Turn of Mind

Turn of Mind

3.9 122
by Alice LaPlante

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A stunning first novel, both literary and thriller, about a retired orthopedic surgeon with dementia, Turn of Mind has already received worldwide attention. With unmatched patience and a pulsating intensity, Alice LaPlante brings us deep into a brilliant woman’s deteriorating mind, where the impossibility of recognizing reality can be both a blessing

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A stunning first novel, both literary and thriller, about a retired orthopedic surgeon with dementia, Turn of Mind has already received worldwide attention. With unmatched patience and a pulsating intensity, Alice LaPlante brings us deep into a brilliant woman’s deteriorating mind, where the impossibility of recognizing reality can be both a blessing and a curse.

As the book opens, Dr. Jennifer White’s best friend, Amanda, who lived down the block, has been killed, and four fingers surgically removed from her hand. Dr. White is the prime suspect and she herself doesn’t know whether she did it. Told in White’s own voice, fractured and eloquent, a picture emerges of the surprisingly intimate, complex alliance between these life-long friends—two proud, forceful women who were at times each other’s most formidable adversaries. As the investigation into the murder deepens and White’s relationships with her live-in caretaker and two grown children intensify, a chilling question lingers: is White’s shattered memory preventing her from revealing the truth or helping her to hide it?

A startling portrait of a disintegrating mind clinging to bits of reality through anger, frustration, shame, and unspeakable loss, Turn of Mind is a remarkable debut that examines the deception and frailty of memory and how it defines our very existence.

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Editorial Reviews

Publishers Weekly
LaPlante's impressive first novel sensitively explores the mental disintegration of widowed 64-year-old Jennifer White, a once-lauded Chicago hand surgeon, who charts her own experiences with Alzheimer's both consciously, in notes she writes to herself and thoughts she shares, and unconsciously, as she records conversations and actions she witnesses but doesn't understand. When someone fatally bludgeons Jennifer's best friend, 75-year-old Amanda O'Toole, who lives just three doors away, suspicion falls on Jennifer because the killer surgically removed four fingers from Amanda's right hand. In a satisfying twist, Jennifer honestly doesn't know herself whether she committed the murder. Jennifer's 29-year-old lawyer son, Mark, wishes to have his mother declared mentally incompetent, while her 24-year-old daughter, Fiona, a sweet, loving flake, and her full-time caretaker, Magdalena, act out of less selfish motives. Mystery fans should be prepared for a subtle literary novel in which the unfolding of Jennifer's condition and of her past matters far more than the whodunit. 16-city author tour. (July)
Library Journal
Dr. Jennifer White, 64, is a widowed retired orthopedic surgeon with rapidly advancing dementia. As she narrates her story, she is alternately eloquent and profoundly disconnected from reality. She lives at home with her caregiver; her son and daughter are doing their best to cope with her mood swings, confusion, and wanderings, but they have their own challenges. When Jennifer's best friend and neighbor is found murdered with four of her fingers surgically removed, she is understandably the prime suspect. She has no memory of committing the crime. Her children do their best to insulate her from incarceration as her grip on reality continues to slip. Her fractured and sometimes brilliant narrative of police questioning reveals the intimate story of two strong women whose friendship was both compassionate and highly adversarial. VERDICT This extraordinarily crafted debut novel guides the reader through family drama that is becoming all too familiar. That the author is able to do it so convincingly through the eyes and voice of the central character is an amazing achievement. Heartbreaking and stunning, this is both compelling and painful to read. [See Prepub Alert, 1/3/11.]—Susan Clifford Braun, Bainbridge Island, WA
Kirkus Reviews

LaPlante's literary novel explores uncharted territory, imagining herself into a mind, one slipping, fading, spinning away from her protagonist, a woman who may have murdered her best friend.

Dr. Jennifer White lives in the dark, shadowy forest of forgetfulness. She is 64, a flinty intellectual, competent and career-focused, but she has been forced to retire from orthopedic surgery by the onset of dementia. Her husband is dead. Her children—precociously intelligent and possibly bipolar Fiona, a professor, and Mark, an attorney like his late father, but only an imitation of that charismatic and competent man—are left to engineer her care. The novel opens with White at home, cared for by Magdalena, a paid companion. Fiona has control of her mother's finances, a source of conflict with Mark, troubled by money problems and the hint of addiction. White's own strobe flashes of lucidity reveal the family's history. White's closest friend, Amanda, was found dead a few days previously, a thing she sometimes understands. Four fingers from one of Amanda's hand had been surgically amputated. Amanda, her husband Peter and Jennifer and James were close friends, but Amanda possessed an arrogant streak, a hyper-moralistic and judgmental attitude, aggravated by a willingness to use secrets to manipulate. Amanda was also childless and jealous, especially of Fiona's affections. LaPlante tells the story poignantly, gracefully and artistically. Jennifer White, as a physician, as a wife, as a mother, leaps from the pages as a powerful character, one who drifts away from all that is precious to her—her profession, her mental acuity—with acceptance, anger and intermittent tragic self-knowledge. LaPlante writes in scenes without chapter breaks. White's thoughts and speech are presented in plain text and those of the people she encounters in italics. Despite the near stream-of-consciousness, FaulknerianSound and Furypresentation, the narrative is easily followed to the resolution of the mystery and White's ultimate melancholy and inevitable end.

A haunting story masterfully told.

