英美报刊选读10文档格式.docx
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Moesteppedbetweenhimandthewomanandapologized.
Whenherepeatedlywanderedintothehousethatwasbeingbuiltdownthestreet—despitethe"
NoTrespassing"
signandthefence—sheexplainedtotheownerthathewasjustcurious.
Possiblythemostembarrassingepisodeoccurredwhentheywerecominghomefromdinner,andshedashedintoamini-martatamarinainOxnardtobuymilk.
"
Doyouknowthatman?
theownersaid,seeingStuinthecar."
He'
sbeenstealingfromme."
Moeremembersbeingbaffled.
Muffinsandcheesecake,theownersaid,showingherphotosfromthestore'
svideocamera."
ButIcan'
tcatchhim.Hedrivesawayinthegolfcarttoofast."
MoeofferedtopayforwhatStuhadtaken."
Hehasnocontroloverwhathedoes,"
shesaidtopolicewhentheyarrived.
Sometimesshewillsaythathehasabraintumor.It'
seasierthansayingfrontotemporaldementiaandhavingtodescribehowthediseasehasstrippedawayhisself-restraint.Stuisnolongerawareofhowtobehaveinthecompanyofothers,andlikeanunknowingchild,willblurtoutthefirstthingthatcomestomindorwillactwithoutconsideringtheconsequences.
Moerealizesthatthisisdifficulttounderstand.Beingrudeordisrespectfulseemslikeadeliberatechoice,andStu,60,hasaquicksmileandaneasylaugh.It'
seasyforpeopletowritehimoffasinconsiderateandself-centered.
ThisiswhatMoeandherdaughters,KatyandJessica,didbeforetheydiscoveredhowsickhewas.
OncecalledPick'
sdiseaseandnowFTD,frontotemporaldementiahidesitssymptomswell.LikeAlzheimer'
s,itistheresultofthedegenerationofneuronscausedbyanabnormalaccumulationofproteinsinthebrain.
Inearlystages,Alzheimer'
saffectspredominantlythehippocampusintheinnerpartofthebrain,wherememoriesareformed,andFTDaffectsthefrontalandtemporallobes,aboveandbehindtheeyes,wheresocialemotionsareformed.Alzheimer'
spatientssenseafuzzinessintheirthinking—awordmisplaced,aconfusionbetweenthepastandpresent—andrealizetheirerrors.MostpatientswithFTDhavenosuchinsightintotheirdisease.
Jessica,22,firstnoticedherfatherbecomingmoreselfishandtemperamentalwhentheylivedinSacramento.Hedoteduponhisdaughtersandwoulddoanythingforthem,butthenthatseemedtostop.WhereonceheletJessicachoosewhattowatchonTV,nowheheldontotheremoteandgotangryifshechangedthechannel.
ThetragedyofFTD,accordingtoMarioMendez,theUCLAneurologisttreatingStu,isitselusivediagnosis.Thepresenceofthediseasecanbeconfirmedonlythroughanautopsy,andMendezreachedhisconclusionaboutStubasedonspecificbehaviorsandbrainscans.
Thediseasebeginswithachangeinpersonalitythat'
softenseenasvolitional.Introvertsbecomeextroverts.Once-agreeableemployeesactrude.Formerlyfaithfulspouseshaveaffairs,andwhiletheyacknowledgetheirtransgressions,theyareunabletoappreciatetheimplications.
Someendupinstitutionalizedbecausetheirbehaviorlookslikementalillness.Someareincarceratedwhentheybreakthelaw.AdiagnosisofFTDledtoreducedchargesagainstaNewYorkCityphysicianwhocuthisinitialsintothestomachofapatient,andwhatcouldhavebeenasmanyas25yearsinprisonendedupasfiveyears'
probation.
Researchersbelievethatbetween30,000and50,000peopleintheUnitedStateshaveFTD.Thereisnocure,andthediseaseleadstodeath,oftenwithineightyears,eitherfromaccidentsorsecondaryinfections.
WhenStubeganactingdifferentlyin2007,bickeringwithJessica,Moedidn'
tthinkanythingofit.SheandStuhadbeenmarriedmorethan25years.Shefiguredrelationshipschange.
Hewasthedreamer,shethepragmaticone.Shewasaconsultantforahealthcarecompany,andhewasaprivategolfcoachandacarsalesman.Buthisrealpassionwascoachingbaseball.AccordingtoJerryWeinstein—whowasheadcoachintheearly1980satSacramentoCityCollege,whereStuworked—Stuwasknownforhiscausticwitanddemandingpractices.Theplayerstrustedhim,Weinsteinsaid.
MoeandStuhadmovedtoSacramentofromLosAngelesin1992.Hisfatherhadjustdied,andhethoughtheshouldbenearhismother.Butadecadelater,whenshewasinher80s,hesuddenlystoppedwantingtoseeher.
WhenMoeaskedwhy,hecouldn'
tsay,andafterhismotherdied,hebecamemorewithdrawnandstubborn.TheysawacounseloranddecidedthatleavingSacramentomighthelpthemgetovertheirproblems.
