Kevin Hu, Sadiq Khwaja, Tamer Radi, and Dominic Vitello

Alzheimer’s Disease – Ms. Swiontek’s 5th Period Anatomy

Characters

Alex Vitello PRE-TITLE

Alex is a sixty-six-year-old man who enjoys flying
planes as a hobby. He is married and has three kids. Alex boards the plane and flies it. Alex and
During the day, he works as a business executive.
Jay converse over the radio.
He’s proud of his education, and feels that his Yale
degree certifies that he is intelligent and in perfect
mental condition. In the past, he has been Jay: Hey Alex, you know the Yale reunion
emotionally stable, although he has recently had is in a few weeks, right?
problems controlling his temper, and he has felt a bit
“low.” He has had trouble recently with his memory,
Alex: Yeah. I don’t think I can go, though.
but he is in denial, insisting that his mind is
completely 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 Alex’s don’t know when the next time will be when
graduating class from Yale. They have been best I’ll have a day off.
friends. Whereas Alex is proud and confident, Jay is
more tempered and more logical. Jay has a paranoia
Jay: I see. How is Ellen?
issue, and is always afraid of the worst. During the
day, he works as a doctor.
Adjectives: Pessimistic, loyal, persistent Alex: Ellen?

Dr. Hu Jay: You know, your daughter?

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

Jay: You even forgot your daughter’s name.

Alex: angry Jay! I’m fine, okay? We both

know that I’m intelligent, and that my brain

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 Kevin Hu, Sadiq Khwaja, Tamer Radi, and Dominic Vitello
Alzheimer’s Disease – Ms. Swiontek’s 5th Period Anatomy
is in pretty good shape. I went to Yale, for
crying out loud. Stop exaggerating my
problems! You keep making up symptoms
to diseases that you want to believe I have!
Silence
Alex: I’m sorry, Jay. I didn’t mean that.
Jay: That’s okay, Alex. I understand.
You’ve been really stressed out lately.
Alex: Uh, Jay, have you ever flown a plane
before?
Jay: No. Why?
Alex: I just realized that what goes up, must
come down. And I don’t think I ever learned
how to land this thing.
Jay: Alex, you’ve flown plenty of planes by
yourself before. I’ve seen you land.
Alex: Well, this isn’t good. I remember
pressing a button… a button that like, puts
down the uh, the things, the rolling things on
a plane…
Jay: Wheels?
Alex: Yeah, wheels. Jay? Jay?
Jay: Alex, don’t panic. I’ll call for help.
Alex: panicking Jay, I don’t know what I’m
doing!
Jay: Alex, hang in there. Don’t touch any of
the controls. Alex?
The plane dips downward and is about to
crash.
Alex: I forgot, Jay. I forgot.
The plane crashes.
TITLE
SCENE 1
Dr. Khwaja and Jay are talking outside of
the hospital.
Jay: emotional I’m so worried. Will he be
okay? What’s going on right now?
Khwaja: He will be okay. He just needs a
few casts and a few stitches, and then some
physical therapy and rehabilitation. It is
amazing that he has survived, at his age.
Jay: Thank you. I’m sorry, what’s your
name?
Khwaja: My name is Dr. Sadiq Khwaja. I
am a licensed neuropsychologist, and I will
be one of the doctors treating your friend.
Jay: Pleasure to meet you. Wait, you’re a
neuropsychologist?
Khwaja: Yes. It was very strange that your
friend forgot how to properly fly a plane,
and I will be running tests on him to see if
he has any problems with his brain.
Jay: I see.
Khwaja’s phone rings. He picks up.
Khwaja: Hello? Ah yes. The friend? Yes, I
am actually talking to him right now. The
psychotherapy department? Yes, I will send
him. Yes. Thank you.
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 Kevin Hu, Sadiq Khwaja, Tamer Radi, and Dominic Vitello
Alzheimer’s Disease – Ms. Swiontek’s 5th Period Anatomy
Khwaja: I’ve been asked to take you to the
psychotherapy department, where you are to
meet one of your friend’s other doctors. He
will ask you a few questions.
They walk.
Khwaja: Here we are. I will see you soon!
SCENE 2
Jay enters a room, where he sees Dr. Hu
lounging on a chair.
Hu: Please. Take a seat.
Jay: Thanks.
Hu: So. My name is Dr. Hu. I am a trained
psychotherapist. Your little buddy, Alex? I
will be his therapist. First, I have a few
questions to ask you.
Jay: Sure.
Hu: First of all, how come you didn’t catch
him when the plane crashed?
Jay: What?
Hu: Oh, sorry. Too soon. Bad joke. Laughs
to himself. Anyway. Monotone drone. What
is your relation to the subject?
Jay: Friend, and classmate.
Hu: How long have you known the subject?
Jay: About thirty, forty years.
Hu: Okay, actually, this form is so stupid. I
remember, back in mother China, we never
had to use stupid forms like this. We would
just ask useful questions, and get answers
quickly. Stupid American bureaucracy. So
let me ask you. Has Alex had problems with
memory lately?
Jay: Yes, actually. He didn’t recognize the
name of a family member, and obviously, he
didn’t remember how to land a plane.
Hu: Very interesting…
Jay: Really? What’s interesting, doctor?
Hu: Nothing. I was just kidding. Have you
noticed any emotional problems?
Jay: Yeah. He’s been a pretty angry person
lately. And also, he’s a business executive,
and he used to be on top of his game. He
would be the first to work and the last to
leave. He would be innovative, and –
Hu: Come on, you’re not giving him a
eulogy yet. What other emotional problems?
Jay: He doesn’t seem to have the same drive
anymore. And he doesn’t sleep well.
Hu: I see. Well, I think this paints a pretty
clear picture. Have you ever seen those
pictures of the rice paddies that Chinese
artists drew? The masterpieces?
Jay: No…?
Hu: Oh… well, never mind. Anyway, I
believe your friend Alex may have the
Alzheimer’s Disease.
Jay: That’s what I was afraid of…
Hu: Symptoms of Alzheimer’s disease
include memory loss, confusion, loss of
initiative, increased anxiety and aggression,
outbursts of anger, problems recognizing
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 Kevin Hu, Sadiq Khwaja, Tamer Radi, and Dominic Vitello
Alzheimer’s Disease – Ms. Swiontek’s 5th Period Anatomy
friends and family members, and SCENE 4
restlessness.
Alex is in a hospital bed. Jay is at his side.
Jay: You sound like you have that
memorized. Jay: Alex, I have something serious I have
to talk to you about.
Hu: My mother made me memorize the list
when I was twelve. Alex: What is it? Is everything okay?

