— So how have we been doing?

The question was directed at Lena but seemed to include both of us. So when Lena glanced over to me to deflect it, I stepped up to the plate.

— Well it’s been a bit up and down …

— Let’s hear what Lena has to say, shall we?

— It’s LAYna, not LEEna. It’s the Swedish pronunciation.

A raised finger told me I wasn’t supposed to be part of this conversation. To make it absolutely clear, the woman spun her office chair a few inches away from me and towards Lena.

— So LAYna, how are you feeling today?

— I’m fine, thank you.

— That’s good. Let’s just get to know one another, shall we? So, I see from your notes you’re Swedish, right?

— Yep.

— Where from?

— From Sweden.

— No, which town I mean?

— Oh. From Stockholm.

This was easy. Lena threw me a quick sideways smile, proud of her performance like a child in front of a watching parent. And like a parent, I was willing her to do well, to be the star of the show. Like she always had been.

A few weeks after the diagnosis we were back at the hospital. Just like before we’d waited in the lavender room, but this time it felt different. With the diagnosis behind us, we had nothing to fear. Now it was time to start planning the rest of our lives and we had Trisha Norris, the Community Psychiatric Nurse, to help us.

I’d been learning lots. For a start, I knew now that the building we were sitting in was called Meadowbrook, the hospital’s dedicated mental health unit. I knew — from a conversation with the GP who gave Lena her ECG — that there’d be a meeting at Meadowbrook every six months to monitor Lena’s condition and the impact of the medication.

— So what brought you to the UK?

Lena hesitated, then turned to me. She needed a prompt.

— I did.

Trisha’s eyes shot darts at me, making it clear this was my last warning. Let Lena speak.

— And how did you two meet?

— In Beirut.

And then Lena dried up. Maybe because it wasn’t true.

It wasn’t in Beirut at all. Although it all started with Beirut.

+ + + + +

A chance meeting one evening in Abu Dhabi. Laura, the girl I was seeing at the time introduced us. Three guys, and sitting between them, this striking Swedish girl. I don’t remember who suggested it but somehow the whole gang of us ended up at the Hilton Hotel discotheque. Somehow I ended up sitting next to the Swedish girl — Lena, she said her name was, as she leaned in closer so we could hear each other above the music. 

— So what brings you to Abu Dhabi?

— I came with my boyfriend. Funny, his name is Alan too.

— The guys with you, I didn’t catch all their names. Is one of them Alan?

— No. Alan went to Iraq on a contract. They’re looking after me while he’s away.

— Ah, they’re your minders.

— Sorry?

She didn’t know the word.

— And how do you like living in the Arab world?

— I love it. I have so many good memories from here. In Cairo. In Lebanon.

— You’ve been to Lebanon?

— I lived in Beirut for two years.

— So did I! What were you doing there?

— I was on a dance contract, at the Casino du Liban. Did you ever go to the Casino?

— No, out of my league. You had to be rich, didn’t you?

— So what did you do in Beirut? As well as not getting rich.

— I was an English language teacher. At the Hamra School. Did you ever go to the Hamra School?

— No!

I loved Lena’s laugh. And as she talked and I talked — talking with her seemed so easy — I sensed myself back in the city we both loved, with its fragrance of citrus and spices, cinnamon and cedar, the ancient desert dust blown in from the east and the Mediterranean salt from the west. We quickly worked out that I’d arrived in ’74 just as she left. The stories we told each other that night were of different times, different experiences, and very different lifestyles. But for both of us, Beirut was a place of glamour, excitement, adventure. A city hovering on the brink of civil war, where we all lived on the edge. Where the people we met were larger than life and in full colour.

And for me, everything around us faded into the background as we sat there close together, swapping memories. The music, the people, the dancefloor …

Until suddenly, all the lights in the room came on, signalling the end of the evening. And Lena’s minders were back with us.

— Come on, Lena. Time to go home. We’ll give you a ride.

And just like that, she was gone.

I looked around for Laura, but she’d gone too. I found a friend, who pointedly told me she’d left ages ago, because I’d been ignoring her all night. I knew we wouldn’t be seeing each other again.

I walked home, back along the Abu Dhabi Corniche and into the city, my head full of Lena and thinking “If only …”

But she was already taken. And we’d probably never meet again. What were the chances?

+ + + + +

And yet here I was over 30 years later with that same Lena in a place that couldn’t have been more different — a cool, sterile room in a mental health unit in Salford. Back then her words and thoughts and feelings had flowed. Now she was tight-lipped and cautious as she answered Trisha’s questions.

— How’s your appetite, Lena? Are you eating and drinking OK?

— Yes. Fine.

— What about cooking? Do you still prepare meals yourself?

— Usually. But Alan helps too.

I bit my lip.

— And what about money? Can you cope with money and organise your finances?

— Yes, of course.

