My grandmother was so weak she couldn’t even cry real tears any more. The grief was so strong that it should have wracked her body and bent her over in shrieking howls, but her body couldn’t do that any more. Instead, she just sort of hopped up and down a little in the chair, the tears leaking out of her pale blue eyes and rolling down the runnels of cheeks.

“I don’t want to be here, Billy,” she said, snapping back out of the haze of dementia into that sudden, awful focus that seizes the old sometimes. “I don’t want to be here.”

I knew everything that made her terrified. It was bad enough, waking up every morning to have whole chunks of your memory gone, but worse when you woke up in an alien world where callous Nigerian nurses pushed you around and barked orders.

This wasn’t a home. It was a prison. A prison where they stuck her in a wheelchair and then left her like a sack of meat for hours in front of the television set so loud it blared like a siren, for a program she didn’t even want to watch.

And at a time like this, when her mind was drifting like a boat without a sail, when she kept forgetting who she was for hours at a time, waking to that reality over and over again must have been the most distilled horror I can imagine.

But I also knew the other truth: We couldn’t keep her. She kept trying to get up, thinking her withered body was just fine, and she was going to break a hip when she discovered that her legs were now just greensticked lumps of flesh. My Uncle Tommy, the son who had cared for her for thirty years, couldn’t get up from the couch himself to change her diapers.

Every day we wrestled with the decision, knowing that this was the best path. Oh God, we hated ourselves for it, but it was the best thing we could do.

I’m used to words. When she started to go senile, I wrote her a long email that told her that we would ride this all the way down with her – that it would be scary, but she would never be alone. And my Mom told me it was those words that comforted her more than any other.

But here? There was nothing to say. So I stroked her strawlike hair, feeling it crackle at my touch, and said words that spoke whole universes of meaning – words that acknowledged the pain, expressed bottomless sympathy, and informed her that this was awful but set in a hard stone that would not change.

“I know,” I said. “I know.”

But it wasn’t enough.

That was the place where words came to an end.

(39 shouts of denial | tell me I'm full of it)