“Well, he has a very nice name. All dogs have a name …”

Ellen trailed off and looked at me with a puzzled, unreadable expression.

“What color is he?” I prompted. Although most hospitals don’t allow pets, that never
stopped Ellen’s canine companion from making frequent appearances, and I was curious to find
out a little more about him.

“Brown,” she replied.

“And what type of dog is he?”

Ellen tugged at her frizzy white hair. “Well, normal size. Not too big.” Her gaze shifted
to the corner of the room. “Look, there he goes!”

I turned to look in the direction she pointed, knowing I would see nothing there.

Five years ago, Ellen began describing to her family images of dogs and cats, children
playing, and small cars driving themselves inside the house. Gradually, it became apparent that
in addition to the bizarre visuals she claimed to see, her memory was suffering too. Within a few
years she could no longer take care of herself or make her own decisions. Memory problems,
cognitive decline, and visual hallucinations – particularly of people and animals – are classic
symptoms of Lewy Body Dementia, a neurological condition that is unfortunately progressive
and presently incurable. I met Ellen and her mysterious pet dog after her memory issues
culminated in an accident that brought her to the hospital where I was a rotating medical student.

A few hours later, I came around to check on Ellen again. She was in the middle of
conversation, addressing the transparent form beside her.

“Now Murray, don’t you move from there.”

Hearing Ellen mention Murray generally made people uncomfortable. To the medical
team, Murray was a symptom of the pathology that was irreversibly eating away at her synapses
and neurons. To Ellen’s son and daughter, Murray was another sign that their mother was
drifting further into an unrecognizable reality, losing sense of her former self. Murray was an
uncomfortable reminder of how much their mother had changed since her diagnosis, which
affected not only her memory and thinking, but also the most essential elements of her mood and
personality. I learned from Ellen’s children that while she had been extraordinarily eventempered
before dementia settled in, any slight provocation – from wearing an uncomfortable
sweater to taking her medications – would now anger her, resulting in daily outbursts of crying
and screaming.

But Ellen never directed any anger toward Murray, I noticed. Nothing seemed to
particularly bother her during her one-sided conversations with the dog sitting dutifully at her
feet. In fact, Ellen was calmest when she spoke to him, chatting idly about one subject or
another. She delighted in watching him run back and forth, and in those moments, I saw in her
eyes a true warmth and joy that was rarely evident otherwise. Murray’s presence seemed to coax
out the real Ellen, the Ellen that her dementia had stifled.

Murray appeared and disappeared erratically throughout the day, as hallucinations in
Lewy Body Dementia are apt to do. Yet he was often nearby, silently standing guard, when Ellen
was alone and at her most vulnerable. Ellen saw him perched near the window when she awoke
in the mornings. And at the end of the day, Murray was there with her when the door closed and
she clambered silently into bed.

I never asked Ellen whether she knew Murray wasn’t real. There wouldn’t be any
meaning in that question, because Murray was real enough. Not in a physical sense, and not in a
sense that I or any other observer could tangibly grasp. I couldn’t see Murray, but I could
perceive his form in her smile and serenity amid the confusion of her daily life. No scientific
discovery or technological marvel could breach the strangeness of the universe that dementia had
constructed for Ellen, but Murray brought the comfort of a mutual companionship, perhaps an
equal therapeutic to anything that medicine could offer her at present.

Ellen’s convoluted reality – still indecipherable by modern medicine – had somehow
created a healer of its own, indispensible to her survival in that world.

Connie Shi is a medical student at Harvard Medical School. She received her undergraduate degree from the University of Michigan, where she won the Department of Women’s Studies McGuigan Prize for her essay examining survivorship and breast cancer. Her narrative medicine essays have also appeared in KevinMD and the Journal of the American Geriatrics Society. "A Healer of Its Own" was chosen as an Honorable Mention in the 2016 Intima Essay Contest, “Patients, Providers and Pets: One Health for All,” a call for stories that reflect the term zooeyia, which has been coined to account for the salutary effects pets bestow upon humans.