Alzheimer’s, the onset of Dementia, and a sensitive and evocative exploration of this condition in the movie “three of us”

On 26th November 1901, a day after Madam Auguste Deter was admitted to his hospital in Frankfurt, Dr. Alois Alzheimer recorded the following observation in his clinical notes: ” Sitting up in bed, expression distraught.” Auguste was fifty-two years old, and her husband had brought her to the psychiatric clinic after his wife had begun to act strangely. She was confused, restless, and often slipped into a state of paranoia – sometimes even forgetting that she had a husband. During moments that she remembered him, she suspected him of infidelity. Auguste was losing her grip on herself, and the composition of her identity was compromised. Her family doctor, with nothing else to diagnose the condition, called it ” paralysis of the brain” and referred Auguste to Dr Alzheimer. Two days later, after her admission, Dr. Alzheimer ran a few memory tests and noted in his file: ” Constantly distraught, anxious and resists everything.” What was expected to be a routine check-up turned out to be a one-way door for Auguste. She would continue to stay in the hospital for five more years, gradually losing her identity and regressing to a child-like state. Towards the end, she was often found groping around the corridors of the hospital, desperately feeling the walls, as if she were blind and attempting to extract meaning through tactile gestures. She became utterly oblivious to everything around her. She lay in her bed with a vacant stare into a private unknown and a terrified and anxious look on her face. She would cry out in anguish that she didn’t understand what was going on around her or remember anything. She would recognize Dr. Alzheimer as a doctor one day, and the next, she would call him an imposter, wanting to cut her up. She was baffled. Her body gradually shrunk, and as the end neared, she began assuming fetal positions. One of the last entries Dr. Alzheimer made before she passed away was ” total feeble-mindedness.”

In 1907, two years after Auguste’s death, Dr. Alzheimer presented his case to the leading group of psychiatrists and neurologists and pointed to the “tangles” and “plaques” in pictures of Auguste’s brain taken during the Autopsy. Dr Alzheimer believed that this was an important finding that could impact the study of the human brain. The medical community, however, brushed his presentation aside. Nobody in the audience was even faintly excited or had questions. The chairman rose to introduce the next speaker, and the show went on. Interestingly, Carl Gustav Jung, one of the leading figures in psychoanalysis, was in attendance. However, he had a heated debate with the group on the future of psychoanalysis and didn’t find Auguste’s case to be of importance. In a report on the conference the next day, the local newspapers dismissed Dr Alzheimer’s paper with a single-line summary, more as a formality than as anything else. For ninety years, Dr. Alzheimer’s case file with just his notes on Auguste Deter languished in dusty archives at the Frankfurt clinic. Serendipitously, it was founded in 1995, and a couple of years later, five photographs also surfaced. In the intervening decades, advances in medical science and hygiene have led to increased life expectancy. And with increased life expectancy, age-related issues began to increase as well. When Dr Alzheimer identified tangles and plaques, he didn’t have the necessary numbers to convince the medical fraternity of a critical medical condition. But in 1995, there were enough patients with similar symptoms as Auguste Deter. Their brain scans resembled the pictures of Auguste’s brain taken during her Autopsy. After all, Dr Alzheimer’s diagnosis was correct, and this medical condition was named after him.

The key word in Dr. Alzheimer’s notes on Auguste Deter’s case is “distraught.” Oxford Dictionary describes distraught as “extremely upset or anxious.” In Auguste’s case, she was losing her memory. Perhaps losing is not the right word. Having lost something means we recollect having had it with us in the past. This kind of forgetting is quite common. Sigmund Freud, the great Vienesse master, studied this kind of sudden slippage of memory quite extensively. He, of course, attributed it to some deep childhood trauma that causes sudden lapses in memory. To Freud, everything in the mind was about one’s childhood. Anyway, coming back to the point, benign lapses of memory don’t push us to question ourselves. We don’t get distraught because of occasional forgetfulness. We may get a little anxious, perhaps, but we generally brush it aside and carry on. The reason we are able to do that is that we are sure we knew it once, and we are confident that what couldn’t be retrieved now will eventually come back to us in due course, or even if it doesn’t, it doesn’t affect our sense of sanity or identity. But imagine if we are totally blank about what we are seeking, every trace of it is wiped off or irrevocably inaccessible, and there is the total blankness of consciousness. We don’t even know if we knew, and there is a black hole in the tapestry of memories – about which we can know, think, feel, or speak about. Now, that can be scary. If such moments of unknowing are rare, we shrug it off and move on. However, if it frequently occurs, let’s say, in the middle of daily activities, it is as if there is a sudden void in our consciousness, halting us in our tracks without knowing what to do next. We would be “distraught” – a sudden existential anxiety can take hold.

