“I don't know what I am, who I am or where I am” Betsy wails. “What am I doin' here? I want to go home. Why won't you let me go home?”

“You are home Auntie Betsy” I tell her. “This is your home and you know who you are. What's your name? “

“I'm Betsy Wolfe” she answers.

“Almost right, Auntie Betsy. What's your name?

“I'm Betsy Watson. Mrs. Watson.”

She is quiet for a few moments and then she says again, “I don't know what I am, who I am or where I am. What am I doin' here? I want to go home. Why won't you let me go home?”

Betsy is sitting on the edge of the bed. She wears a navy blue and white print polyester dress, no bra, knee-highs sagging around her surprisingly trim ankles and shapeless shoes. Her wispy white hair is combed flat on her head and her teary eyes are large and limpid behind thick lenses. Although it is a cool, breezy day, her forehead and thick nose are shiny with sweat and she dabs at it often with a tissue. We are sitting in her sunny room in Heatherdale House, the assisted living residence she moved into two years ago. Her ample frame makes a deep valley in the bed which is covered by a bright golden yellow bedspread. There are pictures of family and friends on the bureau and her window looks down on a rose garden in full bloom.

I am re-arranging her photographs in a new pocket album. The old one has become so tattered that the pictures are getting dog-eared and falling out into the lumpy handbag she carries with her everywhere. It's hard to know what to bring her when I fly over once or twice a year from New York to London to visit but the little photo albums I pick up for her in the drugstore are always a good bet. I've brought gummed labels and I paste one on each picture. “Mother in the garden at Palmers Green”, “Your sister Rose”, “Cynthia's grandchildren”. Occupying myself with this task, and showing her the photographs, I try to distract her from her agitated state.

“Let's go for a walk, Auntie Betsy.” I say and we walk down the corridor together, hand in hand, Betsy lumbering along, rolling slightly from side to side like a sailor newly ashore. Other residents greet us.

“'”Ullo Betsy” they say. “Is that your niece all the way from America?” and at last, she smiles.

”Yes,” she says. This is my niece, Cynthia.”

I sigh with relief that she remembers my name. Her deterioration into the nightmare of Alzheimer's disease is slow but relentless and I know that, one day, I will come and she will have no idea who I am.

Betsy is my mother's youngest sister; the last of my grandmother's five children. She is ninety three. No-one in the family has lived so long.

She was born in 1910. At thirty two, my grandmother, Rivke-Leah, had thought that her childbearing days were over. The first four children had been born, “steps and stairs”, every two years. When Betsy came along Fan, the oldest in the family, was twelve and Rivke-Leah pressed her into service as baby-sitter and general household help.

Although she was only four when Betsy was born, my mother, Tilly, became her caretaker while the older children were in school. Tilly didn't start school till she was seven when word leaked out that the Wolfe family had another child at home who was ready for school and the truant officer came calling.

Monday was wash day. At 5.30 am Rivke-Leah attached a garden hose to the kitchen faucet filled the huge copper boiler, and lit the gas jet underneath. When the water started to heat up, she dropped in a cube of “Reckett's Blue” , filled the boiler with the white clothes and sheets and, stirred them with a sawn off broomstick. She baled steaming hot water out of the galvanized tub on the stove into the kitchen sink and she started scrubbing the diapers on a washboard before she added them to the copper boiler. As soon as all the diapers were boiling, she picked up the baby, sat on the rocking chair and nursed her. But when she put Betsy down in the cradle, she refused to settle.

“Tilly”, she called “ Come here.”

Tilly came in from the girls' bedroom, dragging her feet. She'd been playing with a rag doll – a dishtowel rolled up to look like a real baby – and resented the interruption.

“ You can be a big help to Mama. How would you like to take Betsy for a walk?”.

“Do I have to, Mama?” Tilly pouted.

“Yes you do.” Rivke-Leah insisted. “See if you can get her to go to sleep. I think she has a tummyache”.

