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Alzheimer's Concerns in Aging Friends

Alex, a 66-year-old business executive, crashes his plane after forgetting how to land it, exhibiting symptoms of memory loss, confusion, and aggression that concern his friend Jay and doctors; two doctors, a neuropsychologist and psychotherapist, examine Alex and Jay and determine Alex is exhibiting symptoms of Alzheimer's disease based on his worsening memory and emotional issues.

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Kevin Shui Hu
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0% found this document useful (0 votes)
9 views11 pages

Alzheimer's Concerns in Aging Friends

Alex, a 66-year-old business executive, crashes his plane after forgetting how to land it, exhibiting symptoms of memory loss, confusion, and aggression that concern his friend Jay and doctors; two doctors, a neuropsychologist and psychotherapist, examine Alex and Jay and determine Alex is exhibiting symptoms of Alzheimer's disease based on his worsening memory and emotional issues.

Uploaded by

Kevin Shui Hu
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd

Characters emotional.

He has recently become less


organized, and is flustered whenever others
Alex Vitello point this out.
Alex is a sixty-six-year-old man who enjoys Adjectives: Asian, passionate, and self-
flying planes as a hobby. He is married and conscious
has three kids. During the day, he works as a
business executive. He’s proud of his PRE-TITLE
education, and feels that his Yale degree
certifies that he is intelligent and in perfect Alex boards the plane and flies it. Alex and
mental condition. In the past, he has been Jay converse over the radio.
emotionally stable, although he has recently
had problems controlling his temper, and he Jay: Hey Alex, you know the Yale reunion
has felt a bit “low.” He has had trouble is in a few weeks, right?
recently with his memory, but he is in
denial, insisting that his mind is completely Alex: Yeah. I don’t think I can go, though.
sound.
Adjectives: Classy, class-conscious, well- Jay: Why not?
educated
Alex: I need some time with my family, and
Jay Radi you know how the business world works… I
Jay is a sixty-four-year-old man who was in don’t know when the next time will be when
Alex’s graduating class from Yale. They I’ll have a day off.
have been best friends. Whereas Alex is
proud and confident, Jay is more tempered Jay: I see. How is Ellen?
and more logical. Jay has a paranoia issue,
and is always afraid of the worst. During the Alex: Ellen?
day, he works as a doctor.
Adjectives: Pessimistic, loyal, persistent Jay: You know, your daughter?

Dr. Hu Alex: obviously flustered Oh, right. That


Dr. Hu is a fifty-year-old psychotherapist Ellen. She is… doing all right.
who studied medicine in China before
immigrating to the US. He has a strong Jay: …Alex, are you okay? You haven’t
accent. He is extremely sarcastic, to the seemed normal these past few days.
point of bitterness. He likes to eat food, and
is constantly reminded of his “motherland.” Alex: Yes, Jay. I am okay.
Adjectives: Asian, cranky, and impersonal
Jay: You’ve been having some memory
Dr. Khwaja problems lately. And face it: you’re getting
Dr. Khwaja is a sixty-five-year-old old. We’re not in our mind’s primes
neuropsychologist who studied medicine in anymore.
India before immigrating to the US. He has
a strong accent. He is passionate and deeply Alex: aggravated Jay, I’m fine.
involved in his work, and often gets

Page 1/11
Jay: You even forgot your daughter’s name.
The plane dips downward and is about to
Alex: angry Jay! I’m fine, okay? We both crash.
know that I’m intelligent, and that my brain
is in pretty good shape. I went to Yale, for Alex: I forgot, Jay. I forgot.
crying out loud. Stop exaggerating my
problems! You keep making up symptoms The plane crashes.
to diseases that you want to believe I have!
TITLE
Silence
SCENE 1
Alex: I’m sorry, Jay. I didn’t mean that.
Dr. Khwaja and Jay are talking outside of
Jay: That’s okay, Alex. I understand. the hospital.
You’ve been really stressed out lately.
Jay: emotional I’m so worried. Will he be
Alex: Uh, Jay, have you ever flown a plane okay? What’s going on right now?
before?
Khwaja: He will be okay. He just needs a
Jay: No. Why? few casts and a few stitches, and then some
physical therapy and rehabilitation. It is
Alex: I just realized that what goes up, must amazing that he has survived, at his age.
come down. And I don’t think I ever learned
how to land this thing. Jay: Thank you. I’m sorry, what’s your
name?
Jay: Alex, you’ve flown plenty of planes by
yourself before. I’ve seen you land. Khwaja: My name is Dr. Sadiq Khwaja. I
am a licensed neuropsychologist, and I will
Alex: Well, this isn’t good. I remember be one of the doctors treating your friend.
pressing a button… a button that like, puts
down the uh, the things, the rolling things on Jay: Pleasure to meet you. Wait, you’re a
a plane… neuropsychologist?

