Confusion, but in a Good Mood

Yesterday morning was a time of significant confusion for Kate. It was similar to several other moments when her memory seemed to be completely blank. She was concerned but showed no signs of the panic she has had in similar situations. I was in the kitchen when I heard her call my name over the video cam. Yes, she did remember my name. This was one of those times the camera paid off. Kate called to me in a somewhat soft tone of voice, nothing like a shout or scream. The microphone is very sensitive. I heard her immediately and went to her.

At first, I didn’t sense the degree of her confusion. As she does so often, she asked me where we were. I told her we were in Knoxville. She looked puzzled. She asked why. I explained that we live here and that “this is our house.” Then I said, “You look like you are a little confused. What could I do to help you?” That opened the door to an hour-long conversation during which she asked questions (often the same ones over and over) and I gave her the answers. We talked about her parents, my parents, and our children and grandchildren. The topics also included how we had met, places we had lived, her work and mine, and other special things we have done.

Several times, I asked if she might like to get up. She declined saying, “I would rather hear you tell me about my family.” The last time I asked, she agreed it was time to get up. She took a shower and got back in bed for another hour. When I got her up for lunch she was fine.

I don’t know how confused or clearheaded she was about our relationship. I only know that she called my name when she wanted me. She was in a pleasant mood throughout the episode and for the balance of the day. This is another good example of the transition she can make extreme confusion to a more normal state. It seems clear to me that when she wakes up most of her connections to the world around her are dormant. As she receives the information I give her and as she directly experiences more of her everyday life, she feels more at ease.

That doesn’t mean she knows where she is or the people around her. Increasingly, she thinks we are staying in some other place than our home. That was true when we got home last night. In the car she asked where we would be staying. I told her we would be in our very own home. She asked if it was very far. When we drove up to the house, I said, “This is where we will be staying.” She admired everything she saw and never realized we were at home, but she was happy.

Conversation

As Kate declines, our conversations are changing as well. Sometimes they are more challenging. Occasionally they are puzzling. Other times they can be humorous.

  • Challenging

We ate lunch at Andriana’s yesterday. That’s the restaurant with the mugshot of Frank Sinatra. We hadn’t been seated long before she asked who he was. I told her, and she said, “It’s not a very good picture.” I said, “Mugshots usually aren’t.” Then she wanted an explanation. I told her that police take photos of the people they arrest, and they aren’t concerned with getting a flattering picture. When I told her he was arrested, she wanted to know what he had done. I told her, and she said, “Who was the woman?” I said I didn’t know, and I told her that in this day and time, he probably wouldn’t have been arrested at all. She said, “Who?” I said, “Sinatra.”

This is a small thing, but it is an example of the kind of complication we can have in conversation. It requires a lot of repetition on my part. In this particular case, her memory wouldn’t let her hold on to Sinatra’s name long enough to last the duration of the very short conversation. As I have reported before, she asks me his name multiple times while we are there, but who we are talking about obviously gets forgotten in a conversation about him as well. This is the kind of thing that most other people would not notice because of the nature of their conversations with her. The fact that it is just the two of us offers her the opportunity to ask more questions, and I am very happy about her interest in knowing about the things she sees around her. It does, however, affect the flow of conversations. It can be one explanation after another.

That leads to another challenge in conversation. It is very difficult for her to understand almost any explanation because it often requires more information than she is able to process. I try to keep things simple, but it’s a challenge to do that and to do it all the time. Two nights ago we had our regular pizza night. We sat at a booth where we have eaten quite a few times. There is a poster on the wall above the table that advertises a flavored seltzer. She responds to this the way she does to Sinatra’s mugshot. She tries to read it but can’t understand and asks, “What is that?” I tell her, but she doesn’t know what seltzer is. That gets us into “Too Much Information.” After my first effort several months ago, I now just say, “It’s a flavored beer.” She gives me a look that expresses just how unappealing that is to her.

