And so began a mother’s long and difficult journey into the night, accompanied by her two grown children. Alberta was a highly trained professional regarding information and communication.  She knew exactly what was about to descend on her, at least its main milestones – confusion, forgetfulness, a sense of loss, and then a sense of finding something.  She recalled helping to edit large columns, years earlier, in Societymagazine that focused on dementia and Alzheimer’s, especially among older women.   She set aside some of the more troubling parts of the article for now and recalled that the very first thing to be done was to get a professional assessment of her condition.  She picked up the phone and was gratified to secure an appointment with her doctor later that afternoon.

With Jenny at work, and a call to Robin left unanswered, she drove her trendy silver and dark blue BMW SUV from the traditional home she and Sandy had purchased early in their marriage to her doctor’s office in nearby Finsbury – a pleasant 15-minute drive.

Elizabeth Fairborough had been her doctor prior to her marriage.  They had met one another at an old bookshop in Notting Hill, listening to a reading from a well-known Irish poet.  Afterward, as the attendees proved hesitant to leave, coffee and pastries had been served.  Both women possessed a certain reserve and yet they easily cast their restraint aside the more they conversed.

It was a friendship that was to survive life’s challenges.  Each had attended the other’s wedding and both attended St. James Anglican parish in Clerkenwell on a semi-regular basis.  Fairborough had delivered both Robin and Jenny and had sat with the family at Sandy’s funeral.  Alberta provided an understanding landing spot whenever one of Elizabeth’s many love affairs was left dashed on the rocks.  Ultimately, she never married but depended on only a few intimate friends like Alberta to fill her social calendar and emotional needs.  

Now, as the two women sat across from one another, that deep friendship was about to rise to another level.

Elizabeth could sense the worry in her friend’s eyes and prepared herself to hear of symptoms that would most likely suggest cancer or heart disease.  The doctor marvelled once more, as she had many times over the years, at the deep level of dignity that emanated from Alberta. 

The physician shifted her position, preparing to stand, and said, “Let’s have you slip into one of these robes and we’ll check out your vitals.”

The hand on her knee and the pleading look in her friend’s eyes caused her to abandon the action and face Alberta directly.

“I think I have dementia … or Alzheimer’s.  I don’t really know the difference.”

If Fairborough was surprised, it didn’t show.  She had seen it before in people like Alberta – those who were extremely intelligent and accustomed to thought processes of the highest order.   Such people were keenly aware when their thinking faculties began to slip and when memories were lost.

For the next few minutes Alberta discussed what had taken place the day before – the elevator, Jenny’s revelations, her own sense that something was out of place.  “Whatever it is, I think it is in its early onset,” Alberta said, with a measure of hope.  “The problem is that I don’t know how serious it is or exactly what it is, and that scares me a little – especially for the kids.”

“Don’t concern yourself with the kids, Bertie.  If it’s what you think it is, you have your own battle to face.”

Elizabeth spent the remaining time explaining the differences between dementia and Alzheimer’s, and how the latter frequently led to the former.  “Many of us have memory lapses as we age,” she noted.   “Dementia is different because it affects our ability to carry out everyday tasks, such as driving, managing finances, cooking, shopping or, in more severe stages, being able to feed yourself. A ‘cognitively normal’ person may occasionally forget where they put their keys; a patient with mild dementia frequently forgets this, and may even forget what keys are for.”

“And Alzheimer’s?” a worried Alberta inquired.

“That’s a bit different. There’s an important part of your brain called the hippocampus which serves as the centre for memory and learning. For reasons we still haven’t figured out, the neurons in this region suddenly just start dying, sometimes slowly, sometimes quickly.  As it continues, it inevitably will lead to dementia.”

She noticed the beginning of tears cumulating in her friend’s eyes and reached out to take her hand.

“I always wondered how things would end,” Alberta said with resignation, “but I wasn’t counting on this. Ever since Sandy has been gone, I could feel myself aging and knew it was only a matter of time.”

“The first thing we have to do is actually diagnose what’s going on, and for that we need to undergo some tests.”

“What does that entail?”

“Some laboratory tests, psychological profile, likely an MRI, and perhaps a time of questions and answers.  Keep in mind that we don’t know what it is, and that even if it is as you fear, such conditions are often treatable and efforts are put in place to protect the brain from pitching into quick decline.”

Alberta looked around the office at the certificates on the wall, clinic books in impressive mahogany shelves, and a glorious oil painting of Scotland’s Ben Nevis – it’s highest peak. Turning to face her friend once more, she asked, “When can we start?”

Elizabeth reached across the desk to grab her calendar and smiled.  “How about tomorrow morning?  I’ll clear my schedule and get you in first thing.  I can line up the schedules so that you’ll be finished by mid-afternoon and get home in time for supper.”

As her friend merely sat in silence, Elizabeth suggested, “Why not stay with me here in Finsbury tonight? We’ll put on a movie and drink some wine.  Then you can come in with me in the morning.”

 That was exactly how the next 24 hours played themselves out. The tests, though not arduous, were exhausting in their repetitiveness.  By three o’clock, they were done and back in Fairborough’s office.

“Well done, Bertie. You survived like a trooper.  Must have been the wine we drank last night.”

“Or the kippers,” Alberta said, smiling.  “God, I haven’t had those in years.  Sandy hated the smell and the kids said it soured their breath, so I gave up cooking them. Still, they were delicious.  Thank you, Liz.”

Her physician placed her hand gently on Alberta’s knee.  “I have asked them to rush the results and they should all be in by tomorrow afternoon. Why don’t you cook up some steak and kidney pie for dinner and I’ll swing by with the results?”

“I’d like the kids to be there; it’s only right.  I think they’ve already figured out that it could be something serious.”

“That decision is totally yours, but remember, you aren’t in this alone, dear Bertie.”

Driving home in the late afternoon, Alberta realized that her friend’s last words were not necessarily true.  If the findings confirmed dementia or Alzheimer’s, then she would be increasingly alone – her future a long but darkening tunnel filled with things remembered and then forgotten.  

She gripped the wheel tighter until her knuckles turned white and her arthritic fingers fired with pain.  Her active mind found itself surveying everything – the keys in the ignition, the speedometer, the sun lowering on the horizon, and the narrow lane she occupied. Then her mind quickly circled back to see if she had forgotten anything.  It was ridiculous, she knew, yet she was filled with fear that everyone else would spot the symptoms long before she would.  That thought troubled her.

A few minutes later, the road sign said Clerkenwell and she steered with practiced precision to her home – thankful that she had remembered it all.  Now came the waiting and the awful sense that the journey she had started on today might contain no map, no signposts and no future.