This wasn’t going well. I knew why Trisha was asking Lena these questions. She was assessing her eligibility for PIP — Personal Independence Payments — a benefit paid in the UK to those who can’t manage the normal functions of everyday life without help. With little hope of future income — taking care of Lena was now my full-time job, and our UK pension prospects were dismal after working so many years abroad — we badly needed the money. So before today’s meeting, I’d tried to coach Lena … to answer truthfully. It was just unfortunate that her truth was different from mine.

— Trisha, can I just add something …?

— Not now. I want to hear from Lena. So Lena, what about washing and dressing, any problems with either of those?

— No.

— Good.

I could see Trisha filling in check-boxes on the sheet in front of her.

— The toilet. All good?

 — All good.

Lena stole another sideways glance at me. Was she doing OK, her eyes asked. I resisted the temptation to shake my head.

— Just a few more questions and then we’ll be finished. What about movement? Can you get around anywhere you want to go without someone else’s help?

— No, I don’t need help.

I couldn’t hold back a moment longer. I didn’t want to upset Lena by openly contradicting her. It was just that she didn’t understand the questions — or the implications of her answers.

— Trisha, I really need to say something. Lena’s right to say she doesn’t need help moving around the house. She can get up and down perfectly well. But outside it’s different. She absolutely needs someone with her when she leaves the house, or she’d never find her way back home.

— I told you, we need to hear Lena’s answers.

— So my opinion counts for nothing, when I’m with Lena every minute of the day and I can see what she can manage and what she can’t? Lena honestly believes the answers she’s given you are true, but … but …

— But what, Alan?

She’s inviting me to call my wife a liar.

— But I just need someone to listen to my side of the story too.

Trisha turned her head to the woman who’d been sitting quietly in the corner, watching the proceedings all this time.

— Shall we?

— I think so, yes.

— OK Alan, why don’t you go next-door with Julie here and get it all off your chest while I carry on here with Lena. I’ll ask her my last few questions and then we’ll do a quick test with her … it’s called the ACE-Mini Test.

Hearing the word ‘test’, Lena suddenly looked terrified, but I gave her the best reassuring grin I could manage as I followed Julie out of the room.

As we sat down, Julie introduced herself as a “senior colleague who sometimes sits in on these meetings”, and then handed over to me to blurt out all my concerns. 

Preparing food? Lena had always loved her kitchen but she hadn’t cooked or baked for months. She could neither remember recipes nor read them. She still wanted to help, but I told Julie about our sprout incident at Christmas — how distressing it was for both of us. I said I didn’t feel Lena was safe in the kitchen around anything sharp. And she didn’t know how to turn on the gas-rings on our stovetop any more, which was probably a blessing.

Getting dressed? I told Julie the shoe-knotting story, and explained how Lena was beginning to struggle with buttons and zips now. I’d try to avoid them with new clothes we bought.

Money? She had no idea, unable to count coins or notes now, or to remember card numbers. Luckily, managing her money wasn’t a problem because we’d always shared everything we owned. The house, bank accounts, everything was in our joint names.

And going out alone? It wasn’t just that Lena had entirely lost her sense of direction since we moved to Salford, a bit less than a year ago. There was also a scary incident a couple of days back, close to home, when she suddenly stopped dead in her tracks, gave a scream, then started breathing very rapidly and trembling all over. She told me she’d seen something, but wasn’t able to tell me what it was that so scared her.

Julie listened carefully, taking notes all the time, asking me little questions to make sure she’d understood correctly. And at the end she said:

— She fakes it really well, doesn’t she?

— No. I don’t think Lena’s ever faked a thing in her life. All this is real for her.

— I’m not saying it isn’t real. It’s just that she doesn’t want to admit that anything’s wrong with her. She’s in denial.

— I honestly don’t think she knows anything’s wrong with her.

We rejoined Lena and Trisha. With the questions and the test over, Lena was comfortable again now, chatting to Trisha, smiling.

— So how did the two of you get on?

— Yes, very well. Alan’s told me about the worries he has, and I’ve taken a few notes.

— Good. Alan, you’re happy too?

— Yes. Thank you, Trisha. I’m so pleased that there were two of you here, so we could do it like this.

— Right, well, while you two were gossiping, I’ve done the ACE-Mini Test with Lena, and she’s scored 16 out of 30. 

— Is that good or bad?

— That’s not quite how we look at it. It’s really a way of measuring how well we’re managing to control Lena’s Alzheimer’s. After this appointment I’ll be prescribing Donepezil – that’s the little pill Lena will take every day. Just 5 milligrams to start with, then moving up to 10 a bit later, when you’re ready. Hopefully that’ll help to slow down the symptoms. So then, in six months time, when I see you next time, we’ll do the test again and compare the results.

So that was it. Just the pills and another appointment in six months. Maybe a chance of a lifeline too if they decided Lena did qualify for PIP. But it wasn’t much of a plan for the coming months, was it? Let alone for the rest of our lives.