Zoe Slutzky
This is a portrait of an unstable mind, an expansive, expertly wrought imagining of memory's failures and potential…Alzheimer's is bleak territory, and to saddle Jennifer with suspected murder seems cruel and unusual punishment. But in LaPlante's vivid prose, her waning mind proves a prism instead of a prison, her memory refracted to rich, sensual effect…The twists and turns of mind this novel charts are haunting and original.
—The New York Times
From the Publisher

—A New York Times Bestseller
—Winner of the Wellcome Trust Book Prize
—A New York Times and Booklist Editor's Choice
—An NPR, Vogue, Milwaukee Journal Sentinel, and Globe and Mail Summer Reading Pick
—A San Francisco Chronicle 2011 Holiday Gift Guide Selection

—Best Book of the Year:

Amazon.com 10 Best Thriller and Mystery Books
Washington Post Notable Fiction
The Guardian Best Thrillers
Kirkus Reviews Top 25 Best in Fiction
Globe and Mail Best Mysteries and Thrillers
Shelf Awareness Top Pick

“To call Turn of Mind a thriller—or a chronicle of illness, or a saga of friendship for that matter—would confine it to a genre it transcends. This is a portrait of an unstable mind, an expansive, expertly wrought imagining of memory’s failures and potential. . . . In LaPlante’s vivid prose, [Dr. White’s] waning mind proves a prism instead of a prison, her memory refracted to rich, sensual effect. There are moments of steely, surgical calm, the language tight and fractured . . . and there are moments of blooming, antic poetry. . . . LaPlante has imagined a lunatic landscape well. The twists and turns of mind this novel charts are haunting and original.”—The New York Times Book Review

"Gripping . . . Skilfull . . . Unique . . . [A] compelling whodunit . . . . LaPlante has created an unforgettable portrait of the process of forgetting."—The Washington Post Book World

"Rare . . . LaPlante's fine novel is both lyrical and shocking." —Boston Globe

"Remarkably poignant . . . An artful, ambitious, and arresting attempt to capture the thoughts and feelings, by turns confused, conspiratorial, canny, and clear, of a person in the throes of mental illness . . . LaPlante reminds us all, passionately, that no matter what the state of our health, reality can be elusive and subjective."—The San Francisco Chronicle

“Expertly paced . . . A stunning act of imagination.”—Chicago Tribune

"Unforgettable . . . It sounds like an almost impossible task: to write a murder mystery from the perspective of a suspect with Alzheimer's. And yet LaPlante pulls it off and with flair. . . . Jennifer is a hard, funny, acerbic woman when she is able to marshal her wandering wits. . . . Fragmented and disorienting . . . [A] distressingly believable portrait of a mind sinking into dementia." —The Guardian (UK)

“This book is to 2011 what Anna Quindlen’s Every Last One was to 2010—the dread-filled, un-putdownable page turner. . . . Skillfully written in the memory-loss first person, the book combines murder mystery with family drama, bringing new meaning to the term ‘psychological thriller.’”—Vanity Fair

"Haunting . . . Blackly humorous . . . Remarkable . . . [Told in] the crisp, super-intelligent, and brutally confused voice of Dr. Jennifer White . . . LaPlante is certain in her footing—the verisimilitude here is unnerving . . . [as] she takes us into a world of gauzy shadows and scattered puzzle pieces."—Newsday

"Daring and confident . . . A tour de force."—Minneapolis Star-Tribune

“This poignant debut immerses us in dementia’s complex choreography. . . . Dr. White is . . . by turns brilliant, hallucinatory, and heartbreakingly vulnerable. . . . [A] lyrical mosaic, an indelible portrait of a disappearing mind.”—People (4 stars)

"This dazzlingly adroit debut novel is full of suspense, rueful humor, and scalpel-sharp insights into the intricacies of love and friendship—as well as the resilience of the human spirit." —More

"A brilliant, even audacious conceit . . . Pitch-perfect."—Chicago Sun-Times

"Not only was I mesmerized by LaPlante's ability to put the reader in the circumstance of a slowly evaporating ability to stay in the present, but the ending of the book was also one of the most indelible I have read in years—I was stunned, silent, and shaken."—The Daily Beast

"Provocative . . . Nervy and stylish . . . What lingers in the reader's mind is not so much the resolution of the plot as the resilience of Jennifer's character. . . . Alzheimer's patients reshape those around them in ways that transcend anguish and frustration. As the best parts of Turn of Mind reveal, the disease opens us to the very things that make us human." —AARP magazine

"A heart-wrenching yet thrilling read . . . It is a mystery, thriller, medical story, family drama, and just an all-around good read."—Deseret News

“How does LaPlante pull a story out of [a protagonist] with no memory? In a word: deftly. . . . A clever whodunit. . . . If this portrait is correct, Jennifer is a sad but true reflection of a disease that ebbs and flows unmercifully. One minute she stares in wonder at a commonplace item like a toothbrush, the next she reacts with almost animal cunning, and the next—almost miraculously—she displays the most salient facets of her former self. The novel’s ending alone will show what a long and winding road it is from confused to comatose.” —The Seattle Times

“Moving . . . Unusual . . . Cleverly and well written . . . I was quickly hooked.”—Literary Review (UK)

“[An] accomplished thriller . . . Vivid . . . Turn of Mind is an incisive, humane exploration of how we can rail against our need for close relationships with others, feeling that they undermine our independence, even as we keep going back for more.”—Times Literary Supplement