Jay: Wheels? Khwaja: Yes. It was very strange that your


friend forgot how to properly fly a plane,
Alex: Yeah, wheels. Jay? Jay? and I will be running tests on him to see if
he has any problems with his brain.
Jay: Alex, don’t panic. I’ll call for help.
Jay: I see.
Alex: panicking Jay, I don’t know what I’m
doing! Khwaja’s phone rings. He picks up.

Jay: Alex, hang in there. Don’t touch any of Khwaja: Hello? Ah yes. The friend? Yes, I
the controls. Alex? am actually talking to him right now. The

Page 2/11
psychotherapy department? Yes, I will send Hu: Okay, actually, this form is so stupid. I
him. Yes. Thank you. remember, back in mother China, we never
had to use stupid forms like this. We would
Khwaja: I’ve been asked to take you to the just ask useful questions, and get answers
psychotherapy department, where you are to quickly. Stupid American bureaucracy. So
meet one of your friend’s other doctors. He let me ask you. Has Alex had problems with
will ask you a few questions. memory lately?

They walk. Jay: Yes, actually. He didn’t recognize the


name of a family member, and obviously, he
Khwaja: Here we are. I will see you soon! didn’t remember how to land a plane.

SCENE 2 Hu: Very interesting…

Jay enters a room, where he sees Dr. Hu Jay: Really? What’s interesting, doctor?
lounging on a chair.
Hu: Nothing. I was just kidding. Have you
Hu: Please. Take a seat. noticed any emotional problems?

Jay: Thanks. Jay: Yeah. He’s been a pretty angry person


lately. And also, he’s a business executive,
Hu: So. My name is Dr. Hu. I am a trained and he used to be on top of his game. He
psychotherapist. Your little buddy, Alex? I would be the first to work and the last to
will be his therapist. First, I have a few leave. He would be innovative, and –
questions to ask you.
Hu: Come on, you’re not giving him a
Jay: Sure. eulogy yet. What other emotional problems?

Hu: First of all, how come you didn’t catch Jay: He doesn’t seem to have the same drive
him when the plane crashed? anymore. And he doesn’t sleep well.

Jay: What? Hu: I see. Well, I think this paints a pretty


clear picture. Have you ever seen those
Hu: Oh, sorry. Too soon. Bad joke. Laughs pictures of the rice paddies that Chinese
to himself. Anyway. Monotone drone. What artists drew? The masterpieces?
is your relation to the subject?
Jay: No…?
Jay: Friend, and classmate.
Hu: Oh… well, never mind. Anyway, I
Hu: How long have you known the subject? believe your friend Alex may have the
Alzheimer’s Disease.
Jay: About thirty, forty years.
Jay: That’s what I was afraid of…

Page 3/11
Hu: Symptoms of Alzheimer’s disease Hu: Well, work with him and tell me what
include memory loss, confusion, loss of you think later.
initiative, increased anxiety and aggression,
outbursts of anger, problems recognizing Khwaja: Got it. I’ll see you later, Dr. Hu.
friends and family members, and
restlessness. SCENE 4

Jay: You sound like you have that Alex is in a hospital bed. Jay is at his side.
memorized.
Jay: Alex, I have something serious I have
Hu: My mother made me memorize the list to talk to you about.
when I was twelve.
Alex: What is it? Is everything okay?
Jay: Oh. Well, these all sound like
symptoms that Alex has. I’ll do some Jay: Yes, but… very deeply emotional well,
research when I get back home. Thanks, Dr. the past few months, whenever I’ve been
Hu. around you, I’ve gotten this feeling.

Hu: You don’t need to thank me with words. Alex: Do you want to talk about it?
That’s what money is for.
Jay: Whenever I talk to you, or email you, or
Jay exits. call you, I… I start to feel… I feel…

SCENE 3 Alex: …Yes?

Khwaja enters. Jay: …Worried, I guess. Worried that you’re


not okay.
Hu: Hey, Dr. Khwaja. So, I think he has
Alzheimer’s. Alex: Jay, are you trying to tell me
something?
Khwaja: Who?
Jay: No… I mean, yes. Yes, I am.
Hu: Alex.
Alex: Come on, Jay. We’ve been friends for
Khwaja: I thought Alex was in the Planned ages.
Parenthood department…
Jay: I know, but… I just don’t want to say
Hu: No, that’s Dominic. Alex is the guy who this. It might make things awkward between
crashed his plane. us.

