By Olivia D’Ambrosia

We sat, as we always did, on the porch with the chessboard between us. He let me choose the white pawns, and he always got the black. I made my first move, and the match commenced. This time, though, it felt different, it felt weird; he was with me physically, but consciously there was a void. 

A few weeks prior, my grandfather had endured a fall and concussion to the head.

Gersam and his granddaughters at dinner. Photo credit: Vanessa D’Ambrosia.

It was a cold night as we were walking back from a performance of The Nutcracker. It had snowed the day before, so there were ice patches along the sidewalk. I grabbed his hand and insisted on skating and sliding on the ice. Being a child at heart, he took my hand and glided with me when suddenly his foot misstepped, and the back of his head slammed onto the pavement. Once he opened his eyes, he appeared displaced. My father helped him up, and we walked him to his car. A lovely couple walking alongside us gave us their blessings and prayers. The man, who seemed to be a preacher, said, “God always has a path home.”

Gersam Tucker: husband to my grandmother, Antonia Tucker; father to my mother Vanessa D’Ambrosia; and grandfather to Ashley D’Ambrosia (’21) and me. Gersam died in October 2020 due to pancreatic cancer. However, in his last few years, he also battled early-onset dementia, which would have progressed further if he had not passed away. Not only was the suffering apparent on him, but his struggle also left its mark on everyone close around him. 

I asked a few adults around my neighborhood: What do you think Alzheimer’s disease and dementia are? The answers were all along the lines of “Oh, it’s memory loss,” “It’s when people put their keys in the fridge,” “Is there a difference between Alzheimer’s and dementia?” and “extreme memory loss, that makes people forget their families and all other memories.” While all of this is correct to some degree, there is much more to be understood about Alzheimer’s disease and dementia related to it. Alzheimer’s is a potentially fatal disease that affects not only the individual but the family and friends around the individual.

According to the National Institute on Aging, dementia is the general umbrella term that describes one’s “impaired ability to remember, think, or make decisions that interferes with doing everyday activities.” A decline in brain function differs from typical aging memory problems. The Alzheimer’s Society discusses that memory impairments caused by normal aging do not involve forgetting knowledge and experiences built over past years; however, dementia does. This can include forgetting old memories, not remembering a relative’s name, using unusual words, etc. Those predisposed to exhibit symptoms of dementia depend on factors such as age, genetics, race/ethnicity, a traumatic brain injury, and heart health. 

Although some people think dementia and Alzheimer’s are the same, Alzheimer’s is one of six different types of dementia. According to the CDC, the six types are Alzheimer’s disease-related, vascular dementia, Lewy body dementia, frontotemporal dementia, mixed dementia, and dementia with possibly reversible causes. 

The difference between a healthy brain and a brain suffering from Alzheimer’s. Image  credit: brainfacts.org.

So, what exactly is Alziemers’s disease? It is the most common form of dementia. In simple terms, it is the abnormal buildup of proteins in the brain that causes nerve cells to lose function and ultimately die. The loss of too many brain cells in one particular region predisposes to brain shrinkage, or atrophy. 

When the brain atrophies, it loses the function connected to the part of the brain that has shrunk. Brain atrophy will happen to everyone. It is part of regular aging when controlled and occurs over time. However, when brain atrophy is uncontrollable, it becomes dangerous. Alzheimer’s disease produces accelerated and grave atrophy, and it starts to impair the function of neurons and connections to other neurons, which causes parts of the brain to die. Once brain cells die, they cannot come back. 

It has been almost four years since Gersam’s death, and until recently, it has been four years since I’ve had the chance to talk about his death with my mom, Vanessa, and my grandmother, Antonia. Antonia and Gersam were both from Nicaragua, and my sister Ashley wrote an article about their immigration story to the United States for The Match in 2020. For this reason, Spanish is their first language, and my mother and I translated many of the following quotes from Antonia into English. 

When I first asked Antonia about dementia, she had no recollection of the word. My mom reiterated my question, “When people forget certain things, it’s called dementia, he had dementia.”Antonia responded, “Oh I know. Dementia, not Alzheimer’s, it’s different?” My mother and I spent the next few minutes explaining to her the difference. To her, Alzheimer’s was a frightening word she didn’t want to associate with Gersam. When he was first diagnosed, Antonia didn’t fully understand the science behind the disease. It was difficult, since English is not her native language; all she knew was that he forgot important things he shouldn’t have forgotten. When I asked about when my grandfather first started demonstrating the symptoms, Antonia immediately exclaimed, “He fell down!” Vanessa added that Gersam always blamed the fall for his memory loss in the beginning stages. 

After Gersam’s concussion, Antonia started noticing small changes in his behavior; he was more tired, forgot simple things, and constantly played piano. The first significant symptom that caught my mom’s attention was after Gersam’s brother, Edgar, died. Every few days, he would receive phone calls from relatives and friends expressing their condolences, but each time, he would forget why they were calling. Vanessa explained, “It was like he was hearing about it for the first time, the constant shock of his brother dying over and over again.”

