The Theft of Memory

Losing My Father, One Day at a Time

National Book Award winner Jonathan Kozol is best known for his fifty years of work among our nation’s poorest and most vulnerable children. Now, in the most personal book of his career, he tells the story of his father’s life and work as a nationally noted specialist in disorders of the brain and his astonishing ability, at the onset of Alzheimer’s disease, to explain the causes of his sickness and then to narrate, step-by-step, his slow descent into dementia.

Dr. Harry Kozol was born in Boston in 1906. Classically trained at Harvard and Johns Hopkins, he was an unusually intuitive clinician with a special gift for diagnosing interwoven elements of neurological and psychiatric illnesses in highly complicated and creative people. “One of the most intense relationships of his career,” his son recalls, “was with Eugene O’Neill, who moved to Boston in the last years of his life so my father could examine him and talk with him almost every day.” At a later stage in his career, he evaluated criminal defendants including Patricia Hearst and the Boston Strangler, Albert H. DeSalvo, who described to him in detail what was going through his mind while he was killing thirteen women.

But The Theft of Memory is not primarily about a doctor’s public life. The heart of the book lies in the bond between a father and his son and the ways that bond intensified even as Harry’s verbal skills and cogency progressively abandoned him. “Somehow,” the author says, “all those hours that we spent trying to fathom something that he wanted to express, or summon up a vivid piece of seemingly lost memory that still brought a smile to his eyes, left me with a deeper sense of intimate connection with my father than I’d ever felt before.”

Lyrical and stirring, The Theft of Memory is at once a tender tribute to a father from his son and a richly colored portrait of a devoted doctor who lived more than a century.

 

“Among Jonathan Kozol’s gifts as a writer is his ability to enter the world of his subjects, to live in the country of their experience and to tell their stories with clarity and compassion. This beautifully told personal account is further enriched by an abiding family love.”

— Reeve Lindbergh, Washington Post (SUNDAY)

“Kozol’s story is one of dogged determination to do right by his parents, who both lived past 100. Their blessings, he writes movingly, “outlive the death of memory.” His empathy should come as no surprise to readers familiar with his advocacy for disadvantaged children in such books as “Savage Inequalities” and “Amazing Grace.” Like so much of Kozol’s work, “The Theft of Memory” addresses important issues about a defenseless segment of society, the elderly, with plainspoken clarity and deep-felt compassion.”

— Heller McAlpin, Washington Post (DAILY)

 “The Theft of Memory” celebrates the bond between father and son in thoughtful, often beautiful prose…”

— Jim Higgins, Milwaukee Sentinel

“His account of how Alzheimer’s overwhelmed his father, and nearly crushed his son, offers powerful and poignant insight into a looming plague…”The Theft of Memory: Losing My Father, One Day at a Time” (Crown, 320 pp., $26) is a travelogue into a scary future, a primer on what to expect when a parent becomes a helpless and confused patient. On a richer level, it is a love story for a new era.”

— Robert L. Smith, Cleveland Plain Dealer

“In the end, this book is less about the loss of memory than the effort to create a testament to forgiveness and love.”

— Kathleen Hirsch, Boston Globe

“…this is a story about breaking conventions, an urge to rethink the patient, and thus the account is very much in keeping with Jonathan Kozol’s singular mind…Those final years were ‘a journey in which our arms were more closely interlocked,’ Jonathan says. “As if together we were navigating the mystery of thinking. The mystery of memory.”

Jennifer Wells, Toronto Star

“The Theft of Memory is a stirring, at times heartbreaking book about a brilliant doctor’s valiant fight for his dignity following a devastating Alzheimer’s diagnosis. Jonathan Kozol delivers this compelling narrative of his father’s life and final years with extraordinary tenderness. Straight from the heart of one of our most thoughtful writers, this book is a revelation, offering both a celebration of the bond between a father and son and an insightful glimpse into the workings of our memories and the legacies we leave behind.”

