A 1,000-word excerpt from the manuscript

Alzheimer's was ricocheting around the corners of my brain like a billiard ball searching for a corner pocket. What in the hell was this lethal disease that chops and cooks the neurons of a healthy brain into chop suey, leaving its victim a hopeless vegetable? I was about to get a first-hand glimpse of its awful devastation.

After finding 220 Normandy Drive in Addison, Illinois, a village of 32,600 people in the suburbs west of Chicago, I braked my 1990 white Nissan Stanza alongside a curb behind a beige minivan. I didn't like the idea of parking on the street so close to an intersection. My car would be such an inviting target to be sideswiped. I got out of the car and headed for the front door of a small ranch house on a corner lot. The neighborhood appeared to be of modest income, with many of the houses resembling the one I was visiting. Carrying my plastic sack containing my hastily packed lunch and a book to read, I was more than a little apprehensive. This was only my second "patient" since I had become a Hospice volunteer two months ago. My first patient died four days earlier, and I had just been to his funeral.

A typical Hospice patient is given a life expectancy of six months or less and is literally sent home to await death. In my Hospice volunteer training, I learned that the role of a volunteer is unique with each patient. You may be called upon to listen to the patient talk, to keep the patient company, or merely to relieve the caregiver. A volunteer typically visits a patient's home once or maybe twice a week, with the duration of the visit varying, depending on the volunteer and the patient's needs.

Mike, my first patient, had lung cancer but loved to talk, even though at times he spoke with great difficulty, punctuated by a racking cough. I had visited his home on six separate occasions, each time sitting for several hours listening to him relate highlights from his life. He had been so grateful that he had found a fresh pair of ears to listen to his exploits growng up as a child and serving with the Air Force in the Southwest Pacific during World War II. He was a tail gunner on a B-25 twin-propeller attack bomber. Mike's wife, his caregiver, didn't want to leave him home alone, and my visits permitted her to get away for several hours at a time to run errands, to get her hair done, and to visit the doctor about her own physical problems.

Virginia, the Hospice social worker, had called me last evening, wondering if I would visit the Addison address at noon today and sit with Gladys Kujawa, an Alzheimer's patient, a woman of 70, to permit her husband, Joe Kujawa, her caregiver, to attend a meeting. She advised me to bring something to read, because I would have little to do.

At the very most, she said I would likely have to give the patient a few drinks. She said the woman was in an advanced phase of Alzheimer's and was unable to communicate. I would be relieving a nurse's aide and would have to sit in attendance with the patient until about 3 o'clock or so, when her husband would return from the meeting.

I looked at the house. About half of the exterior was a brown brick and the other half was a creamy light-green aluminum siding. I figured it probably contained two or three bedrooms, a living room, kitchen, and a bath. I wondered if it had a basement. Some red tulips bloomed brightly in a bed near the front porch, a simple concrete slab with two steps bordered by wrought iron railings. The railings had been painted the same shade of green as the siding. I walked up and glanced inside through the storm door glass. I felt my stomach sink. I saw a bed in the living room and apparently my patient on the bed. I knocked on the door and then, quickly figuring that maybe the nurse's aide wouldn't hear my knock, I pressed the doorbell button. I was startled to hear some rather loud chimes play a shortened version of "Yankee Doodle."

Seconds later a black woman appeared at the door. Her white uniform contrasted sharply with her dark skin. She was about my height, 5 feet 8, and probably weighed in the area of 180 pounds.

"Hi. My name is Joe Schrantz. I'm a Hospice volunteer and am supposed to be here at noon."

I was going to say more, but she cut me off with, "Hi. Come on in. My name is Hazel." She was chewing something while she talked.

"You must be the nurse's aide."

"Yes, that's me," she said, still chewing.

I opened the aluminun-framed storm door and stepped inside as Hazel went back to a high-backed, green cushioned chair in a corner to the right of the door. She sat down and set the chair to rocking slowly. I glanced quickly at the bed and its occupant. The head of the bed was elevated slightly above the horizontal, with the patient's head resting on a pillow. The woman's head turned slowly back and forth, and she seemed to be mumbling something incoherent. She appeared to be looking about at random, at nothing in particular.

"So this is Gladys," I said. "Boy, she seems to be pretty bad off, doesn't she?"

"Yes, she has Alzheimer's real bad," she said, stretching out the word "bad." She reached down with her right hand, picked up something, and put it in her mouth.

"She apparently can't communicate at all?"

"No. Well, every now and then she responds a bit. A little while ago I spoke to her and she seemed to answer me," Hazel said, looking up from the clipboard on which she was writing. She reached back down and again put something in her mouth and continued to chew.

Still carrying my plastic bag, I walked around to the right side of the bed and looked at the patient.

"Hello, Gladys," I said softly, smiling.

She looked at me momentarily, and then her vision left my face and drifted aimlessly about the room. She was making a guttural noise, alternating with a high-pitched undertone of syllables that only slightly sounded like words. Her bare arms and hands were in a constant slow motion, slightly resembling a musical conductor directing an adagio movement. She obviously didn't know if I were there or not. I spoke to her several times again and received the same response: nothing.