The young woman on the inside is strong and vibrant. Self-sufficient and capable. Beautiful and lively.

The woman on the outside, with her greying hair and thin skin, is tiny and frail. She breathes with the help of oxygen and spends her days confined to bed or chair.

Most of the time, they co-exist peacefully, each unaware of the other’s presence.

The discord comes when the two meet. When the woman on the inside tries to stand, but finds she’s unable. Tries to answer questions about herself, but gets even the basic facts wrong. Tries to place food in her mouth, but instead finds it in her lap.

Frustration sets in, because the woman inside knows she is able. But her physical body is no longer in synch with her mind, and the two do not cooperate with one another.

“How are you today?” asks the nurse. “Fine,” she replies, unaware that oxygen is flowing through a tube beneath her nose.

“Do you have any pain?” asks the doctor. “No,” she answers, not remembering that she can no longer stand after breaking her hip.

It’s hard for us to know how to feel. Because of the woman on the inside, anxiety levels are lower. But it frustrates the woman on the outside, because she doesn’t understand. And the two can swap places without any warning. So you never know which one you’re with at any given moment.

The rhythm of her breathing is comforting. It is a reminder of her physical presence. But everything else creates unease. Each new report from the doctor, each change in her physical status brings more questions. But since she is unable to contribute to her own care, others must make decisions for her.

Others must also bathe her and feed her. The lively young woman lies helpless in a bed. Long gone are her dignity and privacy.

Occasionally, the woman on the outside perks up. She watches television, or replies with one of her signature quips. Those moments are rare gifts. And every week there are fewer of them.

At some point, she will need peace. And we will be left with memories of both women. I hope the memories of the woman on the outside fade quickly, leaving us to reminisce with joy about the woman on the inside.