With the baby tucked snugly into the carriage, Tilly started off down the street. She soon forgot her resentment and she felt really grown up pushing the carriage, just like the mummies in the neighborhood or the nursemaids she sometimes saw in the park. She started to skip down the street, playing a sort of hopscotch, hopping first on one foot, then on the other. She lifted her hands from the carriage, only for a moment but the street had become a steep hill and the carriage started careening down, bumping on the cobbles. Tilly forgot hopscotch and started chasing after the runaway carriage, a huge lump in her throat, her cheeks turned flaccid and limp. In no time at all, the baby carriage was all the way at the bottom of the hill and, oh my, it had tipped onto its side and Betsy, swaddled in blankets, was rolling over and over in the gutter. Tilly reached her charge and tried to pick her up but the baby was heavy and awkward wrapped in all the blankets. A woman stopped, sized up the situation, and accompanied the sobbing babysitter and her charge back to the bouse.

“I remember how terrified I was.” my mother told me. “I watched the carriage bumping over the cobbles, and I could hear Betsy screeching. If that kind woman hadn't taken me home, no-one would have known about it. I would have been too scared to tell Mother.”

When Betsy was about ten months old, eleven year old Rosie decided to surprise Rivke-Leah by getting the baby ready for bed before her mother came home from marketing, heavily laden with bags of fish and potatoes. Rosie put the galvanized tin tub on the stove and filled it with water. After about ten minutes, she tested the water temperature with her elbow just like her mother did. She asked her brother Goody to help her lift the heavy bathtub off the stove and onto the kitchen floor and she undressed Betsy and gently lowered her into the lukewarm water. But when she put Betsy in the tub, the baby screamed and refused to sit down. Rosie held Betsy's arms and tried to push her into a sitting position, but the slippery baby writhed out of her grasp and struggled to stand up, slithering all over the tub. Of course, the bottom of the bathtub was red hot. Twelve year old Fan summed up the situation immediately, pulled Betsy out and tried to comfort her before her mother came home. .

The worst accident occurred when she was about fourteen months old. One Thursday afternoon, Rivke-Leah went marketing and left Fan in charge. Betsy was in a large cradle on the floor next to the fireplace and Fan was trying to rock her to sleep. But Betsy insisted on sitting up in the little bed and rocking herself violently. Suddenly, the cradle tipped over and Betsy fell out, hitting her head hard against the brass fender that surrounded the open fireplace. She lay on the floor, limp and silent. After a few moments that seemed like an hour to the other children, she stirred and started to cry and, much to Fan's relief, she soon lay back in the cradle and fell asleep. Fan instructed the other three children:

“Don't tell Ma. I'll give you each a ha'penny if you promise not to tell”. Goody, Rose and Tilly swore they'd keep the secret and when Rivke-Leah came home Betsy was fast asleep. She slept an abnormally long time, not waking till 10 the next morning. Rivke-Leah was glad to have uninterrupted time to complete her chores preparing for the weekend. But when Betsy did wake up, she cried inconsolably and kept on hitting her head with her fist. Nothing would calm her. By Tuesday, when this behavior had continued for four days, Rivke-Leah took her to the doctor. He felt the huge bump on Betsy's head, saw that the baby's eyes were not focusing properly and asked Rivke-Leah what had happened. My grandmother couldn't answer him. She explained that she often left Betsy in Fan's care and he told her to ask Fan how Betsy had banged her head.

When Rivke-Leah got home, she asked,

“Fanny, How did Betsy hurt her head?”

“I dunno” Fan answered, looking down at her feet.

Rivke-Leah stood the other three children in a row and asked them the same question. She was weeping now, rubbing her hands on her face, clutching the fractious baby to her breast.

“What happened to her?” she sobbed, “My poor Betsy-leben, My poor Betsy-lovey.”

Tilly had spent her ha'penny already. “I know what happened” she piped up.

But knowing the cause of Betsy's concussion didn't do anything to heal the harm that had been done to her. After a couple of weeks, she stopped hitting her head with her fist but, whenever she misbehaved or did poorly in school, people would say “Well, what d'you expect? She was dropped on her head when she was a baby.”

