Chapter One One night some months ago, during the fall of 1998, it must have been, I had woken up suddenly with the feeling that something was wrong. I switched on my pencil flashlight and found it was two o'clock. I'd been asleep two hours. I felt bemused but, at the same time, intensely wakeful. For there was a subdued noise somewhere in the house. The sound of voices. Was it burglars? But why should burglars be talking? Did they think the house was empty? I reached over to the other side of the bed. There was nothing there. Iris had gone. She's always such a good sleeper. That was my first thought. In its earlier stages, Alzheimer's disease actually seems to confer minor physical compensations. The sufferers may sleep soundly, look well, never get a cold. Iris liked to go to bed early and slept almost without stirring until eight or nine in the morning. So what had gone wrong? And to whom was she talking? Surprising how eerie her voice sounded, in the silence of the night, coming up muffled from somewhere downstairs. No words to recognise. There wouldn't, in any case, be intelligible words. No doubt that's why it sounded like two or three people conversing together, voices merging. Who were these new friends of Iris, with whom she was chatting as if they were already old friends? My heart sank inside me as I realised that the disease must have entered another phase. Sometimes in the early morning, Iris got up to go to the loo. As I might do, as any one might do. But wandering round the house and chatting to herself at two in the morning was a new development. For a moment, I thought I heard the voice of Macbeth, the most terrifyingly intimate of all Shakespeare's tragic characters. "Methought I heard a voice cry `Sleep no more!'" One is apt to get such dramatic visions of despair into one's head at two in the morning. It passed. Daylight came. A bit of sleep for both of us. And a little later that morning, I had a visitation. Perhaps it was one of Iris's nocturnal friends. Or perhaps it was Dr. Alzheimer's very particular, very special intimate, who in time would become the friend of us both.... Dr. Alois Alzheimer , a native of Alsace, wrote a treatise in 1907 on the disease or condition that is named after him. He had observed it in patients who were in their fifties, as well as in older people, and he had concluded that this type of dementia differed from more generalised aspects of senility. The condition was also marked by a regular progression, which might be either rapid or slow; but he found no cases of remission or recovery. A bleak outlook, which left not much room for lightness of heart in the sufferer, or for those who attended the sufferer? Not necessarily. There may be rewards and alleviations on the way, for all parties. As well as anxiety in the patient, there may be a kind of merciful indifference, even lightness of heart, a shrugging off of responsibility for the things most of us feel we have to do every day--washing, dressing, keeping up appearances. Even the good doctor's name, ill-omened as it might seem, can possess a droll freedom of association. Remove it into other circumstances and it could signify other and more cheerful things, more comical things even. The Alzheimer, a potent vintage racing car that in its time even challenged the Bugatti? A gambling club, a select restaurant? Or when a guest praised the pâté, a youthful hostess might candidly admit that she had got it at Alzheimer's.... Bad situations survive on jokes. That is the point of trench humour. If they are in close contact with each other, caregiver and patient can even share such things. I will tell my thoughts, such as they are, to Iris; and she will smile at me when she sees from my face that I am wandering off into some sort of fantasy. It is possible for both of us to have friends in common with Dr. Alzheimer, who certainly does have his friends. And now it's as if my own memories are becoming Iris's friends, too. * * * On that morning last fall, I was fully conscious that Iris's affliction had suddenly entered a new and ominous phase. I did not know it would be all but the final one. At the time, I was more aware of what I now think of as a visitation, even an annuciation. Perhaps it started in my head as a kind of joke. Perhaps I came to associate the joke later not with Dr. Alzheimer himself but with a delightful and humorous man, a real doctor from the Warneford Hospital, who, although he was immensely busy, came regularly to call during the final stages of Iris's illness. A true scholar and healer, as well as the kindest of men. It was he who saw when the time had come, the moment when we had to get Iris into a home as soon as possible. But on that morning, after her night out downstairs, Iris was peacefully asleep. I went