Walking briskly down a Portland, Oregon, street I see a man in a wheelchair, facing a most confused direction in the middle of a crosswalk. I spring into action and as I grab the chair and start pushing, I quickly gauge this man's cognitive abilities.

He is in his late 50's and a bit muddy of mind. Immediately I analogize his condition to that of my now-deceased father's toward the end. Multiple sclerosis or Parkinson's or some such thing I unconsciously decide as I try to figure which direction to take this man and when to stop caring.

We get to a safe location on the sidewalk and he starts talking to me with a purpose. I lean in and he says in an all-too familiar tone and cadence, "cheeseburger,... cheeseburger."

I recognize this kind of shameful demand as the world constricts and crushes my chest. My emotional attachments discontinue and I say in a friendly tone, "You are safe now. I've got to go. Be careful," and slowly walk away.

At some point, some (perhaps all) of these cases, the people with the degenerative neurological type of disease, lose the strength not to use others as a means to their ends. They use those around them to enable their cravings, enable their many masks and delusions, and most tragically to enable their now-inevitable rapid decline. I had seen it before.

It's not that I didn't wish to help the man. I wanted to help him. I just knew that I couldn't.