A Fairytale Life, a Tragic Ending: The Case I Wish I Could Rewrite

Mark E. Williams, MD

The lifecare community I worked in early in my career accommodated a wide variety of primarily affluent people from around the world. Caring for frail people who, in some cases, felt entitled was sometimes challenging but it was rewarding work. Service was expected on the individual patient's schedule.

The facility had various levels of care, ranging from independent living to nursing home care, including a locked dementia unit.

One day, I was scheduled to see Mary Elizabeth, a patient in her early 60s who had just moved into the independent living area of our facility. I welcomed her into the clinic room and noticed a Parkinsonian stiffness in her gait. She was very trim with dyed red hair and hazel eyes. Her examination was essentially benign, although I wondered if she had an eating disorder. Her history was instructive.

A Charmed Life

Mary Elizabeth was an only child from an old aristocratic family. Her father owned several businesses related to farm supplies and equipment. She lived a very privileged life on a large estate with horses and formal gardens. She learned to play piano from the best instructors in the area, becoming an accomplished pianist who performed in an orchestra and at major social events, including formal receptions at the governor's mansion.