Obsessed (7 page)

“Turns out the place is a horrendous mess and Uncle Jack is in La La Land.” Annie's words belied the seriousness of her tone. She was holding back tears. “I went over there that day after work. That's why I couldn't meet you at the restaurant. It was…pretty awful. I was over there again today, trying to make a dent in the mess.

“That's not the worst part, though. It's Uncle Jack. I don't know how to describe it—it's as if he's gone flat. He'll be there, then all of a sudden he's not. And he's stooped over and moving around like an old man.”

None of it sounded good. Flat demeanor. Shuffling gait. Suggested some kind of dementia.

“How old is he?”

“Not even seventy.”

“Has he been ill?”

“Not really. Though my mother says she noticed that he's been more confused the last month or two. And he's lost a lot of weight.”

“Do you think he's okay alone?”

“We've got a visiting nurse checking on him. And the people in the downstairs apartment. He should be okay for a night or two, but after that…”

“Good thing he's got family nearby,” my mother said. “By the time your father and I got down to Florida, Uncle Louie was beyond help and the apartment—it was atrocious. I don't think it had been cleaned since your Aunt Gertie died.” She wiped her hands on a napkin, as if some of the filth in Uncle Louie's apartment was still on them. “He had extension cords strung all over that house, draped over everything. Had to, of course. You couldn't get near the walls to plug anything in.” She blew on her tea. “Don't know why I remember that.”

“Why does this have to happen now?” Annie asked. “Mom has plane tickets for Ireland—leaving next week. She's never been. Her relatives are planning a family reunion and everything. Now she says she doesn't see how she can go. I don't know what to tell her.”

I had my datebook out. At least this was something I knew a great deal about and could help with. “Why don't I go over with you and see him tomorrow morning? I haven't got anything scheduled until eleven.”

Relief flooded Annie's face. Then she looked down at her plate, as if she were embarrassed by the emotion.

The pot roast was falling-apart tender, and the noodle pudding was dense and chewy with a crisp outer layer, savory—not sweet the way some people make it. Annie picked at hers. We both turned down seconds.

As we were leaving, my mother handed Annie a plastic container with her leftovers, reached up, and put her hands firmly on Annie's shoulders. “You listen to me. If there's anything I can do to help, you just ask.” Annie gave a mute nod. “I've been there. Alone with this is not where you want to be.”

Annie gave my mother a hug.

To me, my mother muttered loud enough for anyone three blocks away to hear, “Her you stand up for a date with a brain?”

On the porch, I watched as Annie rummaged in her backpack.

“So what
did
happen to you?” she asked.

“That woman who works on the unit—the one who I helped out with a flat the other night at the Pearce?”

“The one who was being stalked.” Annie narrowed her eyes. “It happened again?”

“Not exactly. She's the one who arranged for me to watch a functional MRI. When she pulled out of the garage after—”

“You walked her to her car?”

“Uh-huh. I noticed her taillights were out. They weren't out the other night, and it's a new car. I thought…” What had I thought? Why did I have to go rushing out after her, follow her home? “I thought her car had been tampered with. Maybe there was a gas leak, too.”

“So you followed her home.” Annie had a bemused expression. In retrospect, it hadn't been the most rational thing to do.

“Her ex-boyfriend was waiting at her apartment.”

“So he thought you were the stalker and you thought he was,” she said, putting it together. “Two protectors stalking the stalker.” She shook her head. “She must be something else.”

“She's—” I did a double-take. “She's a post-doc.”

“You're a good guy, Peter,” Annie said, giving me a patronizing pat on the back. She pulled out her car keys and gazed up at me. “You know, I kind of like you with that shiner. Remember Marlon Brando in
On the Waterfront
?”

“I coulda been a contender,” I snarled.

“He was a pretty sexy guy, you know.” Annie slid me a smile.

“He was, was he?”

I took her in my arms and nuzzled her neck. I loved her smell—it was sharp and sweet, like fresh-cut grass and watermelon. Usually Annie melts into me, but tonight she felt stiff.

“Yeah, he was.”

“You don't have to go home, you know.”

“Yeah, I do.”

“Annie?”

She held my gaze for a few moments, then looked away. “I'm sorry, Peter. I wouldn't be much company. I'm a complete basket case from worrying about my uncle, and I hate it that there's not a damned thing I can do. And I hate having to come running to someone for help.”

Before I could say, “But I'm not
someone
,” Annie was walking out to the street. She turned and blew me a kiss. Then she got into her car, started the engine, and took off.

Damn. I unlocked the door to my house and switched off the porch light. I turned and gazed up the street where Annie had driven off. “I'm sorry I wasn't here for you tonight.”

T
HE SMELL
was what you noticed first. Burnt food, mothballs, and the sharp, dried sweat smell of old age. There was a whiff of it in the entryway. It got stronger as we climbed to Uncle Jack's second-floor apartment. The stairs of the Somerville triple-decker were stacked with newspapers.

“It didn't used to be like this,” Annie said.

In the upstairs hallway were more newspapers, paint cans from decades of home repair, bags piled on top of bags. I peered into one of them. There were dozens of cardboard toilet-paper tubes, paper napkins that looked as if they might have been used and refolded, a road map, and an empty plastic spray bottle of Windex.

