Most people don’t know this but my name isn’t actually Libby. My legal name – used by tax collectors, doctors, and SPAM artists – is Helen.

Helen is family name on my father’s side of the family, accompanied by a huge yellow diamond, the Helen Diamond, that I would someday inherit. Libby is short for Elizabeth, a family name on my mother’s side of the family. Dad always liked the name, Libby. The most beautiful girls he knew were named Libby, he told me once.

Thanks, Dad, no pressure.

Even after I reached the age where I could have insisted on another name – Helen, light from god; Beth, reminiscent of Little Women; or the more independent, Liz – I chose to stick with Libby.

Helen was reserved for my aunt. Even now, when a doctor’s assistant calls my name for an appointment, I think of my Aunt Helen.

Aunt Helen was my grown-up.

When I was born, my father was stationed in the DMZ in Vietnam and my mother was alone. Although my father flew back not long after I was born for a quick home leave, for the rest of his tour of duty, she was a single parent. We spent some time with her family in Florida but, for much of that time, we just had each other. When my father returned home, my mother had another baby, a happy, smiling baby, which I no longer was. (As a little girl, I had a perpetually running nose and warts along my top lip. I was also an angry young child – mainly, I suspect, because I had been displaced by my sisters. With their birth, I was banished literally to the attic of our remote home, while my sisters who needed baby-care slept near my parents on the main floor.) That sister was quickly followed by another baby sister who had very bad colic and needed constant care, much of which fell to my father.

This established a pattern that remained constant until my parents were divorced: My youngest sister was Dad’s responsibility and held his hand when we went out. My middle sister was Mom’s. Like Kipling’s cat, I walked alone.

Except when my Aunt Helen came to visit. Then I had my grown up.

She understood what it was like to be an angry, unloved, funny-looking kid. And, as a psychiatric social worker, she had the tools to listen, to reflect, to reframe. Her understanding got me through my awkward pre-teen years, through my wild teen years, and through college.

When I emerged on the other side relatively unscathed, we became friends. We continued to travel together and I visited her home in Nashville. Even when my father moved there, when I went to visit, I stayed with Helen. After her cat, Sunshine, died and Helen adopted two adorable kittens, I did my best to nurse her other older cat, Raindrop back from depression – it seems a little thing but she mentioned it even years later.

Helen was the “Best Woman” at my wedding, the only person I invited to be in my wedding party.

When my dad ended up in the hospital after a hit-and-run driver mangled his body and his bike, it was Helen who phoned me. “Your dad didn’t want me to call,” she said, “he didn’t want you to be worried but I thought you should know. He’s pretty badly hurt.”

Despite our close relationship, I didn’t catch the signs at first.

Outbursts of anger – so unlike my smiling, happy, larger-than-life Helen. When her necklace detached itself and slid down a power-flush toilet in an airport restroom, her rage was magnificent but displaced onto the maintenance supervisor who could not help. (Oddly, I was often terrified of angry people – a hold-over from the abusive rages of my paternal grandfather – but Helen’s rages didn’t scare me.) It seemed disproportionate to me but it was her favorite necklace…

And then that strange vacation together in the Outer Banks… Helen had come to us directly from a professional workshop that she had attended and I ascribed her odd behavior to a week of reflective listening. She repeated everything I said.

Literally, I would say, “What a beautiful day,” and she’d repeat, “It is a beautiful day.”

I’d say, “I think I’m going to have a muffin for breakfast,” and she’d repeat, “I’m thinking of having a muffin for breakfast, too.”

It got to the point where I said, “Your repeating my every word is driving me crazy,” and she said, “My repeating you is making you crazy.”

At that point I slammed out of the room, screaming.

My husband told me at the time that he hadn’t even noticed it. A friend I saw over the weekend who had been there remember enjoying her company on a lovely vacation.

I recognize now that she wasn’t doing it to irritate me or as the hangover of some crazy reflective listening exercise.

She was covering.

I gave her some space after that vacation and then, missing her and remorseful for losing my temper, I tried calling. I left message after message on her cell and home phone, more and more frantic as she didn’t return my calls. I emailed her and mailed cards. No response.