In her 2007 Novel “Still Alice,” Lisa Genova, a neuroscientist and author, drew a vivid picture of how Alzheimer’s can creep into one’s life surreptitiously, without any warning or symptom. Alice Howland, the character in “Still Alice,” is a professor of cognitive psychology at Harvard, a brilliant academic at the peak of her career with a caring husband and three daughters when Dementia sets in. From casual episodes of memory lapses that seem innocuous at first, the disease gradually intensifies until Alice’s world is completely stripped of what she is. Her life is upended. Her identity is slowly dismantled, and her spirit of independence is chipped away bit by bit until what remains as the residue is still Alice, but just the shell of a once vibrant personality and dependent on a caregiver for even the most basic of biological functions. In 2014, the book was adapted for the screen with Julian Moore in the role of Alice. It was a brilliant and sensitive portrayal of a person succumbing to Dementia. A performance that won her Academy Award that year.

The film “Three of Us” was released in November 2023. There wasn’t much about the movie in the media. I am not surprised. When big-budget movies with extravagantly paid commercial stars and absurd content take all available space, it leaves nothing for meaningful art and actors to surface. This is the tragedy of Indian cinema today. I happened to come upon this movie when I was desultorily flipping through Netflix. The picture of Shefali Shah in the thumbnail caught my eye. She is one of my favorite actors, and there is no way I would want to miss a movie in which she features. And what a brilliant film it turned out to be. The film revolves around three characters: Shailaja ( Shefali Shah), her husband Dipankar (Swanand Kirkire), and Pradeep (Jaideep Ahlawat), a childhood friend of Shailaja’s. She has been diagnosed with early stages of Dementia. She has quit her job, knowing that it may be challenging to hold on to it soon. The Husband-wife chemistry between Dipanker and Shailaja, after decades of being together, is one of quiet acceptance, harmony, and unexpressed love. Right from the first frame, there is a sense of apprehension in Shailaja – beautifully brought out by Shefali – that, gradually, everything will become alien, strange, and unknown to her. Even though she is in the early stages of Dementia, the signs are visible. There is a scene at the beginning of the film with Shailaja sitting in a park passively watching the children play, when an older woman selling some ware approaches, recognizes Shailaja, and begins to talk to her. But Shailaja has no clue who the lady is. She stares vacantly at the gesticulating woman, distraught, unable to remember or recollect anything about her. There is a deep void in her perception. Shefali’s beautiful, dark lotus-shaped eyes reflect the anxiety, distress, and acceptance – all at the same time. It is a brilliant piece of acting that sets the stage for the rest of the story. One evening, Shailaja expresses a wish to travel to a coastal village in Konkan. She has spent a few years of her childhood there, and all of a sudden, there is this powerful urge to set foot again in the village. Dipankar is a little surprised, but he realizes the importance of fulfilling Shailaja’s wish, given that her grip on her memories is loosening with each passing day. Both of them embark on a week’s journey.

