by Nancy Rue
“Who came up with that?” I said to the screen.
It just blinked back at me and gave me a list of symptoms that could have been taken out of my diary entries about Mother—if I’d been keeping one. But what really shook me was the description of the later stages, given coldly, as if the writer were making out a grocery list:
Total loss of motor control
Total loss of all language functions
Severe dementia
There was no cure, it told me matter-of-factly. The progression couldn’t even be slowed down. Its rate varied from a duration of less than two years to well over ten.
That’s about the time I turned the computer off and made myself a cup of extra-strong Earl Grey. There was no way. We had to be talking at worst a tumor—which would more than probably be operable—or at best a case of severe mid-life crisis, which, knowing Mother, she could knock out of commission in about three sessions with a psychiatrist. Make that two.
By the time I finished deciding all that, the sun had long since come up and it was time to head for Sloan. I splashed some cold water on my face and threw on an outfit I wasn’t sure was a whole lot better than the little number my mother had worn the day before.
The woman is haunting me, I thought as I headed across campus at a trot. We have to resolve this.
I was practically running by the time I got there, and I forced myself to slow down and get it together. Just because my mother was losing it didn’t mean I had to. It was time to get out of the what-to-do-about-Mother compartment and into the what’s-going-on-with-my-thesis slot. It would be bad form to actually look like I’d been up all night when I met with Nigel.
I fumbled in my bag for a clip and, using the front door for a mirror, organized my hair into some semblance of order. There wasn’t much I could do about the bags, fully packed, under my eyes. For once I wished I did drink more coffee.
I closed my eyes, took a couple of deep breaths, and pushed through the double doors. They swung open into the cool, clean, orderly place that was my real world.
Except that Jacoboni was right there, leaning into the half-door on the department office.
“Have mercy, McGavock,” he said. “I thought you looked bad yesterday.”
I gave him a sour look and glanced at my watch. “What are you doing here at this hour? Am I that late?”
“No, the Arab terrorists roped me into meeting them for breakfast. Do people really eat at this ungodly hour?”
“The who?” I said. And then I put up a hand. “Never mind. I don’t want to know.”
“Actually it’s Peter and Rashad, but—”
“Jill, I’ve been looking for you.”
It was Nigel, emerging from the classroom across from the department office. It took a few seconds for that to register. My brain was like a 45 rpm being played at 33⅓.
“I’m sorry,” I said. “My mother and I had an accident yesterday on the way to lunch—”
To my utter amazement, Nigel put out a hand and curled it around my arm. “Come in here. We don’t need to discuss this in the hallway.” He drew me toward the classroom door, his eyes on Jacoboni. “Keep the noise to a minimum, would you, please, Alan? I have a class taking an exam in here.”
I let him usher me into the classroom like I was some kind of bereaved mourner, but the minute we were in I managed to tactfully pull away. His eyes swept the room where ten students were hunched over their Scantrons and wiping away beads of sweat. Nigel motioned me toward one of the wide windowsills on the bowed window that overlooked Lomita Mall and the Science and Engineering Quad beyond it. I perched dutifully and tried to reclaim an aura of composure. Fortunately, I’d just clipped my hair back or I would’ve raked it.
“Have you had a chance to look at my new proposal?” I said.
Nigel gave me a long look.
Not a good sign, I thought.
“Is it a huge problem?” I said. “I felt confident about—”
“Were you hurt?” he said.
“By what? I haven’t checked my mailbox yet this morning. Did you put some kind of reply in there? If the proposal is trash, I can deal with that.”
“I’m talking about your accident.” Nigel’s normally impassive face was puckered. Was every middle-aged person I knew undergoing a personality transplant?
“I’m fine,” I said. “A couple of stitches and a bump on the head. I’m ready to get focused on this issue.”
“And your mother?”
She has nothing to do with this! I wanted to shriek at him. Only my reverence for all things mathematical reined me in. I explained my mother’s injuries, leaving out the part about the psychiatric evaluation. Stanford was a mammoth community as universities go, but its grapevine was as efficient as any.
