That was the beginning, except of course it wasn’t the beginning.  That was the event that led to a diagnosis of Lewy Body Dementia.  At what point did it begin?  Was it when he found calendars confusing?  When shapes sometimes appeared in his peripheral vision?  When he started shuffling?  Or years and years ago, when he sometimes stopped in the middle of a sentence and couldn’t find the rest, or when he started thrashing and shouting in his sleep?

David had known, and had told me, that something was terribly wrong: he was struggling with schedules and having trouble giving library instruction.  I knew that he sometimes forgot to close his garage door and sometimes left groceries on the counter; he would call to ask me whether he could eat the yogurt that had sat out all night.  He’d been anxious and easily distracted for forty years.  Fiona and I had concluded long ago that he had an anxiety disorder and undiagnosed ADHD, so none of this was new or surprising.  He’d also read every headache as a sign of stroke and every pain as a tumor as long as I’d known him – so I was accustomed to deflating the rhetoric of crisis.

A full year before the potato hallucination, though, I saw at close hand the increase in his anxiety, forgetfulness, and confusion.  I was directing a study abroad program in London, and David joined me for the first two weeks.  We traveled there together.  It was as if he had never been through airport security and never boarded a plane.  Once we got to London, he couldn’t learn the way to the Tube station or navigate on his own.  He couldn’t unlock the door to our building or our flat.  He was afraid even to walk down the street by himself.  He’d wait for me in a coffee shop while I taught my three-hour class or attended orientation meetings, and he’d be vibrating with anxiety when I rejoined him. 

I tried pointing out landmarks and writing out directions.  I tried making lists of the Tube stops he’d pass on his way to a museum or park.  Nothing worked.  I’d bought basic flip-phone mobiles, but he couldn’t learn to use the phone.  I was frustrated and baffled and scared. 

David had been a tireless urban explorer, always the one to lead the way to the next museum or café.  He was anxious, yes, but he had – we both had – confidence in his mysterious ability to reach any destination.  I can navigate using a map, but it’s a laborious process that involves rotating the map one way and the other as I figure out the turns.  I still sometimes glance down at my thumb and index finger to reassure myself about which side is the left.  David had walked, and driven, like a human City Mapper.  He could exit from the interstate and find a building he’d read about, circle it once, and ease back onto the highway.  He could still find his way through familiar terrain in Minnesota, but no amount of effort could fix London’s streets and buildings on his mental maps. 

David took a short neuropsych exam after he returned to Minnesota, and the diagnosis was Mild Cognitive Impairment.