Still Alice (6 page)

Cognition class

Finalize conference poster and itinerary

Run

Airport

She drank the last watery sip of her iced tea and began to study her lecture notes. Today’s lecture focused on semantics, the meaning of language, the third of six classes on linguistics, her favorite series of classes for this course. Even after twenty-five years of teaching, Alice still set aside an hour before class to prepare. Of course, at this point in her career, she could meticulously deliver 75 percent of any given lecture without consciously thinking about it. The other 25 percent, however, contained insights, innovative techniques, or points for discussion from current findings in the field, and she used the time immediately before class to refine the organization and presentation of this newer material. The inclusion of this constantly evolving information kept her passionate about her course subjects and mentally present in each class.

Emphasis for the faculty at Harvard tipped heavily toward research performance, and so a lot of less than optimal teaching was tolerated, by both the students and the administration. The emphasis Alice placed on teaching was in part motivated by the belief that she had both a duty and the opportunity to inspire the next generation in the field, or at the very least not to be the reason that the next would-be great thought leader in cognition abandoned psychology to major in political science instead. Plus, she simply loved teaching.

Ready for class, she checked her email.

A cold and dusty lightbulb flickered on inside Alice’s head. That was what the mysterious “Eric” had meant on one of her to-do lists last month. It didn’t refer to Eric Wellman at all. It was meant to remind her to email those slides to Eric Greenberg, a former colleague at Harvard, now a professor in the psychology department at Princeton. Alice and Dan had put together three slides describing a quick and dirty experiment Dan had run as part of a collaboration with Eric’s postdoc Michael, to be included in Michael’s talk at the psychonomic meeting. Before doing anything else that might distract her, Alice emailed the slides, along with sincerest apologies, to Eric. Fortunately, he’d get them in plenty of time. No harm done.

A
S WITH MOST EVERYTHING AT
Harvard, the lecture auditorium used for Alice’s cognition course was grander than necessary. The blue upholstered chairs arranged in stadium
seating numbered several hundred more than the students enrolled in the class. An impressive, state-of-the-art audiovisual center stood at the back of the room, and a projection screen as big as those in any movie cinema hung at the front. While three men busily hooked up various cables to Alice’s computer and checked the lighting and sound, students wandered in, and Alice opened her “Linguistics Classes” folder on her laptop.

It contained six files: “Acquisition,” “Syntax,” “Semantics,” “Comprehension,” “Modeling,” and “Pathologies.” Alice read the titles again. She couldn’t remember which lecture she was supposed to give today. She’d just spent the last hour looking over one of these subjects but couldn’t remember which one. Was it “Syntax”? They all looked familiar to her, but none more salient than the others.

Ever since her visit with Dr. Moyer, each time Alice forgot something, her foreboding intensified. This wasn’t like forgetting where she left her BlackBerry charger or where John left his glasses. This wasn’t normal. She’d begun telling herself, in a tortured and paranoid voice, that she probably had a brain tumor. She also told herself not to freak out or worry John until she heard the more informed voice of Dr. Moyer, which unfortunately wouldn’t be until next week, after the psychonomic conference.

Determined to get through the next hour, she took a deep, frustrated breath. Although she didn’t remember the topic of today’s lecture, she did remember who her audience was.

“Can someone please tell me what it says on your syllabus for today?” Alice asked the class.

Several students called out in a staggered, collective voice, “Semantics.”

She had gambled correctly that at least a few of her stu
dents would pounce on the opportunity to be visibly helpful and knowledgeable. She didn’t worry for a second that any of them would think it grievous or strange that she didn’t know the subject of today’s class. There existed a great metaphysical distance in age, knowledge, and power between undergraduate students and professors.

Plus, over the course of the semester, they’d witnessed specific demonstrations of her competence in class and had been wowed by her dominant presence in the course literature. If any of them gave it any consideration whatsoever, they probably assumed that she was so distracted with other obligations more important than Psychology 256 that she didn’t have time even to glance at the syllabus before class. Little did they know that she’d just spent the last hour concentrating almost exclusively on semantics.