When I talked to my father – also living in Nashville – I asked if he had spoken with her or seen her recently. Oh yes, he said, unphased. They had dinner together recently.

When? I asked.

(My father, notoriously dense, had once forgotten to mention a freak home accident that left his young wife blind in one eye until I asked about her at the end of the hour-long phone call. Oh, he said, did I mention… and told me the whole story. When did this happen, I demanded, wondering if it had been so long ago that he perhaps thought he had already told me. He thought a moment and replied, Last weekend; she just returned home from the hospital yesterday.)

Dad thought for a moment. When had he had dinner with Helen last…? Oh yes, it was in February.

Dad, I said, it’s June. Could you drop by and make sure she’s okay? She’s not answering her phone and her voicemail is so full that it’s not accepting messages.

He said later that she was fine. But she never called me.

Heartbroken at the loss of a relationship so important to me, I nursed my hurt privately.

My Aunt Mary called me after that. She had gone to visit Helen – they had the kind of relationship where Mary just flew to Nashville and showed up on Helen’s doorstep – and found the townhouse filled with unopened QVC packages and Helen’s accounts overdrawn.

Helen had developed early-onset dementia and could no longer live alone. Mary was moving her into care in Florida, near Mary’s home.

I was in shock. I should have known something was wrong. I should have known she wasn’t shunning me, she just couldn’t figure out how to use her phone anymore. I should not have trusted my father – who, in retrospect, was probably dealing with the leading edge of Parkinsons at that point – to check in on her.

Helen did not take well to care. At first, she insisted there was nothing wrong with her and kept escaping the facility, wandering the parking lot searching for her car (sold to pay debts, along with the Helen Diamond) so she could return home to Nashville. The care facility requested that Mary find another place for her.

She hopped facilities after that, continuing her escape plans, lashing out in anger at random men that she encountered in hallways.

Finally, she settled down. Mary said she had reached the point where Mary was the only one that Helen recognized. Mary visited weekly, brushing Helen’s hair, painting her nails, shaving her legs, the care that only a sister can give.

When my mother visited Florida on her farewell tour, I went down to visited her and we made the pilgrimage to see Helen together. Somewhere deep inside me I hoped Helen would remember me.

She looked exactly the same, young and – to me – beautiful. She didn’t look like you would imagine someone with dementia would look. And she was pleasant, just as I remembered her.

I said, “It’s so lovely to see you again. I’ve missed you.”

“It is lovely,” she said, “I’ve missed you, too.”

And that’s when the penny dropped. She had already been exhibiting symptoms on that beach vacation. My husband, my friends, who hadn’t even noticed her behavior, weren’t close enough to pick up that something was wrong. I noticed but I thought it was conscious behavior on her part – I hadn’t realized that she was slowly losing control.

This is what happens when the people we are closest to experience cognitive decline: we grow frustrated with their seeming willful annoying behaviors. It’s only when an objective outsider evaluates the situation that the pieces fall into place and we do the V-8 smack: I should have realized.

When my sisters and I gathered last month, a year after my mother’s death, to release Mom’s ashes into the sea, I received a call from my Aunt Mary, who broke the news that Helen had finally escaped the institution for good.

We have all experienced so much loss over the last four years. Pressed up against the screen of my living room window in 2020, beating pots and pans every night for months, for the medical practitioners that live in my building and pass by on their way to / from the hospitals nearby. The loss of our sense of community, as people break off from friends, neighbors, and relatives who think differently than them – or drift away, distracted by the new hardships introduced by the pandemic. Mourning the loss of a world that has stopped making sense, as the markets tower higher and higher, and the economists tell us things are getting better but the gap between the richest and the poor grows wider and LinkedIn is filled with people who have been laid off from their jobs.

I’ve lost my father to Parkinsons, unable to visit due to Covid and unable to talk to him by phone, something his wife had helped with until he went into the care facility. I lost my mother to pulmonary fibrosis aggravated by depression and loneliness that set in during the pandemic isolation.

And now Helen. My rock. The person who understood me and stood by me, and helped me make sense of the world.

My grown up.