Losing his understanding of the world

The semantic variant of primary progressive aphasia means that the person loses their understanding of how the world works. What does that even mean to not understand how the world works? When his psychologist first mentioned those words to me, my mind ignored them. I knew what aphasia meant, my father had developed that from a blood clot in his brain. And it was painful watching him lose his ability to communicate. I knew what was coming. But losing his understanding of the world? Four years later, now I know what that means. For example, if a glass breaks, he doesn’t know it can cut him. He starts picking it up with his bare hands. And when he gets cut and bleeds, he goes on with whatever he is doing without reacting. Naturally, if you don’t know what bleeding means, why do anything about it? Or, what does it mean when someone cries? I couldn’t help but cry the other day while we were eating breakfast as I thought about the need to move him into a nursing home. He looked up from his plate and saw my tears, pointed at his eye, chuckled slightly, and then went back to eating. Or, what is the purpose of an object? He doesn’t know if he doesn’t use it on a daily basis. It had been a month since he shaved. I assumed he wanted to grow a beard. After all, he had a big thick mustache when I met him.  But when I saw him with little cuts on his face, I discovered that he tried to cut his beard off with a scissors instead of shaving it with a razor.  When he was first diagnosed, he couldn’t name objects but he could describe their purpose. Show him a pen, and he could say it was for writing. Show him a light, and he would say it was for seeing. Most of those verbs are now inaccessible. He still knows what to do with a pen or a light, be he can’t give you the verb to write or to see.  Then there are those objects that he hasn’t used in years: a screwdriver, a hammer, the printer. He cannot name them, or tell you their purpose, or know what to do with them. This feeling of watching someone disappear is indescribable. But I feel fortunate that he does not know what the tears mean.