Let Me Remember for You
Letter to a Father with Alzheimer’s
Dad,
So, I have this memory. You were there, too; but don’t worry if you don’t remember. I can remember for you.
It’s a hot, breeze-less summer day in 1971, and Hatzic Lake is lukewarm and the color of milky coffee that’s been left on the counter all morning. Motorboats tear across the water, yanking water-skiers across the surface of the lake, filling the air with a sound like a swarm of angry wasps. You are chest deep in the water, with your feet braced in the soft, muddy lake bed. I am four years old and clinging to you, as if to life itself.
I am wearing a polyester bathing suit of sickly-bright green and yellow. You’re in a pair of cut-off jeans; you are not the sort of man who has time for expensive, trendy bathing suits. Your eyes are hidden behind a pair of aviator shades, the kind that 1970s TV cops wear, and your black sideburns are a stylish four inches long and one inch wide. Officially, you are second-in-command at the family-run printing company but, in your secret mind, you are a cowboy, a book-smart loner who breaks wild horses deep in the tall grasses and lodge pole pines of British Columbia’s wild, unpopulated Chilcotin region.
You are trying to teach me how to swim. My arms are flung around your neck, and I can feel your back. It has a familiar, healthy oiliness to it. You are strong, but I am panicking. I can’t see through the water. Even despite the clear evidence that the water only comes up to your chest, I can’t help but suspect that the lake is bottomless.
“I gotcha, Stephen,” you keep saying, in a gentle voice. “I gotcha.” I keep reminding you that I can’t swim. I am a fearful little boy. I’m not old enough to be cognizant that people die, but I seem to have an innate sense that underneath the surface of the water there is an underworld that could consume me in a split second. Your bravery astounds me. I hold on tight and try to absorb it from you.
After the swim, we dry off on the concrete and stone pier. My grandmother calls us with a high, cheerful “Yoo-hoo!” and we head up to the big white farmhouse where the great aunts, in their floury aprons, are peeling homegrown apples for pie. The windows are all open and Granda has just come around the side of the house on his red and white Toro riding lawnmower; the air smells of cinnamon and fresh-cut grass. Above the dining room table is a painting of a cowboy on a horse, high above a dry, grassy ravine. You can’t see the cowboy’s face, because he is looking off into the distance, like cowboys do.
I stand at the painting and stare deep into it, my eyes following the barren ridges fading into the horizon. I can’t get enough of this painting because I know that you painted it. Every time I look at that cowboy, I see you.
*
When you were first diagnosed with Alzheimer’s disease, I was living in Nashville, Tennessee, struggling to make it big as a country songwriter. Mom told me over the phone that you had been given some tests for your memory, but she didn’t use the words Alzheimer’s or dementia, even though the test results had indicated cognitive impairment. I think she was probably too shell shocked by the news to face it head on. Since the A word had not been uttered, I wasn’t greatly alarmed by the news; as far as I was concerned, having a few details slip your mind now and then was just a natural part of aging. You’d always been a little forgetful, anyway, unless you were talking about World War II or the printing business, subjects you could have given Ted Talks about.
We’d been living away from the West Coast for almost 15 years by then, so I’d really missed out on a lot of the day-to-day changes in your cognitive abilities, but Mom routinely filled me in, over the phone. You’d been forgetting the names of people you’d known for decades, had trouble with basic instructions, and making decisions had become almost impossible. Mom made a doctor’s appointment for you, the first of three you’ve had.
The test you took was called the Cogniciti Test. First of all, you were given a list of five random items to remember. Then the doctor asked you to tell him the time, day and month. Having distracted you with those queries, he then asked you to recall as many items from the list of random items as you could. Mom says she was squirming in her chair for you, wishing she could help you. Later, the doctor asked you to count down from 100, in sevens, and you got stuck in the high 80s. Rattled, you tried to shrug it off, admitting that math had never been one of your strengths (I feel your pain, Dad. I didn’t get that gene either). You were told to draw a three-dimensional box and, being an artist, you aced that. Then you were presented with the standardized Clock Face Test.