Between patiently repeating information and attempting to make things simple, it can be work. On the other hand, there is an element of pleasure seeing her interest and also succeeding in satisfying that interest, at least trying to. I do pretty well on the patience end, but I find it more difficult to explain things to her.

  • Humorous

At lunch on Saturday, she looked me over. Then she said, “Your glasses don’t do anything for you.” I jokingly said, “Some people think they make me look more handsome.” She burst out laughing. I said, “You don’t agree?” She said, “You’re a nice guy, but you’re not handsome.” This has been a continuing theme for quite a while. I don’t expect it to lessen now.

  • Puzzling

Yesterday afternoon I was seated across from her while she rested on the sofa in our family room. She opened her eyes and stared at a bench located between us. She looked as though she might be dreaming. I watched a moment and then asked what she was looking at. She tried to explain but couldn’t do it well enough for me to understand. She mentioned something about a “Lin.” I didn’t know what that was, and she couldn’t think of how to tell me. I asked her a series of yes/no questions like “Is it a type of clothing?” She was finally able to say that it was something you put in something else. She looked toward the patio, and I asked if it might be a flower pot.  It wasn’t, but she said, “It’s something you put in the ground.” Then I asked if she was talking about plants. That was it. From there I determined that she wants to buy some flowering plants and put them “someplace.” She continued talking. What she wants is to put them in the front yard.

This kind of conversation does not happen a lot, but it is becoming more frequent. It appears to me like she has had a dream that she thinks of real and talks with me as though I know what she is talking about. As her aphasia gets worse, she has more trouble explaining what she wants. As in this illustration, the words sometimes won’t come to her. Most of the time, I don’t understand her. We both reach a point at which we say it is time to forget it.

The good news is that we are still having conversations though I must say that she is not talking as much now as she did a few months ago. I miss that.

During the Night

Although Kate generally sleeps well at night, she was awake for a couple of nights this past week. Night before last, I had gotten up about 1:00 to go to the bathroom. When I got back in bed, she said, “Who are you?” She didn’t sound frightened or upset. She merely wanted to know. I gave her my name and told her I was her husband. Then she asked her name. At first, I thought this might be one of those times she was anxious about not knowing where she was or who she was with, but it wasn’t that at all. She was quite calm.

This made me think about something I have thought about before but not mentioned in my blog. During the night, I am very careful not to put my arm around her while she is sleeping. Since I know that she is often confused when she wakes up, I have been afraid that she might be frightened if I did so. On the other hand, she isn’t always, or even usually, confused upon waking. In fact, she frequently moves right next to me during the night and puts her arm around me. Her intuitive ability apparently leads her to respond to me as naturally as she has before her Alzheimer’s.

During the night at our hotel on Saturday, something else occurred. I heard her say something and asked if I could help her. She said she I could and tried to explain what it was she needed. She was very concerned about whatever it was, but she couldn’t explain it to me. I was only able to determine that it involved a mutual friend of ours and that she needed to make a list. At first, she just referred to “him.” When I asked who that was, she gave her usual answer, “You know.” I feel sure she does this because she can’t remember. I mentioned several names but was never sure who she was talking about. Ultimately, we both drifted off to sleep. I’ll never know what she was talking about, but it was of great concern to her. It reminded me of several other times when she has had a dream and thought she needed to be someplace and was worried about being late.

Yesterday’s Lunch Conversation

I wasn’t at all surprised that Kate was up earlier than usual yesterday morning. She had rested plenty the day before. She was also alert and even called me by name. She got ready early enough for us to make a trip to Panera before leaving for lunch.

It was an unusually pleasant and leisurely lunch that was a beautiful example of how much pleasure one can have living in the world of a person with dementia. We had at least a thirty-minute conversation that a listener might have found interesting without realizing that Kate has Alzheimer’s.

