and the president of the National Domestic Workers Alliance. In the realm of medicine proper (a problematic idea) and medical training, two American physicians in teaching institutions at opposite sides of the continent relate similar stories regarding eldercare and the education of doctors. Louise Aronson is a gerontologist and professor of medicine at the University of California, San Francisco. Jason Karlawish is Professor of Medicine, Medical Ethics and Health Policy, and Neurology at the University of Pennsylvania and Co-Director of the Penn Memory Center. In the 2019 Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life (a finalist for that year’s Pulitzer Prize in
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General Nonfiction), Aronson argues that the “science-as-king” model of medicine and medical training ignores the very person-focused care and attention that senior citizens frequently need more than they do drugs or surgery (if they need the latter at all).6 Additionally, she pleads for awareness that senior citizenship is not a monolithic stage of life. A stillemployed, tennis-playing, white-collar sixty-five-year-old with a managed financial portfolio has neither the health nor the day-to-day problems of a widowed eighty-year-old with incontinence, bone-on-bone knee pain, adult offspring with substance abuse problems who live in another city, and no income outside Social Security earned from decades in an unskilled labor position. Either could develop dementia; neither will ever be thirtyfive again. Karlawish, author of the 2021 The Problem of Alzheimer’s : How Science, Culture, and Politic Turned a Rare Disease Into a Crisis and What We Can Do About It, knows, like Aronson, that the patients he sees are reaching the end of their lives but mostly need to be kept safe, clean, and cared about—not to be medicated or operated on.7 He notes that the “Alzheimer’s crisis” is not “simply a scientific puzzle to be solved, a menace of ‘druggable’ pathologies to be conquered. It’s the vortex of the scientific political, cultural, and social problems of aging and disability.”8 I have earlier called dementia a public health issue. For Karlawish it is “a humanitarian problem” and addressing it “with a strategy that relies on discovering ‘the cure’ is like planning for retirement with lottery tickets.”9 Both Aronson and Karlawish relate incidents of describing to doctors-intraining the sort of human-centered care they know is best for particular patients, only to be greeted with the response that what they advocate isn’t medicine. Maybe it should be, but if not, well, so what? If I am hobbling on crutches down a steep hill with no sidewalks, offering me a ride is surely a better form of aid than pulling over to hand me, or sending me, a notice to tell me I should be investigating surgery. (P.s.: the crutches may be a temporary part of a post-surgical rehab program.) Loneliness, fear, needing a diaper changed or help with bathing, not being allowed to walk outside alone (with an ankle monitor, if need be, as a form of intervention in case of getting lost and thereby being trackable), wanting to go for a ride but being unable to drive (or not owning a car) are problems with low-impact solutions that both authors discuss, none of which is on the radar of the current medical system writ large, except for impoverished people who qualify for nursing homes with Medicaid coverage, and then there is no guarantee of much in the way of person-centered,
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nurturing care, much less any interest in, or money for, the ankle monitor idea. Who, then, is supposed to provide person-centered, help-with-dailyliving sort of care? The old-fashioned expectation that an eldest daughter or self-sacrificing wife will become a full-time, typically unpaid and overtaxed servant-in-residence is no longer really tenable, or at the very least this is recognized as no longer fair. Many Americans in need of caregivers would like to have trained assistants, but therein lies a sticking point. Caregivers are notoriously underpaid, indicating both the low esteem in which their labor is held and also, perhaps, an unwillingness on the part of those who would pay them, to part with money. Most Americans would prefer to age at home10 ; many are doing the equivalent of Karlawish’s buying lottery tickets to prepare for their final years. If, as Ai-jen Poo and Ilana Berger note,11 an absence of available aides/professional carers means that many will not be able to age at home, we are left with the options of moving in with harried and possibly reluctant relatives or depleting limited resources and relying on Medicaid. Raising the minimum wage for caregivers might cause more people to seek that kind of employment; it would certainly elevate the esteem in which such work is held. Still, with quotidian care not really qualifying as “medicine,” and with Medicaid—a state-run program—having different requirements and benefit levels across the nation, where will this money come from? In 2021, President Joe Biden proposed as part of an infrastructure plan increased benefits to pay caregivers (see Chapter 2). In August 2022, a final version of the multi-pronged plan, the Inflation Reduction Act, was signed into law. While the new statute addresses some concerns of some elders, some of whom live with dementia, because it does reduce some health care costs, items that