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A World of Light

University of Nebraska Press

Chapter One

Clarence is a wanderer. That's why Meg the social worker and Lucy the activities coordinator are peering through a crack between the locked doors of the Memory Impairment Unit. They need to be sure Clarence isn't poised on the other side waiting to make his escape when those doors open.

"Oh, no," Meg whispers. "He's right there." "So is Eva," Lucy says. "Over against the wall."

They turn around to face me and Beverly. "All right, here's what we do," Meg tells us. She is a solid woman in her late thirties, authoritative but somehow gentle at the same time. Meg inspires confidence here where confidence is difficult to achieve. "When the doors open, you both walk straight in. Don't stop and don't let Clarence get hold of you. I'll take Clarence for a walk; Lucy will deal with Eva." I nod, but must look troubled because Meg adds, "Don't worry, this is normal with Alzheimer's. It's not because they're being mistreated or anything. A lot of them wander. But your mother's not a wanderer."

No, my mother is not a wanderer. In fact, at ninety she vastly prefers to perch on a chair and catch the action as it passes. Though she can ambulate with a walker, she prefers to stay put. Any aide who crosses her field of vision is asked what time it is, at which point my mother will check her wrist watch and agree. Any staff not carrying or pushing something is askedto call me on the phone so my mother can find out why I never come to visit. Any man who happens by is invited to sit beside her. If there are activities going on, she wants to be involved: she sings, she draws, she even goes on "mystery outings" where, for example, she has picked raspberries on a nearby farm, something I cannot imagine no matter how hard I try. She has been at the nursing home for a month; changes are happening to her quickly now, and not all of them seem bad. She is uncharacteristically mellow and friendly. She often smiles or hums snatches of old standards. She makes few demands or complaints, except around the issue of my visits. The problem is that she forgets them as soon as Beverly and I leave, and is convinced we never come to see her though we are there at least weekly. We have bought a wall calendar for her on which to note our visits, but know she will not remember to look at it.

Not a wanderer, not incontinent, astonishingly healthy for someone who smoked Chesterfields for sixty years and was always overweight and never exercised, my mother is thriving now that we have moved her from New York to Oregon. But, though she has not been diagnosed with Alzheimer's disease, her memory impairment is severe and progressing steadily. After a month of transition in the nursing home's Intermediate Care Unit, she has been recommended for the Memory Impairment Unit where she can receive more appropriate, concentrated support. This is also where Clarence and Eva live, and where we are all going for a tour if we can charge in without letting the others escape.

Before she turns back to open the door, I ask Meg if everyone in the unit spends the whole day trying to get out. I wonder if this is the right move for my mother.

"Oh no, just Clarence and sometimes Eva. If she sees him waiting by the door, she follows. The rest are like your mother, and we take them out for all the usual activities." She places a hand on my arm for a moment. "Really, don't worry. If you don't feel good about this, we won't move your mother at all."

The door is opened, and Clarence is led out. Head down, arms raised to wedge aside any further obstacles, he nods as he rumbles like a fullback toward the lobby. As the doors close, Lucy and I elude a stunned Eva. But Beverly-who is a hospice social worker and deeply empathetic toward the elderly-stops in front of her, smiling. Eva is tense and wants to go after Clarence, but relaxes as Beverly speaks. She smiles back, nods. Then her eyes flick toward the door and she tries an end-run to Beverly's right. Moving with Eva, never restraining her, keeping her verbally engaged, Beverly gets her to settle down.

An obviously relieved Lucy leans back against the wall and begins to ask me about my mother's history. She says my mother is charming, cooperative, and talented, a joy to work with. We chat about my mother's easy adjustment; then out of the corner of my eye I see Jessica Tandy edging her way toward us.

"Hello, Millie," Lucy says when Jessica Tandy reaches us. "Millie, this is Floyd. His mother will be moving onto the unit soon."

Jessica Tandy-Millie's resemblance to the late actress is too striking to ignore-keeps moving closer to Lucy, even though she's already in contact with her. It seems at first as though she's trying to crawl inside Lucy's skin, which I imagine as another form of escape. But then I see she has gripped Lucy's upper arm and is squeezing it, crowding the younger woman against the wall. Her knuckles and Lucy's biceps whiten.

"I know what you're up to," Jessica Tandy hisses. "Don't think you can fool me."

"That's all right, Millie."

"You shameless hussy!"

Now Lucy is trying to disentangle herself and I can see that Jessica Tandy is beginning to turn toward me. I'm next, and don't want to imagine what Ms. Tandy has in store for me, so I wave to Lucy and head for the doors, where Beverly waits.

