In some people it reverses in five years. But they’ve only been doing it for seven years, so who knows?
Gus had diagrammed the benefits. At very best he would be cured. Most likely they would only have spent a lot of money to slow the disease down. “And even if I’m cured, the disease could come roaring back,” he’d said. “I don’t think I want to have this disease for a long time. I know I don’t want to have it twice.”
His hands are small for a man, which sounds dainty but isn’t. His hands are perfect, the nails neat and smooth, but he hadn’t been fussy. He’d been deft with a pencil, had been good at engineering drawings before they did them on computer, and his diagram of benefits and liabilities on a piece of computer paper had been neat. “Don’t cry,” he’d said.
Gus couldn’t handle it when she cried. For the thirty years of their marriage, when she’d had to cry—which was always at night, at least in her memory—she’d gone downstairs after he’d gone to sleep and sat on the couch and cried. She would have liked him to comfort her, but in marriage you learn what other people’s limits are. And you learn your own.
For the cost of her house, she can have them put an enzyme in Gus’s brain that will scrub out the Alzheimic plaque that has replaced so much of his neural structure. And then they will put in undifferentiated cells and a medium called Transglycyn and that medium will contain a virus that tells the DNA within the cells to create neurons and grow him a new brain.
She calls Dan in Boulder.
“I thought you and Dad didn’t want to do this,” Dan says.
“I thought so, too,” she says. “But I didn’t know what it would be like.”
Dan is silent. Digital silence. You can hear a pin drop silence. “Do you want me to come home?” he asks.
“No,” she says. “No, you stay out there. You just started your job.” Dan is a chef. He studied at the Culinary Institute of America, and spent a couple of years as a line chef in the Four Seasons in New York. Now Etienne Corot is opening a new restaurant in Boulder called, of course, “Corot,” and Dan has gotten a job as sous-chef. It’s a promotion. The next step in making a name for himself, so that someday he can open his own restaurant.
“You need to keep your eye on Schuster’s,” she says. It’s an old joke between them, that he’s going to open a four-star restaurant called Schuster’s. They both agree that Schuster’s sounds like a Big Boy franchise.
“ ‘Artesia,’ ” he says.
“Is that it?” she asks.
“That’s the latest name,” he says. They have been trading names for the restaurant he will someday open since he started at the Culinary Institute. “You like it?”
“As long as I don’t think about the cattle town in New Mexico.”
“No shit,” he says, and she can imagine him at the other end of the phone, ducking his head the way his dad does. Dan is an inch taller than Gus, with the same long legs and arms. Unfortunately, he got her father’s hairline and already, at twenty-five, his bare temples make her tender and protective.
“I can fly out,” he says.
“It’s not like surgery,” she says, suddenly irritated. She wants him to fly out, but there isn’t any point in it. “And I’d get tired of us sitting there holding hands for the next three months while they eradicate the plaque, because as far as you and I will be able to tell, nothing will be happening.”
“Okay,” he says.
“Dan,” she says. “I feel as if I’m spending your money.”
“I don’t care about the money. I don’t like to talk about it that way, anyway,” he says. “I just feel weird because Dad said not to do it.”
“I know,” she says. “But I don’t feel as if this person is your dad anymore.”
“It won’t be Dad when it’s done, will it?” Dan says.
“No,” Mila says. “No, but at least maybe it will be a person who can take care of himself.”
“Look, Mom,” he says, his voice serious and grown-up. “You’re there. You’re dealing with it every day. You do what you have to do. Don’t worry about me.”
She feels tears well up in her eyes. “Okay, honey,” she says. “Well, you’ve got stuff you need to do.”
“Call me if you want me to come out,” he says.
She wants him off the phone before she cries. “I will,” she says.
“Love you, Mom,” he says.
She knows he can tell she was crying.
“I’m not sick,” Gus says.
“It’s a check-up,” Mila says.
Gus sits on the examining room table in his shorts and T-shirt. It used to be that she said the litany of what she loved when she saw him like this—his nose, his blue eyes made to look the distance, the hollow of his collarbone, his long legs. Show me your butt, she’d say, and he’d turn and shake it at her and they’d cackle like children.