did not make it into the Act include “raising wages for the work force that provides caregiving, four weeks of paid family and medical leave, and subsidies for families in need of child care.”12 Ai-jen Poo points out in an editorial written just after the new law was passed that America’s seventy-three million baby boomers are going to need some kind of assistance at some point—many already do.13 As Stephen Miller made crystal clear in a July 2022 Wall Street Journal article, seventy percent of American adults age sixty-five and over will need long-term services and support but will be stymied by a shortage of caregivers that is only anticipated to get worse over the next ten years. Miller’s article carries the no-punches-pulled title “Many Baby Boomers Will Soon Need Adult Supervision; The Shortage of Caregivers for the
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Elderly is Becoming a Crisis.”14 Poo makes clear that the current median annual income for a home care worker is just over $18,000 per year.15 “Who cares” is a question with two possible implications. First, who is concerned about this egregious lack of respect in the form of a living wage? Second, though, is, who is going to care for the myriad of elders who do or will need caregivers? This is, as I have observed several times, a book about theatre, so I return to the question of what theatre can do to help drive the United States—or at least American citizens interested in working on the problem—to greater awareness of the depth and many facets of dementia and caregiver rock and a hard place where the not-too-wealthy and not dirt-poor find ourselves. Can theatre offer dramas around dementia that do more than traffic in decline narratives? Is the game over in our neoliberal, uber-individualist nation of support for “others” who don’t hit too close to home—loud, messy, incontinent, incoherent, possibly lower-class and/or long-term unemployed seniors, for instance? I return here to an observation from the opening chapter of this book: “I hope the American theatre can anticipate new plays exploring new perspectives. Lorraine Hansberry’s A Raisin in the Sun broke ground in 1959 not only because it depicts Blacks as ‘real people’ (clearly this was an idea targeting non-Black audiences), but also because it depicts underpaid domestics as having lives, points of view, strategies, and needs influenced by but well beyond the realm of their jobs, much less their employers’ points of view or anxieties. Caregivers deserve something analogous.” And I will add that caregivers, too, can develop dementia, which, on an income of $18,000 a year means the likelihood of being warehoused in an understaffed nursing home if there is no family member to shoulder the care burden. People aging with dementia and other health problems don’t come from a single class or ethnicity. Paid caregivers are (too) frequently immigrants who may or may not have documented status in the United States. I have an opening scene in mind. Two women in nurse’s uniforms or scrubs share the stage. Lillian is whitepassing, sounds like she was born in the United States, and is in her eighties. Maia is not white, and American English may be her second or third
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language. Each carries a tray with small paper cups of the sort used to deliver pills to people in hospitals or nursing homes. Maia gently takes Lillian’s tray. MAIA There we go, Ms. Lillian. Finished for the day. (She leads Lillian to a side table where she deposits both trays. Then she leads Lillian upstage, where lights come up to reveal a bed. She helps Lillian into the bed and gets her into a nightgown.) LILLIAN Finished for the day. More work tomorrow. New patients? MAIA Yes. You’re a good nurse. You’ll be on the day shift. LILLIAN Will you be back? MAIA Yes, ma’am. Night shift coming on now. I’m going home. (MAIA heads downstage left, where lights come up on what is her living area. Maybe a recliner. Maybe a sofa. Maybe a television. She talks on her cellphone.) Yeah, my knees. Feet, too. I be fine in the morning. Aspirin. Uh huh. Marc in bed? Good. Too tired to eat. Yes, that in the morning, too. (Pause, while whoever is on the other end of the line speaks.) No, don’t wanna think about my birthday. Too many of those already. (Another pause, while the other person speaks and MAIA listens.) Best I can do. She don’t know. --------------------Where might this show go? Is it time for a play that might summon an ensemble response to the lives of caregivers? Do they deserve to be seen in their own play minus any employers? Could my very brief setup segue into a play that could yield an assembly response with the inclusion (on either side of the footlights) of, say, some M.D.s, a state senator, the manager of a rehab facility, a working mother, and a teenager in a wheelchair? Well, I’m just the scholar in the room. Is there a playwright in the house?
