Remembering Death

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Remembering Death    (SAMPLE)                    BACK TO SYNOPSIS

(Parker DuPont, PI Book 2)

Prologue

Lester Winters was 5'10" in his prime, now stretching to reach 5'8", if he were to think about it and stretch. Some of Lester's thinking days were long past him, or at least his remembering days. No one had a clue what he was thinking; not his wife, not his children, not his friends; not even his doctors of which there were a few. Celeste Winters, his wife of 49 years, was wondering if it was time to cease all the doctors and allow Lester to continue on to the end of his life gracefully, if that was possible. Lester was in his third year of Alzheimer's, pieces of him, of who he was, disappearing at an alarming rate. Celeste knew it'd really been longer than three years, though. There were signs which, in hindsight, were obvious.

"This is the end," Celeste said to no one in particular, though her daughter, the only other person in the waiting room, was sitting next to her. It was the first time, when referring to her husband's condition, that those four words had ever left her mouth and for a few seconds they shocked her. She realized that they'd been waiting to be said for quite some time. "After this I'm not putting him . . . us . . . through anymore of this. I let you and your brother talk me into this last Hail Mary,"—It was as much her push as theirs—"as Michael likes to call it, but after they're through poking around in his brain we have to stop."

"Okay, Mom."

The two words caused Celeste to look at her daughter in surprise. "Yes? You agree?" And then she saw the tears and the fact that Marybeth was making no effort to wipe them away. Celeste herself, without realizing what she had been doing over the years, had placed a wall against her own tears, a barrier made up of determination and anger. She was angry that this had happened to her husband and was determined that she would do absolutely everything humanly possible to find a way to hold off the disease until a cure could be found. The anger and determination, however, had slowly eroded away and now she was on the edge of admitting defeat. Or maybe she had already gone over the edge with her statement that this was the end, that she was ready to let her husband die.

Die! She couldn't believe she actually thought that word. He wasn't on his death bed yet; far from it, actually. So many people kept telling her he would die from Alzheimer's and there was nothing that could be done about it. But he just forgot things, people, got lost easily. He was no more close to death than was she. Where the hell did that word come from?

Whatever it was that she was ready for, she had been on that edge for a couple of months now, but was being held back by her children, by this last Hail Mary. Maybe deep down she was glad they were holding her back, determined as they were that they were not going to abandon their father.

Was Marybeth now admitting defeat? Michael, too? The two of them always stood together.

They were perched on one of several waiting room sofas, so Celeste slid over close to her daughter and put her arms around her. "I'm sorry, Marybeth."

And then she couldn't hold them back any longer and so for a full minute mother and daughter cried in each other's arms.

"Mrs. Winters?"

The two women broke apart and, embarrassed, looked up at Scott Forrester, the nurse who'd taken charge of their needs while Mr. Winters was being prepped.

"I'm so sorry to have to interrupt," he said. "They're about fifteen minutes away. When you're ready, we're ready for you two to get gowned up."

Celeste nodded and accepted a handkerchief from Marybeth. "Thank you, Scott. Can we have another minute or two?"

"Certainly," he said, and retreated.

She took a moment to wipe at her face while Marybeth did the same. Finally, she took a deep breath and folded both of her daughter's hands in hers. "I don't think I've ever told you and Michael this, but back about the time your father retired, he told me he didn't ever want to be a vegetable."

"You have living wills. We know that, Mom."

"The living wills define what to do if we are kept alive only by machines. Turn off the machines and let us die. That's not what he was saying, or yes, that's part of what he was saying. When we moved into the retirement community we met a number of people, older people, who were not on machines, were at home leading regular lives but having no idea who anyone was. They always had a companion. He didn't want to become like them. Some use the term vegetable, which I hate by-the-way. What your dad actually said was potted plant."

"Potted plant!"

"He didn't ever want to become a potted plant."

Marybeth just stared at her mom.

"It was after he had himself tested."

"Tested? What do you mean tested?"

"Apolipoprotein E. They call it a risk gene. It's the main genetic determinant for AD. He tested positive for it."

"You bought that house ten years ago. Why were you already thinking that he needed to get a test for Alzheimer's Disease?"

"Your grandfather had Alzheimer's, so . . ."

"Grandfather died in an auto accident when I was in college."

"In '93, yes." Celeste took a deep breath and continued on, knowing she should have told her children this long before now. "What we never told anyone is that at the time of the accident he was showing early signs of AD. The accident saved him from having to age into it fully."

"Oh." There was a long silence as the implication took root. "Oh! It's genetic?"

"I'm afraid so."

Nothing more was said about that. Celeste was certain that the news would be passed from Marybeth to Michael and then would come up at the next family dinner. The two of them would have to be tested.

"Then you are in agreement that this is the last Hail Mary? Have you and Michael talked about it at all? I know he's always researching."

Marybeth shook her head.

"Let's see what happens today and then we'll go on from there." She stood, feeling better for having talked about it. "I guess it's time for Doctor Barstow to start probing about in his brain."

"Does Dad understand what's happening?"

"He understands better than you think."


They stood maybe fifteen feet away but in full view of Lester, or at least his face. The rest of him was covered in a sheet, the top and back of his head completely blocked from their view. Harsh lights illuminated him from several angles. The monitors that were being used by the surgeon were arranged so that the women couldn't observe the procedure. They stood side-by-side, donned in paper gowns, booties, gloves and hairnets. A glass partition was placed between them and Lester so that they didn't have to wear masks, thus he could see their faces. Their purpose for being in his view was to be a memory trigger. He was awake, semi-aware of what was going on, smiling at them. Fortunately, he was a gentle soul, not the violent Alzheimer's victim so many talked about.

