Dr. Jennifer White, age 64, is read her rights in a Chicago police station. But how much does the retired orthopedist who specializes in hand surgery really understand? Dr. White has Alzheimer's dementia. Her score of 19 on a mini-mental state examination (MMSE) is consistent with a moderate degree of cognitive impairment. She is questioned about the death of a neighbor, 75-year-old Amanda O'Toole, who lives 3 houses away. Amanda happens to be Dr. White's best friend and the godmother of her daughter. Amanda died at home, the result of head trauma. Four fingers of her right hand were cleanly and expertly chopped off. It seems that Dr. White is genuinely incapable of recalling whether she committed a murder or not. The physician is not charged with the crime but remains a suspect.

Dr. White's memory and mind are no longer reliable. In her lucid moments, she jots down notes in a journal. She dubs the notebook her "Bible of consciousness" [5] and it assists her in filling in the blanks of her past life. Her husband James has died. She has approximately $2.5 million of financial assets. Her two adult children - Mark and Fiona - squabble.  Throughout the course of her disease, family secrets are revealed and intimate details are exposed. Relationships fray.

Despite a slew of prescription medications (galantamine, an antipsychotic, an antidepressant, and a benzodiazepine as needed), Dr. White's mental status and behavior deteriorate. Her confusion, wandering, forgetfulness, and episodes of agitation worsen. The story is structured in four sections, based on the residence of the protagonist: First is Dr. White's time in her own home aided by a live-in caregiver, Magdalena. Next is her stay in an assisted living facility. Then she briefly escapes from that place and has a 36 hour adventure of sorts. Finally, Dr. White is incarcerated in a state mental health facility.

Ultimately, the circumstances of Amanda's death are made known. And while Dr. White did not kill her best friend, the surgeon was present at the scene with a scalpel in her hand. Another character was there too.


This hybrid novel - murder-mystery and illness narrative - is presented from the unique perspective of a physician-turned-patient afflicted with Alzheimer's dementia, Dr. Jennifer White. Her process of loss and progression of disease are poignantly revealing. She loses almost everything that matters: memories, dignity, independence, occupation, husband, best friend, and sense of reality.

The significance of the human hand in this story cannot be overstated. At one time, Dr. White was cognizant of its value. Knowing the human hand and repairing its anatomy were her career. She understood how the hand connects us to other people and the world. And how we make things with our hands. And how the sense of touch empowers people.

The importance and ramifications of both financial and health care power of attorney are underscored. Matters of competency, corruption, and clarity are explored. Fear of being abandoned, an incapacitated state of being, and shame are constant threats presented in the story. A mother's love lingers longest even while everything else dissipates. Ultimately, it is the impending sense of oblivion that makes this tale so vital and unsettling. In a moment of lucidity, Dr. White frames the problem this way: "How do you endure that interval between when you know you're dying and when you actually die?" [99].


Turn of Mind was awarded the 2011 Wellcome Trust Book Prize, as well as the 2012 California Book Award for first fiction.

Primary Source

Turn of Mind


Atlantic Monthly Press

Place Published

New York, NY



Page Count