It began when I said something about a memory of a sailing trip my brother and I took in the Virgin Islands with our two sons when they were about twelve or thirteen. Kate often responds to something like this by saying, “Why didn’t you take me?” That prompted me to say that except for business trips it was the only trip I had ever taken without her.

As I started to tell her the story of that trip, I mentioned Kevin’s name. Our conversation seemed so normal that I assumed she knew that she was Kevin’s mother. Then she said, “You’re a father?” I told her I was and said, “And you’re a mother.” She scowled and said, “No, I’m not.” That led me to ask how she thought we were related. She said, “Friends. Good friends.” I said, “Who are living together.” She frowned and said, “I would not express it like that. I’m surprised that you would even say that.” I said, “Why not? We live together.” She said, “Yes, but you know what I mean.” I said, “We’ve lived together for a long time.” She said, “That’s different.” I asked if she would ever think about having children. She said, “I would like to have children some day but not yet.” Then she said something funny, but I can’t remember what. I said, “That’s one of the things I like about you. You can be funny.” She said, “Only around you. When I am with my girl friends, they don’t think I’m funny.”

About that time, I suggested it was time to leave. I said, “I love you.” I read her lips. She said, “I love you too.” And we left for home.

Day 2 of our Trip to Nashville

Yesterday’s visit with the Greeleys turned out well though Kate had a rough start first thing in the morning. Morning confusion is becoming more common now. That is especially understandable when she wakes up in a strange place.

As usual, I had gotten up a good while before she awoke about 8:30. She said, “Hey.” I walked over to the bed, and she said, “Who are you?” I asked if I looked familiar to her. She said I did. I gave her my name and told her I am her husband. She said, “Who am I?” When I told her, she wanted to know where she was and then why we were there. I explained about our coming to Nashville to see the Jan and Scott. She said, “Who?” I gave her the background to our friendship and specifically that she and Scott had been friends her entire life. Nothing rang a bell. I didn’t say anything about our having been with them the previous afternoon or having dinner with them. I relied on something I frequently tell her when we are at home. “It’s early in the morning. Sometimes you are confused when you wake up, especially when you are in a strange place. Once you are up you’ll feel better.” Then I told her it was still early and asked if she would like to get up or rest a little longer. She wanted to rest. I told her I would be just across the room at the desk and that I wouldn’t leave her. She said, “Good.” She woke up again two hours later. As she did earlier, she asked where she was and then why we were there. I went through the same explanation as I had done previously.

We checked out of our room in time to meet the Greeleys at our hotel for lunch. I didn’t want Kate to have to walk to the car and back, so I kept our suitcase and computer case with us until they arrived. I made a mistake when Jan and Scott walked in. I should have said, “Look Kate, it’s Jan and Scott Greeley.” Instead I greeted them as I always have. That would have worked in the past, but this time Kate needed me to remind her of their names and that we were having lunch together. Of course, I had told Jan before they arrived, but she had forgotten. When I realized, I called them by name, and Jan gave her name. Then I suggested that I take our things to the car and for the group to wait a moment. That is when Kate got up and said, “I’ll go with him.” That prompted Scott to say, “You don’t have that much. Why don’t we just take them with us to our table.” That worked well.

The lunch also went well. It was a buffet, and Kate and Scott remained at the table while Jan and I got our food. I also brought Kate’s to her. Even though it was not crowded, it was much easier than her doing it herself. Kate accepts this very naturally. This was not one of those times for independence.

As happens so often now, Kate asked that we repeat ourselves a number of times. This is commonplace. It is difficult for her to follow conversations. Even when we are alone, she asks me to speak more slowly. Apart from that and the insecurity she showed when I was about to leave her to put our things in the car, she enjoyed herself as did the rest of us.

