Still Alice
“I think you probably shouldn’t be teaching anymore, but I’d like to respect your time line. Do you have a plan?”
“I’d hoped to stay on for the year and then take my sabbatical, but I hadn’t appreciated the extent to which my symptoms were showing and disrupting my lectures. I don’t want to be a bad teacher, Eric. That’s not who I am.”
“I know it’s not. How about a medical leave that would take you into your sabbatical year?”
He wanted her out now. She had an exemplary body of work and performance history, and most important, she had tenure. Legally, they couldn’t fire her. But that was not how she wanted to handle this. As much as she didn’t want to give up her career at Harvard, her fight was with Alzheimer’s disease, not with Eric or Harvard University.
“I’m not ready to leave, but I agree with you, as much as it breaks my heart, I think I should stop teaching. I’d like to stay on as Dan’s adviser, though, and I’d like to continue to attend seminars and meetings.”
I am no longer a teacher.
“I think we can work that out. I’d like you to have a talk with Dan, explain to him what’s going on and leave the decision up to him. I’d be happy to coadvise with you if that makes either of you more comfortable. Also, obviously, you shouldn’t take on any new graduate students. Dan will be the last.”
I am no longer a research scientist.
“You probably shouldn’t be accepting invitations to speak at other universities or conferences. It probably wouldn’t be a good idea for you to be representing Harvard in that kind of capacity. I have noticed that you’ve stopped traveling for the most part, so maybe you’ve already recognized this.”
“Yes, I agree.”
“How do you want to handle telling the administrative faculty and people in the department? Again, I’ll respect your time line here, whatever you want to do.”
She was going to stop teaching, researching, traveling, and lecturing. People were going to notice. They were going to speculate and whisper and gossip. They were going to think she was a depressed, stressed-out addict. Maybe some of them already did.
“I’ll tell them. It should come from me.”
September 17, 2004
Dear Friends and Colleagues,
Upon thoughtful consideration and with deep sorrow, I have decided to step down from my teaching, research, and traveling responsibilities at Harvard. In January of this year, I was diagnosed with early-onset Alzheimer’s disease. While I am likely still in the early to moderate stages of the disease, I’ve been experiencing unpredictable cognitive lapses that make it impossible for me to meet the demands of this position with the highest of standards that I’ve always held myself to and that are expected here.
While you’ll no longer see me at the podium in the lecture auditoriums or busy writing new grant proposals, I will remain on as Dan Maloney’s thesis adviser, and I’ll still attend meetings and seminars, where it is my hope to continue to serve as an active and welcome participant.
With greatest affection and respect,
Alice Howland
THE FIRST WEEK OF THE fall semester, Marty took over Alice’s teaching responsibilities. When she met with him to hand over the syllabus and lecture materials, he hugged her and said how very sorry he was. He asked her how she was feeling and if there was anything he could do. She thanked him and told him she was feeling fine. And as soon as he had everything he needed for the course, he left her office as fast as he could.
Pretty much the same drill followed with everyone in the department.
“I’m so sorry, Alice.”
“I just can’t believe it.”
“I had no idea.”
“Is there anything I can do?”
“Are you sure? You don’t look any different.”
“I’m so sorry.”
“I’m so sorry.”
Then they left her alone as quickly as possible. They were politely kind to her when they ran into her, but they didn’t run into her very often. This was largely because of their busy schedules and Alice’s now rather empty one. But a not so insignificant reason was because they chose not to. Facing her meant facing her mental frailty and the unavoidable thought that, in the blink of an eye, it could happen to them. Facing her was scary. So for the most part, except for meetings and seminars, they didn’t.
TODAY WAS THE FIRST PSYCHOLOGY Lunch Seminar of the semester. Leslie, one of Eric’s graduate students, stood poised and ready at the head of the conference table with the title slide already projected onto the screen. “Searching for Answers: How Attention Affects the Ability to Identify What We See.” Alice felt poised and ready as well, sitting in the first seat at the table, across from Eric. She began eating her lunch, an eggplant calzone and a garden salad, while Eric and Leslie talked, and the room filled in.
After a few minutes, Alice noticed that every seat at the table was occupied except for the one next to her, and people had begun taking up standing positions at the back of the room. Seats at the table were highly coveted, not only because the location made it easier to see the presentation but because sitting eliminated the awkward juggling of plate, utensils, drink, pen, and notebook. Apparently, that juggling was less awkward than sitting next to her. She looked at everyone not looking at her. About fifty people crowded into the room, people she’d known for many years, people she’d thought of as family.
Dan rushed in, his hair disheveled, his shirt untucked, wearing glasses instead of contact lenses. He paused for a moment, then went straight for the open seat next to Alice and declared it his by plopping his notebook down on the table.
“I was up all night writing. Gotta get some food, be right back.”
Leslie’s talk ran the full hour. It took an excessive amount of energy, but Alice followed her to the end. After Leslie advanced past the last slide and the screen went blank, she opened up the floor to discussion. Alice went first.
“Yes, Dr. Howland,” said Leslie.
