Turn of Mind

By Alice LaPlante

The New York Times bestseller—a stunning first novel, both literary and thriller, about a retired orthopedic surgeon with dementia.
 
With unmatched patience and a pulsating intensity, Alice LaPlante brings us deep into a brilliant woman’s deteriorating mind, where the impossibility of recognizing reality can be both a blessing and a curse.
 
As the book opens, Dr. Jennifer White’s best friend, Amanda, who lived down the block, has been killed, and four fingers surgically removed from her hand. Dr. White is the prime suspect and she herself doesn’t know whether she did it. Told in White’s own voice, fractured and eloquent, a picture emerges of the surprisingly intimate, complex alliance between these life-long friends—two proud, forceful women who were at times each other’s most formidable adversaries. As the investigation into the murder deepens and White’s relationships with her live-in caretaker and two grown children intensify, a chilling question lingers: is White’s shattered memory preventing her from revealing the truth or helping her to hide it?
 
“An electrifying book. Thought-provoking, humane, funny, tragic, a tour de force that can’t be a first novel—and yet it is.” —Ann Packer, New York Times–bestselling author
 
“This poignant debut immerses us in dementia’s complex choreography . . . [A] lyrical mosaic, an indelible portrait of a disappearing mind.” —People
 
“LaPlante has imagined a lunatic landscape well. The twists and turns of mind this novel charts are haunting and original.” —The New York Times Book Review
 

• Language: English
• Publisher: Open Road Integrated Media
• Release date: Jul 5, 2011
• ISBN: 9780802195562

Alice LaPlante

Alice LaPlante is an award-winning writer whose bestselling books include Half Moon Bay, A Circle of Wives, Method and Madness—The Making of a Story, and the New York Times bestseller Turn of Mind. She taught creative writing at Stanford University where she was a Wallace Stegner Fellow and in the MFA program at San Francisco State University. She lives with her family in Mallorca, Spain.  

Book preview

TURN OF MIND

TURN OF MIND

Alice LaPlante

Copyright © 2011 by Alice LaPlante

All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without permission in writing from the publisher, except by a reviewer, who may quote brief passages in a review. Scanning, uploading, and electronic distribution of this book or the facilitation of such without the permission of the publisher is prohibited. Please purchase only authorized electronic editions, and do not participate in or encourage electronic piracy of copyrighted materials. Your support of the author’s rights is appreciated. Any member of educational institutions wishing to photocopy part or all of the work for classroom use, or anthology, should send inquiries to Grove/Atlantic, Inc., 841 Broadway, New York, NY 10003 or [e-mail].

Published simultaneously in Canada

Printed in the United States of America

eBook ISBN-13: 978-0-8021-9556-2

Atlantic Monthly Press

an imprint of Grove/Atlantic Inc.

841 Broadway

New York, NY 10003

Distributed by Publishers Group West

www.groveatlantic.com

For Alice Gervase O’Neill LaPlante

TURN OF MIND

ONE

Something has happened. You can always tell. You come to and find wreckage: a smashed lamp, a devastated human face that shivers on the verge of being recognizable. Occasionally someone in uniform: a paramedic, a nurse. A hand extended with a pill. Or poised to insert a needle.

This time, I am in a room, sitting on a cold metal folding chair. The room is not familiar, but I am used to that. I look for clues. An office-like setting, long and crowded with desks and computers, messy with papers. No windows.

I can barely make out the pale green of the walls, so many posters, clippings, and bulletins tacked up. Fluorescent lighting casting a pall. Men and women talking; to one another, not to me. Some wearing baggy suits, some in jeans. And more uniforms. My guess is that a smile would be inappropriate. Fear might not be.

I can still read, I’m not that far gone, not yet. No books anymore, but newspaper articles. Magazine pieces, if they’re short enough. I have a system. I take a sheet of lined paper. I write down notes, just like in medical school.

When I get confused, I read my notes. I refer back to them. I can take two hours to get through a single Tribune article, half a day to get through The New York Times. Now, as I sit at the table, I pick up a paper someone discarded, a pencil. I write in the margins as I read. These are Band-Aid solutions. The violent flare-ups continue. They have reaped what they sowed and should repent.

Afterward, I look at these notes but am left with nothing but a sense of unease, of uncontrol. A heavy man in blue is hovering, his hand inches away from my upper arm. Ready to grab. Restrain.

Do you understand the rights I have just read to you? With these rights in mind, do you wish to speak to me?

I want to go home. I want to go home. Am I in Philadelphia. There was the house on Walnut Lane. We played kickball in the streets.

No, this is Chicago. Ward Forty-three, Precinct Twenty-one. We have called your son and daughter. You can decide at any time from this moment on to terminate the interview and exercise these rights.

I wish to terminate. Yes.

A large sign is taped to the kitchen wall. The words, written in thick black marker in a tremulous hand, slope off the poster board: My name is Dr. Jennifer White. I am sixty-four years old. I have dementia. My son, Mark, is twenty-nine. My daughter, Fiona, twenty-four. A caregiver, Magdalena, lives with me.

It is all clear. So who are all these other people in my house? People, strangers, everywhere. A blond woman I don’t recognize in my kitchen drinking tea. A glimpse of movement from the den. Then I turn the corner into the living room and find yet another face. I ask, So who are you? Who are all the others? Do you know her? I point to the kitchen, and they laugh.

