Difficulty speaking.
You hear yourself. Your speech is labored. Not slow as in soporific. Rather as in staggered, where words are small victories fought for syllable-by-syllable.
Memory loss. Whole periods — months. You know you were there, you have photos. You don't remember what you did there, or when you came home.
Unclear etiology. Stroke? Thyroid? Infection? Depression, tuberculosis, sleep deprivation, meds, stress, dementia?
Trying, trying, trying, trying, trying, trying.
At some point you wonder what for, where the cost/benefit calculus becomes too unmistakably extreme to continue to deny, and all you want in the universe is sleep.