Diagnosis
We sit in the neurologist’s waiting room, my mother struggling to complete a form about her personal information. She holds the pen loosely while the boxes and text of the page somehow impede her ability to write.
“Name,” she whispers loudly. She writes “Carol” above the designated box.
“That’s for your last name,” I correct her. She frowns, and then quickly scribbles her surname above the “first name” box.
“Date of birth,” she sounds out the words, her eyes moving across the page. “Oh, I should know this.” Her evenly-toned voice is only as concerned as if thinking of the answer to a trivia question. There is no hint of the hours she spent crying as my father tried to help her re-memorize her birthday.
“June 1953,” I coach, trying to ignore the receptionist’s blatant staring from behind the check-in window.
“Oh, I should have known that,” my mother repeats.
“Why don’t I finish this,” I say as she struggles to fill in the numbers. I commandeer the clipboard and stop almost immediately at the next section. “Do you have your Social Security number in your purse?” I ask.
She turns her head toward me, her eyes unfocused and wandering. “What?”
“We’ll wait until Dad gets here,” I sigh, counting the minutes until he can leave his job for the day. The receptionist continues to ogle from over the top of her computer screen. My face reddens and I try to ignore the fire burning in my cheeks. Some people have no shame, I think, though I know if the roles were reversed, I would be unable to look away.
***
My father, mother, and I sit in the examination room, eagerly waiting for this, the fourth new doctor in five months, to provide some explanation for my mother’s slow memory loss.
The forty-something doctor wears khakis and a turtle neck, his Med. Center id covered in plastic and dangling around his neck. He is accompanied by a medical student, who is probably just a few years older than me. The young woman is carrying a clipboard, pen, stethoscope, and a pocket full of notepads. She is the only one of the pair wearing a lab coat, and I wonder about the neurologist, is this guy freelancing as a doctor, or just going casual?
My father and I sit in chairs along the wall. I’m holding a pad of yellow lined paper and a pen, assigned to take as many notes as possible.
My mother sits in a chair along another wall where she can easily look out the room’s only window. We watch as the doctor asks her to sit on the high examining bed. She stares through eyes narrowed by suspicion. The doctor repeats the instructions, and she tries twice before successfully hoisting herself atop the raised platform.
The doctor checks usual vital signs: pupils, reflexes, heartbeat; all the while, my mother silently pleads across the small room for the awkwardness to be over.
Next, the doctor asks my mother to remove her shoes so he can check a few more things. Today, she is wearing chunky, bright white tennis shoes, almost identical to a pair I wore in middle school ten years earlier. She gets them off, but asks twice if he is sure she has to remove them. This makes her very uncomfortable—especially since she knows we are all watching her.
The tests are easy, and she does them well: walk around the room, touch her toes, turn in a circle.
That’s my mom, I think, more interested in her ability to complete simple actions than any larger issues.
The doctor says she can sit back down, so she takes back the chair next to the window. She is very preoccupied with putting her shoes back on, but the doctor continues with ten diagnostic questions.
Of these, she fails every one.
“What city are we in?” he asks.
She names the town she lives in, the town I live in, and finally the right one.
“Repeat these three things: pencil, tree, chair.”
She can’t say one back.
“Draw a circle, and then put an ‘X’ inside of it,” he says, handing her a pencil and paper.
“Circle?” she asks, scribbling a line on the page.
He draws a hexagon and asks her to draw one just like it. She gets two sides before making it into a triangle.
She is nervous, and I want to shout at him, No, she can do this! You are asking her wrong. She just doesn’t like everyone watching her. The doctor isn’t being inconsiderate, just trying to be as proficient as possible. The medical student takes notes on a little notepad, not saying anything. She is somber, but the corners of her face twitch as she tries to plaster a layer of professionalism over the curiosity bubbling under the surface. She cannot take her eyes off of my mother.
“Has Carol shown any other differences in behavior besides memory loss?” the doctor asks my father.
My father thinks a minute then replies that my mother does the dishes obsessively, as well as daily loads of laundry. “Usually she would let them build up a little,” he says, thinking about how frequently she is at the sink.
“I think she’s compensating,” the doctor explains, “for the things she isn’t sure about. She is trying to make herself useful.”
The doctor asks if we brought any of her records from other doctors, and my dad hands him a folder stuffed with computer printouts, mailed sheets, results of countless blood tests, paperwork from a spinal tap, notes from a psychiatric visit, and a disk with my mother’s last M.R.I. My father hands them over, silently pleading, “please, take this chaos of the last year and create some order from it.”
I, too, am armed, only with half a dozen far-reaching scenarios that my sisters, friends, and I had amassed over the past few months to explain the slow memory loss. All of them abnormal, but each one treatable.
Suddenly, I realize: my father wants an answer; I want a cure.
As soon as the doctor leaves with the med student, my mother continues putting on her shoes.