Jay: Oh. Well, these all sound like Jay: Yes, but… very deeply emotional well,
symptoms that Alex has. I’ll do some the past few months, whenever I’ve been
research when I get back home. Thanks, Dr. around you, I’ve gotten this feeling.
Hu.
Alex: Do you want to talk about it?
Hu: You don’t need to thank me with words.
That’s what money is for. Jay: Whenever I talk to you, or email you, or
call you, I… I start to feel… I feel…
Jay exits.
Alex: …Yes?
SCENE 3
Jay: …Worried, I guess. Worried that you’re
Khwaja enters. not okay.

Hu: Hey, Dr. Khwaja. So, I think he has Alex: Jay, are you trying to tell me
Alzheimer’s. something?

Khwaja: Who? Jay: No… I mean, yes. Yes, I am.

Hu: Alex.
Khwaja: I thought Alex was in the Planned
Parenthood department…
Hu: No, that’s Dominic. Alex is the guy who
crashed his plane.
Khwaja: Oh, right right right. Yeah, that
makes sense.
Hu: Well, work with him and tell me what
you think later.
Khwaja: Got it. I’ll see you later, Dr. Hu.
Alex: Come on, Jay. We’ve been friends for
ages.
Jay: I know, but… I just don’t want to say
this. It might make things awkward between
us.
Alex: Spit it out, Jay.
Jay: Okay. Alex, I… I feel… silence. I feel
like you have Alzheimer’s Disease.
Alex: shocked What? No! calmer Well,
thankfully, you’re not a doctor.
Jay: Actually, Alex, I am.