— Gay Talese, author of A Writer’s Life

 “For a number of reasons, many of us avoid thinking about old age, fading health, and death. Kozol’s plainly and powerfully written book about his remarkable father is a notable and compassionate exception. It deserves to live on a small shelf with John Mortimer on Mortimer senior, Didion on Dunne, Bayley on Iris Murdoch, and Gawande on Gawande…A fine and often eloquent book about holding on while letting go.”

— Lawrence Hartmann, M.D., Past President, American Psychiatric Association

“Jonathan Kozol accomplishes something remarkable in The Theft of Memory: He preserves the essence of his father in the one place disease cannot touch him—on paper. As his father, a brilliant, Harvard-trained neurologist, falls deeper and deeper into the darkness of dementia, Kozol illuminates his father’s past in jigsaw: through stories, research papers, patient histories, love letters, old stethoscopes—creating a soulful collage of a great man by his supremely gifted son.”

— Susannah Cahalan, author of Brain on Fire

“Readers familiar with the emotional toll exacted by a loved one with Alzheimer’s will embrace Kozol’s nostalgic, often heart-wrenching narrative as an important addition to the genre. A compassionate, cathartic, and searingly intimate chronicle of a crippling condition.”

— Kirkus Reviews, starred review

“The author’s approach is shrewd yet warmly empathetic; he is curious about how the mind’s gradual breakdown exposes its machinery, and raptly attuned to the emotional effects of these changes on his parents and himself. The result is a clear-eyed and deeply felt meditation on the aspects of family that age does not ravage.”

— Publishers Weekly, starred review

CHAPTER ONE
The Onset of an Illness

My father was diagnosed with Alzheimer’s disease in 1994 when he was eighty-eight years old. He was a neurologist, with an extensive practice in psychiatry as well, and had taught for many years at one of Harvard’s major teaching hospitals. It was one of the doctors he had trained who made the formal diagnosis of his illness.

The earliest signs of problems with his memory appeared about four years before. There would be times when he found it difficult to summon up the name of someone he knew well. Now and then, he’d also lose his purchase on a set of facts with which he wanted to support an argument. At other times, he’d briefly lose his sense of continuity in the course of what was otherwise a cogent conversation.

But my father had tremendous social competence. He’d navigate these awkward moments with congenial ease. He’d smile at his own mistake, then offer me perhaps a glass of brandy, and sit down and question me about my work, or tell me of a book that he was reading, or share with me an anecdote about his own career.

Sometimes he would light his pipe. (He liked to take his time packing the tobacco.) The aroma of the smoke as it rose up about him remains in my memory, comfortably intertwined with the sense of relaxation, confidence, and calm that I identified with all those other quiet and consoling conversations we had had over the years.

Then, in 1991, he started to get lost at night when he’d go out to take a walk in Copley Square, which is in the neighborhood of Boston where he and my mother lived. He’d come home three hours later and report perhaps that he had made friends with a couple visiting from London or Geneva, or that he had been at Buddenbrooks, a bookstore that was close to his apartment, and had had a conversation with a foreign student whom he might have met there. My mother would worry terribly, of course, when he was gone so long. His interesting narratives, I thought, were meant to reassure her.

In spite of his confusions, he continued to try very hard to get some work done every day. He had given up his medical practice by that time, but he was determined to complete some papers he’d begun— summations of ideas that he’d developed in the course of his career on the neurological and psychiatric origins of certain forms of pathological behavior. A friend of mine, a teaching assistant at a local university, was helping him to organize his thoughts and bring coherence to his writing. On occasion, when my father asked, I would help him too.

It was not long after this, however, that my father’s restlessness would overcome his capability for concentration. After an hour or two of work, he would push the pages aside, get up from his desk, put on his jacket and an overcoat, if it was cold weather, go down to the lobby of the building, and head off into the nearby streets for another of his evening journeys.

One night in 1992, he asked me to sit down with him in a room of his apartment that he’d been using to store an old examination table and some other items from his former office. He said there was something he needed to discuss with me. He told me that he hadn’t yet decided whether it was wise to discuss this with my mother.

