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On Pluto

On Pluto

Inside the Mind of Alzheimer's
by Greg O'Brien 2014 240 pages
3.96
1k+ ratings
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Key Takeaways

1. Alzheimer's: A Personal Journey Through Memory Loss

"Death comes to all. While in the natural, we have little rule over time and place, we can choose the attitude as we head through the tunnel to a brighter light."

A devastating diagnosis. Greg O'Brien, a seasoned journalist, receives a life-altering diagnosis of early-onset Alzheimer's disease at age 59. This sets him on a journey of self-discovery, reflection, and a race against time to document his experiences while he still can.

Facing the monster. O'Brien describes Alzheimer's as a "death in slow motion," gradually eroding his cognitive abilities, short-term memory, and sense of self. He candidly shares his struggles with:

  • Confusion and disorientation
  • Loss of executive function and judgment
  • Visual misperceptions and hallucinations
  • Intense emotional swings and rage

Despite these challenges, O'Brien chooses to fight back, using his journalistic skills to provide an insider's perspective on living with Alzheimer's, offering hope and guidance to others facing similar battles.

2. The Impact of Alzheimer's on Family Dynamics

"Mi casa es su casa!"

Family as a lifeline. O'Brien's Alzheimer's journey profoundly affects his family relationships. His wife, Mary Catherine, becomes his primary caregiver and emotional anchor. His children - Brendan, Colleen, and Conor - struggle to come to terms with their father's changing condition while providing support and understanding.

Role reversals and tough decisions. The family faces difficult choices:

  • Transferring legal and financial control to protect assets
  • Balancing independence with safety concerns
  • Navigating changing family dynamics as roles shift

O'Brien's experience echoes that of many families dealing with Alzheimer's, highlighting the importance of open communication, patience, and flexibility in maintaining strong family bonds in the face of this devastating disease.

3. Coping Strategies for Living with Alzheimer's

"Dr. Barry Conant, a close friend, an extraordinary man, and a better golfer than I, has offered the best advice to date. He has urged me, on numerous occasions, to stop assaulting Alzheimer's head on."

Adapting to a new reality. O'Brien develops various strategies to cope with his changing cognitive abilities:

  • Extensive note-taking and use of reminders
  • Regular exercise to maintain physical and mental health
  • Continuing to write and engage in creative pursuits
  • Developing a repertoire of conversation topics to mask confusion

Finding humor in darkness. O'Brien emphasizes the importance of maintaining a sense of humor, even in the face of embarrassing or frustrating situations. This approach helps him:

  • Reduce stress and anxiety
  • Maintain social connections
  • Preserve dignity and self-esteem

By sharing these coping mechanisms, O'Brien provides valuable insights for others living with Alzheimer's and their caregivers.

4. The Importance of Long-Term Memory in Alzheimer's

"In Alzheimer's, brain cells in charge of short-term memory are losing the war. But long-term memory is still safely tucked away in a relatively peaceful neighborhood."

A refuge in the past. As Alzheimer's erodes short-term memory, O'Brien finds solace and stability in his long-term memories. He vividly recalls:

  • Childhood experiences in Rye, New York
  • Family traditions and relationships
  • Professional accomplishments and milestones

Preserving identity. These long-term memories serve crucial functions:

  • Maintaining a sense of self and personal history
  • Providing comfort and familiarity in times of confusion
  • Offering a means of connection with loved ones

O'Brien's experience underscores the importance of nurturing and preserving long-term memories for those with Alzheimer's, as they can serve as an anchor to identity and a source of comfort throughout the disease's progression.

5. Caregiving Challenges and the Toll on Loved Ones

"Mary Catherine bountifully carried water for me as mother and surrogate father, buckets of it; still does, as she had for my mother."

The unsung heroes. O'Brien's narrative sheds light on the immense challenges faced by Alzheimer's caregivers, particularly spouses and adult children. These challenges include:

  • Physical and emotional exhaustion
  • Financial strain and legal complexities
  • Balancing caregiving with other responsibilities
  • Coping with the gradual loss of their loved one

A call for support. O'Brien emphasizes the need for:

  • Greater recognition of caregivers' contributions
  • Improved support systems and resources for caregivers
  • Open discussions about the realities of caregiving

By highlighting these issues, O'Brien advocates for better support and understanding for the millions of caregivers who play a crucial role in the lives of those with Alzheimer's.

