florida center -- florida senator marco rubio outlined his plan to advance economic opportunity.

>> jonathan remembers the life of his father a neuropsychiatrist who self diagnoses on alzheimer's disease next on book tv. >> tonight i am delighted to introduce an acclaimed writer and tireless advocate and integrated public education.

for 50 years he has worked among the nations most vulnerable children. his books, as you well no, include the shame of the nation, amazing grace, savage inequalities and being a teacher. he received the national book award at an early age chronicling his teaching. he has received the robert f kennedy award two hi fella ships and two rockefeller scholarships. the book about what she will be talking tonight is his knew book perhaps the most personal story of his career telling the story of his father the nationally known physician who specialize in brain disorders and shared an astonishing ability at the onset of his own alzheimer's disease to explain the causes of the sickness and they're a step-by-step the slow

descent into dementia. the boston globe causing less about the loss of memory in the effort to create a testament to forgiveness. ladies and gentlemen please join me in welcoming jonathan to the free library of philadelphia. [applause] >> thank you very much. i'm honored to be here and very grateful for the work you have done for the library. thanks also. i hope i'm browsing a right. all the other good folks at this very special library. one of the real cultural treasures of our nation. i say that kind from boston.

we had a good library to. they see each and every one of you for being here tonight. as jenna told you -- on to thank one other person. i just received's a card from somebody in the audience. yes. mother was my mother's roommate at wheaton college in massachusetts in the class of 19 25. that's right. 1925. [inaudible question] >> before i was born probably. zero, i see. anyway i am delighted you are here. as jenna told you i spent

almost my entire adult life working with children especially the little ones in the early years of there lives adventure. but meanwhile starting in the early 1990s and largely unknown to my readers i was forced to contemplate the last years of our lives has my parents became elderly and my father started to become confused by some lapses in his memory one evening in 1992 when he was 86 years old as he was born in 196 1992 he sat me down. he was a neurologist, i should say. also a psychiatrist who have been trained at harvard and practiced at the well-known

in g8 massachusetts general hospital in the boston area for nearly 60 years. he sat me down in a room in his apartment, close the door someone mother cannot here. he did not want her to no about this yet. and he confided in me that he had been having a series of attacks which he called amnestic spells and also episodes of what he called interrupted consciousness. and drawing upon the language of neurology and his decades of clinical experience he explained to me in neurological language what he was describing himself the early indications of alzheimer's. he diagnosed himself.

two years later the diagnosis was confirmed by one of his younger colleagues, one of the students. and two years after that he was in a nursing home. he lived for more years, and during those years as surprising as this may appear to some people we became closer to each other than we had ever been before a lot of people are surprised by that. some of you may be able to understand what, i mean,. for one thing i was with him more than any time since i was young boy. earlier in my life before he became ill i was away a lot because i had to travel a great deal visiting schools in different cities, philadelphia, for example. once he became ill i set aside time in order to be

closer in order to see him which proved to be extremely important. in order to see him was sufficient frequency so that the bond between us remain strong and so that they're would be some degree of continuity between our conversations. then to my father had been a charming and old-fashioned man. actually, in pennsylvania couple years ago -- i won't name which one but i met ai met a woman who had been one of his patients when she was a college student. and he -- she still remembered how pleasant it was to be with them. he was charming and he always reveled in the conversation. he was good at that. and that delighting

conversation never totally abandoned him. even when a word was missing or a sentence uncompleted he still retained a sense of the rhythm the to and fro the conversation. and he still could come back with very quick repartee not always, but when it mattered. ii used to bring my dog with a lot to visit them. a golden retriever. and he had known him since he was a puppy and still recognized her because if i came -- he spent most of his early years in the living room of the nursing home. he would be sitting there are leather armchair. when you enter the nursing home you had to go around the corner in order to get to living up. my. my dog, i would let her off the leash and she would go

racing ahead of me and right up to my father. sometimes she would put her paws up on my father's knees so that she could slobber him with kisses. he would look at her and say , is jonathan here? anyway once a nurse who love my dog listen to was her name she was petting my dog and looked up at my father and said this one is an angel. i think she was. the sweetest dog. this one is an angel. i'm not sure i'd go that far, he said. and she was great. she kept up the dialogue. she said what is she doctor , if she is not an angel. he said practicing to be an angel.