Betsy soon assumed the special role of family troublemaker. The other four children were good students, obedient and well behaved. Rivke-Leah and her husband, Shlomo-Zalman were proud of their four good looking, high achieving children. Betsy, however, floundered in school. She was inattentive and uninterested in her lessons and she soon learned that she could attract a lot of attention by misbehaving. She became a frequent truant and a glib liar. She habitually stole money from her mother's handbag and escaped from school to the comforting darkness of the local cinema where she loved to lose herself in the breast-heaving romances of the silent movies. By the time she was thirteen, she'd made her name for herself in the family as a “wild child”.

“I used to loved goin' to the cinema,” Betsy told me when I was a teenager. “But I was always in trouble. Once a boy took me to the pictures and gave me a box of chocolates. When I got home, I offered them round to everyone and Ma said, ‘where'd'you get those?' I told her a boy had given them to me. Ma said that a boy doesn't give you such things for nothing. She told Daddy and he took the belt off the sewing machine and beat me with it. Ooh, it didn't half hurt.”

I asked my mother how her parents could have been so mean to Betsy.

“Mean?” my mother said. “What did she tell you?” I repeated Betsy's story. “That's not how it happened,” my mother sniffed. “Mother emptied Betsy's pockets to wash her dress and she found a condom. She didn't know what it was, so she showed it to Daddy. He'd never seen anything like it and he took it to Goody. Poor Goody was so embarrassed having to explain what it was. That's when Daddy took the belt off the sewing machine and beat her. My parents didn't know what to do with her. They were at their wits' end.”

When she was fourteen, Betsy left school. My grandparents expected her to apprentice to one of the needle trades – dressmaking or tailoring. But Betsy hated sewing and she had no talent for it. She begged to be allowed to learn hairdressing and my grandfather reluctantly agreed. She enjoyed the work and became an expert at Marcel waves and permanents

She was still a constant worry to her parents. Even though the other children had left school at the same age, they read serious books and were interested in politics, opera, and the theatre. Betsy stayed out late and ran with a wild group of flappers and their beaus.

One day, Goody was invited to a party. As he was getting ready to leave, Rivke-Leah asked him to take Betsy with him. He must have been terribly resentful at being asked to take his fifteen year old little sister to a party where most people would be in their twenties but Goody, always the dutiful son, agreed to take her along.

It was usual to play parlor games at such gatherings; charades and word games were popular and, at this party, they decided to play “Think, Word, Letter,” an elimination game in which you set up a clapping rhythm, and go around the circle in turn. The first person might say “Think, elephant, R.” The next person in the circle would have to think of a word beginning with “R” so they would say “Think rattle T.” and the next person would say “Think Triangle P” and so on. First the rhythm is established and, as the game progresses, it gets faster and faster. This is an elimination game, like musical chairs. The first person unable to think of a word, or who breaks the rhythm, is “out”. Betsy sat down with the others to play but Goody looked over to her and said “Don't you play this.” He knew she would be hopeless at this game.

“I wouldn't've minded being the first one out if he'd let me play. I was so ashamed when he made me leave the circle so that he could play with all his clever friends.”

Pushed aside by her family, Betsy found her own level. Her friends were children of janitors or costermongers who had stalls in the vegetable market. She borrowed money from her sisters which she never returned. She often came home in the wee hours of the morning and her parents were deeply concerned that she would one day get pregnant.

Betsy and I have a cup of tea and a piece of cake in the dining room and we walk along the sunlit corridor hand in hand. Back in her room, I pull out a big, black photograph album with a scuffed cover. It is full of snapshots of Betsy on vacation in the Channel Islands in the early 1930's. She is very slim, wearing shorts or a sagging bathing suit and every picture shows her with a different young man. Her arms are often draped around their necks or she is leaning over them, lips pursed ready to give her partner a juicy kiss. Finally I find the picture I'm looking for.

“Who's this?” I ask her

“That's Jim,” she says. “Jim Watson. Isn't he handsome?” The photograph shows a square jawed man in his thirties. He has a thin, slightly turned up nose and a shock of wavy blond hair. His teeth protrude slightly like a doll's. This is my Uncle Jim.