6. The Progression of Alzheimer's: From Early Symptoms to End-Stage

"Alzheimer's is a marathon, if one chooses to run it. It is exhausting, fully fatiguing, just staying in the moment and fighting to remember like an elephant, the largest land animal on Earth."

A relentless march. O'Brien describes the progression of Alzheimer's through its various stages:

  • Early symptoms: memory lapses, confusion, difficulty with problem-solving
  • Middle stage: increased memory loss, behavioral changes, need for greater assistance
  • Late stage: severe cognitive decline, physical deterioration, total dependence on caregivers

The long goodbye. Throughout this progression, O'Brien observes:

  • The gradual loss of independence and identity
  • Increasing isolation and withdrawal from social interactions
  • The emotional toll on both the individual and their loved ones

By detailing this journey, O'Brien provides a roadmap for others facing Alzheimer's, helping them anticipate and prepare for the challenges ahead.

7. Finding Purpose and Hope in the Face of Alzheimer's

"We all need memories; they define us. Saul Bellow, the Pulitzer and Nobel Prize winner, once observed, 'They keep the wolf of insignificance from the door.'"

A new mission. Despite the devastating effects of Alzheimer's, O'Brien finds renewed purpose in:

  • Documenting his experiences to help others
  • Raising awareness about the disease and its impact
  • Advocating for increased research and support

Small victories. O'Brien learns to appreciate and celebrate:

  • Moments of clarity and connection
  • The ability to continue writing and communicating
  • The love and support of family and friends

By focusing on these aspects, O'Brien demonstrates that it's possible to find meaning and hope even in the face of a progressive, incurable disease.

8. The Role of Faith and Spirituality in Dealing with Alzheimer's

"All the darkness in the world, my mother taught me, cannot snuff out a single candle."

Spiritual anchor. O'Brien's Catholic faith plays a significant role in his journey with Alzheimer's:

  • Providing comfort and strength in difficult times
  • Offering a framework for understanding suffering and purpose
  • Connecting him to a supportive community

Finding meaning. Through his spiritual lens, O'Brien interprets his experiences as:

  • A opportunity for growth and deepening faith
  • A chance to inspire and help others
  • Part of a larger plan, even if not fully understood

O'Brien's narrative illustrates how faith and spirituality can serve as powerful coping mechanisms for those facing the challenges of Alzheimer's and other life-altering conditions.

9. Alzheimer's: A Growing Epidemic Requiring Attention and Research

"It's been said that, in 25 years, there will be two kinds of people in the world: those with Alzheimer's and those caring for someone with the disease."

A looming crisis. O'Brien highlights the growing prevalence of Alzheimer's:

  • Current estimates: 5 million Americans diagnosed
  • Projections: Up to 16 million Americans by 2050
  • Economic impact: Potential to bankrupt Medicare without intervention

Call to action. O'Brien advocates for:

  • Increased funding for Alzheimer's research
  • Greater public awareness and education about the disease
  • Improved support systems for patients and caregivers
  • Policy changes to address the long-term care needs of an aging population

By framing Alzheimer's as a public health crisis, O'Brien urges readers to take an active role in confronting this growing epidemic and supporting efforts to find effective treatments and, ultimately, a cure.

Last updated:

Review Summary

3.96 out of 5
Average of 1k+ ratings from Goodreads and Amazon.

On Pluto offers a raw, personal account of living with early-onset Alzheimer's. Many readers found O'Brien's candid portrayal insightful and moving, praising his courage in sharing his experience. Some appreciated the glimpse into the mind of someone with Alzheimer's, while others found parts repetitive or meandering. The book resonated strongly with those affected by the disease, offering understanding and hope. However, some felt it lacked practical advice or scientific explanation. Overall, reviewers acknowledged the importance of O'Brien's story in raising awareness about Alzheimer's.

Your rating:

About the Author

Greg O'Brien is a journalist and author who was diagnosed with early-onset Alzheimer's disease in 2009. He comes from a family with a history of Alzheimer's, having watched both his mother and grandfather battle the illness. Despite his diagnosis, O'Brien has continued to write and advocate for Alzheimer's awareness. He draws on his investigative reporting background to provide a unique insider's perspective on living with the disease. O'Brien's work aims to destigmatize Alzheimer's and push for more research and funding. He balances his narrative with humor and honesty, offering readers insight into the daily challenges of cognitive decline.

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