T
HE SUNNY DAY HAD TURNED
cloudy and raw by evening, the first real flirtation with winter. A hard rain the night before had knocked most of the remaining leaves off their branches, leaving the trees nearly naked, underdressed for the coming weather. Comfortably warm in her fleece, Alice took her time walking home, enjoying the cold autumn air smell and the crunchy swishing sound her feet made as they strolled through the piles of grounded leaves.

The lights were on inside her house, and John’s bag and shoes rested next to the table by the door.

“Hello? I’m home,” said Alice.

John walked out from the study and stared at her, looking confused and at a loss for words. Alice stared back and waited, nervously sensing that something was dreadfully wrong. Her
mind raced straight to her children. She stood frozen in the doorway, braced for horrible news.

“Aren’t you supposed to be in Chicago?”

“W
ELL
, A
LICE, ALL OF YOUR
blood work came back normal, and your MRI is clean,” said Dr. Moyer. “We can do one of two things. We can wait, see how things go, see how you’re sleeping and how you’re doing in three months, or—”

“I want to see a neurologist.”

O
n the night of Eric Wellman’s holiday party, the sky felt low and thick, like it was going to snow. Alice hoped it would. Like most New Englanders, she’d never outgrown a childlike anticipation of the season’s first snow. Of course, also like most New Englanders, what she wished for in December she’d come to loathe by February, cursing her shovel and boots, desperate to replace the frigid, monochromatic tedium of winter with the milder pinks and yellow-greens of spring. But for tonight, snow would be lovely.

Each year, Eric and his wife, Marjorie, hosted a holiday party at their home for the entire psychology department. Nothing extraordinary ever happened at this event, but
there were always small moments that Alice wouldn’t dream of missing—Eric sitting comfortably on the floor in a living room full of students and junior faculty on couches and chairs, Kevin and Glen wrestling for ownership of a Yankee-swapped Grinch doll, the race to get a slice of Marty’s legendary cheesecake.

Her colleagues were all brilliant and odd, quick to help and argue, ambitious and humble. They were family. Maybe she felt this way because she didn’t have living siblings or parents. Maybe the time of year made her sentimental, searching for meaning and belonging. Maybe that was part of it, but it was also much more.

They were more than colleagues. Triumphs of discovery, promotion, and publication were celebrated, but so were weddings and births and the accomplishments of their children and grandchildren. They traveled together to conferences all over the world, and many meetings were piggybacked with family vacations. And like in any family, it wasn’t always good times and yummy cheesecake. They supported one another through slumps of negative data and grant rejection, through waves of crippling self-doubt, through illness and divorce.

But most of all, they shared a passionate quest to understand the mind, to know the mechanisms driving human behavior and language, emotion and appetite. While the holy grail of this quest carried individual power and prestige, at its core it was a collaborative effort to know something valuable and give it to the world. It was socialism powered by capitalism. It was a strange, competitive, cerebral, and privileged life. And they were in it together.

The cheesecake gone, Alice snatched the last hot-fudge-drenched cream puff and looked for John. She found him in
the living room in conversation with Eric and Marjorie just as Dan arrived.

Dan introduced them to his new wife, Beth, and they offered hearty congratulations and exchanged handshakes. Marjorie took their coats. Dan had on a suit and tie, and Beth wore a floor-length red dress. Late and much too formal for this party, they’d probably gone to another one first. Eric offered to get them drinks.

“I’ll have another one, too,” said Alice, the glass of wine in her hand still half full.

John asked Beth how she liked married life so far. Although they’d never met, Alice knew a little about her from Dan. She and Dan had been living together in Atlanta when Dan was accepted at Harvard. She’d stayed in Atlanta, originally content with a long-distance relationship and the promise of marriage after he graduated. Three years later, Dan had carelessly mentioned that it could easily take five to six, maybe even seven years for him to finish. They had married last month.

Alice excused herself to use the ladies’ room. On the way, she lingered in the long hallway that connected the newer front of the house to the older back, finishing her wine and cream puff as she admired the happy faces of Eric’s grandchildren pictured on the walls. After she found and used the bathroom, she wandered into the kitchen, poured herself another glass of wine, and fell captive to a boisterous conversation among several of the faculty wives.

The wives touched elbows and shoulders as they moved about the kitchen, they knew the characters in each other’s stories, they praised and teased each other, they laughed easily. These women all shopped and lunched and attended book
clubs together. These women were close. Alice was close with their husbands, and it set her apart. She mostly listened and drank her wine, nodding and smiling as she followed along, her interest not truly engaged, like running on a treadmill instead of on an actual road.

