TURN OF MIND, by Alice LaPlante. Atlantic Monthly Press, 307 pp., $24.
'Something has happened. You can always tell. You come to and find wreckage: a smashed lamp, a devastated human face that shivers on the verge of being recognizable.
"Occasionally someone in uniform: a paramedic, a nurse. A hand extended with the pill. Or poised to insert the needle.
The opening passage of Alice LaPlante's first novel, a literary thriller about a 64-year-old retired orthopedic surgeon with Alzheimer's, establishes the crisp, super-intelligent, and brutally confused voice of Dr. Jennifer White, a narrator who will never herself fully grasp the story she reveals to us through images, reported dialogue, visions and excerpts from her notebook.
In this first scene, Dr. White finds herself in what she figures out is a police station. Why she is there, she has no idea. Later, she is back home, watching through the window as people dressed in black file into the neighborhood church. She asks the blond woman in her kitchen (her caretaker, Magdalena, whom she recognizes only occasionally) what is going on. Magdalena flips back a few pages in the notebook to show her a newspaper clipping: "Elderly Chicago Woman Found Dead, Mutilated."
The murdered woman is Dr. White's longtime best friend, Amanda O'Toole -- also her neighbor and godmother to her daughter, Fiona. Amanda died of head trauma, and four of the fingers of her hand were surgically removed -- a bizarre detail that makes the doctor a prime suspect. But she cannot even remember from moment to moment that her friend is dead, much less whether she did it, or why.
Told in brief, haunting paragraphs, the book is divided into four parts, tracking Dr. White's deterioration. In the first section, she still lives at home. She attends an Alzheimer's support group and goes through her own mail, although news of endangered pandas and whales is as bewildering as the 19 percent decrease in her financial portfolio. She receives disturbing visits from detectives, lawyers and finally the ex-husband of her murdered friend. She is sometimes violent, sometimes incontinent. By the end of this section, a girl and a boy she does not recognize have come to tell her she will be moving to the Memory Unit of an assisted-living facility.
The institution is not a pleasant place for Dr. White: a demeaning, confusing cuckoo's nest. "The woman with no neck is screaming again. A distant buzzer and then the muffled sound of soft-soled shoes on thick carpet hurrying past my door." As Dr. White's anger escalates, she wakes one day into a moment of clarity and a plan. She does not take her pills and manages to slip out the front door as a crew of painters arrives.
In the third section, the most lively and blackly humorous, Dr. White is on the lam, returning to her old neighborhood and workplace, performing medical examinations, sleeping on the streets with homeless people. This brief period ends quickly when she is nabbed by the detective investigating her case. She is incarcerated in a state mental institution; here it will end.
Throughout it all, Dr. White has flashes of crystal clear memory, particularly of episodes from the distant past and of the surgical and diagnostic minutiae of her profession. At other times, she cannot recognize her daughter and does not know if she herself is a man or a woman. Her son is often confused with her dead husband, which smooths his way as he finagles large sums of money to support his drug and other habits.
The idea of a narrator with Alzheimers is a daring one, and LaPlante is certain in her footing -- the verisimilitude here is unnerving. Weaving the existential mystery of dementia with the contrived mystery of a murder plot, she takes us into a world of gauzy shadows and scattered puzzle pieces. LaPlante makes sure that we fully understand the whole story at the end -- by which time the narrator understands very little indeed. The solution to the mystery is a little awkward, perhaps a little amateurish -- but the way in which it is revealed is remarkable.
EXCERPT: "Turn of Mind" by Alice LaPlante
A large sign is taped to the kitchen wall. The words, written in thick black marker in a tremulous hand, slope off the poster board: My name is Dr. Jennifer White. I am sixty-four years old. I have dementia. My son, Mark, is twenty-nine. My daughter, Fiona, twenty-four. A caregiver, Magdalena, lives with me.
It is all clear. So who are all these other people in my house? People, strangers, everywhere. A blond woman I don't recognize in my kitchen drinking tea. A glimpse of movement from the den. Then I turn the corner into the living room and find yet another face. I ask, So who are you? Who are all the others? Do you know her? I point to the kitchen, and they laugh.
I am her, they say. I was there, now I'm here. I am the only one in the house other than you. They ask if I want tea. They ask if I want to go for a walk. Am I a baby? I say. I am tired of the questions. You know me, don't you? Don't you remember? Magdalena. Your friend.
The notebook is a way of communicating with myself, and with others. Of filling in the blank periods. When all is in a fog, when someone refers to an event or conversation that I can't recall, I leaf through the pages. Sometimes it comforts me to read what's there. Sometimes not. It is my Bible of consciousness. It lives on the kitchen table: large and square, with an embossed leather cover and heavy creamy paper. Each entry has a date on it. A nice lady sits me down in front of it.
She writes, January 20, 2009. Jennifer's notes. She hands the pen to me. She says, Write what happened today. Write about your childhood. Write whatever you remember.
I remember my first wrist arthrodesis. The pressure of scalpel against skin, the slight give when it finally sliced through. The resilience of muscle. My surgical scissors scraping bone. And afterward, peeling off bloody gloves finger by finger.
Black. Everyone is wearing black. They're walking in twos and threes down the street toward St. Vincent's, bundled in coats and scarves that cover their heads and lower faces against what is apparently bitter wind.
I am inside my warm house, my face to the frosted window, Magdalena hovering. I can just see the twelve-foot carved wooden doors. They are wide open, and people are entering. A hearse is standing in front, other cars lined up behind it, their lights on.
It's Amanda, Magdalena tells me. Amanda's funeral. Who is Amanda? I ask. Magdalena hesitates, then says, Your best friend. Your daughter's godmother.
I try. I fail. I shake my head. Magdalena gets my notebook. She turns back the pages. She points to a newspaper clipping:
Elderly Chicago Woman Found Dead, Mutilated
CHICAGO TRIBUNE -- February 23, 2009
CHICAGO, IL -- The mutilated body of a seventy-five-year-old Chicago woman was discovered yesterday in a house in the 2100 block of Sheffield Avenue. Amanda O'Toole was found dead in her home after a neighbor noticed she had failed to take in her newspapers for almost a week, according to sources close to the investigation. Four fingers on her right hand had been severed. The exact time of death is unknown, but cause of death is attributed to head trauma, sources say.
Nothing was reported missing from her house.
No one has been charged, but police briefly took into custody and then released a person of interest in the case.
I try. But I cannot conjure up anything. Magdalena leaves. She comes back with a photograph.
Two women, one taller by at least two inches, with long straight white hair pulled back in a tight chignon. The other one, younger, has shorter wavy gray locks that cluster around chiseled, more feminine features. That one a beauty perhaps, once upon a time.
This is you, Magdalena says, pointing to the younger woman. And this here, this is Amanda. I study the photograph.
The taller woman has a compelling face. Not what you'd call pretty. Nor what you would call nice. Too sharp around the nostrils, lines of perhaps contempt etched into the jowls. The two women stand close together, not touching, but there is an affinity there.
Try to remember, Magdalena urges me. It could be important. Her hand lies heavily on my shoulder. She wants something from me. What? But I am suddenly tired. My hands shake. Perspiration trickles down between my breasts.
I want to go to my room, I say. I swat at Magdalena's hand. Leave me be.