“I think you’re missing a control group that measures the actual distractibility of your distracters. You could argue that some, for whatever reason, simply aren’t noticed, and their mere presence isn’t distracting. You could test the ability of the subjects to simultaneously notice and attend to the distracter, or you could run a series where you swap out the distracter for the target.”
Many at the table nodded. Dan uh-huhed through a mouthful of calzone. Leslie grabbed her pen even before Alice finished her thought and took vigorous notes.
“Yes. Leslie, go back to the experimental design slide for a moment,” said Eric.
Alice looked around the room. Everyone’s eyes were glued to the screen. They listened intently as Eric elaborated on Alice’s comment. Many continued nodding. She felt victorious and a little smug. The fact that she had Alzheimer’s didn’t mean that she was no longer capable of thinking analytically. The fact that she had Alzheimer’s didn’t mean that she didn’t deserve to sit in that room among them. The fact that she had Alzheimer’s didn’t mean that she no longer deserved to be heard.
The questions and answers and follow-up questions and answers continued for several minutes. Alice finished her calzone and her salad. Dan got up and came back with seconds. Leslie stumbled through an answer to an antagonistic question asked by Marty’s new postdoc. Her experimental design slide was projected on the screen. Alice read it and raised her hand.
“Yes, Dr. Howland?” asked Leslie.
“I think you’re missing a control group that measures the actual effectiveness of your distracters. It’s possible that some of them simply aren’t noticed. You could test their distractibility simultaneously, or you might swap out the distracter for the target.”
It was a valid point. It was, in fact, the proper way to do the experiment, and her paper wouldn’t be publishable without that possibility satisfied. Alice was sure of it. Yet no one else seemed to see it. She looked at everyone not looking at her. Their body language suggested embarrassment and dre
ad. She reread the data on the screen. That experiment needed an additional control. The fact that she had Alzheimer’s didn’t mean that she couldn’t think analytically. The fact that she had Alzheimer’s didn’t mean that she didn’t know what she was talking about.
“Ah, okay, thanks,” said Leslie.
But she didn’t take any notes, and she didn’t look Alice in the eye, and she didn’t seem at all grateful.
SHE HAD NO CLASSES TO teach, no grants to write, no new research to conduct, no conferences to attend, and no invited lectures to give. Ever again. She felt like the biggest part of her self, the part she’d praised and polished regularly on its mighty pedestal, had died. And the other smaller, less admired parts of her self wailed with self-pitying grief, wondering how they would matter at all without it.
She looked out her enormous office window and watched the joggers as they traced the winding edges of the Charles.
“Will you have time for a run today?” she asked.
“Maybe,” said John.
He looked out the window, too, as he drank his coffee. She wondered what he saw, if his eyes were drawn to the same joggers or if he saw something entirely different.
“I wish we’d spent more time together,” she said.
“What do you mean? We just spent the whole summer together.”
“No, not the summer, our whole lives. I’ve been thinking about it, and I wish we’d spent more time together.”
“Ali, we live together, we work at the same place, we’ve spent our whole lives together.”
In the beginning, they did. They lived their lives together, with each other. But over the years, it had changed. They had allowed it to change. She thought about the sabbaticals apart, the division of labor over the kids, the travel, their singular dedication to work. They’d been living next to each other for a long time.
“I think we left each other alone for too long.”
“I don’t feel left alone, Ali. I like our lives, I think it’s been a good balance between an independence to pursue our own passions and a life together.”
She thought about his pursuit of his passion, his research, always more extreme than hers. Even when the experiments failed him, when the data weren’t consistent, when the hypotheses turned out to be wrong, his love for his passion never wavered. However flawed, even when it kept him up all night tearing his hair out, he loved it. The time, care, attention, and energy he gave to it had always inspired her to work harder at her own research. And she did.
“You’re not left alone, Ali. I’m right here with you.”
He looked at his watch, then downed the rest of his coffee.
“I’ve got to run to class.”
He picked up his bag, tossed his cup in the trash, and went over to her. He bent down, held her head of curly black hair in his hands, and kissed her gently. She looked up at him and pressed her lips into a thin smile, holding back her tears just long enough for him to leave her office.
She wished she’d been his passion.
SHE SAT IN HER OFFICE while her cognition class met without her and watched the shiny traffic creep along Memorial Drive. She sipped her tea. She had the whole day in front of her with nothing to do. Her hip began to vibrate. It was 8:00 a.m. She removed her BlackBerry from her baby blue bag.
Alice, answer the following questions:
1. What month is it?
2. Where do you live?
3. Where is your office?
4. When is Anna’s birthday?
5. How many children do you have?
If you have trouble answering any of these, go to the file named “Butterfly” on your computer and follow the instructions there immediately.
September
34 Poplar Street, Cambridge
William James Hall, room 1002
September 14
Three
She sipped her tea and watched the shiny traffic creep along Memorial Drive.