I am her, they say. I was there, now I’m here. I am the only one in the house other than you. They ask if I want tea. They ask if I want to go for a walk. Am I a baby? I say. I am tired of the questions. You know me, don’t you? Don’t you remember? Magdalena. Your friend.

The notebook is a way of communicating with myself, and with others. Of filling in the blank periods. When all is in a fog, when someone refers to an event or conversation that I can’t recall, I leaf through the pages. Sometimes it comforts me to read what’s there. Sometimes not. It is my Bible of consciousness. It lives on the kitchen table: large and square, with an embossed leather cover and heavy creamy paper. Each entry has a date on it. A nice lady sits me down in front of it.

She writes, January 20, 2009. Jennifer’s notes. She hands the pen to me. She says, Write what happened today. Write about your childhood. Write whatever you remember.

I remember my first wrist arthrodesis. The pressure of scalpel against skin, the slight give when it finally sliced through. The resilience of muscle. My surgical scissors scraping bone. And afterward, peeling off bloody gloves finger by finger.

Black. Everyone is wearing black. They’re walking in twos and threes down the street toward St. Vincent’s, bundled in coats and scarves that cover their heads and lower faces against what is apparently bitter wind.

I am inside my warm house, my face to the frosted window, Magdalena hovering. I can just see the twelve-foot carved wooden doors. They are wide open, and people are entering. A hearse is standing in front, other cars lined up behind it, their lights on.

It’s Amanda, Magdalena tells me. Amanda’s funeral. Who is Amanda? I ask. Magdalena hesitates, then says, Your best friend. Your daughter’s godmother.

I try. I fail. I shake my head. Magdalena gets my notebook. She turns back the pages. She points to a newspaper clipping:

Elderly Chicago Woman Found Dead, Mutilated

CHICAGO TRIBUNE—February 23, 2009

CHICAGO, IL—The mutilated body of a seventy-five-year-old Chicago woman was discovered yesterday in a house in the 2100 block of Sheffield Avenue.

Amanda O’Toole was found dead in her home after a neighbor noticed she had failed to take in her newspapers for almost a week, according to sources close to the investigation. Four fingers on her right hand had been severed. The exact time of death is unknown, but cause of death is attributed to head trauma, sources say.

Nothing was reported missing from her house.

No one has been charged, but police briefly took into custody and then released a person of interest in the case.

I try. But I cannot conjure up anything. Magdalena leaves. She comes back with a photograph.

Two women, one taller by at least two inches, with long straight white hair pulled back in a tight chignon. The other one, younger, has shorter wavy gray locks that cluster around chiseled, more feminine features. That one a beauty perhaps, once upon a time.

This is you, Magdalena says, pointing to the younger woman. And this here, this is Amanda. I study the photograph.

The taller woman has a compelling face. Not what you’d call pretty. Nor what you would call nice. Too sharp around the nostrils, lines of perhaps contempt etched into the jowls. The two women stand close together, not touching, but there is an affinity there.

Try to remember, Magdalena urges me. It could be important. Her hand lies heavily on my shoulder. She wants something from me. What? But I am suddenly tired. My hands shake. Perspiration trickles down between my breasts.

I want to go to my room, I say. I swat at Magdalena’s hand. Leave me be.

Amanda? Dead? I cannot believe it. My dear, dear friend. Second mother to my children. My ally in the neighborhood. My sister.

If not for Amanda, I would have been alone. I was different. Always apart. The cheese stands alone.

Not that anyone knew. They were fooled by surfaces, so easy to dupe. No one understood weaknesses like Amanda. She saw me, saved me from my secret solitude. And where was I when she needed me? Here. Three doors down. Wallowing in my woes. While she suffered. While some monster brandished a knife, pushed in for the kill.

O the pain! So much pain. I will stop swallowing my pills. I will take my scalpel to my brain and eviscerate her image. And I will beg for exactly that thing I’ve been battling all these long months: sweet oblivion.

The nice lady writes in my notebook. She signs her name: Magdalena. Today, Friday, March 11, was another bad day. You kicked the step and broke your toe. At the emergency room you escaped into the parking lot. An orderly brought you back. You spat on him.

The shame.

This half state. Life in the shadows. As the neurofibrillary tangles proliferate, as the neuritic plaques harden, as synapses cease to fire and my mind rots out, I remain aware. An unanesthetized patient.

Every death of every cell pricks me where I am most tender. And people I don’t know patronize me. They hug me. They attempt to hold my hand. They call me prepubescent nicknames: Jen. Jenny. I bitterly accept the fact that I am famous, beloved even, among strangers. A celebrity!

A legend in my own mind.

My notebook lately has been full of warnings. Mark very angry today. He hung up on me. Magdalena says do not speak to anyone who calls. Do not answer the door when she’s doing laundry or in the bathroom.

Then, in a different handwriting, Mom, you are not safe with Mark. Give the medical power of attorney to me, Fiona. It is best to have medical and financial powers of attorney in the same hands anyway. Some things are crossed out, no, obliterated, with a thick black pen. By whom?

My notebook again:

Mark called, says my money will not save me. I must listen to him. That there are other actions we must take to protect me.

Then: Mom, I sold $50,000 worth of IBM stock for the lawyer’s retainer. She comes highly recommended for cases where mental competency is an issue. They have no evidence, only theories. Dr. Tsien has put you on 150 mg of Seroquel to curb the episodes. I will come again tomorrow, Saturday. Your daughter, Fiona.

I belong to an Alzheimer’s support group. People come and they go.

