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Every age has its own way of dying. The 19th century had consumption, the 20th century had the heart attack, and the 21st century will be the age of Alzheimer's disease. Degenerative and incurable, Alzheimer's today afflicts about 4 million Americans, but in the next few decades, as lives get longer and baby boomers get older, that number will rise steeply. Although our life stories are getting longer, medical miracles have not made the final acts any less painful. Three fearless new memoirs about life with Alzheimer's give us a look at what we're up against.
Though all end the same way, each case of Alzheimer's announces itself uniquely. Sue Miller's The Story of My Father (Knopf; 174 pages) starts with a phone call. The police have found her father knocking on strangers' doors at 3 in the morning. A quiet, spiritual man, he had been a professor at Princeton Theological Seminary, but within months he was barely keeping it together in a nursing home. Miller notes his cerebral short circuits with stricken fascination. He began to mistake his shadow for "a strange black animal dogging him," and he could find only the food on the right side of his plate. Miller, the author of several best-selling novels, including The Good Mother and While I Was Gone, manages to spot the rare moments of accidental levity. "One thing I haven't figured out about this place," the lifelong academic observes about his new home. "No one ever seems to graduate from here."
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Alzheimer's isn't all quirky, Oliver Sacks moments — far from it — and Miller doesn't sentimentalize. She leads us lucidly, almost lyrically, through the neurological origins of the disease, and she doesn't spare us its ugly side, as when her father slams her into a wall in a demented rage. Her performance is an astonishing one, honest and free of wallowing, drenched in remembered pain but at a calm remove from it. When her father's end finally comes, Miller is brave enough to face her relief. "Guilty as I felt, terrified as I was, shamed as I felt for feeling it, I was glad."
In some cases the relationship between patient and caregiver can take on the character of a duel, wits on one side, willpower on the other. Eleanor Cooney's mother was brilliant and glamorous, a successful novelist who once won a beauty contest judged by Frank Sinatra. In Death in Slow Motion (HarperCollins; 251 pages), Cooney chronicles her mother's gradual, grinding dissolution--"death's warm-up act," Cooney calls it — describing the hallucinations and the circular conversations, the fits of rage and neediness that wreck her own life and get her mother kicked out of her nursing home, all in wry, learned prose. Even when Cooney resorts to lies (for her mother) and booze and Valium (for herself), she never stoops to self-pity. "I understand that there is only one drug in the world that can keep my mother calm and centered," she writes, "and I am that drug."
In 1999 Elizabeth Cohen found herself in a house in upstate New York balancing a new baby, Ava, and her father, who was in the early stages of Alzheimer's, by herself. Her husband had lasted nine weeks in the menage, then departed for the winter. But as Cohen records in The House on Beartown Road (Random House; 256 pages), a curious symmetry emerged out of the chaos. As one of her charges misplaced words, the other found them for the first time. "They skirt language in opposite directions," she writes. "Daddy mixes fragments of words together to make new ones. Ava, speaking in almost-words, a sloppy protospeech, dances at language's doorway." Cohen's amazing reserve of humor and honesty in the face of adversity — which includes occasional passes from her dad — recall such classics of domestic perseverance as Anne Lamott's Operating Instructions.
These books are hard to read, no question, just as they must have been hard to write, but they are more than just dutiful filial exercises or neurological horror stories. They have pleasures to offer — watching the weave of a mind unpicked, thread by thread, makes the act of reading itself, of stringing words together and turning them into sense, feel like a fresh miracle. Doctors estimate that by 2020 the number of Americans suffering from Alzheimer's will have increased to 14 million. "People aren't prepared for what is coming," Cohen warns us. "An army of the forgetful is about to march on the whole country." Armed with books like these, we may be ready to meet them.
- Lev Grossman