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  For everyone touched by dementia, especially for Pat Hanrahan, who will never be forgotten

  1

  Anna

  Fifteen months ago …

  No one trusts anything I say. If I point out, for example, that the toast is burning or that it’s time for the six o’clock news, people marvel. How about that? It is time for the six o’clock news. Well done, Anna. Maybe if I were eighty-eight instead of thirty-eight, I wouldn’t care. Then again, maybe I would. As a new resident of Rosalind House, an assisted-living facility for senior citizens, I’m having a new appreciation for the hardships of the elderly.

  “Anna, this is Bert,” someone says as a man slopes by on his walker. I’ve been introduced to half a dozen people who look more or less like Bert: old, ashen, hunched-over. We’re on wicker lawn chairs in the streaming sunshine, and I know Jack brought me out here to make us both feel better. Yes, you’re checking into an old folks’ home, but look, it has a garden!

  I wave to Bert, but my gaze is fixed across the lawn, where my five-year-old nephew, Ethan, is having coins pulled out of his ears by a man in a navy and red striped dressing gown. My mood lifts. Ethan always jokes that he’s my favorite nephew, and even though I deny it in public, it’s true. He’s the youngest of Jack’s boys, and definitely the best one.

  Once, when he was four, I took him for a spin on my motorcycle. I didn’t even bother asking Brayden or Hank; I knew they’d just say it was dangerous and then tattle to their mother. As far as I know, Ethan never tattled. Brayden and Hank know what’s wrong with me—I can tell from the way they constantly glance at their mother when they talk to me. But Ethan either doesn’t know or doesn’t care. I really don’t mind which one.

  “And this is Clara.”

  Clara wanders toward us with remarkable speed (compared to the others). She’s probably in her eighties—but portly, more robust looking than the rest. With a cloud of fluffy yellow-gray hair, she reminds me of a newborn chick.

  “I’ve been looking forward to meetin’ you,” she says, then gives me a whiskery kiss. A burst of fragrance fills my airspace. Normally I don’t like to be kissed, yet from her, the gesture feels oddly natural. And these days, I make a point of respecting people who are natural around me. “If you need anything at all, you let me know, honey,” she says, then wanders off toward a huge oak tree. When she gets there, she kisses the man in the navy and red striped dressing gown full on the mouth in a way that feels vaguely territorial, like she’s staking her claim.

  Beside me, Jack is talking to Eric, the center’s manager—a paunchy, red-faced man with a thick Tom Selleck mustache and a titter of a laugh that, by rights, should belong to a female in her eighties. Every time I hear it (which is a lot, he seems to chortle at the end of every sentence), I jerk around, looking for a ladies’ auxiliary group giggling over its knitting. He and Jack talk, and I listen without really hearing. “We do a lot of activities … we’ll keep her active … twenty-four-hour care and security … experience with dementia … the best possible place for her…”

  Blah, blah, blah. Eric has a certain desperate-to-please manner about him that, a few years ago, Jack and I would have exchanged a look over, but today Jack is eating it up. He’s happily oblivious to Eric’s false laugh, his too-tight chinos, his gaze that wanders to the right (and vaguely near my chest), every few moments. Eric’s only redeeming quality so far is that when we arrived, he asked my advice on an old knee injury that had been giving him some trouble (probably because he hoped I’d offer to give it a rub). He needed a doctor, not a paramedic, and I explained this, but I appreciated him asking. These days, the most interesting conversations I have are about my favorite color or type of food. I like it when people remember that I’m a person, not just a person with Alzheimer’s.

  Jack seems to have forgotten that. Ever since I went to live with him and Helen, he’s stopped being my brother and started being my dad, which is beyond annoying. He thinks I don’t hear when he and Helen whisper about me in the kitchen. That I don’t notice them exchanging a look whenever I offer to walk the boys to school. That I don’t see Helen trailing after me in the car, making sure I don’t become disoriented on the way there.

  Jack’s been through this before—we both have—and I know he considers himself an expert. I have to keep reminding him that he’s an attorney, not a neurologist. Anyway, the situations are different. Mom was in denial about her disease. She fought to hang on to her independence right up to the point when she burned down the family home. But I have no plans to fight the inevitable. It’s why I’ve checked myself into residential care.

  The upside of this place, if I’m choosing to be positive, is that not everyone is nuts. Jack and I looked at a few of those dementia-specific units, and they were like Zombie City, full of crazies and folks doing the seven-mile stare. This place, at least, is also for the general aging community—the ones who need their meals cooked and laundry done—kind of a hotel for the elderly (the wealthy elderly, judging by the zeros on the check Jack wrote this morning).

  Still, I’m not exactly thrilled to be here. It was bad enough when Jack sent me to “day care.” Seriously, that’s what it’s called. A day program for people like me. Also for people not like me, because with only 5 percent of Alzheimer’s cases occurring in people under the age of sixty-five, there aren’t a lot of people like me. That’s what makes this situation all the more unusual. I’m not checking into just any residential care facility—no sirree. We’ve traveled all the way to Short Hills, New Jersey, from Philadelphia so I can live in a facility with someone like me. A guy, also with younger-onset dementia, someone Jack heard about through the Dementia Support Network. Since learning about the guy, Jack has been hell-bent on getting me into the very same care facility as him. It’s like he thinks having two young people in a place filled with oldies makes it spring break instead of residential care.

