brett

On the way to the doctor’s office with my dad and mom, I look out the window at the restaurants, dry cleaners, tire stores, banks, and juice places. For a moment, it seems to me that they are all different now. I’m not sure how, but the world has tilted.

And because of it, I feel that no one should be going about life as though nothing’s happened. Maybe the stores should all close so I don’t see content, disinterested people wandering about. It’s a self-centered thought, that they all should be as bewildered and anxious as we are, somehow. But they’re not. It’s a strange scene to my mind, which now wants time to stop for a while—and perhaps start going backward. But that’s not going to happen, obviously.

I said I wanted to tag along, and as hard as it will be to hear whatever the doctor has to say, it would be even harder not to be there.

Scott and Trish are already waiting when we arrive. The room is tiny. We all cram in, which makes the situation that much more uncomfortable.

“I’m sorry, honey,” my mom says to me.

“What? Don’t be. This is nothing to be sorry about. It’s not your fault.”

“I’m just sorry you have to go through this,” she says. “I know you’re frightened.”

“Don’t worry about me, Mom,” I say. “I’m fine.”

I’m not fine. I’m anything but fine. I wish Layla was here right now.

The doctor walks in and introduces himself. Dr. Frankel. He asks us all to take a seat and says that he’ll go over everything, but if we have any questions while he’s explaining how the testing will go, we should feel free to ask.

“The first thing we’re going to do is a CT scan and an MRI,” Dr. Frankel says. “We’ll do this to rule out tumors, hemorrhages—maybe she had a mild stroke and nobody knew—and hydrocephalus, which can masquerade as Alzheimer’s disease.”

There. He said it. The dreaded A-word. I heard my mom catch her breath when he said it, which made it that much worse.

He goes on. “These scans can also show the loss of brain mass associated with Alzheimer’s disease and other dementias. In Alzheimer’s, the region of the brain known as the hippocampus may be disproportionately atrophied. If we see this, then it’s pretty straightforward.”

“Okay,” my mother says.

“We’ll do an EEG to detect abnormal brain-wave activity. Typically, an EEG is normal in people with mild Alzheimer’s disease. The EEG is, again, meant to rule out other types and causes of dementia, Creutzfeldt-Jakob disease, for instance.”

“Okay,” she says again.

“Your symptoms do match up with early-onset Alzheimer’s. I’ll know better when we’ve examined your scans and administered some tests.” He goes on to explain the neuropsychological tests they’ll do both as interviews and as paper-and-pencil tests. He tells us these tests will take several hours, and they might agitate my mom. He warns us that she may get frustrated having to answer what seem like obvious questions but that we should reassure her and help keep her calm if anything should arise. These tests are used to determine which areas of cognitive function are impaired and which areas are still intact. They assess memory, reasoning, writing, vision-motor coordination, comprehension, and her ability to express ideas.

There’s one thing I notice throughout the visit. It’s that my mother says “okay” to everything. That’s not who she is. Before now she’d have asked for a second, a third, a seventeenth opinion, called the doctor a fine young man (but a little goofy), and told him the carpet was fine and not at all the problem—but the window treatments were another matter. But she’s just accepting of everything the doctor tells her. This is what kills me. Because for every “okay” she utters, the look on her face says otherwise.

For some reason my mom doesn’t grasp the severity of the situation. It becomes very apparent to me that until this moment she thought there was another option. That maybe she could just take a bunch of ginkgo and she’d be okay. And yet once she hears everything the doctor says, she’s just so resigned.

I feel helpless. I feel scared for her. I’m never comfortable in doctors’ offices to begin with, but when I see my mom this vulnerable, it’s just too much to take. I notice my dad keeps looking at me to make sure I’m okay, when really the only person we should be concerned about is Mom.

When all is said and done the doctor asks if we have any questions. The only question I can think to ask is Why? But I don’t ask.

• • •

The tests come back positive. Which sounds so misleading. Positive. She has Alzheimer’s. The doctor explains the different medicines. He tells us the one he’s leaning toward doesn’t cure it—nothing does—but it will improve her thinking, memory, attention span, and ability to do simple tasks.

We’re all crowded into the same tiny room again as we listen to the doctor give us the results of her memory screening and diagnostic workup. He tells us about her orientation, attention, cognitive skills, and recall. He tells us again that her test results are all consistent with Alzheimer’s. Every time he says it I flinch. They can’t stop the disease, but they can slow the progression in some people. He tells us of the emotional, physical, and financial challenges of caring for someone with Alzheimer’s, and mentions that caregivers are subject to high levels of stress and that we should all do as much research on the subject as possible, which will not only help my mom but will also help us understand and cope.

Then he starts talking about her diet. Says he’d also like her to take vitamin E and vitamin C twice a day, and tells us that a diet rich in omega-3 fatty acids could positively impact cognitive decline. I notice that everything he says is directed at us. Not her. It dawns on me that my mom can no longer take care of herself. And I want to cry.

Instead I storm out. Then I cry.