The rest of the movie is about the hesitant unfolding of Shailaja’s memories of her childhood and her associations. She is desperate to meet Pradeep, a bank manager in the town, with whom she was apparently very close during her school days. Pradeep takes time off from his work and accompanies Shailaja to various locations that hold meaning for them. They recreate their past through the medium of the present. Pradeep’s wife is aware that Shailaja holds a special place in her husband’s heart, and she gives him the emotional space he needs. Time has changed the texture of everyone’s lives. Shailaja and Pradeep know they have moved on, married with children, and all that is left between them is the perfume of memories they carry. For Pradeep, they will remain fresh forever, but for Shailaja, it is a precious gift slowly slipping away from her. The camera follows Shailaja as she wanders around the town, looking at moss-filled homes and lush green spaces, revisiting remote corners of the village where, as children, they secretly sought refuge, and then there is this serene blue sea that embraces the town, whose shores were witness to so many childhood memories. Shailaja visits her dance academy and meets her teacher. At the teacher’s behest, she joins the young student group for a Bharatanatyam practice session. Even though Dementia is eating away at her emotional and chronological memories, her musical acumen is still intact. Nothing is lost there. Her body sways rhythmically to the demand of the classical piece, including the expressions, keeping pace with the youngsters, until she suddenly forgets the following steps and withdraws to hide behind a pillar, half elated, half surprised. In Shefali’s eyes, there is a glint of pride and happiness and a childish sense of embarrassment, too, at her ability to recollect and perform. Music and Dementia have a curious relationship with each other. Where words fail, music heals.

It is Avinash Arun’s directorial vision and cinematographic skills that sustain the movie. It is a slow burn, no doubt. Time unfolds steadily on screen, and in each frame, Arun explores the vertical depth of time and not just its chronological march. The sunsets and sunrises, pink twilights, iridescent moonlit nights, and erratic coastal rains form the backdrop of this cinematic poem. It is all about memory. Memory is time, as J Krishnamurti would often say to his perplexed listeners. Time as the self is an autobiographical palimpsest stitched through the cicatrices of memories. And when there is a break in the tapestry, a lapse, a hole that cannot be fixed, our sense of self begins to disintegrate. Dementia is the wedge that creates the chasm in our understanding of self. Anxiety sets in, and our carefully constructed world begins to crumble and take on an alien aspect. In “Three of Us,” Shailaja is in her early stages of Dementia. She is still in control of herself. There is just an occasional lapse in memory, but nothing serious. And that is the reason she is keen on making this trip. She wants to finish the unfinished business in the sleepy village on the Konkan coast and complete the incomplete conversations with her childhood friend Pradeep. If not now, it may be too late. Towards the end of the film, Shailaja explains to Pradeep that he may continue to remember their time together for a long time, but she may not. What is fresh, beautiful, and meaningful now may, over time, fade away, lost in the black hole of Dementia. This is a lovely moment in the movie when Pradeep and Shailaja are seated on a Giant wheel erected as part of a local fair, and in mid-air, two mature adults have a deep conversation about the fragrance beautiful memories can bring. Pradeep cannot contain his grief; he tries hard not to cry. Shailaja, on the other hand, looks content and happy that she has reached a closure on an essential part of her life, an unresolved relationship, healed.

What a performance by Shefali Shah. Incredible!. She brings a child-like innocence to Shailaja’s character. The whole panoply of emotions passes through her reflective face without leaving a trace beyond what is necessary. She belongs to that rare breed of actors who can channel and adapt their emotional and intelligence intelligence to the characters they play. The great Russian actor and master, Konstantin Stanislawski, who revolutionized the technique of acting in the early twentieth century, often referred to a state of “perezhivanie,” – which loosely translated from Russian means “experiencing” or ” re-experiencing.” Perezhivanie happens when an actor is wholly connected and invested in the truth of the role and has thoroughly merged with the imaginary reality of the character. It is a state when actors begin to think and feel the way the characters would without losing sight of themselves, and the actor’s living consciousness and the fictional consciousness of the role are able to meet fully and completely. Shefali’s performance falls into the zone of perezhivanie. She lived as Shailaja on screen. Swanand Kirkire and Jaideep Kirkire are equally good on screen. Especially Jaideep. I have come to admire his skills. There is a studied intelligence to his acting that serves well. Avinash has sketched his character well, too. Pradeep has a beautiful relationship with his wife. Both of them understand the sudden appearance of Shailaja in town and what it means, yet it doesn’t cause any dissonance between them. On the contrary, It bonds them further. They realize that the past is the past, and the present can only provide an opportunity to reconcile and heal, not to live the past all over again. This is mature characterization and storytelling and gives the story its authenticity and strength. The background score by Alokananda Dasgupta is quiet, balanced, and exquisitely scaffolds the vision of the movie.

“Three of Us” is streaming on Netflix, and I think it is a must-see. I wish more films were made like this. It is well-made, well-performed, enjoyable, and thought-provoking.