Glen Campbell walked onstage at the Grammys earlier this month looking confident, but not exactly like the Glen Campbell I had seen performing before. Something about his stance — the way he held his shoulders — seemed familiar to me. And then the camera panned toward his eyes: That was it. A sparkle was gone. Something was flatter, more far away. Distant.
The band started playing. He stood up straighter. His eyes suddenly engaged. He began singing - the timbre and tone in his voice still strong, but a little wobbly, a little different. And then I started to cry.
It was eerily similar to the way my father was onstage, performing with his a capella singing group, the Grunyons, even after he'd had Alzheimer's for more than 10 years.
Mr. Campbell and my father: They were there. But they weren't ... at the same time. The disease had taken almost everything away — except the music. Their connection to the music, the way it made them come alive despite their disease — it was the same.
Dr. Oliver Sacks, the renowned neurologist and author ("Awakenings") has done extensive research on music and Alzheimer's, much of it compiled in his recent book, "Musicophilia."
"Remembering music, listening to it or playing it, is entirely in the present, and, while it lasts, it can bridge even the abyss of extreme amnesia or dementia," he writes on his website. "Music can be more powerful than any drugs."
And the return to earth afterwards can be just as sudden and jarring as the crash from a drug high.
Lost and found
Mr. Campbell's performance was triumphant. There were many tears in the audience. He even hit all the high notes. But as "the Rhinestone Cowboy" left the Grammy stage for what will probably be the last time, did he understand that he had just given a stellar performance despite a fatal disease that takes memories away? Probably not.
Just the way it had happened when my father finished a performance: The minute the music was over, Mr. Campbell's shoulders slumped a bit. His confidence dissipated, suddenly, like a deflated balloon. A lost and almost fearful look came over his eyes, and then he spoke the words that will ring in my ears, always: "Where do I go?" I saw his wife watching him perform — so proud, in awe. And then — at those words, "Where do I go?" — spreading alarm in her eyes: Oh, ... no. ... He's lost, again. ... He might not be able to get off the stage by himself.
At the end of almost every evening toward the end of my father's life, when he was still living at home, when he started getting sleepy, he said — over and over again: "Where do I go now?" He had no idea what house he was in, or where his bedroom was.
As my father's disease progressed, we used music to calm him, to make him happy, to energize him, to soothe him to sleep. We used different songs for different tasks. My mother and I woke him up with Frank Sinatra's "Wee Small Hours of the Morning." For showering, Cole Porter's "Night and Day" worked well. At dusk, "sundowning" (a state of late afternoon agitation common in Alzheimer's) would kick in; Diana Krall's "I Get Along Without You Very Well" always helped him settle in and settle down. And of course, he sang along. And he almost always knew all the words, even though when you pointed to an object — a chair, a television, a spoon — he had no idea what it was called.
When he was very hard to reach, almost as if his batteries had run down, I would often begin singing "Hail to the Victors," the fight song of his alma mater, the University of Michigan. He always smiled and chimed in, and he always knew all the words.
I recently found this unattributed quote: "No matter how lost you are, music can bring you home."
Performing music made my father feel like he was home — something he otherwise rarely felt, even when he was, well, home.
Many advances have been made recently in the use of music to help people with Alzheimer's disease. There are reports of people with Alzheimer's who have been unable to speak for many years, who, when music is brought in to their lives — often with the help of a music therapist — are suddenly able to speak again. Some Alzheimer's patients can't speak at all, but can sing, play piano and dance. Music can help Alzheimer's patients participate in tasks and renew relationships with family and friends. Yet, despite advances in research and treatment, explanations for these observed effects remain elusive.
Many doctors dismiss the notion there's anything mysterious or magical about the residual musical affinities and capacities that defy erasure by Alzheimer's. They write it off to mere "muscle memory" — automatic physical memory of a repeated task.
"We have heard of preserved skills at domino and bridge," says Dr. Lola Cuddy, professor emeritus in psychology and director of the Music Cognition Laboratory at Queen's University in Ontario. "If so, that would mean music does not have special status, but rather that it shares preservation with some overlearned 'meaningful' skills."
However, Ms. Cuddy goes on to say that "it may be that there are specially preserved networks in the brain for music."
It's true that, toward the end of my father's life, if you gave him a golf club or a tennis racquet, he held both perfectly and could hit a ball with the same expertise he had in his 20s. The same is true of many other Alzheimer's patients.
But music? I have to believe it's different than remembering how to play a sport. In "Musicophilia," Australian music therapist Gretta Sculthorp calls music a "can opener for people's memories."
Call me a romantic — but, uh, have you ever heard anyone say that sticking a cross-court forehand volley takes them back to their first kiss?
When I interviewed Dr. Sacks for my book, "Measure of the Heart," he located music within a "protected place" in the brain. "People with Alzheimer's disease and other dementias can respond to music when nothing else reaches them," he wrote in a 2008 article. "Alzheimer's can totally destroy the ability to remember family members or events from one's own life — but musical memory somehow survives the ravages of disease, and even in people with advanced dementia, music can often reawaken personal memories and associations that are otherwise lost."
Some people think it's because music has a direct connection to the heart. Others say it's because music has a spiritual quality that even Alzheimer's can't take away.
"Music allows connections to remain," says Dr. Connie Tomaino, executive director and co-founder of the Institute for Music and Neurologic Function and senior vice president for music therapy services at Beth Abraham Family Health Services in the Bronx, N.Y. "It allows people to be with each other in a way they couldn't be if music weren't present."
For whatever ultimate reason — whether spiritual transcendance or brain circuitry — music brought Glen Campbell back to life during his Grammy appearance, and music keeps him in this world on a daily basis, just as my father was revived and engaged when he sang with his beloved a capella group or just listened and sang along with his favorite songs. Most likely, music is keeping Mr. Campbell engaged and able to survive with Alzheimer's much longer than if music had never been a part of his life, the same way music helped my father.
Music might provide an "alternative entry point" to unlock doors in an injured or diseased brain, Harvard University neurologist Gottfried Schlaug told the Los Angeles Times in 2010. Pitch, harmony, melody, rhythm and emotion engage different regions of the brain, he explained, and might even coax out certain functions of the brain through other than the normal routes.
Several doctors who treated my father felt that music was more helpful for my father's memory, physical abilities, mood and longevity than any drug they could have prescribed.
Mr. Campbell's wife, Kim Wollen, said in an interview last year that she recognizes the healing role of music. Noting the whole family's participation in Mr. Campbell's farewell tour, she said, "It's healthy for all of us. Music is good medicine."
My father's last performance was recorded in the HBO documentary "The Alzheimer's Project: The Memory Tapes." It is chillingly similar to Mr. Campbell's rousing performance at the Grammys. As you can see in the documentary, he didn't know where to go after he finished singing his song, either, even though he knew exactly what to do during his performance onstage. Even though he - like Mr. Campbell - nailed every note, a member of the group had to lead him off the stage because he didn't know where to go.
When we knew we were nearing the end of my father's life two years ago, the entire family came to be with him. We surrounded his bed, sang songs with him, and played all his favorite CDs. He sang along, humming and sometimes whistling, until the very last hours. I know he felt comforted not just by our presence, but by the presence of his favorite songs, and his ability to sing along.
I hope that, as it was with my father, Glen Campbell will be able to sing and perform until it's physically impossible, and that music will surround him until the end of his days and beyond — when he will know exactly where to go, as surely as if he were going home.
• Mary Ellen Geist is the author of "Measure of the Heart: a Father's Alzheimer's, a Daughter's Return" (Hachette). She is currently the morning anchor at FM News 101.1 in Chicago.