Between Rains, page 10
Pop stood. “Jared, you might want to go on home. Who’s going to take care of things on the line today? We need you there.”
Jared rubbed at his chin. “Alfredo will take care of everything, Pop.”
Wylie’s eyebrows pulled together in concern. “Alfredo?”
Jared patiently nodded and motioned for their dad to sit back down. “Alfredo’s got it covered.”
Their mother crammed her knitting needles inside her bag. “What time is our appointment?”
“Ten o’clock,” Rhett reported. “But they warned they were running a bit late.”
As if on cue, a woman wearing slacks and a white medical jacket appeared. “Mr. Duvall?”
Grace and Wylie stood in unison. “This is Mr. Duvall,” Grace said, motioning to her husband.
The woman gave them a warm smile. “I’m Jacqueline Reynolds, Dr. Michaels’s nurse practitioner. Let’s have you all follow me.”
Dr. Michaels’s office was on the fourth floor. Ms. Reynolds got them all seated in around a small conference table to the right of his desk. A credenza held a framed photo of what appeared to be his family—he was flanked by a wife with long blonde hair and two well-dressed children. The walls were decorated with framed licenses and awards, a few displaying articles from prestigious medical publications.
They waited only minutes before the door opened, and Dr. Michaels walked in. He greeted them with a wide smile, then held out his arm to Wylie. “Well, it’s nice to finally meet you, Mr. Duvall. May I call you Wylie?”
Rhett’s pop nodded. “It’s nice to meet you as well.”
“Yes,” Rhett’s mom added. “We appreciate you taking the time to see Wylie.”
Dr. Michaels slid into a place on the nearby sofa. He held up a folder packed with papers. “I’ve reviewed Wylie’s medical history, including all of Dr. Cannon’s records.” He looked directly at Grace. “He’s a fine physician, a colleague I greatly admire.”
That was a nice touch, Rhett thought. One that seemed to instantly put his mother more at ease.
“This is only a start, but I’d like to ask you some questions, Wylie. Would that be all right?”
Wylie nodded. “Sure, let’s get this over with. I have a lot of work to do back home and need to get to it.”
Dr. Michaels smiled. “We’ll hasten things up and get you back on the road as soon as possible. So, shall we get started?” He pulled his desk chair from around his desk and positioned it in front of Wylie, bringing with him a pad of lined paper and a pen.
Rhett listened intently as Dr. Michaels started with a battery of questions. Did he know what day of the week it was? He asked whether he was having any difficulty sleeping and tested him on his memory of a number of life details—his family’s names and birth dates, facts about the town and state he lived in, when he was married and where. Pop passed most of these with only a little hesitation.
Then came a series of questions designed to evaluate Pop’s recollection ability. Dr. Michaels recited a list of items and asked Pop to say them back to him. He struggled to do so. When asked to repeat them backward, he was unable to. Ten minutes later, Pop couldn’t recall even one of the listed items.
Finally, Dr. Michaels clicked his pen closed. “Well, that was extremely helpful. I tend to agree with Dr. Cannon’s initial assessment. There is a level of impairment going on. However, the issue before us is a very complicated one. Additional tests should shed some important light on what we’re dealing with.”
He went on to explain the medical process was a little like a puzzle. “The entire picture isn’t clear until all the pieces are in place.” He stood and clapped his hands. “So, let’s get with it, shall we? We’ll run a battery of important physical tests, and when we have the results, I suspect we’ll know a whole lot more.”
“Will we have results today?” Grace asked.
The doctor stepped near, placed his hand on her shoulder. “Well, sometimes these labs are a little backed up. It appears I pull a little weight around here, and so we’ve been moved to the front of the line.” He grinned at her with assurance.
That seemed to cement his Dr. Michaels’s merit in this mother’s mind. “Thank you. That’s—well, our family appreciates everything you’re doing for Wylie.”