She filled her wineglass again, slipped unnoticed out of the kitchen, and found John in the living room in conversation with Eric, Dan, and a young woman in a red dress. Alice stood next to Eric’s grand piano and strummed the top of it with her fingers while she listened to them talk. Each year, Alice hoped that someone would offer to play it, but no one ever did. She and Anne had taken lessons for several years as children, but now she could remember only “Baby Elephant Walk” and “Turkey in the Straw” without sheet music, and only the right hand. Maybe this woman in the fancy red dress knew how to play.

At a pause in the conversation, Alice and the woman in red made eye contact.

“I’m sorry, I’m Alice Howland. I don’t believe we’ve met.”

The woman looked nervously at Dan before she answered. “I’m Beth.”

She seemed young enough to be a graduate student, but by December, Alice would have at least recognized even a first-year student. She remembered Marty mentioning that he’d hired a new postdoctoral fellow, a woman.

“Are you Marty’s new postdoc?” asked Alice.

The woman checked with Dan again. “I’m Dan’s wife.”

“Oh, so nice to finally meet you, congratulations!”

No one spoke. Eric’s gaze bounced from John’s eyes to Alice’s wineglass and back to John, carrying a silent secret. Alice wasn’t in on it.

“What?” asked Alice.

“You know what? It’s getting late, and I’ve got to get up early. You mind if we get going?” asked John.

Once they were outside, she meant to ask John what that awkward saccade was about, but she became distracted by the gentle beauty of the cotton-candy snow that had begun to fall while they were inside, and she forgot.

T
HREE DAYS BEFORE
C
HRISTMAS
, A
LICE
sat in the waiting room of the Memory Disorders Unit at Massachusetts General Hospital in Boston pretending to read
Health
magazine. Instead, she observed the others who waited. They were all in pairs. A woman who looked twenty years older than Alice sat next to a woman who looked at least twenty years older than her—most likely her mother. A woman with big, unnaturally black hair and big gold jewelry talked loudly and slowly in a thick Boston accent to her father, who sat in a wheelchair and never looked up from his perfectly white shoes. A bony, silver-haired woman flipped pages of a magazine too quickly to be reading anything next to an overweight man with matching hair and a resting tremor in his right hand. Probably husband and wife.

The wait to hear her name took forever and seemed longer. Dr. Davis had a young, hairless face. He wore black-rimmed glasses and a white lab coat, unbuttoned. He looked like he used to be thin, but his lower torso slumped a bit beyond the outline of his open coat, reminding Alice of Tom’s comments about the poor health habits of physicians. He sat in a chair behind his desk and invited her to have a seat across from him.

“So Alice, tell me what’s been going on.”

“I’ve been having lots of problems remembering, and it doesn’t feel normal. I’m forgetting words in lectures and conversation, I need to put ‘cognition class’ on my to-do list or I might forget to go teach it, I completely forgot to go to the airport for a conference in Chicago and missed my flight. I also didn’t know where I was for a couple of minutes once in Harvard Square, and I’m a professor at Harvard, I’m there every day.”

“How long have these things been going on?”

“Since September, maybe this summer.”

“Alice, did anyone come here with you?”

“No.”

“Okay. In the future, you’re going to have to bring a family member or someone who sees you regularly in with you. You’re complaining about a problem with your memory; you may not be the most reliable source of what’s been going on.”

She felt embarrassed, like a child. And his words “in the future” harassed her every thought, commanding obsessive attention, like water dripping from a faucet.

“Okay,” she said.

“Are you taking any kind of medicine?”

“No, just a multivitamin.”

“Any sleeping pills, diet pills, drugs of any kind?”

“No.”

“How much do you drink?”

“Not a lot. One or two glasses of wine with dinner.”

“Are you a vegan?”

“No.”

“Have you had any sort of past injury to your head?”

“No.”

“Have you had any surgeries?”

“No.”

“How are you sleeping?”

“Perfectly fine.”

“Have you ever been depressed?”

“Not since I was a teenager.”

“How’s your stress level?”

“The usual, I thrive under stress.”

“Tell me about your parents. How’s their health?”