that was you no 30 year into dementia. amazingly to me he also caps on speaking of his neurological condition as if he still wasn't thinking of himself somehow from the vantage.of a physician. that was like the imprint of his years of training very classical training in neurology at harvard in the 19 and late after harvard and he did his residency. and epilepsy brain damage part of a team that did the 1st trial testing of a drug called the lenten which is now standard, i believe for some kind of seizures. so was interesting. even well he knew he was the patient he seemed to move upon it as if he were a

physician at the same time. and partly for this reason. as pieces of his memory were increasingly failing him he never seemed to fall into self-pity. instead, he seemed to have an interesting and persistent sense of clinical curiosity about his own bewilderment's. again, as if he were the dr. , fascinated as he always was by the workings of the mind. also, of course i have known them for so long that even when he said something that seems to make no sense and to most people would make no sense at all i can often pick up on the single word or phrase's that i knew had been put on before.

i found if i repeated it the emphasis our asked exactly the right question it would frequently unleash or release i probably should say the more stirring portion of the memory. i give you one example. thinking of this was driving over your. at one time and again, well in the probably the late -- well into the middle stages of dementia he started to talk one evening. during the early evening he was serene and have a living all caps off usually -- have a living room to himself usually. one night he started talking just like he had this in his mind before i got they're.

he said i saw a huge man a huge fat man sitting in a car. and he kept saying this in different ways. most people that would seem to be some kind of illusion but i knew right away what he was talking about because he told me once he was going back almost a hundred years at that.tony was six years old. i knew the story. he was six years old his family was one of very few jewish families in irish neighborhood of boston south boston. and a priest in the neighborhood really loved his mother. he always said he loved his mother's cooking and only showed up on friday nights. have a glass of snobs that my grandpa 1st.

and he sort of protective them. and once my father was six years old they're was a big parade going through south boston. he took my father on his shoulders so that my father could see and there was indeed a very large man, an enormous man sitting in an open car driving along slowly waving to people. and he had told me this once he had asked the priest who was in the priest said the menu looking at is the president of the united states. let's blame howard taft running for reelection 1912. if my memory is right that is the year the teddy roosevelt split the ticket and we will sit ended up being elected, woodrow wilson which was unfortunate for several years he kept on

writing notes and memos to me usually brief some of which sort of jagged and didn't make too much sense. very eloquent, i thought. dear jonathan son they would begin no longer than an hour ago i received some information that might improve my situation but much is taken place beyond my capability to heal. please provide whatever information on this matter you may have. remember agent circumstance. it was quite moving. agent circumstance. another note even briefer he had heard the nurse inadvertently tell him i was ill so i cannot visit for a week. he said do jonathan

someone that we no has not been feeling well. i hope you will be better in the soon in the soon. fate matters. it will keeping close dispatch. your loving father. he also wrote another during letter to a nurse lucinda father love lucinda. a terrific crush on her. she is one of the people that would have really live where conversations with my dad. she never talked to him. that singsong voice that people use in nursing homes as other talking to an infant in a nursery, how are we feeling today harry. she talked real talk to my father. she said, i don't want to bore a man who has known so many interesting people.

i don't want to bore myself. he had a real crush on her to read one day he saw her at the end of the corridor talking for a while with a much younger and very handsome man. and he wrote it is not which you show me later. you lucinda i hope your knew friend enjoys his opportunity. please report to me on other gentleman with whom you spend your time. ask the asked me lots of questions. most importantly six years after he had gone to the nursing home he began to ask me whether it was time to go home. i'm sure this is familiar to some of you.

he kept asking this in different ways. typically he would ask it when he saw me getting up at the end of the evening, putting on my coat. it was winter. and he would look up at me so as say we going on now. can you take me with you? and it went on for a long time. and he obviously was thinking strategically. he somehow got the idea that the nursing home was a present. they were keeping them they're would not let him leave. one that he whispered here's a were going to do. our go out toward the door and if anyone stops me say my son is coming for me. as soon as i'm outside auditor currently.

