Diagnosis

One morning in 2001, I became a Mama in the Middle. My relationship with my mom had changed over the years, but my role as her caretaker was formalized in one 20-minute doctor’s appointment.

I was already entering a new phase of motherhood: freshly released from my teaching job to the nesting phase of maternity leave, I was enormously pregnant with my second child. I dropped three-year-old Zoë off at her preschool at 8 a.m. and picked up Ma at 9, for our third trip to the U.C. Davis Alzheimer’s Disease Center in Martinez.

Today was the day of reckoning; we would finally find out what was causing Ma’s memory problems.

“This doesn’t look familiar,” Ma said as we arrived. “Are you sure this is right?”

“Yep.”

I silently observed that she was disoriented in a setting that should be familiar to her. Hair: greasy. Same clothes as yesterday. Over the past year, I had developed a sort of internal accounting system to catalogue her subtle personality shifts and memory lapses.

“Well, I’m sure glad you’re driving,” she said as we arrived.

I frowned. Even though I had insisted on these appointments, I resented having to be in charge. I wanted to be the college kid who cut off her ponytail while hitchhiking across Europe and sent it home in a box with some snapshots and a note asking could they please loan me more money. I wanted to throw myself down on the bed and cry, like I did when I was thirteen and full of black despair–and Ma sweetly advised me, “Oh, Punkin, what you need is sex.”

My role with Ma should be to receive, not to administer; to ask her, not tell her, what to do. But today, she needed me.

“It’s ok if you feel anxious, you know,” I said as we waited in the reception area.

She scowled. “I’m fine. I don’t know why you had to bring me to this place.”

I descended into a familiar vortex of self-doubt. Would the doctors say Ma’s behavior was perfectly normal for her age? Maybe I was just trying to get my old mom out of my hair so I could reclaim my life. Ungrateful, punishing daughter. But then the facts trickled in: She barely smiled any more, and almost never initiated conversation. She had forgotten her granddaughter’s name. She had forgotten that she loaned us fifty thousand dollars.

Ma hunched in her chair, staring at the carpet. I petted the sides of my belly, telegraphing my love to the little sprout inside. Then the neuropsychologist appeared.

“Ruth?”

“Yes,” I replied, smiling. “We’re Ruth.”

She led us into a conference room with a long white table, where the clinical nurse sat waiting. We made small talk as we waited for the third member of their team, a neurologist.

I was wired and anxious, but not afraid. I just wanted to hear the bottom line. I hated the squirming, nebulous feeling I got when I saw the changes in Ma but could not name them. A diagnosis of Alzheimer’s would at least be concrete, something I could work with.

But also, I actually hungered for calamity. Like a driver passing an accident on the freeway, straining in spite of herself to see the spray of blood on the windshield, I was eager for a glimpse of the unthinkable.

As the neurologist sat down, I reached for Ma’s hand. I did this not so much out of an immediate need to warm or comfort her, the way I would reach for a crying child, but because I had seen compassionate people portrayed on television at critical moments like this one, and this was how they behaved. The nurse smiled reassuringly, and I guessed that to her we looked correct: Ma looked scared, and I looked supportive. The truth was, she was annoyed and I was excited.

I felt a swell of remorse. My mind flooded with images of her young smile, her summer freckles, soothing voice, strong arms that picked me up and hugged me fiercely. I didn’t want this to be the End. I just wanted my old mom back.

When the neuropsychologist finally spoke, she said simply, “Ruth, we believe that you are suffering from Alzheimer’s disease.”

I looked at Ma, who was looking down at her lap. I kept my body perfectly still, as if that could stop time. A car started outside. Finally, I nodded, took in a breath and slowly let it out. Ma didn’t look up. Her expression did not change.

***

That night, I drove up to Lake Anza. Under a gnarly old oak, I slipped off my clothes and stepped into the black water. With a quiet slurp, it swallowed me up.

I surfaced, rolled onto my back and watched wisps of high fog rush past the half moon as though in a hurry to get somewhere.

Floating there with the faint moonlight on my pregnant belly, I saw that now I would take care of Ma, too. It wasn’t her fault; she had a disease. I felt a new, forlorn, soft, something unfolding, and after a moment’s confusion recognized it as compassion. I made a vow to be kind to the worried stranger who inhabited my mother’s body. I made a wish for the little life within mine. Then I swam back to shore.