Page 76 of Dream Lake

“They were nonalcoholic drinks,” Alex said.

“Oh, of course,” Maggie said brightly.

The ghost snorted. “She’s not buying it.”

With a self-mocking smile, Alex took a sip of bitter black coffee. Given his past, it was entirely reasonable to think that he might get drunk on such an occasion. And Maggie, being a sweetheart, was trying to handle it in a way that would spare his pride. “I’m not talking to myself, by the way,” he said. “There’s an invisible guy sitting right beside me.”

Maggie laughed. “I’m glad you told me. Otherwise I might have accidentally sat on his lap.”

“Feel free,” the ghost said without hesitation.

“He wouldn’t mind,” Alex told Maggie. “Have a seat.”

“Thank you, but I’ll leave you and your friend to your conversation.” She bent to kiss his cheek. “Drink the whole cup of coffee, okay?” And she left, taking his half-finished Coke with her.

Eighteen

When Alex went to the Dream Lake cottage on Monday morning, the home-care nurse, Jeannie, met him at the door with an expression that instantly warned something was wrong.

“How’s it going?” Alex asked.

“It was a tough weekend,” she said quietly. “Emma had a downturn.”

“What does that mean?”

“The term for it is TIA. Transient ischemic attacks. Tiny blockages that stop the blood flow to the brain. They’re so minor that you may not notice any stroke symptoms, but the damage adds up. With the kind of mixed dementia that Emma has, there’ll be a steady decline with these occasional downward steps.”

“Does she need to see a doctor?”

Jeannie shook her head. “Her blood pressure is fine, and she’s not having any physical discomfort. Many times after a step-down, a patient will show signs of temporary improvement. Today, Emma’s doing well. But as time goes on, the moments of confusion and frustration will last longer and happen more often. And the memories will keep disappearing.”

“So what exactly happened? How can you tell that a TIA occurred?”

“According to Zoë, Emma woke up on Saturday with a slight headache and some confusion. By the time I got there, Emma was determined to make herself breakfast—she insisted on frying an egg at the stove. It didn’t go well. Zoë kept trying to help her—put a pat of butter in the pan first, turn the heat lower—but Emma was having a tough time trying to do something she’d always done, and that made her frightened and angry.”

“She took it out on Zoë?” Alex asked in concern.

Jeannie nodded. “Zoë is the most convenient person for her to vent her frustration on. And even though Zoë understands, it’s still stressful.” Jeannie paused. “Yesterday Emma repeatedly asked for the car keys, messed up Zoë’s computer when she tried to get on the Internet, and kept arguing with me to get her some cigarettes.”

“Does she smoke?”

“Not for forty years, according to Zoë. And cigarettes are the worst possible thing for someone in Emma’s condition.”

The ghost, who stood just behind Alex, muttered, “Hell, let her have them.”

The nurse wore a resigned expression. Alex couldn’t help wondering how many times she had accompanied patients along this path, watching their inevitable deterioration, steering families through the pain and confusion of losing someone day by day. “Does it ever get easier?” he asked.

“For the patient or—”

“For you.”

The nurse smiled. “You’re very kind to ask. I’ve been through this with many patients, and even knowing what to expect… no, it doesn’t get easier.”

“How long does she have?”

“Even the most experienced doctors can’t predict—”

“In your personal opinion. You’ve been in the trenches, you probably have some idea. What’s your take on how it’s going to progress?”

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