that was almost late to eventually said that. almost six years. and i start thinking about it. you no should i take it home? with the handle it back my mother was at home. a lot in the book about my mom. love to have a lot of it very, very funny because she was clear right to the end. she became increasingly irreverent dish get older and older and would say things that were quite shocking. the only delusions and fantasy she developed at some time she started saying in front of one of her attendance she said hillary clinton wants to marry you.

and one of the attendance is very funny. well sherry has a husband of her own. mother said, yeah, but he is treating right. she was jonathan. i said why me. tougher than i could handle. anyway when he started asking to go home i sort of thought about a lot. so my friend said to me he doesn't no what he's saying. he's a demented man. essentially, you know ignore that. well i mean he was in the middle stages of dementia but i thought he still knew what he was saying. and i said -- ii thought

myself, this is something that my father truly wants. you here it in his voice. i could see it in his eyes. so i decided this taken. finally one night when he looked at me and asked again we going on now i said to him yesterday this time failure to come home and he lived the rest of his life is obama. and he was so happy to be home. he had been quite turbulent when he went into the nursing home. was not safe from a moment that. but now he was quite serene and calm. they would have lunch together almost every day. not much conversation obviously but something wonderful about that. he would often spend the afternoon sitting at his

leather covered desk which had been his office desk for more than 50 years. i had it moved to the apartment when he closed his office. he kept on writing memos to himself. they made no sense at all but he has a constant and prideful look he was sitting there. i still remember that. much of the attendance never called a very. they: doctor p. always. around that time in starting in fact a bit earlier playlist on the nursing home i began looking through dozens of cartons that he had sent to my home many years before which held some truly extraordinary documents case studies,

correspondence with his peers and patients tapes and transcripts and the like which opened up intensely detailed stories from his early in midcareer including several high-profile cases in which he was involved some of which now have a place in history. the case the test my father was profoundly was that of our nation's greatest playwright nobel laureate eugene o'neill. you remember audio? i asked college kids. no, they shake their heads. a member who arthur miller was. but o'neal suffered from a tremor that resembled parkinson's but was not the same.

prevented her from my. a deep depression. and my father i don't know if i've said this at trained in psychiatry and neurology and he was widely admired for his expertise in being able to untangle the intermingled causes and symptoms of both physiological and purely psychiatric illness. and so he was asked by one of o'neill's closest friends to come to new york and examine him. o'neill took an instant liking to him. this happened a lot. something just about the way my father examined him very thoroughly. and i say psychiatrist or not he always gave his patients medical exams car real medical exams with a

stethoscope and a funny little hammer you no. they just took a liking to his personality. so he moved to boston and took an apartment directly across the street from my dad's office so that he could see him almost every day for the remainder of his life. and when he sometimes felt especially depressed at night that would happen sometimes rather late at night. his wife would, father at home. were not ask any questions. he would drive back into the city and maybe spend 30 minutes chatting with one -- chatting with o'neill at his bedside and joking with him. he can always make his

patient smile. just long enough so that o'neill would have a peaceful sleep the night. the two of them became close friends. o'neill confided in him for hours and hours the agony underwent in the initial stages of creating a knew play. very vivid. hundreds of pages ordered from them. he spoke annoying a gnawing sense of guilt at imprisoning always in the. trapped within me and struggling to come out. the only pc ever had was in completing a knew play. then he added to that. could not do both. o'neill has long been distance from his only daughter and extraordinary

interesting woman, a beautiful woman who he does sound. do you remember this? the sounder when at the age of only 17 or 18 she married charlie chaplin of colonial disapproved and ran away with and live in switzerland but only about all my father that he had had 2nd thoughts and felt remorse for the way he treated her. harry, he asked for my do you no what it is like to have a guilty conscience? and before my father can answer he said, is they're any other kind? when o'neill died my father sat beside his bed for most of three nights in three days. they held his wrist. i held his wrist within my hand as his pulse was

failing. i did not want to let him go i had a sense of desperation that was only one of many many cases in which his personal attachment to a patient went far beyond the ordinary role of the physician. but in all his cases, even those that were purely psychiatric he never ceased to be a medical dr. you don't see this often nowadays. he always carried a dr.'s bag with him. you remember doctors banks? i still have it. i opened it again recently. there is a stethoscope and that little triangular hammer and the thing they put around your arm. your blood pressure gauge. sixteen wouldn't throw sticks with elastic around them and a box of sterile

pads johnson & johnson sterile pads. he later filled a very different role as a court psychiatrist, an expert psychiatric witness is a highly controversial cases. one of them was the case of patricia hearst. i won't describe to the very young people here were brought her into court, but i'm sure -- how many of you have some sense of what it was? okay. almost all the. in any case after she had been kidnapped by a group that called itself the liberation army she then joined the and began helping them and armed robberies.