“We’ve waited long enough,” Gus says.
“It’s not that long,” Mila says, and at that moment the doctor knocks and opens the door. With him is a technician, a black woman, with a cart.
“Who are you?” Gus says.
“I’m Dr. Feingold.” He is patient, is Dr. Feingold. He met with them for an hour yesterday and he talked with them for a few minutes this morning before Gus had his blood work. But Gus doesn’t remember. Gus was worse than usual. They are in Atlanta for the procedure. Lexington, Kentucky, and Windsor, Ontario, both have clinics that do the procedures, but Dr. Feingold had worked with Raymond Miller, the Ph.D. who originated the treatment. So she picked Atlanta.
Gus is agitated. “You’re not my doctor,” he says.
Dr. Feingold says, “I’m a specialist, Mr. Schuster. I’m going to help you with your memory problems.”
Gus looks at Mila.
“It’s true,” she says.
“You’re trying to hurt me,” Gus says. “In fact, you’re going to kill me, aren’t you?”
“No, honey,” she says. “You’re sick. You have Alzheimer’s. I’m trying to help you.”
“You’ve been poisoning me,” Gus says. Is it because he’s scared? Because everything is so strange?
“Do you want to get dressed?” Dr. Feingold says. “We can try this in an hour.”
“I don’t want to try anything,” Gus says. He stands up. He’s wearing white athletic socks and he has the skinny calves of an old man. The disease has made him much older than fifty-seven. In a way she is killing him. Gus will never come back and now she’s going to replace him with a stranger.
“Take some time,” Dr. Feingold says. Mila has never been to a doctor’s office where the doctor wasn’t scheduled to death. But then again, she’s never paid $74,000 for a doctor’s visit, which is what today’s injection of brain scrubbing Transglycyn will cost. Not really just the visit and the Transglycyn. They’ll stay here two more days and Gus will be monitored.
“Goddamn,” Gus says, sitting back down. “Goddamn you all.”
“All right, Mr. Schuster,” Dr. Feingold says.
The technician pushes the cart over and Dr. Feingold says, “I’m going to give you an injection, Mr. Schuster.”
“Goddamn,” Gus says again. Gus never much said “Goddamn” before.
The Transglycyn with the enzyme is supposed to be injected in the spine but Dr. Feingold takes a hypodermic and gives Gus a shot in the crook of his arm.
“You just lie there a moment,” Dr. Feingold says.
Gus doesn’t say anything.
“Isn’t it supposed to be in his back?” Mila says.
“It is,” Dr. Feingold says, “but right now I want to reduce his agitation. So I’ve given him something to calm him.”
“You didn’t say anything about that,” she says.
“I don’t want him to change his mind while we’re giving him the enzyme. This will relax him and make him compliant.”
“Compliant,” she says. She’s supposed to complain, they’re drugging him and they didn’t tell her they would. But she’s pretty used t
o him not being compliant. Compliant sounds good. It sounds excellent. “Is it a tranquilizer?” she asks.
“It’s a new drug,” Dr. Feingold says. He is writing it down on Gus’s chart. “Most tranquilizers can further agitate patients with Alzheimer’s.”
“I have Alzheimer’s,” Gus says. “It makes me agitated. But sometimes I know it.”
“Yes, Mr. Schuster,” Dr. Feingold says. “You do. This is Vicki. Vicki is someone who helps me with this all the time, and we’re very good at doing it, but when we roll you on your side, I need you to lie very still, all right?”
Gus, who hated when doctors patronized him, says dopily, “All right.” Gus, who during a colonoscopy, higher than a kite on Demerol, asked his doctor if they had gotten to the ileum, because even with his brain cradled in opiates, Gus just liked to know.
Vicki and Dr. Feingold roll Gus onto his side.
“Are you comfortable, Mr. Schuster?” Vicki asks. She has a down-home Atlanta accent.
Dr. Feingold goes out the door. He comes back in with two more people, both men, and they put a cushion behind Gus’s knees so it’s hard for him to roll over, and then another cushion at the back of his neck.
