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The somebody is Wendy Mitchell as she was before she was diagnosed with Alzheimer’s disease at the age of 58. She was a highly active, well-organised NHS manager with a responsible job, able to deal with nursing rotas for a hospital in her head. The dementia first declared itself with a stroke-like episode that came out of nowhere. Over time after this, she became aware of fluctuations in her ability and a sense of fog in her mind. Remaining at work required being super-organised to stay in front of her tasks though, in the end, even she was unable to keep up.

By the time she received a diagnosis, Wendy Mitchell was not surprised though even so it had a big impact. She documents various things that she had enjoyed that came to an end – running, baking and driving, for instance. However, her organisational talents have helped her to remain independent. This may appear effortless ('you haven’t changed’, people frequently say to her) but actually it is at the cost of a big effort. For example, to go on a train journey requires attention to every detail of the route, including obtaining pictures of landmarks that she will pass between arriving at the station and her eventual destination. She needs to set alarms on her iPad so she doesn’t leave her suitcase on the train. She also talks eloquently about how she is prone to paralysing anxiety, which of course makes her cognition worse, and how she has learned to deal with it. Mainly this is a matter of letting it pass, but also of seizing the moment when she is feeling capable.

It behoves us as health professionals to bear in mind what a small part we play in the course of someone’s life with dementia. Most of it is spent doing ordinary things, time with family and friends, adjusting to small changes as they happen. This book reflects that – there is not too much mention of contact with the NHS. And what there is salutary. There is little on offer beyond the diagnosis, and the NHS as her employers were a great disappointment as the only option on offer appeared to be health retirement with no discussion of adaptations that could have been made to supprt her at work.

The Wendy Mitchell she used to know had been quite a private person. She would listen to others’ troubles but rarely venture her own. After dementia, this changed as she made the decision to go for everything that was offered. This included participating in research, speaking at conferences, and in the end writing a best-selling book. She reflects on how dementia made this possible.

Finally, the book is a declaration of love for her two daughters. She is determined that they will not be her carers. She has been attentive to them all their lives and she continues to be so, though she also has to accept that she needs their support too. The front cover shows them as little girls on Blackpool beach. One can imagine Wendy insisting on the picture being included.

Somebody I Used to Know by Wendy Mitchell. Published by Bloomsbury, 2018.

@WendyPMitchell