This morning Magdalena says it is an okay day, we can try to attend. The group meets in a Methodist church on Clark, squat and gray with clapboard walls and garish primary-colored stained-glass windows.

We gather in the Fellowship Lounge, a large room with windows that don’t open and speckled linoleum floors bearing the scuff marks of the metal folding chairs. A motley crew, perhaps half a dozen of us, our minds in varying states of undress. Magdalena waits outside the door of the room with the other caregivers. They line up on benches in the dark hallway, knitting and speaking softly among themselves, but attentive, prepared to leap up and take their charges away at the first hint of trouble.

Our leader is a young man with a social-worker degree. He has a kind and ineffectual face, and likes to start with introductions and a joke.

My-name-is-I-forgot-and-I-am-an-I-don’t-know-what. He refers to what we do as the Two Circular Steps. Step One is admitting you have a problem. Step Two is forgetting you have the problem.

It gets a laugh every time, from some because they remember the joke from the last meeting, but from most because it’s new to them, no matter how many times they’ve heard it.

Today is a good day for me. I remember it. I would even add a third step: Step Three is remembering that you forget. Step Three is the hardest of all.

Today we discuss attitude. This is what the leader calls it. You’ve all received this extraordinarily distressing diagnosis, he says. You are all intelligent, educated people. You know you are running out of time. What you do with it is up to you. Be positive! Having Alzheimer’s can be like going to a party where you don’t happen to know anyone. Think of it! Every meal can be the best meal of your life! Every movie the most enthralling you’ve ever seen! Have a sense of humor, he says. You are a visitor from another planet, and you are observing the local customs.

But what about the rest of us, for whom the walls are closing in? Whom change has always terrified? At thirteen I stopped eating for a week because my mother bought new sheets for my bed. For us, life is now terribly dangerous. Hazards lie around every corner. So you nod to all the strangers who force themselves upon you. You laugh when others laugh, look serious when they do. When people ask do you remember you nod some more. Or frown at first, then let your face light up in recognition.

All this is necessary for survival. I am a visitor from another planet, and the natives are not friendly.

I open my mail myself. Then it disappears. Whisked away. Today, pleas for help to save the whales, save the pandas, free Tibet.

My bank statement shows that I have $3,567.89 in a Bank of America checking account. There is another statement from a stockbroker, Michael Brownstein. My name is on the top. My assets have declined 19 percent in the last six months. They apparently now total $2.56 million. He includes a note: It is not as bad as it could have been due to your conservative investment choices and a broad portfolio diversification strategy.

Is $2.56 million a lot of money? Is it enough? I stare at the letters on the page until they blur. AAPL, IBM, CVR, ASF, SFR. The secret language of money.

James is sly. James has secrets. Some I am privy to, more I am not. Where is he today? The children are at school. The house is empty except for a woman who seems to be a sort of housekeeper. She is straightening the books in the den, humming a tune I don’t recognize. Did James hire her? Likely. Someone must be keeping things in order, for the house looks well tended, and I have always been hostile to housework, and James, although a compulsive tidier, is too busy. Always out and about. On undercover missions. Like now. Amanda doesn’t approve. Marriages should be transparent, she says. They must withstand the glare of full sunlight. But James is a shadowy man. He needs cover, flourishes in the dark. James himself explained it long ago, concocted the perfect metaphor. Or rather, he plucked it from nature. And although I am suspicious of too-neat categorizations, this one rang true. It was a hot humid day in summer, at James’s boyhood home in North Carolina. Before we were married. We’d gone for an after-dinner walk in the waning light and just two hundred yards away from his parents’ back porch found ourselves deep in a primeval forest, dark with trees that dripped white moss, our footsteps muffled by the dead leaves that blanketed the ground. Pockets of ferns unfurled through the debris and the occasional mushroom gleamed. James gestured. Poisonous, he said. As he spoke, a bird called. Otherwise, silence. If there was a path, I couldn’t see it, but James steadily moved ahead and magically a way forward appeared in front of us. We’d gone perhaps a quarter of a mile, the light diminishing minute by minute, when James stopped. He pointed. At the foot of a tree, amid a mass of yellow green moss, something glowed a ghostly white. A flower, a single flower on a long white stalk. James let out a breath. We’re lucky, he said. Sometimes you can search for days and not find one.

And what is it? I asked. The flower emitted its own light, so strong that several small insects were circling around it, as if attracted by the glare.

A ghost plant, James said. Monotropa uniflora. He stooped down and cupped the flower in his hand, being careful not to disengage it from its stalk. It’s one of the few plants that doesn’t need light. It actually grows in the dark.

How is that possible? I asked.

It’s a parasite—it doesn’t photosynthesize but feeds off the fungus and the trees around it, lets others do the hard work. I’ve always felt a kinship to it. Admiration, even. Because it’s not easy—that’s why they don’t propagate widely. The plant has to find the right host, and conditions must be exactly right for it to flourish. But when it does flourish, it is truly spectacular. He let go of the flower and stood up.

Yes, I can see that, I said.

Can you? James asked. Can you really?

Yes, I repeated, and the word hung in the heavy moist air between us, like a promise. A vow.

Shortly after this trip, we quietly got married at the Evanston courthouse. We didn’t invite anyone, it would have felt like an intrusion. The clerk was a witness, and it was over in five minutes. On the whole, a good decision. But on days like today, when I feel James’s absence like a wound, I long to be back in those woods, which somehow remain as fresh and strong in my mind as the day we were there. I could reach out and pluck that flower, present it to James when he comes back. A dark trophy.

