Would you rather

When I was a kid, hanging around with other kids, trying to kill some of the infinite and renewable stocks of time that kids have, we used to play a game called Would You Rather? “Would you rather be blind or deaf?”; “Would you rather be able to fly or be invisible?”; “Would you rather be able to see into the past or the future?”; “Would you rather have three very tiny ears or only one huge ear?”; “Would you rather never be able to tell the truth or never be able to tell a lie?”; “Would you rather fight 100 chicken-sized horses or one horse-sized chicken?”

It’s a game I still play today, especially on car journeys and sometimes with the stranger seated beside me on a long-haul flight, and of course the point of the game isn’t so much the answer itself as the arguing and reasoning out of the choice. The thing we would rather – or rather the reason we would rather it – is an investigation into who we are, conducted through the prism of what matters to us. That’s always the problem with choosing – we think choices determine who we are, but really they just reveal it.

Halfway through last year, I became convinced I had early-onset dementia. I started blanking on the simplest of details: names and places and even occasionally common nouns were constantly on the tip of that pink fleshy thing in my mouth. I had begun noticing this in a vague, nagging way but the clear recognition came when I was driving through Romania. I could remember with great precision the little town I’d just left – the crooked alleys and the big square with the good bookshop just off it, the eye-shaped windows of the houses and the Bridge of Lies that creaks and sighs if you cross it while saying something untrue – but all of a sudden I couldn’t remember the name of the town. A short word. Starts with an S. I think it has a z in it. When Josh Waitzkin was a young chess prodigy he played a tournament there. I knew it last night. I knew it this morning. In fact, I said it in conversation half an hour ago – where’s it gone?

This was a bad development. I started testing myself. Who played TC in the original Magnum P.I.? What’s the capital of Wyoming? Who shot JR? But how can you test your memory by asking yourself questions you already know? I noticed it more and more – I would stop in the middle of a sentence and wave my hand around and say “you know … whatsisname” or “Damn it, what’s his name?” or “Oh for god’s sake, that guy, you know him, the one who was in that show.” I was turning into my grandmother.

I started scrutinizing my writing for signs of a shrinking vocabulary. Scientists at the University of Toronto studied the works of Agatha Christie trying to determine the moment at which Alzheimer’s began to show itself in her writing, long before she received any diagnosis. They counted the number of different words and indefinite nouns she used in each book. Indefinite nouns are those vague stand-ins for specific words (“thing”, “something”, “anything”) that we use when more useful words aren’t at hand, and we aren’t always aware we’re using them. They found a gradual decline in the vocabulary size in the novels she wrote in her 70s, and then a precipitous falling off in the text of Elephants Can Remember, which showed a 30% decline in word types, 18% more repeated phrases, and three times as many indefinite nouns. The same scientists tracked similar results Iris Murdoch’s writing before her Alzheimer’s diagnosis. But I didn’t have their computer software and when you’re writing, you don’t know whether you’re using fewer words or not – you use the words that occur to you, and if you have Alzheimer’s, you don’t notice that fewer are occurring to you. If you have Alzheimer’s, you don’t notice you have Alzheimer’s.

I came home and went to my doctor. Doctors are not very sympathetic when you tell them you think you might have Alzheimer’s. They think everyone who comes to them without a broken leg or an axe in their head is a hypochondriac. This is because most people who go them are hypochondriacs, but still. I went to another doctor.

The second doctor was a woman, and I don’t know why anyone ever goes to a male doctor because as a general rule female doctors at least pretend to take their patients’ concerns more seriously.

“Hmmm,” she said thoughtfully. “Are you taking any medication?”

As a matter of fact, I was. Early last year I had a choice to make between two equally impossible courses of action. I could do nothing without hurting someone, and doing nothing wasn’t possible, and I felt an anxiety that was difficult to distinguish from depression. The situation wasn’t bearable so I was prescribed a daily pill to help me bear it. I’d never taken such a pill before although I now recognize I’ve probably been quietly anxious most of my life. It’s only when the anxiety eases that you realize that nothing, however hard, is really impossible, and that in any case there are seldom only two courses of action, that life isn’t a game of Would You Rather.

But sometimes it is. My doctor told me that some people taking my pill experience minor memory disturbance. Nothing serious, she said, just names and places, occasional words. I told her that occasional words are really all I have. She said at least I still remember the big things, and I said I wondered what makes a life, whether it’s the big things or whether it’s the infinite accumulation, like data points or pointillist dots, of all the rags and tags and odds and ends of your interests and experiences. And then I said that maybe that’s a false opposition, that a life is neither the one nor the other but a combination of the two, and rather than do without any of it, I would rather be anxious and depressed.

“Would you, though?” she said, and that was a good question. If I lose part of my mind, I lose part of myself, but what’s so great about being yourself if yourself is so panicky and sad?

Fortunately, I didn’t have to choose. She prescribed a different pill, and since then the picture has become less pixelated. It’s true that the other day I couldn’t remember The Beatles’ first number one single in the UK, but then again I’m not sure I ever knew. But I’ve been noticing something else.

Over the past few months, no matter what I do, I have been expanding outwards around the middle, like a beachball being taken into outer space. I catch glimpses of myself in shop windows or in people’s sunglasses and feel embarrassed. I’m not saying I was some slim-hipped sylph before, but now I feel like I’m being played by Steve Carrell in a fat suit. I don’t know why Steve Carrell, exactly, except that he has a dumb-looking face and when I feel fat I start disapproving of the other parts of myself as well. I was once very fat for about two years, and it did not make me jolly.

Last week I returned to the doctor. “One of the side-effects of those pills is weight gain,” she said. “Some people put on 10 kilograms. Some people put on 15.”

“I can’t put on 10 kilograms,” I said.

“You probably can,” she said.

“No, I mean, I don’t want to.”

“Well,” she said, leaning back in her chair.  “I suppose you have to choose: would you rather be fat or stupid?”

Would You Rather is a wretched, childish game, but it reveals quite a lot to you about yourself. I’m interested to see what choice I’ll make.

Times, 22 February 2019