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house, the first thing I noticed on the table in the front hallway was a bill from the neurologist who had found nothing wrong with Harvey. I crumpled the bill into a wad and threw it in the trash. I refused to pay.
    Despite my regular talks with Henry Masur, I did not know that a few of Harvey’s colleagues had started talking to the administration-level managers about easing him out of his job. At the very least, they insisted, management needed to get Harvey thoroughly examined. In the lab that Harvey was nominally running, the day-to-day responsibilities fell to his two deputies. It was hard for them to do their own work and Harvey’s too. At the suggestion of these colleagues, Harvey’s boss attended the speech. He was shocked by Harvey’s demeanor and performance.
    The next morning, Harvey’s boss called him into the office and told him that under no circumstances was he allowed to see patients. He needed a clean bill of health and the last report didn’t count. Harvey promised to limit his work to the lab. His two deputies were also called to the front office and assigned to keep an eye on him. But right after Harvey agreed to the new arrangement, he seemed to forget it. It was an almost impossible task to keep Harvey in the lab and away from the wards.
    Harvey wasn’t responsible only for himself and the patients. There were fellows and graduate students whose career advancement depended on Harvey. They needed his help to supervise their research and shepherd their papers through the review process and into publication in prestigious journals. They wanted him to mentor them. All of this he was now unable to do. Morale in the lab started to flag.
    Less than two weeks after Harvey’s final speech, he was supposed to fly to London for a meeting of the FAB—for French, American, and British—leukemia classification committee. Harvey had been invited to join years back, and it was one of the highlights of his career. There was one other American on the committee; everyone else was based in Europe. This meant regular trips to Paris, his favorite city, and to London, a city he also had gotten to know very well.
    Harvey wanted to attend the meeting in London, but after the confusion he had exhibited during the speech, I was terribly concerned. He rejected my offer to come with him. The situation had the makings of a disaster.
    This was the most challenging point in his illness, when Harvey stood on the border between who he had always been and what would characterize the rest of his life. For a while, he had been able to keep one foot on each side. There were days when he was still his old self, with flashes of the intelligent and funny Harvey. He would make a joke or refer to something that happened in the news. He could make conversation, and he had strong opinions about what he wanted to do. But then, without warning, his eyes would glaze over and he would get a distant, vacant expression. He seemed to be looking off in the distance, perhaps at the fate that awaited him. I worried that he would not be able to keep himself together for the long overseas flight. Harvey still maintained the demeanor of a high-functioning man. If he fell apart, who would be there to help him?
    I had lost whatever influence I once had over him. He was far enough into the early stages of mild cognitive impairment to be obstinate and unwilling to listen to reason. My tears and pleading that he should stay home fell on deaf ears. The visit to the neurologist who had told Harvey he was fine turned out to be the one episode he did not forget. Now I had lost my standing as his defender. Harvey treated me as his enemy; someone he could not trust. By this point, we were the only ones living at home. There were no allies to help me dissuade him from leaving for London.
    A dementing mind sees only its own reality.
    The morning of the flight, he frenetically packed his bags. The process took two hours because he kept