Ms. Reynolds reappeared and led Wylie out. “You can wait here, but I suggest the waiting room at the end of the hall. There’s coffee and a television. I think you’ll be more comfortable.
Over the following hours, Rhett and his family sat and waited while Wylie was tested.
“Mama, do you want me to go get you some lunch?” Leila offered.
Grace shook her head. “No, I can’t eat right now.” She returned to staring out the window.
Jared threw Rhett a look Rhett could only decipher as disgust. There was no mistaking his younger brother still felt Rhett had overstepped and was responsible for their mother’s obvious angst.
Rhett understood. He, too, was anxious about what the findings might reveal. The internet provided a plethora of information, not all of it comforting. Of course, he had to keep reminding himself it was important not to assume every piece of information out there applied to his father’s situation. That was a dangerous road that could lead to unnecessary despair. On the other hand, there was also clear indication that waiting to properly assess and treat what appeared to be a cognitive decline in his father’s mental function also had negative consequences. Even if seen as the villain in this situation, he had done the right thing.
Several hours passed before Ms. Reynolds appeared and invited them back to Dr. Michaels’s office, where the doctor sat behind his desk, alone.
Grace’s face darkened with worry. “Where’s Wylie?”
Dr. Michaels gave her a reassuring look. “Your husband is resting in another room. They are bringing him dinner while I speak to you privately.
Rhett’s gut clenched. Before he could open his mouth to speak, Jared ran his hand through the top of his hair, asking the question on Rhett’s mind. “Then, it’s bad?”
“Well, it’s extremely good that we’ve assessed Wylie and can establish a plan.”
The statement might normally give Rhett some level of pleasure. He had been vindicated. But he could take no pleasure in the look on the doctor’s face. Bad news was coming. He braced himself.
Dr. Michaels invited them to all take a seat so he could further explain. “We put Wylie through a number of significant tests today—an MRI, CT scans, and neuroscience brain mapping. We ran a series of blood cultures and further evaluated his cognitive state, including some special tests designed to establish his mental state. Patients suffering from dementia often struggle with various levels of psychopathologies, like depression and anger. And we ran tests to rule out other contributing factors, such as vitamin deficiencies or Lyme Disease.
“What did you find?” Rhett asked.
“While there is no way to definitively establish the root cause of Wylie’s issues, the tests have given us a window into information that has led me to rule out Alzheimer’s disease.”
Grace immediately buried her face in her hands. “Oh, thank God.”
“Then what is it?” Jared demanded. “Why is Pop forgetting things? Like his birthday?” He looked to the others. “Remember, he didn’t even remember his birthday party.”
Dr. Michaels’s expression filled with sympathy. “We have reason to believe Wylie is suffering from what’s called Lewy body dementia.”
“What’s that?” Leila asked, her lip quivering.
Dr. Michaels placed his forearms on his desk and leaned forward. “Lewy body dementia, also known as LBD, is a type of progressive dementia that leads to a decline in thinking, reasoning, and independent function.”
Rhett rubbed his sweaty palms across the top of his jeans. “Isn’t that what Alzheimer is?”
“The symptoms are very similar, but the variable is the cause. In LBD, abnormal deposits of alpha-synuclein protein damage brain cells over time.” Dr. Michaels explained.
“What does all that mean?” Grace asked, wiping at tears.
“It means you made the right decision bringing him to the Brain Institute. Our team is one of the best. We’re committed to guiding your family through this diagnosis and what is ahead.” He leaned back in his chair. “Dementia is an umbrella that covers many types of cognitive digression. Now that we have determined the likely cause, there are many medical trials and medications we can offer that will be very effective.”
“In curing our dad?” Leila asked.
“There is no cure,” Jared said quietly, staring at the carpet while leaning over with his forearms on his knees.
