How's That for Fine?
On Showtime, the performance of wellness, and what caregivers carry alone
Some things our body just knows, without our mind to help it.
Tie our shoes. Pick up a fork and eat. Brush our teeth. The brain internalized the pattern long ago — and without thinking, we do it.
Same with feelings. I’m married, Vicki’s my wife. The ease of Hey buddy, how are you? The automatic I feel good at the doctor’s office. Conditioned responses to people and situations, built from a lifetime of social interactions — running quietly beneath the surface.
Some skills go even deeper. A sailor who ties a perfect bowline without looking. A carpenter who reads a blueprint and already sees the room. A nurse whose hands tend to a wound while getting ready for the next patient. So ingrained that there is no thinking involved. Your hands just know.
It’s Showtime
Lee could Showtime with the best of them.
He could follow a conversation — or seem to. A nod at the right moment. A smile. A kiss hello and how are you? He chatted with family members at the memory care home as if he belonged there in a different way — as a guest, not a resident.
It fooled me for a while. Longer than I’d like to admit.
Quite frankly, I was happy to live with that delusion for a time. It was so nice to have my husband back, even briefly. Even if it was an illusion.
“Showtime” in dementia refers to a phenomenon where a person temporarily rallies — appearing lucid, coherent, even symptom-free — to doctors, visitors, or medical professionals. It’s usually brief. Fifteen to thirty minutes. And it costs them enormously afterward.
Research points to reasons: nervousness, fear of losing more independence, the instinct to fit in for just a few more minutes. Social skills that are so deeply ingrained even significant cognitive decline can’t fully reach them — not right away. They can be summoned, with great effort, for a short window. Often, after Lee returned from the doctor having summoned his stage personality, he was completely exhausted and slept for hours.
Showtime deceives everyone who only sees that window. Friends, family, even professionals conclude that things must not be as serious as reported. Reliance on one short encounter can delay further diagnosis — no visible decline, so no changes are needed.
Lee’s doctor would ask how he was feeling. Doctor, I’m fine. No changes. The professional took him at his word. I was typically not consulted as to my observations. I only lived with him 24/7.
I learned to ask to speak with the provider alone afterward. To explain that earlier that week he had sundowned three times. That he had threatened violence when his needs weren’t met immediately. That he had started to forget how to brush his teeth.
How’s that for fine?
The Before, the Performance, and the Crash
Before. The evening prior, a bad sundowning episode — we are both exhausted. The following morning he wakes, wanders, won’t eat breakfast, yells if I don’t answer him immediately. It takes an hour with my help to get dressed for the appointment.
The Performance. He walks up to the receptionist with a bright smile. I have an appointment with Dr. X at 2:00. Provides his date of birth upon request. Sits patiently until called. Answers questions quickly, confidently. I am doing great, Doctor. Feeling good. The doctor takes him at his word. Chart closed.
The Crash. We get into the car. He slumps over and falls asleep almost immediately. I can barely get him into the house. He gets into bed and sleeps for hours.
After the effort of holding it together, even briefly, he is more exhausted, more confused, more depleted than before.
For the caregiver, Showtime is its own kind of loneliness. And it hits even harder because the performance your spouse just gave is a reflection of everything they are losing. From the simplest act of brushing teeth to the most complex expressed emotion — I love you — you see the full picture. You know what others cannot see.
You know the before and the after. The performance and the crash that follows.
But remember — this was Lee. My husband. The love of my life. Not a patient, not a number. The lovely, handsome man who stole my heart twenty-five years ago. Who with every Showtime performance and crash, broke it again and again.
You’re the caregiver, you see it all. You know.
You are the one who sees that reality.
And you hold it, quietly, alone.
I was a caregiver for my husband with Alzheimer’s. I write about Belonging to Self, Community and Home, both during and after caregiving.
If this would be of value to you to hear more about how I restored my sense of community after 4 years of caregiving, Subscribe to Vicki’s Substack, “The Tender Warrior”