He focused on Nina. "Mrs. Hampton, I'm Dr. Van de Vliet. You're a pretty lady, and we've had some luck helping other ladies like you."
"Honey, if I had you in my bedroom, then maybe you could help me."
OMG, Ally thought, she's about to go ribald on us. But that's a sign she's coming out of her funk.
But then she had another thought. Maybe Nina sensed he was older than he looked. Like that paranormal perception that told her Grant was involved in something evil. So far, however, that particular perception hadn't panned out (though Grant clearly was up tosomething).
Maria was mortified. She blushed and made a disapproving animal noise low in her throat and turned her face away, but Van de Vliet simply smiled even more broadly.
"Mrs. Hampton, I don't think you should be talking that way in front of your daughter." He gave her a wink. "What you and I do together is none of these people's business. But I do think we should consider keeping them informed if only a couple of hints."
Ally found herself wanting just to listen to his voice. There was an intelligent warmth about it that reminded her of a kindly professor at Columbia, a truly gifted architect who also could quote Keats and make you cry. You wanted to give yourself to him. My God, she thought, how am I going to stand up to this man?
"There're some issues you and I need to discuss," he said turning back to Ally. "The first thing I need to do is take a look at Mrs. Hampton’s records. But whatever they say, it won't do any harm to run what we call a 'mental state examination' for her, to establish a general baseline of cognitive impairment as of now."
"How long will that take?"
"Actually, Ellen can start in just a few minutes," he said "Of course, we'll need to hear about the usual danger signs everybody knows. Does Mrs. Hampton have recent-memory loss? Does she get confused about places and people? Does she have trouble handling money and paying her bills?"
"The short answer is yes."
All of those things, Ally knew, had accelerated in the last six months. It was the tragic, recognizable onset of the latter stages of Alzheimer's. Already more than once Maria had said there were times when she didn't think Nina recognized her. More and more she seemed to be confused, unable some days to find her way around the apartment, and she'd started repeating herself. She often had trouble finding the right words, and she was increasingly paranoid and suspicious. Maria, who had worked with other Alzheimer’s patients, feared she might begin hallucinating soon, seeing things that weren't there.
Ally turned to her. It felt obscene to talk about her when she was sitting right there with them.
"Mom, sweetie, do you understand what Dr. Van de Vliet is asking? Do you think you have trouble doing everyday things?"
She knew the answer but she was determined that her mother not be treated like a potted plant.
"Ally, you know that half the time I can't remember a blessed thing. I'm getting crazy as a bloody coot."
Then Nina turned and looked Van de Vliet in the eye.
"I don't want to lose my mind, Doctor. I don't want to see the shade closing in. I can't do crosswords anymore. I used to do them all the time. And all the music I used to know. It was my love and now. . now I can't tell Scriabin from Strauss half the time. It wasn't supposed to happen that way. I thought my mind would go on forever."
"Mrs. Hampton, if you'll let me, what I want to do is try to work on your recollection. I don't know how much I can help you with crosswords, but then I've never been much good at them myself either. Your memory of music should improve, though. There are no guarantees, but-"
"Then I'm ready to try it, Doctor," she cut in. "You're all that stands between me and losing the only thing I have left, my past" Next came a burst of rationality. "Now, I hate to be a pest but could you explain what exactly it is you're going to do. I want Ally to hear this too and then maybe she can go over it with me later and help me understand it."
He smiled and reached over and stroked her slightly thinning hair. "I'd be happy to try, Mrs. Hampton. It's actually pretty simple."
Then he turned to Ally. "We touched on some of this on the phone. Do you want to hear it again?"
"Yes, I'm still trying to get it all into my simple mind."
"Well," he began, "to go back to the very beginning of my interest in stem cells the focus of our research has been directed toward challenging the notorious Hayflick limit. Back in the 1960s, Professor Leonard Hayflick discovered that when tissue cells are taken from the body and cultured in a laboratory dish, those cells grow and divide about fifty times, give or take, and then they stop. They have reached old age, senescence. The physical basis of the Hayflick limit is a section of DNA known as telomere, which gets shorter each time the cell divides. Eventually the telomeres become so short that all cell division stops. It's like an internal clock telling them the game is over. They've had their innings."
"And you're saying you've found a way to beat the clock, to stop the telomeres from getting shorter?"
"All cells possess a gene known as the telomerase gene, which can restore the telomeres to their youthful length. But in most cells the gene is permanently repressed and inactive. It is only found in egg and sperm cells, and in cancer cells." He gazed away for a moment as though collecting his thoughts. Then he turned back. "However, we've found that by isolating and inserting an active copy of the telomerase enzyme into adult stem cells, which can be found in minute quantities throughout the body, we can set their clock back to zero. We extract cells, 'immortalize' them with telomerase, and then return them to the body as a youthful infusion."
"And is that what you'd be doing for Mom?"
"There'd be a series of injections, but given what appears to be her level of mental awareness right now, the procedure probably can be accelerated." He patted Nina on the shoulder.
"All right," Ally said "but can you use the same procedure for someone's heart?"
"Well, yes and no," he said. "Did you bring your medical records? I should have a look at them before making any pronouncements."
To prepare for this moment, she'd printed off a copy of the medical files she'd scanned into her computer.
"There're a lot of files," she said, opening her bag. "I've got copies of my EKGs over the past eleven years. Dr. Ekelman, my cardiologist, says my condition is getting progressively worse."
She took the folder out of her bag and handed it to him. He flipped through the files with what seemed an absent manner, almost as though he already knew what was in them and was just going through the motions. Then he looked up.
"Well, your physical condition looks pretty good. You clearly exercise. And I don't see anything here that would suggest a complication. As to how your procedure might differ from your mother's, I guess the main area of concern is simply the scale." He laid her files on the steel table. "Your heart has reached the stage of aortic valve stenosis where cardiac output no longer can keep up proportionately with vigorous exercise. And that has put an even larger strain on an already weakened condition. What we are about to undertake here corresponds to what might almost be considered an aortic valve replacement, though it is done at the cellular level. We call it regenerative medicine. Millions of cells will be involved We'll attempt to reverse the calcification and also to develop new blood vessels that supply the heart muscle."
"You know, this is so risky. I remember that not long ago they tried to use fetal cell injections into the brain for treating Parkinson's disease. And it turned out that the side effects were horrendous. Why should I assume that this is any safer?"
He looked pained. "I assure you we don't do anything here that is remotely like that particular, unfortunate procedure."