Takes one to know one: Doña Quixote, aka my dementia, has a heart-to-heart with Donald Trump

Photo credit: Peter uncovered this Kirlian image of Doña Quixote in a photo from the Boston Globe.

Like many people of my acquaintance—and others I know only from their opinions in social- and other media—I have more than once theorized that Donald Trump must have a mental illness: some of his confusions about facts and the world in general sound remarkably like mine. I was reminded of this similarity over the weekend when the media was buzzing about the crazy interview the president gave to the Associated Press’s Julie Pace. Tuesday morning, the matter came to mind again while I was listening to Terry Gross’s discussion on NPR with Dr Elizabeth Ford, a psychiatrist whose new memoir, Sometimes Amazing Things Happen, tells about her experience of treating mentally ill inmates from New York City’s Riker’s Island Prison who had become too sick, violent, delusional, or suicidal for the jail to handle, so that they were sent to Bellevue Hospital Prison Ward for treatment.

The inmates in Bellevue’s Psychiatric Prison Hospital are awaiting trial for a variety of offenses, ranging from sleeping on the subway to murder. (Spencer Platt/Getty Images NY Times).

In the interview, Dr. Ford describes an interaction with a patient on whom she was giving a second opinion to determine whether he fit the bill of a patient who requires transfer from Rikers to Bellevue. The evaluation took place in her office at Bellevue, with attorney and a social worker present.  At the time, Dr. Ford was in the last stages of a pregnancy and, during the interview, felt too physically uncomfortable to sit down. She stood by her desk, leaning on it with one hand, The patient stood at the other end of the small room. With no apparent provocation, he suddenly threw a plastic chair at her. Fortunately, the chair did not hit her right on and was also too light to have done any real damage, but the incident naturally unnerved everyone in the office—including, apparently, the patient, who walked off to his room.

Image credit: Debate.org The patient believes he is passing a chair to to a pregnant woman Image credit: Pinterest The thought in his head is, “A pregnant woman should never stand.”

Once she had reassured herself that she had not been injured and had regained her composure, Dr. Ford went to the patient’s room to discuss the incident with him. During further discussion, Dr. Ford elicited the man’s thoughts while seeing her standing. Apparently he had noticed her discomfort and intended to offer her a chair. “A pregnant woman should never stand,” he said. His throwing of the chair was, at heart, a kindly intended gesture that misfired because of his confused mental state. When paired with the chain of logic happening in his head, his action actually showed an intent that, at first glance, seemed to come from nowhere.

How does this relate to Trump? I hope to explain my sense that Trump’s mental state is not healthy by comparing his actions (confused speech, in this case,) to how I myself sometimes say or do things that look nonsensical from outside; My crazy actions illustrate my growing disconnection from the material world, which results in me retreating into my head to a point where I don’t consider how I appear to others. My example is from ordinary daily activities—nothing on the level of throwing a chair so far. I think this type of experience will be familiar to many people, whether mentally ill or not. Maybe you, too, remember an instance of a spouse or child or friend performing an action that does not fit the context of a foregoing discussion, because their thoughts are somewhere else. While most people now and then do strange things while distracted, I ascribe my recent odd behavior to my dementia, because things like this happen to me almost every day, often several times a day.

The Trump Derangement Syndrome. Cartoon source: Pinterest

Example: This is what happened when Peter and I were washing dishes one night. As usual, he washes and I dry. (We have a dishwasher, but like to wash our colorful cookware—red—by hand, so that the dishwasher doesn’t eat off the color.) When I get to the pots, I dry them, I put them on the glass top cooking surface, one by one, each on its own plate. I dry the lids, place each lid on its pot one by one. My job done, I start walking away.

“Are you still going to cook something else tonight?” my diplomatic husband asks.

I say I’m done in the kitchen, puzzled about his question. He points to the pots on the stove. Only then does it register: I had placed the pots on the glass top of the stove neatly from big to small, each on a corresponding plate size, instead of putting them in the drawer right next to the sink. I immediately saw that this was weird and realized I should have put them away. We both started laughing. In fact, we laughed until I cried. Really cried.

  

The 1950s kitchen (Pinterest)  The millenial kitchen (“Artistic Hoarding“).

