Blue Hydrangeas

Later that day, Jack watched while Dr. Fallon grimly examined Sara, took samples of her blood, and performed a few mental tests. When the examination was over, he brought them into his office and tried to be optimistic, but warned them the situation could be grave. Following his recommendations, they consulted a neurologist and a psychiatrist. She went for a MRI of her brain.

Several stressful weeks passed before all of the test results and consultation reports were in. They returned to Dr. Fallon’s office and he explained the diagnosis. He was blunt, left no room for misunderstanding, and told them what to expect.

Jack refused to believe it. “I want a second opinion,” he said. “I want her to see the best specialists we can get. We’ll go to Boston, to New York. Nobody in our family has ever had Alzheimer’s disease. Find something else. You have to do more tests.”

Sara sat by his side and clung to his hand. An air of despondency descended upon her. Silent, she studied the doctor’s face.

“I wish I could tell you otherwise, Jack, but there is no single test to diagnose Alzheimer’s,” Dr. Fallon explained. “We’ve done all the tests available to rule out other conditions that might explain Sara’s symptoms. Everything indicates probable Alzheimer’s, and there’s nothing more to do.”

“You say it’s ‘probable,’” Jack argued. “See? You’re not sure. It could be something else.”

Dr. Fallon leaned toward Jack and looked deep into his eyes. “Jack, right now all I can say is that it is probable, because only an autopsy can provide a definitive diagnosis.”

Jack had no words to respond to that suggestion.

The doctor wrote a prescription for a medication that might slow the progression of the disease and they agreed to try it.

“Sara,” Dr. Fallon said, turning toward her, “the best you can do is live one day at a time, and try to maintain as much of your routine and lifestyle as possible.” He encouraged them to go on with the operation of their bed and breakfast for as long as they felt able, and he urged Sara to continue with her artwork.

The next day, Jack visited the library and asked the librarian to point him in the direction of the books on Alzheimer’s disease. He spent hours holed up in a corner of the reference section poring through textbooks, medical journals, and self-help guides. As he studied the reading material, he realized how much he did not know about this illness. He read with uninterrupted concentration, and did not like what he learned.

Sara was but one of an estimated 5.1 million Americans with probable Alzheimer’s.

There is no cure.

Damage to the brain may start a decade or more before problems become evident. Jack thought back over the last few years, trying to pinpoint the first time Sara showed any sign that this monster disease had settled inside that brilliant brain of hers. He shook his head. He had not seen this coming, not until it was well on its way. Perhaps if he had paid closer attention to her senioritis they may have been able to staunch its spread.

As Alzheimer’s progresses, he learned, people may be unable to recognize family and friends. They may be unable to carry out tasks that involve multiple steps such as getting dressed, or cope with new situations. They may suffer from hallucinations, delusions, and paranoia, and behave impulsively.

In its late stages, the person becomes completely dependent on others for all aspects of their physical care, and may be bedridden most or all of the time as the body slowly and painfully shuts down.

Deep into his reading, he came upon a chilling fact: those with Alzheimer’s may live, on average, just three to nine years from diagnosis. This information brought tears to his eyes, and he closed the book, staring at the desktop, willing the tears not to spill and his heart not to break.

Three to nine years, he thought. That’s all.