Fritz Goss has been battling Alzheimer's for the better part of a decade. He will not go gentle into that good night.
It seems strangely fitting that it all began with a black eye.
Way back when, Fritz Goss was a teacher at Westmoor Middle School on the Hilltop, and he spent his summer vacations working in a bar on Cape Cod, Massachusetts, where local pubs held an end-of-summer charity boxing match. When Kate McElligott was reassigned to Westmoor in 1984, a co-worker suggested she seek him out for advice. He greeted her with a fresh Cape Cod shiner. They were married two years later.
He was already an accomplished fighter by then. Fritz started boxing at 7 years old, captained the wrestling team in high school and was introduced to the sport of judo at 19, in December 1966. He fell in love with it—the slamming, the pinning, the choking, the arm bars that can break bones. He says he won his first tournament two months after his initial lesson, followed by the Ohio AAU Judo State Championship and the 1970 Big Ten championship as a member of Ohio State's club team. As an officer in the Navy during the Vietnam War, he spent six months at Naval Base Coronado in the San Diego Bay training SEAL Team One in judo, and he won the all-Navy championships two years in a row.
Fritz was still competing when he met Kate, and he was the sensei of a youth judo club at the YMCA down the street from Westmoor, where he taught social studies. He started teaching in 1973 and later became a guidance counselor. He's always loved kids, “little rascals” in his jargon. He and Kate eventually had two children of their own, Danny in 1989 and Nora in 1992.
It's April of 2017 and Nora is grown, sitting next to her father at the kitchen table of the Dublin home he and Kate share. He's 69 years old and retired. For a man who has dealt in blackened eyes and broken bones, he's affable, goofy even, and he likes to get laughs, especially from his family. They're tight-knit.
He's discussing Alzheimer's disease, which is consuming more and more of his life. It's a subject most people with the debilitating illness don't talk about much, embarrassed by their deficient memory. Not Fritz. “I'm not the least bit afraid to let people know it,” he says. “That's the first thing I say to people when I meet them.”
Nora says the effects were difficult for him at first because he'd always been so social. He'd remember her friends' names a year after meeting them once. Then he no longer could. “That's right, that's right,” Fritz says, nodding. He and Nora often slip into this rhythm, her providing context like a trail of breadcrumbs through the wilderness, him reaffirming the details as he follows her path.
He walks me to the porch when it's time to leave and asks my name again, an hour after meeting. “This is the bullshit that plays with my mind,” he says. Then he tells me goodbye and returns to the house.
It's not that Fritz can't remember anything. To the contrary, his memory of the past is largely intact. He still remembers the home on Karl Road that his family moved into when he was 3, the one near his North Linden grade school. He remembers serving as the captain of the wrestling and football teams at Brookhaven High School. He remembers more than he's forgotten.
This is how the disease works, says Gary Wenk, a professor of neuroscience, immunology and medical genetics at Ohio State University. Alzheimer's is the leading cause of dementia, a syndrome characterized by cognitive problems like confusion and memory loss, and the portion of the brain that's damaged worst in the early stages deals with short-term memory. Areas that store long-term memory aren't usually affected until very late.
In Central Ohio, about 30,000 people have the disease, says Vince McGrail, the executive director of the local chapter of the Alzheimer's Association. Fritz is at the forefront of the aging baby boomer generation that's fueling a steep increase in cases. The most recent association report estimates that 5.7 million people have the disease nationwide, and that number could escalate to as many as 16 million by 2050. It's the sixth leading cause of death in the U.S., and between 2000 and 2015, its mortality rate increased 123 percent.
For decades, Wenk says, the dogma among researchers has been that the key to curing the disease was eliminating the abnormal protein structures called plaques and tangles that accumulate in the brain. That theory now appears less and less likely to be true, he says. The drugs meant to remove those plaques and tangles haven't yielded positive outcomes, and clinical trials have repeatedly failed, even resulting in patient deaths. In January, the pharmaceutical giant Pfizer pulled out of Alzheimer's research altogether.
In looking for clues to how Alzheimer's develops, Wenk says researchers have discovered some curious trends: Arthritis patients, people in India and marijuana users don't get the disease at nearly the expected rate. The theory is that steady doses of anti-inflammatories over a long period—from active compounds in marijuana, medication for arthritis and a chemical in curry, a mainstay of Indian diets—help reduce the chances of getting the disease in old age.
“There are things that people have done in their lives that have indicated to us that it's all about the inflammation, and anything you do to worsen it—such as diabetes or head trauma or other problems—you will put yourself at risk,” says Wenk, who is studying synthetic cannabinoids, the same compound found in marijuana, for their anti-inflammatory benefits. In this view, Alzheimer's is more of a lifestyle disease than a genetic disorder, and the best remedy is prevention rather than a cure-all medication.
