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During their 37 years of marriage, Ann and Julian raised three children. Ann trained as a speech pathologist and worked part-time while their children were growing up. The children went off to college, and later their daughter produced three grandchildren.

There's Still a Person in There: The Complete Guide to Treating and Coping With Alzheimer's By Michael Castleman, Dolores Gallagher- Thompson, Ph.D., and Matthew Naythons, M.D. G.P. Putnam's Sons, 370 pages Nonfiction Buy this book at B&N.com

Over the decades, Ann adjusted to her husband's workaholic preoccupation with his career, admiring his intellect and fretting with him over his lectures, grant applications, journal articles, committee responsibilities, and the vagaries of academic politics. Of course, she got annoyed when she realized, too frequently, that Julian was not giving her his undivided attention. She did not like to repeat herself or say, "Julian, listen," because he was off in some physiological reverie instead of focusing on her. He was the classic absent-minded professor. Ann was forever reminding him not to forget his briefcase, or his keys, or his brothers' birthdays, or the dinner or concert date they had in the evening.

Yet their love was deep and enduring, their marriage strong, and when her moments of irritation over Julian's daydreaming passed, Ann understood that one of the things that endeared him to her was his ability to live in his imagination, and to revel in the life of the mind.

In 1986, when he was 54, things started to change for Julian. "I didn't see it at first," Ann recalls, "and certainly no one else had any inkling, but Julian was convinced that he had memory problems, and he became concerned." For 20 years, Julian had no problem delivering lectures to Stanford medical and graduate students from brief notes. Then one day he found they were no longer enough. He began outlining his lectures more thoroughly, and by the late 1980s, he felt he had to write them out and read them word for word. Julian also found it increasingly difficult to write scientific papers and grant applications. When colleagues broached new ideas, he had trouble absorbing them and giving cogent feedback. "What you hear at many Alzheimer's workshops," Ann says, "is that in the early stages, those with the disease typically deny that they have memory problems. That happens with a lot of people, but not everyone. Julian was the first to realize that something was wrong."

For three years, with rising apprehension and anxiety, Julian complained to Ann about his memory. At first, she chalked it up to chronic career stress, but after a while she noticed that her absent-minded husband seemed increasingly scattered. Still, it didn't concern her too much. "He misplaced things a little more, but that was completely in character. He'd always lost things. So he did it a little more. So what?"

Despite Ann's efforts to comfort and reassure him, Julian insisted that something was really wrong with him, and, true to his training, he began seeking answers as a scientist would, in an organized, systematic fashion. He consulted his family doctor, who did not suspect Alzheimer's because Julian was not yet 60 and the disease is rare in people under 65. But Julian was clearly anxious, so his doctor sent him to a psychologist.

Julian had good reason to be anxious. Both of his older brothers had died a few years earlier at age 59, one from Hodgkin's disease, the other from complications of coronary bypass surgery. Julian took this information to his doctor, who prescribed anti-anxiety medication along with counseling from a psychotherapist. His memory problem did not improve.

Then, Julian began using words incorrectly, often saying the opposite of what he meant. He'd mean "up" and say "down," mean "increase" and say "decrease." Ann noticed but didn't take her husband's lapses too seriously. "Who hasn't said 'left' when they meant 'right'?" But Julian's Stanford colleagues were not quite so generous. Science demands precision, and Julian's increasingly frequent errors irritated them and frustrated his students, which only increased his anxiety and growing sense of apprehension and shame.

In early 1989, Julian began forgetting appointments with Ann. "We'd have a date to meet for lunch, and he wouldn't show up, or he would agree to pick me up at a certain time and place, and then leave me hanging." Alzheimer's disease was still the farthest thing from Ann's mind. Julian was so young. No one in either of their families had ever had it, and Julian still functioned more or less competently -- a far cry from the picture Ann had of the disease. Ann didn't think her husband was ill. On the contrary, he was the picture of health. She figured he was being rude or uncaring. "I was furious with him for much of the year before his diagnosis," Ann admits. Ann's anger made her less sympathetic to Julian's growing plight, and it made him feel even more anxious and ashamed.

Maybe the psychologist was right, Julian thought. Maybe anxiety was his underlying problem. But as the months passed, he became convinced that, independent of any anxiety or depression, his memory was going. He asked a Stanford colleague, a neuropsychologist who did memory research, to evaluate him. "His short-term memory was a bit deficient," Ann recalls, "but still in the normal range. Julian felt reassured. His memory trouble seemed to be caused by anxiety, which was the result of stress."

Next page | The diagnosis hit Ann like a slap in the face