I can’t really explain why I arranged the pots in a pattern instead of putting them away, but in hindsight I interpret it as an attempt to create some sort of order in what increasingly seems to me to be a chaotic world. I have always loved mathematics and the sciences because they provide us with a framework, such as the periodic table or the binomial theorem that maps onto an apparently random physical world to reveal a pattern. I can see, though, that from the outside my actions must have appeared crazy.

 

The trinomial cube is a visual, sensorial representation of the mathematical formula, (a+b+c)3. Left, unsorted trinomial components (Baby Speelgoed Montessori Trinomial Cube Math voor Vroegschoolse Educatie Voorschoolse Training). Right, provisionally sorted trinomial components (Montessori)

So on to a question that seems at the foundation of Trump’s subjectivity: “Mirror Mirror on the wall, who is the greatest in the land?” Any praise, not matter how faint, elicits the reply his ego craves, “Mr. President, you are the greatest in the land.” On the contrary, any “attack,” which might be as innocuous a question that he should have expected and prepped for, invokes a defensive response, one that often includes an attack on someone he perceives as a foe.

Who’s the Greatest? Left: If only. Right: No question (HuffPost).

In light of Trump’s fragile ego, it seems to me that his nonsensical answers in Terry Pace’s AP interview this past Sunday, April 23, is the result of him being in a situation he perceived as chaotic—being “attacked” by the “terrible press” with “gotcha” questions. To calm his discomfort, I propose, he invoked earlier situations in which he felt good about himself, cases when he believed he was being praised. For example, let’s look closely at the following “word salad.” It is from a phase of the interview when he was asked whether he could overcome the House Democrats’ resistance to his health plan. Trump responded that he could. Some democrats loved him, he implied. As evidence, he cited “praise” he received from one democratic member, Rep. Elija Cummings (D-MD), when they spoke a month before the AP interview, that is, in March:

TRUMP: He said you will be the greatest president. He said you will be, in front of five, six people, he said you will be the greatest president in the history of this country.

AP: He disputed that slightly.

TRUMP: That’s what he said. I mean, what can I tell you?

AP: Yeah.

TRUMP: There’s six people sitting here. What did he, what, what do you mean by slightly?

AP: He said, he said that he felt like you could be a great president if and then —

TRUMP: Well he said, you’ll be the greatest president in the history of, but you know what, I’ll take that also, but that you could be. But he said, will be the greatest president but I would also accept the other. In other words, if you do your job, but I accept that. Then I watched him interviewed and it was like he never even was here. It’s incredible. I watched him interviewed a week later and it’s like he was never in my office. And you can even say that.

Ouch.

Elija Cummings, Donald Trump (WBBAL TV).

With the aid of a few background notes, I believe, Trump’s missing train of thought can be figured out in the same way in which Dr. Ford reconstructed her patient’s thoughts when he threw the chair.

  1. The initial interaction between Senator Cummings and President Trump took place in March. During the first week of April, in an interview with the New York Times, the president first made the claim that Cummings said, “You will go down as one of the great presidents in the history of our country.”
  2. An April 6 Huffington Post article reports Cummings’s negation of Trump’s claim: “During my meeting with the president and on several occasions since then, I have said repeatedly that he could be a great president if … if … he takes steps to truly represent all Americans rather than continuing on the divisive and harmful path he is currently on.”
  3. When, during the April 23 AP interview, Trump repeated his claim about Cummings calling him the greatest president, the interviewer reiterated Cummings’ correction. Accordingly, while spouting the “word salad” above, Trump had both his own claim and Cumming’s  response in his head.