“Are you all right, Mr. Schuster?” Dr. Feingold asks. “Are you comfortable?”
“Okay,” Gus says, fuzzy.
Vicki pulls his undershirt up and exposes his knobby backbone. Dr. Feingold marks a place with a black pen. He feels Gus’s back like a blind woman, his face absent with concentration, and then he takes a needle and says, “There will be a prick, Mr. Schuster. This will make the skin on your back numb, okay?” He gives Gus another shot.
Gus says “Ow” solemnly.
And then Dr. Feingold and Vicki make some marks with the pen. Then there is another needle, and Dr. Feingold makes a careful injection in Gus’s back. He leaves the needle in a moment, pulls the part of the hypodermic out that had medication in it, and Vicki takes it and gives him another one and he puts that in the hypodermic and injects it.
Mila isn’t sure if that’s more painkiller or the Transglycyn.
“Okay, Mr. Schuster,” Dr. Feingold says. “We’re done with the medicine. But you lie still for a few minutes.”
“Is it like a spinal tap?” Mila asks. “Will he get a headache?”
Dr. Feingold shakes his head. “No, Mrs. Schuster, that’s it. When he feels like sitting up, he can.”
So now it is inside him. Soon it will start eating the plaque in his brain.
The places it will eat clean were not Gus anymore, anyway. It’s not as if Gus is losing anything more. It bothers her, though, the Transglycyn goo moving along the silver-gray pathways of his neurons, dissolving the Swiss cheese damage of the disease. And then, what, there are gaps in his head? Fluid-filled gaps in his brain, the tissue porous as a sponge and poor Gus, shambling along, angry and desperate.
She wants to stroke his poor head. But he is quiet now, sedated, and maybe it’s best to let him be.
* * *
The clinic is more like a hotel than a hospital, the bed has a floral bedspread and over it is a painting of cream and peach roses in a vase. After being sedated during the day, Gus is restless. He will not go to bed. If she goes to bed he’ll try to go out into the hall, but the door is locked from the inside so he can’t get out. There’s a touchpad next to the door and she’s used 0815, Dan’s birthday, as the code. She doesn’t think Gus knows Dan’s birthday anymore. A sign on the door says, IN CASE OF FIRE, ALL DOORS WILL OPEN AUTOMATICALLY. Gus runs his fingers along the crack between the door and the wall. “I want to go out,” he says, and she says that he can’t. “I want to go out,” he says, and she says, “We’re not home, we have to stay here.”
“I want to go out,” he says, again and again, long after she stops answering him. He finally sits and watches five minutes of television but then he gets up and goes back to the door. “Let’s go home,” he says this time, and when she doesn’t answer, he runs his long fingers like spiders up and down the edge of the door. He sits, he gets up and stands at the door for minutes, twenty, thirty minutes at a time, until she is blind with fatigue and her eyes burn with tears and she finally shrieks, “There’s no way out!”
For a moment he looks at her, befuddled. The he turns back to the door and says querulously, “I want to go out.”
At one point she goes to him and folds both his hands in hers and says, “We’re both trapped.” She is dizzy with fatigue but if she cries he will just get worse. He looks at her and then goes back to searching the door, moth fingers fluttering. She turns out the light and he howls, “Oww-ow-oww-ow—” until she snaps the light back on.
Finally, she shoves past him and locks him in the room. She goes down to the lounge and sits on a couch, pulling her bare feet up and tucking them under her nightgown. The lounge is deserted. She thinks about sleeping here for a few hours. She feels vacant and exposed. She leans her head back and closes her eyes and there is the distant white noise of the ventilation system and the strange audible emptiness of a big room and she can feel her brain swooping instantly into a kind of nightmare where she is sliding into sleep thinking someone is sick and she needs to do something and when she jerks awake her whole body feels a flush of exhaustion.
She can’t stay here. Is Gus howling in the room?
When she opens the door he is standing there, but she has the odd feeling he may not have noticed she was gone.
He finally lets her talk him into lying down around 3:15 in the morning but he is up again a little after six.