I am in the office of a Carl Tsien. A doctor. My doctor, it seems. A slight, balding man. Pale, in the way that only someone who spends his time indoors under artificial light can be. A benevolent face. We apparently know each other well.

He speaks about former students. He uses the word our. Our students. He says I should be proud. That I have left the university and the hospital an invaluable legacy. I shake my head. I am too tired to pretend, having had a bad night. A pacing night. Back and forth, back and forth, from bathroom to bedroom to bathroom and back again. Counting footsteps, beating a steady rhythm against the tile, the hardwood flooring. Pacing until the soles of my feet ached.

But this office tickles my memory. Although I don’t know this doctor, somehow I am intimate with his possessions. A model of a human skull on his desk. Someone has painted lipstick on its bony maxilla to approximate lips, and a crude label underneath it reads simply, MAD CARLOTTA. I know that skull. I know that handwriting. He sees me looking. Your jokes were always a little obscure, he says.

On the wall above the desk, a vintage skiing poster proclaims Chamonix in bright red letters. Des conditions de neige excellentes, des terrasses ensoleillées, des hors-pistes mythiques. A man and a woman, dressed in the voluminous clothing of the early 1900s, poised on skis in midair above a steep white hill dotted with pine trees. A fanciful drawing, not a photograph, although there are photographs, too, hanging to the right and left of the poster. Black-and-white. To the right, one of a young girl, not clean, squatting in front of a dilapidated shack. To the left, one of a barren field with the sun just visible above the flat horizon and a woman, naked, lying on her belly with her hands propping up her chin. She looks directly into the camera. I feel distaste and turn away.

The doctor laughs and pats me on the arm. You never did approve of my artistic vision, he says. You called it precious. Ansel Adams meets the Discovery Channel. I shrug. I let his hand linger on my arm as he guides me to a chair.

I am going to ask you some questions, he says. Just answer to the best of your ability.

I don’t even bother to respond.

What day is it?

Going-to-the-doctor day.

Clever reply. What month is it?

Winter.

Can you be more specific?

March?

Close. Late February.

What is this?

A pencil.

What is this?

A watch.

What is your name?

Don’t insult me.

What are your children’s names?

Fiona and Mark.

What was your husband’s name?

James.

Where is your husband?

He is dead. Heart attack.

What do you remember about that?

He was driving and lost control of his car.

Did he die of the heart attack or the car accident?

Clinically it was impossible to tell. He may have died of cardiomyopathy caused by a leaky mitral valve or from head trauma. It was a close call. The coroner went with cardiac arrest. I would have gone the other way, myself.

You must have been devastated.

No, my thought was, that’s James: a perpetual battle between his head and his heart to the end.

You’re making light of it. But I remember that time. What you went through.

Don’t patronize me. I had to laugh. His heart succumbed first. His heart! I did laugh, actually. I laughed as I identified the remains. Such a cold, bright place. The morgue. I hadn’t been in one since medical school, I always hated them. The harsh light. The bitter cold. The light and the cold and also the sounds—rubber-soled shoes squeaking like hungry rats against tile floors. That’s what I remember: James bathed in unforgiving light while vermin scuttled.

Now you’re the one patronizing me. As if I couldn’t see past that.

Reviews for Turn of Mind

[heatherlinc · Rating: 3 out of 5 stars]

Sixty-four year old, Jennifer White, was a renowned hand surgeon until Alzheimer's took hold of her mind and she was forced into early retirement. Her best friend, Amanda has been found dead with four fingers removed and Jennifer is the major suspect. Told from Jennifer's confused point of view, the reader catches glimpses of her brilliance as a doctor but also suffers with her as she struggles to stay in control becoming more confused, angry and childlike. Like Jennifer's mind, the paragraphs are jumbled allowing the reader insight into her past and present life as she moves in and out of varying periods of time. Although an unreliable narrator, the essence of Jennifer shines through - her strength, determination and intelligence.'Turn of Mind' is not a crime thriller nor is it an uplifting book, but it is fascinating and tragic as we watch the demise of Jennifer's mind until it reaches its unrelenting end.

[annhepburn · Rating: 4 out of 5 stars]

Great, very suspenseful book in the vein of of "Before I Go To Sleep" (SJ Watson) but with an even more unreliable narrator.

[john_warner-1 · Rating: 3 out of 5 stars]

Amanda O'Toole, a 75 year widow, is found murdered with four fingers of her right hand surgically removed. She was the long-term friend of Jennifer White, next-door neighbor and renown orthopedic surgeon. Jennifer has retired from her practice because she has Alzheimer's Disease. The police consider her the primary suspect in her neighbor's death, but Jennifer doesn't know rather or not she committed the crime. The author, Alice LaPlante uses Jennifer's voice to drive the plot of this novel. The prose, which is expertly exercised by the author, is comprised of Jennifer's past memories and present experiences in a style which one might expect of someone with dementia. Alice LaPlante describes what it must be like to realize that your self-identity is slipping away.