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Notes 1. https://www.congress.gov/111/plaws/publ375/PLAW-111publ375. pdf (Accessed 9 April 2023). The opening of the document specifies that in the Act, the word Alzheimer’s is to mean both AD “and related dementias.” 2. https://www.alzint.org/u/Dementia-Asia-Pacific-2014.pdf (Accessed 9 April 2023). 3. https://www.alzint.org/u/apreport2006.pdf (Accessed 9 April 2023), 28–29. 4. Sandra Tsing Loh, “Daddy Issues,” The Atlantic, 6 February 2012. https://www.theatlantic.com/magazine/archive/2012/03/daddy-iss ues/308890/?single_page=true (Accessed 9 April 2023). 5. Ai-jen Poo with Ariane Conrad, The Age of Dignity: Preparing for the Elder Boom in a Changing America (New York and London: The New Press, 2015), 39. 6. Louise Aronson, Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life (New York: Bloomsbury Publishing, Inc., 2019). Quote is on 43–44. 7. Jason Karlawish, The Problem of Alzheimer’s: How Science, Culture, and Politic Turned a Rare Disease Into a Crisis and What We Can Do About It (New York: St. Martin’s Press, 2021). 8. Karlawish, 230. 9. Ibid. 10. Ai-jen Poo and Ilana Berger, “Many of Us Want to Age at Home. But That Option Is Fading Fast,” New York Times (30 March 2022). https://www.nytimes.com/2022/03/30/opinion/homecare-aides-industry.html (Accessed 9 April 2023). 11. Ibid. 12. Ai-jen Poo, “How Long Will the U.S. Continue to Disrespect Its Caregivers?” New York Times, 17 August 2022. https://www.nyt imes.com/2022/08/17/opinion/home-family-child-care.html (Accessed 9 April 2023). 13. Ibid. 14. Stephen Miller, “Many Baby Boomers Will Soon Need Adult Supervision; The Shortage of Caregivers for the Elderly Is Becoming a Crisis,” Wall Street Journal, 19 July 2022. https://www.wsj.com/articles/many-babyboomers-will-soon-need-adult-supervision-caregivers-mental-physical-hea lth-medicare-support-network-11657475582 (Accessed 9 April 2023). 15. Poo, “How Long Will the U.S.…”
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Index
A Abbey Theatre, 65 abortion, legalized, 85 ACT (A Contemporary Theatre), Seattle, 140 acting dual consciousness in, 177 Stanislavski-inflected, 138 Actors Studio, 85 Actors Theatre, Louisville, 192 Adler, Stella, 85 Adler, Tony, 220 ADRDA (Alzheimer’s Disease and Related Disorders Association), 229–230 aducanumab (Aduhelm), 234–236 affect, empathy as, 196 African Americans dementia prevalence/comorbidities, 191 distrust of facilities/dementia assessments, 190 material and nutritional deprivation, 191
medical care shortcomings for, 209 aging dementia vs., 4, 22, 24–25, 32 fear of, 42 agism, 25–26 Ahmed, Sara, 246 Albrecht, Hardie Hunter Albright, Hardie All the Living bio, 83 career, 85–86 Allen, Edward B. “Paranoid Reactions in the Aging”, 110 All the Living (Albright) as activist melodrama, 48 background, 9, 77–79 barriers to later productions, 95–98 institutionalization prominence in, 22 medical staff as inspiration, 79–83 plot/characters, 80, 83–84, 86–89 as reflecting 1930s research, 78 reviews, 89–93
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 D. Chansky, Losing It, https://doi.org/10.1007/978-3-031-20902-4
313
314
INDEX
setting, 7 source material for, 83 Alzheimer and the Dementias (Berrios and Freeman), 20 Alzheimer, Alois, 22, 80, 228 Alzheimer’s Association founding of, 230–231 on olive oil research, 237 role in FDA approval of Aduhelm, 236 Alzheimer’s construct, 228, 245, 246, 254 Alzheimer’s Disease. See also dementia age at onset, 229 aphasia/apraxia and, 131 beta amyloid protein as target, 234–235 Black/Hispanic risk of, 207 brain damage from, 190 cost of, 233 dementia with Lewy bodies misdiagnosed as, 115 as diagnostic category/disease of the young, 23, 80 diagnosis, 14, 183, 190 discovery of, 22 drugs for, 190, 234–236 fear of, 5, 227 research funding, 230–231 in senile and presenile categories, 107 as seventh in the top ten causes of death, 150 slow progression of, 131 statistics, 19 Alzheimer’s Disease International Dementia in the Pacific Region, 276 Alzheimer’s Disease Research, mailers from, 29, 35 amateur theatre, 63, 69 American Geriatrics Society, 109 American Repertory Theatre, 86
American Theater Company, Chicago, 256 Ames, Winthrop, 55 AMSAII (Association of Medical Superintendents of American Institutions for the Insane), 80 Anderson, John, 90–91, 93 aphasia definition, 131 symptoms, 151 apraxia, definition, 131 Aricept (donepezil), 233 Aristotle on audience pleasure, 254 Poetics , 139 Aronson, Louise, 34 Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life, 277–278 arteriosclerosis, 151 Artists Repertory Theatre, Portland, Oregon, 256 Artson, Bradley Shavit, 221 Asian immigrants, medical care shortcomings for, 209 Association of Medical Superintendents of American Institutions for the Insane (AMSAII), 80 atherosclerosis, 151 Atkinson, Brooks, 90, 93, 94, 112 attentive encoding, 181, 199, 215 audiences affluence/education/influence of, 8–9, 18, 37 for amateur theatre, 69 Black and white, 191–192 generational/personal differences, 41 groups medical, 137 naïve, 137
INDEX
recoiling, 137 imitation as pleasurable to, 139–140 influences on, 43 social context of, 69 types of, 140 Auslander, Philip, 143, 148–149 autopathography, definition, 130 Awake and Sing (Odets), 85, 259
B Baby Boom generation, 5 Ballenger, Jesse, 22, 27, 41, 62, 122, 227 Balme, Christopher, 39 Barbican Centre, London, 154 Barnes, Howard, 113 Barranger, Milly S. A Gambler’s Instinct: The Story of Broadway Producer Cheryl Crawford, 101 Basting, Anne Davis on aging, 95, 148 on body in depth, 68, 143 on National Institute on Aging, 26 on positive aging, 25 The Stages of Age, 44 Baumol, William, 37 Beckett, Samuel as Cummings’ inspiration, 138 Krapp’s Last Tape, 43 Waiting for Godot , 3 Belle Reprieve, 144 Benchley, Robert, 93 Berger, Ilana, 279 Bernecker, Sven, 173 Berrios, G.E., 20 Biden, Joe, 35, 279 Biogen, 234, 235 bipolar disorder, 81 Birney, Reed, 256 Bitenc, Rebecca A.
