“I have ‘John’ programmed into my cell phone, and I carry it with me in this bag at all times.”
“Okay, that’s good, but what if the battery goes dead or John’s phone is off and you’re lost?”
“How about a piece of paper in my bag that has my name, John’s, our address and phone numbers?”
“That’ll work, as long as you always have it on you. You might forget to bring your bag. The bracelet, you wouldn’t have to think about.”
“It’s a good idea,” said John. “She’ll get one.”
“How are you doing with the medications, are you taking all of your doses?”
“Yes.”
“Any problems with side effects, nausea, dizziness?”
“No.”
“Aside from your night at the office, are you having any trouble sleeping?”
“No.”
“Are you still getting regular exercise?”
“Yes, I’m still running, about five miles, usually every day.”
“John, do you run?”
“No, I walk to work and home, that’s about it for me.”
“I think it’d be a good idea for you to take up running with her. There’s convincing data in animal models that suggest exercise alone can slow the accumulation of amyloid-beta and cognitive decline.”
“I’ve seen those studies,” said Alice.
“Right, so keep up with the running. But I’d like it if you could pair up with a running partner; that way we don’t have to worry about you getting lost or skipping your run because you forgot about it.”
“I’ll start running with her.”
John hated running. He played squash and tennis and an occasional game of golf, but he never ran. He could certainly outpace her mentally now, but physically, she was still miles ahead of him. She loved the idea of running with him but doubted that he could commit to it.
“How’s your mood been, are you feeling okay?”
“Generally good. I’m definitely frustrated a lot and exhausted from trying to keep up with everything. And I’m anxious about what lies ahead for us. But otherwise, I feel the same, better actually, in some ways, since telling John and the kids.”
“Have you told anyone at Harvard?”
“No, not yet.”
“Were you able to teach your classes and meet all your professional responsibilities this semester?”
“Yes, it took a lot more out of me than it did last semester, but yes.”
“Have you been traveling alone to meetings and lectures?”
“I’ve pretty much stopped. I canceled two university lectures, and I skipped a big conference in April, and I’m missing the one in France this month. I normally travel a lot in the summer, we both do, but this year we’re spending the whole summer at our house in Chatham. We’re heading down there next month.”
“Good, that sounds wonderful. Okay, it sounds like you’ll be well taken care of for the summer. I do think you should come up with a plan for the fall that involves telling the people at Harvard, maybe coming up with a way of transitioning out of your job that makes sense, and I think traveling alone should be out of the question at that point.”
She nodded. She dreaded September.
“There are some legal things to plan now as well, advance directives like power of attorney and a living will. Have you thought about whether or not you’d like to donate your brain to research?”
She had thought about it. She imagined her brain, bloodless, formalin-perfused, and Silly Putty–colored, sitting in the cupped hands of a medical student. The instructor would point to various sulci and gyri, indicating the locations of the somatosensory cortex, the auditory cortex, and the visual cortex. The smell of the ocean, the sounds of her children’s voices, John’s hands and face. Or she imagined it cut into thin, coronal slices, like a deli ham, and adhered to glass slides. In such a preparation, the enlarged ventricles would be striking. The empty spaces where she once resided.
“Yes, I’d like to.”
John cringed.
“Okay, I’ll have you fill out the paperwork before you leave. John, can I have that questionnaire you’re holding?”
What did he say about me in there? They would never talk about it.
“When did Alice tell you about her diagnosis?”
“Just after you told her.”
“Okay, how would you say she’s been doing since then?”
“Very well, I think. It’s true about the phone. She won’t answer it at all anymore. Either I get it or she lets the machine pick it up. She’s become glued to her BlackBerry, almost like a compulsion. She sometimes checks it every couple of minutes in the morning before she leaves the house. That’s a little difficult to watch.”
More and more, it seemed he couldn’t bear to look at her. When he did, it was with a clinical eye, like she was one of his lab rats.
“Anything else, anything that Alice may not have mentioned?”
“Nothing I can think of.”
“How’s her mood and personality, any changes you’ve noticed there?”
“No, she’s the same. A little defensive, maybe. And quieter, she doesn’t initiate conversation as much.”
“And how are you doing?”
“Me? I’m fine.”
“I have some information for you to take with you about our caregivers’ support group. Denise Daddario is the social worker here. You should make an appointment with her and just let her know what’s going on.”
“This is an appointment for me?”
“Yes.”
“Really, I don’t need one, I’m fine.”
“Okay, well, these resources are here if you find you come to need them. Now, I have some questions for Alice.”
“Actually, I want to talk about some additional therapies and clinical trials.”
“Okay, let’s do that, but first, let’s finish up her exam. Alice, what day of the week is it?”
“Monday.”
“And when were you born?”
“October eleventh, 1953.”
“Who is the vice president of the United States?”
“Dick Cheney.”
“Okay, now I’m going to tell you a name and address, and you’re going to repeat it back to me. Then, I’m going to ask you to repeat it again later. Ready? John Black, 42 West Street, Brighton.”
“The same as last time.”
“Yes, it is, very good. Can you repeat it back to me now?”
“John Black, 42 West Street, Brighton.”
John Black, 42 West Street, Brighton.
John never wears black, Lydia lives out west, Tom lives in Brighton, eight years ago I was forty-two.
John Black, 42 West Street, Brighton.
“Okay, can you count to twenty forwards and then backwards?”
She did.
“Now, I want you to raise the number of fingers on your left hand which corresponds to the place in the alphabet of the first letter of the city you’re in.”
She repeated what he said in her head and then made the peace sign with her left index and middle fingers.
“Good. Now, what is this thing called on my watch?”
“A clasp.”
“Okay, now write a sentence about today’s weather on this piece of paper.”
It is hazy, hot, and humid.
“On the other side of that paper, draw a clock showing the time as forty-five minutes past three.”
She drew a big circle and filled in the numbers starting at the top with twelve.
“Oops, I made the circle too big.”
She scribbled it out.
3:45
“No, not digital. I’m looking for an analog clock,” said Dr. Davis.
“Well, are you looking to see if I can draw or if I can still tell time? If you draw me a clock face, I can show you 3:45. I’ve never been any good at drawing.”
When Anna was three, she’d loved horses and used to beg Alice to draw pictures of them for her. Alice’s renditions had looked, at best, like postmodern dragon-dogs and always failed to satisfy even the wild and generously accepting imagination of her preschooler. No, Mom, not that, draw me a horse.