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Earlier this year, I attended a screening of Gone with the Wind at a local theater. It was my first time seeing the film, and I found it beautiful and ambitious, with heartbreaking performances that left its characters as twisted as the war-torn Reconstruction landscape. Unexpectedly, the film's sweeping shots of “Tara,” Scarlett O'Hara's once-proud cotton plantation, unlocked a memory in me about an old man I had not thought about in 2 decades but who played a formative role in my life. During the summer after my high school graduation in 2000, I volunteered at an adult day care facility in Cleveland. Although most of my time was spent joining in languorous games of bingo and balloon volleyball, I also mingled with residents and learned a bit about them. I established particular rapport with one resident, an 80-year-old African-African man diagnosed with Alzheimer's disease who called himself “Mr. Earl.” In addition to his cognitive frailty, Earl had a severely hunched back and walked in a shuffling gait with the aid of a four-point cane. In my callow teenage years, I remember thinking that his small stature—along with fleshy jowls and sallow eyes—made him resemble the cartoon character Droopy Dog. When I introduced myself during each visit, Mr. Earl would motion me to lean in and then, in his raspy voice, tell the same story—almost verbatim—about growing up on a farm in Georgia in the 1930s where film crews had captured scenic footage for Gone with the Wind. His perseveration about the movie became a running joke among care staff. On several occasions, I recall the exasperated activity coordinator saying sarcastically, “Mr. Earl, you've never told us that story before!” In my visits to the facility, Earl showed only tepid interest in the activities around him, seeming happiest when he was simply able to tell me this story—a tale that, however confabulated, succeeded in connecting his humble sharecropper upbringing with a film in the pantheon of American cinematic culture. Even my 18-year-old self could see that this story figured powerfully in Mr. Earl's identity and that, by simply providing an audience for him, I was giving him something important. Until seeing Gone with the Wind as a 32-year-old man this year, I had not fully appreciated how formative the experience with Mr. Earl had been for me. After high school, I matriculated at a local college in Wooster, Ohio, and majored in English and Philosophy. During my senior year, I developed an independent study on Alzheimer's disease titled “Can Narrative Heal?” that explored the therapeutic potential of storytelling in geriatric care. Through this process, I was trained in TimeSlips, a creative storytelling activity used in residential facilities with persons with dementia, and helped facilitate sessions on a locked unit in Wooster with people like Earl. The power of story to facilitate human connection with the cognitively frail—a realization I had first come to understand as an 18-year-old—continued to impress itself upon me. As I moved on to graduate school, I spent several years conducting my doctoral research at the Intergenerational School in Cleveland, a school that invites people with dementia as “mentors” for elementary-aged children. There, I undertook a rigorous study of elderly adults from residential homes who visited the school each week to read books, tell stories, and form relationships across generations. Now, as an assistant professor at a medical school, I teach a course called “Creativity and Narrative in Aging.” My students learn the power of story in person-centered dementia care, and I train them to participate in TimeSlips sessions at a residential home near the hospital. They sit with people like Mr. Earl, receive their stories, and experience firsthand how narrative mediates our identities, relationships, and individual and collective sense of purpose. My hope is that such experiences will nurture physicians capable of working humanely with people experiencing age-related cognitive decline and advocating for systemic improvements in care. When I drove home after seeing the film, I thought about the broad sweep of my life over the past decade and a half. At every juncture of my career development, my experience with Mr. Earl had proven a crucial antecedent for this work, and although his many retellings of the Gone with the Wind story may have been ephemeral moments at the end of a long life, they continue to stay with me and inform my own sense of professional purpose. Conflict of Interest: The author has no competing interests. Author Contributions: The author was solely responsible for the conceptualization, authorship, and preparation of this manuscript. Sponsor's Role: None.
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