315
on autopathography, 130, 162 on imaginative phenomenology, 122, 163 on memories, 148 on person with dementia, 139 Reconsidering Dementia Narratives: Empathy, Identity and Care, 204 on selfhood as cognitive functioning, 42 The Black Drop (Brown), 70 Black actors DeShields, André, 119 Hyman, Earle, 119 Pierce, Wendell, 118, 120 Winkler, Mel, 119 Black experience Bleeker, Maaike, 40 Bloolips (British male drag duo), 144 body, aging/evolution of, 148 boomerang seniors, 5 Booth Theatre, 56 Boston Toy Theatre, 62 Bowen, William, 37 brain damage from Alzheimer’s Disease, 190 diet and, 227 electron microscope for study of, 228 function, 180–181 Brantley, Ben, 220 Brayton, Tim, 214 Brecht, Bertholt, 164, 167 Brown, Alice background, 55–56 The Black Drop, 70 Children of Earth, 55 Joint Owners in Spain One-Act Plays , 62 Pilgrim’s Progress , 71 Brown, John Mason, 90, 92
316
INDEX
Brown, Scott, 142 Buchanan, Jack, 96 Burgoyne, Suzanne, 139 Butler, Robert, 27, 229
C Caldwell, Erskine, 92 Calhoun, Richard, 109 Callen, Harold, 97 caregiving absence of safety net for, 209, 231–232 of author’s husband, viii, 252 by families, 120, 232–233 low-impact solutions, 278 Maine ballot issue, 73 Marte Meo method, 253–254 outsourced, 47 person-centered, 252, 253, 278 play about, 280–281 strain of, 10 in the US, 12, 200 value of, 12 wages for, 35, 122, 279 as women’s work, 35, 47–48, 120, 200, 232–233 Caring Across Generations, 277 Carleton, Will, 60 Carlson, Marvin, 50, 76, 124, 146 on ghosting, 45, 95 on the haunted stag, 112, 143 The Haunted Stage: The Theatre as Memory Machine, 146 Carmody, Joy, 114 Carroll, Luke P., 115 cerebral arteriosclerosis, 81, 108, 111 Chasing Manet (Howe), 57 chatbots, 213 Cheston, Richard, 204 Chicago Little Theatre, 62, 64 Children of Earth (Brown), 55
Chitlin Circuit, 191–192 chitlins, 189, 191, 206 Christopher, Gary, 204 Chronicle of My Mother (Inoue), 42 Civic Repertory Theatre, 85 Clarke, Sharon D., 120 Cleveland Playhouse, 140 Clinton, Bill, 231 Clow, Hollis E. "Paranoid Reactions in the Aging", 110 Clurman, Harold, 85 Coal Mine Theatre, Toronto, 164 Cobb, Lee J., 45 “Coda” (Hadley), 250 code of actions, 164 Coffey, John, 92 cognitive decline Cohn, R., 238 confabulation, 204, 205 Contemporary Narratives of Dementia: Ethics, Ageing, Politics , 30 Cook, Amy, 105, 111, 112, 117, 198 Coppieters, Frank, 69 copyright violations, 63 Cowdry, Edmund Problems of Aging , 109 Cranham, Kenneth, 158 Crawford, Cheryl, 78, 85–86, 101 One Naked Individual: My Fifty Years in the Theatre, 101 Creuzfeld-Jakob Disease, 21 Cromwell, Miranda, 118 Cronyn, Hume, 113 CTE (chronic traumatic encephalopathy), 48 cultural code, 163 Cummings, Constance challenges of, 138 on learning lines, 178 performance of, 133, 140 rehab setting as preparation, 138
INDEX
Tony Award, 136 Currie, Glenne, 133
D Dear Abby letter, 230 fundraising from, 230 staging of, 238 Death of a Salesman (Miller) background, 9, 41, 106–107, 115 dilemmas presented in, 27 feminist criticism of, 120 home ownership, 116–117 as iconic memory play, 48 Miller’s goal for, 116 physician/medical role in, 107–111 plot, 112–113, 116 reviews, 111–112, 113–115, 118–120 salesman vulnerability, 110 writings/publications about, 106 Declining to Decline ( Gullette), 24 De Marinis, Marco, 40 dementia. See also Alzheimer’s Disease age as risk factor, 19, 137 aging vs., 4, 22, 24–25, 32 American theatre as contributing to understanding of, 275 background, 19, 20 behaviors associated with, 271 biomedicalization of, 121 Black distrust of assessments, 190 caregiving causes/signs/symptoms, 5, 81, 108 definition/description, 28 dementia with Lewy bodies (DLB), 115, 118 diagnostic terms, 100 diet claims and, 225–226 as disability with abilities, 164 family responsibilities for, 59 fear of, 5, 227
317
frontotemporal, 225 as gendered issue, 66 increasing numbers of cases, 209 living with, 11, 19, 20, 29, 162, 165, 171, 172, 174, 175, 177, 182, 194, 204, 206, 220, 232, 233, 254, 256, 268 and loss of friendships, 206 MCI as risk factor, 14 medicalization of, 26 memory loss 1950s views of, 98–99 Parkinson’s Disease, 21, 118, 233 Progressive Era views of, 61, 66 Progressive Supranuclear Palsy, 13, 186, 239 recall and recognition tests for, 13, 190 research funding, 230–231 research on, 228–229 shifting views of, 105 simulation of, 189 socioeconomic component, 110 stages of, 20 statistics, 19 stigma of, 26–27 strokes as cause of, 15, 108 subtypes, 30 terminology, 20–21, 59, 81 treatment, 33, 109 drugs, 20, 234–236 European vs. US, 23 virtual experience of, 194 as a women’s problem, 55 Dementia as Social Experience, 30 Dementia in the Pacific Region (Alzheimer’s Disease International), 276 dementia patients, decision-making by, 252–253 dementia praecox, 81, 83, 84, 86, 98