Outside again, in the lobby, I see that Meg has led Clarence to a plush easy chair and is bringing my mother over to meet him. We join them just in time for the introductions.

"Clarence," Meg says, "I'd like you to meet Lillian. She'll be moving onto the unit."

Clarence lifts his hand and places it over his eyes, turning his head away. My mother, whose memory may be shattered but whose flirting instincts remain intact, moves closer to him.

"Hello, Clarence," she says, her voice suddenly deepening.

He turns his head further away, eyes totally hidden.

"Say hello," she coos. "Come on, Clarence."

He sinks further into his chair.

"All right, then. We can meet later." She looks in my direction and smiles. "Floyd! What are you doing here?"

They might as well hang a sign in front of The Home saying "Welcome All!" As life span increases, more and more elderly people inhabit bodies that have outlived their minds. This is surely why Newsweek, in a 1998 cover story, discovered that memory was the main health worry of baby boomers. The chairman of Harvard's Psychology Department, Daniel L. Schacter, says in his book Searching for Memory that "decades of research leave little doubt that aging can impair memory." He notes that "overall brain mass steadily shrinks as we enter our sixties and seventies, at roughly 5 percent to 10 percent per decade." Blood and oxygen flow to the brain diminishes; the frontal lobes shrink; the hippocampus, cornerstone in forming explicit memories and developing our sense of self, atrophies; the basal forebrain, implicated in most amnesias, loses neurons and lessens the production of essential memory chemicals. All this happens in "healthy" aging brains. The situation is even more dire in the brains of people with Alzheimer's disease.

So the longer we live, the more certainly we should begin queuing up for space in The Home. And while we inch closer to the doors, we can imagine what living with a damaged system of memory will be like. In daily life, especially in busy daily lives, memory's normal unreliability offers us glimpses of what my mother or Clarence or Eva are experiencing: a frustrated scramble through your house in search of the lost appointment book that you're carrying in your hand; the smiling man striding across a room toward you with his hand outstretched and saying how good it is to see you again, though you have no idea who he is; the name of that woman you played racquetball with last month, it's on the tip of your tongue, the one you'd like to call because you have an extra ticket to see Carmen; that sailing trip you took with your older brother on Lake Michigan, which he says never happened. These are each different forms of forgetting, of memory's lapses. Most of the time, they are normal occurrences, not signs of illness but signs that memory is doing what it is designed to do, ridding itself of inessential matter, uncluttering. But as age-related dementia sets in, such forgetting intensifies and worsens, eradicating even the most essential matter, until nothing is left.

I find myself coming through the doors of The Home now with a triple sense of distress. Not only is my mother there and her condition worsening, not only are we all headed there, but I have sustained the kind of damage that might accelerate my movement up the queue. Every time I visit my mother, I also feel myself being whisked back to 1988, to Washington DC. I become aware of a creepiness inside the cranium, as though actually experiencing, in real time and as a physical sensation, the invasion of those lesions speckling my frontal lobes, throwing neurochemicals out of balance, fraying cerebral nerve endings, bringing me closer and closer to The Home. Just this week, I have twice forgotten the name of my newly published book, tried to plug the coffee maker into the vent on the microwave, left my wallet in the car while bringing the tire gauge inside and placing it on the shelf where my wallet goes, phoned my doctor when I meant to phone my Internet service provider, and said I walk with a horn when I meant to say I walk with a cane. If tested by The Home's staff on a bad day, I'm afraid I might qualify for a room my-mother's dream come true.

We are accompanying my mother down the hall. A plastic tag printed with her name has been wound around her walker's cross bar and she stops to point this out to us.

"Look! It says my name."

"Yes. That's because this is your walker."

"This is my walker?"

I nod and my mother begins moving again. After three steps, she looks down and stops. "Look! This thing has my name on it."

Beverly answers, "That's right, Mother. Lillian Rosen."

"Lillian Rosen? That's my name?"

We take a few more steps and stop. She points toward the plastic tags. "Look here! What does this say?"

"It says your name: Lillian Rosen," I tell her. When she looks up again, eyes turning toward the solarium that is our destination at the hallway's end, I flip the tag over so it dangles downward and won't distract her.

We take three more steps and she stops, looks down, and frowns. "Where is that tag? My name is gone!" She is getting agitated, a mood whose resonances I recognize deep in my bones and haven't felt emanating from her since she has moved here. "Someone must have taken my walker."

I touch her shoulder, sorry for having messed things up, and flip the tag back upright. "No, it was just hidden. Here we go, this is your walker after all."

"This is my walker?"

We are all nodding now, catching our breath. I point toward the solarium, but my mother looks back down to check things out.

"See?" I ask. "Lillian Rosen's walker."