she was seen on tape in one of those robberies spraying machine gun bullets are some my automatic bullets. he spoke with her for 16 hours in five separate interviews before she went to trial. many testified in court that he believed she acted of her own free will and spraying bullets manic going back over. his defense, or defense argued the exact reverse stockholm syndrome and so forth. my father didn't figure it was so. i take unfashionable position. a friend of mine actually i defense psychiatrist robert j lipton father believed

she was responsible and idea for free will. his testimony proved to be decisive and the jury found her guilty. in a more important case in which he was involved was that of a man who strangled 13 women and is known to history as the boston strangler. his name actually was albert h disalvo. the father lapine transcripts lengthy conversations with the strangler when he was asked what is asked to determine if the men was insane or in populous province too crazy to be brought to trial under

massachusetts law. my father had an amazing conversation with them. you know, i've read through it all in typed form. it comes out 245 pages singlespaced. it is sort of priceless documents certainly for research, psychiatric researchers and people concerned with the roots of terrorism the roots of seemingly irrational crime. the man could describe in some gruesome detail a person who he strangled but always a 1st without any connection to himself as though he were watching it or heard about it but not as if you were the one he did it. he said to my father an 85

-year-old woman. she was the one with the pillowcase around her neck. and my father you know, thought, okay, there's the pillowcase. you put it they're? so we asked him. you know, finally so gradually he thought and said i did. that kept happening. my father finally decided that the man was suffering from what he called having a notable -- this is his quotation my notable experience on reality. this combined with the fact that he conveyed a grandiose enjoyment of the fact that he was in the public eye celebrity he thought that my

father to believe that he had undergone's a fragmentation of the essence of his and being which a classic analogy one of the founders the early founders of the field called the enema the essence of his and are being. my father described it as a delusion of the soul. for those reasons he decided the man was unfit to go to trial. of course the city was crying out for vengeance and ultimately he did go to trial ended up in prison without any psychiatric treatment. and some years later around christmas time he sent my father the most affectionate

letter. he really liked them. and you know it ended by him wishing my father good health. he said, i hope this letter finds you in good health and i wish you a happy new year. from the man who strangled 13 women. i want to spend the last few minutes -- and i go into great detail these cases. it's just fascinating. you know, i could've written a whole book on each of these cases. i want to spend my last few minutes now talking about my father's final days. i was very fortunate to find some blessedly unselfish people to take care of him

at home. one of them had also been visiting him as a companion lines of the nursing home. most of all to women i will just give there 1st names who were just blessedly unselfish people and just like this in the the never spoke to him and that phony singsong language. they talked real talk. he would say something that really was beyond the pale. hehe seemed to become just like my mother, more irreverent as he got older. he would say something that was really outrageous. it would give it right back to. once when sylvia was trying to bed.

when sylvia always called his privates from his private parts you can read in the face been said your not going to get it. [laughter] she can my back at him and said i don't need a dr. i have a husband of my own. i was glad to talk to him like that. the same way she talked to other human beings and he smiled. he that light in his eyes. there are people, i'm sure you no who we will tell us -- i have read some writings that tell us that victims of alzheimer's very quickly lose there personalities entirely essentially ceased to be the persons we knew and loved parts of alice.

