by Susan Lewis
David cleared his throat again. ‘So how … How long are we talking?’
Understanding what he meant, Lisa tensed as Isabelle said, ‘It’s hard to be precise, because each individual is different, but early onset, as you probably know, can show itself to be more aggressive …’
‘How long?’ he repeated.
With no more prevarication she said, ‘It could be as little as five years, or I’ve known people to go on for twenty or more, provided of course we do everything we can to minimise the risk of further strokes.’
David took an unsteady breath. ‘And in what kind of state would I be for these five or twenty years?’ he asked.
‘Again, each individual is different, but as you know it is a progressive condition that I’m afraid will only get worse with time.’
His head went down, but as Lisa put a hand on his arm he lifted it again. ‘Well, so now we know,’ he said, with a finality that suggested he didn’t need to hear any more. ‘Thank you for your trouble, Doctor. We probably shouldn’t take up any more of your time.’
‘Please sit down,’ Isabelle said kindly as he made to get up. ‘There’s a great deal we need to discuss about where we go from here, not least of all on the practical side, which is actually very important and probably best dealt with straight away.’ Her eyes moved to Lisa. ‘This is where you come in, because I’m afraid we can’t be sure how much of this David will remember later.’
‘Oh God,’ David groaned.
Taking his hand in an effort to steady him, Lisa said, ‘What do I have to do?’
Seeming to appreciate how pragmatic she’d managed to sound, Isabelle said, ‘First of all you will need to inform the DVLA of the diagnosis.’
At that David’s head came up. ‘You can’t take my … take my …’ His eyes closed in frustration.
‘You’ll probably be able to keep your licence for a while,’ Isabelle reassured him, ‘but I’m afraid they do have to be informed, as do your insurers. It’s also important to decide who you’d like to have power of attorney,’ she continued, addressing David now rather than Lisa, ‘because there will come a time when you won’t be able to handle your own affairs, particularly finances.’
He said nothing, and Lisa found that she couldn’t speak either.
‘You might also want to draw up a living will,’ Isabelle told him. Then she said to Lisa, ‘There are lots of information leaflets and brochures I can give you on all of this, I’m just making you aware now of what steps you can take to prevent any legal or medical difficulties in the long run.’
Lisa looked at David, and seeing how glazed his eyes had become, as though he was no longer listening, she realised she must think of something to say. ‘How long will it take for the drugs to start working?’ she asked.
‘The Aricept will take eleven to twelve weeks.’
Could she ask her next question in front of David? If she didn’t she wouldn’t be able to ask it at all. ‘How much is he likely to deteriorate in that time?’ she said.
‘I’m still here,’ he reminded them shortly. ‘Please don’t talk about me as if I’m deaf or already brain-dead.’
Isabelle’s eyes moved to his. ‘A very common complaint from people with dementia,’ she told him. ‘As for the progress of deterioration, it’s hard to say when much depends on the frequency and level of the mini-strokes. I’m sure you will already have noticed what probably seem like mood swings, or erratic behaviour?’
Lisa nodded.
‘I need the bathroom,’ David suddenly said.
As the door slammed closed behind him Isabelle looked sympathetically at Lisa. ‘It’s not uncommon for someone in his position to become angry and go into denial at first,’ she told her. ‘It’s a means of self-protection, and quite frankly, it’s more important for you to understand what’s going on than it is for him, since you’ll presumably be the one taking care of him.’
Feeling herself teetering on the edge of denial too, Lisa said nothing, only waited for the doctor to continue.
‘It might help to know,’ Isabelle said, ‘that someone with David’s condition finds it increasingly difficult to learn anything new. We’ve seen examples of this in his failure to remember meetings, or what was said at them. This means that new information isn’t always getting through. What’s already learned is still there, and it won’t, or shouldn’t go anywhere for a while yet. However, accessing it can prove problematic.
‘But let’s deal with the new information first, because his difficulties in retaining it are what you’re going to find the hardest to cope with.’ Picking up a pen and pad she began to sketch a diagram. ‘Here’s a rough look at the way the memory brain functions,’ she said. ‘Verbal into working memory takes around forty-five seconds to a minute. From working into short term is between five and twenty minutes. The information then goes into the recent memory store, which directs it through to the executive brain where the major processing is done – in other words what we’re going to retain for future use, or what we can just dismiss. What concerns us at the moment is the working to short-term memory. The working is functioning, meaning that he’s taking information in, but the short term isn’t always sending it on down the line the way it should, so this is where things are getting lost.
‘Over time, the short-term memory will cease to function altogether, while the rest of the memory brain starts to break down too. This is when the problems of remembering something as fundamental as the names of his family, or the timing of certain events in his past, or how to perform everyday functions will start to kick in. You saw the problem with the shirt just now – that could have been nerves, but in a man like David I’m afraid it’s not a good sign.’
Lisa’s face was bloodless as she regarded the doctor. If only her own memory-brain could let this information go, she was thinking, maybe then none of it would be happening. ‘I know he’ll want to carry on working,’ she said, ‘but is that going to be possible? Perhaps I should be asking, how long will it be possible?’
