Continuing with his exam, Dr Alemayehu asked Miss Cathy to spell “world” backwards.
“D, W,R,L….no, that’s not right.” Then she started over again.” D, L, R, R, O,W”
Nodding at her effort (but still making no judgment or comment) he said, “read these words for me” and then he had her repeat “apple, book and key” three times out loud before asking her to move from her chair to the examination table so that he could have a better look at her and administer a series of quick “hands on” tests that lasted about five minutes.
He had her open and close her eyes, follow his pen with her eyes only, tap her fingers then grip his hands firmly with hers and squeeze. After one of these texts he put his pen/pointer back in the breast pocket of his doctor’s jacket and asked.
“Do you remember the three things I had you repeat to me?”
“Yes,” she said, pondered, then started to recite,” Apple….uhhh, gosh, I had it right a the tip of my…..apple and key.”
Miss Cathy tried a couple of times to remember the third item, looking up and around the room as if it were somewhere to be seen, a visual clue somewhere in the small sterile exam room. Finding nothing to help here (and knowing that I’d be of no use) exasperated, she gave up.
After writing some notes in her file the doctor looked at her and reported, ”I’m very pleased with where you are, you remembered two out of three things. That’s very good.”
Hearing this unexpected praise she sat on the exam table, legs dangling in the air like a child sitting on a dock on a summer day who’s just received a Popsicle.
He told her that she could get down from the exam table and once they were reseated in their chairs the doctor asked if she had any questions for him.
Yes doctor I do, “Will the Aricept improve my memory?” she asked.
“No”, he answered, “it keeps your memory ‘where it is.” He went on to tell her that the Aricept buys a patient time because it manages to keep a person from progressing any further in the disease (for a while anyway, until it doesn’t work anymore) but the doctors have no way of knowing how long that will be.
“Will I be able to determine when my memory is failing me?” she asked.
“It’s a gradual process”, he explained, “and I cannot give you a time frame. But, I was concerned about your memory and after seeing you today I can tell you are in the same place you were when you came to see me last. So, your memory so functioning well.”
“Drawing the clock is abstract thinking, which is difficult but you did very well except for putting the numbers in the middle of the clock.”
“I’m very pleased with how well you’re doing so why don’t you come back to see me in six months.”
I helped Miss Cathy gather up her things and drove her back home where she couldn’t wait to get on the phone to call and tell all about her “glowing” report from the doctor.
Who could blame her for being ecstatic, a year ago we sat with the doctor at the beginning of her diagnosis and were full of questions and uncertainty. Six months after that we (all, as a family) had made adjustments in lifestyles and expectations as to what the future could hold.
And now we are in this holding pattern, a “grace period” if you will, life settling into the new normal with no idea when change will occur of how it will manifest. Until that day, Miss Cathy and I will just take it one day at a time and before you know it, another six months will have passed and we’ll be back sitting with the neurologist again.
Hopefully, she’ll be drawing clocks just as well and remembering just as much.