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 Kevin Hu, Sadiq Khwaja, Tamer Radi, and Dominic Vitello
Alzheimer’s Disease – Ms. Swiontek’s 5th Period Anatomy
Alex: What? Okay, okay, maybe I am losing
it. Maybe. But I’m not convinced.
Jay: sighs I’m quite convinced, actually.
Alex: Anyway, Jay, I’m bored. Tell me a
story. I want to get my mind off of things.
Jay: Okay, let me think. Pause So there was
once a German doctor. It was the year 1906,
and he had discovered a bunch of weird
clumps and tangled bundles of fibers in a
woman’s brain. [[[5]]]
Alex: Gross…
Jay: And his name was Dr. Alois Alzheimer.
[[[5]]]
Alex: Okay, Jay, not funny. You really want
to talk about this, don’t you?
Jay: I’m concerned, Alex.
Alex: Fine. Tell me how I’m at risk for
Alzheimer’s Disease. Convince me.
Jay: Well, doctors aren’t entirely sure what
makes certain people at greater risk than
others… [[[2]]]
Alex: So what gives you the authority to tell
me?
Jay: Well, here are a few findings from
recent studies. Let’s see… thinking People
in urban areas are at greater risk. Men and
women are at equal risk. Caucasians are at
greater risk than Asians. But you might be
right about one thing – studies suggest that
people with a higher level of education are
at a lower risk. [[[2]]]
Alex: Ha! There you have it. I can’t have
Alzheimer’s.
Jay: Lower risk, Alex. Five percent of
people between the ages of 65 and 74 have
Alzheimer’s, and the proportions increase
dramatically with age. Almost half of people
over the age of 85 may have the disease.
Alex, five million people in America have it.
[[[4]]] Why do you think you’re immune?
Alex: I don’t know, Jay! Leave me alone! I
want to rest.
Jay: sighs I’ll see you later tonight.
SCENE 5
Khwaja is looking for his office and
stumbles into Hu’s office on accident. Hu is
doing Tai Chi, accompanied by old Chinese
music.
Hu: in Chinese (And then, we release the
chi…)
Hu sees Khwaja and is startled.
Hu: Khwaja, you have interrupted me. This
makes me unhappy.
Khwaja: I’m sorry, Dr. Hu. I was –
Hu: Dr. Khwaja! I challenge you to a battle.
Khwaja: incredulously A battle?
Hu: Not a martial arts battle. That would be
too simple. No, we must fight like real men.
I will destroy you with my Pikachu –
Khwaja: Dr. Hu, I’m really sorry, I was just
trying to get to my office and I… I forgot
where I was going.
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 Kevin Hu, Sadiq Khwaja, Tamer Radi, and Dominic Vitello
Alzheimer’s Disease – Ms. Swiontek’s 5th Period Anatomy
Hu: Khwaja, your office and my office are
so far apart. I made sure of that when they
designed the hospital.
Khwaja: Honestly, Dr. Hu. I just got lost.
Hu: Shame.
SCENE 6
Khwaja finds his office. Jay is waiting
inside.
Khwaja: Oh, Jay. Please, have a seat.
Jay: Thanks.
Khwaja: So, you’re a doctor. Let’s talk
details. What do you know about
Alzheimer’s?
Jay: Not much, to be honest. I don’t deal
much with the brain or the mind. I’m a heart
surgeon.
Khwaja: Okay. Well, some of what I tell you
should be a review from medical school.
Jay: Shoot.
Khwaja: Alzheimer’s patients have two
types of abnormal structures in their brains
that consist of misfolded proteins. [[[10]]]
Jay: So, like prions.
Khwaja: Oh, you know about prions?
Jay: Yeah. I read about diseases caused by
misfolded proteins, like Mad Cow Disease
and CJD, in a book called Deadly Feasts.
Khwaja: I see. Well, anyway, the two
abnormal structures are amyloid plaques and
neurofibrillary tangles. [[[10]]]
Jay: Whoa, that sounds complicated.
Khwaja: I won’t go into complicated detail.
These two structures disable brain cells,
especially in regions of the brain that are
used in memory. [[[10]]]
Jay: I see. Wait, I read somewhere that
Alzheimer’s patients have clumps and
tangled bundles of fibers. Are these what
you’re talking about?
Khwaja: Pretty much. The clumps are made
of amyloid, a protein that’s also involved in
Parkinson’s and Huntington’s Diseases.
Neurofibrillary tangles, on the other hand,
are really only known as the primary marker
of Alzheimer’s. [[[10]]]
Jay: Marker? What does that mean?
Khwaja: Basically, if you find
neurofibrillary tangles in a patient’s brain,
you are probably dealing with Alzheimer’s.
The tangles “mark” the patient.
Jay: Okay, that makes sense. So you said
that these structures are especially present in
regions of the brain used in memory?
Khwaja: That is correct. Actually, a recent
study showed that high numbers of
neurofibrillary tangles in the nucleus basalis
of Meynert are associated with low
neuropsychological test scores and long
disease duration. [[[7]]]
Jay: Nucleus basalis of Meynert?
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 Kevin Hu, Sadiq Khwaja, Tamer Radi, and Dominic Vitello
