by Lisa Genova
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.
“Is that Tom?”
“Honey, she’s in a pink onesie. It’s Lydia.”
She checked the Kodak-printed date on the back to be sure. May 29, 1982. Lydia.
“Oh.”
He pushed his glasses back up onto the bridge of his nose and resumed reading.
“John, I’ve been meaning to talk to you about Lydia’s acting classes.”
He looked up, dog-eared the page, set the journal on the table, folded his glasses, and settled back in the chair. He knew this wouldn’t be quick.
“All right.”
“I don’t think we should be supporting her out there in any way, and I certainly don’t think you should be paying for her classes behind my back.”
“I’m sorry, you’re right, I meant to tell you, but then I got busy and forgot, you know how it gets. But I disagree with you on this, you know I do. We supported the other two.”
“That’s different.”
“It’s not. You just don’t like what she picked.”
“It’s not the acting. It’s the not going to college. The window of time she’s likely to ever go is rapidly closing, John, and you’re making it easier for her to stay out.”
“She doesn’t want to go to college.”
“I think she’s just rebelling against who we are.”
“I don’t think it has anything to do with what we want or don’t want or who we are.”
“I want more for her.”
“She’s working hard, she’s excited and serious about what she’s doing, she’s happy. That’s what we want for her.”
“It’s our job to pass on our wisdom about life to our kids. I’m really afraid she’s missing out on something essential. The exposure to different subjects, different ways of thinking, the challenges, opportunities, the people you meet. We met in college.”
“She’s getting all that.”
“It’s not the same.”
“So it’s different. I think paying for her classes is more than fair. I’m sorry I didn’t tell you, but you’re hard to talk to about this. You don’t ever budge.”
“Neither do you.”
He glanced at the clock on the fireplace mantel, reached for his glasses, and placed them on top of his head.
“I’ve got to go to lab for about an hour, then I’ll pick her up at the airport. You need anything while I’m out?” he asked as he stood to leave.
“No.”
They locked eyes.
“She’s going to be fine, Ali, don’t worry.”
She raised her eyebrows but didn’t say anything. What else could she say? They’d played this scene out together before, and this was how it ended. John argued the logical path of least resistance, always maintaining his status as the favorite parent, never convincing Alic
e to switch over to the popular side. And nothing she said swayed him.
John left the house. Relaxed in his absence, she returned to the pictures in her lap. Her adorable children as babies, toddlers, teenagers. Where did the time go? She held the baby picture of Lydia that John had guessed was Tom. She felt a renewed and reassuring confidence in the strength of her memory. But of course, these pictures only opened the doors to histories housed in long-term memories.
John Black’s address would have lived in recent memory. Attention, rehearsal, elaboration, or emotional significance was needed if perceived information was to be pushed beyond the recent memory space into longer-term storage, else it would be quickly and naturally discarded with the passage of time. Focusing on Dr. Davis’s questions and instructions had divided her attention and prevented her from rehearsing or elaborating on the address. And although his name elicited a bit of fear and anger now, the fictitious John Black had meant nothing to her in Dr. Davis’s examining room. Under these circumstances, the average brain would be quite susceptible to forgetting. Then again, she didn’t have an average brain.
She heard the mail drop through the slot in the front door and had an idea. She looked at each item once—a baby wearing a Santa hat pictured on a holiday greeting card from a former graduate student, an advertisement for a fitness club, the phone bill, the gas bill, yet another L.L.Bean catalog. She returned to the couch, drank her tea, stacked the photo albums back on the shelf, and then sat very still. The ticking clock and brief eruptions of steam from various radiators made the only sounds in the house. She stared at the clock. Five minutes passed. Long enough.
Without looking at the mail, she said aloud, “Baby in Santa hat card, gym membership offering, phone bill, gas bill, another L.L.Bean catalog.”
Piece of cake. But to be fair, the time between being presented with John Black’s address and being asked to recall it had been much longer than five minutes. She needed an extended delay interval.
She grabbed the dictionary off the shelf and devised two rules for picking a word. It had to be low frequency, one she didn’t use every day, and it had to be a word that she already knew. She was testing her recent memory, not learning acquisition. She opened the dictionary to an arbitrary page and put her finger down on the word “berserk.” She wrote it on a piece of paper, folded it, put it in her pants pocket, and set the timer on the microwave for fifteen minutes.
One of Lydia’s favorite books when she was a toddler was Hippos Go Berserk! Alice went about the business of readying for Christmas Eve dinner. The timer beeped.
“Berserk,” without hesitation or needing to consult the piece of paper.
She continued playing this game throughout the day, increasing the number of words to remember to three and the delay period to forty-five minutes. Despite this added degree of difficulty and the added likelihood of interference from the distraction of dinner preparation, she remained error-free. Stethoscope, millennium, hedgehog. She made the ricotta raviolis and the red sauce. Cathode, pomegranate, trellis. She tossed the salad and marinated the vegetables. Snapdragon, documentary, vanish. She put the roast in the oven and set the dining room table.
Anna, Charlie, Tom, and John sat in the living room. Alice could hear Anna and John arguing. She couldn’t make out the topic from the kitchen, but she could tell it was an argument by the emphasis and volume of the back-and-forth. Probably politics. Charlie and Tom were staying out of it.
Lydia stirred the hot mulled cider on the stove and talked about her acting classes. Between concentrating on making dinner, the words she needed to remember, and Lydia, Alice didn’t have the mental reserve to protest or disapprove. Uninterrupted, Lydia spoke in a free and passionate monologue about her craft, and despite Alice’s strong bias against it, she found she couldn’t resist being interested.