Prior to the trip, Scott and I had exchanged emails in which he and I mentioned continuing care retirement communities. He told me that they were looking at one, and I told him about the commitment I had made to one in Knoxville. After lunch, I asked if he and Jan could drive us by the CCRC he had mentioned in his message. I might have expected that it would mean little to Kate, but it turned out to be a good thing. We not only drove around the campus, but we went into the main building. Kate loved the beauty of the place and took special note of the flowers both inside and outside. As I reflect on it, this was the kind of experience in which she can enjoy herself in the company of others without any pressure at all. She was free to walk around on her own and take in things without our pointing them out. It took away all the pressure that conversation represents for her. It may seem strange, but it reminds me of trips to the zoo. She enjoys looking around at things of beauty or special interest to her.

When we left for home, she mentioned how much she had enjoyed the Greeleys. She always has. I knew she would this time. It just took a little longer to feel at ease. I take that as another sign of the progression of her Alzheimer’s.

After dinner last night, we spent some time in the family room looking at the “Big Sister” album that Kate’s brother Ken had made for her a year ago. That has become far more important to her than he could ever imagine. She is enthralled by the cover picture of the two of them. She spends more time with that particular photo book more than any of the others. Last night, she went through it twice with me. I left to take a shower, and she started on it a third time. After my shower, she was still looking at it. I told her it was getting time for us to get ready for bed. She asked if she could take it with her. She held it in her arms and said, “I love it.” She was tired, however, and didn’t look at it again. She got ready and got in bed. She had had a full day and, except for her confusion in the morning, enjoyed every minute.

Another Interesting Conversation

After dinner two nights ago, Kate took a seat with her iPad in the family room while I watered a few plants on the patio. When I came back in, she had closed the iPad and was leafing through a magazine. She looked disturbed, and I asked her about it.

She said she didn’t want to talk about it then, but she was facing a decision. I asked if she could just tell me what the decision was. She said she wasn’t ready but that she would like to talk with me later. I held back a moment. She continued to sit in her chair with her head to one side and resting on her hand. She was very absorbed in thought.

I tried very carefully not to push her, but I repeated how much I would like to be of help. Again, I asked if she could just tell me what kind of decision she was trying to make. Gradually, she started talking. She began by saying, “I really want to help people.” That led her story to unfold, but not in an orderly fashion nor could I understand everything.

I quickly realized that she had imagined having an experience with someone. She told me she “knows” a woman who is trying to help children showing signs of getting into trouble. I wasn’t at all surprised about the expression of her desire to help people, but I was impressed with the thinking she was doing about the problem of helping the woman and the children and how to address it most effectively. She said it was not an easy thing to do and would require a lot of coordination. She wanted us to think about people we could bring in to assist in the planning and implementation of the program. She was also concerned about the time frame. She said there is a lot of planning that needs to be done before taking any action; however, she felt that there could be a danger of not acting as quickly as we need to. We (she) talked about twenty minutes before she seemed to slow up. I told her she seemed to have a grasp of the situation and the challenges she would face. I suggested that she might think overnight on what we had discussed and just relax a while before going to bed. She agreed, and that ended the conversation. As I suspected at the time, it seemed to be forgotten yesterday if it wasn’t before she was asleep that night.

The experience made me think of something that has crossed my mind before. She recognizes how little she is able to do on her own. Occasionally, she says something that indicates a desire to do more to be useful rather than just working on her iPad. Sometimes she helps me with little things like making up the bed. It would be a far cry from launching the kind of program she talked about the other night, but I could enlist her help with other things like the laundry and other household chores. I have often thought of some type of volunteer work, but most of those opportunities require someone that can be counted on to be consistent in showing up. That could be a problem. I’m going to continue thinking about possibilities.

Morning Confusion, But a Good Recovery

I’ve talked before about the way happy and sad moments are often intertwined. That was true for the way our day started yesterday. About 7:45, I saw on the video cam that Kate was sitting up in bed. I went to check on her. She wanted to go to the bathroom. She was very groggy and confused. I walked her to the bathroom. Like the day before, she was unsure of herself. Even when I showed her the toilet, she was unsure that was it. This was not the first time. I’m not sure whether it is the fault of her eyesight or her memory that prevents her immediately recognizing the toilet.

