1 Foundations

classical, lo-fi, rap · 2:57

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Lyrics

[Verse 1]
When memory frays at the edges, not yet torn through,
We call it mild impairment — subtypes number two:
Amnestic, where the hippocampus starts to thin,
Non-amnestic, where attention falters from within.
Conversion rates to dementia hover near fifteen percent,
But some revert to normal — a mercurial event.
Subjective decline means the patient feels the slip
Before our tests can measure any cognitive eclipse.

[Chorus]
Alzheimer's, vascular, Lewy, frontal lobe,
Parkinson's and prion circling the globe,
Biomarkers in the blood and amyloid in the scan,
Stage it, name it, disclose it — that's the clinician's plan.
CDR and FAST and Global Deterioration,
Map the arc of loss with calibrated observation,
Name the subtype, chart the stage, and hold the prognosis clear —
Then sit beside the patient and abolish every fear.

[Verse 2]
Alzheimer's wears the amnestic face most often seen,
With tau and amyloid accruing in the brain's ravine.
New disease-modifying therapies — lecanemab leads the charge,
Their implications stretch the ethics wide and large.
Vascular dementia follows strokes in stepwise decline,
Lewy body brings the triad: hallucinations, the Parkinsonian sign,
Fluctuating cognition like a candle in a draft,
And neuroleptic sensitivity — handle with the utmost craft.
REM sleep behavior disorder is the early harbinger —
The body acts its nightmares out, a somnolent messenger.

[Chorus]
Alzheimer's, vascular, Lewy, frontal lobe,
Parkinson's and prion circling the globe,
Biomarkers in the blood and amyloid in the scan,
Stage it, name it, disclose it — that's the clinician's plan.
CDR and FAST and Global Deterioration,
Map the arc of loss with calibrated observation,
Name the subtype, chart the stage, and hold the prognosis clear —
Then sit beside the patient and abolish every fear.

[Verse 3]
Frontotemporal dementia, younger onset, disinhibited face,
Behavioral variant first — personality displaced.
Primary progressive aphasia steals the word before the mind,
While alcohol, HIV, and TBI leave their trails behind.
Prion disease burns catastrophically fast,
Reversible causes — thyroid, B-twelve — never bypassed.
Mixed dementia wears two pathologies at once,
To miss a treatable etiology marks the clinical dunce.

[Bridge]
Now the diagnosis sits across the table, raw and named —
The clinician carries honesty, the family half-ashamed.
We call this numinous moment: the disclosure conversation,
Where hope is not a falsehood but a reasoned estimation.
Reactions cascade — grief, relief, a strange lethologica —
That word for losing words right when you need them, the ironica.
Post-diagnostic support begins before they leave the room,
Involve the family, build the plan, and punctuate the gloom.

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