Betsy met Jim when she was vacationing on the Isle of Jersey in 1935. He lived in London and worked as a janitor at the Metropolitan Water Board in Islington, a tough, neighborhood in North London. Jim was from a poor, working class family. He'd been in the navy in World War 1 and, when his ship was torpedoed, he'd clung to a spar in the icy water for more than twenty four hours. This was the reason given for his stammer.

It was a stammer like no other I have ever heard. Combined with an almost unintelligible Cockney accent, each sentence was painfully, long-windedly spoken.

“'Allallallallallall-ow, Cyn-cyn-cyn-cyn-whasaname-cyn-cynfia” he would greet me. “''ow-‘ow-‘ow-‘ow-‘ow-‘ow-‘ow-whasaname-‘ow-‘ow are yer?”

And, of course, he was not Jewish.

No-one in the Wolfe family had ever married “out”. Unlike their parents, Rivke-Leah and Shlomo-Zalman who moved exclusively in Jewish circles, the children had Christian friends who they met at work or on vacation but Betsy's sisters and brother wouldn't consider dating any of these friends. They knew how grieved their parents would be if they were to marry a gentile and all four of them were extremely dutiful children. The commandment, “Honor thy father and thy mother”, was not a hollow saying to them. It was a creed.

When Betsy and Jim came home from vacation, they started seeing each other regularly but she never brought him home to meet the family. Finally, in 1937, they were secretly married in a registry office ceremony. Betsy continued to live at home in my grandmother's house. (My grandfather had died ten years earlier) and, on weekends, she would tell her mother that she was going to stay with one of her girl friends. After a year and a half of this routine, my Aunt Rose begged Betsy to tell her mother about the marriage and to bring Jim home to meet everyone.

It was the custom to “sit shiva” for a child who had married out of the faith; to treat them as if they had died, mourn for them and then to cut them off from the family entirely. But my Grandmother couldn't bear the idea of cutting off her child. When Betsy finally brought Jim home and confessed that she was already married, I remember my Grandmother, grief-stricken, rocking back and forth in a kitchen chair, wiping her swollen red eyes with a corner of her apron, and sobbing,

“If he vanted to marry me, I vouldn't hev him.”

Jim was putty in Betsy's hands. After she had introduced him to the family, she asked him to convert to Judaism and in 1939, at the age of forty two, he went into hospital to be circumcised and he studied for conversion with a liberal Rabbi who performed a Jewish wedding ceremony in my Grandmother's living room

But, in spite of his efforts to join the family, my mother's sisters and brother were united in their attitude to Betsy and Jim. They were uniformly ashamed of them. Although they were always included in gatherings of the immediate family, they were never invited to weddings or other large family celebrations. Our extended family was now entering the professions. My cousins became doctors, lawyers and CPA's and they married “well”. Betsy and Jim were treated like double skeletons in our family cupboard

Jim was hard-working and conscientious at his job and he was promoted to the position of head housekeeper at the Metropolitan Water Board. They moved into an apartment on the top floor of the building where they lived till he retired. He appeared to be a model, if somewhat boring husband.

One day, when I was fourteen, I was on my way to the theatre and stopped in to visit them there. When it was time to leave, he took me down in the elevator and, in the overheated, cramped space, surrounded by mirrors reflecting the glaring light, he groped for my breasts and pressed wet, panting kisses on my face while I tried to reach the button marked “G” so that I could escape into the cool air of the London evening.

I look at his picture and shudder slightly and I find a picture of a smiling, tow-headed baby but I turn the page quickly before Betsy can see it.

It's time to clean out Betsy's weighty handbag. Bags of boiled sweets, a cheese and tomato sandwich dotted with blue mold and wrapped in a napkin, and then, at the bottom, a doll with real hair and a jaunty smile and a little teddy bear.

“Aren't these nice!” I say. “Who gave them to you?”

“I don't remember.” she replies.

“You always liked dolls, didn't you, Auntie Betsy.”

“Yes. I love dolls.” She says, dully.

It's time for me to leave. I kiss her clammy cheek.