When she had finished, she said, “What now?” On some days she resists taking a shower. I took advantage of her dependence on me for direction and told her I thought it would be good to take one. I knew it was unusually early for her to get up, and she would want to get back in bed after showering. That is exactly what happened. I got her up in time get to lunch and back before the sitter arrived.

She was still confused and asked my name, and I told her. Then she asked her own name. I told her. It wouldn’t stick, however. She asked the same questions another four or five times before I got her dressed.

Fortunately, it was a day when we had plenty of time to have lunch before the sitter’s arrival. As we walked into the family room, she took a few minutes to admire her plants. She almost always stops just before the door to our kitchen to say hello and goodbye to Pepper, the ceramic cat that lies on the floor near the fireplace. She did so yesterday. This time she also looked at a photo of our son, Kevin, when he was about ten. She was especially taken with it and asked if she could take it with us. I told her she could. I asked if she knew who he was. She didn’t. When we reached the restaurant, she asked if she could take it inside. I told her that would be fine. She took it along with her and kept it in front of her during the entire meal. By the end of our lunch, she seemed to be back to normal.

She was tired when we returned to the house. She was resting on the sofa when Mary arrived. I told her I was leaving to donate platelets and that Mary was there if she needed anything. She told me goodbye and greeted Mary but didn’t get up. When I came home, the two of them were talking. It was another good experience with the sitter.

She wanted to rest again after Mary left. She rested about forty-five minutes. Then she said, “Would you add one other thing to what I had written? Tell him where we live.” I said, “I will.” I didn’t ask who. I am sure it was another instance of her thinking about something and believing it was a conversation we were having.

At dinner, Kate was confused about what to do with her napkin. First, she asked our server what she should do. The server didn’t understand what she wanted. I placed the knife and fork for her. Then I told her to put the napkin in her lap. She could not understand that. It may have been that she didn’t recognize the word “lap.” She is forgetting more words these days. For example, she didn’t know the word “pickle” at lunch and never remembers “gelato” even though we have it twice a week. At any rate, I got up and placed the napkin in her lap. By the time I got back to my chair, she had already put it back on the table and asked, “Is this all right?” I told her it was.

Normally, when we get home from dinner, we sit in stay in the family room a while before going to our bedroom. Last night, Kate was tired, so we skipped the family room. I watched a little of the evening news and then took a shower. I turned on YouTube videos of Sierra Boggess at one of the BBC’s PROMS concerts. When I finished my shower, I saw her sitting in her chair enraptured by the music. She was smiling with her eyes closed and her head moving in sync with the music. She watched the videos a while longer and then wanted to go to bed.

When I got in bed an hour later, she was almost asleep. I moved over close to her. We chatted a couple of minutes.

Kate:              “Who are you?”

Richard:        “Do you mean my name or my relationship with you?”

Kate:              “Both.”

Richard:        “First, tell me if I seem to be someone familiar to you?”

Kate:              “Yes, very familiar.”

Then I told her my name and that I was her husband. She didn’t display any surprise as she sometimes does. It wasn’t long before we were asleep.

Another Social Experience

Kate and I are in Nashville today where we plan to meet our friend, Ellen, who is in a memory facility here. Because Kate sleeps so late in the morning, we came yesterday afternoon to have dinner and spend the night before our visit this afternoon. I have found that works better than rushing her in the morning so that we can make it a day trip.

For the second time in two weeks, I had arranged to meet another Twitter friend, Joan, who lives on the east side of Nashville. We met at a Cracker Barrel about 3:15 and chatted for a little over an hour before going to our hotel. I am glad to say this was another social situation in which Kate was quite at ease and talkative. It was as though she had been yearning to talk with someone and found a good listener. Once she started, it was hard for her to stop. It was good to see her so engaged in conversation.