You’ll be interested to learn the history of that procedure, Dad: When war veterans returned home from Europe after World War One, doctors often utilized this simple, effective technique for assessing the patient’s level of traumatic stress. They would sit the patient at a table with a piece of paper and ask them to draw a clock showing a particular time, typically 10 after 11. Easy to administer and only ten minutes in duration, the clock face activity could do a lot of heavy lifting. It gauged the patient’s verbal understanding (could they comprehend the instructions?), spatial knowledge (could they correctly situate the circle, and place the numbers and the clock hands in their right positions?), visual memory (did they remember what a clock face looked like?) and, finally, abstract thought (did they understand what the clock hands represented?). You nailed that one, too.
*
Between 2016 and 2020, during our yearly Christmas visits back to the West Coast, I began to notice some changes in your working memory, if not your personality. You seemed to be able to keep up your end of the conversation, but I made it easy for you. I instinctively stuck to subjects I knew you’d find interesting and didn’t overpopulate my stories with names of people you might not remember.
Your memory loss, over time, has had an unexpected grade to it: It hasn’t just been a slow, constant downhill glide. It’s like a plateau, then a drop, then a unexpected lurch upward, followed by another plateau. I am always exhilarated by those lurches — you’re struggling to find words like sauna, hose or umbrella when suddenly, like a strand of hair coming into focus under a microscope, there’s a moment of startling clarity.
On one of my visits earlier this year, you and I were sipping on coffees in the kitchen, and Mom was at the grocery store, buying steaks and asparagus for dinner. We had the photo albums out on the kitchen table, and I was chronologically recalling, in as much detail as I could muster, the six homes we’d lived in while I was growing up. These houses were so much more than just the places we lived. Always drawn to the artistic idea of a home, you designed, detailed and blueprinted each abode, often with the help of family friends who were professional architects. These beautiful structures lived in your head long before the first nails were hammered. It must have been a thrill to watch the architecture come together in real time, cedar plank by cedar plank. I’m amazed by people who can do that, Dad; as you know, I haven’t the ability to conjure up anything more complex than a tree fort. (Who am I fooling? I can’t build a tree fort.)
I was in the middle of describing the equestrian park just down the road from the North Vancouver home we occupied in the early 1970s when, all of a sudden, a light went on in you. As I sat there, trying not to look surprised, you recounted, in detail, every single horse you rode as a teenager, and the ones we had when I was growing up. You could recall their breeds, their colors and their names. Their mannerisms, shortcomings, the quality of their teeth. You explained to me, in layman’s terms, the finer details of gelding a horse, and the reasons why a stallion was chosen to be a gelding in the first place. Your blue eyes were alive, your excitement palpable. It was as if it were 1988 again, with the two of us lingering at the dinner table, sparring over politics and culture as we slowly liberated a full bottle of red wine.
*
Lately, I’ve spent many spare moments on my iPhone, reading about the brain. I’ve learned that dementia (cognitive decline and memory loss) is the illness and that Alzheimer’s (a build-up of plaque and neural tangles in the hippocampus) is the cause. I understand that, for all patients, a decline in mental — and eventually, physical — facilities is unavoidable. But in Dr. Sanjay Gupta’s wonderful book, Keep Sharp: Build a Better Brain at Any Age, I have also found thrilling new research showing that even patients with considerable plaque build-up have experienced great improvement with what Gupta calls the Five Pillars: exercise, discovery, stress-reduction, diet and social stimulation. Artistic abilities like singing, playing a guitar, and painting tend to remain intact in patients with dementia, even in those at an advanced stage. I overheard that you recently described your working memory as “more contemporary than historical.” Get this, Dad: your observation just happens to support the latest research suggesting that people with dementia can continue to build neural pathways in the brain, and learn new things.