Scientists still don't know enough about the disease's mechanisms, making continued research crucial. In the face of Big Pharma's failures, Wenk's spirits are buoyed by a dramatic increase in research funding at the National Institutes for Health, from $500 million to $1.8 billion annually in the last five years. McGrail says he wants to reach $2 billion per year, the magic number NIH researchers claim will allow them to create an effective treatment by 2025.
While Alzheimer's deaths have skyrocketed, the mortality rates for many leading diseases have been declining. People with cancer and HIV are living longer, or even beating the diseases. Yet there isn't a single Alzheimer's survivor, and nothing even significantly slows its progress. “So when you receive a diagnosis,” McGrail says, “you're either going to die from it, or die with it.”
In 1997, doctors informed Kate that she had breast cancer. She received treatment and improved for a time, but in 2000 they discovered it had metastasized to her liver, Stage IV. Doctors estimated she had about six months to live.
Nora relates the story, told to her years ago by Fritz, of when her mom received a bone marrow transplant during treatment, a procedure she describes as “catastrophic.” Kate was dying, but every day afterward she forced herself to walk on the treadmill or through the hospital hallways, to the staff's amazement. She refused to let it kill her, Nora says. Doctors gave her a last-ditch option, a drug called Taxol. Eighteen years after Kate's terminal diagnosis, she's still enjoying life with her family. She's as reserved and private as her husband is outgoing, but every bit as strong.
A few months after they found out Kate had cancer, Fritz's father, Albert, wandered off down state Route 23 in his underwear. He was suffering from Alzheimer's and had been for some time, but his son's family never knew. Fritz's two sisters lived out of state, so he had to handle many of his father's affairs while also serving as primary caregiver for Kate during her treatment and raising two children. Albert was in a long-term care facility, but in many cases family members are the only daily caregivers for Alzheimer's patients, especially in the early stages of the disease. For every person who's diagnosed, McGrail says, there are typically two to three nonprofessional caregivers. It can take a devastating financial and emotional toll.
Danny remembers accompanying his dad to visit his grandfather in long-term care. “I don't really think I understood the weight of it, having to reintroduce yourself to your father every time you see him,” he says. “I don't think I fully understood the gravity of that.”
Albert died in 2002, and Fritz retired from Columbus City Schools about the same time. He'd been working in finance part-time, persuaded by some investor friends when Kate got sick, and he turned that into a full-time business, Goss Financial Services. Several years later, he started forgetting things, first minor tasks at home, then bigger responsibilities at work. In 2010, at the age of 63, doctors gave him the bad news. It was a shock to Nora, and Danny says it made him feel helpless after having watched his grandfather's decline. He knew where his father was headed.
Fritz and Kate began attending support groups through the Alzheimer's Association, and Nora joined the association's Junior Committee for young professionals after participating in RivALZ (then known as Blondes vs. Brunettes), the group's powderpuff football fundraiser. Fritz exercised like crazy, attended special workout classes intended to help cognitive ability and completed puzzles to keep his brain active. He resolved to do everything he could to prolong his health, inspired by his wife who already had outlived her prognosis 20 times over.
“Our whole family attitude is just kind of like, you just fight everything,” Nora says. “That's life.”
“When you got something god-awful facing you, well, you can lay down and have them kick you to death, or you can stand up and fight till you're gone,” Fritz says. “And we're the fighters till we're gone.”
It's a gorgeous summer day in July of 2017, two weeks after Fritz's 70th birthday. He and Nora are on the back deck of his home, basking in sunshine. She graduated from OSU in May, and this fall she'll start teaching social studies and English at Graham Elementary and Middle School near the campus area, where she lives. Danny has become a counselor serving adolescents and young adults through Wellspring, a local Christian agency. He also trains in Brazilian jiu jitsu.
In retirement, Fritz enjoys watching movies, every night if he can. He has to sleep in the guest room if he watches violent ones because, predictably, he fights in his sleep afterward—he even punched the head board once. Nora likes it when the family gets together on Christmas to watch the home movies they made when she was very young, when they tried to cram a whole childhood of memories into a matter of months after her mom got sick.
Fritz's last judo tournament was about six years ago, but he still works with kids and teens twice a week, at Ronin Training Center near Grandview and Triumph Brazilian Jiu Jitsu in Dublin. He also volunteers two afternoons a week at North Linden Elementary, teaching reading skills to kids from other countries who are learning English. Nora thinks it probably helps slow his deterioration.
