He’d been up all night in anticipation of this moment, desperate to know he’d made the right choice. In the dim alcove of his private lab, Dr. Adrian Kessler inserted the tissue sample he’d prepared into his electron microscope. The enlarged image revealed spider webs of twisted white filaments throughout the gray matter confirming his diagnosis of Alzheimer’s Disease. This thin slice of brain tissue came from Gladys Johnson, a woman of high intelligence until AD destroyed her mind and made her a resident at his facility. He had specifically selected her as a test subject because of that prior intellect, thinking a positive result in her could be dramatic. And it had been, briefly. For a few days, she’d been back… focused and present, able to converse with him and her family, cognizant of time and place. But then she began to fade again, and he knew that meant her organs would soon fail and she would be dead within weeks. As repeatedly proven in the mice, the only way to examine any regenerated neuron cells at that point was to harvest the brain immediately. But this wasn’t a mouse this time. It was a human being. Ethics dictated he let nature take its course. Science demanded he preserve the evidence. Faced with a wicked choice between following the rules or making a giant leap forward in his research, he had erred on the side of science.
Adjusting the controls, he further magnified the image, bringing an individual cell into focus. His eyes widened. There was the evidence he sought, a neuron cell suspended between death and rebirth—its synapses partially reconnected, cell body structures partially restored to normality. The word Eureka! screamed in his mind, but he only smiled in celebration. He was not alone. Outside this alcove was the brightly lit area where two of his research assistants walked silently across the polished tiles in their fabric-booted feet, speaking in hushed tones lest they disturb him. Without alerting them to his excitement, he moved the field of view to other neuron cells, some fully restored, others frozen in process. Still more showed signs of deterioration, confirming he had acted wisely to harvest the brain when he did. Here was indisputable evidence that his method of delivering CRISPR re-engineered stem cells directly into the hippocampus could resurrect dead neuron cells in a diseased human brain. He wanted to yell out in triumph but remained silent. No one must know he was conducting unauthorized experiments on human test subjects. Not yet. Not before he obtained FDA approval for clinical trials. His treatment still needed more testing in the animal labs to qualify. To date, only a handful of mice had survived for more than a few months, and he still didn’t know why.
Sometimes, he worried that hidden factors in the bio-chemical equation might be beyond the ability to detect with tools currently available to medical science. What he needed was to determine which expression of DNA made the ultimate difference, but the exact path AD took to destroy a mind differed nearly as much as the affected individuals themselves. Such was the nature of a disease that attacked the essence of personality.
Dr. Alois Alzheimer reported the first case in 1906 after his postmortem exam of a woman in her fifties. By the end, she no longer recognized her own reflection, and patted the faces of others thinking they were her own. She literally lost herself. In examining her brain, Dr. Alzheimer noted an ‘unusual disease of the cerebral cortex’ marked by abnormal clumps and tangled bundles of fibers. Research had since identified those clumps as amyloid plaques, and the fibers as neurofibrillary or tau tangles, but to this day no one knew why they formed. Were they merely symptoms of the disease or the cause?
One thing certain, AD was an eventual death sentence, and before the end it dragged its victims into a bleak state of existence where they were unable to express coherent thought, recall the past, or consider the future. He imagined that mental blankness must be like floating in a shore-less sea, trying desperately to remember something… anything. The image gave him nightmares of being lost and alone in dark, endless waters.
What are we but memory and knowledge amassed over time? he often pondered. If all that vanishes, what’s left?
He wished his patients could tell him while they still lived, but it was only by examining what remained of their damaged brains under a microscope that he had any chance of learning the answer. This slide confirmed he’d acted wisely to preserve evidence of cellular renewal at the first sign of regression. He still had two more human test subjects who remained alive. They too showed marked improvement in cognition and he was keeping a close eye on them, hoping for better results, but if they followed the same downward path, he would not hesitate to act. Never again would he wait patiently for a test subject to die on their own and allow his work to be destroyed.