After he had closed the door, and both of us were seated, he started to lay out to me, in fairly graphic terms, what he described as “new and more specific indications” of problems he was having, which, he said, were “clearly neurological.” He checked again to be sure the door was firmly closed and then began explaining to me what he meant by “more specific indications.”

He said that he’d been having “spells”—he added that he did not mean by this the incidents of memory loss, which he called “amnestic spells,” but something “of a different order altogether.” He spoke of these as “brief attacks of interrupted consciousness” during which he recognized “a sudden cutoff from my own surroundings,” “a definite blocking of ‘capacity,’ ” lasting “maybe only for a millisecond or for several seconds or a trifle more.” These episodes, he said, had been preceded in each instance by “an aura of impending danger” that he likened to the sense of warning epileptics often feel just prior to a seizure.

He did not say this with the urgent sense of self-concern one might expect a series of events like these would ordinarily arouse. Instead, he spoke as if he was attempting to position these events at a distance from himself, so that he could speak of them with the detachment of an interested observer.

“I can pinpoint this as a neurologist,” he said, and he speculated that his recollection of what he’d been observing in himself might hold potential value for clinicians and researchers. For this reason, he plugged in his office tape machine, which he had used to dictate letters and reports on patients he was treating, and he recorded the remainder of our conversation.

He said that the amnestic spells were “clear-cut indications of degeneration of the cells in the cortex of the brain and in the hippocampus,” and he showed me by the placement of his hand exactly where the hippocampus lies. He speculated also that “mini-strokes of very short duration,” which he termed “a vascular phenomenon,” were in all likelihood the reason for his episodes of interrupted consciousness.

Even more specific was the detail that he brought to the portrayal of that aura of anticipation that preceded this. He described it as “a feeling of uncommon and uncomfortable heat, ‘a hood of heat,’ as it were, that someone or some unknown force is drawing down over my forehead and my eyes . . . , as far down maybe as my chest or throat,” and in another and, to me, more memorable phrase, “a feeling of impending desecration of my own autonomy—a premonition of my imminent removal from contextual reality. . . .”

During that experience, or intermingled somehow with the loss of consciousness that followed, my father told me he was suddenly aware of “a very bright light,” like that of “a locomotive bearing down upon you in a station.” But then, after a moment of reflection, he corrected this from singular to plural—“No. Not a single light. Many lights”—and then, as if he was, step by step, retrieving the experience with more and more precision, he said, “I’m now recalling it more clearly. This was not a static light. It was more like flashing lights, coming up in rhythm. Thousands of lights shooting upward . . . and symmetrical. I remember that this frightened me. I needed you to know this.”

It was the first time in the conversation that he let himself concede that he had been alarmed by this experience. “Those flashing lights are warnings of irregular electrical activity in the neurons, or between the neurons, which may terminate quite rapidly—or may not. In my case, it ended very quickly.”

In the most recent incident, he recalled, “As I was coming out of this, I was aware of being very cold. There was cold sweat on my upper lip. Your mother was with me. She could see me shivering.”

When I asked him where he was, he said, “In a restaurant. We were having dinner.” As the attack subsided, he went on, “I heard a loud voice. ‘Harry, are you hearing me?’ ” Although my mother realized that he wasn’t well, he did not reveal to her what he’d just been through, because, he said, “Your mother’s constant worrying is worse than anything my hippocampus may intend to do to me.” I hoped my mother wasn’t listening outside the door while he was speaking. . . .

Having said this much, he seemed to be relieved, and he fell into a more reflective and more contemplative state of mind. Speaking now with less of the alarm he had displayed a moment earlier but once again in the more measured tone with which he had begun the conversation, he speculated that the light phenomena he had recalled (those “flashing lights coming up in rhythm . . . and symmetrical”) “would have to have emerged from the occipital”—“from the posterior of the occipital,” he specified, which he then explained to me, as if I were his student in a class on physiology, “is the region of the brain that processes our visual experience.

“This part,” he said, “is something of a puzzlement. It’s something that I’ve never seen in any of my patients. . . .”

At that point, I suggested—not without some hesitation—that perhaps he ought to speak about these episodes with one of his colleagues. I asked him whether it was wise for him to try to fill the role of being his own doctor.