318
INDEX
Dementia Reconsidered: The Person Comes First (Kitwood), 252 dementia, views from the inside background, 130–131 Wings demographic changes, 4–5, 10 Dennehy, Brian, 113, 117 DeShields, André, 119 Deutsch, Albert on distrust between neurologists and psychiatrists, 74 The Mentally Ill in America—A History of Their Care and Treatment from Colonial Times , 77, 79–80 role/contributions of, 79–80 Dewey, John, 267 The Diagnostic and Statistical Manual of Mental Disorders (DSM I), 100 diagnosis Alzheimer’s Disease, 14, 183, 190 delays, 20 of witchcraft (seventeenth century), 79 Diderot, Denis, 177 digital cohabitation, definition of, 219 Dix, Dorothea, 21, 79 Dixon Place (theatre), 146, 147 DLB (dementia with Lewy bodies), 115, 118 Dock Players, Sandwich, New Hampshire, 256 Dolan, Jill, 143 donepezil (Aricept), 233 Dot (Domingo) audience, 191–192 background, 6, 11, 12 plot, 47, 173–174, 187–190, 194, 199–200 reviews, 189, 192–194 script inaccuracies, 191 dream/dreams, 8, 70, 178
recounting of a dream, 140 Dress Suits to Hire (Shaw), 144 Drexel, Kitty, 263–264 Droege, Paula, 176 Duke of York’s Theatre, 158 Dunnock, Mildred, 138 Dykstra, Ted, 164–165 Dziemianowicz, Joe, 166 E East Village, New York, performances, 149 Ebbinghaus, Hermann, 183 Eder, Richard, 133 Ehrenberg, Ruth, 108 eldercare, colonial era laws, 59 Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life (Aronson), 277–278 Elliott, Marianne, 118 “Embodied Memory: Again, Neuroculture and the Genealogy of Mind” (Katz), 147 encoding memory, 178 The End of Senility (Freese), 28 English Poor Law, 59 epilepsy, paraldehyde as treatment for, 82 episodic foresight, 194 episodic memories, 179, 184, 195, 215 episodic memories, 176 Erikson, Erik H., 25 Eugene O’Neill Theatre, 117 An Evening With Mike Nichols and Elaine May , 45 Everyman (late 1400s), 3 F Falcus, Sarah, 24, 46, 48
INDEX
false memories, 178, 184 family caregiving The Father (Zeller) audience, 158, 159, 162 awards, 157–158 background, 6, 10, 20, 46, 157–158, 183 as farce, 26, 48 plot, 7, 158–162 realism in, 163–164, 167 reviews, 162–163, 165, 166 three phases of dementia in, 20 Featherstone, Mike, 25 Federal Art Project, 96 Federal Housing Administration, 116 Federal Music Project, 96 Federal Theatre Project (FTP) House Un-American Activities Committee attacks on, 96 idealism of, 78, 89 and Works Progress Administration, 95 Federal Trade Commission, false promises, 226 Federal Writers’ Project, 96 Feldman, Adam Time Out New York, 247 Fences (Wilson), 114 Fernández, Jordi, 184, 215 Fernyhough, Charles, 172 Fish, Stanley, 69 Fitzgerald, Ella, 133 Flanagan, Hallie, 96 Folbre, Nancy, 47 Food and Drug Administration (FDA), 234, 236 forgetting Förstl, Hans, 23 Fox, Patrick J., 229 Freeman, H.L., 20 Freese, Arthur, 28 Freud, Sigmund, 179
319
Freytag, Gustav, 136 Frohman, Charles, 93 FTP Fuchs, Elinor, 24 functional psychoses, behaviors associated with, 107
G Gamerman, Amy, 270 Gardner, Elysa, 263 Gawande, Atul, 239 Gélinas, Isabelle, 158 geriatrics/gerontology, 109 Geriatrics: The Diseases of Old Age and Their Treatment (Nascher), 21, 66 Gerontological Society of America, 109 ghosting of actors, 69 definition of, 45–46 Gibson, Janet, 14 Gillespie, Benjamin, 148 Giraudoux, Jean, 114 Glass Menagerie (Williams), 200 Glover, William, 133 Golden Theatre, New York, 241 Gollaher, David, 33 Graebner, William, 110 Greenberg, Martha, 141 Greenber, Richard Our Mother’s Brief Affair Greenblatt, Leah, 242 Gregory, Augusta, 65 The Group, 85 Group Theatre, 78, 85, 94 Gullette, Margaret Morganroth, 24–25 Guthrie Theatre, Minneapolis, 113, 119
320
INDEX
H Haber, Carole, 21 Hadley, Tessa “Coda”, 250 Hampton, Christopher, 6, 158 Hansberry, Lorraine A Raisin in the Sun, 13, 280 Harper, Lynn Casteel, 129, 133, 150, 152, 155, 206, 247, 253, 270, 271 on brain death, 133, 253 on dementia, 246–247 On Vanishing: Mortality, Dementia, and What It Means to Disappear , 129, 247 Harrison, Jordan Marjorie Prime, 213. See also Marjorie Prime (Harrison) Hartman Theater, Stamford, Connecticut, 119 The Haunted Stage: The Theatre as Memory Machine (Carlson), 146 Hawkins, William, 113 Hayden, Dolores, 116 health care insurance, 73 Heckart, Eileen, 242, 254 Hedges, Lucas, 242 Helen Hayes Theatre, New York, 256 Herskovits, Elizabeth, 228, 246 Hinsie, Leland E., 32, 35 Hippocampus, 180, 181, 183 Hirsch, Judd, 113 Hirsch, Robert, 157 Hochschild, Arlie Russell The Second Shift , 75 Hofer, Scott, 118 Hoffman, Dustin, 113, 118 Hoffman, Philip Seymour, 114 Holstein, Martha, 21, 23, 61 home loans, discrimination in, 117, 118