they become a stranger the other. and as a boston journalist wrote recently pray for the diocese possible. i never pray for my father and i. i wanted him to live is why is he was comfortable and take some satisfaction in existence. in the end it was an error on the part of his position that brought about his death i have time with our doctor. i disguise are carefully. my publisher insisted on it. but i had our time with her so did sylvia and julia because she is almost never reachable. you know when they were cars sometimes in a moment

of emergency or just deep concern about my dad she very seldom call back. but not without long delay. she was, you no buffered walled off in a sense from her patients by all these layers of assistance and assistance to assistance. she was never they're is a presence in my father's life. there was no personal connection. well, you know one of the problems is we don't have enough geriatric specialists in this country. it is an overwhelming ratio of patients to physicians which has to be corrected. still she could've called them back. and when they did ask a question and get the answer from assistant. we never no if the answer is

based on what we actually asked. so it was a bureaucratic mess. in any case time finally came when my father had a serious infection in his urinary tract. this timethis time the dr. did callback, but she said she saw no reason at all to examine and. instead she said she would find a prescription to the drugstore across the street. told them the dosage. the trouble is she was in a hurry. so she gave the wrong medicine. she gave him medication to it she had a very bad reaction in the past been to which he had previously told us he was allergic that she did not check his records and he went into cardiac arrest before they got into hospital. my father was an

old-fashioned doctor peabody spent hours with his patients. he knew them well. he knew everything about them and he never cut them off when they pouredfrom the.out there hearts to him and this was not so in the case. well-known people like o'neill. this was also true that the poor, destitute people that he treated in the clinics of mass general and boston city hospital. and when he had a phone call assumed happen all the time just as we were sitting down to dinner phone call typically from an intern and resident of a hospital or sanitary and the seven what his patients was an extreme anxiety were talking about suicide. he would leave his inner right away. my mother would answer the phone and put her hand over

the speaker and say harry are you home. he always said yes, i'll take it. he was out the door. we don't have many of those kinds of a. whether in psychiatry or any other field. and in any case the entire world of medicine is utterly transformed. in this age of russian time and rationed care many people scarcely no the doctors and more. examinations by assistance. examinations by technicians examinations by other intermediaries. i find this in my own life. i'm getting old. i need medical attention to. now i am seeing it from the.of view of the patient.

in an hour-long appointment patients get to actually be with her dr. probably ten minutes at the end of the lucky. now we also here distant self-care. have you heard that? by computers. while it may be useful in some situations in rural areas, for instance, still i worry deeply. but comfort the warmth and consolation of the human bond between the dr. and the patient the dialogue of life and death hope and fear trust and faith between them has i'm convinced, therapeutic value in self. that is one of the many lessons my father tommy. he lived in the end to be 100 to. so to do my mother. i wrote this book when my

memory of there memories were still fresh and clear. some of it is already fading more, of course inevitably will fade in time. but i would like to believe i need to believe that the essence of the blessings that are parents give us outlive the death of memory. thank you. [applause] thank you very much. thank you. some questions now. >> thank you. if you raise your hand will get a mike to you and start right here in front.

>> in your voice i can here a good deal of pain at various points as you go through this. as you go on the book tour and european versions of this lecture, is a leading to a catharsis of some kind? >> leading to what? >> a catharsis of some kind? >> that's a good question. i don't think -- i don't think going on a book tour has any cathartic effect. i see absolutely no benefit all except i get to meet some wonderful people. but writing the book was itself in some ways a cathartic experience. i started writing it actually before my father's death mostly in the year 12 months after his death.

then as you will see i put aside for many years. i wanted to get down well remembered it but then i was afraid to look at it again just like i was afraid of his doctors bag's. when i did it may be proud of him but also it was painful because it was exactly as he left it on the last day that he used it. but in another sense writing the book and then coming back to it as i did today the epilogue the past two years and then another sense it kept -- it kept him alive for me's, same with my mom. i mean she has a very prominent role in the book. it was as if they were still they're for me because i was summoning up all these vivid memories.

and i mean funny things to. once my mother's assistance of you asked me in front of her well, you write about children. do you ever wish you had children of your own? i wasn't married. and i said well, i would like to have children. she said -- and my mother would be really happy. sylvia said 1st we have to find a way for him. my mother said wife? you can have them anyway. she was wonderful. writing the book them alive longer for me. it was concluding the book

this past winter and even this past june months helping the last proofs to rest. that was part of his pain is like saying about him again. other questions? yes. >> you describe dutifully your reaction to your father's decline. the beautiful moments you experienced. i wonder if you could tell us a little bit about how he experiences decline and if you have morbid thoughts about his condition. west it was over sentiments to that effect. >> whether he wished it was over, life was over. >> more than you recount that you despair. because he -- the loss of the time.