He looked at me for a long moment, searchingly, it seemed. Then he said that he intended to talk with a neurologist with whom he’d consulted on many of his cases—“I think I told you he was once my student”—but he took the opportunity to entertain himself by remarking that, although the man in question was “very bright” and “top-rate in the field,” he was “a peculiar fellow, humorless and dour. Always was, as long as I have known him. I used to want to ask him what it’s like to go through life without a personality.”

He told me, in any case, not defensively or angrily but simply as a statement of determination, that he would see him at a time of his own choosing. “I want to ask you not to pressure me about this.” He added that his confidence that I’d respect his judgment was precisely why he’d had this conversation with me, and not with my mother.

He waited another year and a half, but when he knew the time was right he phoned his younger colleague and set up the consultation. There were no surprises. He knew what he would hear. The diagnosis by his former student was simply confirmation of what he already had discerned.

CHAPTER TWO
The Ends of Days

My father continued to live in the apartment for two years after that. It wasn’t easy for my mother as his restlessness intensified and his memory progressively declined. The friend who had been helping him to organize his writings began to stay there overnight to relieve my mother’s burden and to help my father deal with his confusions.

There were days when he would seem almost clear of mind. His conversational agility had not departed him. When he was in a tranquil mood, he could still be courtly with my mother. For all the tensions that simmered up between them, she didn’t want to lose him.

Then, in 1996, he fell in the street in front of their apartment building on a rainy evening. A police car took him to the hospital. He had suffered a displacement of his hip. After surgery, when he came out of anesthesia, he had lost almost all recognition of what had happened to him, what his present life was like, or even where he lived.

After several weeks had passed, he regained a number of these memories, as well as a partial understanding of the situation he was in; but the time in which he’d been under anesthesia seemed to have left its permanent result in an unmistakable reduction of his cognitive capacity. He had to be placed in a rehabilitation center after surgery, and then, because of the suddenly accelerated diminution of his competence, I had to move him to a nursing home.

I was somewhat on my own in making these arrangements. Although I have an older sister, she had moved away from Boston more than forty years before and had settled in the Midwest with the man she married. She had two children (they were adults now) and an extended family of her husband’s relatives, and many obligations and demands upon her time far from Massachusetts. For these reasons among others (my father had appointed me to be his legal guardian), decisions about choosing the right nursing home, working out the numbers for the costs this would entail, and making it a smooth transition fell to me, as did later choices that affected his well-being. My mother, of course, guided me as best she could in most of these decisions.

In the following month, my mother asked me to come in and try to sort out some of Daddy’s correspondence and his other papers. Several years before, he had sent me most of the case histories and related documents from his medical career for safe-keeping in my home, where they remained in large sealed boxes I had never opened. But there were other items he’d left here in his desk and in a metal filing case in a corner of the living room.

While looking through these documents, I found a picture of my father as a child. The photo was from 1912, when he was six years old. He was wearing knickers and a long-sleeved shirt, leaning against his father, who was wearing a formal-looking suit, a shirt with a round collar, and a broad and thickly knotted tie. My father’s hand was holding his father’s hand. The photo had a brownish tinge.

My mother was older than my father. He was ninety when he went into the nursing home; she was ninety-two. Although her body had grown frail, she was still a relatively healthy woman and still sharp and lucid in her thinking. But when my father had to go into the nursing home I saw a lost look in her eyes I’d never seen before. When I was sitting with her in her bedroom later in the week, she looked away from me, gazing out the window, across the river, at the Cambridge skyline, for the longest period of time. I had to speak in a loud voice to bring her back so she would see that I was there and speak to me directly. I showed her the picture of my father that I’d found. She said, “Your grandfather was a handsome man, but no man that I ever met was as good-looking as your father!”

My grandfather had come to the United States ten years before that photograph was taken: the start of a century that now was nearly at its end. He had grown up in a village in the Ukraine, which was part of Russia then. My grandmother followed him two years later on a ship from Rotterdam to Boston.

