Still Alice Page 0,76
a particular thing, but no matter how hard she thought about it, the details of the dream eluded her. Gone forever.
“It’s John Somebody. You know, you ask me this every time, and I’ve never been able to remember where that guy lives.”
“Okay, let’s take a guess. Was it John Black, John White, John Jones, or John Smith?”
She had no idea but didn’t mind playing along.
“Smith.”
“Does he live on East Street, West Street, North Street, or South Street?”
“South Street.”
“Was the town Arlington, Cambridge, Brighton, or Brookline?”
“Brookline.”
“Okay, Alice, last question, where’s my twenty-dollar bill?”
“In your wallet?”
“No, earlier, I hid a twenty-dollar bill somewhere in the room, do you remember where I put it?”
“You did this while I was here?”
“Yes. Any ideas at all come to mind? I’ll let you keep it if you find it.”
“Well, if I’d known that, I would’ve been sure to figure out a way to remember it.”
“I’m sure you would’ve. Any idea where it is?”
She saw the focus of his stare deviate to her right, just over her shoulder, for the briefest moment before settling back on her. She twisted around. Behind her, there was a whiteboard on the wall with three words scrawled on it in red marker: Glutamate. LTP. Apoptosis. The red marker lay on a tray at the bottom, right next to a folded twenty-dollar bill. Delighted, she stepped over to the whiteboard and claimed her prize.
Dr. Davis chuckled. “If all my patients were as smart as you, I’d go broke.”
“Alice, you can’t keep that, you saw him look at it,” said John.
“I won it,” said Alice.
“It’s okay, she found it,” said Dr. Davis.
“Should she be like this after only a year and being on medication?” asked John.
“Well, there are probably a few things going on here. Her illness probably started long before she was diagnosed last January. She and you and your family and her colleagues probably disregarded any number of symptoms as fluke, or normal, or chalked them up to stress, not enough sleep, too much to drink, and on and on. This could’ve gone on easily for a year or two or longer.
“And she’s incredibly bright. If the average person has, say for simplicity, ten synapses that lead to a piece of information, Alice could easily have fifty. When the average person loses those ten synapses, that piece of information is inaccessible to them, forgotten. But Alice can lose those ten and still have forty other ways of getting to the target. So her anatomical losses aren’t as profoundly and functionally noticeable at first.”
“But by now, she’s lost a lot more than ten,” said John.
“Yes, I’m afraid she has. Her recent memory is now falling in the bottom three percent of those able to complete the tests, her language processing has degraded considerably, and she’s losing self-awareness, all as we’d unfortunately expect to see.
“But she’s also incredibly resourceful. She used a number of inventive strategies today to answer questions correctly that she couldn’t actually remember correctly.”
“But there were a lot of questions that she couldn’t answer correctly, regardless,” said John.
“Yes, that’s true.”
“It’s just getting so much worse, so quickly. Can we up the dosage of either the Aricept or the Namenda?” asked John.
“No, she’s at the maximum dosage already for both. Unfortunately, this is a progressive, degenerative disease with no cure. It gets worse, despite any medication we have right now.”
“And it’s clear she’s either getting the placebo or this Amylix drug doesn’t work,” said John.
Dr. Davis paused as if considering whether to agree or disagree with this.
“I know you’re discouraged. But I’ve often seen unexpected periods of plateau, where it seems to stall, and this can last for some time.”
Alice closed her eyes and pictured herself standing solidly in the middle of a plateau. A beautiful mesa. She could see it, and it was worth hoping for. Could John see it? Could he still hope for her, or had he already given up? Or worse, did he actually hope for her rapid decline, so he could take her, vacant and complaisant, to New York in the fall? Would he choose to stand with her on the plateau or push her down the hill?
She folded her arms, unfolded her crossed legs, and planted her feet flat on the floor.
“Alice, are you still running?” asked Dr. Davis.
“No, I stopped a while ago. Between John’s schedule and my lack of coordination—I can’t seem to see curbs or bumps in the road, and I misjudge distances. I had some terrible falls. Even at home, I