At the end of our conversation, before ceding his chair to the student who administered the tests, Dr. So-and-So said he’d call to discuss the results in a week. We agreed to a time and I nodded, ready to thank him for his help, but he had one last thing to do. Plucking a business card from the holder on his desk, he jotted a reminder in large block letters on its blank side and extended it to me. It read “Dr. So-and-So will call with test results. Tuesday, 12-10-24, 10:00.” This courtesy made me feel almost as inept as some of the tasks I’d soon complete.
There was no point in taking it personally — we were at a friggin’ memory clinic, after all — but I felt mildly indignant anyway. “You forget one mortgage payment and leave the house without buttoning your shirt and suddenly everyone thinks you’re unreliable,” I wanted to joke. But I was also a little sad. Sitting in an office like his was an experience I hadn’t expected to have until much later in life, like playing shuffleboard or canasta and comparing Medicare supplements. Other than former football players or boxers, who’s sent for these tests at 41? What’s worse, I knew I was in the right place.
Crankenstein had hopscotched between dread and denial in the days leading up to the appointment, as she’s wont to do away from work, where she must be decisive. “However bad you think it is, or [the MDS] thinks it is, it’s worse,” I told her of my cognitive difficulties when she optimistically suggested the results might be fine. “You spend a lot less time around me than you realize. You’re always working or running or taking a nap, but I’m with me 24/7. I’m not myself anymore. Something’s wrong. Joe saw it, too, and it didn’t help his depression.”*
There’d been a similar (but less personal) interaction with the MDS days earlier. After I’d accepted her referral for testing, she mentioned that some disability claimants prefer to pay privately for neuropsychological evaluations. They can suppress unfavorable reports — ones that don’t support their claims — by avoiding the paper trails attached to health insurance documentation. She wasn’t sure if our clinic cooperated with such requests and advised seeking clarification from the scheduler if I hoped to preserve the option.
Rather than exclaim “That would be unethical!”, which was my knee-jerk reaction, I smiled as wryly as my facial rigidity allowed and joked “That’s OK, I’ve got nothing to hide.”** It was inconceivable the findings would be any milder than those of the Lacoste-wearing consultative examiner, so I knew Crankenstein was setting herself up for disappointment by entertaining other notions. On the other hand, she’d already noticed plenty of clinical warning signs, so maybe I’d misread her rationalizations and she was only trying to put me at ease.
That theory went out the window as soon as Dr. So-and-So started talking and her face fell, then froze, in the same stricken expression as when the MDS diagnosed Parkinson’s. I’d scheduled the call to coincide with her weekly administrative time, which she often spends working from home, because she’d wanted to listen and ask questions. But she could barely speak, which I found astonishing — how was she not prepared to hear what we both already knew? “You certainly are your mother’s daughter,” I would’ve joked if she wasn’t so ashen.
“Don’t look so disappointed,” I said after we hung up. “It could’ve been much worse.” We’d again been told that I’m fine in many areas (including judgment and long-term memory) and impaired in others (like short-term memory and processing speed). There were some details that upset me — deficiencies in categories where I previously excelled — but none that surprised me. Crankenstein was troubled by all of it, particularly the way Dr. So-and-So repeatedly prefaced results with “Compared to the average 41-year-old female…”
“My wife’s not an average 41-year-old,” she bristled. “Cognitively, you’ve never been average.” She’d belatedly hit upon the same concern I’d expressed the evening I returned from testing, one she might’ve accidentally ignored while absorbed in sloth memes.
“That’s why I think this is worse than others realize,” I agreed. “If our roles were reversed and you brought the same complaints to the same experts, they’d see a doctor, an Ivy Leaguer, and any noticeable decline in your cognitive function would raise an alarm. They look at me and know something’s wrong but they also think ‘Hmm, high school education, unimpressive job history. She hasn’t lost that much.'”^
The p-word — “processing” — is currently so overused by insufferable navel-gazers that I’ve come to detest it, but Dr. So-and-So used it with us, encouraging us to take time to process everything he explained. We’re still working on that, Crankenstein with her therapist and me with posts like this one. There’s more I’ll want to say once I’ve had adequate time to organize my thoughts on all of this. For now I’m glad to have confirmation that I’m not imagining things; his findings matched my observations.^^
* It’s not the first time I’ve disappeared right in front of her, I tersely noted — it took her a while to notice the Crohn’s flare of 2016-2017 — and won’t be the last. Crankenstein’s unquestionably helpful and supportive when we share the same reality, but ‘Niles’ frequently distracts her with nonexistent problems while the real ones slip in undetected and rampage through our home like the bulls of Pamplona.
** It’s understandable why someone with a more nuanced complaint, like debilitating depression or PTSD, would worry about a clinician’s subjective analysis sinking their case. Cognitive assessment is more objective and no aspiring fraudster’s going to have a medical history like mine, anyway.
^ Since then I’ve had the opportunity to read some of the neuropsychologist’s report. He noted my performance on several tests, including reading aloud from a long list of complicated words and answering general knowledge questions, indicated above average intelligence. But I doubt he has any clue that my scores would’ve likely been perfect just a couple years ago. (If it isn’t clear from my writing, I don’t think too highly of myself in many respects. Most of my finer qualities are shared by German Shepherds and they make better companions. The one thing I always had going for me was a facility with words — writing them, reading them, and remembering them — and losing that would be much harder than losing my mobility.)
^^ “Results” is another word I don’t want to hear again any time soon, unless it’s about the album Liza Minnelli made with the Pet Shop Boys. Let’s sing along with her “Losing My Mind,” secure in the knowledge that mine’s still here for now. It’s slower and jankier than ever before but still capable of retaining useless trivia about Rent-a-Cop and Arthur 2: On the Rocks, which is more important to any self-respecting homosexual than timely mortgage payments or fully buttoning one’s shirt, anyway.