Khwaja: Oh, right right right. Yeah, that Alex: Spit it out, Jay.
makes sense.
Jay: Okay. Alex, I… I feel… silence. I feel
like you have Alzheimer’s Disease.

Page 4/11
right about one thing – studies suggest that
Alex: shocked What? No! calmer Well, people with a higher level of education are
thankfully, you’re not a doctor. at a lower risk.

Jay: Actually, Alex, I am. Alex: Ha! There you have it. I can’t have
Alzheimer’s.
Alex: What? Okay, okay, maybe I am losing
it. Maybe. But I’m not convinced. Jay: Lower risk, Alex. Five percent of
people between the ages of 65 and 74 have
Jay: sighs I’m quite convinced, actually. Alzheimer’s, and the proportions increase
dramatically with age. Almost half of people
Alex: Anyway, Jay, I’m bored. Tell me a over the age of 85 may have the disease.
story. I want to get my mind off of things. Alex, five million people in America have it.
Why do you think you’re immune?
Jay: Okay, let me think. Pause So there was
once a German doctor. It was the year 1906, Alex: I don’t know, Jay! Leave me alone! I
and he had discovered a bunch of weird want to rest.
clumps and tangled bundles of fibers in a
woman’s brain. Jay: sighs I’ll see you later tonight.

Alex: Gross… SCENE 5

Jay: And his name was Dr. Alois Alzheimer. Khwaja is looking for his office and
stumbles into Hu’s office on accident. Hu is
Alex: Okay, Jay, not funny. You really want doing Tai Chi, accompanied by old Chinese
to talk about this, don’t you? music.

Jay: I’m concerned, Alex. Hu: in Chinese (And then, we release the
chi…)
Alex: Fine. Tell me how I’m at risk for
Alzheimer’s Disease. Convince me. Hu sees Khwaja and is startled.

Jay: Well, doctors aren’t entirely sure what Hu: Khwaja, you have interrupted me. This
makes certain people at greater risk than makes me unhappy.
others…
Khwaja: I’m sorry, Dr. Hu. I was –
Alex: So what gives you the authority to tell
me? Hu: Dr. Khwaja! I challenge you to a battle.

Jay: Well, here are a few findings from Khwaja: incredulously A battle?
recent studies. Let’s see… thinking People
in urban areas are at greater risk. Men and Hu: Not a martial arts battle. That would be
women are at equal risk. Caucasians are at too simple. No, we must fight like real men.
greater risk than Asians. But you might be I will destroy you with my Pikachu –

Page 5/11
Jay: Yeah. I read about diseases caused by
Khwaja: Dr. Hu, I’m really sorry, I was just misfolded proteins, like Mad Cow Disease
trying to get to my office and I… I forgot and CJD, in a book called Deadly Feasts.
where I was going.
Khwaja: I see. Well, anyway, the two
Hu: Khwaja, your office and my office are abnormal structures are amyloid plaques and
so far apart. I made sure of that when they neurofibrillary tangles.
designed the hospital.
Jay: Whoa, that sounds complicated.
Khwaja: Honestly, Dr. Hu. I just got lost.
Khwaja: I won’t go into complicated detail.
Hu: Shame. These two structures disable brain cells,
especially in regions of the brain that are
SCENE 6 used in memory.

Khwaja finds his office. Jay is waiting Jay: I see. Wait, I read somewhere that
inside. Alzheimer’s patients have clumps and
tangled bundles of fibers. Are these what
Khwaja: Oh, Jay. Please, have a seat. you’re talking about?

Jay: Thanks. Khwaja: Pretty much. The clumps are made


of amyloid, a protein that’s also involved in
Khwaja: So, you’re a doctor. Let’s talk Parkinson’s and Huntington’s Diseases.
details. What do you know about Neurofibrillary tangles, on the other hand,
Alzheimer’s? are really only known as the primary marker
of Alzheimer’s.
Jay: Not much, to be honest. I don’t deal
much with the brain or the mind. I’m a heart Jay: Marker? What does that mean?
surgeon.
Khwaja: Basically, if you find
Khwaja: Okay. Well, some of what I tell you neurofibrillary tangles in a patient’s brain,
should be a review from medical school. you are probably dealing with Alzheimer’s.
The tangles “mark” the patient.
Jay: Shoot.
Jay: Okay, that makes sense. So you said
Khwaja: Alzheimer’s patients have two that these structures are especially present in
types of abnormal structures in their brains regions of the brain used in memory?
that consist of misfolded proteins.
Khwaja: That is correct. Actually, a recent
Jay: So, like prions. study showed that high numbers of
neurofibrillary tangles in the nucleus basalis
Khwaja: Oh, you know about prions? of Meynert are associated with low
neuropsychological test scores and long
disease duration.