But there are a whole host of other problems beyond declining cognitive abilities, like the disease's tendency to alter personalities. Nora says Fritz used to be the most positive, happy and supportive person she knew. “When I was upset when I was little, I would go to him for comfort, and that just changed.” Now he gets dejected sometimes and often says how frustrating the disease is.
The two of them are still very close, and they spend much of their time together joking and laughing. Nora says Fritz's resilience has been pretty remarkable, especially since he has the early-onset type of Alzheimer's, which tends to be more aggressive. “You could be in the Guinness book of world records!” she exclaims. “Longest-living crazy man.”
I ask if he's noticed any changes since our first meeting. “Yeah, I wet my pants every day,” he deadpans. “Just kidding.”
“Not funny, Dad!” Nora says, laughing despite herself.
“Well, my whole deal with the thing is, if I don't laugh about it, I got to cry about it. And I ain't a flippin' crybaby. I'm just not. And I never lost a real fight in my life, and I like to fight,” he says. “If I can find something to strangle—I mean in judo, you strangle people, you break their arm or their shoulders. It's, well, it's violent, you know?”
The disease is his combatant, if only it would show itself. Meanwhile, something dawns on Nora. “Have you, though? Have you seen any changes?” Her voice is tentative.
Fritz sputters at first before finding his words. “It just seems like in the last six months it's harder and harder for me to remember real basic stuff that I was supposed to do, you know.”
Just yesterday, he got lost with Kate's car when he took it across the street to Walmart. By the time he finished shopping, he'd forgotten which car he drove. He walked home because he thought his had been stolen.
Nora tells him if he had just called Kate, she would have let him know he drove her car. His desire to fight the disease can make him hesitant to ask for help.
“That's right,” Fritz says. “That's a good insight on your part.”
“That's the only problem with not just accepting defeat,” Nora says, “is sometimes you get very frustrated that you are sometimes being defeated.”
Fritz slams the man across from him into a padded wall hard enough to make the corrugated metal backing shake. He's demonstrating the proper way to perform a move during a judo class at Ronin Training Center. Over and over he slams the guy with a force that belies his slight frame, hidden inside his white gi. His movements are quick, sure-footed and powerful, burned into muscle memory in a way the disease hasn't yet erased.
For about five years, Fritz has been helping teach judo through the Columbus Youth Guild, a nonprofit that offers the classes for free. Nick Wolak, the guild's executive director, says Fritz is their highest-ranked sensei; he's a sixth-degree black belt, and in the mid-1980s he won a national championship in the over-30 division. Wolak says Fritz's mastery of the skills is unparalleled, even if his Alzheimer's prevents him from fully grasping the daily curriculum.
Etienne Otero, another of Ronin's senseis, says the disease can make teaching difficult because sometimes the two of them struggle to get on the same page. But they work through it, and it's a blessing to have a legend like him helping. Plus, Fritz loves working with kids; it keeps him sane, Otero says. On this Saturday morning in mid-March, sensei Fritz spends much of his time training, chasing and generally horsing around with some of the youngest judokas, a smile plastered on his face.
When class ends, Fritz and I each drive a few blocks to Grand Day Café for lunch. He gives updates on the family: Nora is still teaching; he gets weekly lunches with Danny, who also trains at Ronin; Kate's health is good—she's still getting chemo every three weeks. He's less optimistic about his own condition. His ability to organize his thoughts is “shot to pieces”—it's a struggle to get anything done. He does the housework, but Kate handles the money because he can screw things up so easily, despite being a retired financial adviser. Worst of all, he used to work out an hour or two a day, six times a week, and that has fallen by the wayside for reasons that escape him. “Now I'm probably lucky if I get three days a week for an hour, and that's disgusting to me,” he says. “I'm failing myself.”
He's been feeling down more often lately, much of it related to the beguiling inertia that prevents him from exercising. He'd jump on the chance to get in a clinical trial. He'd let them open up his head if it would help. But it seems there isn't much available—no Taxol for Alzheimer's, no miracle drug on the near horizon.
Outside the café, he shows off his brown leather jacket with “USN”—U.S. Navy—hole-punched along the interior lining. He begins talking about his father and the major battles he fought in Europe during WWII, how he got his knee shot up, how he came home a changed man. Then he recalls a high school wrestling partner who was killed in Vietnam. War is so senseless, he says, on the verge of tears seemingly out of the blue Saturday sky.
It isn't clear if this is a moment of emotion that had been building quietly, or if it's the seesaw effect of the disease. It passes, and Fritz walks to his car. He asks my name again and tries to rhyme it with his as a pneumonic device—Chris, Chris, Chris, Fritz, Fritz, Fritz. I'm a new memory he cannot make.
