Seventy Two

Seventy Two. That’s the number that stumped me and was the first pin to fall before the others came crashing down.

I have Alzheimer’s.

There. With that one out of the way, it should be easier from here on. I mean, easier for you. After all, you can now slot me into a defined category of diagnosis and treat me accordingly. Without the categorisation and the medical terminology owed to the work done by a certain Mr. Alzheimer, I’d be just another senile elderly gentleman with whom you’d be tolerant but not abundantly.

I’ve always wondered if Alois Alzheimer really wanted his name to have the connotation that it does and that too for perpetuity. Whilst I can understand a cure, a medicine, a remedy being named after the person who discovers it, naming a disease after a person who works to identify, research and describe it to the world so that concerted efforts can be made to manage and eventually defeat the malady is not really honouring the person. I would’ve rather named Donepezil or any of its cousins after Alzheimer even though none of these medications really medicate or so I am given to understand.

Meghna, my daughter, was not satisfied with our interactions with a Sudoku peddler neurologist, and decided to consult another physician. To say that I, too, was keen for a second opinion would have been an understatement. After all, all he had offered was the suggestion that I pick up Sudoku to combat the slowing neurons.

Not knowing what day it is, or ringing a neighbour’s doorbell thinking it to be your own, or wanting breakfast just when everyone else at home is getting ready for bed, mistaking their night attire and sleepiness for the early morning ‘just woken up’ look can be fairly disconcerting. And somehow, ‘You’re getting old’ wasn’t doing it for me anymore.

It can be quite surreal when that all important 1300–1400 grams of mass residing inside your skull decides to play a modified version of peek-a-boo with you. Like a kid, you are slightly apprehensive and uneasy when you lose it for a while, only to smile and giggle when you get it back. It’s the thought that makes everything real, physicality is otherwise just an illusion.

By this time, I’d been reading up and doing some research online about my symptoms and was thus introduced to Alois. Meghna, and Varun, my son in law, too had made his acquaintance and with most of what seemed to be going on with me pointing towards a very high probability of Alzheimer’s, had made an appointment with one of the few specialists in the city.

I remember spending a restless night before the day of the appointment. Having studied numerous articles and other published information on the ailment, I wasn’t sure if I was ready for a diagnosis that confirmed my coming years to be a steady and inevitable deterioration of life as I knew it. Till now, I’d been hoping that it wasn’t just old age - that left me with nothing but helplessness. How do you fight old age, after all? I wanted a named adversary, an opponent I could lock horns with, but now I was having second thoughts.

“I’m getting old” seemed to be a far better option compared to the “I have Alzheimer’s” alternative. Heck, I was even willing to make an effort to start liking Sudoku if I could somehow avoid being told that I have plaques and tangles in my brain that will not only ensure I die in the next few years but that equally, most certainly, a long time before that, I won’t be able to recognise my own family or be able to walk, eat or dress myself.

Each of us is serving an inevitable death sentence the moment we are born. But when the preordained noose begins to tighten its hold across our necks, making the inescapable something that is no longer around a corner down the road, but something staring you right in your face, the infallible human instinct to try and survive is bound to kick in.

And so I began preparing myself for, what I recalled from my research, would be some of the tests certain to be carried out the next day. I decided to take the battle head on. It was somewhat naïve, I know, but hey, could anyone really blame me for trying to prove the symptoms wrong and nip this thing in the bud. Even though I’d read about some of these diagnostic tests, I had not really tried conducting any on myself.

I switched on the light, went to sit on my desk and opened my laptop. Having already bookmarked most of the relevant material, I started to glance through the diagnosis section to refresh my memory of the common tests. The simplest and most common seemed to be MMSE or the Mini Mental State Examination and the Clock face test. I took out my favourite pen from the wooden pen holder that was a gift from my wife, Radha, on one of our anniversaries but I can’t, for the love of my life, remember which one. Taking a plain sheet of paper, I drew a circle and proceeded to convert it into a clock face by putting numbers for each of the 12 hours. It took me no more than a few seconds, definitely less than minute, and that brought a smile to my face. That wasn’t too difficult, was it? All numbers there on the clock face, right from 1 to 12.