down to the kitchen and made myself a mug of green tea, "gunpowder" tea. Each curly dark green leaf expands to unexpected size in the boiling water, like a Japanese paper flower. In its dry unexpanded state, it must have looked to those early tea merchants like a grain of gunpowder. I had become partial to it in the early morning. Should be made weak, when it's mild and delicious. Said to be good for the heart. Good for the memory perhaps, too. Coming up from the kitchen with my mug of tea, I caught the tail of my vest on the arm of a kitchen chair. Over the years, the vest had become ragged, with a sizable hole at the back. I pulled at it like a dog pulling at a lead, but this did not help. I put the tea down, wriggled around, and managed at last to unhook the vest from the arm of the Windsor chair--a chair polished by more than forty years of me sitting in it. We bought the chair cheap at a junk shop in 1957, the year after we were married. The proprietor had showed us its wormholes with a great appearance of candour, and he went on to sell us a little can of some chemical treatment, with a tube and nozzle which had to be inserted into each wormhole in turn. Iris did this conscientiously for more than a week, like the priestess of some strange cult. And the chair still hangs together, so perhaps her labours were not in vain. When I got back upstairs with my tea, Iris was still peacefully asleep. I looked at her quiet face, remembering that ancient time, and the zeal with which she had manipulated her little can of chemical. And there was something else, too, trying to get into my mind. What was it? Proust was quite right about the onset of memory, although his theory of it soon begins to sound rather too portentous. But it is sudden, and it is unexpected. It is also a source of joy. Back in bed beside Iris, I lay and thought of that moment when I had freed the tail of my vest from the arm of the Windsor chair. The moment was bringing something back to me. But what was it? I looked at the dear creature asleep beside me for inspiration, but it was nothing to do with her.... And then I remembered. Sleeping and at peace at last as she was, she had brought me this visitation. Even though it came from a much earlier time, a time long before she knew me. Lying back, relaxed now and sipping, I found I was on the golf course of my childhood, the golf course of Littlestone-on-Sea, which is near New Romney on the Kentish Coast. But I was not trying to play golf. It was the family game, but I had always managed to avoid it. I had other things to do on the golf course. At that moment, I was slinking furtively through the thick seaside grass--the rough--at the side of the course. I was making for an old and derelict brick cottage, which lay in the no-man's-land between the golf course and the fields and dykes of Romney Marsh. Had it once been a smugglers' lair? Was it still perhaps? I had been reading about their exploits. The book was Dr. Syn , by Russell Thorndike, brother, as I later discovered, of the famous actress Sybil Thorndike. Dr. Syn must have appeared in 1931, when I was six. Perhaps 1932. But I was not much interested in smugglers as such. It was the place itself, its nearness and its otherness. It was close to the links, where dedicated golfers in plus fours selected and swung their clubs, but it seemed all the more remote and strange for that, in a world of its own. And what preoccupied me at that moment was something quite different from smugglers or golfers. It was mantraps. I knew that these diabolical contrivances had once been set among long grass to catch poachers, and why not to catch smugglers, too? I knew it because one rainy morning I had opened a book on the shelves of our seaside house. I hardly registered the title at the time, but it must have been Hardy's novel The Woodlanders . It opened at the page on which the heroine, skimming lightly along a woodland path, just escapes the jaws of a mantrap. Her foot touches the plate and sets off the trap, but so swift and lissome is she that her ankles evade the clash of the serrated iron jaws as they spring together. Not so her trailing skirts, however. Pulled down by them, she finds herself helpless in the monster's grasp. Unable to move, she is compelled at length to abandon decorum and contrive to slip out of her silk dress and her petticoats. The scene then shifted to her estranged husband, awaiting her in the midnight gloom at their agreed-upon rendezvous. But distraught wives and estranged husbands were not an exciting topic. Having established the heroine's safety, I lost interest and put the book back in its place. Dr. Syn , which I had already twice devoured, fascinated me much more. Not only was one of the miniature engines on the Romney Hythe and Dymchurch Light