The Stranger in the Plumed Hat: Extract

“If many remedies are prescribed for an illness,” Anton Chekhov once wrote, “you may be certain that the illness has no cure.”

There is as yet no cure for Alzheimer’s disease. Though some treatments are now believed to retard the relentless progress of the disease, scientists do not understand its etiology. Pre-senile Alzheimer’s, which represents 5-10% of all cases, appears to be hereditary in nature, but the more common one striking individuals past the age of sixty is believed to combine a genetic predisposition and some other unknown factor(s). This is nebulous enough to permit a measure of optimism to victims’ offspring – except on those days when some impish spirit seems to have made off with your keys or glasses, or some commonplace word lies stubbornly glued to the proverbial tip of the tongue.

When my mother’s condition became irrefutable, I began to take both estrogen and vitamin E, and to keep plying my mother with anything of potential efficacity. Because she was all too aware of the deterioration of her memory, my mother had no objections to trying bottle after bottle of Ginkgo, choline, vitamin E, Aricept. She took them all eagerly, optimistically, sure that sooner or later, we would find a pill, a treatment, a doctor, able to arrest her atrophying memory.

One cold afternoon, some months after the interview at the Montreal Neurological Institute, I took my mother to the Douglas Hospital. The man we were to see was Dr. Serge Gauthier, head of McGill University’s Centre for Studies in Aging. My mother had been referred by Dr. Aube, in the hope that she might participate in an experimental drug program.

We waited in a bright, pleasant room with a fireplace, eventually to be greeted by a dark-haired man in a suit and tie: the well-known neurologist himself. He smiled at my mother and spoke to her in a hearty manner, but I could see at once that she did not trust him, perhaps because he was not in a hospital and was not dressed in white.

“Who is he? Why are we going with him?” she kept whispering.

He led us to his office, and we sat across from him, answering questions. It was Dr. Gauthier’s task to assess my mother’s suitability for the experimental program and this required family and medical history, as well as a review of her recent symptoms. My mother was visibly unhappy, sitting idle while I answered questions, and no less so when the doctor began to question her, testing her short-term memory and cognitive powers. Short-term memory is invariably the first to go in Alzheimer’s disease, precluding the ability to process new information, and thus to learn. Long-term memory, on the other hand, often lasts until quite late in the patient’s life.

The oral questionnaire administered by Dr. Gauthier was a standard one for Alzheimer’s patients, but my mother answered it rather grudgingly, and with an air of growing bewilderment. “Where do you live?” asked the doctor, and my mother told him: the street, city, province, country, looking at me as if to say: What does he think I am – an idiot? She told him, correctly, what day it was, what date and year; how many children she had, what her husband did for a living. She was able to do this because neural impairment is not only spotty; it progresses in an unpredictable fashion.

“Who is this man?” my mother paused to ask in one of her stage whispers. “Why does he want to know all these things?”

I explained to her as best I could, and the doctor went on to pose a few questions involving arithmetic. She did surprisingly well on those too, but had obvious trouble following instructions. When the doctor dropped a sheet of paper and asked her to pick it up from the floor, she looked at him with undisguised hostility.

“Tell him to pick it up himself,” she said to me, speaking Polish. I did not translate, but was all too aware that the doctor’s determined charm had begun to evaporate: he could not get the patient to cooperate. It occurred to me that my mother’s resistance to the doctor’s commands might arguably carry a positive significance – hadn’t she always been a woman possessed of a strong, independent spirit? Why should a stranger’s arbitrary command be used to judge a patient’s mental competence anyway?

I left this thought unvoiced, but tried to explain that there obviously was a language problem. My mother quite simply did not understand words like “backwards” or “design;” could not possibly spell “world” or follow instructions to “keep subtracting.” The test had clearly been designed with native speakers in mind, but no one apparently thought to adapt it to the thousands of immigrants seen by doctors in a cosmopolitan city like Montreal. I offered to translate the questions to my mother, but Dr. Gauthier insisted on communicating directly with the patient. He drew a box for her and asked her to copy it as best she could. This time, my mother did as she was told, though the box looked more like a park slide than a box. She thrust the sheet of paper toward the distinguished doctor.

“My memory make me crazy!” she said, the emphasis seeming to imply that she had not come all this way to draw pictures or pick up sheets of paper from the floor. “My memory make me crazy,” she repeated, speaking her usual flawed English, but speaking the absolute truth.

Hope keeps us going, but at an ever slower pace.

My mother was, I believe, beginning to lose hope. She did, at any rate, refuse to participate in the experimental drug program. It was not the only issue on which she would not yield, for, as time went on, my mother’s famously indomitable will began to seem increasingly like pigheadedness. She had always been hard of hearing in one ear from a childhood infection, and, what with growing deafness in the second ear, and failing cognitive powers, conversations with my mother became fraught with non-sequiteurs. She refused to go for a hearing test, however, and would sometimes grow angry when we tried to insist.