"A page-turner . . . Creates a startling range and texture of fear. From agonizing, slow-motion-car-crash moments to the ironic frissons of a good horror movie, [LaPlante] hits every bell. . . . The complexity never fades . . . The razor sharp quality of [Jennifer's] thoughts, even at their most fragmented, gives her entire ordeal a "Twilight Zone" feel. Up until the final stages of the disease, she still somehow manages to retain the quality of a lone sane person adrift in a world that definitely isn't." —Los Angeles Times

"Brilliant . . . Turn of Mind is relentless and chilling."—The Globe and Mail

"The basic premise of this debut novel is pure genius . . . Masterfully written and satisfying."—Shelf Awareness (starred review)

“Executed with skill and elegance . . . . LaPlante’s real achievement here is creating a character who—even in the midst of losing her mind—is concrete, complicated, smart, and sympathetic. . . . Painfully sad and utterly true.”—Bookreporter

"Engrossing . . . Exhilarating . . . A page-turning mystery."—San Jose Mercury News

“A powerfully affecting novel.”—Easy Living (UK)

"A unique premise for a murder investigation . . . Compulsively readable . . . The mystery of the mind has surely been solved."—New York Journal of Books

"Turn of Mind is one of my favorite books of the year. I can't wait to see what LaPlante comes up with next." —Karin Slaughter, author of Fallen

“What bumps Turn of Mind up into the exalted Daphne Du Maurier/Ruth Rendell category of ‘literary thriller’ is LaPlante’s fearless and compassionate investigation into the erosion of her main character’s mind. . . . Turn of Mind reads as a series of fragmentary-but-illuminating first-person conversations between Dr. White and various other characters. . . . In the short space of these dialogues, Dr. White’s grip on reality fades in and out, like an iffy radio frequency and time frames collapse into each other with fluid ease. We readers become (nervously) at home in the haunted house of Dr. White’s head . . . [and] LaPlante’s turn on the suspense formula is especially ingenious because, as anxious-but-enthralled readers, we have to agree to be entrapped inside Dr. White’s crumbling mind for the duration. . . . Forgetfulness, it turns out, may be something of a mercy after all.”—Maureen Corrigan, NPR’s Fresh Air

"Heartbreaking . . . Telling the story from the point of view of a woman whose mind is slowly failing could have been gimmicky, but LaPlante completely pulls it off."—Ladies' Home Journal

“Impressive . . . Part mystery novel, part family drama . . . LaPlante has a gift for rhythm, crafting rat-a-tat passages that are their own pleasures. . . . It’s no small feat that LaPlante manages to spin a coherent tale despite her main character’s profound disorientation.”—Entertainment Weekly

"An electrifying book, impossible to put down. Gripping, thought-provoking, humane, funny, tragic, it is masterfully done, a tour de force that can’t be a first novel—and yet it is. I’ll read whatever LaPlante writes next, and the sooner the better.”—Ann Packer

"A uniquely entertaining murder mystery. LaPlante's portrayal of the prime suspect's escalating dementia is gripping, unnerving, and utterly brilliant."—Lisa Genova

“The Stone Angel meets Momento in this literary page-turner. . . . Smart, strong . . . With its timely and compelling storyline, LaPlante’s debut is ambitious . . . Both an impressive technical stunt and a moving portrait of a difficult, undaunted woman.”—Winnipeg Free Press

“Haunting . . . [A] startling portrait of a fiercely intelligent woman struggling mightily to hold on to her sense of self. . . . This masterfully written debut is fascinating on so many levels, from its poignant and inventive depiction of a harrowing illness to its knowing portrayal of the dark complexities of friendship and marriage.”—Booklist (starred review)

“LaPlante’s literary novel explores uncharted territory, imagining herself into a mind, one slipping, fading, spinning away from her protagonist. . . . LaPlante tells the story poignantly, gracefully, and artistically. Jennifer White, as a physician, as a wife, as a mother, leaps from the pages as a powerful character. . . . A haunting story masterfully told.”—Kirkus (starred review)

“This extraordinarily crafted debut novel guides the reader through family drama that is becoming all too familiar. That the author is able to do it so convincingly through the eyes and voice of [a woman with Alzheimer’s] is an amazing achievement. Heartbreaking and stunning, this is both compelling and painful to read.”—Library Journal (starred review)

"Impressive . . . A subtle literary novel."—Publishers Weekly (starred review)

“Poignant . . . It’s hard to believe that this is a first novel—it’s so carefully written and satisfying in every way. . . . A masterful family drama and a thrilling murder mystery.”—Valerie Ryan, Shelf Awareness

Turn of Mind blindfolds the reader and spins her around, gives her a push into a maze of echoes. Alice LaPlante’s debut is a tricky nouveau nouveau roman, rife with danger.”—Stewart O’Nan

“Alice La Plante's brilliantly original novel took me not simply into the life of a woman falling apart, but directly into her crumbling brain as she tries desperately to keep her sense of her own identity from slipping away. She held me there for three hundred riveting pages—and for weeks after I'd turned the last one. If one of the measures of wonderful fiction is its capacity to grant a reader access to characters and experience she might never have imagined (and I think it is), Turn of Mind surely qualifies as a masterful accomplishment.”—Joyce Maynard

"Wonderful. This harrowing exploration of the slow disintegration of the mind is deeply touching and utterly heartbreaking, while also being a compelling page-turner. I loved it."—S. J. Watson

