Ask any Hepatitis C veteran, and he or she will tell you about “brain fog,” the actual medical term for sudden, occasionally crippling bouts of fatigue and confusion. As a hep cat myself, I was intrigued to learn this week that brain fog is caused by ammonia. Doctors have known this for decades, but I just found out, thanks to a CPA I know from the Y who once backed into a needle and ended up on a liver transplant list.
But enough about him. There’s now a test that can measure the ammonia in the blood. Which, somehow, makes it sound like if I get a paper cut, I bleed Windex. I guess I’ll find out.
My big fear, though, is that the smoke in the attic is not the result of some liver-brain combo impairment. Forget ammonia fume – it’s straight up EOA. Early Onset Alzheimer’s. And I’m going to be that 59 year old with a drool cup who just grins and masturbates. In public. Maybe I’ll be still be able to understand the snide remarks of passers-by –“Isn’t he a little young to be senile?” But I won’t be able to react.
To the extent that a man is defined by his fears, my own have changed from under-30 to over-50. When I was thirty and strung, I’d worry about running out of drugs. Now I’m post-50 – unstrung – and worried about running out of – what’s the word? Sanity? Awareness? Time? Pre-senilitude?
Out of sheer fear of the malady, I decided to research it, a little. By research, I mean, I googled Early Onset Alzheimer’s, read the first three entries out of five jillion, and scared the shit out of myself.
What really broke my will to live was that I was already squirming after the first two questions of the Alzheimer’s Associations 10 Warning Signs of Alzheimer’s.
1. MEMORY LOSS and 2. DIFFICULTY PERFORMING FAMILIAR TASKS. By the time I bumped in Number Three: PROBLEMS WITH LANGUAGE. I began to experience a deep and unrelenting sense of foreboding. What men’s adventure magazines in the Fifties liked to describe as “inchoate fear.” This language difficulty was something, unironically, I had not been able to articulate until I saw it in print. At the online Alzheimer’s’ party place. I mean, their site. Jesus!
Listen: People with Alzheimer’s disease often forget simple words or substitute unusual words, making their speech or writing hard to understand. They may be unable to find the toothbrush, for example, and instead ask for “that thing for my mouth.”
Maybe that’s part of it, talking as if you’re translating from Low Yiddish. Or maybe that’s how the Disease works, slowly taking away one word at a time, as though your brain were a piano with one key removed every week. Until it ended up like the mythic circus piano Theologies Monk learned to play on. (A jazz legend anecdote I probably have wrong – my memory being what it is.) It brings to mind Stravinsky’s epigram, “The more limitations I have, the more creative I can be.” Not that I’ve ever read a word of Stravinsky. But one category of memory that seems to remain intact are Smart Things Other People Have said. I have about five of these, which I’ve been squeezing into pretty every conversation I’ve had in the past five years. One is the Stravinsky thing, the other’s from George Bernard Shaw, “Ideas are not responsible for those who embrace them.” Don’t ask me what masterpiece old vegetarian and daily human breast milk drinker planted this nugget in. The last big one is from Voltaire – whom I actually have read, though don’t ask me to quote from Candide.
Perhaps, once my brain is drained like the battery of a 56 Impala whose lights have been left on for a week, the one category of memory left will be stolen apercus. The stuff lifted from books of quotations next to whatever bed I’ve been unable to sleep in for the past half century and change.
What’s the harm, if I’ve still got a few brain ells, in responding to any query with “’Fear Plus Hate equals power.’ Eugene Burdick.” Or “A man’s got to take a lot of punishment to write a really funny book.” Ernest Hemingway. The last one’s a real icebreaker. Try it the next time somebody asks you how you’re doing. It also works, in airplanes, if you want to put the kibosh on chatty seatmates. But still… Nothing can hide the fact, when the fog rolls in and it’s time to go on automatic, that I’m as shallow as a stuffed parrot. Kind of a Chauncey Gardener meets Bartlett’s Quotations thing. Maybe senility is just not giving a shit – when you don’t know you don’t give a shit. Even if you’re a little addled, what’s the downside of spouting the wisdom of the ages to passersby? There are worse things in live to end up than an oracle.
But back to the Alzheimer’s test. Every category concludes with the eternal question: “What’s normal?” Which, in the case of 4. PROBLEMS WITH LANGUAGE, breaks down to a single sentence. “Sometimes having trouble finding the right word.”
