Souls on a Walk is a moving first-hand account of a husband and wife’s journey with Alzheimer’s disease during the final chapter of their 56-year marriage. While similar in some respects to other accounts of caring for a significant other with Alzheimer’s, the memoir offers a unique dimension in that the author is a prominent academic family physician. Nevertheless, despite his medical expertise, Dr Geyman recounts the story of his wife, Gene Geyman, primarily from the perspective of a loving and caring husband. As such, he is painfully honest about sharing the heartache, frustrations, disappointments, and occasional rewards in devoting himself to his wife’s care and well-being. Souls on a Walk honestly but lovingly shows each step of the couple’s journey with “The Great Thief,” chronicling a 16-year saga in which every shred of independence and selfhood is fought for and every decline resisted before his wife passes away.Dr Geyman carefully describes his wife’s inevitable downward spiral, which simultaneously touches on experiences common to many Alzheimer’s patients and is also particular to her circumstances and who she is as a person. Importantly, the book illustrates how Gene’s personality and life values determine crucial treatment decisions. Throughout her life, Gene avoided closed spaces, and care decisions avoiding restrictive confinement and restraints were made with this in mind. When Gene is no longer able to swallow and suffering from pneumonia, Dr Geyman opts for hospice care, a choice that honors what his wife would have wanted for the final phase of her life. Understanding a person’s values, joys, and fears is instrumental in providing meaningful and dignified care, unique to that individual, as his or her disease progresses.Although many of his and Gene’s experiences with medical treatment are positive, Dr Geyman also describes difficult encounters with the health care system, beginning with an insensitive disclosure of Gene’s dementia diagnosis. He relates a particularly frustrating experience with care in the emergency room, where even as he advocates for his wife, she becomes increasingly agitated due to the bewildering foreign environment and multiple health care personnel. As Dr Geyman comes to recognize, many of our health care systems are not ideal and in fact may be detrimental to the care of persons with dementia.Dr Geyman also shares his own perspective, which, although in some ways unique, also parallels that of many other caregivers. He makes the wrenching decision to give up his medical practice so that he has the freedom to stay at home to care for his wife. Arranging caregiving, modifying the house, and assuring her safety quickly become full-time tasks, which he assumes willingly and uncomplainingly, yet with awareness of all he has lost. One of the most striking aspects to Dr Geyman’s account is how little he sounds like a doctor in the telling. He never tries to hide his emotions as a husband behind his professionalism as a doctor or to second guess her physicians. To his credit, he works with the health care system as much as possible and, at the same time, accepts responsibility for navigating his wife’s illness as her soulmate and life partner with grace and candor.Significantly, the book does not stop with Gene’s death because life does not stop with death. Dr Geyman frankly discusses aspects of his life after the loss of his beloved spouse, including his grieving process, his reconnection with family medicine research, his exploration of spirituality, and even his hope that he will eventually find a new companion. The last chapter of the book provides valuable guidelines for patients and families who are living with Alzheimer’s disease.Because of Dr Geyman’s willingness throughout this story to be a man and husband first and a physician second, Souls on a Walk will be a valuable and at times consoling resource for the lay public. It is also an important book for health care professionals
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