Making Rounds and Oscar (2010) (9 page)

CHAPTER ELEVEN

"There are two means of refuge from the miseries of life: music and cats."

ALBERT SCHWEITZER

THE FERRETTI HOUSE LOOKED LIKE ONE OF THOSE
spreads you'd see in
Architectural Digest.
Situated on one of North Providence's many hills, the townhouse faced south, with a commanding view of the city through large picture windows. The layout was open and airy as one room flowed seamlessly into another. The home was decorated with modern furniture, with every surface spotless, every corner clean and well lit. Bookshelves and artwork adorned every wall.

"This was where my husband and I were going to retire," Jeanne Ferretti said to me as she gave me the tour that winter afternoon. "He loved it here."

She escorted me to the kitchen table and we sat down.

"I want you to look at this," she told me, placing a three-ringed binder in front of me on the table. "My husband was a very open person. We didn't have many secrets, but he did have a drawer where he kept his work journals. That was his private place and I respected it. It was six months after his death before I got up the nerve to look through them."

I opened the front cover of the binder and looked at the first page.

dear--

--GOD

thank--

you--

I didn't know what to make of it.

"It seems kind of strange to be coming from someone who was losing everything," Jeanne said. She was standing by the window as I sat at the table. "Turn the page."

There, similarly arranged, were three words:

JEANNE

Missy

SweetIE

"Those are nicknames he gave me over the years," she said. Terms of endearment.

I flipped to the next page and found the days of the week, Monday through Sunday, printed in block letters, one on top of the other. It was like looking at a child's primer, but one that captured some element of Lino's life and his fight against his disease. On one page the alphabet was written out twice, printed first and then written in script. There was another page of dates that had been important to him, including his anniversary, his son's birthday, Independence Day, Thanksgiving, and Christmas.

I stopped to study the next page. It was a crib sheet, the kind a grade-school child might produce in preparation for a test. Printed on the page were the answers to questions commonly found on memory examinations: the date, the season, the day of the week, the names of the president of the United States and the governor of Rhode Island.

I felt odd looking at Lino's cheat sheet, as if I were prying. I looked up at Jeanne, who was staring out the window.

"He was trying to fight it," she said after a moment, "doing battle against his undoing. I never realized how hard he fought it until after he was gone. He just didn't let me in."

She looked down at the binder and pointed to the crib notes for his doctor's exam.

"I helped him with this one. He knew he was going to the doctor and was adamant that we study these questions. We went over it for hours before the appointment. I thought he threw it out."

Jeanne shook her head and smiled wryly.

"It didn't help, though. He still missed most of the questions. I think I almost started to cry when we were there in the doctor's office and he was missing all of the questions that he so diligently studied for."

As a frequent administrator of those tests, I was surprised. It had never occurred to me that people would prep for them, try to game the system.

Jeanne took the binder from me and flipped through its pages until she found what she was looking for.

"Look at this," she said, setting it back in front of me.

The page was taken from a musical dictionary. It contained detailed definitions of various musical instruments: trumpet, piano, saxophone, trombone, and others. On the following page was a schematic picture of all the major and minor chords. At the bottom, in Lino's shaky handwriting, was the date: January 2003--more than three years before he died and at least four years after the onset of his Alzheimer's.

"My husband's world was music," she said.

TO APPRECIATE
the full magnitude of a man, you need to know his whole story. Ercolino Ferretti--Lino to his friends--was born in the early part of the twentieth century to one of the thousands of first-generation Italian-American families new to the industrial suburbs of North Boston. His father scratched out a living on the railroad while his mother worked as a seamstress in one of Boston's many factories. It was a hard life, the kind shared by many of the immigrant families that built this country.

Over the course of his eighty-seven years, Lino escaped work in the factories by becoming the very definition of a renaissance man. He was a musician, and he learned to play a number of instruments with ease. Though the army temporarily took him away from his passion, Lino returned to his love of music when he returned home after World War II. He attended the prestigious New England Conservatory of Music, where several of his teachers proclaimed him one of his generation's most talented composers.

Pushing the boundaries of modern music, Lino explored complex compositions. But his pieces required 200-plus-piece ensembles, and that presented logistical problems. He needed a new framework for his music, an outlet for his unorthodox compositions. He found that platform in the developing world of computers.

Though he may not be a household name, Lino Ferretti was a pioneer. Had he pursued more conventional compositions or become an orchestral conductor as his teachers had suggested, he might be more famous today. Instead, he launched himself into computers when they were still large enough to fill a room. He taught at MIT and lectured around the world, discussing his findings with like-minded innovators. Lino was right about computers as a forum for music. Anyone who powers on a PC today or listens to an iPod knows just how much music has gone digital. But few of us know how much his research helped to make that all possible.

Lino had a curious and nimble mind that allowed him to keep up with the rapidly changing world of computers. He remained active in that field even after he retired from university life.

Then one day he was stumped.

"How do I log on?" he asked his baffled wife one morning in 2001. Suddenly, the man who had performed works of startling complexity was thrown by a simple task. Yes, he had forgotten things, missed appointments, and there was that time he couldn't make out a check, but those lapses were always so easy to dismiss.

"He's just tired," his wife had said in the past, making excuses. "He's got a lot on his mind." But the morning that her husband couldn't turn on his computer was the beginning of the end for Jeanne. It frightened her, and she immediately sought medical attention for him.

When I initially met Lino in my office a few years after he was diagnosed, he was still able to carry on a conversation and function independently at home. Two years later he was in need of twenty-four-hour care. His final year was spent at Steere House, with Jeanne his constant companion.

