I had a phone call on Monday morning. The woman asks for George. I tell her that George has signed a paper — she can talk to me.
The neurology consultation that was scheduled for July — would we like to get in on Thursday instead?
Yeah. We would. So, that’s set.
By “we,” I mean: My father-in-law, George, who is the patient. His wife, Carole. His son, Kevin, who is my husband. And me. The nurse has to bring in more chairs.
My mother-in-law, who isn’t the patient this time, has dementia that manifests as thought loops. She gets stuck on ideas. Repeats the same sentence over and over until something else knocks it out of its orbit.
After the nurse leaves, Carole says, “That black nurse sure was nice, wasn’t she?” I smell a loop, from the first time she says it. And I’m right. I close my eyes and say a silent little prayer that it will let go of her brain before anyone else came in the room.
The doctor walked into the room and actually did a little double-take, but he took the crowd in stride.
I wonder how often he faces rooms full of people. He’s a brain doctor. Surely George isn’t the first or only patient he’s ever had who wouldn’t be able to manage an appointment like this on his own.
He needs his wife. She needs her son.
My husband is an only child. He was thirty-five when we met. When he was twenty, he moved out on his own for the first time — and his father had a heart attack almost immediately. He moved home again and never left until we were married.
The three of them are like a three-legged stool. Or like two planets who orbit around George who is the sun. They wobble without him.
I’m there, in that little exam room, because someone with some remove has to be.
And now it’s official. We didn’t have to wait until July to find out for sure, although we already knew. Deep down, we did. George has dementia that’s not caused by depression or a vitamin B12 deficiency (even though he has both) or by any other medical cause.
When everything else is ruled out, the doctor says, the answer is most likely Alzheimer’s Disease.
And there’s Carole’s next loop. She asks every three or four minutes for the rest of the meeting — so you’re saying he has the start of Alzheimer’s?
The doctor says, every three or four minutes, right back — no, this isn’t the start. This is in it. This is the middle. He’s clearly has broken this news before. He does it with a kind bluntness that leaves no space for false hope.
George was probably deteriorating for years, he says. It was well masked by his natural inclination toward routine and by a wife who has taken care of him on a micro-level for more than fifty years.
When Carole got sick two years ago, it became more obvious. She wasn’t there to make his meals or speak for him if he forgot his words. By the end of her hospitalization, it was clear they couldn’t live alone anymore. That’s how they ended up in our basement apartment.
Things will get worse. There is no slowing this thing. The symptoms, maybe, can be held back a little with medication. Maybe not. If the side-effects (diarrhea, vomiting . . .) are too much, it’s okay to stop the taking it. Just stop it, like that. Leave the doctor a message, so he knows, but no need to get permission.
Because it’s probably not going to do much anyway.
A Mediterranean diet might help. Maybe. But probably not.
Exercise. Maybe. But probably not.
Staying busy is always a good thing, but it won’t slow things down. It certainly will not reverse it.
Nothing really will help much. The goal is to keep him living at home (especially since he didn’t plan for a good retirement, much less Alzheimer’s disease.) And happy.
If he’s confused, but doesn’t know he’s confused, that’s something to hope for.
Usually it’s the loss of bodily functions that precipitates a move to a higher level of care. Or when he starts wondering off and we can’t keep him safe anymore.
But that’s probably some time off.
What goes through my mind is that he’s lost his stories. He will lose other things, he has already. But it’s his stories that have gone first. And I think about my own dad, five-hundred miles away.
We’ve been debating a move back to Las Vegas and suddenly I know we’ll do it. We’ll do it because my dad is seventy and I will not be able to forgive myself if I’m 500 miles away if a kindly blunt doctor ever tells him that he’s lost his stories and they aren’t coming back.
It’s important, the doctor tells me privately, as we leave. It’s important that Kevin and I take care of ourselves. After George tells him that it’s 1977. After he’s spent half an hour clearly noticing that Carole is nearly as confused as her husband.
It’s important, he says. This will be a long haul. A very long haul.
Shaunta Grimes is a writer and teacher. She lives in Reno with her husband, three superstar kids, and a yellow rescue dog named Maybelline Scout. She’s on Twitter @shauntagrimes and is the author of Viral Nation and Rebel Nation and the upcoming novel The Astonishing Maybe. She is the original Ninja Writer.