On Tuesday, March 26th, when Judy and I completed our semi-annual physical with our Primary Care Physician, Dr. Highlander, I explained Judy’s memory issues and asked for the name of a good neurologist. Concern showed on the doctor’s face as he gave me the name of Dr. Gravier, a prominent local area neurologist.

“He’s busy, but he is taking on new patients.”

When we got home, I called the neurologist’s office; when I explained to the scheduler why I wanted an appointment with Dr. Gravier, she asked, “What’s the nature of your wife’s problem?”

I described some of Judy’s memory issues. “She needs to be evaluated to find out the cause.”

“Dr. Gravier’s first available appointment is June 28th,” she said.

I calculated three months plus a week or two for the test results, then a consultation appointment came to almost four months for a diagnosis.

“Is there an earlier appointment available?” I asked.

“I have an opening with Dr. Aldrich Femsby for next Monday,” the scheduler offered.

I checked my calendar. “That would be the first of April,” I said. “We’ll take it.”

It didn’t occur to me that there might be a reason for Dr. Femsby’s early availability.

During our wait for her appointment, Judy didn’t mention that Alzheimer’s could be hereditary. If this thought occurred to her, she kept it to herself.

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On the way to Judy’s neurologist’s appointment, she sat on her side of the car gazing out the window. Then, she faced me. “What time is my appointment?”

 “9 AM,” I said. We just discussed the time this morning I thought.

Judy stared out the window. Then she asked again, “What time is my appointment?” She  sat there calmly waiting for the answer.

“9 AM,” I repeated.

In my mind, Judy’s questions reinforced my reasons for making this appointment. I needed to know if something was wrong with Judy so I could prepare for any challenges we’d face dealing with it.

In the neurologist’s waiting room, we filled out the new patient forms. Soon, a nurse came and led us to an examination room where Judy and I sat in chairs against the back wall facing the door. A gurney to the right buttressed up against the corner of the room; a blood-pressure cuff hung on the opposite wall over the end of the gurney. A small computer-like table hugged the wall to our left.

Dr. Femsby—tall, slender and fortyish, with graying temples and a slight paunch—entered and sat at the computer table facing us.

After a minimally civil greeting, Dr. Femsby launched into a scripted monologue. “I studied at McDill University in Quebec. I’m fluent in French,” he offered. “I took Latin before attending university.”

If this is Femsby idea on putting a patient at ease, he missed the boat I thought.

Dr. Femsby was studying his iPad. A little late for reviewing Judy’s new patient forms I thought. That’s strike one.

Judy scowled. She was thinking the same as I was.

The doctor picked up a reflex hammer from his computer table. “Move to the gurney and sit facing me.”

He tapped her right and her left knee for reflex action, then he moved back to his computer table.

I didn’t understand the purpose for this knee-knocking exercise. We were there to have Judy evaluated for memory issues.

“What day of the week is this?” Femsby asked.

Judy turned to face me.

“Tuesday,” I said.

Dr. Femsby looked askance at me. “I asked her, not you,” he scolded. “You keep quiet.”

This man is rude, I thought.Strike two!.

Judy sat quietly with her gaze lowered.

“Who is the President of the United States?” Femsby asked.

“Barrack Obama,” she answered promptly.

“What year is this?”

“Two thousand thirteen.”

“Who was recently seated as freshman Senator from Virginia?”

My jaw dropped. Did Femsby expect Judy to remember a political event that happened three months prior? I wagered that most people in the state of Virginia couldn’t name their senators to the U.S. congress, much less when they got there. If this was a test of Judy’s memory, the doctor failed.

“Does this happen often to…” Femsby glanced at his iPad, then he turned to face me. “Judy… not remembering major events going on around her?”

He doesn’t know Judy’s name! How could a neurologist come into an examination room to question a patient to figure out if she needed testing and not come prepared for the interview? I normally give doctors the benefit of the doubt, but not this guy. Strike three!

I explained Judy’s memory lapses in sufficient detail to ensure Dr. Femsby would recommend cognitive testing.

The doctor faced Judy. “I’m having you go for three tests,” he said. “A blood test to determine if there’s a B-6 and B-12 deficiency, an MRI to measure blood flow to the hippocampus, and an oral cognitive evaluation. This latter is a one-on-one test with our staff psychologist to find if there’s cognitive impairment.”

Judy sat staring at her hands. I could see she didn’t want any part of this testing. Then, she looked up. “Okay,” she said.

On our way out, changing neurologist was on my mind, but I scheduled Judy’s follow-on appointment with Dr. Femsby. I thought this to be the fastest way to get a diagnosis.

“We can schedule the blood work and the MRI on the same day,” the scheduler said. “I suggest doing the cognitive test on a different day. That cognitive test runs for five to six hours. You’ll be tired when it’s finished.”

Judy was quiet in the car. At home, she walked into the den, sat in her chair, and  looked up at me. “I don’t like Dr. Femsby,” she said.

This came as no surprise to me; I didn’t like him either. “Femsby can give us the results of the tests faster than anyone else,” I said. “Then we can change neurologists if you need one.”

The mistake I made when making this appointment was not accepting the offered appointment with the preferred neurologist, Dr. Gravier. I should have accepted the appointment and asked that Judy’s name be put on Dr. Gravier’s cancellation call list. If Judy were offered a cancelled appointment with Dr. Gravier, she would have had the best neurologists in the area. Having an excellent neurologist would have helped us navigate this journey in a more informed way, especially in the final stages of the disease.

My concern in doing this was that if I were on the golf course when that call came, I wouldn’t have had time to get home, pick up Judy, and get to the appointment on such short notice. The right thing to do would have been to stop all golf activities until the call came for a cancelled appointment. At the time, I didn’t realize how important having the right neurologist would be.