Turn of Mind is that rarest of books that defies simple classification. It’s absolutely bursting at the seams with humanity, in the fullest possible array, with all of the twists and turns life can throw at us, and which we in turn hurl ourselves toward. Impossible to put down and yet from the very first page so vivid and ripe with language and comprehension that I knew this was not only a book to be savored, but returned to. Alice LaPlante offers a glorious achievement.”—Jeffrey Lent

“Hey readers, Alice LaPlante has arrived. Turn of Mind features a crazy-smart narrator in a gripping family drama that is itself a brilliant murder mystery. LaPlante possesses both the wild audacity to attempt such a tour-de-force and the pure talent to pull it off. Totally compelling, dark and yet at moments also darkly funny, completely unforgettable. Lord knows what LaPlante will write next. I can’t wait.”—Colin Harrison

“As the narrator’s mind is devoured by dementia, she struggles to remember the extent of her involvement in her best friend’s murder. LaPlante’s characters are completely convincing, the plotting masterful.”—Donna Leon

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Product Details

Grove/Atlantic, Inc.
Publication date:
Sales rank:
Product dimensions:
6.20(w) x 9.10(h) x 1.20(d)

Read an Excerpt

Something has happened. You can always tell. You come to and find wreckage: a smashed lamp, a devastated human face that shivers on the verge of being recognizable. Occasionally someone in uniform: a paramedic, a nurse. A hand extended with a pill. Or poised to insert a needle.
This time, I am in a room, sitting on a cold metal folding chair. The room is not familiar, but I am used to that. I look for clues. An office-like setting, long and crowded with desks and computers, messy with papers. No windows.
I can barely make out the pale green of the walls, so many posters, clippings, and bulletins tacked up. Fluorescent lighting casting a pall. Men and women talking; to one another, not to me. Some wearing baggy suits, some in jeans. And more uniforms. My guess is that a smile would be inappropriate. Fear might not be.

I can still read, I'm not that far gone, not yet. No books anymore, but newspaper articles. Magazine pieces, if they're short enough. I have a system. I take a sheet of lined paper. I write down notes, just like in medical school.
When I get confused, I read my notes. I refer back to them. I can take two hours to get through a single Tribune article, half a day to get through The New York Times. Now, as I sit at the table, I pick up a paper someone discarded, a pencil. I write in the margins as I read. These are Band-Aid solutions. The violent flare-ups continue. They have reaped what they sowed and should repent.
Afterward, I look at these notes but am left with nothing but a sense of unease, of uncontrol. A heavy man in blue is hovering, his hand inches away from my upper arm. Ready to grab. Restrain.

Do you understand the rights I have just read to you? With these rights in mind, do you wish to speak to me?
I want to go home. I want to go home. Am I in Philadelphia. There was the house on Walnut Lane. We played kickball in the streets.
No, this is Chicago. Ward Forty-three, Precinct Twenty-one. We have called your son and daughter. You can decide at any time from this moment on to terminate the interview and exercise these rights.
I wish to terminate. Yes.

A large sign is taped to the kitchen wall. The words, written in thick black marker in a tremulous hand, slope off the poster board: My name is Dr. Jennifer White. I am sixty-four years old. I have dementia. My son, Mark, is twenty-nine. My daughter, Fiona, twenty-four. A caregiver, Magdalena, lives with me.
It is all clear. So who are all these other people in my house? People, strangers, everywhere. A blond woman I don't recognize in my kitchen drinking tea. A glimpse of movement from the den. Then I turn the corner into the living room and find yet another face. I ask, So who are you? Who are all the others? Do you know her? I point to the kitchen, and they laugh.
I am her, they say. I was there, now I'm here. I am the only one in the house other than you. They ask if I want tea. They ask if I want to go for a walk. Am I a baby? I say. I am tired of the questions. You know me, don't you? Don't you remember? Magdalena. Your friend.

The notebook is a way of communicating with myself, and with others. Of filling in the blank periods. When all is in a fog, when someone refers to an event or conversation that I can't recall, I leaf through the pages. Sometimes it comforts me to read what's there. Sometimes not. It is my Bible of consciousness. It lives on the kitchen table: large and square, with an embossed leather cover and heavy creamy paper. Each entry has a date on it. A nice lady sits me down in front of it.
She writes, January 20, 2009. Jennifer's notes. She hands the pen to me. She says, Write what happened today. Write about your childhood. Write whatever you remember.
I remember my first wrist arthrodesis. The pressure of scalpel against skin, the slight give when it finally sliced through. The resilience of muscle. My surgical scissors scraping bone. And afterward, peeling off bloody gloves finger by finger.