Railway called after him but in the book he was a local parson, admired by his flock, who had been a pirate and was now secretly a smuggler. I could appreciate that. I loved the deceit of it, and the enigmatic figure of Dr. Syn himself. Would the ruined cottage perhaps turn out to be his private lair? It was twenty years or so before I actually read The Woodlanders . Had I been six or seven years older when I found it in our seaside cottage, I might have been more intrigued by the heroine's predicament as she sped on agitatedly to her rendezvous, now clad only in her vest and drawers. It must have given her husband a thrill, and no doubt assisted in their subsequent reconciliation. Hardy was very well aware of the graphic and dramatic possibilities of female underwear in his plots. For a Victorian, he sailed quite close to the wind on this occasion, and on another, too: In his early novel A Pair of Blue Eyes , he has the heroine remove all her underclothing to make a rope to rescue her fiancé, who is clinging precariously to the edge of a cliff. But at the age of eight, even though I was nearly nine, female underwear had no special charms. Mantraps were the thing. They equally thrilled and alarmed my imagination. And so I approached the ruined cottage with exaggerated care. Who knew what might lie concealed in the thick marsh grass around it? Partly in the story I was telling myself inside my head, partly in sober reality, I was relieved to reach the crumbling brick wall of the cottage unscathed, untrapped. I could now see a sort of hatch in the wall like a miniature barn door, not very high up. I gave the side of it a tentative pull, and with a creak it swung open. I was mentally prepared for smugglers, but not for the apparition now confronting me. Two feet in front of my face sat a large living creature. It had a snowy white breast and huge dark eyes. We stared at each other. Then it swept over my head and flew across the marsh, a soundless brown shadow. These memories had all come from the moment when I had freed the tail of my vest from the arm of the Windsor chair. I had wriggled out of the trap, like Hardy's heroine. Iris was still peacefully asleep, lying on her back, giving an occasional little snore or grunt. Beside her, I sipped my tea and abandoned myself to thoughts of that summertime at Littlestone, the ruined cottage, Dr. Syn, the great barn owl.... Consciously and greedily, I gave myself up to these memories. The habit of memory has become a real solace now. Almost, one might say, a fix. Especially in the early morning. With Iris still sweetly and childishly asleep, still unafflicted with the compulsions of Alzheimer's, which will cause her on bad mornings, and most mornings are bad, to shed silent, miserable tears, or to utter small anxious cries and queries on waking. "Where is? We going? Then go? Where this?" I shall stroke her, soothe her. With luck, she may go to sleep again. If she does, I shall plunge back into the flow of memory, as if I were slipping down the bank and into a cool river on a hot day. Later on in the day, I shall be able to attend to Iris with one part of my mind while continuing to meander about in my own thoughts. But they will not then be so vivid or so complete, so almost sensually satisfying as they can be at this early hour. It reminds me of one of the devils in Paradise Lost , who, while his more heroic companions are planning a hazardous vengeance upon God, wants only to be left safe to think his own thoughts. Milton speaks on his behalf with great eloquence. For who would lose, Though full of pain, this intellectual being, These thoughts that wander through eternity ... Never mind eternity: I am quite content to wander back to actual years and months, actual places. But when Iris wakes up, they will have to vanish, at least for the moment. I cannot make the right noises, and deliver reassurance, while they are going on. Something in what's left of Iris's mind would know that her anxieties were not being paid full attention to; and they would increase. Alzheimer's is implacable: It grows worse all the time, but insensibly. It is only by thinking back a few months, or looking in my diary, that I can register the changes. But as the condition grows worse, and its successive stages more difficult to cope with, compensations multiply. It is these compensations I think of as friends. Iris's and mine. Dr. A.'s too. Some are mutual. Today we can still cuddle together; we still enjoy lucid, jokey moments, small bouts of pleasure in each other, at each other. But many more now have to be solitary unshareable. It is no use trying to tell Iris about these memories as I would once have done, no use trying out an idea or a thought on her. It upsets her; a bothered look can come over her face, but