By the time I stagger through 4: Disorientation to time and place. (Check) 5: Poor or decreased judgment. (Check) and 6: Problems With Abstract Thinking. (Check.) I’m ready to collapse in a Dread Nap. Is it even necessary to even say it? I have every symptom. More accurately, I can’t remember not having them. But what consolation is that – know you were pre-senile (as opposed to prehensile) at seventeen? It’s a grim psychic crawl from 8. Changes in Mood or Behavior. (What time is it now?) to 9. Changes in Personality.
That’s it. Fuck it. I’ve had enough. I don’t want to know about Ten.
Yes, I am a coward. Thanks for asking. I’d rather remain ignorant, cling to some dim hope that I’ve dodged the clean Alzheimer’s Quiz sweep. Maybe – call me a cockeyed optimist – a tenth of my neuro-transmitters are yet quick and nimble, balancing out the 9/10 that require trained care-givers. Although, this being tax time, its probably worth inquiring as to whether care-givers are tax deductible. On the off chance The Time Has Come.
By fickle coincidence, the police department in my hometown publishes a pamphlet called “Safety for Seniors,” one of which some concerned public servant slipped under my windshield in a supermarket parking lot. My first reaction was to check and see if any other cars had senior crime tips under their wipers. I was the only one. Which made it hard to believe that me getting the pamphlet wasn’t some kind of “message.” (Maybe Number Ten on the test included the word “paranoiac.”) Either that or I was driving an “old man’s car.” A possibility. Though the simmering furor of product placement in blogs prevents me from being more specific. But keep an eye out for Kias in hipster auto blogs this Christmas. That’s all I’m saying.
Once you are actually senile, are you even capable of taking the senility Quiz – let alone being functional and aware enough to pop a stress-goiter worrying about whether you have Alzheimer’s – or whether you can have all the symptoms and not have it? (Somehow I think Charlie Kaufman answered that question in Synecdoche. I couldn’t tell you in which scene. It’s around where Philip Seymour Hoffman starts pretending he’s his ex-wife’s maid.)
I made the mistake of glancing at the pamphlet at a red light, and became immediately fixated. Under the topic Elder Abuse, there is the directive, “Look to see if elderly friends’ homes are unusually unkempt…” If they are, the concerned friend is advised to contact the authorities.
I’m not completely sure why this got me tweaked. Unless it was the thought that, at some future date, being a slob could get you arrested. Not that I’m a slob. It’s just, on certain days, if I’ve been working, with a few too many hours in a row alone, I confess to leaving an absent-minded slime-trail of paper around the house, a dozen opened and discarded books, scribbled notes on the bottom of Kleenex boxes, dishes slipped under a chair, talk radio, television and music all blaring at the same time… A scenario which, to the casual observer, might look “unusually unkempt.” Depending on what their idea of kempt is.
Was it right that, after you’d clawed your way to some high rung on the chronological ladder, being a slob morphed into a sign that you were some kind of crime victim? But when was the cusp? How many years did you have to crumple paper and not read 19 magazines on the floor before the crumple and mag pile had neighbors dialing 9-1-1 – or loved ones signing papers to make you a ward of the state? One of my happiest childhood memories is going to visit my grandmother in the County Care Facility. She sat on a folding chair and clapped all day. Somehow, even if you knew she was an all day clapper, just walking toward her across a room and being applauded felt great.
If I had more ambition, I’d insert some wry observation about how creativity, on some level, is a kind of dementia right here. I could probably come up with something. But I’m just too tired. I can’t keep the thoughts straight in my head. Except for one or two. Which I should probably write down before I forget… I just can’t remember why.
The good news is, I don’t have to worry about succumbing to Early Onset Alzheimer’s somewhere down the road. I already have it. In fact, I can’t remember ever remembering where I put the car keys once I put them down. At any age. Maybe, after the ADD craze fades, the grade school shrinks will come up with another pathology: Adolescent Alzheimer’s. They’ll switch prescriptions from Adderall to Vasopressin. (A nasal spray prescribed, originally, to the elderly in mental decline; and adapted, underground, as a fave smart drug during the smart drug craze of the 90s.)
In the end, what can you do but make friends with obsesso-fear? I mean, if I really do get Alzheimer’s before I pass the old speed limit, say, of 55, the nice thing is I won’t know it. That’s the heinous beauty of it all. If you forget you’re old and fucked, maybe being old and fucked can be fun. You may look like you have Stage III Charles Laughton, but inside, you might feel nine. What the hell….
If you have to be alive, mentally challenged, and dying, what could be more pleasant?
Jerry Stahl’s books include Permanent Midnight and I, Fatty. Pain Killers, his new novel, will be published by Wm Morrow in March, 09