Grandpa was a tailor but was earning very little money at the time when she arrived, so she somehow managed—I still do not know how—to rent or lease a tiny store where she sold eggs and milk and ice and soda, which was known as “tonic” in those days, and some other groceries. I was close to my grandmother when I was a child. She lived on Seaver Street in Roxbury, which had been a mostly Jewish neighborhood until recent years. When I was at Harvard College, I would sometimes visit her on Friday nights.

My grandmother seemed to me a woman from the Bible. She lit the candles in front of me and said her prayers and gave me blessings and good dinners. Even when I was twenty-one years old, she’d still put candy Kisses in my pocket when I was about to leave.

When I became a teacher in the Boston Public Schools in 1964, I would now and then bring students with me to her house on afternoons or weekends. My students were black children. My grandmother had been hostile to black people when they moved into her neighborhood. Their presence had frightened her at first. But the playfulness and sweetness of the eight-and nine-year-olds I brought to visit her soon dispelled her biases and fears; they won her over with their innocence. She fed them and coddled them the same way she had done with me. They too got candy Kisses.

Now and then I brought my students to my parents’ home as well, and, after my grandmother died, I did this more and more. My mother grew attached to certain children and would sometimes take the girls on shopping trips, then bring them home for tea. My father later helped some of my students go to college.

Many of my friends during the 1960s were political rebels and seemed to turn against their families for a time. Like them, I often had strong disagreements with my father, and I sometimes caused him needless worries and hurt him unintendingly; now and then, he could be harsh with me as well. But even in the last years of the 1960s and the first years of the 1970s, when my political beliefs became most heated and most radical and, I’m sure, more than a trifle grandiose, I found that I would turn to him when I was feeling insecure. He had a steadying hand.

As the years went by, however, and I found myself increasingly caught up in policy debates and in political forensics and was forced to travel a great deal, there were periods of time in which I didn’t see my parents very much. Those were also years when I was writing books with a determined productivity that left me little time (or gave me an excuse to think that I had little time) to give them the attention they deserved.

Now, with my father in the nursing home and with my mother more and more confined to her apartment, with attendants to look after her, I felt angry at myself for all the opportunities I’d missed to be with them in the preceding years. As my father lost his wonderful proficiency with words, I wanted most to talk with him. As his memory failed and recollections of significant events that had taken place within the recent past appeared to have been lost for good, I wanted most to draw him out about the things he did remember.

My father had led a fascinating life that had involved dramatic changes in direction and, at one important moment, in the choice of his career. He spent much of his boyhood in South Boston, where his parents settled first after they arrived from Russia, and his later teenage years in Roxbury. He went to Boston English High, was admitted to Harvard in 1923, and earned enough to pay for his expenses by working at South Station as a soda jerk in his freshman year. He couldn’t afford to live at college in a student dorm, so he was commuting from his home in Roxbury that year. Starting in his sophomore year, he lived at Stoughton Hall in Harvard Yard and tutored wealthy classmates who, he said, often didn’t go to class and “drank more than they should” and, it seems, relied on him to get through their exams.

During his college years, he immersed himself in literature. He told me he had been especially attracted to Elizabethan poetry and theater; but he majored in psychology and spent much of his senior year working at a psychiatric institution called McLean and wrote his honors thesis—its title was “Religion and Insanity”—on the basis of his conversations with a schizophrenic patient he had helped to care for there.

In spite of his wish to continue with his interest in psychiatry, he went directly into Harvard Law School after college, pressured by his mother, who had wanted him to emulate his older brother, who had finished with his legal studies one year earlier. Only after traveling to Europe on a fellowship one summer to investigate the work of specialists in schizophrenia and meeting the man who coined the term, the great physician Eugen Bleuler, at his sanatorium in Switzerland, and later talking with the elderly neurologist Pierre Janet, an iconic figure in the study of hysteria, at the Hôpital Salpêtrière in Paris, did he make up his mind to give up law school and go back to Harvard College for two difficult semesters of chemistry, biology, and organic chemistry. By the end of that year, he entered Harvard Medical School, which was the start of yet another long and sometimes convoluted journey.

