Article by: Kathryn Butler
Few medical diagnoses rival dementia in its sense of hopelessness. Cancer, heart disease, and stroke devastate patients and families. Diabetes and kidney failure reconfigure lives. The cognitive decline of dementia, however, enshrouds all it touches with a mantle of despair.
Our limited treatment options for dementia contribute to the despondency. We have no cure, and few medications slow its progress. Instead, we watch patients weep from sufferings they cannot articulate. We feel the sadness in our bones when we care for a veteran who won wars, but now can’t remember how to dress himself. A nurse reminds her patient that his wife died decades ago, and he howls and sobs, his grief fresh, his loss recurrent. The relentless demands of caregiving deplete family members as they mourn for a loved one who still lives. To grapple with a tumor risks life and livelihood; to fade into dementia jeopardizes personality, rationality, and independence. Dementia threatens identity.
Against this bleak landscape, Dr. John Dunlop’s Finding Grace in the Face of Dementia offers patients and families a cool cup of water. Equipped with 40 years of experience caring for geriatric patients, Dunlop combines medical and biblical insight to break through the desolation of dementia, and to remind sufferers and caregivers of their life-sustaining identity in Christ. “Setting forth the dignity of every human being is the basic premise of this book,” he writes (55). Through informative and poignant narrative, Dunlop reminds us that even when the darkness encroaches, we remain God’s image-bearers. In Christ, our value endures.
Dunlop’s experience uniquely qualifies him to comment on the subject. He writes not only as a seasoned clinician, but also as a son whose parents and mother-in-law suffered from dementia. He witnessed his mother’s combativeness as she declined, and knows firsthand the challenges caregivers face. He also carries a genetic predisposition to dementia, so he analyzes the disease as one anticipating a descent into its depths. His viewpoint isn’t merely clinical, but also deeply personal and spiritual, and he expertly interweaves these strands in his writing.
The ultimate effect as one reads Finding Grace is of Dunlop seated at a bedside, wrapping his fingers around a reader’s weary hand, speaking in a cadence both careful and heartfelt. His approach both epitomizes good doctoring and also embodies Christian empathy (Mark 12:31). “Compassion is not only showing love and kindness,” he writes, “but it is also understanding how others feel and then allowing ourselves to feel that same way” (61). Through his discerning balance of pragmatism and tenderness, he guides us in loving our neighbors whom dementia has afflicted.
Finding Christ in the Struggle
Dunlop equips patients and caregivers with practical knowledge to decipher the complexities of dementia. He confronts the challenges of the disease without shying from the ugly details, and he prepares his readers for an unparalleled struggle. Even amid medical exposition, he points to the cross. He leads us from each technicality back to Christ, and to the promise that he will wipe away every tear. Dunlop steels caregivers for their arduous road through affirmation of their Christian call to serve (John 13:34). “As we engage in loving service and relationships,” he writes, “not only do we honor God, but we find more meaning in life, whether we are the caregiver or the victim of dementia” (83).
Dementia can also deepen our faith by compelling us to depend on God. As Dunlop writes, “When dealing with dementia we very quickly learn that we aren’t in control, and, try though we may, we will never fully understand God’s purpose this side of heaven. Dementia becomes a splendid opportunity to learn to trust God fully” (160). Further, Dunlop emphasizes the promise of the new heavens and new earth, when the old order—of which dementia is a part—will pass away (135; cf. Rev 21:3–4).
In its emphasis on Christian hope, Finding Grace offers value even to those unacquainted with dementia. In an era when deriving identity from professional accomplishments is common, Dunlop advances an ethic of relationality rooted in the gospel. “When we buy into the myth that our intellects and abilities define our worth,” he explains, “we diminish the value of those who lack the same capacities. We demean one made in God’s image, and in that sense we desecrate God himself” (103).
In Finding Grace, Dunlop reminds us of our preciousness as image-bearers. He highlights our God-given call to love and service. Above all, he emphasizes our hope that however our minds fail, and however disease enfeebles our bodies, on the last day those in Christ “will be standing fully restored along with those who have selflessly cared for them” (182).
John Dunlop. Finding Grace in the Face of Dementia. Wheaton, IL: Crossway, 2017. 208 pp. $18.99.
Kathryn Butler (MD, Columbia University College of Physicians and Surgeons) is a trauma and critical care surgeon who recently left clinical practice to homeschool her children. She has written for Desiring God and Christianity Today, and her book on end-of-life care through a Christian lens is anticipated in 2019 (Crossway). She blogs at Oceans Rise.