Turn of Mind by Alice LaPlante — 320 pgs

Dr. Jennifer White is slowly losing her mind after having been diagnosed with Alzheimer’s disease. Jennifer, once a prominent and skilled orthopedic surgeon, has not only lost her ability to practice medicine, but her independence, mobility and cognitive skills. Now she regresses day by day to the point of an aggressive and almost childlike senility. Jennifer has good days and bad days, but recently she’s had to have a home health aide move into her home to assist her, a fact that embarrasses and angers her. Her grown children, Fiona and Mark, visit frequently, but it’s debatable whether they’re helping their mother or hindering her. When Jennifer’s best friend and neighbor of many, many years, Amanda, is found murdered with four fingers from one hand surgically removed, the police investigators come right to Jennifer as the prime suspect. The problem is that Jennifer has deteriorated so badly that she can’t remember if she committed the crime or not. But this isn’t a cut-and-dried case, for Amanda was good at alienating and threatening everyone around her, and through the increasingly muddy reflections of Jennifer's ailing mind, a picture begins to emerge of two women who are ideally suited for each other yet repugnantly averse to each other as well. As Jennifer’s cognitive abilities begin to dwindle more and more rapidly every day, she’s left in the position of having to be moved into a full time care facility while her children watch her mind slowly slide away. Will Jennifer ever remember if she played a role in Amanda’s death or not, and what will become of her when she’s no longer able to mentally function or recognize those around her? In this harrowing and suspenseful novel, the day to day life of one woman living through Alzheimer's disease is achingly portrayed in all its terrible impact, leaving her to cope with impotent fury at the inevitable future that’s lurking just around the bend.

Though this book was incredibly suspenseful, it was also very, very sad. Having to watch as one woman loses every faculty her mind possesses was not only enervating, but also at times torturous. The book is written in a unique style of small paragraphs that each house snippets of dialogue or action, and as such, the story moves quickly in small digestible bits of information and narration. As the reader works their way through the tale, more and more is revealed about Jennifer and the people surrounding her, and the effect of the parceling out of this information has a stunning impact on the realities of what type of life this woman is living and has lived in the past. Though her future is terrible to contemplate, her past was also filled with woe and discomfort, and it’s Jennifer’s ability to remain detached, both in the past and present, that allows for greater impact in the story of her life.

Both of Dr. White’s children are somewhat suspect. Her son, Mark, seems always to be looking for a handout and will sometimes manipulate his unwell mother in order to get what he wants. He seemed to be very untrustworthy and at times even cold and hostile to his ailing mother. Fiona was a little better, but there was something about her that evaded normalcy and made her a person who was not always trustworthy either. LaPlante succeeds in making the people who interact with Jennifer seem a bit debauched, and by doing this, the reader can start to feel like they’re inhabiting Jennifer’s mind and feeling the suspicion and paranoia that the protagonist is experiencing. As Jennifer deteriorates, she has moments and even hours of stiff lucidity that allow her to reflect on her life and the lives of her family. She never regrets the things she’s done, but there is a certain wistfulness at the way things have turned out for her. At other times she’s no better than screaming, biting harridan, incapable of behaving normally or remembering who her family are. In the typical fashion of Alzheimer’s, Jennifer swings from bad to good several times a day, and though she’s usually compliant, there are times when she is violent, refuses her medication, and acts out.

When the news of the murder reaches Jennifer, she is disbelieving, and because of the nature of her disease, she must have the news broken to her over and over again. As Jennifer mentally regresses, she’s sometimes able to get lost in the memories of her friendship with Amanda in all its unhealthy and strange permutations. Amanda was the type of woman who was controlling, demanding and secretive. She has information at her disposal and uses it to blackmail others and make demands that she would otherwise not be able to make. Her friendship with Jennifer is strange in that both women seem to both hate and love each other, and there is a dependence that they share for one another that is not in the least healthy. When I was reading, I was wondering why Jennifer kept her friendship with Amanda going, why she kept forgiving this woman. Ultimately I think it came down to power. Amanda had it, and Jennifer was envious of it, and because of the inequality in the balance of power between them, the friendship crossed boundaries that it normally wouldn’t have. At the bottom of all this was the fact that no matter how abusive Amanda was to her, Jennifer genuinely loved and cared for her. This was one reason why it was so hard for her to understand that the police suspected her in Amanda’s murder, and why it was so painful for her to have to receive the news over and over again. In a way, Jennifer was closer to Amanda than she was to anyone in her own family, even her children.

This was a suspenseful knot of a read that kept me guessing all the way to the final page. The book’s plotting was exceptionally tight and though the story was written in a slightly different style, it was the kind of book that’s easy to become emotionally invested in on several levels. Far from being only a murder mystery, this book has the added depth and pathos of sharing the story of a woman in the throes of a disease that is eating her consciousness away day by day. In the end, I think you‘ll be just as surprised as I was at the implications of this story, and though it’s a difficult read, it’s definitely one that will keep its readers guessing time and time again. Recommended.

---

This book was provided as a complimentary review copy.