THE PRESIDENT OF THE UNITED STATES took René’s hand. “Great job. We’re very proud of you, all of you,” he said. “You’re making medical history.”
“Thank you,” said René, still trying to process whose grip she had just been in.
The president made his way down the line of nurses and other staffers of Broadview Nursing Home, being led by Carter Lutz and an entourage of VIPs, including Gavin Moy and other GEM Tech execs, officers from the Alzheimer’s Association and other health care organizations. Also with them were Nick Mavros, Jordan Carr, and several other clinical physicians as well as security guards.
The president entered the dayroom and chatted with residents who sat in their chairs and had their photos taken. Some recognized him from television and were delighted. Other patients—those not receiving Memorine—were not sure who he was. One of the women announced that she saw Dwight Eisenhower once. The president complimented her on her memory.
As the president approached him, Louis Martinetti rose to attention with a crisp salute. He was dressed in his uniform, now two sizes too small for him. Several people chuckled, although René felt a pang of embarrassment for Louis. He did not seem to be playacting but stood there in stern pride with his Purple Heart, Combat Infantryman Badge, parachutist badge, and other medals and looked straight ahead as the president stopped before him, saluted back, then walked on by, smiling and nodding.
Carter Lutz called attention to the gathering and thanked the president for visiting them. He praised the president for his track record of advocating for the elderly and supporting legislation aimed at early detection of Alzheimer’s disease. Lutz also thanked him for keeping his campaign pledge and embracing “the Memorine Solution.”
The president thanked Dr. Lutz and everybody associated with the Memorine study. “One doesn’t have to look beyond this room to see miracles in action. I congratulate all of you and the good people at the other clinical sites and the researchers and scientists who have made this possible. Memorine
represents a sea change in the treatment of Alzheimer’s disease. I wish you continued success in bringing hope to AD victims and their caregivers everywhere.”
A joyous applause filled the room.
The president was right, of course. The AD unit at Broadview was a changed place. In the months since René first entered the ward, the decibel level of the chatter had multiplied. And not just the white noise mumbling and gibberish “word salads,” but talk—purposeful, coherent talk. Patients communicating with staffers, other patients, visitors, themselves. Likewise, the collective kinetic energy level had risen. A year ago, a time-lapse video of the ward would pass for a still life, with an occasional nurse or aide scurrying across the camera or a few patients shuffling by on foot or walker across the dayroom set. Today the ward could easily be mistaken for an active senior citizens center. Patients who months ago would sit and gape at nothing for hours on end were now mingling with others or following aides around asking if they could help.
The president concluded, “I need not remind you that a cure for Alzheimer’s disease would save over fifty billion dollars of American taxpayer money in health care.”
More applause.
Of course, the president’s endorsement was also a public relations bonanza for GEM Tech, whose stock value was soaring as the public anticipated the drug being brought to market soon. And everybody knew that, including Jordan Carr, who was beaming brightly at René from the other side of the room.
When the place settled down, Nick addressed the group, thanking the president for his support. “We are seeing extraordinary progress. And the evidence is in this room, as you have seen, Mr. President. But more work needs to be done, and that’s what we’re doing in collaboration with researchers at GEM Tech.”
Some of the nurses and aides nodded in agreement. Jordan Carr, who was standing with the GEM Tech VIPs, shot a glance to Gavin Moy and the other suits, then turned toward Nick, where all lines of attention converged.
In guarded language, Nick praised the progress of the trials, then added a subtle warning: “But I must caution that the road to success is long and winding and fraught with unexpected turns, although I am very confident that as we continue to make our way, one measure at a time, we will succeed.”
More applause.
The president and entourage left the room, and Louis snapped to attention with a salute.
BEHIND NICK’S CAUTIOUS WORDING WERE THINGS that the president did not see: the growing number of recovering patients lapsing into regressive flashbacks. The weird infantilizing of their personalities. The sudden morphing into some past self that talked to people who weren’t there while not recognizing those who were. The sometimes frightening lapses into traumatic flashbacks when the only recourse was to dope patients down until they had no more affect than when lost in the fog of dementia.
That’s what the president did not see. Or the cameras.
THEY ALSO DID NOT SEE THE Louis Martinetti beneath the chest of medals.
Every health care worker has patients she likes and patients she dislikes. Some are simply unpleasant to deal with—people ill-tempered, mean, or belligerent. At the other end are individuals in whose comfort and well-being one feels an extra emotional investment. For René, Louis Martinetti fell into that special category of favorites.
Yes, Louis reminded her of her own father. Each was a Korean War vet, each had lived an active mental life, and each had been a devoted family man and a great guy. It was those ordinary “great guy” characteristics that over the months were beginning to reemerge and endear Louis to René.
An hour after the president had left, René sat with Louis in the small parlor with a view of the woods. “So, what did you think of the president’s visit?”
“Pretty good.”
“I think he liked your saluting him like that.”
