Mum’s expression was as confused as I imagine my own was.
‘Alzheimer’s?’ she repeated. ‘No. We have nothing like that in our family.’
‘Are you saying I have Alzheimer’s? How is that even possible? I’m only thirty-nine years old, for God’s sake.’
The neurologist turned back to face Amelia. ‘The blood test we ordered was a shot in the dark, really – it was more to ruleouta diagnosis. But I’m afraid what it has revealed is unequivocal. You have a condition known as FAD, which stands for familial Alzheimer’s disease. It’s an extremely rare type of Alzheimer’s that affects only about one per cent of people who suffer from the disease. It’s a very specific anomaly caused by an inherited defective gene, which was why I asked if anyone in the family had ever suffered with similar symptoms: memory loss, forgetfulness, confusion. Can I ask about your father? I see from medical records that he passed away.’
‘He died in an accident over twenty years ago, and he definitely didn’t have dementia,’ I said. My response was pricklier than I’d intended, but I felt like we were under attack, and I’d gone straight into defensive mode.
‘Why are you so convinced this is what I have?’ asked Amelia. ‘Couldn’t your tests be wrong?’
The neurologist was clearly not used to families ganging up and refusing to accept his diagnosis. ‘We ran them several times. I’m afraid they’re conclusive. This particular mutated gene presents itself again and again in affected families. There isalwaysa traceable link from generation to generation. When someone has this faulty gene, they have a fifty per cent chance of passing it on.’
‘Well, there you are then. You’re clearly on the wrong track. Dad didn’t have this illness.’ I turned to Mum, expecting her to be nodding in agreement. What I didn’t anticipate was the tortured expression on her face as she turned towards the doctors.
‘My husband was adopted as a baby, so he never knew his biological family.’
The information seemed to float in the air, settling on everyone in the room like a contamination.
‘Well, okay,’ I said, already grappling for a solution. ‘That’s not an insurmountable problem. There’ll be adoption records somewhere. I know these things are sealed, but I’m sure, given the importance of finding out if this thing reallyisin Amelia’s genetic make-up, we’ll be able to get them unsealed.’
‘Not justmymake-up,’ Amelia said quietly.
I turned slowly towards her, amazed that it had taken me this long to grasp the implications of what the neurologist had said.Any child of an affected parent has a fifty per cent chance of inheriting the gene.If Amelia had this thing, then there was a chance that I did too.
‘Thereareno records of his biological parents,’ Mum said, her voice heavy with sadness. ‘Your dad was what they used to call a foundling. An abandoned baby. He was left in a cardboard box on a piece of wasteland. There’s no way of knowing if anyone in his family ever suffered from Alzheimer’s disease.’
I wasn’t aware that I’d sunk down on to a chair until I felt it beneath me.
‘We knew Dad was adopted, but why did no one tell us about the circumstances before?’
‘I wanted to, but he didn’t want you both to know.’
‘Why? Because right now it seems pretty fucking important that we know our own family medical history.’ Amelia was angry and I was only a step or two behind her.
‘He was embarrassed, Amelia. He didn’t want you to know he’d been unwanted.’
A long moment of silence settled on the room. Eventually, it was broken by the question the neurologist had been patiently waiting to ask.
‘Is it possible, in hindsight, that your husband had any of the early symptoms of FAD?’
‘No,’ I said, too quickly to have thought my answer through. ‘He died in a stupid accident when he…’ My voice trailed away.
‘…Forgot to check the time of the incoming tide. Dad drowned because he forgot to give himself enough time to get out of the cove,’ completed Amelia.
My eyes found hers and then my mother’s, as the implication of what we were saying finally struck home. For over twenty years, we hadn’t understood how Dad could possibly have made the stupid mistake that cost him his life. Could the reason he forgot to check the tide have something to do with FAD? Was that any more or less ridiculous than his own daughter walking on the mudflats in the middle of the night wearing only her nightgown?
Suddenly I began to cry.
‘His keys. The morning he left to go fishing in the cove, he couldn’t find his car keys anywhere.’
‘Losing objects like your keys or a phone is very often an early symptom of the condition,’ Mr Robinson said quietly.
Amelia’s eyes were filling with tears because she knew exactly what I was about to say.
‘Dad wouldn’t have gone fishing that day if I hadn’t stupidly helped him look for his keys. I was the one who found them. If I hadn’t, he wouldn’t have been able to drive to the cove, so it wouldn’t have mattered if he’d forgotten about the tide or not. He’d have been safe.’
Mr Robinson was shaking his head. ‘It’s impossible to be certain, but it sounds very much as though your father’s forgetfulness might have been a symptom of the early stages of FAD.’