Annie knocked at the door.

From what I could see, bags in the lower levels and further in were less of a hodgepodge—there were paperbacks in one, Styrofoam packing and nested plastic deli containers in another.

Annie knocked again. “Hey, Uncle Jack, it's me, Annie.”

Still no response. Annie unlocked the door. Inside it was dark, and the air felt thick and musty. There were more shopping bags, stacks of newspaper and boxes in the entryway, and the smell was stronger.

“Uncle Jack!” Annie called.

Looking one way I could see the kitchen, its sink stacked with dirty dishes. The other way was the living room. Dark green drapes were drawn across tall windows. A fat gray tabby jumped down off the back of the couch, came over, and rubbed up against Annie's leg. Annie bent down and scratched the cat behind the ears. He got up on his hind legs, put his front paws on her shoulder, and gave a strident “Yeow.”

“Hey, Columbo,” Annie said, picking up the cat. “How you doin'?”

Columbo rubbed one side of his jaw against Annie's face, then the other, marking his territory. Smart cat.

A man appeared in the kitchen doorway. He was tall and stooped. His dark cardigan seemed a few sizes too large.

“Annie?” he said in a flat voice, his face slack and without expression. His belt was tied to keep his pants up.

“Did you get my message?”

Uncle Jack blinked back at her. “Message?”

“Yeah, I called to say we were coming.” Annie gave me an anxious look. “This is my friend Peter.”

We worked our way through the dining room. There on a credenza was a black-and-white wedding photo. The man, presumably Uncle Jack, was about a foot taller than Annie's radiant young Aunt Felicia. I could see a little of Annie in her eyes. He looked like a prizefighter, the way the lapels of his jacket bowed away from a broad chest. Uncle Jack had undergone quite a transformation since then.

“Friend of Annie's?” Uncle Jack gave me a direct look, his face suddenly alive and wary. Made me feel like a kid who'd showed up unannounced to take out his daughter. He still had a firm handshake.

Annie set Columbo down on the floor. He went over and sniffed one of three open tins of cat food, turned up his nose, and stalked off.

Some of the kitchen cabinets were open. One was filled with cat food—cans of Friskies beef and liver dinner, Friskies seafood entrée, boxes of chicken liver treats. Another cabinet held more than a dozen boxes of Jell-O, spaghetti, and more cat food.

Uncle Jack shuffled over to the kitchen table, his gait stiff, his movements jerky. There were metal chairs with padded red vinyl seats, like the set my mother had. Mail, magazines, newspapers, and crusty placemats covered the table. Only an area at the near end was cleared.

“Mr. O'Neill?” I said. He was nodding at the table. I wondered if he was waiting for me to sit. I put my hand on his arm. “Annie tells me your wife passed on? I'm sorry to hear that.”

He didn't respond. He moved to the sink with little jerking steps. Then back to the table. He lowered himself into a chair. His body pulsed and his eyes were going all over the room.

“Felicia vacuum holder thing…” he said, addressing his words to one of the other chairs. “Leave the table—” He paused. “—Stop and Shop.” It was word salad.

Annie pressed herself against the door jamb and put her hand to her forehead.

Uncle Jack became agitated when I started to sit in the chair he'd been talking to. He put out his arm to stop me. I looked at the chair seat, thinking maybe there'd be something on it, but there wasn't.

No sooner had I taken one of the other chairs than he rose to his feet and shuffled out of the kitchen and down the hall to the back of the apartment.

“Hey, Uncle Jack!” Annie said. “Where you going? You can't take a nap. We just got here.”

Uncle Jack chuckled and waved a hand like he was brushing away a swarm of gnats.

I followed him into a bedroom. This room was as cluttered as the rest of the house. There were two television sets, neither of them plugged in, a vacuum cleaner, several old electric fans, more newspapers, piles of bedding and clothing. Long strips of yellowing Scotch Tape ran along cracks in the plaster walls—Uncle Jack's version of home repair.

“How are you doing?” I asked, touching his shoulder again, trying to draw his attention. He looked at me, as if seeing me for the first time. “I'm Peter. Annie's friend?”

“Annie,” he said, and gazed around the room.

Annie appeared in the doorway. “You rang?” She went over and took his hand. “Hey, buddy. How are you feeling today, anyway?”

“Anyway, anyway,” he said. “Been worse, that's for sure.” It was a direct answer to a direct question. He was with us, for the moment at least.

“Can I get you anything?” I asked as he shuffled his way back out into the hallway.

“One of those things out there,” Uncle Jack said.

“What things?”

“On the steps. On the steps.”

Uncle Jack sat at the kitchen table.

“Newspaper?” I said, guessing.

“I'll get it,” Annie said. “I saw one outside.”

While Annie was gone I fished a quarter out of my pocket. I held it out in the palm of my hand. I needed a quick test to gauge the extent of Uncle Jack's confusion.

“I've got a little game—can I try it out on you?”

Uncle Jack looked at the quarter. “Double or nothin',” he said.