Home Owners Loan Corporation (HOLC), 116 Hopkins, Anthony, 157, 158 horizon of expectations, 69 Horn, Dara, 47 Horner, Harry, 91 Hot Peaches (drag company), 144 Houdyshell, Jayne, 256 House Un-American Activities Committee, Federal Theatre Project attacked by, 96 Howe, Tina, 57 The Humans (Karam) audience, 256 awards, 12, 256 background, 6, 41, 46, 228, 255–256 as film, 256 financial issues, 12 as naturalism, 48 plot, 257–259, 261–262 reviews, 256, 260, 270 Hurley, Erin Theatre and Feeling , 195 Hutchinson-Gilford progeria syndrome (HPGS), 50 Hyde, Lewis on importance of forgetting, 186 on memories of grief, 215 A Primer for Forgetting , 182 Hyman, Earle, 119
I I Knew 3000 Lunatics (Small), 77, 81, 82–83 imaginative phenomenology, 122, 162, 163 implanted memories, 177–178 Inflation Reduction Act (2022), 279 Inoue, Yashusi, 42 interpretive community, 69
INDEX
Irish National Theatre Society, 65 Isherwood, Charles, 193, 209 Ishii, Wendy, 141 J Jackness, Andrew, 133 Jauss, Hans Robert, 69 Jefferson, Joseph, 93 Jenkins, Ray, 121 Johnson, Christopher, 19, 164 Joint Owners in Spain (Brown) audience, 61 background, 9, 41, 55–56 characters, 65–66, 66–67, 71 as comedy, 48 dementia portrayed in, 26, 59–62 dramaturgy and depictions, 56–59 institutionalization prominence in, 22 longevity of, 67–69 plot, 56–57, 58–59 reception of, 62–66 reviews, 63–65 Jones, Chris, 247 K Kakutani, Michiko, 118 Karlawish, Jason on aging vs. dementia, 32 on Alzheimer’s Association focus, 230 on Alzheimer’s Disease annual cost, 233 on donepezil development, 233 The Problem of Alzheimer’s , 5, 278 Katzman, Robert, 229 on Alzheimer’s Disease and senile dementia, 238 “Prevalence and Malignancy of Alzheimer Disease: A Major Killer”, 229
321
Katz, Stephen “Embodied Memory: Again, Neuroculture and the Genealogy of Mind”, 147 Kazacoff, George, 96 Kazan, Elia, 117 Kelley, Margot Anne, 139 Kennedy, Dennis, 39, 69 Kimberly Akimbo (Lindsay-Abaire), 45 kinesthetic empathy, 196–198 King Lear, signs of early dementia, 3 Kingsley, Sidney, 85 Kissel, Howard, 133 Kitwood, Tom Dementia Reconsidered: The Person Comes First , 252 Klein, Lauren, 256, 263 Kline, H., 96 Kopit, Arthur on audience types, 140 on brain damage, 136 Burgoyne on, 139 Wings Kraepelin, Emil, 23, 80 Krapp’s Last Tape (Beckett), 43 Kyoto Declaration (2004), 276
L Lahr, John, 118 LaMama (theatre), 146, 150 Langella, Frank, 158, 163, 166 Langill, Ellen, 70 Larson, Charles U., 226 Laura Pels Theatre, New York, 256 Lavin, Linda, 200 Law and Order: Special Victims Unit , 38 Le Gallienne, Eva, 85 Leicester Square Theatre (London), 96 lesbian/queer theatre, 143, 146
322
INDEX
Levittowns, 117 Levitt, William, 117, 125 The Life Cycle Completed (Erikson), 25 life expectancy of women, 26, 121 Lindsay-Abaire, David, 45, 50, 57 Lipscomb, Valerie, 43 Little Theatre Movement, 26, 55, 62–63, 74 Living Newspapers, 96 Locke, John, 147 Lock, Margaret, 32 Lockwood, J. Samaine, 57–58 Loftus, Elizabeth, 178, 180, 181, 199 Loh, Sandra Tsing, 276–277 long-term memory, 199 Lucille Lortel Award, 256 Lukács, Gyorgy, 164, 167
M Mace, Nancy, 151 The 36-Hour Day , 130 MacLaine, Shirley The Turning Point , 180 Madden, John, 133 Magelssen, Scott Simming: Participatory Performance and the Making of Meaning , 195 Manhattan Theatre Club, 158 manic depression, 81 Mantello, Joe, 256 Mantle, Burns, 90, 93 Margolin, Deb, 143 Marjorie Prime (Harrison) audience, 216 background, 6, 45, 213–214 plot, 174, 214, 215–216, 217–220 reviews, 214, 220 Marks, Peter, 242 Mason, M.S., 120
Maxwell, Jan, 142 May, Elaine, 45, 242, 254 Mayer-Gross, William, 107–108 McCullers, Carson, 86 McDonald, George B., 105 MCI (Mild Cognitive Impairment), 4 McKee, John, 88, 93–95 Medicaid, 56, 262, 265, 278 Medicare, 56, 59 Aduhelm coverage limitations, 235 Part B premium increases, 235 role of, 232, 262, 265 Meisner, Sanford, 93 as actor, 84, 85, 87, 92, 94–95 Sanford Meisner on Acting , 94 memory accuracy of, 11, 174 adaptive shaping of, 173 background, 11, 171–172, 173 bias in, 172 characteristics of, 182 confabulation, 204 declarative memory, 176 definition, 176 dependence on brain function, 179 differences in recall, 179 elasticity of, 173 forgetting, 182, 203 impairment from strokes and Lumosity online brain-training games, 226 as mental library, 172 persistence of, 217 recall of events,distant/recent, 177 short-term limits, 180 types of, 176–177, 178 Menopausal Gentleman (Shaw), 144 mental hospitals financial advantages of, 21 history of, 21–22 patient diagnoses, 81 Mental Hygiene Movement, 80
INDEX