“That wasn’t too bad,” I say, trying to comfort her.
“I just want to go home,” she replies.
***
Columns of sunlight drift in through the doctor’s window and surround my mother, just as they had at lunch a few hours earlier. As I watch her fumble with the laces, I think about the conversation we had over bistro sandwiches and small bags of potato chips, when we sat and killed time before the appointment. The restaurant had been illuminated by artificial lighting that seemed dim in comparison to the blinding rays spewing in from the curtain-less windows by our booth. We joked about wearing sunglasses inside, and then moved the conversation to my sisters, other various family members, summer plans…and repeated complaints from my mother that she did not want to have this doctor’s visit.
Right now this detail goes unnoticed, but it will become entangled with my memory of this moment. My mother and light rays will become two of the most vivid images I remember from this day.
***
When the doctor returns, he takes a seat on a rolling stool hidden beside the bed and holds a clipboard in his lap. “I think Carol has a form of dementia, and quite possibly early onset Alzheimer’s disease,” he says, his voice detached, his eyes focused on my father.
My father doesn’t say anything; he doesn’t move, and I don’t know if he’s breathing.
My eyes reflexively dart to my mother, who just looks straight at the floor; the same position she’d been in for the last few minutes. Any recognition of the term “Alzheimer’s” seems to have gone right over her head. She has no idea what this conversation is about.
Though I continue taking notes of what the doctor explains as the symptoms and key signs, my mind is replaying our lunch, and the hope that I had felt that morning of finding out what was happening to my mother. Until the very moment, my mother was suffering short-term memory loss; she was temporarily sick; she was curable. Until this moment, there was the possibility that my mother as I had always known her would return.
I continue taking notes as silent tears splash the notepad. In this moment, I am frustrated and angry —not at the doctor, but at the news, though right now I cannot tell the difference. Unwilling to accept his diagnosis, I assail him with other possible causes. I try to keep my composure by writing the responses as the doctor counters my theories of Lyme disease, aspartame poisoning, and side effects of sleep deprivation, extreme depression, and radon exposure.
My pen stops only when the doctor has written a prescription for new medication and escorted us over to Scheduling. He wants a six-month checkup for my mother. I vow to return with more “believable” prognoses next time.
My mother smiles as we talk with the nurse. My dad seems to act as if everything is normal, and I try to avoid an emotional breakdown. My mother laughs with the nurse—she is glad to be leaving, glad to see me, and glad to go home. She no longer has any idea what the word “Alzheimer’s” means, but my father and I do, and that one word will change our lives forever.
“Name,” she whispers loudly. She writes “Carol” above the designated box.
“That’s for your last name,” I correct her. She frowns, and then quickly scribbles her surname above the “first name” box.
“Date of birth,” she sounds out the words, her eyes moving across the page. “Oh, I should know this.” Her evenly-toned voice is only as concerned as if thinking of the answer to a trivia question. There is no hint of the hours she spent crying as my father tried to help her re-memorize her birthday.
“June 1953,” I coach, trying to ignore the receptionist’s blatant staring from behind the check-in window.
“Oh, I should have known that,” my mother repeats.
“Why don’t I finish this,” I say as she struggles to fill in the numbers. I commandeer the clipboard and stop almost immediately at the next section. “Do you have your Social Security number in your purse?” I ask.
She turns her head toward me, her eyes unfocused and wandering. “What?”
“We’ll wait until Dad gets here,” I sigh, counting the minutes until he can leave his job for the day. The receptionist continues to ogle from over the top of her computer screen. My face reddens and I try to ignore the fire burning in my cheeks. Some people have no shame, I think, though I know if the roles were reversed, I would be unable to look away.
***
My father, mother, and I sit in the examination room, eagerly waiting for this, the fourth new doctor in five months, to provide some explanation for my mother’s slow memory loss.
The forty-something doctor wears khakis and a turtle neck, his Med. Center id covered in plastic and dangling around his neck. He is accompanied by a medical student, who is probably just a few years older than me. The young woman is carrying a clipboard, pen, stethoscope, and a pocket full of notepads. She is the only one of the pair wearing a lab coat, and I wonder about the neurologist, is this guy freelancing as a doctor, or just going casual?
My father and I sit in chairs along the wall. I’m holding a pad of yellow lined paper and a pen, assigned to take as many notes as possible.
My mother sits in a chair along another wall where she can easily look out the room’s only window. We watch as the doctor asks her to sit on the high examining bed. She stares through eyes narrowed by suspicion. The doctor repeats the instructions, and she tries twice before successfully hoisting herself atop the raised platform.
The doctor checks usual vital signs: pupils, reflexes, heartbeat; all the while, my mother silently pleads across the small room for the awkwardness to be over.