Chapter 1. Obligations
Josephine Rinaldi stood outside her father’s bedroom door—something that had turned into a nightly ritual—listening for sounds of movement and hoping not to hear any. She leaned against the wall. It would take a while before she could assume it was safe to leave. The light at the end of the hall beckoned, but there was no point in her going back to bed only to be woken again by him wandering through the old house, searching for something he couldn’t name. The diagnosis was Alzheimer’s Disease.
How did this become my life? But she knew the answer. This was the price of being a dutiful daughter. Of her promise to fulfill her mother’s dying wish.
Eyes closed, with her head resting on the wall, she almost fell asleep, but then the old schoolhouse clock next to her chimed, making her jump. She glared at it as if it had intentionally spooked her, then sighed at the hour—two am. She wanted to be at work by eight to prepare for the litigation meeting. She did the math—six hours, minus one to get herself ready and supervise her father if he woke before his caregiver arrived, minus another to allow for traffic—that left four if she fell asleep right here on her feet. Her body demanded seven on average, a requirement she hadn’t met in… what? A week? A month? She’d lost count.
Maybe I’m getting it, too. That would be one way to erase the past, it occurred to her with a bitter note. Stop it, she scolded herself, then automatically heard the words drilled into her by a therapist. It wasn’t your fault. You were just a child.
No matter how many times she repeated that declaration, it never fully registered. Maybe because the sentiment had never been voiced by the one person she needed to hear it from and probably never would.
When all remained quiet, she headed back to her bedroom. Halfway down the hall she paused at the door between her father’s room and her own, placed her palm on the dark wood and whispered, “Good night, Tommy.” She seldom went inside. This simple gesture alone hurt enough.
As she dropped her hand, a low creak stopped her cold, pulling icy fingers down her back.
Don’t be stupid, she told herself. She shook off the eeriness of the moment, then continued down the hall to her own room, closed her door, crawled under the covers, and turned off the light. But as she lay there, the creaking sound nagged and her eyes refused to close, blinking at what she couldn’t see. Stop it, you’re being ridiculous. Time ticked by. She couldn’t stop it. Finally, she had to face that there would be no sleep for her until she proved just how ridiculous she was being. Annoyed, she sat up and turned her bedside lamp back on.
She imagined walking down the dark hall, opening her brother’s door and finding the overhead light inside the room not working. That would be the end of me right there, she thought, and though probably unnecessary, grabbed the flashlight from her drawer.
Leaving the lights off for fear of re-awakening her father, she tiptoed down the hall like a stealthy burglar with her flashlight throwing strange shadows on the walls. She hesitated at the closed door. Come on, this isn’t some stupid low-budget horror movie. At worst, there’s a mouse or a rat in there. Not much liking those possibilities either, she took a deep breath, turned the knob and inched the door open.
Her flashlight cut through the silent darkness. Nothing scurried, chittered, or jumped out at her. She flipped on the wall switch. The overhead light lit up the room, dispelling any notion of lingering spirits. She let out the breath she didn’t realize she’d been holding and experienced an odd combination of relief and disappointment. What wouldn’t she give to see her brother again, even if it were only his ghost?
Although neater than he had ever kept it in life, Tommy’s bedroom looked basically the same, thanks to twenty years of a mother’s loving maintenance. With their mother’s passing and her father’s illness, it was up to Jo to decide what was to become of Tommy’s shrine. So far, she hadn’t touched it. His roller hockey sticks still made an ‘X’ above the bed. Medals and ribbons hung next to a lettered jacket framed on the wall. His high school, Little League and Pop Warner trophies filled the shelves next to hardbound and paperback novels about wizards and warriors, kings and dragons. A surfboard decorated with brilliant blue waves stood on end in the corner. She stared at it and not for the first time wondered if it was same one he’d ridden that day. Had one of Tommy’s friends returned it to his grief-stricken parents? “Hey, thought you’d like to have this.”
Could anyone be that clueless?