percy as clearly as i can. clearly he was aware of the loss. the passage i quoted he wrote a note at one time where he said much you know, much -- much is beyond my healing power or something like that. but he never expressed a wish to die. he never gave a slight extent that he wanted his life to end. in fact, he kept on -- he kept on speaking as a he would enjoy the future as long as he was capable of taking pleasure in life. for example, while he was in the nursing home asking me he was writing the most another you know saying

that he was sorry for the turbulence of the difficulty he had given her when he 1st was sick but that he was looking forward to spending the next years of her. you know so long as my father felt that way i damn well was not going to take on this presently trendy role of the executioner, the kind the executioner who says well you no when a couple of doctors tried to discuss this with me i might've paid more attention to them if they hadn't fallen in to clichés. but they always spoke with the same clichés out of pop psychology about the value of life versus the

end-of-life. it is often seem to me that they were speaking on semi consciously, maybe unconsciously. they were summoning up and ethical reason for what was also economically attractive to society you know, 100 neurologist with dementia is not going to contribute to the nation's competitive edge against japan which is the main criteria i here as an educator when the government wants to add more tests to make our children's life more miserable. they always justified by saying we need those children to grow up to be useful to our corporations

and sharpening our nation's competitive edge. they will never say give them a head start because they are babies and they have a right to be happy. no. so i felt so that was brewing. i wish they had been more capacious the honest with me in any case there was no opportunity. i did not sign a dnr until the very end. there was never a reason. he was strong physically and he enjoyed it, have a great opportunity right after the end. yeah. >> first of all, i would like to thank you for this book. my dad has dementia, not alzheimer's, dementia. i approach this book because a friend gave it to me and

i approached it with a lot of trepidation mostly because i just did not want to read something that was going to be, you no an overview of all the sadness and hardship. in fact,. in fact, the book is completely not that. it is joyous, loving command it has given me a lot of hope. ten years and my dad. like your father strong as an ox. i took them out for breakfast the other day. he ate the pancakes and bacon, on a non-. but it gave me a different attitude about the people who work with him and you should be working with him the approach that they hold in the approach that we should hold his family. >> thank you so much. >> thank you. >> i do think it is a joyful book in a lot of ways. as i said he never really felt end up ainto pathos or self-pity, and he did somehow -- i don't know how it was, that imprint of his clinical training, just a

way of looking at things never totally abandoned him. it was almost as if it did not require memory as though there was something that have become automatic to him to look at illness with interest, you know, with curiosity. a lifelong curiosity about the workings of the mind and the diagnosed sell the generation, brain disorder for years and years. and it was so. that advantage never abandoned him. it did give him a kind of -- i don'ti don't know, but it certainly rescued him from a sense of pathos. >> the migrate here. >> i have not had the pleasure of reading your book yet but i will. my husband is a physician at

penn. he teaches medical students. one of the courses his doctorate, to help medical students as they should. the medical school. and i have a request or suggestion. if you could write an essay because of read your other books and is so helpful to education on your experience and how people treated your dad because when my mother was dying and she was in her 60s this book to her as though she were a child. look, i have a doctorate. this is not the way. should talk to her dr. it's a mrs. grossman, i can teach the medicine. i can't is that humanity. but the.is if there was

something you could write to help teach humanity i can almost guarantee you it will be taught at university of pennsylvania. >> thank you. thank you. i might say very quickly that those of you did not get to ask questions, i will certainly answer your questions during the book signing. that's when i get to no people better. in answer to your., i think i would love to do something like that and i would love to spend time with medical students at medical schools if they would probably. i've had a lot of experience looking at it from all different directions. the truth is, i never felt that they gave back to my father even a small piece of what he had given to patients throughout his life

it is not because they were personally mean-spirited. it's because of his struggle economically driven, sense of time. but talking with the patient i think -- i mean once i think it was on his 95th birthday still in a nursing home. we have a party board. my mom came out. it would have been wonderful a group of people. i honestly did not no but they said they were old friends of his and decided to come. i did not think they had seen in 30 years. it was like a dutiful visit.

something i thought they ought to do. the trouble is once they got they're they sat in a circle around and antarcticinteract across. it is not talk to him. that address themselves to and at one time one of them was sitting next to him an attractive me in a very loud voice said you are fortunate to have had them for so long ..