“It’s nothing life-threatening,” I said.
“But certainly enough to distract you.” Nigel shook his head slightly. “We do not have to talk about this today. A couple of days for you to regroup and be there for your mother isn’t going to hinder you that much.”
If we don’t talk about this right now, I thought, I may explode. That would hinder me.
“Look, Dr. Frost,” I said evenly, “I don’t mix my personal life with my academic life. Whatever needs to be done to get me back on track, I’d like to know now. Did I not go far enough with my thesis? Are you thinking I may be scooped again?”
I could tell I had Nigel a little unnerved, because he was patting his pocket for his half-glasses, which I spotted up on the overhead projector. Fine. Let him be unnerved. This wasn’t about his life anyway.
“My notes are upstairs in my office,” he said when he had given up the search for his specs.
“Shall I go get them?” I said.
“No,” he said heavily. “I would prefer not to go into detail at this time. I will tell you, however, that in my view you may have gone further than you need to with the new thesis. There’s a chance you won’t be able to finish the necessary work on schedule, especially given your mother’s injuries.”
He apparently noticed my jaw tighten, because he continued.
“There are only so many hours in the day, Jill,” Nigel said. “No matter how you juggle them, they still come down to twenty-four. Subtracting sleep, you’re left with sixteen.”
If I got eight hours of sleep a night I’d think I had narcolepsy, I thought.
“I see that you disagree,” he said.
He was getting good at reading me. I didn’t think I was so transparent.
“We will discuss this more thoroughly,” he said. “At present, I think it’s best you simply do what you can in your—” he paused—“academic life.”
I heard his deliberate emphasis, and I resented it. My voice went cold as I said, “Do you have any objections to my continuing work on my thesis until we have a more in-depth discussion? I have to go in the same direction, no matter what is decided about the conclusion.”
He absently patted his pocket again. “It would not be my choice, and I’m advising you against it. However, there will be no official consequences if you do. It is ultimately your decision how you integrate the various aspects of your life.”
“Thank you,” I said.
As I padded out of the room, I could feel him still watching me. He was “integrating” just a tad too much as far as I was concerned. My personal life was none of his business. Having him cross that line was worse than getting the once-over from Jacoboni. Who, I decided as I scooped the paperwork out of my mailbox, was going to get zero details about the accident. Nothing. Nada.
I headed down the hall toward the stairs, quickening my steps as I passed the break room with its odor of overcooked coffee. It was getting more tempting by the minute to take up the caffeine habit. Shuffling mail as I hurried down the steps, I stopped cold in front of the lecture hall at the bottom and stared at my mail. Stuck between the proclamation from American Express that I had qualified for a Gold Card and the latest plea from a distraught freshman to let
him take his midterm late was a pink While You Were Out slip telling me to call a Dr. Fenwick at Stanford Hospital—re: Your Mother.
I took the rest of the turns at a near crawl as I studied it. It couldn’t be an emergency or they’d have called on my cell phone. I’d given the number to that second impertinent little resident. Of course, chances were he’d lost it.
When I got to my office, a dig through my bag revealed that I’d left the cell phone in my apartment. I went for the stairs again and climbed to the grad student lounge on the second floor. It was the only phone we had access to, though with everybody packing wireless it was always available.
I tapped the pink slip against the window as I waited endlessly for Dr. Fenwick to come to the phone. Who the heck was that, anyway? I’d talked to so many doctors the day before, I was surprised I remembered my own name. I stopped tapping and made a concerted effort to pull myself in. It was the crossover from mother-world into math-world that was stressing me out, and that was going to be my downfall if I didn’t nip it in the bud.
“This is Dr. Fenwick,” a deep voice said into the phone.
“Jill McGavock returning your call,” I said. “Regarding Elizabeth McGavock, my mother.”