She shook her head, then poked about, sweeping her flashlight beam across the floor, nudging the empty trashcan with her foot, and ruffling the bed-skirt to see if any scurrying, scrabbling, or other noise resulted. It didn’t.
“See? There’s nothing in here.” Speaking aloud felt almost sacrilegious, but confirmed the only ghost present was the one in her head. One that wouldn’t go away, ever.
This was Tommy’s room. He’d slept here, dreamt here, planned his future here. She remembered him sitting on the orange-and-brown plaid bedspread reading his favorite books aloud to her. That last year, his senior year in high school, he’d been sharing “The Lord of the Rings” with her one chapter a night. She’d been 10 years old then, totally enraptured, not only by the story, but by his voice. To this day the trilogy remained unfinished. She’d never been able to bring herself to read the rest on her own.
She recalled Tommy saying, “Someday, I want to be a brilliant writer like Tolkien.”
“I thought you wanted to be a lawyer like Dad,” she’d said.
“I don’t have to be just one thing, do I?”
Back then, her brother believed he could do and be anything he wanted, and so had she. An athlete and scholar, he graduated first in his class. The only downside for her about the breadth of his accomplishments back then was that he got into the college of his choice and planned to leave soon. Something she’d dreaded. She relied on his counsel, trusted him completely, and did whatever it took to earn his trust in return, even when it meant keeping secrets. When he said, “Don’t tell Mom and Dad,” there was no question. She told them nothing—and that’s what got him killed.
Jo sat down hard on the bed as the old guilt grabbed hold, trying to pull her back into a familiar hopeless regret, that dark place after Tommy drowned where she might have taken up permanent residence if her parents hadn’t intervened.
The words, It wasn’t your fault. You were just a kid, automatically sounded again in her head.
The therapist labeled her with “Situational Depression,” then gave her the mantra and a prescription for Zoloft. The mantra she couldn’t avoid, drilled into her ad nauseam, but the pills got flushed down the toilet. She’d been too afraid to take them, a fear born of the secret she kept to this day, that sometimes Tommy and his friends took drugs, sometimes before going out on the water.
“It’s so cool, Josie. Floating out there high is like being in another world.”
What if these are the same kind he took? she had worried, so only pretended to swallow them. Then she put on a smile and answered everyone’s concerned inquiries with, “I’m fine, really.” But she wasn’t fine, not really, not then, not even now after all these years.
She lay down and buried her face in Tommy’s pillow, hoping to feel close to him again, but it smelled only of laundry soap. Like her, it had been too long without him.
A hand squeezed her shoulder. “Better not let Tommy catch you in here,” her father said.
Startled, Jo realized all at once not only whose bedroom she was in, but that sunlight was streaming in through the windows. She bolted upright. “What time is it?”
His speckled silver and gray hair askew, her father looked at his bare wrist and frowned. “Where’s my watch?”
“Who knows? Probably in the flour bin again.”
He turned his scowl on her. “That’s absurd.”
“Agreed.” She noticed he was fully dressed, a surprise, and that no item of clothing matched, which wasn’t. She scrambled to her feet and hurried out into the hallway to look at the clock. Its hands pointed to 7:20. Leaning over the mahogany railing, she called downstairs. “Teresa?” No answer. Dammit, she’s late again.
“Dad, I need to get ready. Would you please wait in your bedroom until Teresa gets here?”
“Your caregiver. She comes every morning, stays until I get home. Remember?”
“If I forgot half what I know, I’d still know more than you ever will.”
Jo grimaced at the familiar insult but said nothing as she guided him back to his bedroom and turned on the morning news, hoping to keep him occupied long enough for her to shower and dress. When he seemed content, she ran back down the hall, grabbed what she needed and jumped in the shower. She finished in record time, threw on her clothes, then checked on him again… still watching television, and still no sign of Teresa.