Louis smiled proudly. He was still wearing his army shirt with the decoration and his old dog tags around his neck. Even in his facial expression he resembled René’s father. And in these quiet moments she was brought back to tender intimacies as a girl. Perhaps that was why Louis’s progress was of special concern for her—as if, in Jordan Carr’s metaphor, she were witnessing the defeat of the demon that had left her father a ragged husk of himself.
Louis’s progress was remarkable on all fronts. Nick’s imaging sequence over the last several months showed a reduction of protein deposits and neurofibrillary tangles in the frontal temporal lobe—the seat of language and logic functions—as well as the hippocampus, a region of the brain essential to maintaining memory. Likewise, the gray-matter tissue had increased in density. As his functional abilities for his basic activities of daily living (dressing, personal hygiene, feeding himself) approached baseline normal, Louis had become more self-directed and more socially deft than he had been, now mingling with other residents. He had also become more concerned with his appearance, no longer emerging from his room in mismatched tops and
pants. And, of course, René always complimented him on how nice he looked, and Louis loved that.
With some effort he could read news headlines. He knew the days of the week and the schedule for his favorite TV shows. He recognized the people and faces in the photos in his room without labels. He’d sometimes talk to the guys in the Korea snapshots by name, often snapping them a salute.
Louis’s Korean memories were important to him. As his daughter once said, in spite of the time spent in a POW camp—something he never talked about—the army had been the best time of Louis’s life. He was young, feeling immortal, bonding with other guys, and engaged in an effort he deeply believed in. Ironically, Korea was part of why he had been committed to Broadview two years earlier. Louis had thrown a violent fit when he thought that his wife had hidden his Purple Heart. When he calmed down, she showed him that the medal was stored in the special war memorabilia chest in the bedroom where it had always been. An hour later he accused her of taking it once more. When she again showed him the medal, he claimed she was trying to trick him. She denied it, and he pushed over the chest and smashed a mirror. A few days later he pushed Mrs. Martinetti to the floor. It was then he had been admitted to Broadview. Luckily, he remembered nothing of the incident.
The definitive evidence of Louis’s progress were the Mini-Mental State Exams, which consisted of different memory tests—lists of grocery or household items that the subject was asked to repeat in any order, word associations, et cetera. For healthy individuals from eighteen to twenty-four years of age with at least nine years of schooling, the median score is twenty-nine out of thirty. For healthy individuals seventy to seventy-nine years of age and older—Louis’s range—the median is twenty-eight. When first tested last year, Louis scored sixteen, indicating moderate cognitive impairment. That morning of the president’s visit he scored twenty-four. Also impressive was that Louis had developed learning strategies, clustering items according to semantic categories—food, tools, clothes, et cetera—a practice more sophisticated than simply remembering serial order. He also enjoyed taking the tests because he could measure how daily dosages of Memorine were bringing him back.
“You’re doing a great job, Louis, and we’re all proud of you.”
He smiled with pleasure. “Coming along.”
“I never told you this, but my father was in Korea.”
Louis’s eyes widened with interest. “What branch? I was in the 187th Airborne.”
“Yes. I saw the photograph from Korea in your room. My father was in the navy, and spent most of his time on a ship called the USS
Maddox.”
“USS
Maddox.
That was the Seventh Fleet.”
René was astounded. It was one of the few things she knew about the
Maddox.
“Yes, it was. How did you remember?”
“I remember lots of stuff about the war.” He looked away for a moment as he began to gather some recollections. “The guy in that picture. He was my best friend, Fuzzy Swenson. You look like his sister.”
René began to feel uncomfortable and thought it best to change the subject. “Maybe you can tell me about where you grew up.”
But he disregarded her. “He was our platoon sergeant. His real name was Sam but all the guys called him Fuzzy. Blond hair, cut real short,” and he held up his forefinger and thumb, making a small gap. “Like peach fuzz. Why we called him Fuzzy. He was our gunner, real good kid from … Racine, Wisconsin. We used to josh him about being from the land of milk and beer.”
“It’s great that you can still remember him.”
“Yeah, I remember him.” Louis nodded then looked out the window.
He looked back at her for a puzzled moment and René felt herself brace against whatever was coming next. His eyes rounded as his glare intensified—and she could swear something passed through them. “Louis?”
His head snapped at the window again. “They said it would be a surgical drop.”
“What’s that?”
He looked back at her, and his eyes seemed slightly askew.
“Louis, are you okay?”
“Captain Vigna. He said we were going to fly a special mission one night when conditions were just right.”
“Louis, I don’t know what you’re talking about.”
He smiled furtively and cocked his head. “I don’t know when it’s gonna be, but it’s going to be a drop behind enemy lines. Gonna take out those bastards for what they did.”
“Louis, maybe we should change the subject.”
But he did not respond—just stared off someplace and began to get jiggly.
She took his hand. “Come on, let’s go to the dayroom.” She started to pull, but he snapped his hand away.