"I should give it back to her," my mother says. "Because I have one of my own. It has my name on it."

There is nothing to be done about my mother's wrecked short-term memory system. She will only get worse, each instant vanishing into the next without continuity. But there is a remote hope that her long-term memory can still be stimulated.

We have brought a series of framed photographs and placed them around my mother's half of the room. The nurses and residential care manager have told us that photos are very important. There is one of me and Beverly, a little out-of-date now according to the lack of grizzle in my beard and the length of Beverly's blond hair. There is a nice one of my daughter Becka and her then-husband Gualtiero. In the last two years, my mother saw them several times, when she still lived in New York, and they traveled up from Pittsburgh to visit. She was dazzled by Gualtiero's good looks and warmth, almost as much as by his Italian name and accent. Before her symptoms began their final worsening, she loved telling him that she once lived for a year in Rome, so she was practically an Italian native. With a flutter of her eyes, she would say a few words to Gualtiero in Italian. Why, if Becka wasn't careful, my mother would say, she just might lose her husband to her own grandmother. We've given Becka's photo pride-of-place on the bedside table. Nearby is a large photo of my mother's brother Al, who died about fifteen years ago. They were eighteen months apart in age and he was someone, perhaps the only person I could remember, that my mother adored without restraint or criticism. There is also a photo of her second husband, Julius Rosen, a man to whom she was married for a quarter century after my father's death.

Visits commence with an examination of these images. A few months ago, my mother was having trouble recalling the faces, so Becka taped the relevant information on the back of each: "Beverly and Floyd - Lillian's son and daughter-in-law;" "Becka and Gualtiero - Lillian's granddaughter and grandson-in-law." But now my mother either forgets that the labels are there, or removes and places them on different pictures. I think that when her brother becomes her second husband and her granddaughter becomes her daughter-in-law, it perfectly reflects the state in her mind. I can never decide whether the presence of these pictures helps or haunts my mother.

"Who is this?" she says, holding the one of me and Beverly. She looks from the picture to my face and then to Beverly's, looks back down, back up, and her eyes widen. "This is you!"

"That's right. Me and Beverly."

"Who?"

"Beverly," I say, and nod toward the closet where Beverly is examining the condition of my mother's clothes.

My mother's voice lowers toward a whisper. "She's a beautiful girl. You ought to marry her."

She replaces the picture and picks up the one of Becka and Gualtiero. "Do I know these people?"

"That's your granddaughter," I tell her. "Becka."

"I have a granddaughter?" When I nod she shakes her head vigorously and says, "Can't be."

"Why not?"

"I'm not old enough." She looks at me to see what I will say to that.

I realize she is not sure how old she is, or if she's even "old" at all. I also begin to sense that she's not certain who I am, or how we might be connected. In the last month, she has mistaken me for her husband, her grandson, her last boyfriend, and her doctor, though initially - upon first seeing my face or hearing my voice - she knows me to be Floyd and her son. As visits progress, though, or as she tires, facts blur. She is puzzled now, looking at the picture, then at me, then at the skin of her hand that holds the picture. The hand captures her attention. She puts the picture down and runs a finger over the wrinkled surface of her other hand. "How old am I?" she finally asks.

"You're ninety."

"Ninety? I certainly am not."

"It's true, Mother; you'll be ninety-one in October."

"October 14!" she announces, smiling. "And don't you forget my birthday, either. I want chocolate." But her mood stays foggy; she reaches for the picture and notices her hand again, then looks up at me, her expression unstuck, bewildered. "I was born in 1910, wasn't I?"

"Yes, and it's 2001."

She begins some kind of count, folding fingers in turn, then shakes her head. "How old am I?"

"Ninety."

She sighs. "Don't say that."

Turning the photo back over, she asks again who these people are.

"That's Becka and Gualtiero."

"What kind of name is that? Quateero?"

"It's Italian." She does not respond. "You lived in Italy for a year, Mother. Remember?"

She shakes her head. "Why would I do a thing like that?"

I reach for the photo of her brother, ready to change the subject as she wishes, alarmed by how far and how fast she has deteriorated. This was always her favorite photo; it was taken at a ski resort in Switzerland, probably sometime in the late 1970s. Al was nearing seventy but looks much younger despite his graying hair.

"Who is that boy?" she asks.

"This is your brother."

"Oh, Albie." She closes her eyes, shakes her head. "It's so sad. That was taken when he was in high school. Yes, yes. He died when he was a baby, you know. I never got over it."

(Continues...)

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Excerpted from A World of Light by Floyd Skloot Copyright © 2005 by University of Nebraska Press. Excerpted by permission.
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