She hurried back to put on her make-up and fix her hair, then examined the finished product in the mirrored doors of her closet. Her dark shoulder-length hair lay smooth, the make-up softened the freckles over her nose, and the pale-pink lipstick complemented the rose-colored blouse under her navy-blue pantsuit. She decided the overall effect was professional enough to make her look like she belonged where she was headed. Now she just needed to get there, but first back to her father’s room. He still sat staring at the TV, wearing a blank look on his face as if waiting for someone’s redirection. Looked like that someone had to be her.
“Come on, Dad. Let’s go downstairs and get you some breakfast.”
They took the steps one at a time, arm-in-arm. He refused to use a walker or cane even though his balance couldn’t be trusted. Once down the stairs, she took him into the kitchen and chose something quick to fix—instant oatmeal with raisins. A minute-and-a-half out of the microwave later, she set the bowl and a creamer of milk on the round wood table in the nook. The windows overlooked a small green yard and the San Diego skyline beyond.
“Come eat,” she said while pointing at the bowl and his chair. Instead, he stood in the middle of the room scowling at his bare wrist, which reminded her to check the flour canister. Sure enough, there inside the tip of a flour-encrusted sock poked up and inside the sock she found not only was his gold watch but his wedding ring. She slipped the watch into her pocket and put the ring on her thumb before taking the sock over to the sink to rinse off. Under the running water, it returned to its former black, and the flour formed a puddle of thick white goop, slowly sliding toward the drain. A metaphor for her life. Her father—the esteemed Thomas Lorenzo Rinaldi, Harvard graduate cum laude, professor of law—was gradually losing his mind and if this situation continued much longer, so would she.
Startling her from behind, he stabbed his forefinger into the puddle and popped it into his mouth before she could stop him.
“Ugh, that’s disgusting,” he said, making a face and waggling the licked finger at her. “You should take cooking lessons. Now my Amanda, there’s a woman who knows her way around a kitchen.”
Jo dropped the sock, washed his hand and dried it, then steered him back to the kitchen table.
“You need to eat before your breakfast gets cold.”
He sat down but pointed at the dark mottled clouds above the city skyline. “Looks like rain.” As if the clouds heard him, drops spattered the windows.
“Well, we definitely need it,” Jo said. It was mid-January and a dry winter so far.
Wondering what was keeping Teresa, she checked her cellphone messages and found one. [Sorry so late. Car not start. Be there soon.]. Jo turned on the small television above the food preparation island, hoping to catch a traffic report, but they were talking about a political debate. As usual, the two parties sharply divided. One demanded prison reform, the other opposed increased regulations. After working as a paralegal for a public defender, Jo leaned on the side of reform.
“It’s always so empty without flowers,” her father said out of nowhere.
“What?” She turned to see him frowning at the table before him. “Oh. Sorry. I didn’t have time.”
“Amanda always makes time. She loves flowers.”
The memory made Jo smile. “True. She used to say they were little miracles you could hold in your hand. She especially loved her roses.” As soon as the past tense slipped from her mouth, she regretted it.
He blinked, his mouth working soundlessly, then his face darkened, and he threw his spoon on the floor. “You think I’ve forgotten she’s gone?”
“No, I… I didn’t mean…”
“It’s not your place to remind me.”
“I know. I’m sorry. Forget what I said, it doesn’t matter.”
“No, it doesn’t. It doesn’t at all.” He glared at her for a moment, then sighed as if losing energy for the exchange. He turned back to his oatmeal, poking at it with his finger. “That’s odd. Amanda knows I prefer fresh fruit. She must have run out.”
Jo turned away lest emotion take over. It was a now familiar pattern. Once his anger passed, he quickly returned to a strange, muddled world of mixed realities. She took a breath, got another spoon for him from the drawer and wiped off his finger. She stood over him until he started eating. Once satisfied he would continue doing so, she looked at the clock on the microwave, her worry growing.
“Dawson’s going to kill me if I’m late again.”
Her father looked up from his breakfast. “What? Who’s going to kill you?”
She instantly regretted speaking aloud. “No one. Sorry. I just need to get to my litigation meeting.”