Taking the missing thought train into consideration, and omitting all the “but”s that seems to be a tic in Trump’s speech–—I set them off with { } below—Doña Quixote was able to fill out the missing links and offers the following translation:

Well he [CUMMINGS] said, “you’ll be the greatest president in the history'”{of}[I THINK TRUMP MEANT “IF” HERE], but you know what: [I, TRUMP, AM AWARE THAT CUMMINGS HAS A DIFFERENT RECOLLECTION], I’ll take that [CUMMINGS’S CLARIFICATION WITH THE “IF”] also, {but}that [IF TRUMP FOLLOWED CUMMINGS’S GUIDELINES], [IN CUMMINGS’S WORDS] “you could be [A GREAT PRESIDENT].” [TRUMP GOES ON TO INSIST THAT CUMMINGS’S RECOLLECTION IS WRONG], But he [ACTUALLY]said, “will be the greatest president” but I would also accept the other [THAT IF I CHANGE SOME THINGS I CAN BE THE BEST PRESIDENT]. In other words, [CUMMINGS’S SAID I COULD BE THE BEST PRESIDENT] “if you do your job,” {but} I accept that. Then I watched him interviewed [THE INTERVIEW IN WHICH CUMMINGS CLARIFIED THE SUBSTANCE OF THE CONVERSATION BETWEEN HIM AND THE PRESIDENT] and it was like he never even was here [I.E. TRUMP STICKS TO HIS OWN RECOLLECTION OF THE CONVERSATION AND DENIES CUMMINGS’S]. It’s incredible. I watched him interviewed a week later and it’s like he was never in my office. And [GIVING THE AP INTERVIEWER THE PERMISSION TO QUOTE] “you can even say that.”

Sort of.

Doña Quixote thinks the trinomial cube is child’s play. However, she found the president to be a bit harder to figure out. Baan Dek

My attempt to make sense of Trump’s bizarre words is not in any way intended to defend his actions as president. It is rather a desire to show that the signs of mental illness and shrinking skills he demonstrates resonates with the way I see my own capacities diminishing. Just about everyone who knows me will have experienced sentences I uttered, the logic of which they or other people in the room couldn’t follow. This deficit shows up more clearly in my spoken than written language. I believe that, when I write, I appear much more intelligible than when I speak in real time, where distractions abound. In writing, I still have the self-awareness to become my own editor, that is, I can reread the piece over enough times to see that information is missing from certain sentences or paragraphs and fill it in. (This is my fifth day on this piece, even though I have taken all the hours I could spare from household activities every day. This must be about the seventeenth draft. If I were still being paid by an employer, I would surely have been fired years ago.) But, then, I did not run for president. I am not the president. Neither am I a psychiatrist. But I do have a growing mental illness.

If my sense (and others’) that Donald Trump has a mental illness is correct, what does it mean the we have a president who will likely keep on declining mentally over his term? Moreover, the demands of his position are incredibly stressful—and the worst enemy of clarity in thinking and speaking in the context of mental illness is stress.

A question I have about Trump, is “Where is his family?” In my case, my family started noting my lapses in logic and memory for at least 2 years before I was diagnosed. As my family and I together progress on the road toward my total irrationality, I often reiterate that I want them to constantly evaluate me and act, now with—and later, without—my permission to take the hard steps of deciding that I’d be better of in a care center, or, when I no longer care about them and the world and appear to be unhappy more often than I am happy, to help me achieve the assisted suicide for which we have long planned. I’m not at all suggesting that Trump, or anyone else with a fading intellect, should seek an assisted death. What I am puzzled about is why his family—especially Ivanka, to whom he seems very close, is not talking to him about it. Or maybe she and her brothers do, and try to prevent him from appearing as disturbed as he is by urging him to follow a script whenever possible. Or—this is too much to hope—encourage him NOT to run for another term. Or maybe no one—not even his children—dare tell him anything he would not want to hear.

I’ll end on my usual disclaimer when I talk about my planned assisted suicide. The time is NOT nigh. While I am undoubtedly daily losing skills that used to be automatic, I still feel far from the day when the life and love around me no longer makes up for the damage of the disease—for me as well as for everyone who loves me. Accordingly, there is nothing to do about my deficits but laugh and love and live to the full under “the fierce urgency of now.”

 

Hindsight: Maybe these photos help explain why arranging things from small to big makes me feel calm and in control?

The Steenekamp family in 1969: from short to tall, Tertia, Boshoff, Lana, Ma Susan, Carel, Gerda, Pa Boshoff, Klasie. The Steenekamp family in 2000, from short to tall: Ma Susan, (Pa Boshoff had by then been dead for 23 years), Lana, Gerda, Tertia, Klasie, Carel, Boshoff.