“I know your mother well. We did some work together at UC San Francisco years ago.”
I impatiently pulled the clip out of my hair and shook it out as I waited for him to cut the chitchat.
“We were able to schedule a psych consult last night,” he said. “The psychiatrist on call was Dr.—”
“What did he say?”
“He was able to get your mother to talk—minimally—enough to conclude that this is not a psychiatric problem.”
“So it’s not depression, stress, schizophrenia, mid-life crisis.”
“Right. Obviously those aren’t things we can run blood tests for, but all the indicators rule those out.”
“So she hasn’t gone around the bend. What’s next?”
“As her primary care physician, I’d like to call in a neurologist and have some tests done.”
“For?”
“A number of possibilities.”
“Name them,” I said.
“I don’t want to scare you.”
“I don’t scare. What are you looking for?”
“We’ll want to rule out the possibility of a tumor. Then we’ll look for evidence of brain disease, which can’t be diagnosed with certainty, but we’ll look for indicators and match those with her behaviors.”
“Constellation of findings,” I said. I didn’t want him to think he was dealing with an imbecile.
“Correct,” he said. I heard him chuckle. “You are your mother’s daughter. You’re not in med school, are you?”
“No. So let me be clear on this—you’re looking for a tumor, brain diseases—dementias?”
“We’ll consider that, but again, let’s not jump to any conclusions.”
Jump? Pal, the conclusions are standing there waiting to slap us in the face.
“How soon can they run the tests?” I said.
“Since she’s already here, and because she’s on staff, I think we can expedite the process somewhat. Say, results by day after tomorrow?”
Forty-eight hours. Could I handle that?
Of course I could handle it. Why shouldn’t I be able to? Where the heck had that question come from?
“Fine,” I said. “Should I call you or—”
“I’ll catch up to you at the hospital. I’m sure you’ll be there spending time with your mom.”
“How long is she going to be in there, anyway?” I asked.
“You’re looking at a good four or five days—and that of course is contingent on whatever we find in the neuro workup.”
I hung up feeling something even my mother had never been able to make me feel: that my life was somehow not completely my own anymore.
SIX
The next forty-eight hours elongated themselves like a pair of stretch pants. I was so busy tearing from Stanford Hospital to Sloan and back to the hospital—barely touching down at Escondido for a change of clothes and a few hours’ catch-up work—the time should have flown by. But the hours, I learned, tend to drag when nothing is as it’s always been. And nothing was.
During the day, it wasn’t too hard to keep my mind on teaching, tutoring, and making up for lost time on my thesis. When I didn’t have to be at my desk for office hours, I worked in a corner of the computer room so I didn’t have to put up with Jacoboni. My sessions with Tabitha were trying, because her inability to grasp derivatives seemed to be directly proportional to my need to get back to my own work.
But the evenings were decidedly more difficult. I spent them in my mother’s hospital room amid the veritable jungle of flowers and potted plants that had been delivered. When she was awake, I sat next to her bed, across from Max on the other side, trying to get her to say something. It was a challenge I never imagined myself facing. Max was content to pretend Mother was participating. It drove me nuts. I hated small talk under the best of circumstances.
When she was asleep, I prowled the room while Max kept up a nonstop monologue.
“God forbid it’s a tumor,” he’d say. “It can’t be a tumor. She hasn’t complained about pain. Although, you think she’d tell me if she were in pain? She wouldn’t tell me. When she broke her arm skiing up at Tahoe, did she say a word? No. She’s a martyr. She could’ve been in agony all this time and who would know?”
“She’s not a martyr, Max,” I told him. “She’s a lot of things, but that’s not one of them.”
We must have had the same conversation about twelve times over those two nights, and we were launching into a thirteenth go-round the second evening when two men in signature white coats came in, looking doctor-grave. I glanced at the name tag on one of them: Carl J. Fenwick, M.D. The other one I couldn’t see because the man must have been six foot nine. His head barely cleared the doorway.
