I started living with my grandparents in autumn of 2002 when I began attending the nearby university. When I got there Grandpa was an independent man who could drive us down back country roads that would turn out in some small town where the Methodists were having a $6 supper. During the course of my college education Grandpa developed symptoms of Alzheimer’s disease: unable to use the TV remote. Unable to drive. My brother came to provide around the clock care until, in 2009, Grandpa became unable (or unwilling, really) to live.

Alzheimer’s disease can progress fitfully, seeming to recede as the brain tries to adapt to its own impairment. You can hear from a person suffering from Alzheimer’s what it is like to lose your mind. With time and empathy and attention you might learn as much as my brother did. I provided some weekend relief for my brother in care-taking, and between his observations and my own I am convinced that you can be alive even if your brain doesn’t work. It is, after all, only an organ. You can be alive without an arm or a kidney. You can even be in some sense conscious and aware that your brain is not working.

So how do you give up on your own mind? If you were aware that you were losing your cognitive abilities, how do you reconcile to that truth? How much courage does it take to admit that some of what you “see” and “know” is false? When, in those earlier days when you sometimes are still right–when you are right more often than you are wrong–should you admit that your mind is flawed and you need someone else to think about every important action you could take? Now my mother’s father is also in mental decline, and we talk about what he ought to do. O physician, take your own dose! Would you today give up all your right to make decisions?

I am decades away from my struggle with Alzheimer’s, should it come to me in the way it is most known. But Alzheimer’s is not the only disease that wrecks your brain. Almost anything you do is directed by your brain, so almost anything can be affected by a malady of the brain. But the brain is an ocean, with layers and currents and moods and no real boundaries. Like the geyser of a broken derrick, the presence of pollution in the mind is easier to identify than it is to define. Here there is a problem; there, not; but so much of elsewhere there is a trace of corruption that is only apparent over time.

Grandpa dies of Alzheimer’s, but his father killed himself. The “Purdy temper” is moody with a cynical bent, given to depression and quick to conclude that all is vanity. Maybe that’s treatable, like heartburn, or high blood cholesterol. Maybe one little pill can fix up our warped minds. Maybe it is just Tylenol. Maybe that’s not a bad thing.

You would think that’s a hopeful thought. It’s not. It’s terrifying.

Think of a happy day. Maybe it was a birthday party. Maybe a loved one came home after a long time away. Maybe you graduated, or were accepted into school, or maybe that was the day your wife said yes.

Think of an ordinary day. Last Tuesday, say, unless that was a special day. Think of some just plain ordinary day. I don’t know how you can think of an ordinary day because ordinary days are pretty much forgettable, but if today was an ordinary day just review it in your mind and hold it there.

Now bottle it up. In fact, squeeze it down to a pill.

Take your ordinary day experience – the feelings, the memories, the conversations – and put it into a pill. Would you take that pill?

Put that pill side by side with the happy day that you thought of earlier, in another pill. Put the happy pill right there by the ordinary pill. And now put an unhappy pill next to the other two.

Would you chose your truth? Is the truth even true if it is just something you choose? Which truth would you choose, if you could choose your own truth?

Let’s leave the question of dependency on mind-altering drugs out of it. If you can take a pill and change your perception of reality, is it even real? If you could take a pill when it was literally raining, and the sun would literally come out, is that real?

What if I offered you eye surgery: remove one of your eyes and I’ll replace it with one that can see colors you have never seen before – color no person has ever seen before. Maybe it’s real but maybe it’s a hoax. Would you agree? You’ll tell me that taking a pill isn’t the same as removing an eye, a pill is not a lobotomy. But then again an eye isn’t your brain. An eye is only your lens to the visible world. Your brain is the lens to the entire world. Once you start playing with the dial you can no longer talk about the “natural color,” as it were. Maybe you oversaturated red tones. Maybe you amped up the contrast. Maybe you did dial the colors in “right,” too, but who’s to say? Do even the “normal” people all see colors the same way?

To take a pill for your brain is to call yourself a liar. Not just an occasional liar but a habitual, pathological liar who simply can’t be trusted, but the person you are lying to is yourself.

It’s easy to say what to do if your brain disease is bad enough. If your Alzheimer’s disease is so bad that you actually can’t figure out how to start a car, it’s easy enough to say that someone else should drive you. It might not be a fun thing to say but the necessity is pretty clear. But what if you just missed a turn? Everybody does that. What if you just couldn’t find your way home for a bit? You made it eventually. I have never curled up in the tub screaming silently at the horror of existence. Indeed that is so far beyond my fits of melancholy that I have trouble conceiving of it as more than a fantasy. Surely under that great a strain the non-physical part of your mind just… explodes. Surely reality can’t include visions of nothing more than horror.

How do you know if your mind is broken when you live in a broken world?