“You're on. See this quarter?” I closed the quarter into my fist, put my hands behind my back like I was passing it from hand to hand. Then I held out both fists. “Which hand is it in now?” This time it would be a simple guessing game.

Uncle Jack cocked his head and stared at the back of one hand, then the other. He jabbed a finger at my left hand. I opened the hand and showed him. He'd guessed right. He tried to swipe the quarter.

“Hang on. Now I'm going to switch the coin to my other hand.” I said it slowly, with careful emphasis on the word
other
. I put my hands behind my back and transferred the coin. Then I held out my fists.

Once again Uncle Jack's eyes darted from one hand to the other. I waited. He pointed to the same hand he'd guessed the first time. Wrong. Not a good sign.

The simple game was a test of flexible thinking—one of the first things to go at the onset of dementia. It had been nothing more than a spot-check, but it confirmed what I suspected and what I knew Annie was dreading.

I could hear the front door shut and Annie's footsteps on the stairs. “You win,” I said, and handed him the quarter.

Annie slid the morning paper out of its plastic bag and handed it to Uncle Jack. He took the paper and also the plastic bag. Carefully he pressed the bag on the table and folded it in quarters. Then he went over and shoved it into the cabinet under the sink, which was already bulging with bags. He returned to the table, opened the newspaper, and seemed to pore over it.

“Red Sox won again,” Annie said.

“Pshaw,” Uncle Jack said. “It's spring.” He was with us again.

Uncle Jack was working his lips and brushing the fingers and thumb of one hand together, a pill-rolling tremor. “Nixon's a crook,” he said.

“There was mold growing in the bottom of the kitchen sink,” Annie said later as we sat at a table at the back of a Dunkin Donuts.

We'd stayed at Uncle Jack's for a couple of hours. I'd washed down the kitchen floor, counters, and table while Annie did the sink and stove top, and gave the bathroom the once-over. We'd thrown out the open cans of cat food. Uncle Jack got upset when I tried to get rid of some of the newspapers.

I inhaled the coffee and donut smells, trying to flush out the smell of the cramped apartment. The counter person gave me an odd look—reminding me that my face looked like I'd run into a door. It only hurt when I smiled.

“So?” Annie asked. “What do you think? I mean, he's there some of the time. And then other times he's not.” Her voice was brisk, like she was trying to hold this at arm's length.

Automatically I catalogued the rest of what I'd observed. There were word-finding problems. Parkinsonian symptoms—tremors and a shuffling gait. Social withdrawal. Poor hygiene. Hoarding. Taken together, that was a collection of symptoms for which we had a name, though not a precise diagnosis: Diogenes syndrome. Diogenes of Sinope had been a philosopher in ancient Greece who supposedly showed his contempt for material things by living in a barrel. He wandered about Athens with a lantern in the daytime looking for an “honest man” but never finding one. Diogenes syndrome often marked the boundary between eccentricity and a dementia such as Alzheimer's or Lewy body. Without intervention, half of the patients with Diogenes syndrome die within a year.

Added to the Diogenes syndrome I noted the rapid onset of symptoms, high energy, waxing and waning consciousness. And I wondered if he'd seen someone or something in that chair that he wouldn't let me sit in. Maybe he was hallucinating.

If I'd had to give a diagnosis then and there, I'd have said Lewy body dementia. The usual treatment options were palliative at best. I didn't want to get Annie's hopes up, but I wondered if Dr. Shands would be willing to evaluate her uncle. Maybe enroll him in their research study and qualify for experimental treatment.

“He needs to be evaluated,” I said. “We probably won't get a definitive answer, but it may indicate what kind of treatment—”

“It's treatable?” Annie asked, pouncing on the possibility.

“There are drugs that may lessen the symptoms, plus some experimental treatments that are showing promise.”

Annie dug her thumbnail into the Styrofoam of the cup. “So what are you saying? Diagnosis is iffy and the only treatment is experimental?”

It pained me to admit she was right. Welcome to my world—modern mental health, house of smoke and mirrors.

“Do people with this always end up living like that?” Annie asked.

“You and your mom caught this early. Much earlier than usually happens when someone's living alone.”

“Maybe if I come over more often…”

“Annie,” I said, leaning across the table and putting my hand on her arm, “we can get the place cleaned up. Get him a geriatric care manager to help day to day. That will buy time. But he needs a thorough evaluation so we know what we're up against.”

Annie pushed away the coffee. “You think I'm in denial.”

“You're not the first person to have a hard time coming to terms with something like this.”

“I suppose that should reassure me.”

Denial, anger—both were perfectly normal. “Listen,” I said, “I was in deep denial when my father started showing unmistakable symptoms of Alzheimer's, and I was an expert on the disease.”

Some of the tension ebbed out of Annie's face. “I guess I'm not ready to lose him.”

“Let me see about getting him admitted to my unit. We can do some tests, try to figure out what's going on. Maybe there are some medications that will help. And there is something you can do now. Get him to sign a health-care proxy and give you power of attorney. That way you'll be able to make the decisions you think he'd make himself.”

“When he's unable to?” Annie asked, reading between the lines. “It's that bad?”

Sadly, I couldn't disagree.