Winston Ross | Longreads | December 2019 | 21 minutes (5,290 words)
A week before Thanksgiving last year, I got a call from an officer with the Berkeley Police Department. As I’d suspected, it was about my mother.
My mom, who was 73, hadn’t lived in Berkeley for 28 years. In early November, she told a neighbor she was headed from her home in Springfield, Oregon, to California, to see some old friends. She’d be back, she said, in a year. A couple of days after that, she showed up in our old neighborhood in south Berkeley driving a white Toyota Prius inexplicably decorated with decals of children’s handprints. She then began walking casually into strangers’ homes and refusing to leave.
As the largest wildfire in California history drove tens of thousands of people from their homes and from the Golden State altogether in search of refuge from pernicious levels of smoke and ash choking the skies, my mother headed straight towards the inferno, her car loaded to its ceiling and her loyal dog, Bosley, at her side. And I was powerless to stop her.
When the cops called, I had a pretty good idea why. When the officer said she’d been sleeping in this strangely appointed Prius on the streets of my hometown, I wasn’t surprised. My mother had a home but refused to live in it, convinced I had bugged it as part of a nefarious plot I’d conceived to create a Truman Show out of her life. She traded in her three-year-old car for another one because she believed I’d somehow hacked and disabled her keys. She was homeless by her own making, or at least by the paranoid conspiracy that had overtaken her mind.
The root of this conspiracy is a syndrome as old as medicine. It is a condition an alarming number of health providers, psychiatrists and others who can both inflict and treat it know too little about. That condition is called post-operative delirium, and it afflicts as many as half of elderly patients who undergo surgery, or two million older Americans, each year. As measured in longer hospital stays and follow-up care in nursing homes, delirium’s estimated costs have reached more than $143 billion annually. When you consider that the country’s fastest growing population segment is people over 65, those numbers are certain to grow.
“We should anticipate we’ll see more of it. We’ve always had a problem,” Karin Neufeld, clinic director of psychiatry at Johns Hopkins Bayview in eastern Baltimore, told me. “My colleagues haven’t paid attention to it at all, for many, many years.”
As I learned last year, post-operative delirium can quickly plunge an otherwise normal person’s life into chaos.