She pulled the stethoscope from her long neck and handed it to him. Her eyes were baffled, alert. Did this wracked being still have a spark of mojo left? He glimpsed himself in the reflection of the window behind her, barely visible against the blazing metal of cars in the parking lot: was that hollow-cheeked apparition really his face? He had never cared much about his looks, aside from knowing that they had sometimes helped him with the subjects in his work, yet now he felt the loss with a pang. He still had his hair, though the curls women used to like were long gone.
The stethoscope smelled faintly like her. He realized why the perfume was familiar to him. It was something Sheila used to wear when they went someplace nice for dinner. Probably he had bought it for her. He had no idea what it was; she’d always written down what she’d wanted and he’d dutifully given it for Christmas and birthdays, never paying attention to the details, his mind on other things.
Heart rate was a bit high, if not as rapid as he had supposed.
Sheila would have laughed at him, Come on now, stop examining yourself and just feel it, will you?—the way she’d laughed at him on their wedding night (was it forty-four years ago already?) when he had battered her with questions, midcoitus, “and this feels good, like this? But this, right here, this doesn’t?” in his eagerness to figure out what worked, his curiosity egging him on, as strong as the desire itself. And what was so wrong with that? Sex, like death, was important, and yet why did no one seem to care enough to ask the questions that mattered? Kinsey did, and Kübler-Ross (and he had, too, or had tried), but they were rare and often faced the hostility of a pea-brained, backward-looking scientific establishment … Let it go, Jer, he heard Sheila say. Just let it go.
He should have been embarrassed—his bride laughing at him on his wedding night, the stuff of comedy—but it merely confirmed to him the wisdom of the choice he’d made. She laughed because she understood what kind of animal he was, she accepted his need to know along with the rest of him, that whole human fleshsack of quirks and failings.
“Dr. Anderson.” The doctor had come around the desk, placed her hand on his arm. That was something he’d never thought of, years ago, when he’d been a resident delivering bad news: the power of touch. He could feel the faint pressure of her nails through the cotton of his shirt. He began to sweat at the thought that she was going to take her hand off, so he pulled his arm away roughly, noting the startled instinctive frown as she processed the rejection. She retreated behind her desk, her diplomas on either side of her: staunch little soldiers in their Latin uniforms. “Are you all right? Can I answer any questions?”
He forced his mind back to what she had been telling him. Back to the moment when she had said that word: aphasia. A word like a pretty girl in a summer dress wielding a dagger aimed at his heart.
Aphasia, from the Greek word Aphatos, meaning: speechless.
“The prognosis is definite?’
A cart rolled through the hallway outside the room, liquids in glasses tinkling.
“The prognosis is definite.”
Surely there were other questions.
“I’m not sure I understand. I didn’t have brain trauma, or a stroke.”
“This is a rarer form of aphasia. Primary progressive aphasia is a progressive type of dementia affecting the brain’s language center.”
Dementia. Now that was a word he would happily lose.
“Like—” He forced himself to say it. “Alzheimer’s?” Did he study this in med school? Was it significant that he didn’t remember?
“PPA is a language disorder, but yes. You might say they were cousins.”
“What a family.” He laughed.
“Dr. Anderson?” The neurologist was looking at him as if he was unhinged.
“Relax, Dr. Rothenberg. I’m fine. Just—processing, as they say. My life, after all…” He sighed. “Such as it was. ‘For in that sleep of death what dreams may come When we have shuffled off this mortal coil Must give us pause.’” He smiled at her, but her expression was unchanged. “Oh, good grief, woman, don’t look so alarmed—don’t they teach Shakespeare at Yale anymore?”
He yanked off the stethoscope, handing it to her. You see what I have to lose? He raged inwardly. Things I never thought I’d lose. Is there life after Shakespeare? Now that is a question worth asking.
Is there life after work?
But he wasn’t finished.
“Perhaps you’d like to talk to someone—there’s a social worker—or, if you prefer, a psychiatrist—”
“I am a psychiatrist.”
“Dr. Anderson. Listen to me.” He noted, but could not feel, the concern in her eyes. “Many people with primary progressive aphasia continue to take care of themselves for six or seven years. More, in some cases. And yours is in the very early stages.”
“So I’ll be able to feed myself and—wipe myself and all of that? For years to come?”
“Most likely.”
“Just not be able to talk. Or read. Or communicate in any way with the rest of mankind.”
“The disease is progressive, as I’ve indicated. Eventually, yes, verbal and written communication will become extremely difficult. But cases vary widely. In many instances, the impairments progress quite gradually.”
“Until?”
“Parkinson’s-like symptoms can develop, along with decline in memory, judgment, mobility, et cetera.” She paused. “This can often impact life expectancy.”