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The first patient with dementia I remember meeting on clinical rotations was a charming and witty woman whose kinetic speech was a symptom of, and cover for, profound cognitive deficits. I met someone very much like her again as the curtain rose on The Waverly Gallery, a Pulitzer Prize–nominated Kenneth Lonergan play currently in revival on Broadway. “I never knew anything was the matter,” says Gladys Green, age 85, in the first of many words that will spill out of her over 2 acts. The playwright’s instructions characterize Gladys as an “immensely charming and absolutely relentless talker” who “lives for company and conversation” and “demands the full attention of her interlocutors with a cheerful and unremitting zeal that can be very wearing after a few minutes.” The opening dialogue suggests Gladys’ miscues and fumbles are a result of age-related hearing impairment, but I was fairly certain she was already symptomatic like the patient I encountered years ago. She is witty and charming, and we spend the rest of the play watching her lose her housekeys and her mind.
If that story seems too familiar from our own family members and patients, there are a number of reasons to see this production. Foremost is the craft and presence of Elaine May who, perfectly cast, acts the dementia phenotype with precision, humor, vulnerability, and pathos. May’s legend dates back to her work with Mike Nichols in their comedy duo, a smart improv act that was a darling of the intellectual set in the 1950s and 1960s. (Their 1961 “Nichols and May Examine Doctors” charts the faintest of through-lines connecting May’s engagement with medical matters from her peak fame to the present.) Now nearly 87 years old, May is a petite actress who appears frail on stage, and the contrast between her slight physicality and the clear strength of intellect behind her performance makes Gladys’ decline that much more personal, as if May is anticipating it for herself and testing the experience in front of an audience to see how it will feel. Beyond May the production has a pedigreed movie star cast, and taking the likes of Joan Allen, Michael Cera, and Lucas Hedges off the silver screen onto the stage into a domestic drama in a smallish theater echoes the effects of dementia, transforming larger-than-life faces and personalities onto fallible human scale.
Elaine May as Gladys Green in Kenneth Lonergan’s The Waverly Gallery, staged at the Golden Theatre in Manhattan, New York, October 25, 2018, through January 27, 2019.
The Waverly Gallery has artful things to say about dementia that may not be obvious from our routine encounters with family members and patients with the illness. The play’s characters are kind, caring, and more or less in possession of their faculties, and they are intrusive, emotionally labile, a little selfish, and at times socially obtuse, hinting that dementia is a release of inhibition of traits we all have, and that the distinction between people with and without dementia is one of difference, not of kind. The show also is a reminder that with dementia, as perhaps with all progressive debilitating disease, the family is the patient; Gladys’ slow decline spreads like tau protein through her relationships, leading to short-circuiting of previously reliable connections, with local and global family dysfunction. Finally, the show is a so-called memory play, framed through the memory of Gladys’ grandson Daniel. “I want to tell you what happened to my grandmother, Gladys Green, near the end of her life,” he says early on. The Waverly Gallery is a story about the disappearance of memory, told from and through memory, enlisting all of us to remember that storytelling is a form of caring, and implicating us in the upkeep of our own family histories.
The novel Anna Karenina famously begins with the pronouncement that “All happy families are alike; each unhappy family is unhappy in its own way.” The Waverly Gallery offers a private view of one such unhappiness, a (fictional) family’s response to the illness of one of its keystone members. This is dementia as it happens outside our antiseptic health care spaces, and it is sobering, and on a private and entirely ordinary scale, devastating.
Corresponding Author: Michael Berkwits, MD, MSCE, JAMA (firstname.lastname@example.org).
Published Online: January 10, 2019. doi:10.1001/jama.2018.22035
Conflict of Interest Disclosures: None reported.
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Berkwits M. The Waverly Gallery—Dementia on Broadway. JAMA. Published online January 10, 2019. doi:10.1001/jama.2018.22035
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