MoefoundarentalinOxnardonthestrandbetweentheharborandtheocean.Withsomanygolfcoursesinthearea,shethought,Stuwouldbeabletofindajobandplayasmuchasheliked.Heworkedforafewmonthsandthenstopped.Theyfought,andoneday,almostayearaftermovingtothebeach,shecamehometofindhimpackingaU-Haul.
HesaidhewasmovingbacktoSacramentoandhadnoexplanationotherthan"
becausethisiswhatI'
mdoing."
Moe,52,stillremembershowemptyhisexpressionwasthatMayafternoonin2010.Familymembersthoughthewashavinganaffair.
Herentedaone-bedroomapartment.Afamilyfriend,EdModeste,visitedhimandfoundtheplacenearlyempty:
aTV,achair,notmuchmore.Sturarelycontactedthefamily.
Divorceseemedinevitable.ThenonenightKaty,26,calledMoeintears.
ShewaslivingintheMontereyareaandhadinvitedherfatherfortheweekend.SheandStuwentonabikerideinthehillsaboveFt.Ord,andhedisappeared,showinguptwohourslater,hardlyconcernedthattheyhadbecomeseparated.ThenextdayattheU.S.OpenatPebbleBeach—herFather'
sDaytreatforhim—hecouldn'
tstandstillorbequiet,andshethoughtthey'
dbekickedout.
Sheinsistedthathermothertakehimtothefamilydoctor;
shehadneverseenherfatheractthisway.MoeflewtoSacramento,andafterStuunderwentanMRI,shefeltherlifeshiftingagain.
Stu,thedoctortoldher,isinnopositiontolivebyhimself.Youcaneitherproceedwiththeseparationoryoucansetyourfeelingsasideandtreatthislikeamedicaldisease.
Moewasn'
treadytoforgiveStuanymorethanshewaspreparedtobehiscaretakerorhiswidow.Butshecouldn'
tleavehimonhisown.
Studidn'
tknowthathehadhurthisfamily;
hehadlosthiscapacitytocare.Moehadtoexplaintofriendsandfamilywhyshetookhimbackafterhisthree-monthabsence.MosthadneverheardofFTD;
somethoughtitaweakexcuseforamid-lifecrisis.
Undertheswayofthedisease,impulsesinStu'
sbrainwentunchecked.Helogged30milesonhisbikeinthecourseofthreedailyridesandhebecameagitatedifhedidnotgettothegolfcourseeachday.Hewasinconstantmotion,snappinghisfingersandtappinghistoes.Hesnackedcompulsively,especiallywhenMoewasn'
taroundtostophim.
Readingaboutthedisease,MoecameacrossthenameofMarioMendez,aprofessorofneurologyandpsychiatryatUCLAandthedirectoroftheneurobehaviorunitattheWestLosAngelesVeteransAffairshospital.
MendezandJillShapira,anursepractitioner,seeFTDpatientsonWednesdays,andMoemadetheirfirstappointmentforSept.8,2010.MendezandShapirareassuredMoethatwithmedicationsandguidance,Stu'
smoreuninhibited,repetitivebehaviorscouldbesuppressed.
MoeandStualsoagreedtotakepartinastudyofthedisease.BecauseFTDmakesempathy,embarrassment,guiltandshameallthemoreconspicuousfortheirabsence,Mendezisinvestigatinghowsocialemotionsariseoutofthephysiologyofthebrain.
MendezandShapirarananumberoftestsonStudesignedtoisolatedifferentpartsofthefrontalandtemporallobes.Somewerewritten;
somewereconductedinconversation,andinoneinstance,Stulookedatphotographsofflowers,mountains,roadkillandstarvingchildrenasmonitorscapturedhisskintemperatureandheartrate.
Whatdoesitmeanthatpeoplewholiveinglasshousesshouldn'
tthrowstones?
MendezaskedStuduringafollow-upappointment.
You'
dbreaktheglass,"
Stusaid.
Justasheisincapableofinterpretingthissayingorengaginginabstractthinking,heissimilarlyunabletodeciphersocialsituationsandknowwhyinsultingastrangerwithtattoos,trespassingonprivatepropertyorstealingiswrong.
InNovember,MoeandStuarrivedatUCLAforanotherMRI.Moehopedtoseehowfarthediseasehadprogressed.Stulaydowninsidethehugemachine.Whenthetechnicianaskedifhewantedtolistentomusic,heaskedfortheRollingStones,oneofhisfavoritebands.
LetItBleed"
begantoplay.
TheBryants'
livingroomfrontsthedunes.TheChannelIslandsfloatonthehorizon,andabovethegaragehangsasignthatreads"
LazyDays."
MoegivesStudailytasks—walkingthedogs,cleaningwindows,feedingthetortoise,vacuuming—tokeephimoccupiedsohewon'
twanderinandoutofthehouseorsearchforfoodthatshe'
shidden.Shefeignsforgetfulnesswhentheytalk,sohewillexercisehismemory.Sheplansspecialoutings,likeawhale-watchingtripafewweeksago.
TherecentMRI,accordingtoMendez,showedonlyminutechangesinStu'
sbrainoverthelastyear,butMoeishardlyreassure