usually there is only vacancy and, with luck, a smile. In 1997 , I wrote a book about Iris, our past life and our present one. Worse as the condition now is, we can still go along living alone together. The certainty of things getting worse is our most unexpected friend; yet undoubtedly he is one. And I suppose it is the friend who sharpens an appetite for living in the past, gives the process a kind of connoisseurship. Someone with cancer once told me of the relief he felt when he refused further therapy, although doctors urged him to stick with it. The future had ceased to concern him. He was free to think only of the past. Iris is awake. Her endless fidgets and queries begin to empty my mind. I must summon up logic and language, and reply properly. At this time of day, she relies--paradoxically--on what seem to be real answers: jokes and nonsense--old chums that they are--won't do. I sometimes say, "Don't worry, darling, we shall soon be dead." This causes a silence, but not exactly a restful one. Is Iris thinking about it? Does the word still mean something? I have no way to find out. I do not regard suicide or euthanasia as Iris's friends, or as friends of Dr. A. Belial, that unheroic devil in Paradise Lost , would not have approved of them, either. He deprecated his fellow devils' heroic wish to immolate themselves in the destruction of heaven and earth. He was for life, at any price; he knew that as things get worse, the life of the mind can seem ever more and more worth having. And yet I have had frequent thoughts of doing ourselves in together, if there were a nice, safe, reliable way. In 1983, the writer Arthur Koestler and his wife did that. He was ailing and had cancer. She was young and in good health, but she wanted to go with him. Hard to understand, and yet there it is. Would she have had second thoughts the next day, if there had been a next day? Like impulse buys in the supermarket, most suicides only seemed a good idea at the time, for the time. In a sense, it has all happened before. Iris's mother succumbed in her eighties to what was then called "senile dementia." No reason to suppose it hereditary; no fear then it might affect her daughter, too. But as Iris's mother began to go round the bend, her minder, Jack, amassed on her behalf a collection of sleeping pills: barbiturates--the real thing. A host of bloodred capsules. After her death, I found and appropriated them, thinking they might come in handy one day--if they still worked. They must be somewhere in the house, but in this house, or any house we've ever lived in, I would be most unlikely to find them. We used to have a phrase for things gone missing: "Gone to Pieland." Once we had bought a pork pie, a very fine pie indeed, from some superior delicatessen. We put it on the table to eat for supper, and when the moment came, the pie had disappeared. It has not been seen since. Resolving itself back into its contingent ingredients, the pie seemed to have gone to a happier place. Perhaps to the "Valley of Lost Things," once visited by the hero of Ariosto's mock-heroic epic, Orlando Furioso . Thank goodness that does not apply to those memories of the distant past that now keep me going. And Iris with me. On that full morning in 1998, Iris woke, and mental life had to be suspended. I gave a last wistful glimpse back at the barn owl, the ruined cottage on the links, the mantrap fantasy.... What took place in my head when I hooked my vest tail on the chair seemed involuntary, a sensation too immediate for pleasure. Only afterwards, when I got back to bed, did I begin to enjoy it. Proust must have been the same. He dramatised the joy he received from that sudden flooding back of the past, its recapture through the cake in the tea (how disgusting that combination sounds!) and the way he knocked his foot against an irregular piece of pavement. But I feel sure that he had to arrange such things quietly in his mind before he really began to enjoy them. Proust never saw TV, but the process seems to me now a little like sitting down in front of one's own private television screen and turning it on. Total recall at my age is a very deliberate process. And Belial, that insinuating devil, was surely right. But never mind the present; it is saying good-bye to one's life in the past that would make one think twice about suicide, however simple and easy its process. Leaving the present would be nothing: It has no shadow and no substance, no memory power, either. When addressing an envelope the other day, I came to a sudden stop. The letter was to somebody I knew well, and I'd written his first name. What's the other? I thought it was gone. It would be back in a few minutes, but in the meantime, I wanted to post the dammed letter and be rid of it. The life of the