Gersam, Antonia, and Vanessa in the early 2010s. Photo credit: Vanessa D’Ambrosia.

As the dementia progressed, the effects started to get more aggressive. He couldn’t remember that he had showered, and he couldn’t remember that he had eaten. He couldn’t remember the names of his neighbors. My grandmother described, “Neighbors would come to the door, and he wouldn’t recognize them, and after they left, I reminded him who they were, and he would say ‘Oh yes, I remember now.'” Even the frequent visits from my mom, he didn’t remember. She usually visited two to four times a week, but every time she came, he would exclaim that she hadn’t been over in weeks or months. The same thing happened when she called. Vanessa stated, “He would make it sound like it was way longer that I had spoken to him than I really had.” 

In the spring of 2020, Gersam was diagnosed with pancreatic cancer, which made matters worse. He couldn’t remember that he had cancer and never had an appetite. My grandmother would force him to eat, but he would continuously “vomit and claim that he wasn’t hungry,” Antonia stated. It was easy to get frustrated, but my mom mentioned how it was essential to understand that he was struggling with a disease, and it was not truly him. My grandmother remembered, “I didn’t like it… it was frustrating… I had to learn to be patient.”

Although Gersam was an possible candidate for the Whipple surgery, a procedure that treats tumors in the pancreas, after two doctors’ opinions and many family discussions, we decided against it. If he couldn’t remember that he had cancer, how would he remember why he got the surgery? It would be impossible for him to recover. Getting the Whipple would’ve required him to adjust his eating habits, but he was already adamant about not eating, so it would’ve been challenging to establish a pattern.

Gersam at the piano. Photo credit: Vanessa D’Ambrosia.

Before his fall, piano, the marimba, and music were integral parts of Gersam’s life and identity; he wrote hundreds of notebooks filled with his music. Whenever he came to our house, he would go straight to our piano and play songs. Music was his language, and was his way to communicate with the people around him who had trouble understanding him due to the language barrier. However, there came a point where he didn’t want to play anymore, or when he did, he would play the same song repeatedly, because that was all he could remember. Antonia said, “Repeat, repeat, repeat, but I just let him play.” It was upsetting to see my grandfather lose the spark for a passion he indulged over his entire life.

He was no longer his extroverted, happy self; he would get annoyed whenever anyone told him to do something. He wouldn’t eat, he was constantly showering, sometimes listening to the radio, and my grandmother would just let him be, and do as he pleased, compliant to the dementia that was taking over him. Antonia added, “he was suffering.”

As time progressed, Gersam grew temperamental and started getting frustrated with himself and, therefore, taking it out on those around him. He knew he was forgetting things, which put him in an irritated mood. Antonia would try to tell him it was because he was hungry and that if he didn’t eat, he was going to die, and he would say he wanted to die anyway. My mother would try to incentivize him by reminding him about Ashley’s graduation from Collegiate in the spring of 2021, but “he didn’t care anymore.”  

As a family, we made the ultimate decision to put him into a nursing home. He didn’t understand why, but he didn’t seem to care. Death was upon him, and he was ready to accept it. 

Two days before his death, I came to visit him. It was during a time of COVID-19 restrictions, so I couldn’t go inside, but I made him a sign that said I love you. I tried talking to him through the window and called him on the phone. I remember it was so difficult talking to him. The language barrier always made it hard to communicate, but this was a different challenge; I could hear death in his voice and see it on his face. He told me, “I love you too, Ashley,” and I quickly corrected him and told him I was Olivia. I realized I had taken for granted all the moments we had together. At the time, I was only 13, so I only knew what was happening and how he was feeling to an extent. Talking with my mom and grandmother recently was the first time I had heard most of these stories. It was heartbreaking. He died on October 20, 2020. 

My grandmother thought his death was unfair in the sense that “he was in a better place, calm and peaceful, but I was left down here suffering.” She added, “I prayed for him to get better, but he didn’t… But his suffering stopped after he died. God always has his ways of doing what is best.”

Gersam and Antonia at an apple orchard. Photo credit: Vanessa D’Ambrosia.

Antonia carries patience with her, as she has learned to live without him. She commented, “I pray to God every day to give me health, because that is most important. Second is patience, and third is to keep walking.” Antonia never learned to drive, so the hardest adjustment for her without him was how she would get around. She still has the wooden cane Gersam made for her. Her daughter Vanessa brings her the things she needs and takes her where she needs to go.

Gersam’s memory will continue to live on through us, his family. One of the things my grandmother misses most about him is going on drives out in the fall and spring and seeing the trees and flowers. In New York, they would walk to different parks and take in the floral landscape. My mom misses his curiosity and quirkiness. He was always interested in learning about the random things in life. He gave me my love for art and influenced my creative outlook on the world. And, of course, we will all always admire his music. “His legacy will live on through his music,” Vanessa reiterated. 

Featured image credit: Olivia D’Ambrosia.