Chapter 9: Surgical Treatments for Dementia

This chapter of the book on surgical treatments will begin not with a particular surgical solution, but rather a question. The question arose from a surgical proposal from the 1970s for an 84-year-old dementia- stricken man. This man’s incessant yelling caused him to be unmanageable in all settings, whether it was in his private home with his aged wife or in a hospital facility. The proposal suggested removing one of the nerves supplying the patient’s vocal cords, changing his voice to “a very acceptable soft tone.” At the time, the proposal was suggested and unanimously endorsed by an ad hoc advisory committee consisting of psychiatrists, internal medicine physicians, Ear, Nose and Throat (ENT) surgeons, and other staff members at the hospital where the patient was admitted. Although conflicted, the patient’s wife maintained that her husband himself would have wanted the surgery. Ultimately, the hospital’s Department of Surgery did not allow the surgery on the terms that it involved some risk and was a non-medical operation. Dr. George Robertson, from the Department of Anaesthetics at the Royal Infirmary in Scotland, brings a different perspective on why this surgical proposal was to be rejected. He asked whether a treatment such as the one proposed above would effectively help improve the patient’s general condition. He related this treatment to the treatment of the recurrent pneumonias that an Alzheimer’s patient is very likely to contract. How many recurrent pneumonia infections do you treat when an Alzheimer’s patient is likely to contract it again? Should there be a limit?…