  “Would you like to meet Luke, Anna?” Eric asks, and Jack nods enthusiastically. Luke must be the guy. I wonder if he’s going to rappel down from a tree or something. His entrance will have to be pretty impressive if they think it’s going to make a difference to my mood.

  “I just want to go to my room,” I say.

  Jack and Eric glance at each other, and I feel the wind leave their sails.

  “Sure,” Jack says. “Do you want me to take you there?”

  “Nope. I’m good.” I stand. I don’t want to look at Jack, but he stands, too, gets right in my face so I can’t look anywhere else. His eyes are full and wet, and I catch a glimpse of the softhearted man he used to be before his brushes with dementia and abandonment hardened him up.

  “Anna,” he says, “I know you’re scared.”

  “Scared?” I snort, but then my vision starts to blur. I am scared. One thing about being a twin is that you get used to having someone right by your side whenever you want them. But in a moment, Jack’s going to le
ave. And I’m going to be alone.

  “Get lost, would you?” I tell Jack finally. “I have a pedicure booked in half an hour. This place has a health spa, right?”

  Jack laughs a little, shooing a drop from his cheek. When we were younger Jack sported a golden tan, but now his skin is vaguely gray, almost as white as my own. I suspect this has something to do with me. “Ethan! Come and say good-bye to Anna.”

  Ethan thunders across the lawn to us and tosses himself into my arms. He strangles me in a hug. “Bye, Anna Banana.”

  When he pulls away, I take a long hard look at the large white bandage covering his left cheek and try to remember the angry red burns and welts underneath. I need to remember them. They’re the reason I’m here.

  * * *

  The first time I knew something was wrong with me, I was at the mall. I was lugging my bags toward the exit when I realized I had no idea where I’d parked my car. The parking lot was seven stories high. In the elevator, I stared at the buttons. None seemed any more likely than the other.

  Eventually I made my way to the security booth. The man behind the desk laughed and said it happened all the time. He picked up his walkie-talkie and asked for the license plate number. When I looked blank, he smiled. “Make and model?”

  It was such an easy question. But the more I tried to find the answer, the more it blacked out. Like a photograph with a question mark over the face, a criminal with his jacket over his head—something was there, but my brain wouldn’t let me see.

  The man’s smile faded. “The color?”

  All I could do was shrug. I waited for him to say this happened all the time. He didn’t.

  I caught the bus home.

  If I’d been tested for the mutated gene, as Jack was, I’d have known for sure it was coming. But finding out you’re going to be struck down in your prime didn’t fit into my life’s plan.

  After that, things started happening all the time. Usually, I could explain the incidents away. Sure, I forgot a lot of appointments, but I was a busy paramedic. Getting lost on the way home from work was a little stressful, but directions had never been my strong suit. Unfortunately, there were things that were harder to explain. Like the time I smashed my car window with a ski pole when I couldn’t get the keys to open the door (and then found out the car belonged to the family across the road). And the time I showed up to work on my rostered day off (for the fourth time in a row).

  It was the time I forgot the word “twin” when introducing Jack to my buddy Tyrone, from work, that I really started to worry. It was a year after the parking lot incident. I remember staring at Jack, wondering if there was indeed a word for what we were. I searched the dark, dusty corners of my brain, but it was useless. Eventually I called him a person who my mother carried in her uterus at the same time as me. I know, I remember “uterus” but not “twin.” Tyrone laughed; he’d always thought I was nutty. But Jack didn’t laugh. And I knew the jig was up.

  I quit my job that day. If I couldn’t remember the word “twin,” what would happen when I couldn’t remember how to resuscitate someone or when I decided it was a good idea to move a patient with a possible neck injury? I had a feeling I’d already been off my game. And when I know something’s going to happen, I don’t see the point in dragging it out.

  The same theory applies to life. Life’s going slowly in one direction. I can stay in the slow lane, just keep rollin’ on down that hill, gathering moss and cobwebs until finally, when I come to a stop, I’m so covered in crap, I’m unrecognizable. That’s what Mom did. That’s what most people do. But that’s never been my style.

  * * *

  At Rosalind House, there are a lot of drugs. Enough that everyone has their own basket. Every morning and afternoon, the nurse rolls her table-on-wheels through the halls with the baskets, a veritable candy woman of pharmaceuticals. In my basket is Aricept, a round peach-colored tablet responsible for slowing the breakdown of a compound that transmits messages between the nerve cells. Also in the basket is vitamin E, clear and yellow, long and thin. Lastly there is Celexa, a powerful antidepressant responsible for making all of this feel like no big deal. That’s the one I know for sure isn’t working.