[rdhawk6886 · Rating: 4 out of 5 stars]

One of the most original mysteries of the last several years. Memento meets The Woman Upstairs. The most unnerving aspect of the book is the narrator, Dr. Jennifer White's, descent into Alzheimer's. The interesting aspect is that, like in Memento, not only can the reader not rely on the narrator but the narrator cannot rely on themselves. Dr. White has fragmented recollections from various time periods from which she weaves her own reality. Even in her moments of clarity, we are uncertain how much to rely on the information provided by others around her, who are aware of her damaged and malleable memory. Interwoven through the narrative is an interesting family drama, hidden secrets, choices made, opportunities taken and untaken, complicated friendships and loves. The book loses its tightness in the 3rd quarter and the ending feels a little too pat or forced. The book may have benefited from ambiguity in which the reader was left to stitch together what they believed to be the truth from the mosaics provided by the narrator.

[petreaburchard · Rating: 4 out of 5 stars]

When I began to read I thought, "Hmm, good writing." Pretty soon, I couldn't put it down. I never thought I'd say that about a book told from the point of view of a woman with Alzheimer's, but this one's a page-turner.

Petrea Burchard
Camelot & Vine

[susan.h.schofield · Rating: 4 out of 5 stars]

Very unique book - definitely dark and gloomy. It is described as a mystery but I didn't feel it was as much of a mystery as it was a character study.

[martha.ott · Rating: 2 out of 5 stars]

She used to be a surgeon, now her mind is slowly disintegrating. A victim of Alzheimer's disease, is she also a murderer? Even she isn't sure. Did she kill her best friend? The police think so, but why, and how could she?

[liz_57-1 · Rating: 4 out of 5 stars]

While this is fiction the whole aspect of the story from the person with Alzheimer's was facinating. One of my grandmothers had Alzheimer's and one had "dementia". So each time I forget something or it takes longer to process information I get a bit nervous. Excellent story telling.

[grothenberger-1 · Rating: 2 out of 5 stars]

I have very mixed feelings about this book. The writing was very good. I felt the ending was somewhat predictable, but no more so than a lot of other books I've read. My main problem was the main character. I have problems dealing with main characters with dementia, especially when the story is told almost exclusively through that character's point of view. It makes it difficult to follow. In fact, I was having such problems following things in the print version, I had to switch to the audio version. None of the characters other than the police detective were really likeable. Many of them had few redeeming qualities at all. It does make for an interesting glimpse into the mind of someone living with dementia. What is less obvious is the effect that person's disease has on those s/he interacts with. A wider range of viewpoints might have helped with that, made the story easier to follow, and made some characters more likeable. To sum up, the story was good, but it's not something I want to read again.

[jmoncton_1 · Rating: 3 out of 5 stars]

This combination fiction/mystery tells the story of Dr. Jennifer White, a brilliant surgeon who specializes in hand surgery, and is suspected of murdering her best friend and then carefully removing her fingers. The hitch in this story is that Jennifer has Alzheimer's and can't even remember that her friend has died, let alone whether or not she was the murderer. What makes this book fascinating is that the narrator is Jennifer and is told in the voice of someone with drastic mood swings and severe memory loss. I really enjoyed seeing this perspective of Alzheimer's. But, the mystery portion was only mediocre for me. In fact, I finished this book less than 2 months ago and somehow, I cannot remember who was the murderer (at least no spoilers here!). Maybe it's early onset dementia for me, but the mystery part of this story was not that captivating (or memorable), but the emotion and frustration of a highly skilled person going through such a debilitating disease was fascinating.

[cather00 · Rating: 4 out of 5 stars]

This is more of a 3.5-star review because of the ending. I loved the story from Jennifer's perspective, although at times, it was heartbreaking.

[2lz · Rating: 3 out of 5 stars]

In Turn of Mind by Alice LaPlante, Dr. Jennifer White is a talented orthopedic surgeon suffering from Dementia/Alzheimer's Disease. Her disease has forced her to retire. Her best friend, Amanda, has been killed and whoever murdered her, surgically removed 4 of her fingers with precision. Thus, Dr. White is the person of interest in Amanda's murder. The problem is that Dr. White's mind is deteriorating so rapidly that it is difficult to get to the truth.I liked that the story was written as journal entries. The reader does have to adjust to this writing style because the entries are written mostly by Dr. White (but by others as well) in different tenses and with varying degrees of clarity. The writing felt real to me and captured a struggling mind. The entries allowed you to gather just enough information to determine what was happening, but also caused you to question their validity. What was true or a skewered version due to Dr. White's disease or her hope to hide the truth?However, for the most part this book was not for me. I wanted to feel for this main character. She was a brilliant woman, educated and hard-working who was becoming a shell of herself. I couldn't find a way to like her, even though I tried throughout the book. In fact, there weren't many characters that I did like, including the victim. I found her son, Mark, to be self-absorbed and self-involved. There were moments that I felt for her daughter, Fiona, but they were brief. The only characters that I felt any real connection with were Magdalena, the care-giver at the beginning of the story and the police detective. I would have liked to have known more about them. Part of the problem is that with a main character suffering from a memory disease, the reader is limited as well by her illness. Maybe the reader was supposed to be frustrated with the lack of information as the main character was frustrated by her own memory loss.Additionally, there were events that took place in the story that I don't believe ever would have happened. For example, once an attorney was obtained for Dr. White I don't believe that there could legally be any police interaction with her without her attorney being present, especially with a person suffering from a mind illness. Dr. White was incapable of waiving her rights. The police could not rely on the truth of her statements, and any information obtained during those illegal interrogations could not be used against her.This story had the potential to unfold into an exceptional mystery. It fell flat. In fact, there was no real intrigue.I was expecting more. I found Lisa Genova's Still Alice to be a better story with more emotional impact.