“After the imagery, you layer on the Elijah question, ‘Why this night rather than any other?’” said Lydia.
The timer beeped. Lydia stepped aside without being asked, and Alice peeked in the oven. She waited for an explanation from the undercooked roast long enough for her face to become uncomfortably hot. Oh. It was time to recall the three words in her pocket. Tambourine, serpent…
“You’re never playing everyday life as usual, the stakes are always life and death,” said Lydia.
“Mom, where’s the wine opener?” Anna hollered from the living room.
Alice struggled to ignore her daughters’ voices, the ones her mind had been trained to hear above all other sounds on the planet, and to concentrate on her own inner voice, the one repeating the same two words like a mantra.
Tambourine, serpent, tambourine, serpent, tambourine, serpent.
“Mom?” asked Anna.
“I don’t know where it is, Anna! I’m busy, look for it yourself.”
Tambourine, serpent, tambourine, serpent, tambourine, serpent.
“It’s always about survival when you boil it down. What does my character need to survive and what will happen to me if I don’t get it?” said Lydia.
“Lydia, please, I don’t want to hear about this right now,” Alice snapped, holding her sweaty temples.
“Fine,” said Lydia. She turned herself squarely toward the stove and stirred vigorously, obviously hurt.
Tambourine, serpent.
“I still can’t find it!” yelled Anna.
“I’ll go help her,” said Lydia.
Compass! Tambourine, serpent, compass.
Relieved, Alice took out the ingredients for the white-chocolate bread pudding and placed them on the counter—vanilla extract, a pint of heavy cream, milk, sugar, white chocolate, a loaf of challah bread, and two half-dozen cartons of eggs. A dozen eggs? If the piece of notebook paper with her mother’s recipe on it still existed, Alice didn’t know where it was. She hadn’t needed to refer to it in years. It was a simple recipe, arguably better than Marty’s cheesecake, and she’d made it every Christmas Eve since she was a young girl. How many eggs? It had to be more than six, or she would’ve taken out only one carton. Was it seven, eight, nine?
She tried skipping over the eggs for a moment, but the other ingredients looked just as foreign. Was she supposed to use all of the cream or measure out only some of it? How much sugar? Was she supposed to combine everything all at once or in a particular sequence? What pan did she use? At what temperature did she bake it and for how long? No possibility rang true. The information just wasn’t there.
What the hell is wrong with me?
She revisited the eggs. Still nothing. She hated those fucking eggs. She held one in her hand and threw it as hard as she could into the sink. One by one, she destroyed them all. It was marginally satisfying, but not enough. She needed to break something else, something that required more muscle, something that would exhaust her. She scanned the kitchen. Her eyes were furious and wild when they met Lydia’s in the doorway.
“Mom, what are you doing?”
The massacre had not been confined to the sink. Empty shards of shell and yolk were splattered all over the wall and counter, and the faces of the cabinets were streaked with tears of albumen.
“The eggs were past the expiration date. There’s no pudding this year.”
“Aw, we have to have the pudding, it’s Christmas Eve.”
“Well, there aren’t any more eggs, and I’m tired of being in this hot kitchen.”
“I’ll go to the store. Go into the living room and relax, I’ll make the pudding.”
Alice walked into the living room, shaking but no longer riding that powerful wave of anger, not sure whether she was feeling deprived or thankful. John, Tom, Anna, and Charlie were all seated and in conversation, holding glasses of red wine. Apparently, someone had found the opener. With her coat and hat on, Lydia poked her head into the room.
“Mom, how many eggs do I need?”
JANUARY 2004
She had good reasons to cancel her appointments on the morning of January nineteenth with the neuropsychologist and D
r. Davis. Harvard’s exam week for the fall semester fell in January, after the students returned from Winter Break, and the final exam for Alice’s cognition class was scheduled for that morning. Her attendance wasn’t crucial, but she liked the sense of closure that being there provided, of seeing her students through the course from start to finish. With some reluctance, she arranged for a teaching fellow to proctor the exam. The bigger good reason was that her mother and sister had died on January nineteenth, thirty-two years ago. She didn’t consider herself superstitious like John, but she’d never received good news on that day. She’d asked the receptionist for another date, but it was either then or four weeks from then. So she took it, and she didn’t cancel. The idea of waiting another month was that unappealing.
She imagined her students back at Harvard, nervous about what questions they would be asked, hurrying a semester’s worth of knowledge onto the pages of their blue exam books, hoping their heavily crammed short-term memories wouldn’t fail them. She understood exactly how they felt. Most of the neuropsychological tests administered to her that morning—Stroop, Raven’s Colored Progressive Matrices, Luria Mental Rotation, Boston Naming, WAIS-R Picture Arrangement, Benton Visual Retention, NYU Story Recall—were familiar to her. They were designed to tease out any subtle weakness in the integrity of language fluency, recent memory, and reasoning processes. She had, in fact, taken many of them before, serving as a negative control in the cognition studies of various graduate students. But today, she wasn’t a control. She was the subject being tested.
The copying, recalling, arranging, and naming took almost two hours to complete. Like the students she imagined, she felt relieved to be done and fairly confident in her performance. Escorted by the neuropsychologist, Alice entered Dr. Davis’s office and sat in one of the two chairs arranged side by side, facing him. He acknowledged the empty chair next to her with a disappointed sigh. Even before he spoke, she knew she was in trouble.
“Alice, didn’t we talk about you coming here with someone last time?”
“We did.”
“Okay, it’s a requirement of this unit that every patient comes in with someone who knows them. I won’t be able to treat you properly unless I have an accurate picture of what’s going on, and I can’t be sure I have that information without this person present. Next time, Alice, no excuses. Do you agree to this?”