Page 6/11
Khwaja: When you have a mental disorder,
Jay: Nucleus basalis of Meynert? you often don’t want to believe it.

Khwaja: It’s a group of nerve cells in the SCENE 7


basal forebrain. The basal forebrain is
important in the production of acetylcholine. Khwaja is sitting in Hu’s office. Silence for
a few seconds.
Jay: What’s acetylcholine?
Hu: Well? Why are you not talking?
Khwaja: It is good you ask that question.
That brings me to another point. Silence.
Alzheimer’s Disease is also characterized by
reduced production of neurotransmitters, Hu: Confucius said, “Be not ashamed of
which are chemicals used for mistakes and thus make them crimes.”
communication between nerves.
Acetylcholine is one neurotransmitter. Two Silence.
others linked to Alzheimer’s are serotonin
and norepinephrine. Hu: Well, if you are not going to talk, I am
going to watch Korean soap opera. New
Jay: I’m guessing neurotransmitters travel episode: so good!
between one nerve cell’s axon terminal and
another cell’s dendrite? Khwaja: Okay, I’ll talk.

Khwaja: You are correct, my friend. Well, Hu: Oh thank you. I thought I was really
where was I? going to have to watch the Korean drama.

Jay: You were talking about the causes of Khwaja: I’m not myself lately.
Alzheimer’s.
Hu: Having girlfriend problems? That’s why
Khwaja: Ah, yes. Sorry, I’ve been a bit arranged marriage is such a good idea.
scatterbrained lately. When all the things I
was just talking about happen, the brain cells Khwaja: No. I just… I’ve been really
lose connection, so the cells slowly lose disorganized lately, and I keep missing
their function and die. appointments and getting lost, and it’s
getting to me. I’m just getting old, I guess.
Jay: That’s kind of scary. So Alex’s brain But it’s frustrating. I keep waking up at
cells might be dying? night, and I’m anxious. I don’t even know
why.
Khwaja: That is what we believe.
Hu: Hmm, I know what will help.
Jay: sighs I don’t know what to do… He
won’t believe me. He’s in denial. Khwaja: excitedly What? You do?
Anything!

Page 7/11
Hu: Acupuncture.
Khwaja looks concerned.
Khwaja: Really?
Jay: Well done. Are you convinced yet?
Hu: No, you fool! You are a doctor, not an
old Chinese grandmother. Think like a Alex: Maybe…
doctor.
Jay: What are the middle symptoms?
Khwaja: I think it’s just a normal part of
aging. Alex: Uh, let me see. Anger, wandering,
problems recognizing family members,
Hu: How would you know? You’ve never inability to learn or cope with new
aged before. situations, lack of self-control…

Beeping. Khwaja looks at his cell phone. Jay: Alex, you’re matching with a lot of
these…
Khwaja: Oh, I have to see my patient.
Khwaja looks very concerned.
Hu: Take care of yourself. Drink tea, it helps
with memory. Alex: Well, I know I don’t have any severe
symptoms, like weight loss, seizures, or
Khwaja: Really? inability to swallow or communicate.

Hu: No, you fool! Jay: Are you convinced, though?

SCENE 8 Alex: Fine. I have to admit that I’ve been


worried about it since… it’s just that I’ve
Jay and Khwaja are next to Alex’s bed. refused to acknowledge it.

Jay: Alex, do you remember the list of Khwaja looks very, very concerned.
Alzheimer’s symptoms I gave you
yesterday? Jay: Dr. Khwaja, you look… concerned.

Alex: Yeah. To test my memory, I tried to Khwaja: Yes… to be honest, I’ve been
remember as many as I could. having many of the same issues lately. And
I’m getting old. Alzheimer’s isn’t a normal
Jay: What are the early symptoms? part of aging.

Alex: Well, the easy one is memory loss. Jay: Do you think you might have it?
Other ones include disorientation, difficulty
performing familiar tasks, problems with Khwaja: Perhaps…
planning, trouble with language, personality
changes, changes in sleeping habits, and Hu walks in.
poor judgment.

Page 8/11
Hu: Aha! So there we have it. Perfect. healthy level of acetylcholine, increasing
You’ve both gotten past denial. brain function.