The Mentally Ill in America-A History of Their Care and Treatment from Colonial Times (Deutsch), 77, 79–80 Metzger, Sean, 219 Meyer, Adolph, 84 Mieke Bleeker, 95 Miller, Arthur Death of a Salesman on Willy Loman, 26, 115 Seattle doctor’s question to, 105 Miller, Stephen, 279 Mitchell, David, 171, 198–199 Mitchell, H. Weir, 23 Molina, Alfred, 158 Montreal at the Hemispheric Institute, 154 Moore, John, 141 Moore, Julianne Still Alice, 8 Morris, Pam Realism, 163 Moser, Ingunn, 236, 253 multi-infarct dementia, 15 The Myth of Alzheimer’s (Whitehouse), 28 N narrative prosthesis, definition of, 171 Nascher, I.L., 21, 31, 65, 66, 75, 121 Geriatrics: The Diseases of Old Age and Their Treatment , 21, 66 on stereotypes, 66 National Alzheimer’s Disease Awareness Month, 129 National Alzheimer’s Project Act (2011), 276 National Council on Aging, 109 National Domestic Workers Alliance, 277 National Institute on Aging, 26, 229, 231
323
National Service Bureau, 96 National Theatre, London, 113 Neighborhood Playhouse, 62, 94 Nelson, Richard, 259 neoliberalism, 265 Neuman, M.A., 238 neurology, psychiatry contrasted with, 82 New England regionalism, 59 Newspapers Chicago Daily News , 16, 35, 42, 49, 50, 63, 75, 90, 99, 101, 102, 105, 112, 113, 115, 122–126, 142, 151–153, 155, 166, 186, 201, 205–207, 211, 235, 237, 240, 269, 272, 282 Newton, R.D., 238 New York Shakespeare Festival Public Theater, 133 The New York Times readership discussion, 235–236 Nichols, Mike, 45 Nixon, Cynthia, 141 Noll, Richard, 33, 99–101, 103, 150 O Oases Theatre, Buffalo, 119 Obama, Barack, 276 Odets, Clifford Awake and Sing , 85, 259 Oedipus at Colonus, 3, 46 Okano, Y¯ uichi, 46 O’Keane, Veronica, 176, 179, 180 One-Act Plays (Brown), 62 O’Neill, Eugene, 259 On Vanishing: Mortality, Dementia, and What It Means to Disappear (Harper), 129, 247 organic psychoses, characteristics of, 107, 111 Østby, Hilde and Ylva, 173, 180, 185, 216
324
INDEX
Our Mother’s Brief Affair (Greenberg) background, 6, 11, 200 as detective story, 48 inconsistencies within, 207 plot, 174, 200–203, 205 reviews, 200, 203, 205–206, 209
P paraldehyde, 82 "Paranoid Reactions in the Aging"(Allen and Clow), 110 Pasadena Playhouse, 158 "Pathologic Changes in Senile Psychoses and Their Psychobiologic Significance"(Rothschild), 108 Pecross’ Mother and Her Days (Okano), 46 Penn Memory Center, 230, 277 Performing Age in Modern Drama (Lipscomb), 43 Performing Arts: The Economic Dilemma (Baumol and Bowen), 37 Perry, Tyler, 192 persona, definition of, 148 personhood movement (1990s), 30 Phelan, James, 198 Phipps Psychiatric Clinic, 84 Pic Magazine, 98, 103 Pierce, Wendell, 118, 120 Pilgrim’s Progress (Brown), 71 Pinter, Harold, 162 Pittsburgh Public Theatre, 256 Playwright’s Horizons, New York, 220 playwrights, male preponderance, 35, 62 Poetics (Aristotle), 139 political, definition of, 265 polyphonism, definition of, 46
Poo, Ai-jen, 15, 31, 277, 279, 282 Population Reference Bureau, 4 positive aging, 25, 45 postmodern theatre, 271 Post, Stephen G., 227 “Prevalence and Malignancy of Alzheimer Disease: A Major Killer” (Katzman), 229 A Primer for Forgetting (Hyde), 182 priming, definition of, 214 Problems of Aging (Cowdry), 109 The Problem of Alzheimer’s (Karlawish), 5, 277–278 procedural memory, 176, 195 Progressive Era views of dementia, 61, 66 Promenade Theatre, New York, 241 Provincetown Players, 62 Psychiatric Dictionary, (Oxford University Press), 28 psychiatrists European vs. US, 23–24 expectations of, 62 training, 84 psychiatry, neurology contrasted with, 82 psychodynamic approach, 108 Psychology Today, on dementia and sweets, 225 psychosis with cerebral arteriosclerosis, 81 publishers Macmillan, 62, 70 Walter Baker Company, 62, 65
R Rabinowitz, Peter J., 5 Rabins, Peter, 151 The 36-Hour Day , 130 A Raisin in the Sun (Hansberry), 13, 280
INDEX
Raskin, Naomi, 108 Reagan, Ronald, 129 Realism (Morris), 163 Reconsidering Dementia Narratives: Empathy, Identity and Care (Bitenc), 204 Reed, Maria Gilman, 70 Reinelt, Janelle, 40 Reiss, Allison, 227 Repertory Theatre, St. Louis, 256 repressed memories, 176, 179 research funding, 230–231 residences almshouses/poorhouses, 21, 60, 79 almshouses/poorhouses, ballad about, 60 asylums, 21 institutional, 59 mental institutions, 62, 71, 79 private homes as, 60 retrofitting, types of, 203 Reynolds, Dee, 196 Rich, Jessica, 227 Ripcord (Lindsay-Abaire), 57 Roach, Marion, 42 Robinson, DayDay, 164, 165 Robins, Sarah K., 176 Rogers, Carl, 252, 270 Roland Barthes, 163 Rose, Lloyd, 113 Ross, Matthew, 109 Rothschild, David on causes, 27, 98 "Pathologic Changes in Senile Psychoses and Their Psychobiologic Significance", 108 Roundabout Theatre Company, New York, 256 Ruff (Shaw) audiences, 147, 149–150 as autopathography, 130
325