It was rare for my mother to get angry anymore, but for much of her life, she had been hypersensitive and quick to take offense. She would perceive criticism in every difference in taste or opinion; any lifestyle choice different from her own. In my childhood, an atmosphere of gloom and doom would settle over our household whenever my mother was angry or disappointed in one of us. When crossed, she could grow as fierce as an Old Testament prophet, forecasting disaster whenever we failed to heed her counsel.

My mentally afflicted mother, however, while often obdurate, was also becoming increasingly good natured. She seemed incapable of taking umbrage, and, now that her short-term memory was gone, could no longer hold a single grudge. Much of her atrophying brain seemed taken up with fear of thieves, murderers, burglars. She refused to go to Florida because of the high crime rate, and put up steel bars across all her doors. My father had been a jeweller and she had the idea that burglars would try to break in, hoping to find gold and diamonds. She tried to persuade me, too, to put similar bars across my doors.

And then, my mother herself became a thief. It first happened at a neighborhood pharmacy, where my mother had picked up a $3 item and put it in her bag, only to find herself seized by two burly security guards after she left the store. She did not go meekly. She fought them on the busy sidewalk, scratching and kicking, and shrieking her innocence before passersby; bursting into tears only after my father arrived on the scene.

The pharmacy agreed to drop the case on condition that my mother never set foot in the store again. She had no intention of doing so, though she went on shopping at a neighborhood mall, presumably paying for her purchases. Several months later, she was arrested by supermarket security, accused of stealing a bunch of grapes, though she did have a receipt for her other groceries. This time, my father could not be reached; my mother was kept prisoner for hours, insisting she had no idea how the grapes ended up in her shopping bag. Perhaps someone else had put them there by mistake? she suggested.

My mother was becoming known in the shopping mall, a persona non-grata in stores where she had shopped for decades. For the first time in his life, my father began to do some of the grocery shopping, but even he could not prevent his wife from leaving the house when she was bent on going. Soon, there was another arrest. This time, the police were involved. They understood, of course, the mental condition of the accused, but insisted she must be prevented from shopping on her own. From now on, my father would be fined if ever she was caught shoplifting again.

This never happened, but only because something far worse did: my parents’ house burnt down one day, in a fire caused by my mother while frying chicken legs. My father had left her alone for a couple of hours, without removing the stove fuses as he had explicitly been told to do by a visiting social worker. When he came back in the afternoon, it was to find his home of almost forty years gone up in smoke, and his wife, rescued by neighbors and restrained by municipal employees, struggling to escape from a mobile shelter parked in his own driveway.

The house was a smoking, charred skeleton, but my mother kept straining to go back in, impelled by a raging desire to undo what she had done. She knew that she had done it, but seemed incapable of comprehending the enormity of the damage, even after being briefly permitted to go through the devastated rooms. It was thought that seeing the damage for herself might bring her to her senses. Instead, she promptly set about searching for a broom and dust pan, babbling about the pervasive chaos and fighting off everyone’s determined solicitude, mine included.

It was a chilly Friday afternoon in April, with rain blowing in through the gaping windows, and neighbors arriving one by one, shaking their heads and breathing in the smell of ashes and smoke, and sodden, still dripping rafters. This, I knew was the beginning of the end. It was also, though I did not immediately think of it, an all-too-obvious metaphor for my mother’s affliction; a mental catastrophe subsuming her former self as relentlessly as the flames had the home she cherished. It would not be long before it came to me that over half a century’s worth of photographs had also been consumed by the flames, compounding the cruelty – as if fate, not satisfied to expunge my mother’s vibrant self, were determined to eradicate any evidence that it had ever existed. There had been the old sepia photographs, and the black-and-white ones that came to replace them, and the more recent Canadian ones, in ever brighter colors – four albums full of images snapped in studios, carriages, kitchens, forests; on streets and trains and terraces and beaches, on three continents.

Had a snapshot been taken of my mother that early-spring afternoon in 1998, it would have captured a shriveled old woman of under five feet, wrapped up in a grey firemen’s blanket, her still-fair hair seemingly on end, her crooked feet bare in a pair of furry, sooty pink slippers. She was clutching the blanket at the throat, her eyes swimming in confusion, reminding me of the only photograph I had ever seen of my mother’s childhood. It was a snapshot showing my mother at the age of five, seated against a stark background of snow, surrounded by a group of bundled, picnicking relatives. She could never explain this odd winter scene, but the relatives were quite likely inebriated, all brandishing Vodka glasses, while my mother, the lone child, sat in their midst, looking oddly lost, clutching her scarf in one hand, and a doll in the other. The photograph had been taken in the Russian Urals. I still remember my grandmother’s entry on the back: Orenburg, 1926, written in purple ink. I remember my grandmother’s dreamy gaze in the photograph, and the birches in the background, and the possessive, vaguely anxious way with which my mother sat clutching her doll. I remember the doll had a porcelain face and what looked like a knitted cap on her head.

I try to find reassurance in my ability to remember such things.