As I reflect, I think there were several things that made our meeting such a success. First, there was just one other person with us. That meant there was no distracting conversation that can occur when there are four or more people. Second, the way we were seated lent itself to more conversation between Kate and my friend. When we took our seats, I deliberately put Kate directly across the table from Joan. I sat beside Kate. Third, Joan is a very warm, friendly person. She immediately gave her attention to Kate who became a key person in the conversation. Fourth, one of the good things about initial meetings like this one is that people discover things they have in common. It wasn’t long before we learned that Joan had been a librarian. That opened the door for Kate to talk about her own experience in the field.

Since Joan and I have been Twitter friends, I would have enjoyed talking more with her about her own experience as a caregiver as well as her blog. I was glad, however, to let that go in order for Kate to have such a good experience.

There were a couple of other things worth noting. One is how well Kate was able to communicate without having a memory to draw on. Of course, that means that some of the things she said weren’t really true. For the most part, Joan probably didn’t notice though I did. Much of the conversation didn’t require much in the way facts. Kate could talk about her feelings for her work and her family.

The other thing is that Kate’s Texas pride has increased substantially in the past few years. As we were walking out, someone overhead Joan’s voice and asked where she was from. When she said, “Nashville,” the man told her she didn’t sound like it. Then she said she was originally from Long Island. That began a somewhat more extended conversation between the two of them. While they were talking, Kate tried to interrupt them to ask the man to guess where she was from. It was very much like what a child might do. I got her to hold back for a minute. When she finally asked her question, he said, “Where?” She couldn’t remember. I was standing behind her and whispered, “Fort Worth, Texas.” She repeated it in perfect timing. He might not have noticed her slip.

I was very glad that we stopped to meet Joan. My own purpose was to meet face to face with a woman I had known only through brief tweets. The bonus, like our meeting two weeks ago, was seeing how much Kate enjoyed herself.

Another Bedtime Conversation: An Example of Kate’s Intuitive Thought/Ability

In yesterday’s post, I talked about the challenges that Kate faces in some types of conversations. I also noted that we converse about as much as we did before Alzheimer’s. I failed to say that until I took her off of Trazadone a year ago, she didn’t talk much. Most mealtimes we hardly spoke at all. Looking back, I think she may have been taking a higher dose than she needed. She was very sleepy. I am glad to say that is no longer an issue. We do have conversations, and some of those are unlike anything I could have imagined. Night before last we had one of those.

As usual, Kate was still awake when I got into bed. I moved over close to her and commented on what a nice day it had been. I told her I loved her. She said, “I like you. I even think I love you.” She went on to say that she was not ready to marry me. From there, she took us in a very different direction.

She talked about a “project” that she was thinking about. She never got specific, but she wanted to do something for people who have chronic financial problems. She expressed a desire to recruit a large number of people who could join together to address these issues. She wanted me to work with her. I told her I would. As with other conversations, she was very repetitive. She would circle back around and say the same things she had said earlier. She was confident with the two of us working together we could make a difference in people’s lives.

This conversation was another good illustration that her feelings are working. She can’t remember any facts, but she retains a sense that there are people with many needs. Her heart goes out to them. This particular idea about initiating a project to help people in need is just one example of that. It is also apparent when she talks about her mother, she invariably talks about her mother’s kindness to others and her desire to “help people.” Her mother was indeed kind, but I view this mostly as an expression of Kate’s personal feelings about relating to other people. It is also evident in the way she interacts with strangers. She is a caring person. This is not something new, but it is more pronounced now than in the past. It is certainly a more positive symptom of Alzheimer’s than one usually imagines.

Kate and Conversation

Like other caregivers I know, I often miss the kind of conversations Kate and I used to have. Much of our ordinary conversation requires remembering things she can no longer retain in her memory. All is not lost, however. Caregivers learn to talk about things that their loved ones can also talk about. On an average day, I’m not sure that Kate and I talk any less than we did before Alzheimer’s, but the content of those conversations is different and repetitive. We are both happy with this approach.