“Will you come back?” she asks.

“Yes.” I say.” I'll be back the day after to-morrow.”

Two days later, I find Betsy, sitting by a window, reading the “Daily Mirror” and whistling a little tune.

“Hullo darlin'” she says. “Are you here for your holidays?”

“Yes. But I'm going home soon. Back to New York. Look, Auntie Betsy. I've brought you a present.”

I pass her a big shopping bag and she pulls out a baby doll with a dimpled, smiling face and eyes that open and close.

“Ooh!” she says. “Thank you so much, darlin'. How lovely. I love her.” She kisses the doll's face, lifts it up to her shoulder and pats its back gently. “She's goin' to be so spoilt.” She says and her eyes fill with tears. “I don't know why,” She says. “I'm so happy that you brought her and I do love her, but I feel sad too. I don't mean to but I just do.” She sits dreamily in her chair, patting the doll gently. Then she cradles it in her arms.

In 1940, Betsy became pregnant. Although my grandmother was not resigned to Betsy's marriage, she was excited at the prospect of a new baby. As Betsy's time drew near, my grandmother and her friends guessed the sex of the child. Carry high and it would be a girl; low and it would be a boy. A needle was suspended on a thread over her belly. Swinging in a circle signified a girl; if it swung back and forth, it would be a boy. It was hard to determine the pattern so opinions were evenly divided. When her time came, Betsy was in labor for more than twenty four hours and her baby girl was delivered stillborn. The next year, she was pregnant again. The atmosphere around her was electrically tense and this time, when the baby was born, the cord was wrapped around his neck and he died also. It was 1943 now and Betsy was thirty three – getting old for bearing children – and now she found that she was unable to conceive. Jim said to my mother “Uv-uv-uv-uv-whasername-uv-uvver women jist ‘as to lif-lif-lif-lif-lif-whasername lif-lif-lift their skirts and they gits pregnant.”

Finally, my cousin Martin was delivered by Caesarian section on July 24, 1946.

Martin was a sunny-natured baby with white-blond hair and his father's china-blue eyes. My grandmother and aunt Rose doted on him and baby-sat with him often. My brother, a year older than Colin, was a colicky baby who cried most of the time. He had a stubborn nature and temper tantrums. The contrast between the two cousins was palpable and Martin was clearly the favorite.

Betsy was thrilled with her newborn but, soon after Martin's first birthday, when he began to assert his independence a little, she became very impatient with him. If he didn't obey her, she smacked hit him often. He soon became a mass of nervous tics and, when he began to speak, he stammered. By the time he was two and a half, his behavior had become rather bizarre. He flapped his hands, rocked back and forth, and poked his finger in his eye with a twisting motion. As he grew older, he became obsessed with the timetables of London Transport and, by the time he was eight, he could give you directions to any location in London, telling you where to change buses or get on the Underground. I believe he was mildly autistic and that he may have had Asberger's syndrome – a manifestation of autism which includes nervous tics, difficulty socializing with others, and obsessive “idiot savant” type of learning. Betsy took him from one doctor to another to try to find treatment for his unusual behavior but no-one seemed to be able to help him. Betsy sent him to a Jewish day school and he grew up to be good at mathematics and conscientious at any job he took on – just like his father. When he was twenty, he decided to move to Israel where he lived on a kibbutz and his good work habits were valued. He would have stayed there but Jim became very ill with emphysema and he came home, moved back in with his parents and never left. After Jim died, Martin became Betsy's constant companion. She still shouted at him if he didn't do as he was told but he clearly adored his mother, called her “My lamb” and seemed content to live with her and chauffeur her to the supermarket or Bingo games. Living at home, doing sedentary work and taking virtually no exercise, he became obese and, when he was forty two, he dropped dead on the floor of the living room where Betsy found him when she came home from her Bingo game.

Betsy holds the doll tight on her shoulder patting it rhythmically.

“I always wanted a baby of my own.” She says. “I didn't have any children did I?”

“No”. I lie. “But you can take care of this one now.”

I am amazed that Alzheimer's disease can be a blessing