It had been hard for him to turn his back on expectations after he had been at law school for two years. To give that up because he had been stirred by his acquaintance with two elderly and eminent European doctors and was fascinated by the theories they discussed with him about psychopathology—and to do this at a time when he had yet to take the basic science courses that would be required for admission to the school of medicine—seemed very risky to his teachers and his mother. He did it anyway. Somehow the sheer bravado of this choice helped to fire up his energies and intellect enough so that he did it, not just with success but, as the years ahead would prove, with honor and distinction.

My father’s life intensifies my feelings of respect for people who do not insist on too much certitude about the maps they’re using and do not insist on knowing in advance what destination they’ll arrive at in the ends of days. For many years he worked primarily in diagnosis of brain injuries and tumors, while he also grew involved with the brilliant Stanley Cobb, a pioneering figure in modern neuroscience, and the famously autocratic Derek Denny-Brown, a New Zealand-born neurologist, during trial periods of a medication called Dilantin, which proved to be a major breakthrough in prevention of the seizures undergone by epileptics. Later, he gravitated more and more into the practice of psychiatry. He was, according to his former colleagues, a sensitive clinician with unusual capacity to diagnose and to identify the separate elements of neurological and psychiatric illnesses in highly complicated and sophisticated people.

Some of these were well-known people—artists, writers, intellectuals, for instance. In Eugene O’Neill’s last years, the playwright and his wife, a former actress named Carlotta Monterey, moved to Boston so that they could live close to my father’s office. Beginning in the spring of 1951, they took a suite of rooms in a small hotel on Bay State Road diagonally across the street from the handsome town house where my father practiced. He saw O’Neill, who suffered from a neurological disorder, a tremor that had been misdiagnosed as Parkinson’s disease, as well as from severe bouts of depression, at least once almost every day until O’Neill died of pneumonia in 1953.

He later entrusted to me many carefully packaged volumes of his daily observations of the playwright’s state of mind and records of their conversations with each other, which reveal the growing sense of fondness that evolved between them. My father was, of course, much younger than O’Neill, and he looked even younger than he was. As unexpected as this may appear in the relation-ship between a patient and his doctor, and in particular in the case of someone as allegedly austere and undemonstrative in the display of his affections as O’Neill, it strikes me that he looked upon my father somewhat in the way a person might have looked upon a younger brother or a son. O’Neill had lost one of his sons to suicide about eight months before he had become my father’s patient and had long been distanced from his other son and from his only daughter. Perhaps there was some kind of compensation in the close attachment he developed with my father.

I still have vivid recollections of the warm but often anguished references my father made to me about O’Neill, as well as his frustration with the playwright’s wife, who, as I recall, competed with her husband for my father’s time and loyalty.

I also remember the December day on which O’Neill was buried at a cemetery close to Boston. There were only three mourners at the grave site: the playwright’s nurse, my father, and Carlotta. None of O’Neill’s close colleagues from New York was present at the burial. My father later told me that they hadn’t been invited by Carlotta, in keeping with her husband’s wish that he be buried with simplicity and privacy.

After the playwright’s death, my father underwent a period of grief that my mother felt was almost clinical in its duration and intensity. “I held his wrist within my hand as his pulse was failing and his heart stopped beating,” as he recollected in one of the memos he was writing at the time. “I didn’t want to let him go. I had a sense of desperation. . . .” He later brought me and one of my college friends to see Long Day’s Journey into Night when it began its run in Boston, but he grew distraught during the play and had to leave the theater to recover his composure.

His memories of O’Neill and other patients he had treated were fading in and out, and growing less reliable, by the early 1990s; but his memory of what he did during the 1930s and the 1940s in the area of neurological impairment remained almost crystal-clear until the episode of injury and anesthesia that marked a sharp dividing line between the early phases of his illness and the onset of a deepening dementia.