In the latter stages of the disease, the symptoms and effects escalate. Maya Gosztyla, an Ohio State neuroscience and molecular genetics major, as well as a member of the Alzheimer's Association Junior Committee, says the disease can cause sleep disturbances or dramatic mood swings. Muscles may stop working properly, and people need help with feeding. Sometimes they get apathetic and don't care about themselves or loved ones.
Kaitlin Watterson, another committee member, watched some of those changes take place in her grandma, who died last September, four years after diagnosis. “I think one of the scary things about Alzheimer's is because it transforms your loved one and it completely deteriorates their personality, by the time my grandma passed away, the grandma that I was spending time with was nothing like the grandma that I had for most of my life.”
Watterson is one of six Junior Committee members volunteering on a Monday evening at Glenwood Alzheimer's Special Care Center in Dublin, which is bustling just after 6 o'clock. Committee member Andrew Spurling flips through a book called “Maui on My Mind” with a resident who used to live in Hawaii. Across the hall, people gather around tables for a card game, betting poker chips for winnings paid in Hershey Kisses. A resident with a Virginia license plate on her walker does shuffling laps around the facility's circular central hallway, which Glenwood administrator Debbie Cassel refers to as I-270.
About half a dozen groups come in regularly to volunteer, and Cassel would like to grow the program because the residents' moods improve noticeably when they're here. “I don't know if they always remember you, but I think they remember how they feel when they see you,” says Matt Garrido, the Junior Committee's vice president of volunteerism.
Most people in Glenwood are in the middle stages of Alzheimer's when they arrive, Cassel says, but they run the gamut. Some hardly seem affected by the disease at all, while others are catatonic, nonverbal. Outside residents' doors, plaques display their biographies alongside photos of their younger selves. They are introductions to visitors and monuments to the lives they've lived.
The Gosses have already taken a preliminary tour of another memory care center, The Ganzhorn Suites. It's only minutes from Fritz and Kate's home, and they were all impressed by the facility. Still, Nora says, you can't help but picture what that life will be like when you're there. Fritz got a preview when he had knee replacement surgery about five years ago and completed a post-op stint at an assisted rehab center instead of at home. It opened his eyes to the extent of the daily support Kate provides, and to how difficult it all would be if he didn't have an amazing caretaker. “She's a remarkable human being, really.”
On a rainy morning in April, one year since our first meeting, the mood inside Fritz and Kate's home is lighthearted at first. Nora is excited because she'll be able to participate in RivALZ this June after missing last year's event. Fritz is fiddling with a radio, and he rattles off the lyrics to some song that brings him back to his days as a deejay in bars in the '70s. Kate is here too, smiling as she watches over her husband and her daughter.
The newest updates aren't good, though. Fritz lost his phone and recently got into a fender bender—another one, Nora and Kate say—so he won't be driving anymore. He's determined to keep volunteering at North Linden, Ronin and Triumph, and Nora is helping Kate download Uber and Lyft apps on her phone so that they can arrange rides for him. “You'll be chauffeured, so that'll be nice,” Nora says.
When I ask how he's doing, his face scrunches up, pained. “I'm not getting better.”
“But that's expected,” Nora replies quickly.
He feels like he's deteriorating faster and faster, he says. Not being able to drive is upsetting him. Nora tells him he'll stay busy because he has lots of plans and family nearby. Plus, she reminds him, he and Kate moved here anticipating the day he could no longer drive. He can walk to the gym and the store from their house.
The house. That's his biggest concern—how long will he be able to stay here? The idea of being separated from his family is what upsets him most. “We're not going to put you somewhere and forget about you,” Nora says, trying to assuage his concerns one by one.
He will have to move at some point, but they don't know when that day will come. Kate says that even now people don't always believe he has the disease when they meet him. He's still plenty sharp. They only think of Alzheimer's patients as unresponsive, slumped in a chair. They don't see the slow decay. Fritz wants them to understand. “People ought to know what an ass-kicker this is,” he says.
He's been wrestling with this god-awful disease for eight years, but he doesn't talk much about fighting it today. Still, he isn't content to wait solemnly for what comes next, and soon the mood has shifted again. They seem determined to savor their time together.
During the photo shoot, Fritz hams it up for the camera. He got his hair cut, he says—all four of them. He's been telling that old-man joke so many years that Nora's childhood drawings of him only had four hairs poking up from his head. Kate looks on with delight as her husband messes around. “You enjoying yourself Fritz?”
He's a happy camper as long as he can make people laugh. “As you can tell, we're still trying to enjoy life,” he says. “We're not whining and crying about it.”
And then it's time to go. Fritz walks toward the door and sticks out his hand. He pauses, hand outstretched. “It's Chris,” I say. “Chris, Chris, Chris,” he repeats, then he follows me outside onto the porch and waves goodbye.