My father's brain Life in the shadow of Alzheimer's

In this propulsive memoir, cardiologist Jauhar (Heart: A History) delivers an aching account of "the hardest journey ever taken" as he witnessed his father, Prem's, health, personality, and cognition get subsumed by Alzheimer's. The closeness between Jauhar, his brother Rajiv, and sister Suneeta--all doctors--was strained by debates regarding care and end of life decision-making. "I learned long ago that families break down over these issues," Rajiv observes as Jauhar resisted placing Prem, a world-class scientist and geneticist, in assisted living after his wife's death. Jauhar layers the narrative with research about Alzheimer's, a look at a groundbreaking "dementia village" in the Netherlands, interrogations of ideas like "therapeutic deception" (playing along with a patient's beliefs), and existential quandaries about whether losing one's memories constitutes losing one's identity. Jauhar masterfully depicts the siblings' fractious despair as he, clinging to hope, pushed for one more intervention as Prem's death approached. The author's brutal honesty--about his father's decline and his own inability to fully reckon with it--is expertly complemented by his medical rigor. Every family who's ever faced an Alzheimer's diagnosis will see themselves in this exceptional work. Agent: Todd Shuster, Aevitas Creative Management. (Apr.)

A doctor and bestselling writer chronicles his father's battle with dementia. Jauhar, a cardiologist and author of Interned, Doctored, and Heart, begins with the revelation that his father, Prem, a world-class geneticist in his 70s, was forgetting more than usual. Prem noted that forgetting is a normal part of aging, but while waiting for a doctor's appointment, the author asked what they ate for lunch, and he couldn't remember. In a testing session, Prem counted backward from 100 by sevens and wrote a sentence correctly but failed to spell world backward or draw a clock with the time 11:10. The diagnosis was mild cognitive impairment--mental functioning "worse than expected for his age." MCI affects about 1 in 5 elderly adults, 20% of which will progress to Alzheimer's. Readers will know the outcome but continue to turn the pages as Jauhar delivers a gripping account of Prem's steady decline through the "seven stages" of Alzheimer's. He was soon unable to manage his finances or remember details of his personal history. Within two years, he entered the middle stages, requiring help with daily activities such as dressing, and he became paranoid and suspicious and lost his way if he left the house. In the advanced stages, he was unable to walk alone or control his bowels and bladder, all of which led to a protracted period of being bedbound, incontinent, and refusing to eat. Unlike many Alzheimer's patients, Prem remained at home, the consequence of a devoted extended family, plenty of money, and an incredibly dedicated helper. Besides his father's story, Jauhar describes the disease's history, its affect on the brain, and how America's health care system deals--or fails to deal--with it. Caring for a dementia patient can cost families $80,000 per year, and medical-related bills lead to over half of bankruptcies. European nations do better, but there is little political support in the U.S. for reform. A painful yet affecting read that is also difficult to put down. Copyright (c) Kirkus Reviews, used with permission.