Some of the most moving conversations that I had with him prior to his injury involved his effort to explain to me why memories of relatively recent happenings were beginning to be less and less accessible while others, such as memories of boys he knew and played with in first grade, and of the teachers he admired most at Harvard in the 1920s—Alfred North Whitehead, William McDougall, Abbott Lawrence Lowell, who was the president of Harvard at the time but also taught a government course my father took in sophomore year—were not only easy to recall but fresh and vivid, as if these were people he’d just seen or things he had just done.

“Lowell,” he said, “had a little dog, maybe twelve or fifteen pounds. He’d walk with him in Harvard Square. At the curb, he’d hook his cane under the dog, lift him up, and carry him across the street. . . .”

When he mentioned once that he’d studied with George Lyman Kittredge, whose annotated Shakespeare I relied upon when I wrote my thesis in my senior year, I naturally asked if he had had a chance to grow acquainted with him. “No,” he said. “It was a large lecture class and, as I recall, I was just a sophomore. Or, now that I think of it, I might have been a freshman. I would not have dared to try to talk with him. I can’t imagine what I would have said.”

But some years later, when he was in Geneva with my mother on the way to Zurich to meet Dr. Bleuler, he said he saw “the great professor” walking by the lake. “He was just in front of us. I guess I must have stared at him, but I didn’t have the nerve to introduce myself. ‘Speak up, young man!’ he said to me. I told him, ‘When I was an undergraduate, you were my professor.’ He was very kind to us and took us to have coffee. He even recommended a good place for us to eat. He said, ‘The price won’t kill you!’ But when we looked into the window we could see that it was too expensive. . . .”

My father took a lot of pleasure in recapturing these details, even while he recognized that he was losing track of many more important things that had happened recently. But it was the memories of his years of medical instruction and his retention of the terminology of neurological evaluation—because he used that terminology to describe his own condition—that I found to be particularly stirring.

Even after he had moved into the nursing home, he continued to retain some partial capability to speak about brain function. When he could not find a word he needed, he did not appear to be especially annoyed so much as curious and interested, like a scientist, to recognize in himself the same phenomenon he’d observed in others through the years. I could imagine him in the 1950s bringing young physicians with him on his rounds at Boston City Hospital or at the Massachusetts General, which was usually spoken of in Boston simply as the MGH, stopping at one bed, and then another, to discuss each case, and then arriving at a patient who presented the most perfect case of all to illustrate a point that he was making, even though the patient in this instance was himself.

Experiences like these had two effects on me. They heightened my respect for his capacity to reach beyond immediate predicament and find at least some elements of dignity and intellectual engagement in a situation in which others might have settled for self-pity. But they also were, of course, reminders of the probable prognosis for the future. The observations on brain function, as I knew, could not go on forever. Soon he would cease to be the doctor and remain only a case for other doctors to describe.

Once the injury to my father’s hip was fully healed, he was able to stand and walk without assistance from the nurses and attendants. In nice weather I would take him out to walk along the road beside the nursing home. The road, which ran along a narrow stretch of water in a wooded and secluded area, ended at a tiny inlet in which ducks and ducklings floated back and forth and children would throw bits of bread onto the surface of the water just in front of them. In the other direction, we could walk along the woods and open fields for approximately half a mile to an elevation where there was an old stone chapel and a grove of apple trees.

These pleasant and unhurried walks brought back to me nostalgic memories of a time when I was nine or ten years old and my father used to take me with him on long evening walks around the neighborhood in which we lived, about ten miles west of Boston. The area, now thoroughly suburban, had been like a country village when I was in kindergarten. There was a cow named Daisy grazing on a hill across the street from us. By the time I was seven Daisy’s meadow had been subdivided into lots for three brick houses. On several of the streets nearby, expensive-looking Tudor houses were constructed on the edges of tree-shaded properties that had been farms or large estates until the 1940s. Some of these houses were quite beautiful and stately and looked as if they had been built a hundred years before. On other streets, however, there were starkly modern mini-mansions, set on landscaped lawns with lighted terraces and pools, that looked too large and lavish for the lots on which they stood.

My father had a walking stick, with tiny copper medals nailed into its sides, that he had gotten years before when he went to Switzerland to talk with Dr. Bleuler. He liked to tap it on the pavement as we walked. Sometimes he’d stop and point it at a house we passed and tell me anecdotes about the owner.