present is full of such exasperations, riddled, too, with angst, alienation, fear of contemporary life. Fifty, even forty years ago, everything was so much better, wasn't it? Well, naturally. If we had grandchildren, the present time might not seem so repulsive, so vulgar, so swiftly decaying, so full of daily dread and dislike. I can't imagine having had a family, but I suppose what they say must be true: We are born to reproduce, and to find satisfaction when old in the thought of those others' future. Though I avoid children, even I can see that they cannot help finding this world a wonderful place, and some of that continuing wonder must rub off, as it were, on their grandparents. How would Iris feel about it, if she did feel nowadays? Even in the midst of the poor darling's endless agitations--banging on the front windows to alert passersby, jerking endlessly at the locked front door, carrying clothes and cutlery round the house--there does seem to remain a core of serenity, in her smile, in the response to a tease, that I can't find anywhere in myself. Illusion? Or is that still centre, from around which everything else has departed, another of the friends, come to drop in on us at this stage of Iris's dark journey? Nearly five years now since the first symptoms declared themselves. They are trying to find out, so a doctor told me, what it is that Alzheimer's patients actually die of. Physically, they can appear in good health; but they do die, usually within seven or eight years of diagnosis, and seemingly of nothing in particular, although pneumonia steps in at the end. The last of the friends. So what about hastening the process? Couldn't we do it together, as I said? I may forget names when addressing envelopes, but there are two names as firmly in my head as any steadfast memory of childhood. Dr. Alzheimer, of course: He is in my mind every day, just as the badge of society named for him is in my buttonhole. But there is another name, too. Dr. Kevorkian. A strange, saturnine name. Dr. Kevorkian, death's angel, often pops up in newspaper features, showing off his polythene apparatus, teaching his fragile, willing victims to do it themselves. Surely he, too, must be a boon and companion of our old pal Dr. A? Might that seem suitable? But no. On reflection, he certainly isn't a friend--very much the opposite. Dr. A.'s rewards and compensations, even the most unexpected ones, are concerned with being alive; finding out not only how much there is in being alive but what surprising new things there turn out to be: freedoms, and pleasures in constraint, which we would never have imagined or thought of, never even have considered possible. "Sweet are the uses of adversity ..." The commonest, sanest Shakespearean wisdom. And yet it doesn't seem like adversity exactly. Just the way things are, or have become. That everpresent need to escape, Dr. A.'s most elusive friend, can only be implemented in the mind. If I had a stroke or broke an arm, I should be frantic to get back to Iris. If Iris went, I would hardly know what to do. This is obvious, but it less easy to grasp the inner point: that I have been engaged in a certain way of life, and could hardly find another one now. What would become of the mind, the memories I cling to now, if I were free to do as I wanted, free to go anywhere and do anything? I cannot imagine Iris without me. Just as I cannot imagine myself without her. She is always there, and so am I. She cannot do without me. Now I tell her I am going to the loo or into the kitchen, and she gazes at me anxiously and tries to come along. When I evade her, she stands very close, fretting and peering. The objects she is usually carrying have the look of empty space, no longer having a purpose, even if they are ordinary cups or knives and forks. As her condition worsens, and our imprisonment becomes more complete, the compensations mount up--they have to. For her as well as for me? I can hope so at least. We both still have our small pleasures, which have become happily and mutually important: more and more important, not only because they are all we have left but because we can still share them. When Beau Brummell, once the lawgiver of high society's dress and behaviour, lost all his money and began to go mad, he took pleasure in walking on the beach at Boulogne, where he had fled to escape his creditors. He picked up seashells, carried them home to his lodgings, and experimented in restoring their brightness by painting them with vinegar. As I watch Iris absorbed in the twigs and bits of paper she has picked up on our walks, I enter more and more into what she seems to be feeling. I look serious with her as she does it. We bend our heads together over what she has found. Copyright © 2000 John Bayley. All rights reserved.