Khwaja: Dr. Hu? You knew? Jay: It makes sense!

Hu: The whole time. Hu: Of course. Memantine is a new drug


that regulates levels of glutamate, which is
Jay: So what’s next? another neurotransmitter involved in
memory.
Hu: First, we’ll have to test you to see if you
really have Alzheimer’s. I’ll give you a few Alex: So if I take all of these drugs at the
neuropsychological exams to assess your same time, will it be like a super drug? I
intellectual function, including memory tests know that AIDS victims take drug cocktails.
and naming tests. I’ll also see if your
symptoms are so severe that they prevent Hu: I would not recommend taking multiple
you from everyday activities. If these two acetylcholinesterases at the same time. With
steps pass, I will make sure that it’s drugs, it’s not like one plus one equals two.
Alzheimer’s and not something else that’s It could equal three, or fifty, or negative one
causing you problems; you’ll need blood million. Confucius said that “To go beyond
tests, x-rays, CT scans, and MRI scans. is as wrong as to fall short.” I say we start
both of you on donepezil, one of the
Alex: Is there a cure for Alzheimer’s? acetylcholinesterases, and memantine. A
reputable study has shown the combination
Hu: Unfortunately, no. But there are of donepezil and memantine significantly
treatments that will slow down brain improves brain function in Alzheimer’s
degradation and suppress some of the patients with moderate to severe symptoms.
symptoms.
Khwaja: How about Ginkgo biloba? I’ve
Khwaja: Ah, yes. heard it helps.

Hu: Donepezil, rivastigmine, and Hu: It may, but scientists haven’t found
galantamine are three drugs that will treat anything significant. Drinking green tea may
mild or moderate symptoms. They slow help though.
down and inhibit the action of
acetylcholinesterase. Khwaja: Really?

Jay: Acetylcholinesterase? That word seems Hu: No, you fool! Well, Dr. Khwaja, I think
to contain “acetylcholine.” you should order the drugs.

Hu: Well done, Captain Obvious. Khwaja: I’ll do that right away.
Acetylcholinesterase breaks down
acetylcholine, which is a necessary Hu: Well, I think we are finished here. Let’s
neurotransmitter. So by inhibiting not get too sentimental with goodbyes.
acetylcholinesterase, the drugs maintain a

Page 9/11
Alex and Jay: Thanks Dr. Hu!

Hu: Yeah, yeah. Feel better soon.

Hu exits, and quickly returns.

Hu: And also, my Pokemon challenge still


holds. Pre-Title: Dominic, with Sadiq filming.
(Tamer voice-over).
Alex: Pokemon? Scene 1: Tamer and Sadiq
Scene 2: Tamer and Kevin
Khwaja: Long story. Scene 3: Kevin and Sadiq
Scene 4: Tamer and Dominic
Jay: Tell us! Scene 5: Kevin and Sadiq
Scene 6: Tamer and Sadiq
Khwaja: Oh, I forgot. Scene 7: Kevin and Sadiq
Scene 8: All
FADE TO BLACK.
FADE FROM BLACK TO AERIAL
FOOTAGE; CALM AND HAPPY MUSIC
IN THE BACKGROUND. PLAY
CREDITS ON THE FOOTAGE.

Filming

Day 1: (Dominic and Sadiq, Pre-Title and


Credits) Dominic and Sadiq will arrive at
the airfield. Sadiq will film Dominic
entering the plane. Dominic will take off and

Page 10/11
start flying. He will read his lines in the Pre-
Title section and pause, to accommodate
Tamer’s “radio” conversation. Dominic will
pretend to crash the plane. Sadiq will stop
filming here. Next, Dominic will continue
flying for a bit, and Sadiq will hold the
camera against/out of a window to get aerial
footage for the Credits.

After Day 1, Sadiq should lend his camera


to Dominic for Day 2.

Day 2: (Tamer and Dominic, Pre-Title


voiceover and Scene 4)

After Day 2, the Pre-Title should be


complete. Try to have the files so far
uploaded to Dominic’s computer so that
Dominic can work on editing. Dominic
should hand off the camera to Sadiq in class
for Day 3.

Day 3: (Kevin, Tamer, and Sadiq, Scenes 1,


2, 3, 5, 6, 7) When one person is not acting,
he can be filming. After Day 3, Sadiq should
hand off the video to Dominic in class.

After Day 3, Dominic should upload the


files to his computer and edit.

Day 4: (All, Scene 8) After we are done


filming, we should stay and help Dominic
edit.

Page 11/11

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