“So Alice, tell me what’s been going on.”
“I’ve been having lots of problems remembering, and it doesn’t feel normal. I’m forgetting words in lectures and conversation, I need to put ‘cognition class’ on my to-do list or I might forget to go teach it, I completely forgot to go to the airport for a conference in Chicago and missed my flight. I also didn’t know where I was for a couple of minutes once in Harvard Square, and I’m a professor at Harvard, I’m there every day.”
“How long have these things been going on?”
“Since September, maybe this summer.”
“Alice, did anyone come here with you?”
“No.”
“Okay. In the future, you’re going to have to bring a family member or someone who sees you regularly in with you. You’re complaining about a problem with your memory; you may not be the most reliable source of what’s been going on.”
She felt embarrassed, like a child. And his words “in the future” harassed her every thought, commanding obsessive attention, like water dripping from a faucet.
“Okay,” she said.
“Are you taking any kind of medicine?”
“No, just a multivitamin.”
“Any sleeping pills, diet pills, drugs of any kind?”
“No.”
“How much do you drink?”
“Not a lot. One or two glasses of wine with dinner.”
“Are you a vegan?”
“No.”
“Have you had any sort of past injury to your head?”
“No.”
“Have you had any surgeries?”
“No.”
“How are you sleeping?”
“Perfectly fine.”
“Have you ever been depressed?”
“Not since I was a teenager.”
“How’s your stress level?”
“The usual, I thrive under stress.”
“Tell me about your parents. How’s their health?”
“My mother and sister died in a car accident when I was eighteen. My father died of liver failure last year.”
“Hepatitis?”
“Cirrhosis. He was an alcoholic.”
“How old was he?”
“Seventy-one.”
“Did he have any other problems with his health?”
“Not that I know of. I didn’t really see much of him over the last several years.”
And when she did, he was incoherent, drunk.
“What about other family?”
She relayed her limited knowledge of her extended family’s medical history.
“Okay, I’m going to tell you a name and address, and you’re going to repeat it back to me. Then, we’re going to do some other things, and I’m going to ask you to repeat the same name and address again later. Ready, here it is—John Black, 42 West Street, Brighton. Can you repeat that for me?”
She did.
“How old are you?”
“Fifty.”
“What is today’s date?”
“December twenty-second, 2003.”
“What season is it?”
“Winter.”
“Where are we right now?”
“Eighth floor, MGH.”
“Can you name some of the streets near here?”
“Cambridge, Fruit, Storrow Drive.”
“Okay, what time of day is it?”
“Late morning.”
“Name the months backward from December.”
She did.
“Count backward from one hundred by six.”
He stopped her at seventy-six.
“Name these objects.”
He showed her a series of six cards with pencil drawings on them.
“Hammock, feather, key, chair, cactus, glove.”
“Okay, before pointing to the window, touch your right cheek with your left hand.”
She did.
“Can you write a sentence about today’s weather on this piece of paper?”
She wrote, “It is a sunny but cold winter morning.”
“Now, draw a clock and show the time as twenty minutes to four.”
She did.
“And copy this design.”
He showed her a picture of two intersecting pentagons. She copied them.
“Okay, Alice, hop up on the table. We’re going to do a neurological exam.”
She followed his penlight with her eyes, she tapped her thumbs and pointer fingers together rapidly, she walked heel to toe in a straight line across the room. She did everything easily and quickly.
“Okay, what was that name and address I told you earlier?”
“John Black…”
She stopped and searched Dr. Davis’s face. She couldn’t remember the address. What did that mean? Maybe she just hadn’t paid close enough attention.
“It’s Brighton, but I can’t remember the street address.”
“Okay, is it twenty-four, twenty-eight, forty-two, or forty-eight?”
She didn’t know.
“Take a guess.”
“Forty-eight.”
“Was it North Street, South Street, East Street, or West Street?”
“South Street?”
His face and body language didn’t expose whether she’d guessed right, but if she had to guess again, that wasn’t it.
“Okay, Alice, we have your recent blood work and MRI. I want you to go for some additional blood work and a lumbar puncture. You’re going to come back in four to five weeks, and you’ll have an appointment for neuropsychological testing on that same day, before you see me.”
“What do you think is going on? Is this just normal forgetting?”
“I don’t think it is, Alice, but we need to investigate it further.”
She looked him directly in the eye. A colleague of hers had once told her that eye contact with another person for more than six seconds without looking away or blinking revealed a desire for either sex or murder. She reflexively hadn’t believed this, but it had intrigued her enough to test it out on various friends and strangers. To her surprise, with the exception of John, one of them always looked away before the six seconds was up.
Dr. Davis looked down at his desk after four seconds. Arguably, this meant only that he wanted neither to kill her nor tear her clothes off, but she worried that it meant more. She would get prodded and assayed, scanned and tested, but she guessed that he didn’t need to investigate anything further. She’d told him her story, and she couldn’t remember John Black’s address. He already knew exactly what was wrong with her.
ALICE SPENT THE EARLIEST PART of Christmas Eve morning on the couch, sipping tea and browsing through photo albums. Over the years, she had transferred any newly developed pictures to the next available slots beneath the clear plastic sleeves. Her diligence had preserved their chronology, but she’d labeled nothing. It didn’t matter. She still knew it all cold.
Lydia, age two; Tom, age six; and Anna, seven, at Hardings Beach in June of their first summer at the Cape house. Anna at a youth soccer game on Pequossette Field. She and John on Seven Mile Beach on Grand Cayman Island.
Not only could she place the ages and setting in each snapshot but she could also elaborate in great detail on most of them. Each print prompted other, unphotographed memories from that day, of who else had been there, and of the larger context of her life at the time that the image was captured.
Lydia in her itchy, powder blue costume at her first dance recital. That was pretenure, Anna was in junior high and in braces, Tom was lovesick over a girl on his baseball team, and John lived in Bethesda, on sabbatical for the year.
The only ones she had any real trouble with were the baby pictures of Anna and Lydia, their flawless, pudgy faces often indistinguishable. She could usually find clues, however, that revealed their identities. John’s muttonchop sideburns placed him solidly in the 1970s. The baby in his lap had to be Anna.
“John, who’s this?” she asked, holding up a picture of a baby.
He looked up from the journal he’d been reading, slid his glasses down his nose, and squinted.