Her Nails Were Smashing Though

During my residency we had this lady in her 60s who was getting progressively more forgetful, just overall declining and getting less and less able to take care of herself. She had been seeing her pcp who diagnosed her with dementia. And she saw a neurologist who agreed. She was not really able to provide an accurate history. After talking to her family and friends it became apparent that her symptoms were progressing unusually quickly. I remember seeing the point where her new hair growth met her bright red dye and also her grown out nails with hot pink polish thinking, wow, it really wasn't too long ago that she was not only taking care of herself but like, going to get her hair and nails done. The lady in front of me was so far from that. The neurologist I was training with recognized this, had her admitted and did every test including lumbar puncture. Workup eventually showed Creutzfeld Jakob disease ("mad cow") which there is unfortunately no treatment for. She died a few months later but at least we were able to prepare her family that she would only continue to decline so they could make arrangements. Really sad situation.