Black. Everyone is wearing black. They're walking in twos and threes down the street toward St. Vincent's, bundled in coats and scarves that cover their heads and lower faces against what is apparently bitter wind.
I am inside my warm house, my face to the frosted window, Magdalena hovering. I can just see the twelve-foot carved wooden doors. They are wide open, and people are entering. A hearse is standing in front, other cars lined up behind it, their lights on.
It's Amanda, Magdalena tells me. Amanda's funeral. Who is Amanda? I ask. Magdalena hesitates, then says, Your best friend. Your daughter's godmother.
I try. I fail. I shake my head. Magdalena gets my notebook. She turns back the pages. She points to a newspaper clipping:
Elderly Chicago Woman Found Dead, Mutilated
CHICAGO TRIBUNE—February 23, 2009
CHICAGO, IL—The mutilated body of a seventy-five-year-old Chicago woman was discovered yesterday in a house in the 2100 block of Sheffield Avenue.
Amanda O'Toole was found dead in her home after a neighbor noticed she had failed to take in her newspapers for almost a week, according to sources close to the investigation. Four fingers on her right hand had been severed. The exact time of death is unknown, but cause of death is attributed to head trauma, sources say.
Nothing was reported missing from her house.
No one has been charged, but police briefly took into custody and then released a person of interest in the case.
I try. But I cannot conjure up anything. Magdalena leaves. She comes back with a photograph.
Two women, one taller by at least two inches, with long straight white hair pulled back in a tight chignon. The other one, younger, has shorter wavy gray locks that cluster around chiseled, more feminine features. That one a beauty perhaps, once upon a time.
This is you, Magdalena says, pointing to the younger woman. And this here, this is Amanda. I study the photograph.
The taller woman has a compelling face. Not what you'd call pretty. Nor what you would call nice. Too sharp around the nostrils, lines of perhaps contempt etched into the jowls. The two women stand close together, not touching, but there is an affinity there.
Try to remember, Magdalena urges me. It could be important. Her hand lies heavily on my shoulder. She wants something from me. What? But I am suddenly tired. My hands shake. Perspiration trickles down between my breasts.
I want to go to my room, I say. I swat at Magdalena's hand. Leave me be.

Amanda? Dead? I cannot believe it. My dear, dear friend. Second mother to my children. My ally in the neighborhood. My sister.
If not for Amanda, I would have been alone. I was different. Always apart. The cheese stands alone.
Not that anyone knew. They were fooled by surfaces, so easy to dupe. No one understood weaknesses like Amanda. She saw me, saved me from my secret solitude. And where was I when she needed me? Here. Three doors down. Wallowing in my woes. While she suffered. While some monster brandished a knife, pushed in for the kill.
O the pain! So much pain. I will stop swallowing my pills. I will take my scalpel to my brain and eviscerate her image. And I will beg for exactly that thing I've been battling all these long months: sweet oblivion.

The nice lady writes in my notebook. She signs her name: Magdalena. Today, Friday, March 11, was another bad day. You kicked the step and broke your toe. At the emergency room you escaped into the parking lot. An orderly brought you back. You spat on him.
The shame.

This half state. Life in the shadows. As the neurofibrillary tangles proliferate, as the neuritic plaques harden, as synapses cease to fire and my mind rots out, I remain aware. An unanesthetized patient.
Every death of every cell pricks me where I am most tender. And people I don't know patronize me. They hug me. They attempt to hold my hand. They call me prepubescent nicknames: Jen. Jenny. I bitterly accept the fact that I am famous, beloved even, among strangers. A celebrity!
A legend in my own mind.

My notebook lately has been full of warnings. Mark very angry today. He hung up on me. Magdalena says do not speak to anyone who calls. Do not answer the door when she's doing laundry or in the bathroom.
Then, in a different handwriting, Mom, you are not safe with Mark. Give the medical power of attorney to me, Fiona. It is best to have medical and financial powers of attorney in the same hands anyway. Some things are crossed out, no, obliterated, with a thick black pen. By whom?

My notebook again:
Mark called, says my money will not save me. I must listen to him. That there are other actions we must take to protect me.
Then: Mom, I sold $50,000 worth of IBM stock for the lawyer's retainer. She comes highly recommended for cases where mental competency is an issue. They have no evidence, only theories. Dr. Tsien has put you on 150 mg of Seroquel to curb the episodes. I will come again tomorrow, Saturday. Your daughter, Fiona.

I belong to an Alzheimer's support group. People come and they go.
This morning Magdalena says it is an okay day, we can try to attend. The group meets in a Methodist church on Clark, squat and gray with clapboard walls and garish primary-colored stained-glass windows.
We gather in the Fellowship Lounge, a large room with windows that don't open and speckled linoleum floors bearing the scuff marks of the metal folding chairs. A motley crew, perhaps half a dozen of us, our minds in varying states of undress. Magdalena waits outside the door of the room with the other caregivers. They line up on benches in the dark hallway, knitting and speaking softly among themselves, but attentive, prepared to leap up and take their charges away at the first hint of trouble.
Our leader is a young man with a social-worker degree. He has a kind and ineffectual face, and likes to start with introductions and a joke.
My-name-is-I-forgot-and-I-am-an-I-don't-know-what. He refers to what we do as the Two Circular Steps. Step One is admitting you have a problem. Step Two is forgetting you have the problem.
It gets a laugh every time, from some because they remember the joke from the last meeting, but from most because it's new to them, no matter how many times they've heard it.
Today is a good day for me. I remember it. I would even add a third step: Step Three is remembering that you forget. Step Three is the hardest of all.
Today we discuss attitude. This is what the leader calls it. You've all received this extraordinarily distressing diagnosis, he says. You are all intelligent, educated people. You know you are running out of time. What you do with it is up to you. Be positive! Having Alzheimer's can be like going to a party where you don't happen to know anyone. Think of it! Every meal can be the best meal of your life! Every movie the most enthralling you've ever seen! Have a sense of humor, he says. You are a visitor from another planet, and you are observing the local customs.
But what about the rest of us, for whom the walls are closing in? Whom change has always terrified? At thirteen I stopped eating for a week because my mother bought new sheets for my bed. For us, life is now terribly dangerous. Hazards lie around every corner. So you nod to all the strangers who force themselves upon you. You laugh when others laugh, look serious when they do. When people ask do you remember you nod some more. Or frown at first, then let your face light up in recognition.
All this is necessary for survival. I am a visitor from another planet, and the natives are not friendly.