“My mother and sister died in a car accident when I was eighteen. My father died of liver failure last year.”

“Hepatitis?”

“Cirrhosis. He was an alcoholic.”

“How old was he?”

“Seventy-one.”

“Did he have any other problems with his health?”

“Not that I know of. I didn’t really see much of him over the last several years.”

And when she did, he was incoherent, drunk.

“What about other family?”

She relayed her limited knowledge of her extended family’s medical history.

“Okay, I’m going to tell you a name and address, and you’re going to repeat it back to me. Then, we’re going to do some other things, and I’m going to ask you to repeat the same name and address again later. Ready, here it is—John Black, 42 West Street, Brighton. Can you repeat that for me?”

She did.

“How old are you?”

“Fifty.”

“What is today’s date?”

“December twenty-second, 2003.”

“What season is it?”

“Winter.”

“Where are we right now?”

“Eighth floor, MGH.”

“Can you name some of the streets near here?”

“Cambridge, Fruit, Storrow Drive.”

“Okay, what time of day is it?”

“Late morning.”

“Name the months backward from December.”

She did.

“Count backward from one hundred by six.”

He stopped her at seventy-six.

“Name these objects.”

He showed her a series of six cards with pencil drawings on them.

“Hammock, feather, key, chair, cactus, glove.”

“Okay, before pointing to the window, touch your right cheek with your left hand.”

She did.

“Can you write a sentence about today’s weather on this piece of paper?”

She wrote, “It is a sunny but cold winter morning.”

“Now, draw a clock and show the time as twenty minutes to four.”

She did.

“And copy this design.”

He showed her a picture of two intersecting pentagons. She copied them.

“Okay, Alice, hop up on the table. We’re going to do a neurological exam.”

She followed his penlight with her eyes, she tapped her thumbs and pointer fingers together rapidly, she walked heel to toe in a straight line across the room. She did everything easily and quickly.

“Okay, what was that name and address I told you earlier?”

“John Black…”

She stopped and searched Dr. Davis’s face. She couldn’t remember the address. What did that mean? Maybe she just hadn’t paid close enough attention.

“It’s Brighton, but I can’t remember the street address.”

“Okay, is it twenty-four, twenty-eight, forty-two, or forty-eight?”

She didn’t know.

“Take a guess.”

“Forty-eight.”

“Was it North Street, South Street, East Street, or West Street?”

“South Street?”

His face and body language didn’t expose whether she’d guessed right, but if she had to guess again, that wasn’t it.

“Okay, Alice, we have your recent blood work and MRI. I want you to go for some additional blood work and a lumbar puncture. You’re going to come back in four to five weeks, and you’ll have an appointment for neuropsychological testing on that same day, before you see me.”

“What do you think is going on? Is this just normal forgetting?”

“I don’t think it is, Alice, but we need to investigate it further.”

She looked him directly in the eye. A colleague of hers had once told her that eye contact with another person for more than six seconds without looking away or blinking revealed a desire for either sex or murder. She reflexively hadn’t believed this, but it had intrigued her enough to test it out on various friends and strangers. To her surprise, with the excep
tion of John, one of them always looked away before the six seconds was up.

Dr. Davis looked down at his desk after four seconds. Arguably, this meant only that he wanted neither to kill her nor tear her clothes off, but she worried that it meant more. She would get prodded and assayed, scanned and tested, but she guessed that he didn’t need to investigate anything further. She’d told him her story, and she couldn’t remember John Black’s address. He already knew exactly what was wrong with her.

A
LICE SPENT THE EARLIEST PART
of Christmas Eve morning on the couch, sipping tea and browsing through photo albums. Over the years, she had transferred any newly developed pictures to the next available slots beneath the clear plastic sleeves. Her diligence had preserved their chronology, but she’d labeled nothing. It didn’t matter. She still knew it all cold.

Lydia, age two; Tom, age six; and Anna, seven, at Hardings Beach in June of their first summer at the Cape house. Anna at a youth soccer game on Pequossette Field. She and John on Seven Mile Beach on Grand Cayman Island.

Not only could she place the ages and setting in each snapshot but she could also elaborate in great detail on most of them. Each print prompted other, unphotographed memories from that day, of who else had been there, and of the larger context of her life at the time that the image was captured.