He showed me once the mansion of a family that had been bootleggers in the 1920s—a member of the family had been “shot dead” by treasury agents on a beach near Marblehead, he said—but they had since achieved respectability as the owners of a liquor import company. My father didn’t speak about these people in demeaning ways; he simply found the twists and turns within their lives intriguing.

More than a few of the people in the neighborhood had turned to my father for professional assistance during times of crisis in their own or in their children’s lives, and he knew a great deal more than he was able to divulge about the sometimes unconventional arrangements and relationships within some of their families. Perhaps because I was a child, though, he shared a little more with me than he would allow himself to share with people of his age.

His observations on the private lives of certain of these families were presented to me, as I now remember this, in highly novelistic ways, as if these people were complex protagonists within a work of Thomas Mann, or Chekhov, or Flaubert. Disappointment, tragedy, and sometimes mild satire at a pretense of gentility in those who had amassed great wealth, but less refinement, in remarkably short periods of time, were commonly the richly woven strands of these narrations.

In later years my mother would explain to me some of the background of my father’s state of mind at that point in his career. She said that he’d become increasingly ambivalent about the work that he was doing and the nature of the clientele he had attracted, which included many people who would travel here long distances from other cities to obtain his services.

A number of these cases tended to involve at least two members of a family whose behavior to each other might appear to be protective and affectionate but would, at the same time, be covertly toxic or sadistic. Simultaneously, within the tangled web of these familial pathologies, there might lie a neurological disorder such as a brain tumor. My father’s diagnostic vigilance, as well as his gift for magisterial diplomacy in handling the tensions, for example, between children and their parents, or a husband and his wife, obviously served him well in these kinds of cases. Even so, according to my mother, he had grown uncomfortable about the role that he was asked to fill for many of these families, which seemed to him to be like that which in another age might have been filled by court physicians who had placed their expertise in subjugation to a very small and privileged elite.

This is not to say that he had ever turned his back upon his sense of obligation to provide his services to people of low income—or, indeed, to indigent people in the wards of Boston City Hospital, which served the poorest neighborhoods of Boston, as well as in the clinics of the Boston Psychopathic Hospital, which was affiliated with the MGH. But, to the degree that he allowed a handful of his patients to commandeer a disproportionate amount of his attention, and the degree to which he was obliged to draw upon his social skills in meeting their complex demands, I think he felt he was the victim of his own eclectic competence. And it was this, my mother said, that seemed to underlie those surges of impatience that would make him restless in the evenings and impel him to invite me to go out on walks with him.

My father’s treatment of O’Neill did not begin until I was a little older. And his attachment to O’Neill, and the sense of honor that he felt at being asked to bring to bear the skills he had acquired in caring for the most respected playwright of his times, obviously compensated greatly for the feelings of frustration that he underwent in coping with Carlotta. Nonetheless, the sense of being in subservient attendance, which was engendered in my father by her overbearing ways, was a source of great discomfort to him.

I knew nothing of my father’s discontent during those early years. I simply knew he liked me to go with him on his evening walks and that he talked with me more openly during those walks than he would do at other times. There was never any destination for our walks. I liked the aimlessness. We walked until his restlessness was gone.

Fifty years had passed since then. Now when we walked along the road beside the nursing home, he chatted with me off and on and usually made lighthearted observations about little things that captured his attention. He enjoyed the squawking of the ducks and ducklings and the sight of children who were feeding them. Sometimes I’d bring bread with me so he could feed them too. He liked to see how close they’d come before they grew afraid and circled off away from the embankment. But there were no more novelistic anecdotes. His ability to sustain a narrative of any length had now departed him.

Still, these were happy times for both of us. Now and then he’d take my arm and would point with his other hand at a wild rose or large sunflower or a graceful bird that floated over us. We’d walk until the reddish glimmer of the setting sun along the surface of the river was extinguished. He didn’t tire easily.

Excerpted from The Theft of Memory: Losing My Father, One Day at a Time. Copyright © 2015 by Jonathan Kozol

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