“It’s spring.”

“What month of spring?”

Alice licked her something chocolate ice cream and carefully considered his question. She couldn’t remember the last time she’d looked at a calendar. It had been a long time it seemed since she needed to be at a certain place at a certain time. Or if she did need to be somewhere on a certain day at a certain time, John knew about it for her and made sure she got there when she was supposed to. She didn’t use an appointment machine, and she no longer wore a wrist clock.

Well, let’s see. The months of the year.

“I don’t know, what is it?”

“May.”

“Oh.”

“Do you know when Anna’s birthday is?”

“Is it in May?”

“No.”

“Well, I think Anne’s birthday is in the spring.”

“No, not Anne, Anna.”

A yellow truck groaned loudly over the bridge near them and startled Alice. One of the geese spread its wings and honked at the truck, defending them. Alice wondered whether it was brave or a hothead, looking for a fight. She giggled, thinking about the feisty goose.

She licked her something chocolate ice cream and studied the architecture of the red-brick building across the river. It had many windows and a clock with old-fashioned numbers on a gold dome on its top. It looked important and familiar.

“What’s that building over there?” asked Alice.

“That’s the business school. It’s part of Harvard.”

“Oh. Did I teach in that building?”

“No, you taught in a different building on this side of the river.”

“Oh.”

“Alice, where’s your office?”

“My office? It’s at Harvard.”

“Yes, but where at Harvard?”

“In a building on this side of the river.”

“Which building?”

“It’s in a hall, I think. You know, I don’t go there anymore.”

“I know.”

“Then it really doesn’t matter where it is, right? Why don’t we focus on the things that really matter?”

“I’m trying.”

He held her hand. His was warmer than hers. Her hand felt so good in his hand. Two of the geese waddled into the calm water. There were no people swimming in the river. It was probably too cold for people.

“Alice, do you still want to be here?”

His eyebrows bent into a serious shape, and the creases next to his eyes deepened. This question was important to him. She smiled, pleased with herself for finally having a confident answer for him.

“Yes. I like sitting here with you. And I’m not done yet.”

She held up her something chocolate ice cream to show him. It had started to melt and drip down the sides of the cone onto her hand.

“Why, do we need to leave now?” she asked.

“No. Take your time.”

JUNE 2005

Alice sat at her computer waiting for the screen to come to life. Cathy had just called, checking in, concerned. She said that Alice hadn’t returned her emails in a while, that she hadn’t been to the dementia chat room in weeks, and that she’d missed support group again yesterday. It wasn’t until Cathy talked about support group that Alice knew who the concerned Cathy on the phone was. Cathy said that two new people had joined their support group, and that it had been recommended to them by people who’d attended the Dementia Care Conference and had heard Alice’s speech. Alice told her that was wonderful news. She apologized to Cathy for worrying her and told her to let everyone know that she was okay.

But to tell the truth, she was very far from okay. She could still read and comprehend small amounts of text, but the computer keyboard had become an undecipherable jumble of letters. In truth, she’d lost the ability to compose words out of the alphabet letters on the keys. Her ability to use language, that thing that most separates humans from animals, was leaving her, and she was feeling less and less human as it departed. She’d said a tearful good-bye to okay some time ago.

She clicked on her mailbox. Seventy-three new emails. Overwhelmed and powerless to respond, she closed out of her email application without opening anything. She stared at the screen she’d spent much of her professional life in front of. Three folders sat on the desktop arranged in a vertical row: “Hard Drive,” “Alice,” “Butterfly.” She clicked on the “Alice” folder.

Inside were more folders with different titles: “Abstracts,” “Administrative,” “Classes,” “Conferences,” “Figures,” “Grant Proposals,” “Home,” “John,” “Kids,” “Lunch Seminars,” “Molecules to Mind,” “Papers,” “Presentations,” “Students.” Her entire life organized into neat little icons. She couldn’t bear to look inside, afraid she wouldn’t remember or understand her entire life. She clicked on “Butterfly” instead.

Dear Alice,

You wrote this letter to yourself when you were of sound mind. If you are reading this, and you are unable to answer one or more of the following questions, then you are no longer of sound mind:

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?

You have Alzheimer’s disease. You have lost too much of yourself, too much of what you love, and you are not living the life you want to live. There is no good outcome to this disease, but you have chosen an outcome that is the most dignified, fair, and respectful to you and your family. You can no longer trust your own judgment, but you can trust mine, your former self, you before Alzheimer’s took too much of you away.

You lived an extraordinary and worthwhile life. You and your husband, John, have three healthy and amazing children, who are all loved and doing well in the world, and you had a remarkable career at Harvard filled with challenge, creativity, passion, and accomplishment.

This last part of your life, the part with Alzheimer’s, and this end that you’ve carefully chosen, is tragic, but you did not live a tragic life. I love you, and I’m proud of you, of how you’ve lived and all that you’ve done while you could.

Now, go to your bedroom. Go to the black table next to the bed, the one with the blue lamp on it. Open the drawer to that table. In the back of the drawer is a bottle of pills. The bottle has a white label on it that says FOR ALICE in black letters. There are a lot of pills in that bottle. Swallow all of them with a big glass of water. Make sure you swallow all of them. Then, get in the bed and go to sleep.

Go now, before you forget. And do not tell anyone what you’re doing. Please trust me.