[angelswing_1 · Rating: 5 out of 5 stars]

Wow! This is a really good book. It's the author's first book, and I really enjoyed it. It's kind of a mystery/suspense story with a twist at the end I didn't see coming. If you haven't read it, you should read it.

[ccayne_1 · Rating: 4 out of 5 stars]

Compelling read with a mix of mystery and medical. LaPlante is very disciplined in keeping the point of view of Dr. White who has Alzheimer's. The reader is as thrown off kilter as are all the characters as they try to figure out who killed Amanda and whether or not Dr. White had any involvement.

[imperfectcj · Rating: 3 out of 5 stars]

I'm impressed that LaPlante wrote the entire book from Jennifer White's fractured perspective and this book wasn't more tedious to read. It's an interesting concept and fairly expertly executed. The effect most of the time was somewhere between reading the "Benjy" section of The Sound and the Fury and watching Memento. I found that I couldn't stop reading in the middle of one of the sections because I would lose my place. So I would just sit down and power through to the end of the section. Most of the time, once I got there, I was so engrossed in the story that I just powered through to the end of the next section.

The narrator was not a likable person. Pitiable? Yes. Likable? While I felt sorry for her, my prevailing feeling was a sort of grim satisfaction: she was now reaping what she'd sown. I was skeptical of how many of her thoughts were spent on her family when she'd until very recently done little more than build her career. Until her illness, it didn't seem as though Jennifer spent much time thinking of her children at all. I was surprised at just how devoted her children were to her after she'd spent their entire lives absent and not at all sure she even loved them. But I suppose LaPlante addresses this by explaining that the nature of Jennifer's illness opens things up, allows her to poke at uncomfortable places in her memory. It's as though her penance for living an unexamined life is to be trapped inside the memories of that life.

And the ending. Well, I won't say anything about the ending except that it was a bit disappointing. Throughout the book, I could see the flame of the firework rising into the sky. I read with anticipation: When it exploded, it was going to be good. But then it got to the top of its arc, shot off a small fountain of purple sparks, and then faded into the night's sky.

But then, I'm rarely satisfied with endings.

I enjoyed this book. It's a unique perspective and LaPlante pulls it off well. So don't let my complaints about the ending and the main character put you off of it.

[emcelroy_8 · Rating: 4 out of 5 stars]

Gripping book from the perspective of a 64 year old woman with Alzheimer's

[tracey8824_1 · Rating: 3 out of 5 stars]

I was so excited to read this book I practically danced out of the library. I told my kids they were on their own for food for the weekend. I had a good book to read. :)

The first thing I noticed when I started reading was the lack of quotations. It took me a little while to get into the story because I was distracted by it. After a while, though, I got used to it.

The story is told by Dr. Jennifer White. She is a very successful surgeon who is retired because of Alzheimer's disease. She has been accused of murdering her best friend, Amanda, and amputating 4 of her fingers. It is challenging finding out what she knows because of the loss of memory. Her children, Sophie and Mark, visit their mother and sometimes she remembers who they are but sometimes she doesn't. They are at odds over control of Jennifer's money and her estate. We are given glimpses into Jennifer's past life with her husband and her friend, Amanda. The author does a wonderful job of showing the relationships Jennifer has with the people in her life without showing us too much.

While I didn't find any of the characters particularly likable, I did feel sympathy for what Jennifer and her family had to deal with in terms of her dementia. The story ended with the reader finding out who killed Amanda.

I wonder how much Jennifer did remember about the murder compared to what she told the police.

[porch_reader · Rating: 4 out of 5 stars]

A murder mystery in which the main suspect has dementia - the premise of this book intrigued me from the time I first read about it. I was pulled into the world of Dr. Jennifer White immediately. LaPlante does an outstanding job of putting us inside the confused world that the recently widowed orthopedic surgeon inhabits. We gradually learn more about the murder that she is suspected of committing from her children, her caregiver, and the detective on the case, but unraveling the details is not easy given that the suspect herself has a shifting memory of what happened. Although I found the experience of being inside Jennifer's head fascinating, the other characters in the book were not terribly well defined (in part, because we saw them through Jennifer's eyes). This made it hard to move beyond Jennifer's perspective and to engage in the broader plot of the book. However, the book was worth reading simply because of LaPlante's ability to capture Jennifer's perspective.

[debs4jc · Rating: 5 out of 5 stars]

Dr. Jennifer White was a highly skilled orthopedic surgeon whose specialty was hands. She was forced to retire because of her dementia, and now she lives a quite life with her caretaker. Her children visit occasionally and have the power to take care of her finances and medical decisions. But her carefully constructed plan for easing her last days is disrupted when her best friend and down the street neighbor is murdered. Amanda was more than a friend to Jennifer--she was the godmother of her children, her confidante, the one who truly understood her. But could Jennifer herself have been involved in her murder?--after all, her fingers were cut off. This is the question that the police, Jennifer's children, her caretaker, and the reader all want to know the answer to. But since this story is told from Jennifer's point of view it is hard to get at the facts through the haze of dementia.This was an excellent story, there is the element of it being a mystery where the reader is trying to guess who killed Amanda. But it is also a fascinating character study as the reader follows Jennifer's thoughts and memories. Her children, family, and friends all come across as vivid characters as well. I think this would make a great book for discussion groups who could discuss these strong characters and their secrets and associations, as well as the role that dementia plays in the book and the good or bad of secrets becoming uncovered.