I open my mail myself. Then it disappears. Whisked away. Today, pleas for help to save the whales, save the pandas, free Tibet.
My bank statement shows that I have $3,567.89 in a Bank of America checking account. There is another statement from a stockbroker, Michael Brownstein. My name is on the top. My assets have declined 19 percent in the last six months. They apparently now total $2.56 million. He includes a note: It is not as bad as it could have been due to your conservative investment choices and a broad portfolio diversification strategy.
Is $2.56 million a lot of money? Is it enough? I stare at the letters on the page until they blur. AAPL, IBM, CVR, ASF, SFR. The secret language of money.

James is sly. James has secrets. Some I am privy to, more I am not. Where is he today? The children are at school. The house is empty except for a woman who seems to be a sort of housekeeper. She is straightening the books in the den, humming a tune I don't recognize. Did James hire her? Likely. Someone must be keeping things in order, for the house looks well tended, and I have always been hostile to housework, and James, although a compulsive tidier, is too busy. Always out and about. On undercover missions. Like now. Amanda doesn't approve. Marriages should be transparent, she says. They must withstand the glare of full sunlight. But James is a shadowy man. He needs cover, flourishes in the dark. James himself explained it long ago, concocted the perfect metaphor. Or rather, he plucked it from nature. And although I am suspicious of too-neat categorizations, this one rang true. It was a hot humid day in summer, at James's boyhood home in North Carolina. Before we were married. We'd gone for an after-dinner walk in the waning light and just two hundred yards away from his parents' back porch found ourselves deep in a primeval forest, dark with trees that dripped white moss, our footsteps muffled by the dead leaves that blanketed the ground. Pockets of ferns unfurled through the debris and the occasional mushroom gleamed. James gestured. Poisonous, he said. As he spoke, a bird called. Otherwise, silence. If there was a path, I couldn't see it, but James steadily moved ahead and magically a way forward appeared in front of us. We'd gone perhaps a quarter of a mile, the light diminishing minute by minute, when James stopped. He pointed. At the foot of a tree, amid a mass of yellow green moss, something glowed a ghostly white. A flower, a single flower on a long white stalk. James let out a breath. We're lucky, he said. Sometimes you can search for days and not find one.
And what is it? I asked. The flower emitted its own light, so strong that several small insects were circling around it, as if attracted by the glare.
A ghost plant, James said. Monotropa uniflora. He stooped down and cupped the flower in his hand, being careful not to disengage it from its stalk. It's one of the few plants that doesn't need light. It actually grows in the dark.
How is that possible? I asked.
It's a parasite—it doesn't photosynthesize but feeds off the fungus and the trees around it, lets others do the hard work. I've always felt a kinship to it. Admiration, even. Because it's not easy—that's why they don't propagate widely. The plant has to find the right host, and conditions must be exactly right for it to flourish. But when it does flourish, it is truly spectacular. He let go of the flower and stood up.
Yes, I can see that, I said.
Can you? James asked. Can you really?
Yes, I repeated, and the word hung in the heavy moist air between us, like a promise. A vow.
Shortly after this trip, we quietly got married at the Evanston courthouse. We didn't invite anyone, it would have felt like an intrusion. The clerk was a witness, and it was over in five minutes. On the whole, a good decision. But on days like today, when I feel James's absence like a wound, I long to be back in those woods, which somehow remain as fresh and strong in my mind as the day we were there. I could reach out and pluck that flower, present it to James when he comes back. A dark trophy.

