by Greg O'Brien
“Do you know you’re supposed to be dead?” a nurse asked me bluntly, trying to engage in conversation, keeping a solemn moment as light as possible, and yet discerning my motive.
“Yeah, but no one had the courtesy to tell me,” I replied.
My mind was racing at the time. I thought of favorite writer Joseph Heller, author of Catch 22, who wrote, “He was going to live forever, or die in the attempt.” I was trying to die in the attempt and was reaching for the stars, fully detached, and now fading in mind and body. Alone in my cubicle, as doctors tried to discern how to stop the bleeding, I had my come-to-Jesus moment. The light. I sensed a powerful, pure bright light at the end of a tunnel; I was at peace and hoped my mother, grandfather, dad, and brothers Gerard and Martin would be there to greet me, but in my gut, I knew this wasn’t my time, not my call. I looked to the ground and saw the pool of blood on the floor, as I had witnessed years earlier with my father in a wheelchair. I cried out on the brink: “Lord, take me home, or bring me back, but please don’t leave me in this place.”
Within minutes, I was wheeled into a surgical unit, and doctors determined how to stop the bleeding. There would be no final trip to Pluto today. The flight had been cancelled.
For all of us, there is a cycle of birth, life, and death. And there are second chances. The human body is intent on living, in spite of what happens in illness. Cells keep multiplying, breathing is involuntary; the brain, even when teetering, directs the intention to live and create. My second chance was reinforced with another encounter with Dr. Alice Daley, the physician on call, a caring individual who had presided over my parents’ end-of-life conversation. Clearly, we were in an orbital path.
“I hope, Doctor, you’re not going to give me the: ‘it’s-ok-to-die’ speech today,” I said as she entered the room.
Dr. Daley smiled in a way that said I had dodged a bullet, direct to the head.
“Go, and sin no more,” the nurse on duty replied. It was a sobering directive.
****
Apoplectic over news of my hospital stay, my personal physician, Dr. Conant, was far more direct the following week regarding my failed attempt to bleed to death. He scribbled in my medical record after a follow-up visit: “Discussed ambivalent feelings, re: near miss with exsanguination. Very concerned about worsening memory; he has to use maps and tricks to function daily; long discussion regarding risk factors.”
Dr. Conant then took a blank piece of paper and drew a bell curve, as if I were back in the sixth grade. He placed a large “X” on the downward slope. “Here’s where you are,” he said, trying yet again to get my attention. “You need to back down on commitments that require high-level cognitive and judgment.”
“Time is running out,” he said. “Things are going to get worse. Do I have to come over to your house and declare you incompetent? If that’s what it takes, I will.”
The words were difficult to swallow. I love Barry like a brother, but screw him, I raged in anger. Sure he had my best interest at heart, but, you know, just screw him. Who does he think he is, a doctor or something?
“Worse, Barry?” I thought to myself, aping again a line from Christmas Vacation. Take a look around you, Barry. We’re at the threshold of hell!
That afternoon I tried to cut through my angst by mowing the lawn, about an acre and a half of it. Driving my sitdown, I was still stewing over what Conant had told me earlier.
Time is running out? I repeated to myself. Really? Yeah, well, Barry, we’ll see.
Trimming the slope behind the house, I noticed that my favorite watch, a gift from my wife, was loose on my left wrist. Within seconds, as I cut between the reedy locusts and a thick pine, the watch, to my horror, slowly slipped off my left wrist and fell to the ground. I witnessed the cutting blade suck the watch under the mower and spit out the remains; a small section of the watch band and a silver, oval watch frame were all that was left.
“Time is running out!” The words echoed through my brain. I’ve kept the oval watch frame and stretch of band in the top draw of my dresser as a reminder of vulnerability.
