studied hers. They were both older than forty, younger than old, both married, highly educated professional women. Alice didn’t know her doctor’s politics. She’d see another doctor if she had to. Her dementia was going to get worse. She couldn’t risk waiting any longer. She might forget.
She had rehearsed additional dialogue but didn’t need to use it. Dr. Moyer got out her prescription pad and began to write.
SHE WAS BACK IN THAT tiny testing room with Sarah Something, the neuropsychologist. She’d reintroduced herself to Alice just a moment ago, but Alice had promptly forgotten her last name. Not a good omen. The room, however, was as she remembered it from January—cramped, sterile, and impersonal. It contained one desk with an iMac computer on it, two cafeteria chairs, and a metal file cabinet. Nothing else. No windows, no plants, no pictures or calendar on the walls or desk. No distractions, no possible hints, no chance associations.
Sarah Something began with what felt almost like regular conversation.
“Alice, how old are you?”
“Fifty.”
“When did you turn fifty?”
“October eleventh.”
“And what time of year is this?”
“Spring, but it already feels like summer.”
“I know, it’s hot out there today. And where are we right now?”
“In the Memory Disorders Unit at Mass General Hospital, in Boston, Massachusetts.”
“Can you name the four things shown in this picture?”
“A book, a phone, a horse, and a car.”
“And what is this thing on my shirt?”
“A button.”
“And this thing on my finger?”
“A ring.”
“Can you spell ‘water’ backwards for me?”
“R-E-T-A-W.”
“And repeat this after me: Who, what, when, where, why.”
“Who, what, when, where, why.”
“Can you lift your hand, close your eyes, and open your mouth?”
She did.
“Alice, what were those four objects in the picture you named before?”
“A horse, a car, a phone, and a book.”
“Great, and write a sentence for me here.”
I cannot believe that I won’t be able to do this someday.
“Great, now name for me as many words as you can in a minute that begin with the letter s.”
“Sarah, something, stupid, sound. Survive, sick. Sex. Serious. Something. Oops, I said that. Said. Scared.”
“Now name as many words as you can that begin with the letter f.”
“Forget. Forever. Fun. Fight, flight, fit. Fuck.” She laughed, surprised at herself. “Sorry about that one.”
Sorry begins with s.
“That’s okay, I get that one a lot.”
Alice wondered how many words she would’ve been able to rattle off a year ago. She wondered how many words per minute were considered normal.
“Now, name as many vegetables as you can.”
“Asparagus, broccoli, cauliflower. Leeks, onion. Pepper. Pepper, I don’t know, I can’t think of any more.”
“Last one, name as many animals with four legs as you can.”
“Dogs, cats, lions, tigers, bears. Zebras, giraffes. Gazelle.”
“Now read this sentence aloud for me.”
Sarah Something handed her a sheet of paper.
“On Tuesday, July second, in Santa Ana, California, a wildfire shut down John Wayne Airport, stranding thirty travelers, including six children and two firemen,” Alice read.
It was an NYU story, a test of declarative memory performance.
“Now, tell me as many details as you can about the story you just read.”
“On Tuesday, July second, in Santa Ana, California, a fire stranded thirty people in an airport, including six children and two firemen.”
“Great. Now, I’m going to show you a series of pictures on cards, and you’re going to just tell me the names of them.”
The Boston Naming Exam.
“Briefcase, pinwheel, telescope, igloo, hourglass, rhinoceros.” A four-legged animal. “Racquet. Oh, wait, I know what it is, it’s a ladder for plants, a lattice? No. A trellis! Accordion, pretzel, rattle. Oh, wait, again. We have one in our yard at the Cape. It’s between the trees, you lie on it. It’s not a hangar. It’s a, halyard? No. Oh god, it begins with h, but I can’t get it.”
Sarah Something made a notation on her score sheet. Alice wanted to argue that her omission could just as easily have been a normal case of blocking as a symptom of Alzheimer’s. Even perfectly healthy college students typically experienced one to two tips of the tongue per week.
“That’s okay, let’s keep going.”
Alice named the rest of the pictures without further difficulties, but she still couldn’t activate the neuron that encoded the missing name of the napping net. Theirs hung between the two spruce trees in their yard in Chatham. Alice remembered many late afternoon naps there with John, the pleasure of the breezy shade, the intersection of his chest and shoulder her pillow, the familiar scent of their fabric softener on his cotton shirt combined with the summer smells of his sunburned