Free On Pluto by Greg O'Brien Page B

My eyes didn’t blink.
    â€œA most unusual situation of a bright man who had the opportunity to witness dementia in a parent … with self-awareness of early symptoms within himself,” Marks wrote in his initial report, dictated on voice recognition software as if the report were being written in slow motion before me. Marks also observed that a previous brain MRI revealed some “frontal Flair/T2 changes, consistent with a previous head injury.”
    â€œThis may have ‘unmasked’ Alzheimer’s pathology,” he added, “but his genetic loading is striking … The brain SPECT scan is most compelling in clinical context for Alzheimer’s.”
    Marks encouraged me to remain as physically fit as possible “as he is to keep his cerebral blood flow out … I suspect he is exhibiting the phenomenon of ‘cognitive reserve’ in which case he may tolerate on a functional basis impairments further into the baseline underlying pathophysiology of the disease longer than one who does not have the same cognitive reserve.”
    â€œThe diagnosis has been made, in my opinion,” he concluded in his report, “… I am not sure how much longer he has in terms of being able to reliably and meaningfully provide the quality of work he has put out in the past. The general point is there needs to be balance between a healthy desire to overcome obstacles and yet acknowledge fundamental reality.”
    A final word of advice, Marks urged me to meet as quickly as possible with an estate attorney to protect family assets, given the statutory five-year “look back” during which a nursing home can attach personal properties and bank accounts. He also recommended that I designate a healthcare proxy, future caregivers, and assign power of attorney.
    In the space of a bleak afternoon, my identity in the real world—my mind, along with the cherished red cedar shingle home that I had built for the family about 30 years ago, the onewith the high-pitched, red cedar wood roof on about two acres of farmland off a winding country road that was now a part of a National Register of Historic Places—was on hold.
    There wasn’t much more to hear or to say. We left the office, and drove home in silence most of the way. The stillness spoke legions. I couldn’t wait to get back over the bridge, my Linus security blanket. Lots to digest quietly in a 45-minute ride home. The assimilation of urgency was choking—bucket lists of cleaning up relationships, end-time planning that we all like to put off, and the strategies of surviving financially, physically, and emotionally. Many before me and many today, I thought, have been captive in such a contorting state of affairs with a range of disabilities, health issues, and timelines. I wasn’t alone. Yet, I felt so isolated.
    I felt sad for my Mary Catherine. This wasn’t fair to her. And I couldn’t fix it.
    Dammit, I couldn’t fix it!
    The tool box was empty. I couldn’t repair my brain. Ever. Not even with duct tape. All my adult life, I had relied on duct tape to fix leaks from the upstairs bathroom in the kitchen ceiling, “repair” broken appliances, hang posters, fix a tail light, repair a garden hose, act as a big Band-Aid, steady a cabinet door, fix a hole in the wall, hold a car door shut or a car window in place, fix a toilet seat cover, hold a choke in place on an outboard engine for the boat, as a wiffle ball, a tool belt, and once, as a last resort, as an ace bandage for a pulled groin to get through the 5K Brew Run one hot August day in Brewster.
    â€œHow are you doing,” I finally asked, as if from Mars.
    My wife, as author John Gray might put it, is from Venus. I love Mary Catherine, but often she doesn’t want to be confused with the facts; she seeks a safe harbor, as any good sailor does. I fly by the seat of my pants. I find reality far below the surface, bottom fishing for