“I’m afraid he’s right. The interventions we offer won’t be a cure, but will serve in slowing the progression. For the patient, having dementia is like Christmas lights in your brain begin to flicker and then eventually go out. With medical intervention, we’ll slow the number of lights that cease to operate.” He paused, letting them take in what he’d said. “Nobody wakes up the day after diagnosis and is at end stage. This disease is a progression. The right meds can slow down the advancement. Our job is to find the right combination. Wylie will be able to do many of the same things he’s always done, he’ll just do them differently which means figuring out how to overcome the obstacles.”
He focused his attention on Grace, the way her hands trembled while folded in her lap. “When our patients encounter a bump in the road, they have two choices. They can move forward or stay stuck. In layman’s terms, having dementia feels like making a list of everything you can do and then crossing a few items off every few months. Our job is to help Wylie slow the number of items he has to cross off.”
“I—I’m not sure I can…” Her voice drifted off as emotions overtook her composure.
Seated beside Rhett, his mother’s face crumpled before she dropped her face into her hands and sobbed.
14
None of them spoke while crossing the lobby and walking across the parking lot out to their cars. Clearly, each of them was trying to absorb the mountain of information provided and settle the fear that came with this diagnosis. There were so many details, and many more possibilities than probabilities.
They learned the rate of progression for Lewy’s varied widely. On average, people with this disease lived between three and eleven years after diagnosis, but some survived twenty years or more. The degree of impairment at diagnosis could affect life expectancy.
After meeting with the family, Dr. Michaels brought in Wylie and delivered the news. The doctor explained Wylie was considered to be in stage three of seven levels of decline. He’d suffered memory loss, though still somewhat mild. There were changes in his ability to concentrate and make decisions. While still able to function normally from a physical standpoint, it wouldn’t be long before impairment would start—tremors, risk of falling, and even the possibility of choking. The projected symptoms were sobering.
Rhett learned that some of the information was already known to his parents. While their understanding had been sketchy, they had sought out additional information on their own prior to today. Rhett suspected Jared had orchestrated some of that, and the idea he’d been cut out of the process earlier continued to anger him.
Given Pop’s future, that was over. Starting today.
Deep inside, Rhett knew he could never return to Chicago, at least not for some time. Sure, the decision would come at severe personal cost—staying longer than he’d intended already had—but what choice did he have? There would never be an instance where he would turn his back and not be here to support his parents when they needed him most.
Rhett tried not to think of the distant future, of what a world without Pop would look like. He couldn’t stomach the thought of the man he so admired being reduced to— Well, he simply couldn’t go there.
What he could focus on was making sure his family and the business his dad had fought to build were secure. The oyster farm needed strong leadership and would require financial direction. Emotional support for his mother and sister would be essential over the coming months. Even Jared, if the kid cared to admit it, could bear some brotherly support from someone who could keep him on a firm foundation.
Time would tell if his brother would walk on his own two feet without using chemical crutches to journey this hard path. Rhett’s money was on the idea the past would repeat and everything would fall on Rhett to shoulder—just as it always had.
The first thing Rhett attended to the following morning was to get out his laptop and type out his resignation letter. Every keystroke caused him to wince. It wasn’t easy to bid goodbye to a position he’d spent years cultivating, working long and arduous hours, giving up relationships and a lot of sleep in order to attain the respect and admiration of all in the financial industry—not only in Chicago, but nationwide.
Of course, Judith Sandidge’s recent decision had eased him into the idea of moving on from the company. Never had Rhett imagined taking an extended sabbatical and leaving the entire financial industry, even temporarily. Rhett swallowed against the lump building in his throat and hit send on the email without knowing when he’d be able to collect the pieces of the life he’d known and step on the treadmill back to success.
The next thing that needed attention was his place in Chicago. He reached out to Joyce Mintzas, the leasing agent who had helped him secure a coveted flat in an up-and-coming area filled with restaurants, shops and lively bars.
