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Review: In Alice LaPlante's 'Turn of Mind' an Alzheimer's patient unravels in front of us

A few months before Turn of Mind begins, 64-year-old Jennifer White, an orthopedic surgeon, notices that she cannot remember where she put her house keys; how she got from her office to the frozen food section of the supermarket; the death of her husband; and the names of her two children, Mark and Fiona.

In the middle of a procedure at the hospital, she forgets the word clamp, asks for "that shiny thing that pinches and holds," and sees the residents roll their eyes.

Afflicted with Alzheimer's disease and forced to retire, Jennifer hires a caregiver, Magdalena, so she can remain in her own house. She tries to obey the command — "Live in the moment" — posted on her kitchen wall. To maintain some continuity in her new life, she keeps a journal.

On good days, she remembers that she forgets, and understands that changes in personality accompany changes in cognition: "Ask a dementia patient who she loves, and she draws a blank. Ask her who she hates, and the memories come flooding in." Nonetheless, Jennifer does not quite understand why she has been deemed "a person of interest" in the murder of her neighbor and best friend, Amanda O'Toole, whose body was discovered with four fingers surgically removed.

The debut novel of Alice LaPlante, Turn of Mind is an artful, ambitious and arresting attempt to capture the thoughts and feelings, by turns confused, conspiratorial, canny and clear, of a person in the throes of mental illness. And by using Jennifer as her riveting, revealing and eminently unreliable narrator, LaPlante reminds all of us, passionately, that no matter what the state of our health, reality can be elusive and subjective.

Turn of Mind is not an especially suspenseful whodunit. Nor are the novel's lesser characters fully realized. But it doesn't matter all that much. Assembled piece by piece, in no particular chronological or spatial order, like a jigsaw puzzle, LaPlante's portrait of the formidable and faltering Jennifer and her relationship with the forbidding Amanda is remarkably poignant.

Jennifer's mind twists as it turns. We learn that Jennifer, passionate about history as well as biology, went to graduate school intending to write a doctoral dissertation on the conflict among doctors in medieval Europe between applying folkloric remedies and following the precepts set forth by Avicenna's Canon of Medicine. She stopped believing in God because she refused to worship a narcissist, who took anything anyone did as a personal affront. Captivated by dissections, she eventually opted for medical school.

Accomplished, acclaimed and affluent, Jennifer has good reasons, we discover, to remain guilt-ridden. She does pro bono work at the Hope Community Health Center. Raised as a Catholic, she never fully divests herself of the religion's traditions, making her most prized possessions an icon of St. Rita of Cascia (the patron saint of lost causes) and a medal with an image of St. Christopher (once but no longer recognized by the church as the protector of travelers against a "sudden, unholy death").

A genius for spotting weaknesses in others, her friend Amanda does not fail to notice these ambivalences. A bit older than Jennifer (who was not enthusiastic about motherhood because it set in motion forces she could not control), Amanda is childless. No egg was tough enough, Jennifer guessed, to "implant itself in her impenetrable womb." And so, Amanda takes very seriously to her role as Fiona's fairy godmother, which Jennifer claims, disingenuously, to have conferred on her as a joke.

Acknowledging that Amanda "out-vultured the vultures," Jennifer does not — and perhaps cannot — explain their intimate and intense friendship. She struggles to assess the potential consequences of a breach between them: "For me, loneliness. For her, I can't guess."

A compassionate caregiver to her fictitious patient, LaPlante is determined to give Jennifer some moments of clarity amid the chaos. Although each day more words disappear, and be-diapered she shares her room with five strangers, one of whom sucks his toes, LaPlante's Jennifer somehow recognizes that she did not "manage a moment of grace in the midst of horror."

As she accepts what she and others have done and what has been done to her, she is also able to get beyond the pain, to imagine that Amanda is "whole and strong," her anger having burned itself out, and to anticipate a reunion with dear friends, including those "that have risen again. Sent by God."

This end, surely, is the one we want for those we love. And Turn of Mind makes us willing, even eager, to suspend our disbelief and allow Jennifer to rest in peace.

Turn of Mind

By Alice LaPlante

Atlantic Monthly Press, 307 pages, $24

Review: In Alice LaPlante's 'Turn of Mind' an Alzheimer's patient unravels in front of us 07/16/11 [Last modified: Saturday, July 16, 2011 5:30am]
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