  I don’t get dressed until my second week at Rosalind House. When I do, I wonder why I bothered. All I do here is lie in bed, scribble in my journal, and stare out the window. Any visitors I might have had (Jack notwithstanding) have been told, at my request, that I’m at a facility on the other side of the country (Hey, I’m not likely to remember them anyway, and I need a “pity visit” like I need a hole in the head). Eric, the manager guy, stops by continually, trying to cajole me into bingo. (Yeah. Like that’s gonna happen.) Various nurses and staff have popped in. But I’ve been out of my room only once, and when I did leave it, I got so twisted around that I couldn’t find my way back. As far as blips went, this one wasn’t so bad. At least I knew I was at Rosalind House. I knew I had a room. But the only thing my little trip out of my room taught me is that I’m in the right place. Residential care.

  Today, outside my window, a handsome gardener prunes the boxwood. It’s warm out, and he’s stripped to a thin white T-shirt, which allows me to enjoy his ripped physique. A few years ago, I’d have leaned out and asked for a sprig of something, or even asked if he needed any help. (When I was a kid, Jack and I used to spend a lot of time in the garden with Mom, planting and weeding and mulching.) But now I can’t even be bothered to return the gardener’s smile. I’m too busy thinking about Ethan. About the incident.

  It happened at night. I get restless at night, one of many joyous side effects of “the disease.” I was in the living room, trying to figure out how to use the Xbox when I heard his little footsteps behind me.

  “Let’s make fongoo.”

  “Fongoo” was a loose derivative of fondue, and it was our word for melting candy bars on the stove and then dipping cookies, marshmallows, or whatever else we had handy into the melted goo. I said yes for several reasons: One, I love fongoo. Two, I’m not his mother—it is not my job to worry about his teeth or his lack of sleep. Three, my life is hurtling toward a point where I’m not going to know myself anymore, and while I do know myself, I sure as hell want to be making fongoo with my nephew.

  We’d finished the fongoo and were playing Xbox when we smelled the burning. Ethan and I locked eyes.

  “Shi—oot!” I said. “The fongoo.”

  I bolted for the kitchen, cursing. Burning the house down would do nothing to assure Jack I was a competent adult. I threw the door open, ready to reach for the fire extinguisher, but instead of finding it, I found the bathroom. I turned, opened another door. A cupboard filled with towels. I spun again. Where, in God’s name, was the kitchen?

  It wasn’t the first time this had happened. I knew all I had to do was stay calm and wait for a few moments, and everything would come back to me. But the burning smell was getting stronger, and I couldn’t see Ethan anywhere. And I couldn’t even find my way out of the fucking bathroom!

  That was when I heard Ethan scream.

  According to Jack, after I ran in the opposite direction, Ethan tore into the kitchen and tried to take the saucepan off the stove. The handle was red-hot. He’d whipped his hand off so fast, he toppled the saucepan, splattering the burning chocolate onto his cheek. The worst part, except for hurting Ethan, was that it confirmed they were right about me. I can’t be trusted with my nephew. I can’t be left alone, even for a second.

  “Knock knock.”

  I roll my head toward the door, which is eternally open, thanks to the skinny helper lady, who has an unnatural obsession with fresh air. Every time I try to close it, she appears like a magical air fairy—fresh air, fresh air, FRESH AIR! But this time when I look, Eric is there with a huge lion of a dog by his side. I feel my insides pull together to form an internal shield.

  “Hey,” he says. “How are you doing?”

  “Fine.” I address the dog since I can’t seem to look anywhere else. />
  “Everyone being nice to you?”

  “Yep.”

  It’s a German Shepherd. Its teeth are yellow and shiny with saliva; its mouth is curved into that smile-snarl that dogs always wear to keep you on guard. Am I happy? Am I angry? Come a little closer and find out.

  “Oh,” Eric says. “Are you afraid of dogs?”

  I try to put on a brave face, but I obviously fail, because Eric sends the dog out. On his way into my room he pauses at a watercolor of a leaf that Jack must have hung on my wall. It belonged to my mother.

  “This is lovely,” he says.

  “Keep it,” I say.

  He frowns at me. “You know you don’t have to just sit in your room all day. There’s a bus that goes into town twice a day. Some folks like to go to a shopping center or to a movie.”

  I sit up. “I’m allowed to do that?”

  “Sure. Trish, one of our staff, is escorting the bus group today.”

  I sink back into my bed.

  “Or there are board games in the parlor,” he says. “We try and encourage residents to congregate in there when they’re home. We find that people feel isolated when they spend all their time cooped up in their rooms.”

  “I’m okay with being isolated.”

  Eric perches on the edge of my bed, a frown bobbing on his forehead. My heart sinks. It must be time for the pep talk. I actually feel bad for Eric. He doesn’t want to give it any more than I want to hear it. Deep down he probably knows that if he were a resident here, he’d stay in his room, too. But that’s not the dish they’re feeding us.

  “Fine,” I say, cutting him off before he can start. (Mostly because I want him to get off my bed.) “The parlor? That’s the place to be? I’ll go there today. Promise.”

  Eric sighs. “You don’t have to go to the parlor. That wasn’t my point. My point is that I want you to be happy here.”

  “I know.” Everyone wants me to be happy here. If I’m happy, they don’t have to feel guilty.