Suddenly Louis’s face began to spasm with emotions. He grimaced out the open window at the trees, looking as if he had spotted something terrible. He ducked down then shot up, and for a second he looked as if he were going
to attack René. Instinctively she pushed back her chair and looked around for help. But in the next instant Louis gasped and pressed the heels of his hands against his brow, as if trying to force back some awful visions.
“They killed him, the bastards. They killed him in pieces.”
“Louis, let’s talk about something else. You’re getting upset.” She thought about calling an aide.
He glared at her through wild eyes. “They took care of him good. Oh, yeah. In the Red Tent, the dirty bastards. The Red Tent is where they did it all. Colonel Chop Chop and Blackhawk, the Russkie.” Louis began to lick his lips and swallow hard against whatever was afflicting his recall. Suddenly his face contorted. “He was sitting right across from me.” Then his voice changed. “Between my goddamn knees,” he cried in dismay. “They put it between my knees. In my goddamn helmet. God!” His voice thinned out into a plea.
“Please don’t. Please don’t. I’ll tell you whatever you want.”
The next moment his face spasmed into something else, and he sat up straight in his chair, his voice hard. He was wavering in and out of some awful recollection. “Yeah, I was there. Not six feet away, and they kept cutting him—the bastard with the baby face and knife.”
Louis’s eyes dilated as he seemed to stare beyond René as he addressed her. “I couldn’t make them stop, you got me? No matter what, I couldn’t make them. And those two bastards stood in the corner telling him to keep going, keep cutting, no matter what I told them. I begged them.” Louis’s face crumbled, and he looked down at his lap and the sleeve of his shirt. “I got his blood on me.”
René took his arm. “Louis, snap out of it. Everything’s okay.”
From the corridor a nurse and two male aides walking by saw the commotion and shot over to their table. René was on her feet trying to calm Louis, who was trying to get away, his face contorted with anguish. When Louis laid eyes on Malcolm, he started yelling and swinging his arms.
“Hey, Louis, what’s the problem?” He tried to catch Louis’s arms and keep him from breaking away.
“Louis, calm down. Everything’s okay,” the nurse said.
But it was clear Louis was beyond reasoning with, lost someplace far away. Malcolm managed to pin Louis’s arms from behind and settle him in a chair.
Louis kept looking behind him. “Over there,” he said to the aide.
“What’s over there?” the aide said, looking at the trees outside.
Louis shook his head. His face was taut, his eyes squinting as if trying to get a clear focus.
“Come on, Louis,” the nurse said. “You’re upsetting all these people.”
But Louis kept looking across the area, his eyes fixed on something else. “Louis, open up.” René could see the nurse hold a pill to his mouth.
“They cut one side, then the other,” he said to the aide. Then he looked down at his lap, seeing imaginary horror.
“Come on, open up.”
Louis looked at the pill and water bottle in the nurse’s hand and pushed her hand away. But she persisted. “You have to take this, Louis. It’ll make you feel better.”
He shot a look at René. “They’re trying to brainwash me,” he whispered. “It’s what they do, they brainwash you.”
“Don’t be silly, Louis,” the aide said. “Nobody’s brainwashing you. Open up.”
René could see the small yellow pill. Haldol. One of the antipsychotics the staff had been giving patients suffering flashbacks. But to Louis the pill represented something else. “Who, Louis?” René asked, disregarding the others. “Who’s trying to brainwash you?”
“The NKPA,” he whispered to her. “The fucking Commies. Take it and you’re gone, kaput.”
He struggled to get up again, still focused on his buddy dying and the blood on his hands and enemy gunners on the ridge. René took Louis’s hand. “Louis, it’s René. Look at me. Please look at me.” Louis turned his face toward her. Tears were in his eyes. “Nobody’s brainwashing you. Please believe me. Please take the pill.”
He glared at her for a moment, then he opened his mouth to say something, and the nurse pressed a pill inside and put the bottle to his lips and squirted some water. Reflexively Louis swallowed as if drinking from a buddy’s canteen. “He’s got a kid sister. What’re we going to tell her, huh? That they cut him up?”
Then something clicked inside of him, and his expression changed. “Gotta get them back,” he said to René in a conspiratorial whisper. “I promised.” The aides raised Louis to his feet and began to walk him to his room. “I gave him my word.” And he tugged against the grip of the aide.
René’s insides squeezed as she took one of Louis’s hands, feeling as if she had betrayed him. Because in a few minutes he’d be back in the ward—in the moment, and that was not where he wanted to be.
“It’s what they do. They brainwash you.”
He wanted to be back with his buddies of the 187th Airborne, going on his “special” drop, avenging whatever they did to Fuzzy Swenson in the Red Tent.
As they approached the door, Louis looked at René, then over his shoulder. “I saw him and his buddy. I saw the bastards.” His eyes were huge and blazing.
“Who, Louis? Who did you see?”
“The colonel.”
“What colonel?”
“Chop Chop.”
“Who’s Chop Chop, Louis? Tell me.”
“They were here.”
“Who, Louis?”
But Louis didn’t answer. He just nodded to himself as they hauled him to his room.