background, 7, 142–143 performance of, 144–146 reviews, 146 stroke as inspiration for, 26, 43, 142 Ryder, Alfred, 98
S safety net absence of, 59 Social Security as, 56–57 Sako, Katsura, 24, 46, 48 Sanford Meisner on Acting , 94 Savage, Henry W., 93 Schacter, Daniel on brain functioning, 180 on memory bias, 172 on persistence in memory, 217 Seven Sins of Memory , 184, 185, 203 Scheck, Frank, 193, 209 Schjeldahl, Peter, 246 Schoenfeld Theatre, New York, 256 Schraeder, Tom, 133 The Second Shift (Hochschild), 75 Second Stage, New York, 142 selfhood, 42 semantic memory, 176, 195 senile psychoses, 81, 114 senile/senility, 66 Seven Sins of Memory (Schacter), 184, 185, 203 sexism, 26 Shakespeare, William, seventh age, 3 Shaw, Peggy butch and male roles played by, 144 Dress Suits to Hire, 144 Menopausal Gentleman, 144 Ruff , 130. See also Ruff (Shaw) status of, 143 as stroke victim, 10
326
INDEX
success of, 144 Shepard, Sam, 259 Sher, Anthony, 115 short-term memory, 180, 186, 199 Simming: Participatory Performance and the Making of Meaning (Magelssen), 195 Simon, John, 242, 251 simulation of ABC news team, 195–196 of dementia, 189, 198 of old age, 195, 210 Small, Victor R. bio, 81–82 I Knew 3000 Lunatics , 77, 81, 82–83 visit to New York City, 92 Smith, Kelundra, 209 Smith, Lois, 45 Smith, Susan Harris, 118 Snyder, Sharon, 171, 198–199 Social Security, 56, 110, 262 Sophocles, 3, 46 South Coast Rep, Los Angeles, 200 Spiderwoman (Brooklyn-based feminist company), 144 Split Britches, 10, 143, 146, 154 The Stages of Age (Basting), 44 Stanislavski, Konstantin, 85, 94 Stasio, Marilyn, 254 Stefanini, Fúlvio, 158 Stevenson, Robert Louis, 55 Stieglitz, E.J., 109 Still Alice (Moore), 8 Stone, Jerome, 238 Strasberg, Lee, 78, 85, 94 A Streetcar Named Desire (Williams), 144 strokes causes of (1899), 33 cognitive impairment from, 15, 131 definition of, 131
dementia risk from, 7, 131 E.R. episode featuring, 141 plays about in the top ten causes of death, 150 types of, 151 Strukus, Wanda, 198 Sundance Festival, 158 sundowning, 38 suppressed memories, 177, 179
T Tannahill, Jordan Theatre of the Unimpressed, 105–106 Teachout, Terry, 205 Teeman, Tim, 254 Tennessee Williams A Streetcar Named Desire, 144 Texas Tech University, Lubbock, Texas, 158 The 36-Hour Day (Mace and Rabins), 130 Theatre and Feeling (Hurley), 195 theatregoers Theatre of the Unimpressed (Tannahill), 106 Theatre Royal, Bath, England, 158 theatre, social impact of, 40 The Theatrical Public Sphere (Balme), 39 Time Out New York (Feldman), 247 Tomlin, Liz, 39, 266–267, 268 Tompkins, E.L., 33 Topham, Karen, 262 Trent, Sheila, 98 Trueman, Matt, 118 Tulving, Endel, 176 The Turning Point (MacLaine), 180 Tversky, Barbara, 198
INDEX
U Unadilla Theatre, Marshfield, Vermont, 158 Under the Radar Festival, 150 Unexploded Ordnances , 150 University of Manchester, performances, 154 V van der Laan, Anna Laura, 190, 235 Vernon, Tom, 92 Vincentelli, Elisabeth, 166 Vittoria, Anne, 254, 270, 271 Voegeli, Tom, 133 W Waiting for Godot (Beckett), 3 Warren, Mercy Otis, 55 Washington Square Players, 62 The Waverly Gallery (Lonergan) audience, 245–246, 254 author’s view on, 247–248, 252 awards, 45, 243 background, 6, 13, 20, 136, 228, 241 plot, 241–242, 243–245, 248–249, 251–252 reviews, 242–243, 245–246, 251 Weaver, Lois, 143, 150 Webster, Margaret, 86 Wernick, Andrew, 25 Whipple, Sidney B., 93 Whitehouse, Peter, 28–29 Wilder, Thornton, 258 Williams, Tennessee, 86 Glass Menagerie, 200 Willis, Bruce, 151 Willy Loman age of, 45 multi-racial/multi-ethnic actors, 118–120
327
Seattle MD’s diagnosis of, 105 White actors as, 113–118 Wilson, August Fences , 114 Winer, Linda, 242 Wings (Kopit) background, 7, 10, 131–142, 183 dementia portrayed in, 26 as explosion of sensibility, 48 inspiration for, 131 Kelley on, 139 parts of catastrophe, 132–133 inner experience of, 134–135 prelude, 132 rehab setting, 136 productions outside New York, 140 reviews, 133–134, 136, 140–141, 142 as speculation informed by fact, 132 stroke depicted by, 131 Winkler, Mel, 119 Wolcott, James, 118 Woman’s World, on sweets and dementia, 225–226 women caregiving by, 35, 47–48, 120–121, 200, 232–233 life expectancy of, 26, 121 Women’s One World (WOW) Café, New York, 143 Woodward, Kathleen, 42–43 word, repetition as binding effect, 246 word salad/gibberish, 135 working memory, 186, 199 Works Progress Administration, 96 World Alzheimer’s Day, 150 World Health Organization, 19 Worthen, Hana, 246, 254, 266–267 Worthen, W.B., 40, 47 WOW (Women’s One World) Café, New York, 143
328
INDEX
Writers Theatre, Chicago, 220 Wyndham’s Theatre, 158 Y Yale Repertory Theater, 133 Yeats, William Butler, 65
Z Zeller, Florian, 26, 157 The Height of the Storm, 34 Zuckerman, Dianne, 141