Dignifying Dementia by Elizabeth Tierney Read Free Book Online Page B

auspicious start.
    The psychologist offered us chairs but never smiled. He asked Jim questions about his personal and professional life; then he took him into another room to give him some standardized tests. I couldn’t believe how unfriendly he seemed. How was Jim going to relax? Afterwards the psychologist wrote a lengthy report indicating that there were “lapses in Jim’s memory.” Thanks! Didn’t we know that without putting him through hoops? But we were no closer to knowing what was wrong, because rather than confirming that Jim had Alzheimer’s, the psychologist wrote that the “lapses” or “cognitive impairment didn’t appear to be Alzheimer’s.” Brain shrinkage? Didn’t appear to be Alzheimer’s? I, of course, held onto the phrase, ‘lapses in memory.’ But other than giving him humiliating tests and offering him drugs, why couldn’t anyone tell us what was the matter with Jim? I was used to doctors being kind and definitive.
    Winters had always included medical appointments, so in addition to seeing the neurologist and psychologist, Jim had an appointment with his urologist for a routine PSA (prostate-specific antigen) test to screen for prostate cancer. Jim’s previous numbers had been elevated, and this test indicated that they still were, so the urologist recommended that Jim have a biopsy to determine whether there were any cancer cells. In preparation Jim took Cipro, an antibiotic. He was accumulating prescriptions. The Aricept and Zoloft hadn’t gone down well, so Versed was no longer the only culprit.
    At 7:30 pm on December 31, 1999, New Year’s Eve – Millennium Eve – Y2K Eve, the phone rang. I picked it up. It was the urologist. I signaled Jim. He picked up the extension. Jim asked me to stay on the line. The urologist said, “I wanted you to know that there are cancer cells in several quadrants of your prostate, and it’s very treatable.” He went on to explain radioactive seed implants. I could see Jim’s face. After the opening remarks, he wasn’t listening, just like me in the neurologist’s office. Jim thanked the doctor for the call. But before we hung up, I blurted out, “By the way, why are you calling tonight?” He answered, “I didn’t want to ruin your Christmas.” Once again, a physician’s choices bewildered me. While I appreciated his giving us the results, what timing! What a rationale!
    After he hung up the phone, Jim appeared thunderstruck. For him, ‘cancer’ was a death sentence. I tried to reassure him by reminding him that he had been successfully treated for skin cancers and that the urologist had said his cancer was “very treatable.” I doubted what I said made any difference.
    Did Jim understand the implication of his cancer being ‘stage one’? That he had a relatively low Gleason score, the degree of aggressiveness of a tumor of the prostate, new vocabulary for us. What he heard was that he had cancer. Jim sank into a depression.
    Over the years, when Jim had been monosyllabic, I would ask, “Are you OK?” He invariably answered, “I am fine. I am just not my usual ebullient self.” Well, if he wasn’t always ebullient before and had become frustrated by his memory problems, now there was this.
    But, at least, this diagnosis was definitive, and we had to weigh different treatment options ranging from surgery, to seed implants, to ‘watch and wait,’ to herbal remedies.
    Believe it or not, I was grateful for the diagnosis of prostate cancer, because focusing on a treatment plan for the cancer distracted Jim from the problems with his mind. Our internist encouraged us to go to a prostate support group meeting. We did – once. It required talking and was too public for Jim, so I went online. Should we go back north to Memorial Sloan-Kettering Cancer Center in Manhattan?
    I had been doing