[jjbooklvr · Rating: 4 out of 5 stars]

I read this for my February book discussion group. Jennifer White is a retired orthopedic surgeon who is suffering from dementia. When her neighbor and best friend is killed, Jennifer is a "person of interest" in her death. The problem is Jennifer does not recall anything about what happened and even if she was there. Or does she? The book is told from Jennifer's point of view and she is not the most reliable narrator. In her moments of lucidity we get bits and pieces of her life story and the people who come in and out of it. The author does a great job of bringing us inside the mind of a person suffering from dementia and the issues the disease causes. Definitely a book that stays with you after the last page is turned.

[alyson_1 · Rating: 4 out of 5 stars]

Fascinating look at this women's mind and an interesting mystery, but not an easy read, because it is so painful at times.

[loosha_1 · Rating: 4 out of 5 stars]

Alzheimer's is a bitch of a disease. I've seen it in its early onset stages with my husband's mom, in its later stages, and in its alternate form, vascular dementia, with my dad. This book gave me more insights into what its victims go through but I doubt the lucidity of speech, the ready access to words and ideas, that we get from this 1st person account. In my experience, limited, (and none of my examples were doctors,) the experience and the suffering is worse than portrayed here. So...hopeful in that some skills are retained in spite of the tremendous losses.It is effective as a mystery-murder story as well.

[smik_3 · Rating: 5 out of 5 stars]

This is the second of two books chosen by my book group for our current read. (The other is BEFORE I GO TO SLEEP by S.J. Watson which I read last year.) Both books deal with memory loss but that is where the similarities really end.Dr. Jennifer White is an a retired orthopaedic surgeon struck down by Alzheimer's at a relatively young age. The story is told primarily through a journal in which Jennifer and those who care for her or visit her record the events of the day. The other main "voice" is Jennifer's own mind as it reacts to the people who visit her, whom she doesn't always recognise, and the conversations that take place around her.Through Jennifer's recollections of her adult life we are able to piece together details of her marriage to her husband James and their relationship with the couple, Amanda and Peter, who lived just 3 houses down.From time to time Jennifer's world is peopled with family members and friends who have long "gone", and at times she thinks she is much younger, still working in a busy practice, while at others she is troubled by mistakes she made. The events in the journal make the reader aware of changes in Jennifer's circumstances as she is moved out of her home and into a care facility. Her children visit with motives not always driven by concern for her.Through the persistence of Detective Luton who is investigating the death of Amanda the reader is eventually led to an understanding of what happened.This is crime fiction because a murder appears to have taken place, but the focus of the story is less on the crime than on what has happened to Jennifer's mind, and on the deterioration still continuing. I suspect for many who have family members stricken with Alzheimer's it will come very close to the bone. The unusual structure of the novel is very effective.

[arielfl · Rating: 5 out of 5 stars]

Dr. Jennifer White is a brilliant hand surgeon losing her mind to the fog of dementia. Before she slips away however, police detective Luton is determined to get answers about the murder of Jennifer's best friend Amanda. Except that Amanda was more frenemy than friend and answers are hard to come by in Jennifer's world.I thought the idea of writing the book from the perspective of a person suffering from Alzheimers was brilliant. The author Alice La Plante does a fantastic job of pulling it off too. The book is told in three parts. In the first part Dr. White is still living at home, in the second part she is a nursing home, and in the third part she makes a run for it. Other than the three parts, the book is not broken up into traditional chapters. The sentences relate Dr. White's stream of consciousness. Some of her thoughts are lucid, some are confused, and some of are remembrances of the past. When she is finally able to dredge up a memory, you get another piece of the puzzle. The author successfully puts you in the mind of someone whose thoughts are slipping away. It takes the idea of a unreliable narrator to a new level.None of the characters in this book had any redeeming qualities. Everyone, whether caregiver or family member was despicable. Liar, thief, drug addict, adulterer, they were all in there. I find it hard to believe that every single character could be so immoral. Also the third part of the book was a little draggy until the big reveal at the end. These are minor quibbles though. I admire La Plant for coming up with such an original and entertaining story. Highly recommended.

[casualfriday_1 · Rating: 3 out of 5 stars]

This literary mystery is narrated by Jennifer White, a hand surgeon suffering from Alzheimer's disease. Her thorny best friend, Amanda, has been killed, and the circumstances implicate Jennifer, who cannot remember that Amanda is dead, much less what her own role might have been in the death.This book has been very well reviewed, but I didn't like it as much as I expected to, and I can't say exactly why. The prose is beautiful and the time-shifting structure and unreliable narration make for an interesting puzzle. I often liked Jennifer's voice very much, but overall, I didn't believe in her voice: it felt more like a narrative device than an accurate portrayal of Alzheimer's.

