A women once told me that she took her husband to a follow-up visit with a neurologist. They were planning to stop at Target on the way home to grab a few things, including toothpaste.

At the neurologist, they received life-changing news that she did not expect. Her husband, the doctor strongly suspected, had frontotemporal dementia. She didn’t know much about it but the doctor gave her a few resources, which she found more frightening than supportive.

As they left the office, she looked at her husband and asked, “Should we still stop at Target?”

He responded, “We still need toothpaste, don’t we?”

She stopped for a moment and realized that people with frontotemporal dementia and their spouses should probably still pursue some level of oral hygiene.

And so they stopped at Target.

As they checked out with their toothpaste and a couple of other items, the woman kept thinking—this cashier has no idea this is the worst day of my life.

It’s something I, perhaps oddly, have thought about a lot the past couple years. I was referred to Mayo Clinic in Rochester for nerve pain in my back in late 2020. After three surgeries and a multitude of appointments, I feel like a regular here.

I say “here” because I am in Rochester right now for an appointment in the morning.

When I am hustling around (and sometimes killing time) at Mayo, I look around and see others doing the same. And I often think–some of these people are having the worst day of their lives.

I’m not sure which ones they are, of course, but I probably cross the path of at least 500 patients and family members/friends when I am there for an appointment. What percentage of those individuals are having the worst day of their lives?

I remember a several years ago I was having a day that I would’ve called one of the worst days on my life…or at least top (bottom?) ten. I pulled up at a stoplight and glanced to the right. I made eye contact with the guy in the truck next to me. Much like the woman in Target, I realized that he had no idea what space I was in. He would’ve assumed this was a normal day for me.

He gave me a quick but pleasant smile…like you do sometimes when you make awkward eye contact. I remember thinking–how can you smile at me on a day like today?

In my job, I regularly interact with people living with dementia and their families. I know dementia can be pretty rough, obviously. And I never know when I interact with people what type of day they are having. People living with dementia have good days. Bad days. In-between days. Their families might feel like they are on a rollercoaster, but roller coasters go up as well as down, right?

I don’t think “Are you having the worst day of your life?” is a great way to start a conversation.

When a conversation begins, I just have to be aware that it might be a possibility.

But, really, I should be aware that’s a possibility with everyone I interact with.