The neurologist had downcast eyes and a sad voice. She was in her forties and I wondered if her melancholy stemmed from so often being the bearer of bad news to her patients. She dealt with strokes, Alzheimer’s, dementia, multiple sclerosis, epilepsy, Parkinson’s, all the heartbreaking neurological maladies that change lives for the worst.
I was seeing her because both my father and grandfather had Alzheimer’s and required intensive care until their deaths. I had taken in my dad after my mother died and, as his condition worsened, I realized I was woefully unprepared for the demands the illness made. A close friend had told me she thought I had memory issues. I have no family left; if I am at risk, I need to make the necessary plans.
When I went to my GP, she asked me how my year had been, and I responded, honestly, that though there had been good moments, 2017 had been horrible, marked by loss, depression and sorrow. She examined the computer screen listing my various health issues over the past couple of decades. Then she asked me to tabulate the number of chemotherapy sessions I’d undergone since being diagnosed with cancer. I did a quick calculation—thirteen surgeries, each of which called for six follow-up chemo sessions. Then there were the preventative sessions I’d recently decided to end. All told, I thought I’d undergone chemo between seventy-eight and ninety times over six years.
She asked, “Have you ever heard of chemo brain?”
I had not.
“With that much chemotherapy, there’s a pretty good chance your brain will be affected, at least temporarily. Memory loss or confusion isn’t uncommon.”
Later, back home, I did a little internet research, something I stopped doing a while back when it came to cancer—too much bad information is out there. I do trust the Mayo Clinic, however, and according to its website, “Chemo brain is a common term used by cancer survivors to describe thinking and memory problems that can occur after cancer treatment. Chemo brain can also be called chemo fog, chemotherapy-related cognitive impairment or cognitive dysfunction.
“Though chemo brain is a widely used term, it’s misleading. It’s unlikely that chemotherapy is the sole cause of concentration and memory problems in cancer survivors. Researchers are working to understand the memory changes that people with cancer experience.
“Despite the many questions, it’s clear that the memory problems commonly called chemo brain can be a frustrating and debilitating side effect of cancer and its treatment.”
So what we have is empirical knowledge, but it made sense.
I mentioned this to the neurologist, and she nodded. “Certainly a possibility,” she said.
She put me through a twenty-minute cognitive test—repeat numbers in and out of order; remember a series of words given at the beginning of the test. I didn’t know the day’s exact date, but then again I seldom do. Did I have trouble recognizing people? I said I sometimes remembered names but forgot faces. She said, “Ha ha.”
I told her that on one or two occasions while driving a familiar route, I’d become disoriented and had to stop to get my bearings. She nodded and scribbled something on her pad.
I drew a cube; I connected numbers to letters and vice versa; I did random word associations; radio and newspapers? Communications. Orange and cereal? Food.
She scratched the bottom of my feet, asked me to clap my hands whenever she said ‘A’ while reciting other random letters. I was given thirty seconds to come up with as many words beginning with F as I could. The first word I thought of was ‘Fuck’ but I didn’t say it. Fruit, flame, fame, ford, final, filial, fearsome… Then I choked. Surely there are more than seven words starting with F in the English language! I switched to French and rattled off a dozen words in a few seconds.
She said, “Do you do that often? Switch between French and English?”
I told her I did so when I couldn’t find the right expression in one or the other language.
Finally, she said, “You passed all the tests…” She paused.
I’ve discovered that when doctors pause while giving you a diagnosis, a but is sure to follow.
“But,” she said, “The disorientation is a bit of a concern.”
I thought, Crap. I shouldn’t have mentioned that, then felt silly for even having such a notion.
“So let’s schedule a brain scan for you. Just to make sure.”
It’s set for two weeks from now. I’ll let you know the results if I remember them.