****
I was feeling particularly vulnerable at my buddy Paul Durgin’s 60th birthday party in Milton outside Boston in late spring. The town and surrounding area is filled with overachieving Irish types from Boston who have dropped their “R”s, and have learned to walk upright—surnames like Mulligan, Norton, Corcoran, Cunningham, Mulvoy, Forry, Brett, and Flynn. I’m comfortable with this lot, fully in my wheelhouse, but today I’m listing portside in the wake of more confusion, swamped by memory loss and the failure at times to recognize old friends. I used to work a room like a seasoned politican; they called me “the senator from Cape Cod”—always with a friendly hand out, piercing eye contact, a quip for all. But in the moment, I’m feeling detached and isolated, a full spin cycle from extravert to intravert—a dizzying turnabout in personality. I’m comfortable in my own skin; it’s just that now I don’t want anyone in there with me.
And so I made the rounds as best I could, trying to reminisce with guys I’ve known for more than a quarter century, following a script that I’ve used many times before. I’ve learned, as a strategy, to keep the chat short, get to the point, move on, and hope that I’m not asked to retrieve information lost. The strategy is tiring, and often “just inches for a quick getaway,” as Jack Nicholson jibed in Terms of Endearment, I get sucked into a black hole of conversation, a gravity pull for me that is smothering. After a fretful working of the room that afternoon, I retired to a seat of comfort—outside the Durgin house, behind the wheel of my car parked on the street. I sat there for an hour and a half, just grabbing the steering wheel, trying to understand what had just happened, and hoping to drive off the face of the earth, yet I knew I was stuck in the present. How did I get to this place?
Reluctantly, I returned to the party, feeling like a time warrior. Paul and his wife, Leslie, knew the drill.
“You back from your planet yet?” asked Leslie.
“Yeah,” I replied, “It was a wobbly trip!”
****
The flight back from San Francisco several months later with daughter Colleen was shaky, lots of forceful air currents rocking the US Airways flight to Boston. I was there on business, and Colleen, as she has throughout my life, was at my side. Doctors have advised me not travel alone. In between meetings, San Francisco was a blissful father-daughter bonding just months before her marriage to Matt Everett, a fine Baltimore lad with misplaced sports loyalties, at least in my silly parochial mind. But that’s what I love about Matt; he presses forward against all odds.
So does Colleen. On the direct flight home from San Francisco, the airline booked me next to an Emergency Exit in the front of the cabin; Colleen in the seat next to me. The flight attendent asked if I was up to the task. Hell, yes, I thought. Colleen obliged. But it was not a good place for me. Some where over Chicago, I was disoriented from being on a plane for hours, and had to take a leak. Happens. My mind told me that the door to the bathroom was directly to the right, the Emergency Exit; all I had to do was to pull up the level. So I grabbed for it. Just seemed the right thing to do.
“Daaaaaad!” Colleen screamed in a cry that could be heard in back of the plane. “What the hell are you doing?”
With my right hand on the Emergency Exit lever, I realized from my daughter’s chilling tone that this was not a good idea. And surely it wasn’t. In a flash, I envisioned being sucked out of the plane with my daughter, along with rows 2 through 30. Helluva way to end a good trip; kinda puts a damper on it.
I envisioned authorities telling my wife: “Your nut of a husband decided to take a short cut home, and things didn’t work out well for the rest of the passengers. That really sucks, ma’am!”
Relax. I won’t sit near the Emergency Exit anymore. Promise!
****
Dr. Conant’s bell curve was beginning to resonate. The bell would toll again on a business trip to Martha’s Vineyard, while meeting
clients at the Chowder House Tavern, elegantly appointed in oak and mahogany, near the edge of pristine Oak Bluffs harbor. With its gingerbread and camp-style architecture, Oak Bluffs is a fantasy unto itself with its network of curving narrow streets. “Carpenter’s Gothic,” it is called here. In the mid-1800s, the town was the site in summer of huge revivalist-Methodist camp meetings in Wesleyan Grove, named after John Wesley, the open-air preacher and founder of the Methodist movement. I was in need of big amen that night.