“We’ll be targeting the hypothalamus,” Dr. Barstow explained as though this was the first time he’d spoken with them about it. Actually, it was the first time for Marybeth. There’d been several meetings in preparation for the procedure so it was nothing new to Celeste, or to Lester. “By introducing small voltages we hope to be able to generate increased activity in the hippocampus, the center of his memory and emotion, as well as his autonomic nervous system. If Lester were much further along, stimulation of the hippocampus would be vital for his breathing, swallowing, et cetera. Fortunately, at this stage, we’re only going after his memory. We know that’s it’s all there. We just want to tickle it a little with small electrical pulses.”

They watched and waited for several minutes as the doctor and his team began the procedure.

Dr. Barstow stepped to within Lester’s view. “How are you doing, Lester?”

Lester just looked at him. Celeste had told Marybeth that her dad understood what was taking place, but sometimes his memory just blinked out and she could usually tell by the look on his face. This time she couldn’t get a read. Maybe the look was simple apprehension.

Dr. Barstow pointed to Celeste and Marybeth. “Keep your eyes on these beautiful ladies over there. Their job is to smile at you and look pretty.”

“They’re very pretty.”

“Do you know who they are?”

“One is my wife . . . Celeste.”

“Excellent. Who is the other?”

Five seconds ticked by before he said, “My daughter . . .”

Celeste glanced at her daughter and squeezed her hand. Marybeth just continued to smile. It wasn’t at all unusual for her father to remember her as his daughter but not remember her name.

“What we’re going to be doing, Lester, is helping you with your memory. If something comes to mind, hold up your hand or say stop.”

“Okay.”

“Let’s test it. Say stop now and hold up your hand.”

Lester looked at him, slowly raising his hand.

“Say the word, stop.”

“Stop.”

“Very good. That was a test. When will you say stop again?”

“When . . . I remember.”

“Excellent, Lester. Let’s get started.” The doctor moved out of his line of view.

Celeste recalled her first meeting with Dr. Fernando Barstow and noting all the initials after his name—MD, MSc, PhD, MHPE, ABNS, CN—and wondered if having more groups of letters meant that he was at the top of his field. Or did it mean that he was all hyped up on himself? She had intended to Google the ones she didn’t know, but never did, though Michael said something about ABNS meaning that he was a member of the American Board of Neurological Surgery. Michael had done the research.

“Deep brain stimulation has been around for better than 25 years,” Dr. Barstow had told her, “but its benefits for Alzheimer’s patients wasn’t discovered until 10 years ago by Dr. Andrew Lozano, a Canadian neurosurgeon. It was really quite by accident that an obese patient on whom he’d been utilizing brain stimulation for the purpose of controlling appetite suddenly had vivid memories. One thing led to another and here we are now.”

And here we are now, she thought. If all goes well they’ll be implanting a brain pacemaker. That’s exactly what he’d called it. What he was doing now was looking for the optimal placement of the probe. To do that he required feedback from Lester, thus a local anesthesia. She knew that prior to them coming in all gowned up and looking pretty, he had to drill a hole in Lester’s head to gain access to the hippocampus region. The exact placement of the probe, however, was still a bit of a guessing game.

Dr. Barstow seemed to settle into the procedure. “So, Lester, we’re going to do some tickling and see if we can generate a memory or two. I’ll also ask you some questions. Nothing hard. Are you okay?”

"Yes."

"What year is it, Lester?"

"Twenty . . ."

Celeste held her breath during the entire pause. On occasion Lester didn't know the year.

". . . thirteen."

She let out the breath.

"Very good."

A few seconds went by while Barstow went about his business of placing the probe, Celeste assumed. She caught herself holding her breath again and released it.

"You okay, Mom?" Marybeth whispered.

Celeste started to say yes, then decided on, "A bit anxious."

"Me too."

"How many children do you have, Lester?"

Lester looked between his wife and daughter, seemed to think about the question for a time and then said, "One."

"What city were you born in?"

"Ypsilanti."

"In what state is that?"

A long, thought-filled pause, then, "I don't know."

A few more seconds went by.

"The pretty ladies watching. Who are they, Lester?"

Lester's eyes had drifted away during the state question. They came back to them. "Celeste and Marybeth."

"Who are they in relation to you?"

"My wife and daughter."

Celeste felt Marybeth's hand squeeze hers. She squeezed back. Does this mean progress?

"I think you're going to get a big star on your test paper, Lester, maybe an extra dessert tonight."

Lester grinned and the ladies grinned back.

"Just a little bit more, Lester; we're almost there. Now is when I want you to raise your hand and say stop if a sudden memory comes to you."

"Okay."

Time seemed to drag; one minute, two, three, then Lester's hand slowly went up.

"Stop."

"Okay, Lester. What do you remember?"

"Eastern Michigan University. I remember a white building . . . Pease Auditorium . . . water. Fountains. Professor Gamble and Sherzer Observatory."

"Excellent, Lester."

"That's where we met," Celeste whispered. "It was in that auditorium." And then she couldn't stop her tears. At least now the tears were different. She continued to smile through them.

His hand went up again. "A football game. It was snowing. So cold."

"Yes," Celeste said softly.

"I think you're going to get ice cream on that dessert, Lester. Just a little bit longer and then we'll be out of your head and you'll have a cute little brain pacemaker to show off to all your friends."

"Okay."

Thirty seconds slipped by during which time both Celeste and Marybeth wiped at their tears. When they finished they put an arm around each other.

"Stop!" With that sudden exclamation, Lester's hand popped up.

"What do you remember, Lester?"

The look on Lester's face was as though someone had fed him a lemon.

"Lester. Tell us what you remember."

"She's dead!"

 

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