Ronald Reagan was never particularly admired for his memory. But in the late 1980s and early '90s, he slowly began to lose his grasp on ordinary function. In 1992, three years after leaving the White House, Reagan's forgetting became impossible to ignore. He was eighty-one.
Both his mother and older brother had experienced senility, and he had demonstrated a mild forgetfulness in the late years of his presidency. Like many people who eventually suffer from the disease, Reagan may have had an inkling for some time of what was to come. In his stable of disarming jokes were several about memory troubles afflicting the elderly. He shared one at a 1985 dinner honoring Senator Russell Long.
"An elderly couple was getting ready for bed one night," Reagan told the crowd. "The wife turned to her husband and said, 'I'm just so hungry for ice cream and there isn't any in the house.'"
"I'll get you some," her husband offered.
"You're a dear," she said. "Vanilla with chocolate sauce. Write it down--you'll forget."
"I won't forget," he said.
"With whipped cream on top."
"Vanilla with chocolate sauce and whipped cream on top," he repeated.
"And a cherry," she said.
"And a cherry on top."
"Please write it down," she said. "I know you'll forget."
"I won't forget," he insisted. "Vanilla with chocolate sauce, whipped cream, and a cherry on top."
The husband went off and returned after a while with a paper bag, which he handed to his wife in bed. She opened up the bag, and pulled out a ham sandwich.
"I told you to write it down," she said. "You forgot the mustard."
It seems clear enough that Reagan was increasingly bothered by personal memory lapses. In a regular White House checkup late in his second term, the President began by joking to his doctor, "I have three things that I want to tell you today. The first is that I seem to be having a little problem with my memory. I cannot remember the other two."
Did Reagan have Alzheimer's disease in office? Yes and no. Without a doubt, he was on his way to getting the disease, which develops over many years. But it is equally clear that there was not yet nearly enough decline in function to support even a tentative diagnosis. Reagan's mind was well within the realm of normal functioning. Even if his doctors had been looking intently for Alzheimer's, it is still likely that they would not have been able to detect the disease-in-progress. A slight deterioration of memory is so common among the elderly that even today it is considered to be a natural (if unwelcome) consequence of aging. About a third to a half of all human beings experience some mild decline in memory as they get older, taking longer to learn directions, for example, or having some difficulty recalling names or numbers.
Alzheimer's disease overtakes a person very gradually, and for a while can be indistinguishable from such mild memory loss. But eventually the forgetting reaches the stage where it is quite distinct from an absentminded loss of one's glasses or keys. Fleeting moments of almost total confusion seize a person who is otherwise entirely healthy and lucid.
By 1992, the signs of Reagan's illness were impossible to ignore. At the conclusion of a medical exam in September, as the New York Times would later report, Reagan looked up at his doctor of many years with an utterly blank face and said, "What am I supposed to do next?" This time, the doctor knew that something was very wrong.
Sixteen months later, in February 1994, Reagan flew back to Washington, D.C., from his retirement home in Bel Air, California, for what would turn out to be his final visit. The occasion was a dinner celebrating his own eighty-third birthday, attended by Margaret Thatcher and twenty-five hundred other friends and supporters.
Before the gala began, the former President had trouble recognizing a former Secret Service agent whom he had know well in the White House. This didn't come as a total shock to his wife, Nancy, and other close friends, but it did cause them to worry that Reagan might have problems with his speech that night.
The show went on as planned. After an introduction by Thatcher, Reagan strolled to the podium. He began to speak, then stumbled, and paused. His doctor, John Hutton, feared that Reagan was about to humiliate himself. "I was holding my breath, wondering how he would get started," Hutton later recalled, "Then suddenly something switched on, his voice resounded, he paused at the right places, and he was his old self."
"Not good" was how Reagan's daughter Maureen characterized his condition in the fifth year following the diagnosis.
The mythic significance of the once "Great Communicator" now steadily unraveling was felt even by Reagan's detractors: Once the most powerful man on earth, he famously confronted the Soviet empire. Now he was caught in a humbling downward spiral, so powerless that he no longer even knew who he was. On the Today show, Ann Curry asked Maureen, "Does he remember being President?" She evaded the painful question.
Earlier in the illness, supporters had made much of the fact that Reagan was continuing to go to his office in downtown Los Angeles every day. He played the occasional game of golf and took casual walks in public parks, making himself accessible to passers-by.
Those visits and games were now over, and the Reagans had sold their beloved "Rancho del Cielo" mountaintop retreat. They were hunkering down for some more difficult times. As expected, Reagan's descent had progressed steadily. Friends and family watched his memory lapse become the rule rather than the exception. There was, for example, the day that former Secretary of State George Shultz visited his old boss. In the midst of a casual discussion about politics, Reagan briefly left the room with a nurse. When he returned a few moments later, he took the nurse aside and pointed to Shultz. "Who is that man sitting with Nancy on the couch?" he asked quietly. I know him. He is a very famous man."
Incidents like this drove him into further isolation. Partly out of simple courtesy to Reagan and partly due to their own personal discomfort, many of his friends stopped visiting when he started having trouble recognizing them.
Then came language stumbles. Over the course of a few years, aphasia crept steadily in and eventually took from him the ability to articulate his thoughts. He could, for a time, still read others' words out loud from a children's storybook. But then that too slipped way.
In visits just after the diagnosis, Maureen and her father would tackle large, three-hundred piece puzzles. "He and I do jigsaw puzzles together," she said. "He loves doing that. When I was a little girl he used to tell me, `do the border first.' Now I sit there and say, `Dad, do the border first.'"
When the intricate puzzles got too difficult, she brought him simpler puzzles of a hundred pieces or so; then simpler puzzles still, with farm animal scenes. Finally, even those became too challenging. In other homes all over Southern California and elsewhere, tiny children were, day by day, learning to distinguish colors and shapes, gaining in depth perception, improving their hand-eye coordination, slowly gaining confidence as their brains developed to full capacity. Here at 668 St. Cloud Drive, the former President of the United States was heading through the same developmental process in reverse.