“Litigation? I should get ready then.” He started pushing away from the table.
“No, no, you just need to eat your breakfast and wait here for Teresa.”
“Teresa, Dad. She’ll stay with you until I get back.”
“Why? Has she got the hots for me? Amanda won’t like that.”
Explaining the who and why of Teresa had become a daily ritual. Sometimes, Jo wasn’t sure if he really didn’t remember or was just trying to make her crazy. Speaking of which made her remember the watch and gold wedding band she’d rescued from the flour canister. She pulled the watch from her pocket and held it out along with her thumb displaying his wedding ring. “I found these in the flour again,” she said, intending to tell him she would keep them safe, but he snatched the ring off her thumb.
Looking at it, he smiled, his face breaking into a thousand spider-web lines.
“When your mother dropped this, everybody scrambled after it. They said we looked like a football team in the middle of a fumble.”
“Yes, I know, Dad.” Jo felt a pang at her impatience, but the wedding story had been told and retold more times than she could count. She reached for the ring, but he balled his hand into a fist and pulled it tight to his chest.
“I want my watch, too,” he demanded. “It belongs to me.”
The last thing she needed was to get into a power struggle. She had neither the heart nor time for it, so she handed the watch to him. “Fine. But keep them on you. Not in a sock buried in the flour.”
He scowled at her.
“Your breakfast is getting cold,” she reminded him again, and he looked back at the bowl as if seeing it for the first time. Her own gaze turned to the built-in desk beneath the television. There, hidden behind the telephone was the brochure she’d brought home days ago and was still trying to get up the courage to show him. She had practically memorized the text: “Seeking residential participants with Alzheimer’s Disease, neurological disorders, or non-diagnosed dementia, residents receive specialized care in a secure park-like environment.” She skimmed the list of symptoms that so perfectly described her father. ‘Ten things to look for…’ and ‘Important questions to ask your health provider…’
Making sure her father wasn’t watching, she took out the brochure to look again at the photos of contented elderly men and women with their uniformed caregivers. On the back was the Institute’s founder, Dr. Adrian Kessler, posed in a way that projected just the right combination of sincerity and professionalism. In his white coat and wire-rimmed glasses, he looked polished and confident, yet unpretentious and caring.
Her father’s personal physician, Dr. Wayne Peters, said Alzheimer’s promised a slow certain death, but if anyone were likely to find a cure in the foreseeable future, it would most likely be this man. To top it off, Dr. Kessler and his Institute were clients of the law firm where she worked and thanks to a personal request from her boss, Matthew Dawson, they were holding a room open for her father, but not forever. If she procrastinated much longer, it might be too late.
Speaking of which… Jo glanced at the time again. She knew when those clouds started dumping, traffic would back up. One thing Southern California drivers couldn’t handle was rain. She felt a rush of relief when she heard the key in the lock and the front door open.
“Hola!” Teresa called out, “Good morning.”
“Hello,” Jo called back.
Teresa was apologizing as she came in, putting away her purse and coat in the living room closet, saying something about car trouble, but Jo wasn’t listening. “Dad, I have to run. Teresa’s here if you need anything, okay?”
“Stop talking to me as if I were a child. Go play lawyer if you must. I’ll be perfectly fine.”
She gave him a peck on the cheek. “Bye, Teresa,” she yelled as she hurried out the side door into the attached garage. She sidled past her father’s aging black Mercedes—she’d hidden the keys from him months ago—and got into her silver Toyota.
Out on the road, the dark clouds let loose, pelting her windshield, and turning the asphalt into a slick black mirror. She waited on the signal-controlled on-ramp only to squeeze into bumper-to-bumper traffic. Recognizing the hopelessness of making the meeting on time, she called her direct line.
“Jo-Rinaldi’s-office-this-is-Beverly-may-I-help-you?” her secretary delivered in a single breath.
“Bev, it’s me. I’m stuck in traffic.”
“He’s not going to be happy.”
“I know, I know… I’ll get there as soon as I can.”