OCTOBER 2004
She sat up in bed and wondered what to do. It was dark, still middle of the night. She wasn’t confused. She knew she should be sleeping. John lay on his back next to her, snoring. But she couldn’t fall asleep. She’d been having a lot of trouble sleeping through the night lately, probably because she was napping a lot during the day. Or was she napping a lot during the day because she wasn’t sleeping well at night? She was caught in a vicious cycle, a positive feedback loop, a dizzying ride that she didn’t know how to step off. Maybe, if she fought through the urge to nap during the day, she’d sleep through the night and break the pattern. But every day, she felt so exhausted by late afternoon that she always succumbed to a rest on the couch. And the rest always seduced her to sleep.
She remembered facing a similar dilemma when her children were around two years old. Without an afternoon nap, they turned miserable and uncooperative by the evening. With a nap, they stayed wide awake hours past their usual bedtime. She couldn’t remember the solution.
With all the pills I’m taking, you’d think at least one would have drowsiness as a side effect. Oh, wait. I have that sleeping pill prescription.
She got out of bed and walked downstairs. Although fairly confident it wasn’t in there, she emptied her baby blue bag first. Wallet, BlackBerry, cell phone, keys. She opened her wallet. Credit card, bank card, license, Harvard ID, health insurance card, twenty dollars, a handful of change.
She rifled through the white mushroom bowl where they kept the mail. Light bill, gas bill, phone bill, mortgage statement, something from Harvard, receipts.
She opened and emptied the contents of the drawers to the desk and file cabinet in the study. She emptied the magazines and catalogs out of the baskets in the living room. She read a couple of pages from The Week magazine and dog-eared a page in the J. Jill catalog with a cute sweater. She liked it in sea-foam blue.
She opened the junk drawer. Batteries, a screwdriver, Scotch tape, blue tape, glue, keys, a number of chargers, matches, and so much more. This drawer probably hadn’t been organized in years. She pulled the drawer completely off its tracks and dumped the entirety of its contents onto the kitchen table.
“Ali, what are you doing?” asked John.
Startled, she looked up at his bewildered hair and squinting eyes.
“I’m looking for…”
She looked down at the items jumbled before her on the table. Batteries, a sewing kit, glue, a tape measurer, several chargers, a screwdriver.
“I’m looking for something.”
“Ali, it’s after three. You’re making a racket down here. Can you look for it in the morning?”
His voice sounded impatient. He didn’t like having his sleep disrupted.
“Okay.”
She lay in bed and tried to remember what she’d been looking for. It was dark, still middle of the night. She knew she should be sleeping. John had fallen back to sleep without ceremony and was already snoring. He was a fast sleeper. She used to be, too. But she couldn’t fall asleep. She’d been having a lot of trouble sleeping through the night lately, probably because she was napping a lot during the day. Or was she napping a lot during the day because she wasn’t sleeping well at night? She was caught in a vicious cycle, a positive feedback loop, a dizzying ride that she didn’t know how to step off.
Oh, wait. I have a way to get to sleep. I have those pills from Dr. Moyer. Where did I put them?
She got out of bed and walked downstairs.
THERE WERE NO MEETINGS OR seminars today. None of the textbooks, periodicals, or mail in her office interested her. Dan didn’t have anything ready for her to read. She had nothing new in her inbox. Lydia’s daily email wouldn’t come until after noon. She watched the movement outside her window. Cars zipped around the curves of Memorial Drive, and joggers ran along the curves of the river. The tops of pine trees swayed in the turbulent fall air.
She pulled all of the folders out of the bin marked HOWLAND REPRINTS from her file cabinet. She’d authored well over a hundred publish
ed papers. She held this stack of research articles, commentaries, and reviews, her truncated career’s worth of thoughts and opinions, in her hands. It was heavy. Her thoughts and opinions carried weight. At least, they used to. She missed her research, thinking about it, talking about it, her own ideas and insights, the elegant art of her science.
She put the pile of folders down and selected her From Molecules to Mind textbook from the bookcase. It, too, was heavy. It was her proudest written achievement, her words and ideas blended with John’s, creating something together that was unique in this universe, informing and influencing the words and ideas of others. She’d assumed they’d write another someday. She flipped through the pages without being lured in. She didn’t feel like reading that either.
She checked her watch. She and John were supposed to go for a run at the end of the day. That was way too many hours away. She decided to run home.
Their house was only about a mile from her office, and she got there quickly and easily. Now what? She walked into the kitchen to make some tea. She filled the kettle with tap water, placed it back on the stove, and turned the burner knob to Hi. She went to get a tea bag. The tin container where she kept the tea bags wasn’t anywhere on the counter. She opened the cabinet where she kept the coffee mugs. She stared instead at three shelves of plates. She opened the cabinet to the right of that, where she expected to see rows of glasses, but instead it housed bowls and mugs.
She took the bowls and mugs out of the cabinet and put them on the counter. Then, she removed the plates and placed them next to the bowls and mugs. She opened the next cabinet. Nothing right in there either. The counter was soon stacked high with plates, bowls, mugs, juice glasses, water glasses, wineglasses, pots, pans, Tupperware, pot holders, dish towels, and silverware. The entire kitchen was inside out. Now, where did I have it all before? The teakettle shrilled, and she couldn’t think. She turned the burner knob to Off.
She heard the front door open. Oh good, John’s home early.