As she turned to leave, she looked at the four girls who sat behind her. They all looked up at her and smiled, probably grateful to her for releasing the pressure and setting them free. She held up her wrist, displaying the time as her irrefutable data.
“I don’t know about you guys, but I have better things to do.”
She walked up the stairs, exited the auditorium through the back doors, and never looked back.
SHE SAT IN HER OFFICE and watched the shiny rush-hour traffic creep along Memorial Drive. Her hip vibrated. It was 8:00 a.m. She removed her BlackBerry from her baby blue bag.
Alice, answer the following questions:
1. What month is it?
2. Where do you live?
3. Where is your office?
4. When is Anna’s birthday?
5. How many children do you have?
If you have trouble answering any of these, go to the file named “Butterfly” on your computer and follow the instructions there immediately.
May
34 Poplar Street, Cambridge, MA 02138
William James Hall, room 1002
September 14, 1976
Three
JUNE 2004
An unmistakably elderly woman with hot pink nails and lips tickled a little girl, about five years old, presumably the woman’s granddaughter. Both looked to be having a grand old time. The advertisement read: “THE #1 TUMMY TICKLER takes the #1 prescribed Alzheimer’s drug.” Alice had been flipping through Boston magazine but was unable to move past this page. A hatred of that woman and the ad filled her like a hot liquid. She studied the picture and the words, waiting for her thoughts to catch up to what her gut understood, but before she could figure out why she felt so personally antagonized, Dr. Moyer opened the door to the examining room.
“So Alice, I see you’re having some difficulty sleeping. Tell me what’s going on.”
“It’s taking me well over an hour to get to sleep, and then I usually wake up a couple of hours after that and go through the whole thing all over again.”
“Are you experiencing any hot flashes or physical discomfort at bedtime?”
“No.”
“What medications are you taking?”
“Aricept, Namenda, Lipitor, vitamins C and E, and aspirin.”
“Well, unfortunately, insomnia can be a side effect of the Aricept.”
“Right, but I’m not going off Aricept.”
“Tell me what you do when you can’t get to sleep.”
“Mostly I lie there and worry. I know this is going to get a lot worse, but I don’t know when, and I worry that I might go to sleep and wake up the next morning and not know where I am or who I am or what I do. I know it’s irrational, but I have this idea that the Alzheimer’s can only kill off my brain cells when I’m asleep, and that as long as I’m awake and sort of on watch, I’ll stay the same.
“I know all this anxiety keeps me up, but I can’t seem to help it. As soon as I can’t fall asleep, I worry, and then I can’t sleep because I’m worried. It’s exhausting just telling you about it.”
Only some of what she’d just said was true. She did worry. But she’d been sleeping like a baby.
“Are you overcome with this kind of anxiety at any other time of the day?” asked Dr. Moyer.
“No.”
“I could prescribe you an SSRI.”
“I don’t want to go on an antidepressant. I’m not depressed.”
The truth was, she might be a little depressed. She’d been diagnosed with a fatal, incurable illness. So had her daughter. She’d almost entirely stopped traveling, her once dynamic lectures had become unbearably boring, and even on the rare occasion when he was home with her, John seemed a million miles away. So yes, she was a little sad. But that seemed an appropriate response given the situation and not a reason to add yet another medication, with more side effects, to her daily intake. And it wasn’t what she’d come here for.
“We could try you on Restoril, one each night at bedtime. It’ll get you to sleep quickly and allow you to stay asleep for about six hours, and you shouldn’t wake up groggy in the morning.”
“I’d like something stronger.”
There was a long pause.
“I think I’d like you to make an appointment to come back in with your husband, and we can talk about prescribing something stronger.”
“This doesn’t concern my husband. I’m not depressed, and I’m not desperate. I’m aware of what I’m asking for, Tamara.”
Dr. Moyer studied her face carefully. Alice studied hers. They were both older than forty, younger than old, both married, highly educated professional women. Alice didn’t know her doctor’s politics. She’d see another doctor if she had to. Her dementia was going to get worse. She couldn’t risk waiting any longer. She might forget.
She had rehearsed additional dialogue but didn’t need to use it. Dr. Moyer got out her prescription pad and began to write.
SHE WAS BACK IN THAT tiny testing room with Sarah Something, the neuropsychologist. She’d reintroduced herself to Alice just a moment ago, but Alice had promptly forgotten her last name. Not a good omen. The room, however, was as she remembered it from January—cramped, sterile, and impersonal. It contained one desk with an iMac computer on it, two cafeteria chairs, and a metal file cabinet. Nothing else. No windows, no plants, no pictures or calendar on the walls or desk. No distractions, no possible hints, no chance associations.
Sarah Something began with what felt almost like regular conversation.
“Alice, how old are you?”
“Fifty.”
“When did you turn fifty?”
“October eleventh.”
“And what time of year is this?”
“Spring, but it already feels like summer.”
“I know, it’s hot out there today. And where are we right now?”
“In the Memory Disorders Unit at Mass General Hospital, in Boston, Massachusetts.”
“Can you name the four things shown in this picture?”
“A book, a phone, a horse, and a car.”
“And what is this thing on my shirt?”
“A button.”
“And this thing on my finger?”
“A ring.”
“Can you spell ‘water’ backwards for me?”
“R-E-T-A-W.”
“And repeat this after me: Who, what, when, where, why.”
“Who, what, when, where, why.”
“Can you lift your hand, close your eyes, and open your mouth?”
She did.
“Alice, what were those four objects in the picture you named before?”
“A horse, a car, a phone, and a book.”
“Great, and write a sentence for me here.”
I cannot believe that I won’t be able to do this someday.