The Cider House Rules

Downstairs, Homer Wells told Olive and Wally that he thought it was something neurological.

"Neurological?" Olive said.

"What's that mean?" Wally said.

They heard Senior cry out from upstairs. "Vent!" he shouted.

Homer Wells, who had a habit of repeating the pigtails of sentences, knew that Senior's repetitions were insane. That habit was the first symptom he described in his letter about Senior Worthington to Dr. Larch. "He repeats everything," he wrote to Dr. Larch. Homer also noted that Senior appeared to forget the names of the most common things; he recalled how the man had become stuck asking Wally for a cigarette--he had just kept pointing at Wally's breast pocket. "I think the word for cigarette had escaped him," wrote Homer Wells. Homer had also observed that Senior could not operate the latch on the glove compartment the last time that Homer had driven him to Sanborn's for some simple shopping. And the man had the oddest habit of picking at his clothes all the time. "It's as if he thinks he's got dirt, or hair, or lint on his clothes," wrote Homer Wells. "But there's nothing there."

Olive Worthington assured Homer that the family doctor, a geezer even older than Dr. Larch, was quite certain that Senior's problems were entirely "alcohol-related."

"Doc Perkins is too old to be a doctor anymore, Mom," Wally said.

"Doc Perkins delivered you--I guess he knows what he's doing," Olive said.

"I bet I was easy to deliver," Wally said cheerfully.

I'll bet you were, imagined Homer Wells, who thought that Wally took everything in the world for granted--not in a selfish or spoiled way, but like a Prince of Maine, like a King of New England; Wally was just born to be in charge.

Dr. Larch's letter to Homer Wells was so impressive that Homer immediately showed it to Mrs. Worthington.

"What you have described to me, Homer, sounds like some kind of evolving organic brain syndrome," Dr. Larch wrote. "In a man of this age, there aren't a lot of diagnoses to choose from. I'd say your best bet is Alzheimer's presenile dementia; it's pretty rare; I looked it up in one of my bound volumes of the New England Journal of Medicine.

"Picking imaginary lint off one's clothes is what neurologists call carphologia. In the progress of deterioration common to Alzheimer's disease, a patient will frequently echo back what is said to him. This is called echolalia. The inability to name even familiar objects such as a cigarette is due to a failure to recognize the objects. This is called anomia. And the loss of the ability to do any type of skilled or learned movement such as opening the glove compartment is also typical. It is called apraxia.

"You should prevail upon Mrs. Worthington to have her husband examined by a neurologist. I know there is at least one in Maine. It's only my guess that it's Alzheimer's disease."

"Alzheimer's disease?" asked Olive Worthington.

"You mean it's a disease--what's wrong with him?" Wally asked Homer.

Wally cried in the car on the way to the neurologist. "I'm sorry, Pop," he said. But Senior seemed delighted.

When the neurologist confirmed Dr. Larch's diagnosis, Senior Worthington was exuberant.

"I have a disease!" he yelled proudly--even happily. It was almost as if someone had announced that he was cured; what he had was quite incurable. "I have a disease!" He was euphoric about it.

What a relief it must have been to him--for a moment, anyway--to learn that he wasn't simply a drunk. It was such an enormous relief to Olive that she wept on Wally's shoulder; she hugged and kissed Homer with an energy Homer had not known since he left the arms of Nurse Angela and Nurse Edna. Mrs. Worthington thanked Homer over and over again. It meant a great deal to Olive (although she had long ago fallen out of love with Senior, if she had ever truly loved him) to know that this new information permitted her to renew her respect for Senior. She was overwhelmingly grateful to Homer and to Dr. Larch for restoring Senior's self-esteem--and for restoring some of her esteem for Senior, too.

All this contributed to the special atmosphere that surrounded Senior's death at the end of the summer, shortly before the harvest; a sense of relief was far more prevalent than was a sense of grief. That Senior Worthington was on his way to death had been certain for some time; that, in the nick of time, he had managed to die with some honor-- ". . . of a bona fide disease!" Bert Sanborn said--was a welcome surprise.

Of course, the residents of Heart's Rock and Heart's Haven had some difficulty with the term--Alzheimer was not a name familiar to the coast of Maine in 194_. The workers at Ocean View had particular trouble with it; Ray Kendall, one day, made it easier for everyone to understand. "Senior got Al's Hammer disease," he announced. Al's Hammer! Now there was a disease anyone could understand.

"I just hope it ain't catchin'," said Big Dot Taft.

"Maybe you got to be rich to get it?" wondered Meany Hyde.

"No, it's neurological," Homer Wells insisted, but that didn't mean anything to anyone except Homer.

And so the men and women at Ocean View developed a new saying as they got ready for the harvest that year. "You better watch out," Herb Fowler would say, "or you'll get Al's Hammer."

And when Louise Tobey would show up late, Florence

Hyde (or Irene Titcomb, or Big Dot Taft) would ask her, "What's the matter, you got your period or Al's Hammer?" And when Grace Lynch would show up with a limp, or with a noticeable bruise, everyone would think but never say out loud, "She caught old Al's Hammer last night, for sure."

"It seems to me," Wally said to Homer Wells, "that you ought to be a doctor--you obviously have an instinct for it."

"Doctor Larch is the doctor," said Homer Wells. "I'm the Bedouin."