Friday, June 10, 2016

A distracted killer

Almost exactly one year ago—June 9, 2015—I submitted to a PET scan at Sancta Maria Nursing Facility in the far west end of Cambridge. Because I would be mildly sedated during the procedure, I was advised not to drive, and my cab driver got me to Sancta Maria well ahead of my 6:45 appointment. The Boston area is famous for its medical institutions, but Sancta Maria struck me as down-at-the-heels. The main part of the building featured the dour institutional architecture of the 1950s, and I wondered if, by chance, this building was once a place where lobotomies were performed. I was led to a temporary wing, consisting of what looked like a series of refurbished box-car compartments. I remember crossing over an elevated piece of corrugated metal to get to one compartment of the facility to the next.
It had been some time since I’d had a deeply unpleasant medical experience. A terrible case of intestinal flu landed me in Mount Auburn Hospital one evening in the late nineties. More notable was an incident a decade earlier, when I was about to start graduate school at Northeastern. The university required evidence that I’d been exposed to one of the very common childhood illnesses of my generation—measles, I think it was. I was certain that I’d had the disease, but I couldn’t document it. And since I had no documentation, I was told I would have to receive the shot. I refused, and in my head I pictured my tormentor as Nurse Ratched in One Flew Over the Cuckoo’s Nest. The more I resisted, the tenser I became. By the time I finally acceded, the needle came close to causing me to pass out.
 And now, at Sancta Maria, more than a quarter-century later, something similar was occuring. The orderly, who might have worked as a medic overseas, did not have an empathetic touch. I began to sweat excessively. And as I did, I had a dark epiphany. Until that moment, I’d been able to hold my fears at bay. But my sweating, and the orderly’s rough handling, left my psyche quivering. The PET scan itself I tried not to think about. I recalled the words of our lawyer, who made the point that we would either continue to negotiate with my employer over my severance package, or I would end up with a disability claim.
 At work, none of my superiors raised the question whether the erosion in my performance might have an organic cause. And the psychologist I worked with the previous year agreed with me that burn-out after working in the same job for an entire decade was the likely cause of my problems. I also consulted a psychiatrist, who posited that a B-12 vitamin deficency might be in play.
How did I react to my diagnosis, a few days after the PET scan? It was a gorgeous early-summer day, and as I’d been doing often after work, I got off the subway at Central Square in Cambridge, ensuring that I would have time to walk vigorously for more than 30 minutes. Trudging up one of Somerville’s steepest hills was invigorating. When I reached our back deck, I was pleased to see that Paula had made tabbouli, one of my favorite warm-weather dishes. It didn’t take long, though, to see that the news was bad. Paula was crying.
I put my left hand to my face, as if by doing so I could blot out the news for at least a minute or so. Didn’t work. I don’t recall eating the tabbouli. But I must have. Like Rusty, the much larger of our two cats, it would take more than a life-changing disease to get in the way of my consuming my food.
Was I wracked with grief? I understood that this was a death sentence. But within a few days I also learned that, in the large majority of cases, Alzheimer’s is a highly distracted killer, a killer who seems to have Alzheimer’s himself. Didn’t I already waste that man last year? Crap, I can’t remember. What’s wrong with me? It’s been ten years, and that guy’s still around? What a piece of shit I am! Merde! Merde! Merde!

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