[bookczuk · Rating: 5 out of 5 stars]

The only reason I picked this book up was because it was the first of this year's Stanford Book Salon's selections. I have a deep, unholy fear of developing Alzheimer's and as a result, avoid anything that has the slightest hint of the disease. Reading this book, it is unavoidable. Alzheimer's enters your life, your mind, your thoughts, and your world. But it's only fair. It has done the same to the narrator of the story, Jennifer White, a recently widowed, gifted and brilliant orthopedic surgeon.Alice LaPlante does a magnificent job of portraying Dr White's world through the use of a notebook she uses to write a record of her days and life, and then through Dr White's own thoughts. She's progressed beyond the phase of lists and sticky notes plastering her home. When the diagnosis of early onset Alzheimer's hit, she retired from her profession, and engaged a live-in companion/helper. The book opens shortly after Dr White's best friend, Amanda, is found murdered, with the fingers of one hand neatly amputated. Dr White is "a person of interest" in the case.The reader is taken through the twists and turns of Jennifer White's diseased mind. We meet her children, her husband, and friend through memories that seem as present day to Dr White. Woven through this world is the underlying investigation of Amanda's death. Dr White is at some moments totally in the present, fully aware of her condition, competent and lucid. At other times, she is (and I mean this in the nicest of ways) crazy as a loon, paranoid, sly, and cunning. It is brilliant, totally real, brilliant. I still am terrified of becoming lost myself, becoming a stranger to myself and my family, but this book really hit a chord, and helped me to explore some of my own anxiety.One of the interesting aspects of this novel for me was that I was so drawn into it, but really didn't like almost all of the characters. Dr White was a highly regarded surgeon, but as a mother and wife, she was less than stellar. Her kids both "have issues." Her husband wasn't all he was cracked up to be. Even the murdered Amanda was a not-so-nice person. The best character for me was the police investigator, gave a beautiful description of what it is to lose a loved one to this horrible illness. I found myself speaking similar words to my aunt, who just had my uncle placed in a long care facility for people with Alzheimer's. Only it wasn't my uncle. He'd left us long ago, for the most part. It has been years since we dealt with just forgetfulness. What loved ones, and even the person themselves, is unprepared for is that the entire personality can change, and the person you love leaves you a thousand different ways, replaced by someone totally unfamiliar. They can be vicious and angry. They can be charming. But they never again are the person you knew. Yet you lose them over and over, every day.This was a compelling book, both heart-wrenching and beautifully drawn. It's yet one more reason I am grateful to the SBS for taking me outside my comfort zone, into the world of amazing writing.

[booklovers2 · Rating: 4 out of 5 stars]

Page turner, easy read- Reads like a diary. Difficult and heart breaking topic. Well done, this author must have experienced dementia of a loved one. Dr. White, a retired ortho-surgeon is having bouts of forgetfullness. Her best friend is found dead with 4 fingers precisely severed. Did she do it? Keeps you guessing til the end.

[michelesw · Rating: 4 out of 5 stars]

Another very quick re-read, just because it was at hand when I was looking for a new book. Turn of Mind is the story of Jennifer White, an Alzheimer's victim who was a successful hand surgeon, wife and mother of two children. As the book opens, Jennifer is living at home in her Chicago brownstone with a caretaker. Her son, Mark, and daughter, Fiona, visit frequently. Fiona is a financial genius who been given control of Jennifer's $2-3 million dollar estate. Mark is a struggling lawyer trying to live up to his father's outsized success. He seems preoccupied with Mom's money, but Fiona is cashing out assets $50,000 at a time, so it's unclear who is the bad child here. There is another major complication, however. Jennifer's best friend and neighbor, Amanda O'Toole, has been murdered in her home; four of her fingers have been sliced off. Jennifer was seen at her home the day of the murder, and was known to have argued with Amanda. The police detective assigned to the case is a thorough, dogged woman (a lesbian as it turns out, whose life partner has died of complications from Alzheimers) who pursues Jennifer beyond all reason. As she declines, Jennifer is forced to leave her home for a private nursing facility. Along the way we discover her secrets one by one, and solve the mystery of who murdered Amanda and why. The book is full of rather cynical observations -- Jennifer thinks that if people knew more about what motivates surgeons they would be more afraid of the doctors than the disease. When she is losing her ability to speak at all on her worst days, she feels freer to think about things she refused to consider before. Her thoughts come largely in picture form, but she sees some things more clearly than ever, and sometimes she can express her thoughts in elementary words - to the dismay of those who are keeping their own secrets. I liked the writing style and the descriptions of mental deterioration seemed believable to me. It's a pretty bleak view, though.

[squeakychu · Rating: 4 out of 5 stars]

This turned out to be a very interesting story told through the perspective of Dr. Jennifer White, an elderly woman and former orthopedic hand surgeon, who is questioned about the murder of her best friend Amanda. Amanda's body was found with four fingers surgically disarticulated. What should have been an easy detective investigation was hampered by the fact that Dr. White was suffering from increasing dementia. With her husband James dead, Dr. White is left under the supervision of caregiver Magdalena and receiving interspersed visits from her son Mark and her daughter Fiona.Throughout the book, we feel the frustration the increasingly demented Dr. White, her family members, and the police as the surgeon's memory not only weaves in and out of clarity but also deteriorates rather rapidly. What makes this story so heartbreaking is that it's quite easy to identify both with Dr. White and those caring for and about her.I admit that I did find the body of book just a tiny bit tedious, but my push through the story was well worth it except for the very ending. At that point, I felt sort of frustrated because I didn't clearly understand (or remember?) all the details that preceded it. I am not good at murder mystery details, so that might be the reason!At any rate, the author did a very good job of making the reader understand what it feels like to lack clarity of thought and personal independence. This is an impressive debut novel and one that will encourage me to read more of Alice LaPlante's future works.

[sheilaref · Rating: 5 out of 5 stars]

Marvelous book, about a woman with Alzheimer's who is suspected of killing her best friend. Since she has dementia, she cannot remember wheter or not she did it. Clever plot, well-written,