in the park.
“Physically, she’s fine,” I say.
“Stop,” he says, with some alarm.
“Pardon.”
“She was shot?”
“Almost.”
“Christ,” he says, suddenly animated. “Are you serious?”
“It was probably some random attack. But I’d love to know what she remembers about it.”
He pauses, apparently lost in thought. “It’s not every day that one of my patients gets shot at.”
He stands.
“Can you wait outside while I examine her?”
“I’d rather stay.”
“She’s liable to look to you for comfort or approval. I need to get a clear sense of her mental state.”
I hesitate, and then stand up. I put a hand on her shoulder. “I’ll be right outside, Grandma.”
Dr. Laramer walks to his window, which is letting in gray light. He peers outside, closes the shade, then turns and walks back in our direction. He turns on a bright overhead light. I leave the pair of them alone.
I stand in the hallway. My cell phone signal is poor, but I try to call my parents. No luck getting through.
Then I hear a shout come from inside the office. More like an expression of shock, or surprise. It’s not coming from Grandma. But Pete.
I open the door. Pete and Grandma sit on the couch. She’s withdrawn to the edge of it. He leans away from her with his palm pressed against his chin. A yellow Nerf ball sits between them.
“What happened?” I ask, moving quickly to Grandma. I bring her close to me. She seems to relax.
“She punched me in the jaw,” he says.
“What?”
Grandma’s right hand is balled into a tight fist.
“I’m sorry. I’m sure she didn’t mean…”
“I leaned in close to test her visual acuity and she let me have it,” he interrupts me. “Not bad strength. Terrific punch, actually. Stings like a bee.”
“Chop,” I say.
“What?”
“Was probably a chop, not a punch. She was a blue belt,” I say. “She studied years ago.”
“She’s definitely agitated,” he says. Then turns to her: “You often roundhouse the help?”
“I’m sorry,” Grandma says. “I’m only supposed to use my training for defense.”
He shakes his head and, finally, laughs. “I’ve had agitated patients spit at me, and vomit. Once I was shoved by a bouncer. Never karate chopped.”
“Pete, what did you say to upset her?”
He shrugs. “I asked her how she was feeling, the year, who is president, whether she is comfortable, the usual stuff.”
“Are you friends with Adrianna?” Grandma asks him.
He looks at me, raises his eyebrows. “Who is Adrianna?” he asks me.
I shrug. “Grandma Lane, who is Adrianna?”
She cocks her head to the side, momentarily frozen in thought, like an overly taxed computer processor. Before she can continue, Pete picks up the Nerf ball. He tosses it in a gentle arc just to the right of Grandma. She raises an arm and swats it to the ground.
“Interesting,” he says.
“What are you doing?” I ask, just shy of irritated that he’s interrupted the conversational flow.
“Testing her spontaneous physical reactions. As you can see, they’re very much intact.”
“So.”
“Whatever her mental state, she’s alert and reactive and plenty physically able. It’s as I thought when I first saw you in the waiting room: the patient presents in terrific physical shape.”
The patient.
“Okay,” I say, trying to piece together what this all means. I turn back to Grandma.
“Who is Adrianna?”
“Years ago, doctors came to your house,” she says.
“Nat, has your grandmother experienced any recent traumas?”
“The shooting at the park.”
“I thought you said the symptoms predate that. Did she get into an argument, or have a problem at her retirement home? Has she been on field trips, or anything else that could have put her in a vulnerable or frightened position?”
I consider it. Nothing comes to mind other than her allusion to the dentist.
“Why do you ask?”
“People get mistreated and it makes them agitated. The retirement-home experience can be… impersonal.”
We fall silent. He closes his eyes, and I can’t tell if he’s lost in contemplation or tired.
“Pete, what is going on with her?”
He clears his throat. “I’m sure it’s no surprise. But I’m sorry to say that she’s exhibiting the classic signs of dementia.”
I shake my head. “When we came in you said she seemed fine.”
“Well, it could be worse.”
Pete starts what I imagine is his stock speech to family members of dementia sufferers. He tells me that Alzheimer’s is the most common form of dementia, affecting more than four million Americans. The disease results in memory loss, personality changes, cognitive dysfunction, then physical dependence. I know this stuff, and I wave him along.
He reminds me there are four stages: predementia, and then early, moderate, and advanced versions. Common complications include dementia coupled with Parkinson’s; vascular dementia, which largely afflicts African Americans; and frontotemporal dementia, which presents with major mood affect.
“She’s probably in an early or moderate stage,” he says. “The good news is, this is very common, and we have some sense of how to treat it, though our treatments are primitive or, rather, of modest efficacy.”
He’s starting to wind down his presentation, just as I’m feeling a rising sense of ire mixed with disbelief.
“Bullshit,” I say with some force, seeming to surprise him, and myself.
What I realize I’m thinking is that Grandma’s symptoms don’t seem common at all. If my own memory of neurological disorders serves even a little, these symptoms don’t add up. Ordinarily, a sharp mental descent would be accompanied by a loss in physical agility and alertness. More significantly, it makes no sense to me that her mental decline has been so precipitous. I’m bothered with myself that I haven’t been paying closer attention in the last month or two.
“When did you see Lane last?” I ask.
“Pardon?”
“When was her last visit here — three, four months ago?”
He walks to his desk. He picks up a green folder, opens and studies the chart inside. “Three,” he says, then corrects himself. “Sorry, four.”
“It just doesn’t make sense to me that as recently as four months ago she was doing relatively well, making sense, and conversation.”
“Suggesting what?” he asks.
“Something odd is going on. This doesn’t seem typical to me at all.”
“Respectfully, Nat, the Internet is not the best place to get medical information,” he says. “Dementia and memory loss can be very hard for family members to accept.”
He maintains eye contact with me, which makes me think he either doesn’t realize he’s being condescending