‘That will be largely up to him. For the time being there will continue to be the same sort of problems he’s already experienced, but unless you tell me differently he’s still able to function on most levels?’
Deciding that in the main he was, Lisa nodded.
Isabelle smiled. ‘I’m going to give you my mobile number,’ she said, taking a Post-it pad from a drawer, ‘so please feel free to call any time. There’s a lot to take in, and you’ll find all sorts of questions coming up over the next few weeks that you’ll need answers to.’ After jotting her number down she handed it over, saying, ‘You’ll be contacted by a memory nurse as a follow-up to this diagnosis. She’ll come to your home to advise you on what to expect, how to proceed, what kind of backup there is … Basically everything you need to know.’
Lisa looked up as David came in.
‘I think we should go home now,’ he said shortly. ‘The doctor must be very busy.’
Lisa looked helplessly at Isabelle.
‘You have my number,’ Isabelle reminded her. ‘Don’t hesitate to use it.’
Moments later they were walking silently out to the car with the echo of Isabelle Manning’s terrible words still ringing in their ears, and the spectre of what was to come already dancing before them.
‘You drive,’ David said, handing her the keys.
Wanting to show she had confidence in him, she said, ‘Are you sure you don’t want to?’
He didn’t answer, only waited for her to unlock the doors, then sliding into the passenger seat he fastened his seat belt.
It was a while before he spoke; they were already heading up the ramp to join the M32 back into town. ‘This isn’t fair on you,’ he told her. ‘You shouldn’t have to be …’
‘Stop,’ she interrupted. ‘It’s not about me. It’s about you.’
His head came round to look at her. ‘Actually, it’s about both of us, which is what I’m trying to say …’
‘I know what y
ou’re trying to say, but now isn’t the time to have a sensible conversation about anything.’
He didn’t argue any further, simply turned to stare out at the passing landscape of terraced houses and rows of shops that he’d never visited and probably never would.
Did that matter? Did anything any more? Of course it did, but right now it was as though he was turning slowly numb inside. Since his brain apparently was, he guessed it was hardly surprising he felt that way. It was the most humiliating and enraging thing to know that he was letting himself down. He was responsible for what was happening. He, David Kirby, who existed, like all men, because of his brain, was shrinking in memory, identity, even purpose. Nothing was the same any more, or ever would be again. From now on, until his brain failed him altogether, or a massive stroke tore it apart, he would have to live with the gradual disintegration of his world. How much longer would he be able to understand what was going on around him and respond to it in a normal, socially acceptable way? How many weeks and months would pass before he stopped recognising the people he knew and loved?
Turning to look at Lisa, he felt himself collapsing inside. Would he forget her name in time, who she was, and how much she meant to him? Was it worth continuing to live if all he was going to bring her was heartache, embarrassment and regret? What kind of man would he be if he kept her trapped in a marriage that could never now bring her joy?
‘I’m hungry,’ he said suddenly, ‘are you?’
Managing a smile she said, ‘Would you like to stop somewhere, or shall we go home?’
‘Let’s go home,’ he answered, and attempting to rein in the rage and self-pity that was threatening to engulf him he turned to look out of the window again. He must back away from his emotions, keep a careful distance from them and somehow treat them as though they belonged to somebody else.
He began wondering what it would be like when he had no more memory, when he could no longer express himself at all. How would he feel? Afraid? Impotent? Alone in a crowd? Would he be cowering in the shell of his body, like a small, shrunken version of himself? How much was he going to understand? Would people treat him like a fool? Would youngsters poke fun at him, the way some did with the elderly and infirm, particularly those who were confused and afraid? How much control would he have over his actions? Would he harm people, or run from them? Would he even understand what they were saying, or doing?
So many questions, and there was no one to ask, because those who were afflicted were unable to tell how it really was. They were watching the world from a prison of damaged cells, there but not, alive, but gone. Did their thoughts make any sense to them? Did the words form coherently in their minds, only to be jumbled on the journey to their tongues? Were they shouting inside with no sound coming out? When they laughed, did they know why? When they cried, were they grieving for who they used to be? When they ate was there a sense of fulfilment? When they slept did their dreams give them cheer, or even have any kind of meaning? What was it like to want to go home, when there was no home to go to any more?
How many of these thoughts, and how much of this fear would he remember tomorrow? Would it all come back as something new to put him through this harrowing angst all over again? What was his life going to be like now he knew the truth? Was there even any point to it any more?
They were at home now, eating a snack lunch of mozzarella cheese and fresh tomatoes. The rain was beating an incessant tattoo against the windows; the garden outside looked windswept and forlorn.
‘We have to talk to Miles,’ David declared, making it sound like an order. ‘Let’s invite him here, to the house.’
Topping up their wine glasses, Lisa said, ‘If you like.’
There was a flintiness in his eyes as he said, ‘I’m sure you’ll be glad of some intelligent company.’
She took a mouthful of food, then made herself smile in the face of his belligerence. ‘It’s not making a difference,’ she told him, managing to sound unruffled when actually she was fraught with all kinds of conflicting emotions. ‘I know you think it is, but you’re wrong.’
‘What are we talking about?’ he demanded.