I am in the office of a Carl Tsien. A doctor. My doctor, it seems. A slight, balding man. Pale, in the way that only someone who spends his time indoors under artificial light can be. A benevolent face. We apparently know each other well.
He speaks about former students. He uses the word our. Our students. He says I should be proud. That I have left the university and the hospital an invaluable legacy. I shake my head. I am too tired to pretend, having had a bad night. A pacing night. Back and forth, back and forth, from bathroom to bedroom to bathroom and back again. Counting footsteps, beating a steady rhythm against the tile, the hardwood flooring. Pacing until the soles of my feet ached.
But this office tickles my memory. Although I don't know this doctor, somehow I am intimate with his possessions. A model of a human skull on his desk. Someone has painted lipstick on its bony maxilla to approximate lips, and a crude label underneath it reads simply, MAD CARLOTTA. I know that skull. I know that handwriting. He sees me looking. Your jokes were always a little obscure, he says.
On the wall above the desk, a vintage skiing poster proclaims Chamonix in bright red letters. Des conditions de neige excellentes, des terrasses ensoleillées, des hors-pistes mythiques. A man and a woman, dressed in the voluminous clothing of the early 1900s, poised on skis in midair above a steep white hill dotted with pine trees. A fanciful drawing, not a photograph, although there are photographs, too, hanging to the right and left of the poster. Black-and-white. To the right, one of a young girl, not clean, squatting in front of a dilapidated shack. To the left, one of a barren field with the sun just visible above the flat horizon and a woman, naked, lying on her belly with her hands propping up her chin. She looks directly into the camera. I feel distaste and turn away.
The doctor laughs and pats me on the arm. You never did approve of my artistic vision, he says. You called it precious. Ansel Adams meets the Discovery Channel. I shrug. I let his hand linger on my arm as he guides me to a chair.
I am going to ask you some questions, he says. Just answer to the best of your ability.
I don't even bother to respond.
What day is it?
Going-to-the-doctor day.
Clever reply. What month is it?
Can you be more specific?
Close. Late February.
What is this?
A pencil.
What is this?
A watch.
What is your name?
Don't insult me.
What are your children's names?
Fiona and Mark.
What was your husband's name?
Where is your husband?
He is dead. Heart attack.
What do you remember about that?
He was driving and lost control of his car.
Did he die of the heart attack or the car accident?
Clinically it was impossible to tell. He may have died of cardiomyopathy caused by a leaky mitral valve or from head trauma. It was a close call. The coroner went with cardiac arrest. I would have gone the other way, myself.
You must have been devastated.
No, my thought was, that's James: a perpetual battle between his head and his heart to the end.
You're making light of it. But I remember that time. What you went through.
Don't patronize me. I had to laugh. His heart succumbed first. His heart! I did laugh, actually. I laughed as I identified the remains. Such a cold, bright place. The morgue. I hadn't been in one since medical school, I always hated them. The harsh light. The bitter cold. The light and the cold and also the sounds—rubber-soled shoes squeaking like hungry rats against tile floors. That's what I remember: James bathed in unforgiving light while vermin scuttled.
Now you're the one patronizing me. As if I couldn't see past that.
The doctor writes something in a chart. He allows himself to smile at me.
You scored a nineteen, he says. You're doing well today. I don't see any agitation and Magdalena says the aggression has subsided. We'll continue the same drug therapy.
He gives me a look. Do you have a problem with that?
I shake my head. Okay, then. We'll do everything we can to keep you in your home. I know that's what you want.
He pauses. I must tell you, Mark has been urging me to make a statement that he can use to declare you mentally incompetent to make medical decisions, he says. I have refused. The doctor leans forward. I would recommend that you not let yourself be examined by another doctor. Not without a court order.
He takes a piece of paper out of his file. See—I have written it all down for you. Everything I just said. I will give it to Magdalena and tell her to keep it safe. I have made two copies. Magdalena will give one to your lawyer. You can trust Magdalena, I believe. I believe she is trustworthy.
He waits for my answer, but I am fixated on the photo of the naked woman. There is doubt and suspicion in her eyes. She is looking at the camera. Behind it. She is looking straight at me.

I can't find the car keys, so I decide to walk to the drugstore. I will buy toothpaste, some dental floss, shampoo for dry hair. Perhaps some toilet paper, the premium kind.
Normal things. I'm inclined to pretend to be normal today. Then I will go to the supermarket and pick out the plumpest roast chicken for dinner. A loaf of fresh bread. James will like that. Small comforts—we share our love of these.
But I must go quickly. Quietly. They will try to stop me. They always do.
But no purse. Where is it. I always keep it beside the door. No matter, there will be someone nice there. I will say, I am Dr. Jennifer White and I forgot my purse and they will say oh of course here is some money and I will nod my head just so and thank them.
I stride down the street, past ivy-covered brownstones with their waist-high wrought-iron fences enclosing small neat geometrically laid-out front gardens.
Dr. White? Is that you?
A dark-skinned man in a blue uniform, driving a white truck with an eagle on it. He rolls down his window, slows to a crawl to keep pace.
Yes? I keep walking.
Not the nicest day to be out and about. Nasty.
Just a walk, I say. I make a point of not looking at him. If you don't look, they may leave you alone. If you don't look, sometimes they let it go.
How about a ride? Look at you, completely soaked. No coat. And my goodness. No shoes. Come on. Get in.
No. I like the weather. I like the feel of my bare feet against concrete. Cold. Waking me out of my somnolent state.
You know, that nice lady you live with won't like this.
So what.
Come quietly now. He speaks soothingly while pulling the truck over to the curb. He holds out both hands, palms up, and beckons with them. Gently.
I'm not a rabid dog.
No, you're not. Indeed you aren't. But I can't stand by and do nothing. You know I can't, Dr. White.
I brush my icy hair out of my face and keep going, but he idles his truck alongside. He takes out his phone. If he punches seven numbers, it's okay. If he punches three numbers, it's bad. I know that. I stop and wait. Onetwothree. He stops. He brings the phone to his ear.
Wait, I say. No. I run around the front of the truck. I yank the door open and clamber in beside him. Anything to stop the phone. Stop what will happen. Bad things will happen. Put the phone down, I say. Put the phone down. He hesitates. I hear a voice on the other end. He looks at the phone and flips it shut. He gives me what is supposed to be a reassuring smile. I am not fooled.
Okay! Let's get you home before you catch your death.
He waits at the curb until I reach the front door. It is wide open, and wind and sleet are gusting through into the hallway. The thick damask curtains on the front windows are drenched. I step on a sodden carpet—a dark Tabriz runner we bought in Baghdad thirty years ago, now considered museum-quality. James had it appraised last year, will be furious. Magdalena's shoes are gone. A lukewarm cup of tea sits on the table, half drunk.
I am suddenly very tired. I sit down in front of the tea, push it away, but not before getting a waft of chamomile. So many old wives' tales about chamomile have proven true. A cure for digestive problems, fever, menstrual cramps, stomachaches, skin infections, and anxiety. And, of course, insomnia.
A fix for whatever ails you! Magdalena had exclaimed when I told her that. Not really, I said. Not everything.