Emboldened by my first successful effort, I decided to plough through the next one which required me to count backwards from 100 in differences of 7. I started with a flourish, 93, 86, 79 and then I was stuck. I was, abruptly, at a complete loss of what was happening. How could something this simple be escaping me completely? Some agonising seconds later or was it minutes, with still no answer emerging in my brain, I decided to count backwards from 79 on my fingers and upon reaching 72 felt completely wretched. This was no longer looking good. A plethora of emotions were running through me but I could clearly make out that the mob was being led by fear and anxiety. I could have stopped then and let things unfold the next day as they would. But I just couldn’t.

So I took a deep breath, stood up to pour myself a glass of water from the bottle lying on the bedside table, and decided to do over. 100, 93, 86, 79….was it 74 next? God, I was stuck again, not sure what the next number was. No matter how hard I tried to calculate the difference mentally, it just started to fog up inside my head. In a moment or so, I was starting to get confused about the starting number from which I was to take the 7 out. Having somehow figured that it was 79, the fingers were asked to come into play once again and I managed to reach 72.

I couldn’t get myself to go through the whole experience all over again and lay down on the bed, grappling with all kinds of thoughts and feelings that enveloped my consciousness. I started to count sheep and reached the seventy second one before dozing off into a fitful sleep.

“Good Morning, Mr. Dewan! I am Dr. Ashish Gupta. I’m glad you have your family accompanying you.”

“Good Morning, Dr. Gupta. This is my daughter Meghna and my son-in-law Varun”, I said, feeling good about being spoken to directly and being prodded into introducing the others. I was still a little apprehensive and nervous after my failed attempt at mental maths the previous night but there was something about the doctor that was having a calming influence on my frayed nerves.

Meghna handed over the medical reports of the earlier tests to Dr. Gupta who glanced through them for a minute before looking up at me and said, “Mr. Dewan, I’d like to hear from you about what you’ve been experiencing over the last few months. I believe there have been instances of forgetfulness, misplacing things and being confused about your surroundings at times.”

I began telling him about some of the incidents but could come up with only a handful of specific examples. He waited for me to continue but I was drawing a blank and probably looking it as well, for he smiled and shifted his gaze towards Meghna and Varun. “Is there anything that you’d like to add?”

Meghna started telling him about things but not before reaching out and taking my hand in hers. I had a faint recollection of some of the instances she mentioned but there were others that I could swear I knew nothing about.

I did not, for instance, remember dressing up in my work suit and calling out to my wife Radha to help me find a matching neck tie. Surely, that had not happened. After all, it’s now been more number of years of me missing Radha than those I spent knowing her.

Then Varun spoke of a time when I opened the door one evening when he returned from office. Apparently, I shook hands with him introducing myself as Meghna’s father and after getting seated in the drawing room proceeded to chat with him as if I was meeting him for the first time as someone Meghna intended to spend her life with. As the examples continued thick and fast, I could not help but notice that Varun was also holding Meghna’s hand and would every now and then give it a gentle squeeze, especially when she seemed to get stressed and agitated talking about her father’s predicament. And then they would look at me and smile, almost apologetically and yet reassuringly as if saying, “Sorry, Dad but all of this has been happening but don’t worry, we’re here with you.”

There were two thoughts uppermost in my mind at the time. One being how glad I was Meghna had found someone like Varun. Over the years, I’ve seen their relationship mature and blossom into a companionship that transcends love and romance. There is a tenderness that somehow adds to its timbre, a familiarity with each other that defines its richness, a depth in their interactions that lends fervour to its vibrancy, a mutual respect for the other’s beliefs and attitudes even when different to their own, that allows for its continuous growth.