Dad, I realize this hasn’t always been easy for you. You aim high. You wanted to pick up an old Spanish guitar and sound like José Feliciano. Grab a tennis racquet, stride out on the court, and play like Arthur Ashe. You know: Be an expert immediately or don’t even bother trying. It’s caused you a lot of frustration.
I urge you to embrace amateurism! Abandon your pride and dare to do something new, badly — maybe even very badly. Do it for your brain.
*
I live by a few key aphorisms. Here is one of them: Tell the people you love that you love them while they’re still alive to hear it.
Until only just recently, you never told me you loved me. That just wasn’t something that Mitchell men said aloud. But I have never doubted that you do, not for a minute. Back when you still answered the phone, I could hear it in the space between “Hello?” and “Stephen, how are you?” That’s when your business-like reserve would melt away and, in its place, would be the utterly disarming tenderness you have always radiated with those you love.
Dad, forgive me, but I watch you closely these days. I know sometimes you find yourself wobbly. You rise from the couch slowly, guiding yourself with the armrest, and it’s usually the first footfall that throws you off. I see this happen many times a day now, when I’m with you; it’s something like a hiccup of the brain, a synaptic command that doesn’t quite land the way it should. Your Gulf Island home doesn’t have any indoor staircases but there are rock steps cut into the tangle of St. John’s Wort covering the steep hillside from the patio to the cement wall at the shoreline. The last time I was on the island, you and I were heading down to the beach to cut brush, and you lost your footing on a loose stone. I had to grab your nylon jacket with two hands to keep you from plunging forward.
“I gotcha, Dad,” I said. “I gotcha.” Now it’s my turn to provide the reassurance.
In my mind’s eye, you are always 45 years old. Kind, thoughtful, consistent, curious and always slightly distracted by a distant thought. You have inspired me, guided me, encouraged me and comforted me. You have provided for me. But you have never needed me. I want you to wrap your head around the idea that you are going to have to ask for help more than you’ll want to, in the years ahead.
Dad, medicine continues to make great strides in decoding Alzheimer’s and dementia. Scientists at the University of New Mexico have found that inoculating lab mice with a specific virus-like particle helps them develop antibodies that eliminate the plaque associated with memory loss. At Yale University, scientists are working on what has been called a “drinkable cocktail of designer molecules” to restore memory. Still another project on the horizon is an endobody vaccine that helps the brain repair itself without the typical side effect of damaging inflammation. And then there is L-Serine, an amino acid found in cheese, poultry, eggs and seaweed. The last time I was staying with you and Mom on the island, I harvested some neon-green sea lettuce and baked it up with olive oil. Mom didn’t like how it tasted, but you ate some of the crispy seaweed chips I gave you and at least pretended to like them. Well, there was a method to my madness: sea lettuce contains L-Serine.
The leading edge of scientific research is finding answers that, someday soon, will make dementia as obsolete as smallpox and polio became in the 20th century. I can’t help being hopeful.
Dad, you have always believed, first and foremost, in science. You taught me that the truth, as we know it, lives in the tension between what we think we know and what we’re sure we don’t know. Science evolves as we evolve. And right now, the science is telling us that the best thing you can do for your memory is to keep on trying to learn new things. Dad, please do this for me: go to the white side table in the kitchen, the one with all your art supplies and the 18x24” drawing pad we gave you a couple of Christmases ago. Watercolor, charcoal, oils, pencil…it doesn’t matter what you work with, use whatever speaks to you. Make me an illustration that can accompany this Medium newsletter article. Somebody will read it. Maybe, thousands of people will read it. Perhaps one of those people will have just learned they have dementia.
A writer who is afraid she may never write again.
A doctor who always wanted to learn Spanish and is afraid that now it’s too late.
A painter who is terrified of picking up a paintbrush…
I know you’re a private man, you don’t have to put your name on it. I won’t publish this until you give me the thumbs-up.
I love you, Dad
Steve
