On my drive into work yesterday, I was listening to a story on NPR about a drug used to treat colorectal cancer. It seems that a nasty little side effect of this thing that’s supposed to help our loved ones is that it causes diminished brain function.

I dug through my purse, through the tampons with torn wrappers, the lipsticks of every shade, the old grocery lists so carefully organized by store aisle, and finally found a pen. I scribbled the name of this drug on the back of an envelope and raced for a break in the traffic so I could safely call my brother.

“A ha!” I thought. I knew I was playing a game with myself, that I was seeking the comfort of getting mad at a greedy drug company for causing my mother’s illness, the comfort not offered by the reality my brother and I face. You see, we handle this in our own ways, looking for something on which to base some hope-- but usually we're reduced to my brother punching the air in front of him, me kicking at rocks that aren’t there, and the two of us stumbling through most days knowing that Momma’s Alzheimer’s will likely be our own some day. We have nothing to blame—it is simply that fate on which we so patiently and anxiously await as we watch it consume our mother.

When I called my brother, he felt that same fleeting surge of hope. We hung up so that he, too, could search for a pen and a scrap of paper. He called back and wrote down the name of the drug, promising to call our mother’s nurse. Before he did so, however, he performed an act of cruelty—he called me back one last time to remind me of this nasty little reality: Momma’s chemotherapy now is for the cancer that has spread to her lungs and her liver—the stuff in her rectum was surgically removed, along with that little bit of dignity and privacy that a woman of her age and upbringing requires. That said, her diminished brain function likely is, well, her very own, and not that which we can place at the foot of the drug companies.

So today, I anticipated phone calls from my brother: Wednesday is chemotherapy day and today was the day he was to bravely ask for a psychiatric evaluation of our mother (in hopes she could start some medication for her failing memory and her periodic confusion). This would be a hard day for my brother, having to finally face what I’ve seen for months, what we’ve always known we’d confront.

He called the first time as I was sitting down for lunch. “Momma’s lost almost 5 pounds since last week. She told the nurse that she doesn’t want to eat after 3 in the afternoon because she doesn’t want to deal with her bag.”

“Bullshit,” I shouted. “She is losing weight because she isn’t remembering to eat.” I explained to him what I’ve said so many times before: she’s giving them a rhetorical response to a question because she just doesn’t know the answer. If she says something, anything, that seems remotely plausible, then she’s off the hook, she doesn’t have to consider that which is (literally) unthinkable: my mother, beautifully intelligent and (so often) charmingly cynical, is losing her wits.

My brother said, “All I can tell you is what she said. I am thinking of buying her some dope to throw her appetite in gear.”

I chuckled then asked, “Did you bring up the psych evaluation?”

“Yes,” and his voice dropped. “The nurse asked her some basic questions that she couldn’t answer.”

“She may have given her a mini-mental exam, asking basic questions like the date and such…I know Momma can’t answer those kinds of questions. The truth is, we need to consider our options.”

His voice was barely audible. “What do you mean?”

“I already know you don’t feel that she’s safe when she’s alone. And she’s likely to give up all hope if she is forced to give up her cats and move into a nursing home. But what’s more cruel? If she were a horse....” I paused and listened to him fight tears. “This Alzheimer’s is some shit.”

“Ann, I’ve got Momma in the car with me. You’re on speaker phone. Will you tell her to eat?”

Fuck, I didn’t know. I had been far more blunt than I would’ve been had I known she was listening. “I’ll call her after I finish eating—let her know I’ll call her shortly.”

I called a few minutes later. “Hi Mom!”

She responded the way she does when she’s confused: “Hello?”

“Mom, it’s Ann.”

“Oh, hello, Ann.” She had no idea who I was other than that I’d just given her my name.

“Momma, my brother said I should call and remind you to eat. Why haven’t you been eating?”

“Oh, nothing sounds good right now. Thanks for asking though.”

“Momma, my brother is threatening to buy you some dope to perk up your appetite—do you want to start smoking pot at your age?”

She laughed nervously and hung up, wondering, I’m sure, what kind of sicko would make a prank call like that. She still has some dignity, y’know.