Not that he spent a lot of time there—he had a cot and a shower at the office and spent most of his time flying—but it was still his place. Joyce would secure a suitable tenant to sublet who would appreciate the fact it came completely furnished. Her firm even offered to pack up his personal belongings and move them to storage, canceling the need for him to make a trip back.
With the urgent tasks now accomplished, Rhett closed his laptop and headed downstairs to find the house empty. “Mom?” he called out. “Pop?
It was then that he noticed his parents standing out on the lawn. His mother’s head was folded against Pop’s shoulder, and he was gently patting her back and whispering something against her ear.
The sight squeezed his heart, and he had to look away. His parents were two of the strongest human beings on the planet. Seeing them like this—so reduced by their circumstances—caused Rhett to choke back the onset of tears. He cleared his throat, swallowed hard, and pulled his phone from his pocket.
He scrolled past Ben’s name in his contacts, pausing briefly at Cam’s name before thumbing on down until he landed on Diane. He took a deep breath and pressed dial.
She picked up on the second ring. “Hello?”
There was a lightness in her voice and instantly, he felt better. “Hey, Diane. It’s me, Rhett. You have time to meet me somewhere and talk?”
He was unsure why he felt the need to reach out to Diane, why he hadn’t asked Cam and Ben to meet him and throw down a few beers. The only answer he could come up with was that in the short time they’d spent reconnecting, he’d learned Diane was a great listener. Spouting his troubles was certainly not his style. Still, he needed to talk to someone. Besides, he wasn’t in the mood to yuck it up with the guys. Not to mention the fact Rhett didn’t want the details out there just yet. His parents deserved privacy while they wrapped their heads around this new reality.
For now, he’d keep the details of Pop’s diagnosis quiet. Upon his urging, Jared and Leila had agreed. Pop was a proud man. He wouldn’t want the entire town knowing what he suffered and what was ahead. He was no victim. The smaller circle of those who knew, the better. At least for now.
Diane suggested they meet at the Ebb Tide Nursing Home out on the lawn. She volunteered twice a week.
The veracity of his immediate negative response surprised even him. “I’m sorry. It’s just—well, I’d rather meet somewhere a little—”
Diane broke into his explanation. “No worries. We can meet where ever you like.”
He could hear something in her voice, confusion—or, perhaps a bit of judgment? It wasn’t like that. How could he possibly explain he had nothing against hanging around the residents of Ebb Tide? That was most certainly not how he felt. He simply couldn’t—well, how could he watch those people, knowing that same full-time nursing care was likely in his father’s future?
He’d rather chew on broken seashells.
They agreed to meet at her place. “I’ll fix us a bite of lunch,” she told him. Then, as if sensing his mood and the need to be alone, she added, “Stacy is helping my mother out at the Whale Museum today. We’ll have the place to ourselves.”
Diane lived at the end of Starfish Lane, the road that extended past New Hope Church. Her modest house was light yellow with a covered porch and white shutters, tucked on a tiny plot surrounded by a thicket of pine trees and ferns.
Rhett pulled into the driveway and parked. He glanced in the rearview mirror, amazed at how tired he appeared. He’d had a few sleepless nights lately, and the lack of rest had taken its toll.
Diane’s sidewalk was lined with flowers. He wasn’t sure of the names, but he recognized some as being the ones his mother had planted in the pots outside the doors leading to the retail store at their place out on the bay—brightly colored petunias and marigolds and tiny blue flowers his mother called lobelia. He stifled a chuckle, surprised he could recall that insignificant fact. He’d never considered the gift of being able to store and recall information, until recently.
Rhett climbed the steps onto the small covered porch and lightly rapped on the white door. It instantly opened and he was met with the image of Diane standing there wiping her hands on a dishtowel.
“Come in,” she said, motioning him inside with a bright smile. She wore white jeans and a T-shirt tucked loosely at her waist. She looked beautiful, standing there with her blonde hair tied back. “I hope you like crab salad. I’m afraid it’s all I had.”