Next, the doctor asks my mother to remove her shoes so he can check a few more things. Today, she is wearing chunky, bright white tennis shoes, almost identical to a pair I wore in middle school ten years earlier. She gets them off, but asks twice if he is sure she has to remove them. This makes her very uncomfortable—especially since she knows we are all watching her.
The tests are easy, and she does them well: walk around the room, touch her toes, turn in a circle.
That’s my mom, I think, more interested in her ability to complete simple actions than any larger issues.
The doctor says she can sit back down, so she takes back the chair next to the window. She is very preoccupied with putting her shoes back on, but the doctor continues with ten diagnostic questions.
Of these, she fails every one.
“What city are we in?” he asks.
She names the town she lives in, the town I live in, and finally the right one.
“Repeat these three things: pencil, tree, chair.”
She can’t say one back.
“Draw a circle, and then put an ‘X’ inside of it,” he says, handing her a pencil and paper.
“Circle?” she asks, scribbling a line on the page.
He draws a hexagon and asks her to draw one just like it. She gets two sides before making it into a triangle.
She is nervous, and I want to shout at him, No, she can do this! You are asking her wrong. She just doesn’t like everyone watching her. The doctor isn’t being inconsiderate, just trying to be as proficient as possible. The medical student takes notes on a little notepad, not saying anything. She is somber, but the corners of her face twitch as she tries to plaster a layer of professionalism over the curiosity bubbling under the surface. She cannot take her eyes off of my mother.
“Has Carol shown any other differences in behavior besides memory loss?” the doctor asks my father.
My father thinks a minute then replies that my mother does the dishes obsessively, as well as daily loads of laundry. “Usually she would let them build up a little,” he says, thinking about how frequently she is at the sink.
“I think she’s compensating,” the doctor explains, “for the things she isn’t sure about. She is trying to make herself useful.”
The doctor asks if we brought any of her records from other doctors, and my dad hands him a folder stuffed with computer printouts, mailed sheets, results of countless blood tests, paperwork from a spinal tap, notes from a psychiatric visit, and a disk with my mother’s last M.R.I. My father hands them over, silently pleading, “please, take this chaos of the last year and create some order from it.”
I, too, am armed, only with half a dozen far-reaching scenarios that my sisters, friends, and I had amassed over the past few months to explain the slow memory loss. All of them abnormal, but each one treatable.
Suddenly, I realize: my father wants an answer; I want a cure.
As soon as the doctor leaves with the med student, my mother continues putting on her shoes.
“That wasn’t too bad,” I say, trying to comfort her.
“I just want to go home,” she replies.
***
Columns of sunlight drift in through the doctor’s window and surround my mother, just as they had at lunch a few hours earlier. As I watch her fumble with the laces, I think about the conversation we had over bistro sandwiches and small bags of potato chips, when we sat and killed time before the appointment. The restaurant had been illuminated by artificial lighting that seemed dim in comparison to the blinding rays spewing in from the curtain-less windows by our booth. We joked about wearing sunglasses inside, and then moved the conversation to my sisters, other various family members, summer plans…and repeated complaints from my mother that she did not want to have this doctor’s visit.
Right now this detail goes unnoticed, but it will become entangled with my memory of this moment. My mother and light rays will become two of the most vivid images I remember from this day.
***
When the doctor returns, he takes a seat on a rolling stool hidden beside the bed and holds a clipboard in his lap. “I think Carol has a form of dementia, and quite possibly early onset Alzheimer’s disease,” he says, his voice detached, his eyes focused on my father.
My father doesn’t say anything; he doesn’t move, and I don’t know if he’s breathing.
My eyes reflexively dart to my mother, who just looks straight at the floor; the same position she’d been in for the last few minutes. Any recognition of the term “Alzheimer’s” seems to have gone right over her head. She has no idea what this conversation is about.
Though I continue taking notes of what the doctor explains as the symptoms and key signs, my mind is replaying our lunch, and the hope that I had felt that morning of finding out what was happening to my mother. Until the very moment, my mother was suffering short-term memory loss; she was temporarily sick; she was curable. Until this moment, there was the possibility that my mother as I had always known her would return.
I continue taking notes as silent tears splash the notepad. In this moment, I am frustrated and angry —not at the doctor, but at the news, though right now I cannot tell the difference. Unwilling to accept his diagnosis, I assail him with other possible causes. I try to keep my composure by writing the responses as the doctor counters my theories of Lyme disease, aspartame poisoning, and side effects of sleep deprivation, extreme depression, and radon exposure.
My pen stops only when the doctor has written a prescription for new medication and escorted us over to Scheduling. He wants a six-month checkup for my mother. I vow to return with more “believable” prognoses next time.
My mother smiles as we talk with the nurse. My dad seems to act as if everything is normal, and I try to avoid an emotional breakdown. My mother laughs with the nurse—she is glad to be leaving, glad to see me, and glad to go home. She no longer has any idea what the word “Alzheimer’s” means, but my father and I do, and that one word will change our lives forever.