She asks the next day if it is the stuff they’ve injected, but of course, it’s not. It’s the strangeness. The strange room, the strange place, the Alzheimer’s, the ruin of his brain.
The social worker suggests that until they are ready to insert the cellular material and stimulate neural growth, Gus should go to a nursing facility for elderly with dementia.
Even if she could afford it, Mila thinks she would have to say no. When they resculpt his brain, he will be a different person, but she will still be married to him, and she wants to stay with him and to be part of the whole process, so that maybe her new husband, the new Gus, will still be someone she loves. Or at least someone she can be married to.
Mila is lucky they can afford this. It is an experimental treatment so insurance doesn’t cover the cost. She and Gus have money put away for retirement from his parents and hers, but she can’t touch that or capital gains taxes will go off, as her accountant says, like a time bomb. But they can sell their house.
The old house sells for $217,000. The first half of the treatment is about $74,000. The second half of the treatment is a little over $38,000. Physical therapy is expected to cost a little over $2,100 a month. Home health is $32,000 through an agency (insurance will no longer pay because this is an experimental treatment). That doesn’t include airfare and a thousand incidentals. At least the house is paid off, and the tax man does some finagling and manages to save her $30,000 for a down payment on a little townhouse.
It has two floors, a postage stamp-sized backyard, and monthly maintenance fees of $223 a month. Her mortgage is $739 a month.
It has a living room and kitchen downstairs and two bedrooms upstairs. The carpet is a pale gray, and her living room furniture, which is all rich medieval reds and ochre and ivory, doesn’t go well, but it doesn’t look bad, either.
“Why is our couch here?” Gus asks plaintively. “When can we go home?”
One evening when he says he wants to go home she puts him in the car and starts driving. When Dan was a baby, when he wouldn’t go to sleep, the sound of a car engine would soothe him, and this evening it seems to have the same effect on Gus. He settles happily into the passenger seat of their seven-year-old Honda sedan, and as she drives he strokes the armrest and croons. She’s not sure at first if the crooning means he’s agitated, but after a while she decides it’s a happy sound.
“You like going for a ride?” she says to him.
He do
esn’t answer but he keeps on crooning, “ooo-ooo-ooo-ooo.”
Another night she wakes up alone in the bed. Alzheimer’s victims don’t sleep much. Used to be that if Gus or Dan got up in the night she heard them, but she’s pretty tired these days.
She finds him downstairs in the kitchen, taking the bowl of macaroni and cheese out of the refrigerator. It’s covered in foil because she’s out of plastic wrap. “Are you hungry?” she asks.
Gus says, “I can take care of it.” His tone is ordinary and reassuring. He puts the bowl in the microwave.
“You can’t put it in the microwave, honey,” Mila says. “You have to take the foil off the top first.” She hates that she only calls him “honey” when she is exasperated with him, and when she doesn’t want to make him angry. It feels passive aggressive. Or something.
Gus closes the microwave door and pushes the time button.
“Gus,” she says, “don’t do that.” She reaches past him and opens the microwave door, and he pushes her away.
“Gus,” she says, “don’t.” She reaches for the door and he pushes her away again.
“Leave it alone,” he says.
“You can’t,” she says. “It’s got foil on it.” Gus is an engineer, for God’s sake. Or was.
She tries to stop him, puts her hand on his forearm, and he turns to face her, his face a grimace of anger, and he pulls his arm back and punches her in the face.
He is still a strong, tall man and the punch knocks her down.
She doesn’t even know how to feel it. No one has punched her since she was maybe twelve, and that was a pretty ineffective punch, even if her nose did bleed. It stops her from thinking. She is lying on the kitchen floor. Gus pushes the start button on the microwave.
Mila touches her face. Her lip is cut, she can taste the blood. Her face hurts.
There is a flicker as the microwave arcs. She doesn’t have it in her to get up and do anything about it. Gus frowns. Not at her, at the microwave.
Mila sits up and explores her face. One of her teeth feels wobbly to her tongue. Gus doesn’t pay any attention, he’s watching the microwave. He’s intent. It’s a parody of the engineer solving a problem.
The Year's Best Science Fiction: Twentieth Annual Collection Page 34