Looking for my clients as I entered the Chowder House—where I’ve eaten many times—I saw a snug anteroom to the right that I had never noticed before. It was decorated much the same as the restaurant, with people sitting around the bar seeming to have fun. They were waving at me. I looked closer and saw my clients at a table in the corner. I waved back, trying to determine how to enter the room. I couldn’t find the door. I knocked on the window, beckoning the clients to come get me. They started laughing. I knocked again. They waved back, almost taunting me. I kept searching for the door, and in frustration, worked my way to the men’s room, thinking there might be access there. No luck. When I returned to the window, the clients were still waving and laughing. I knocked again, then my attention was drawn over my right shoulder. I was stunned at what I saw. My clients were sitting right behind me. I had been looking into a mirror, in the moment peering into infinity, the gateway to a parallel universe, in the vicinity of the Kuiper Belt.
The memory is still vivid. If you squint, you can see Pluto and beyond from the Vineyard.
****
“Memory is everything. Without it we are nothing,” observed neuroscientist Eric Kandel, winner of the 2000 Nobel Prize for his groundbreaking research on the physiology of the brain’s capacity for memory. Memory is the glue, Kandel said, that binds the mind and provides continuity. “If you want to understand the brain,” his late mentor, eminent neurologist Harry Grundfest, counseled him, “you’re going to have to take a reductionist approach, one cell at a time.”
Cell by cell, Kandel took the brain apart. Had he dug a bit deeper, he might have found that memory isn’t all that it’s cracked up to be. While memory offers delineating context and perspective, it doesn’t define us. Definition is found in the spirit, in the soul, but one must dig for it. “An unexamined life,” Socrates once said, “is not one worth living.”
I was in a circumspect mood on the way with Mary Catherine to snug Camden, Maine to celebrate her 61st birthday in late August 2013, stopping off for the night in Portland, a maritime city set on a hill downwind from the Atlantic. Early the next morning, outside the red brick Portland Regency Hotel, the seagulls were dive bombing the downtown in a mock scene from Alfred Hitchcock’s masterpiece, The Birds. The sun was bright at 6 am, lighting up the cobblestone streets; the air was crisp with a hint of fall on this pure, idyllic morning. Even the Portland Press Herald breathed of innocence. Its lead headline on the local and state page reports, “Dunkin’ Donuts Tries New Paper Cup.”
It’s a story about new paper cups designed to mimic plastic foam by keeping the coffee warm in the cup, “cool on the outside.” I was feeling cool on the inside this morning, as I looked about me and began to drift, caught again in a time travel. Soft music from the Regency lobby drifted outside to a nearby park bench where I sat with my back to the sea. Oldies were playing. I heard the Lennon/McCartney song, Yesterday, and was drawn to it.
Yesterday, I was flush with hope; today, I’m adrift in thoughts and images I can’t seem to control. They rule me. Often, I just go with the flow. I’ve acquired a few techniques along the way. One of them is to learn from nature.
You can smell the sea on the road outside Camden. West Penobscot Bay with the secluded archipelago Fox Islands in the distance at the edge of the Gulf of Maine frames a swath of blue that runs endlessly in a way to make one think the world is flat. The archipelago, with its jewels Vinal Haven and Hurricane Island, was first inhabited in 3300 BC by Native Americans called “The Red People.” The rocky coast of Camden and neighboring Rockport, an artistic, cerebral town of about 3,000, if you count the living and the dead, is a place of mind-numbing perspective. Nature overwhelms here, bringing one to the realization of being surrounded by something much larger than one’s essence. There is great security in knowing this, even more for those with Alzheimer’s.