‘You think, because of the diagnosis, that my feelings have changed.’ Had they? How could she know when she was still so far from processing it all?
‘Well, it’s good that you know what I’m thinking,’ he retorted, ‘because it’ll help no end when I’ve forgotten how to speak.’
As a curl of dread wrapped around her heart, she said, ‘What do you want to discuss with Miles?’
Sitting back in his chair, he said, ‘I’m glad you asked, because if I tell you now, and then forget, you’ll remember when he gets here.’
Still managing not to engage with his ugly mood, she said, ‘So tell me.’
‘Do you want to take notes? I usually do. They recommend that, you know, but maybe you should do it from now on, it would help us both.’
‘I’m not your secretary and nor am I going to treat you as an incompetent when you’re far from it.’
‘It’ll be good practice for when I am, and who says I’m not already?’
‘You, apparently.’
‘Because you’re too polite or … or whatever the hell you are.’
Putting her cutlery down she said, ‘David, stop it. I understand this is difficult …’
‘Do you? You know how it feels to have your brain turning on you …’
‘If you can speak as coherently as you are now, then there can’t be too much wrong, can there?’
‘But there is. The doctor just told us.’
‘That’s right, and the good thing is that the diagnosis has clearly got past your short-term memory.’
‘Great. To sit and fester in the big brain like a … like a …’ He slapped a hand against his head. ‘What is it going to take to make you understand that you can’t stay here?’ he barked angrily.
The answer that shot to her tongue hovered nervously for a moment, then daring to go with it, she said, ‘Whatever it is, you don’t have the words.’
He glowered dangerously, but then a hint of amusement began to shine through a chink in his anger. ‘That’s not kind,’ he told her.
‘No, but nor is the way you’re trying to push me away. You’re my husband, I love you and if being with you means having to deal with this crotchety, antagonistic old sod you’ve apparently decided to become, then so be it.’
‘He’s going to be a doddle compared to the bed-wetting drooler coming up behind him,’ he snapped, and throwing down his napkin he walked out of the kitchen.
Lisa continued to sit where she was, unable to argue with him, or defend herself, or even to try and comfort him, because she had no idea how to handle this in a way that would make any kind of difference at all. In fact, she was completely lost in a world where she’d never in her entire life imagined she’d be, a world that she was already struggling to stop herself thinking of as a chasm with no way back to the top.
He was right, she was still young, not yet forty, but fifty-three wasn’t old either, and anyway, no matter what their ages, neither of them deserved to have this unassailable cruelty flung upon them.
Later in the day they were lying in each other’s arms on the bed after making love in a way that had seemed almost desperate in its passion, and yet so profound in its tenderness that the sheer power of it was still reverberating through them. It was as though they’d joined more completely and deeply than they ever had before, and feeling his arms so strongly around her, and the full sense of the closeness they shared binding them more tightly than ever, was almost breaking her heart. How could a man who was so vital and healthy in every other way be falling victim to such a terrible disease? It wasn’t right. It made no sense at all. She could hardly bear to imagine what must be going through his mind now. Was he wondering how often they’d be able to share this sort of physical closeness in the future; how long it would be before he’d forget the desire and so no longer need the release? She want
ed to tell him that it wouldn’t matter, she’d be here anyway, loving him and caring for him in every other way, but she knew it wouldn’t be what he wanted to hear.
How would he react, she wondered, if she told him that she felt something very special had just happened between them, something bigger and more lasting than ever before? With all her heart she longed to be right, but there had been too many times in the past when she’d felt certain she’d conceived and had been disappointed. She wasn’t going to allow herself to get her hopes up now, especially when it meant so much. Instead, she turned her face into his neck and inhaled the wonderful male scent of him, feeling it moving through her with the same stirring potency as the most intimate caress.
David, David, David, she was crying inside. Don’t leave me yet. Please don’t go.
Feeling him press a kiss to her head, she gave a soft moan of protest as he gently disentangled himself and got up from the bed. When he returned from the bathroom a few minutes later, belting his robe, she could see the terrible angst he was trying to hide. ‘I need to talk to Miles,’ he said gruffly.
Though she understood the fear that was compelling him to try and put a distance between them, she wasn’t going to let it happen, so using her own strength of will to bring him back to her she reached out her hand and waited for him to take it. When he did she pulled him to her and wrapped him in her arms. They’d have to deal with the rest of the world sooner or later, she accepted that, but when the time came, which wouldn’t be today, there was no doubt in her mind that his daughter needed to be told before anyone else.
Rosalind was surprised to see Dee getting out of David’s car. The last she’d heard her aunt was unable to make lunch today, because she’d agreed to help an old friend at an antiques fair in Yeovil. Not that Rosalind minded about her coming, in fact she was quite relieved, since she was still half afraid each time she saw her father these days that he was going to start giving her a hard time over the calls she’d made to Jerry’s mistress.
She only knew her father was aware of them because Jerry had told her he’d asked him to make her stop. So far, to her surprise – and relief – David hadn’t mentioned it. However, he’d been quite distant with her lately, which in itself suggested his disapproval, even if he didn’t come right out and express it.
