We noticed. What we’d tended to view as blonde dippiness morphed into blatant repetition and bizarre forgetfulness. Several of us experienced her failure to show up at planned lunches. There were reports of missed appointments at hairdressers and manicurists.’ Carolyn reported that on the last girlfriends’ trip to the spa (an almost annual long weekend after tax day), Pam forgot to pack toiletries and underwear. Maybe that could happen to any of us growing-oldsters, but the oddity was Pam’s reluctance (amounting nearly to refusal) to purchase a toothbrush once she discovered the omission. When a few of us brought the memory subject up to Pam (over what turned out to be the last reserved lunch for which she showed up), she giggled and tossed her hair from side to side so it kept grazing her jawline. “Oh, I talked to the doctor about my forgetfulness when I saw him last. He laughed and said it’s completely common, at our age.” Several of us also see Lou – no way would he field a question about cognition like that.

Meanwhile, Duane was sliding too. The man continued to review and sort his photographs, the operas he attended, the cuisines he prepared, the films he screened (proud to use his TV as a monitor only – no cable or dish for Duane – informing us regularly about how many dozens of movies he was watching every week). But he started to exhibit nervous confusion when he entertained, and then he stopped giving dinner parties. The man who had regularly invited a half dozen friends to his home for a six-course all-homemade meal began to go months between hospitality. And he started misplacing nouns. That was happening to all of us of course, and at first we thought his vocabulary loss was normal but bothering him so much that he complained about it and that made it seem more frequent. But after awhile it became obvious that his lapse wasn’t just a name here and there or a weird word. Carolyn was part of a small group that attended another performance of La Boheme with Duane, and when he lost the word “usher” (“you know, the person who, who seats people”), she says she knew it was serious.

There are facts and there are theories. The facts are grim. Less than five years after Duane lost “usher,” his aphasia is almost complete. The well-read wit is silent. And that’s not all. Duane has lost most of his intelligence too. The man who used to do the Times Sunday puzzle in ink now struggles to complete the crossword in TV Guide. His twin met recently with his closest friends. Carolyn wasn’t present but I was consulted before and after, because as far as any of us can tell, I drafted Duane’s last will, back when we were at the same firm, shortly after his wife died. The decision was made to take his car keys and move an attendant/housekeeper in with him; no one could bear to remove him from the house he has loved for so long.

Pam was houseproud too, but she is no longer at home. In the same five years her memory became so degraded that not even Al, besotted with Pam and experienced at nursing a declining spouse, could take living with her any more. He and her sons recently installed her in a memory care facility. When we learned that, a few of us visited her.

It was dreadful. Al had warned us in a semi-coherent, almost-manic way (I think he’s been alone with the situation for too long, and is desperate to talk, but Carolyn suspects him of something). “She may act like she recognizes you, but she won’t have any context for the relationship,” he said. And he told us Pam had been neglecting hygiene (“It’s been over six months since she had her hair cut or colored,” he said, triggering a conjecture that Al had an unhealthy obsession with the blondeness of his wife).

He understated. As our eyes adjusted to the dim light in Pam’s room,we were staggered at how she looked. Haggard doesn’t do the description justice. Her hair hung in lank dull grey clumps. Her nails were ragged and stained. But the worst aspect was the blankness of expression in her eyes. The only life they exhibited, besides moisture, were fleeting moments of obvious confusion…windows into a brain trying to find perspective for her location, her condition, and us.

The theories are still Carolyn’s. The rest of us shake our heads, murmur statements about doing something to help, and thank our fortunes, stars, God that it isn’t happening to us, yet. Carolyn considers their cases closed – even she thinks nothing can be done now – but she won’t let up on her idea that Duane and Pam brought their early mental demises on themselves. “If only they had been willing to reassess their lives and make fresh decisions,” Carolyn says, “Duane could have learned to use his body for exercise and his heart for love. And Pam could have dropped that ridiculous veneer of culture and allowed real thoughts and feelings into her life. I’ll bet neither would be as gone as they are if only they’d tended their souls…”

But that’s all from Carolyn’s perspective. She’s got her own warp. Carolyn doesn’t exactly blame cancer victims for their condition, but she does think that if one pays enough and correct attention to one’s immune system, then one probably won’t get it. She’s been heard to describe cancer as abnormal immortal cells that must occur all the time, but that usually get wiped out by the body’s own defenses.

Carolyn thought, along with other observers, that hormone replacement therapy would be heart- and brain-protective. She was as surprised as the scientists when the clinical tests proved the exact opposite, and were ended early. For those trials revealed that hormone replacement increased the risk of significant health problems, which connection had been masked in the observational studies by the fact that the women on HRT were better educated than average and more likely to eat well, exercise regularly, and otherwise care for themselves in a way that counteracted what are now known to be the side effects of Premarin.

Why, Carolyn even bought into the public service announcements about the benefits of preschool (most high school dropouts didn’t attend school before kindergarten). She probably believes that marijuana is a gateway drug.

Carolyn’s kind of crazy. She doesn’t seem to notice, but at this point, most of us are watching her.