We are listening to St. Matthew's Passion. It is 1988. Solti is at the podium in Orchestra Hall, and the audience is held captive until the cadences resolve. The diminished seventh chords and the disturbing modulations. The suspense barely tolerable. I can feel the warmth of James's fingers intertwined with mine, his breath warm against my cheek.
Then suddenly it is a cold winter day. I am alone in my kitchen. I fold my arms on the table and lean my forehead against them. Did I take my pills this morning? How many did I take? How many would it take?
I am almost to the point. I have almost reached that point. And hear an echo of Bach: Ich bin's, ich sollte büßen. It is I who should suffer and be bound for hell.
But not yet. No. Not quite yet. I sit and wait.

A man has walked into my house without knocking. He says he is my son. Magdalena backs him up, so I acquiesce. But I don't like this man's face. I am not ruling out the possibility that they are telling me the truth—but I will play it safe. Not commit.
What I do see: a stranger, a very beautiful stranger. Dark. Dark hair, dark eyes, a dark aura, if I may be so fanciful. He tells me he is unmarried, twenty-nine years old, a lawyer. Like your father! I say, cunningly. His darkness comes alive, he glowers—there is no other word for it.
Not at all, he says. Not in the slightest. I cannot hope to fill those mighty McLennan shoes. Give counsel to the mighty and count the golden coin of the realm. And he gives a mock half bow to the portrait of the lean, dark man that hangs in the living room. Why didn't you give me your name, Mom? The shoes would have been just as large but of a different shape altogether.
Enough! I say sharply—for I remember my son now. He is seven years old. He has just run into the room, his hands clutching at his thighs, a glorious look on his face. Water spattering everywhere. I discover his front pockets are full of his sister's goldfish. They are still wiggling. He is astonished at my anger.
We save some of them, but most are limp cold bodies to be flushed down the toilet. His rapture is not dimmed, he stares fascinated as the last of the red gold tails gets sucked out of sight. Even when his sister discovers her loss he is unrepentant. No. More than that. Proud. Perpetrator of a dozen tiny slaughters on an otherwise quiet Tuesday afternoon.
This-man-who-they-say-is-my-son settles himself in the blue armchair near the window in the living room. He loosens his tie, stretches out his legs, makes himself at home.
Magdalena tells me you've been well, he says.
Very, I say, stiffly. As well as a person in my condition can be.
Tell me about that, he says.
About what? I ask.
About how aware you are of what's happening to you.
Everyone asks that, I say. They are astonished that I can be so aware, so very …
Clinical, he says.
You always were, he says. He has a wry smile, not unappealing. When I broke my arm, you were more interested in my bone density than in getting me to the hospital.
I remember someone breaking his arm, I say. Mark. It was Mark. Mark fell out of the maple tree in front of the Janeckis'.
I'm Mark.
You? Mark?
Yes. Your son.
I have a son?
Yes. Mark. Me.
I have a son! I am struck dumb. I have a son! I am filled with ecstasy. Joy!
Mom, please, don't …
But I am overwhelmed. All these years! I had a son and never knew it!
The man is now kneeling at my feet, holding me.
It's okay, Mom. I'm here.
I hold on to him tightly. A fine young man and, wondrous of all, conceived by me. There is something not quite right about his face, a flaw in his beauty. But to my eyes, this makes him even more beloved.
Mom, he says after a moment. His arms around me loosen, he pulls back.
I miss the warmth immediately but reluctantly let go and sit back in my chair.
Mom, I had something really important to say. It's about Fiona. He is standing now, and his face is back to the dark, watchful look he wore when he entered. I know that look.
What about her? I ask. My tone is not welcoming.
Mom, I know you don't want to hear this, but she's gone off again. You know how she gets.
I do know, but I don't answer. I have never encouraged this telling of tales.
This time it's bad. Really bad. She won't talk to me. You used to be able to talk her down. Dad, sometimes. But she listened to you. Do you think you could speak to her? He pauses. Do you understand what I'm saying?
Where have you been, you bastard? I ask.
After all these years, you come here and say these things?
Shhh, Mom. It's okay. I'm right here. I never left.
What do you mean? I've been alone. All alone in this house. Eating dinner alone, going to bed alone. So alone.
That's just not true, Mom. Until just last year there was Dad. And what about Magdalena?
Magdalena. Your friend. The woman who lives with you.
Oh. Her. She's not my friend. She gets paid. I pay her.
That doesn't mean she's not your friend.
Yes, it certainly does. Suddenly I'm angry. Furious! You bastard! I say. You abandoned me!
The man slowly gets to his feet and sighs heavily. Magdalena! he calls.
Did you hear me? Bastard!
I heard you, Mom. He looks around, searching for something. My coat, he says. Have you seen my coat?
A woman hurries into the room. Blond. A woman of heft. Better go, she says. Quickly. Here's your coat. Yes. Thanks for coming.
Well, I won't pretend it's been fun, the man says to me, and turns to go.
Get out!
The blond woman puts up her hand. She moves slowly toward me. No, Jennifer. Put that down. Please put that down. Now, really, did you have to do that?
What has happened. There has been an accident. The phone lies in the hallway amid shattered glass. Cold air sweeps past me, the curtains blow wildly. Outside, a car door slams, an engine starts. I feel alive, vindicated, ready for anything. There's so much more where this came from. O yes, much much more.

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