Sitting by myself on a porch in Rockport with white columns, mahogany railings, and 180-degree views of the bay, I come to understand that I’m not alone. This classic Maine cottage, owned by my brother-in-law, Charlie Henderson, a retired Chicago money manager, stretches the definition of cottage with its 6,000 square feet of Down East elegance. It seems to me more of a biblical ark—300-cubits long, 50 wide, and 30 high—than a home. As I look out over a remnant of the world’s animals, I spot the graceful flight of two ospreys. The majestic sea hawks, weighing about four pounds, with wing spans up to six feet, have a human element to them in instinct and in species. Ospreys are the single-living species in the animal kingdom that exist worldwide. A bird of prey, they mate for life, are nesting home bodies, tediously care for their young, and have voracious appetites: a diet of freshly caught fish. I watch the pair of ospreys practice diving runs over the bay. They fly in circles in tighter orbits, almost like the cone of a tornado, then they strike with wings tucked in an explosion at the surface of the bay. They snatch their prey with fighter-pilot visions from behind, and with sharp talons that act as fishhooks, lifting the prey to the heavens in aerodynamic flight with the fish head first. Then it’s back to the nest for supper. The nest, the size of a Volkswagen bug, sits atop a spike on a 50-foot pine with a commanding view of West Penobscot Bay. My brother-in-law tells me that the nest was destroyed four years ago in a pounding nor’easter. The mating ospreys rebuilt the nest the following spring, twig by twig. The mother, he says, sat in what was left of the nest, while the father flew in building materials. She was cawing at him as if to complain, “Wrong size!”
But, like humans, the eyes and instinct for survival of ospreys are often bigger than their stomachs. The Irish poet William Butler Yeats used the wandering osprey as a symbol of sorrow in his 1889 work, The Wanderings of Oisin and Other Poems. At times, its prey is so heavy that the osprey can’t lift it. Their fish hook talons can’t release, and they are pulled to the sea and drown.
Nature has taught me legions today. Even in death, survival is ever pursued.
****
Back on the Cape, days later at the end of a frenetic summer, I sit in my office with my collection of memories, and the sounds of silence are everywhere. Lessons of the journey invite the stillness. I’ve come now to understand that Alzheimer’s is not about the past—the successes, the accolades, the accomplishments. They offer only context and are worthless on places like Pluto. Alzheimer’s is about the present and the struggle, the scrappy brawl, the fight to live with a disease. It’s being in the present, the relationships, the experiences, which is the core of life, the courage to live in the soul. It doesn’t matter much to me anymore that I don’t remember names or faces, that memory is a lost art, and that I must employ improvisations daily, the tricks of spontaneous intervention. I am always intervening on my own behalf, just to steady the boat—trimming the sails, looking for the terra firma of life, simply to discern where I am. Only to find that a higher power is at the tiller.
All too often, those with the disease have become voiceless, locked in their own insecurities and symptoms, and misunderstood by those who just don’t want to go there. Like every man and woman, these time travelers in disease need guidance, acceptance, trust, and love. So, go there with them at times to Pluto, try to fathom their journey. It’s not such a bad place. We can all get to Pluto; it’s just that some of us are not coming back.
In a stretch, Alzheimer’s is a form of cognitive dissonance. In a state of dissonance, individuals often feel “disequilibrium,” frustration, dread, guilt, anger, embarrassment, anxiety. And so it is with Alzheimer’s. All at once. Perha
ps one might understand the denial, the deflection of Alzheimer’s: like the ceramic elephant from Santa Fe in my office.
Within weeks of my return, the herd was thundering again in a series of chilling manifestations.
****
The elephant emerged again today with sad words that a close college buddy from the University of Arizona, Pat Calihan, had died of dementia. A Phoenix native, Pat excelled in sports, friendship, and in life. He was an Irish storyteller, a mentor to many, a man with a tenacious work ethic and steadfast integrity. We shared many good times over the years on the playing fields, on the ski slopes of the Mogollon Rim, and in the pubs—talking about life, death, and all that happens in between. Pat was an everyman, with an innate ability to connect with people. A handsome dude, who in his youth had sunny blond hair and eyes the color of soldier blue; Pat had game. In college, we gave him the enduring nickname of “Whetto,” and for reasons of political correctness, I won’t disclose why. But the tag stuck, as his zest for life ever deepened.
Years ago, Pat intuitively knew something was wrong and tried to deflect it. Others close to him observed it, as well. The neurons weren’t firing right, but still Pat fought on. In time, the diagnosis came like a death notice: an accelerated form of dementia. Pat, still “Whetto” in spirit, began to fade. He never gave up the will to live, until life itself snatched the will from him. As his obituary noted: “Pat was stricken in the prime of life with an ailment that eventually took away his cognitive abilities but never his thirst for life. But not his soul, not his being; never complaining, never compromising.”