A Moment to Remember is a Korean film about a 27 year old fashion designer named Kim SuJin.

She got spurned by her lover at the train station. Disheartened, she goes to a convenient store and bumps into a tall and handsome, but mysterious man with whom she has a slight misunderstanding. Subsequently, she goes home and receives her father s forgiveness for attempting to elope with her colleague who is also a married man. She then decides to have a fresh start. One day, while she was out accompanying her father making rounds at his construction site, she inadvertently meets the tall handsome mysterious man from the convenient store. His name is Choi Chul-Soo, a foreman at her father s construction site who dreams of becoming an architect someday. Chul-Soo may seem to be your rough and dirty construction kind of guy, but he does exude utter masculinity in its most basic physical form and is pretty handy in terms of carpentry or house repairs. The demure Su-Jin instantly develops affinity towards Chul-Soo and in what seemed to be unlikely of the timid Su-Jin, actively courts him. In the middle of the film, many sweet events take place in the event of their dating and eventually lead to their marriage. Everything was wonderful as it can be for the happy couple as Chul-Soo pursues his lifelong dream. However, shortly after, things quickly go downhill. After a series of mishaps, Su-Jin decides to see a doctor and soon finds out that she has Alzheimer s disease. Alzheimer s is the most common form of dementia. It is a progressive neurologic disorder wherein the brain leads to an irrevocable loss of neurons and loss of intellectual activities such as memory and reasoning which eventually becomes severe enough to hinder social as well as occupational functioning. It starts slowly concerning the parts of the brain responsible for thought, memory and language. Patients suffering from this will have trouble remembering recent happenings or names of the people as well as misplacing items and getting lost on familiar routes just like Su-Jin. Over time, it gets worse. Patients will no longer recognize family or friends and will have difficulty speaking, reading or writing. They will also tend to have trouble doing basic tasks such as brushing their teeth or changing their clothes. One scene in the movie depicting this is when Su-Jin pees herself and barely even notices. The rest of the film depicts how gradually and painfully Su-Jin loses bits and pieces of her memory until she can no longer work, tend to herself and remember anything about her life with her husband. Even more painful is seeing how Chul-Soo deals with his wife s condition after choosing to stay by her side despite how she pushes him away to be with somebody who can take care of him. He agonizes while watching the woman he loves so dearly forget who he is. Eventually, after realizing that she cannot tend to her husband and herself anymore, Su-Jin goes to a nursing home leaving a heartbreaking letter for a good-bye. The movie ends with Chul-Soo visiting Su-Jin and taking her to the convenient store reliving their very first meeting. In that moment, Su-Jin seems to remember her life with Chul-Soo filled with love and happiness. The ending may be a bittersweet one but at the very least, it offers a glimpse of hope.

1. How did the disorder affect the life of the character? Initially, Su-Jin keeps losing pens and pencils so she brings a whole lot of them every time. Then she keeps getting lost on familiar streets and admits that she has difficulty finding her way home. One night, she was hesitant to enter her own house and it took a while before she recognizes she s in the right place. She also loses track of time like when the doctor told her to come back in a week, she came back after two. When the doctor asks her basic questions such as her sister s age and birthday, she is quite confused and barely remembers the right answer. She seems to be lost most of the time and forgets recent events and conversations, like when she and Chul-Soo were in the living room, she was putting glue on the picture and then she suddenly gets up, walks around like she s looking for something, and then sees her husband and asked him where he went, when he was just there the whole time. She then gets back to the picture and thanked her husband for putting glue on it. She then has to quit her job as she will no long be capable to functioning properly. She eventually has difficulty performing basic tasks that take some thought, but used to come easily such as arranging the shoes properly and cooking a delicious viand for her husband for lunch at work only to pack 2 boxes with both rice in them. As the disorder progresses, the symptoms become more evident and interfere with Su-Jin s ability to remember things and people as well as taking care of herself. She keeps forgetting details about current events and losing awareness of what s currently going on. That time when she was out to see her former lover and colleague to formalize her resignation, she suddenly forgets where she was going and upon seeing him, she thought they were still dating. She completely forgets that she was already married to another man. She eventually calls Chul-Soo by her former lover s name, completely forgetting who he is. She then has trouble doing basic activities. She even peed herself and barely notices it. When she was at the nursing home, she needs to be assisted by the nurse in eating. She also keeps drawing Chul-Soo and it was shown that her drawings were becoming less and less structured. In the long run, she does not recognize her husband anymore as well as her family and friends. It becomes difficult not only to Su-Jin but also to her loved ones. They become strangers to her and she becomes, more or less, a stranger to them as well.

2. What could you have done to help the patient as a doctor to improve the quality of life? For patients with Alzheimer s disease, there is unfortunately no cure and no treatment to reverse or halt its progression yet. The only thing we can do now is to treat its symptoms. There are two ways in which we can do this, one is through non-pharmacological ways and the other is through pharmacotherapy. For the former, this includes patient, caregiver and healthcare

workers education of the disorder and how it should be dealt with; caregiver support such that in the movie where Su-Jin is assisted by one when eating and walking; and patient psychosocial treatment. In the case of the latter, for the cognitive symptoms, cholinesterase inhibitors should be prescribed for patients with mild to moderate Alzheimer s disease. But I recommend NMDAreceptor antagonists to Su-Jin because this is used for patients with moderate to severe Alzheimer s. The drug of choice can be Mimantine because it has a low to moderate affinity, uncompetitive N-methyl-D-aspartate receptor antagonist that blocks the pathological activation of NMDA receptor. It decreases the decline of cognition and daily functioning. This can also be used in combination with cholinesterase inhibitors. In addition to these two is Vitamin E. This is used as a supplement in the hope to decrease or slow down the progression of the disease by decreasing the rate of nerve cell damage. For the non-cognitive symptoms, antipsychotics, benzodiazepines and antidepressants are to be prescribed in order to minimize psychotic symptoms and help increase comfort and safety of the patient and her family. For the long term management of Alzheimer s, I recommend one thing from the movie wherein post-its, labels, pictures and guidelines were posted in practically every corner of the house to at least try to let the patient remember things. I also recommend consistently monitoring treatment of cognitive symptoms and detecting and treating the non-cognitive ones. It is also important to balance supervision with meaningful activities as well as educate and advice the patient and the family regarding the prognosis and transitions they are to go through.