Social situations can be very difficult for people with dementia. I wish I could fully understand what’s going on in Kate’s head when we are in large groups. I know it can be very confusing for her. Saturday we attended an 80th birthday party of a man who had been a close friend of my dad’s. There was a large crowd, and we knew only three people besides Dad’s friend. It was wall-to-wall people. She sat in a chair and was mostly silent the hour or so we were there. Withdrawing is one way to handle situations like this. I stood by her the whole time to prevent her being anxious.

My brother, Larry came over for the birthday party. We had planned to go out to dinner with him, but the weather kept us inside that night. We ordered a pizza and ate right here at home. I can’t remember the last time we had done that. I would say at least six or seven years.

We hadn’t seen Larry in quite a while. He and I immediately entered into a conversation that wasn’t of interest to Kate. She worked on her iPad until we ate dinner. I felt bad about that. Fortunately, the conversation took a different turn over pizza. Larry has a farm and brought some fresh blueberries for Kate. That led to a conversation in which he pulled out his phone and showed us pictures of his blueberry and raspberry plants as well as his asparagus. At first, I thought this might not be of interest to Kate, but she seem quite interested. She even asked questions that got Larry talking more about the farm. Again, I felt Kate’s interest might be short-lived, but she seemed quite engaged. I know it was impossible for her to follow everything he said, but she didn’t tune out. It turned out to be a good experience. My own view is that she was an important part of the conversation. She wasn’t being overlooked the way she had been before dinner. I let the two of them talk together while I cleaned up the dishes. I was happy to see her enjoying herself.

Yesterday morning, Larry, who had spent the night at a hotel, came back to the house around 9:45. That gave us some time to catch up on a variety of things that would have been of little interest to Kate. She slept until almost 11:00. Then the three of went to lunch. Everything went well until the end of our meal. As we were talking, Kate got confused over some of the things Larry talked about. At times, I tried to interject and explain. It was a time when it appeared that she really wanted to understand but couldn’t, and her confusion escalated. I feel reasonably sure that at that point in the conversation she didn’t know that Larry was my brother. She asked him directly, “Who are you?” I explained that he is my brother. She asked him his name, and he told her. I can’t remember, but she may have asked mine as well. She must have because I remember her asking my last name. She didn’t realize that I had the same last name as Larry. (That is not unusual. It is typical. This happens all the time when we are going through her family photo albums.) The server dropped by the table. She and Larry talked a bit. Kate pointed to Larry and asked me who he was. When I told her he was my brother Larry, she said, “What’s his last name?” When I told her, she burst out laughing. The server asked what was funny. Kate said, “His last name is Creighton.” She said this as though it was a silly name. Then, looking at the people at the table across from us, she said something about his name. I don’t remember what she said.

Despite her laughter, Kate was irritated with my brother. I can’t explain it. I have a hunch that she somehow felt like an outsider to our conversation. She was rather abrupt with him and made some reference to the way the two of us (Larry and me) act when we are together. She was not in a good humor as we made our way to the door. When we got outside, she immediately apologized to Larry and said something like, “You’ll have to forgive me. I’m trying to not to be this way.” It was as though she were carrying a grudge from the past. I don’t understand.

When we got in the car, she told me she didn’t want to talk. I told her I would turn on some music that she would like. I didn’t say a word until we got home. When we were a few blocks away, I reached over and squeezed her hand and held it a moment or two. She squeezed back and smiled at me. She was herself again.

This was the first time I’ve seen her respond this way with anyone. It wasn’t just a momentary reflex. She was bothered over a period of minutes. She was obviously offended. My best guess is that Larry and I drifted into a conversation that was of greater interest to us, and Kate felt excluded. This will make me more sensitive about conversations in the future. I don’t want Kate to feel this way again.