Relationships are seldom simple but they are rarely complicated as well. And whilst all that’s needed may not always be just love, the other elements are not scarce if you don’t want them to be.

The other was an appreciation that I felt for these two putting up with me and all that I’d been throwing at them time and again in the recent past. It couldn’t have been easy for either of them.

After we lost Radha, Meghna and I had pretty much clung onto each other with an unmasked ferocity that had mellowed with time but never really lost its resonance. The loss of a parent is not easy on a young child but when you are five, life has a way of putting you back on the galloping horse and with all the changing scenery around you, the novelty of each new day is enough for you to, if not forget, at least diminish the pain of the fall.

I was not five, and could never really manage to saddle back up, but I did make sure I ran hard enough to keep pace with my child and occasionally nudge her horse when it needed prodding. And my pain diminished as well. And when the grief and heartache would return, and it invariably does, we’d never make an attempt to hide it from each other. We’d cry together, holding onto each other tight, till we eventually regained the strength to move forward again.

Now, having to see her father lose not only his intellect but also his ability to carry out simple, day to day activities was sure to cause Meghna more than a little angst. I am sure that after all that we’d been through together; the love and loyalty that Meghna felt toward me would somehow help add a couple of layers to her spectrum of patience and tolerance, but what about Varun? The poor lad had to put up with his old father-in-law not only living in his house but also taking an occasional trip to the shower with his clothes on. But here he was, with us, trying to figure this one out. We’d always shared a warm relationship, Varun and I. And though, in all likelihood, it had its foundation in the apple of my eye being the love of his life, we’d managed to build well on the foundation over the years.

My reverie of thoughts was interrupted by the silence in the room. I looked up to see that Meghna and Varun were now both silent and looking at Dr. Gupta who stood up and walked across the table and held out his hand.

“Mr. Dewan, let’s step across to these comfortable sofas where we can chat some more? I’d like to ask you some questions and also carry out some tests that might help with your prognosis.”

This was it, I thought to myself as I settled down onto the sofa. It was one those that lets you sink in and engulfs you once you do.

“Could you tell me your full name?” asked Dr. Gupta

“Aditya Dewan.”

“How old are you, Mr. Dewan?”

“I will be turning 66 in a few months time”

The doctor then told me he was going to show me some pictures and I was to tell him what they were. That seemed fairly simple and I started to get comfortable in the sofa as I identified a hut, an airplane, a cricket bat, a pair of spectacles but then got stuck on the next one. It was apparently a teapot. The one after looked awfully familiar but it took me a while before I could tell him what I thought it was — an alien. He smiled and told me I was close but that it was an astronaut. The game went on for a while and by the end of it, after getting a few more wrong and some others that I couldn’t identify at all, I was beginning to feel fidgety.

He then took a sheet of paper and drew a circle on it. Here it comes, I thought. This one should be a piece of cake. He handed over the paper to me and said, “Could you please make a clock by writing the hours 1 to 12 and then draw the hands for the clock to show 11:40?”

I carefully carried out the task and handed over the paper back to Dr. Gupta. He glanced at it, held it up for me to see and asked me if I was sure of what I had made. I wasn’t sure anymore. It looked like I had all the hours written but somehow they went from 12 to 1 in the clockwise direction which did not quite seem right but I wasn’t sure why.

The doctor saved me from the mental turmoil of trying to figure that one out by saying, “Mr. Dewan, could you please count backwards from 100 in differences of 9?”

“9? Should it not be 7?” I asked.

Dr. Gupta smiled, almost knowingly, and said, “Let’s do it with 9, if you don’t mind.”

I began tentatively. “91….82.” But the next one simply eluded me. I tried to focus in an attempt to calculate and get to the next one but it just wouldn’t come. The harder I tried, the more I could somehow only think of was white sheep climbing over an equally white fence;

and ended up blurting the one number that I had gone to bed with, the previous night, filling up my dying brain: 72