"I wrote in his eulogy that music was his love, life, and passion." She had moved now from the window to my side. She pointed to the page containing the musical definitions of common instruments. "This is what the disease did to him. To see the erosion of his intellect and creativity, to see it come to this...It was the hardest thing to endure.

"I want to play you something," Jeanne said. She walked across the adjoining living room to the stereo. The sound of a jazz quartet filled the air.

"My husband loved jazz," she said over the wail of a saxophone. "This was one of his favorite records. Even as Lino's disease progressed, he never lost his love of music."

As we listened in silence to the sound of four musicians swinging together, I thought about all of the patients I've cared for with dementia. Then I thought of my newborn daughter at home, barely six months old. There's something about music that is innate, something seemingly immune to the ravages of age-related diseases. As many new parents learn, music is sometimes the only way to comfort a screaming child. I thought back on the many late nights my daughter and I had shared recently with Johann Sebastian Bach, how the music soothed her as I rocked her to sleep. The effects can be similar for patients with dementia. Music, it seems, represents a way in--a means to communicate.

"When we lived here together, before he went to the nursing home, we would start each day with a Bach cantata or a Mozart piano concerto," Jeanne recalled. "He loved it, all of it. By the time he went to the nursing home, he no longer knew how to turn the CD player on, but I would put it on for him and he would sit in his rocking chair and listen with his eyes closed, lost in the music.

"One of the things I found most interesting about my husband's disease was that even toward the end of his life he responded to music. Here was this man who could no longer do much of anything. Sometimes he would get agitated. If you put on a jazz record, though, he would just sit contentedly in his chair for hours."

She looked at me. "Why is that? Why is Alzheimer's such a strange disease?"

"My suspicion is that certain ingrained memories never really go away," I said. "I'm convinced that there are some visceral responses that are still accessible, things that are never completely lost. For example, I know that at the end, Lino no longer knew your name. Nevertheless, I am quite sure that he knew you were important to him."

Jeanne nodded. I suspected that this was reassuring to her, or maybe it just confirmed what she already believed.

"Maybe you're right. Still, I wonder why that is?"

"I think that many of the memories are still there. They just aren't readily available. It's kind of like a computer hard drive that crashes but still maintains the files; you just can't get to them. But some things get through. I think this is why so many of the residents respond to babies, and animals like Oscar."

The mention of Oscar made Jeanne smile. "You know, my husband always loved animals, particularly cats. We had two Siamese cats before our son was born. They were our babies. Unfortunately, our son ended up being terribly allergic, so we didn't have any more after they died."

"Did Lino respond to Oscar?"

"Sure, sometimes he'd even follow the cat around the unit."

I pictured the Lino I knew--infinitely curious, filled with wonder--stalking the elusive Oscar. This was not a cat known for cuddling up with residents, remember, and I have to think that our favorite feline must have felt annoyed to find himself the object of Lino's scientific curiosity. For Lino, losing his memory, his faculties, but never his love of music, Oscar might have seemed just out of reach, that last lost chord. Or maybe he just liked chasing animals.

"Was he there at the end?"

"Yes, I think Oscar knew before the nurses did. My husband developed pneumonia. As you know, he started sliding pretty quickly and we didn't want to treat him aggressively. The day he died, I came in the afternoon. He was doing poorly, but hanging in there. One of the nurses came in and told me that she thought that Lino still had time and that I should go home. I agreed to go home to shower and eat dinner, but they called me back almost immediately. When I came back I realized that things were different. I went into the room and saw that they had dimmed the lights. Then I saw that Oscar was there, sitting on the bed holding his own private vigil.

"I guess I knew then. I'd heard about the cat from others on the floor. I called my son and told him to come in. It wasn't until he arrived that I remembered his allergies. I asked him if he wanted me to send Oscar away."

She smiled ever so slightly.

"My son was definitive. 'No,' he said, 'Dad loved cats and would have been happy with Oscar on the bed with him.' He told me he would be okay."

We sat in silence for a while, listening to the music again. Jeanne looked out the window at a bird that had landed on her feeder just outside, but the feeder was empty, and the bird didn't stay long. As it flew off Jeanne looked back at me. Her expression had changed; the wistful memory of her son was replaced by a look of grave seriousness.

"To see someone you love go away like my husband did...that's the hardest thing."

Jeanne wiped her brow with the tissue she had been holding.

"I'm so grateful for the time we had, the good times before...I wouldn't trade those years for anything, but I still haven't gotten to the point where I can see him the way he used to be before the illness."

There was nothing I could add. I was there to learn and listen.

After a moment she said, "I suppose that's what marriage vows are all about--in good times and bad?"

She looked over at the digital frame that sat on her kitchen table. Pictures of her grandchildren came in and out of view, a twenty-first-century slide show.

"My son gave me that for Christmas," she said. I looked over and saw a picture of her grandson, seemingly suspended in midair on a sled, his face a study in exhilaration. It was the kind of photo parents and grandparents everywhere treasure, the purity of childhood with none of the complexities that come later in life.

She pointed at the image and looked back at me.

"Enjoy these times," she said, her final instruction of the day. "They're gone in a blink of an eye." Then she got up from her chair to grab some more cookies from the kitchen counter.

"Now, enough about me and my husband. Tell me about your kids."

WHEN I WALKED THROUGH
the front door of my house that night, I was greeted by the high-pitched squeal of my son, Ethan, who raced out of the kitchen, arms open wide to greet me. His face contained the most unalloyed expression of joy imaginable: All I had to do to make his day was come home. I picked him up and squeezed him tight.

"How's my big boy?" I said, and after kissing my cheek he launched into a breathless and slightly incomprehensible explanation of everything he had done that day.

"Daddy, you'll never guess what I saw today at school."