“Jill,” Fenwick said in his deep voice. He thrust out a meaty hand. “The last time I saw you, you were about five years old.”
I nodded and looked quizzically up at Dr. Ceiling-Scraper.
“This is Dr. McDonald,” Fenwick said. “He’s chief of neurology. I wanted the best for your mother.”
“Jill McGavock,” I said, giving McDonald a nod. “You have results already?”
“Why don’t we all go into the conference room down the hall and chat about this?” Dr. McDonald said.
He had a folksy way of speaking that made him sound more like the owner of the general store than a doctor. He seemed out of place at Stanford.
It was maddening to have to wait another five minutes while we all trailed down to a glassed-in room with plump couches and dim lighting, all of which I assumed was supposed to be soothing. They all sat. I stood against the wall, though Dr. McDonald could still look at me eye-to-eye. Dr. Fenwick glanced at Max.
“This is Dr. Ironto,” I said. “He’s a close family friend.”
Max practically lunged at both of them, hands clasping theirs as if they’d already cured Mother and were about to sign her release papers.
“Thank you, Doctor,” he said to each of them. “You don’t know how much we appreciate your time.”
You think they’re donating it, Max? I wanted to say.
He finally sat, perched on the edge of a chair, wringing his hands. I folded my arms and said, “What did you find out?”
McDonald tilted his head. “Well, now, in cases like this we don’t have a lot of diagnostic tests. When we’re looking at dementias—
“Time out,” I said. “You’ve ruled out a tumor?”
“That’s right. There’s no sign of any lesions.”
“Thank God,” Max said.
Personally, I wasn’t at all sure thanks were in order—to anybody.
“Go on,” I said.
“The results of the brain scan do show some shrinkage of the fronto-temporal lobe. You mind if I ask you a couple of questions ab
out her symptoms?”
“You want symptoms?” I said. “I can give you symptoms.”
I listed them for him, counting Mother’s recent behaviors on my fingers until I ran out of digits. When I was through, Max forlornly reported his own observations. You’d have thought he was betraying a sacred trust. He couldn’t even look McDonald in the eye, and he had to stop twice to blow his nose.
Through it all, Dr. McDonald nodded, his face sympathetic. Dr. Fenwick studied his palms as if they were signed death warrants. I looked from one of the doctors to the other until I felt nauseous.
When Max was finally finished clearing his nostrils into a Kleenex, Dr. McDonald stuck out his neck, cranelike, so he could look directly at me.
“Now, y’see, what happens in cases like this,” he said, “is there’s no way to be 100 percent sure of the diagnosis.”
“How sure are you? Eighty percent? Twenty-five percent? Two percent?”
“About ninety,” he said. “What happens is, we have to look at the test results and what you’ve seen and what I’ve seen. Looking at all that, I’m 90 percent sure your mother has what’s called Pick’s Disease. Now, it’s a pretty rare condition—”
“I know what it is,” I said. I gave him a litany of symptoms and prognosis, sounding more like a medical professional than he did. He just kept nodding.
“You know a lot about this already,” he said.
“I try to be proactive,” I said. “But I don’t know what to expect at this point. How long until she loses her faculties completely?”
“Well, now, from what you’ve told me,” McDonald answered, “she’s been showing symptoms for seven or eight months. She probably knew something wasn’t right several months before that.”
“Whoa,” I said. “Are you saying that she knows what’s happening to her?”
“There’s no way we can know that for sure—”
“Give it your best shot,” I said.
“Pick’s isn’t like Alzheimer’s, where they’re unaware that anything’s up. With this condition, the patient knows what’s going on until the really severe dementia sets in. After that, who knows? When we catch them early enough, they can self-report, you see? They tell us they don’t want to be around people anymore because they can’t think of the right words.” He crossed one endless leg over the opposite knee. “Some of them seem to know that their behavior is out of whack, but what happens is, they won’t admit it to anybody. You see what I’m saying?”