Alzheimer’s Disease – Ms. Swiontek’s 5th Period Anatomy
Khwaja: It’s a group of nerve cells in the
basal forebrain. The basal forebrain is
important in the production of acetylcholine.
Jay: What’s acetylcholine?
Khwaja: It is good you ask that question.
That brings me to another point.
Alzheimer’s Disease is also characterized by
reduced production of neurotransmitters,
which are chemicals used for
communication between nerves.
Acetylcholine is one neurotransmitter. Two
others linked to Alzheimer’s are serotonin
and norepinephrine. [[[3]]]
Jay: I’m guessing neurotransmitters travel
between one nerve cell’s axon terminal and
another cell’s dendrite?
Khwaja: You are correct, my friend. Well,
where was I?
Jay: You were talking about the causes of
Alzheimer’s.
Khwaja: Ah, yes. Sorry, I’ve been a bit
scatterbrained lately. When all the things I
was just talking about happen, the brain cells
lose connection, so the cells slowly lose
their function and die. [[[10]]]
Jay: That’s kind of scary. So Alex’s brain
cells might be dying?
Khwaja: That is what we believe.
Jay: sighs I don’t know what to do… He
won’t believe me. He’s in denial.
Khwaja: When you have a mental disorder,
you often don’t want to believe it.
SCENE 7
Khwaja is sitting in Hu’s office. Silence for
a few seconds.
Hu: Well? Why are you not talking?
Silence.
Hu: Confucius said, “Be not ashamed of
mistakes and thus make them crimes.”
Silence.
Hu: Well, if you are not going to talk, I am
going to watch Korean soap opera. New
episode: so good!
Khwaja: Okay, I’ll talk.
Hu: Oh thank you. I thought I was really
going to have to watch the Korean drama.
Khwaja: I’m not myself lately.
Hu: Having girlfriend problems? That’s why
arranged marriage is such a good idea.
Khwaja: No. I just… I’ve been really
disorganized lately, and I keep missing
appointments and getting lost, and it’s
getting to me. I’m just getting old, I guess.
But it’s frustrating. I keep waking up at
night, and I’m anxious. I don’t even know
why.
Hu: Hmm, I know what will help.
Khwaja: excitedly What? You do?
Anything!
Hu: Acupuncture.
Khwaja: Really?
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 Kevin Hu, Sadiq Khwaja, Tamer Radi, and Dominic Vitello
Alzheimer’s Disease – Ms. Swiontek’s 5th Period Anatomy
Hu: No, you fool! You are a doctor, not an
old Chinese grandmother. Think like a
doctor.
Khwaja: I think it’s just a normal part of
aging.
Hu: How would you know? You’ve never
aged before.
Beeping. Khwaja looks at his cell phone.
Khwaja: Oh, I have to see my patient.
Hu: Take care of yourself. Drink tea, it helps
with memory.
Khwaja: Really?
Hu: No, you fool!
SCENE 8
Jay and Khwaja are next to Alex’s bed.
Jay: Alex, do you remember the information
about Alzheimer’s I gave you yesterday?
Alex: Yeah. To test my memory, I tried to
remember as much as I could. Alzheimer’s
is a brain disorder that worsens over time.
There is a gradual decline in memory and an
impairment of at least one more area of
intellectual function. [[[6]]]
Jay: What are the early symptoms?
Alex: Well, the easy one is memory loss.
Other ones include disorientation, difficulty
performing familiar tasks, problems with
planning, trouble with language, personality
changes, changes in sleeping habits, and
poor judgment. [[[9]]]]
Khwaja looks concerned.
Jay: Well done. Are you convinced yet?
Alex: Maybe…
Jay: What are the middle symptoms?
Alex: Uh, let me see. Anger, wandering,
problems recognizing family members,
inability to learn or cope with new
situations, lack of self-control… [[[9]]]
Jay: Alex, you’re matching with a lot of
these…
Khwaja looks very concerned.
Alex: Well, I know I don’t have any severe
symptoms, like weight loss, seizures, or
inability to swallow or communicate. [[[9]]]
Those are symptoms that lead to death. Did
you know that Alzheimer’s disease is the
seventh most frequent cause of death among
American adults? It’s the fifth most frequent
for those over the age of sixty-five. [[[4]]]
Jay: That’s rather frightening. Are you
convinced that you have the disease yet?
Alex: Fine. I have to admit that I’ve been
worried about it … it’s just that I’ve refused
to acknowledge it.
Khwaja looks very, very concerned.
Jay: Dr. Khwaja, you look… concerned.
Khwaja: Yes… to be honest, I’ve been
having many of the same issues lately. And
I’m getting old. Alzheimer’s isn’t a normal
part of aging.
Jay: Do you think you might have it?
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 Kevin Hu, Sadiq Khwaja, Tamer Radi, and Dominic Vitello
Alzheimer’s Disease – Ms. Swiontek’s 5th Period Anatomy
Khwaja: Perhaps…
Hu walks in.
Hu: Aha! So there we have it. Perfect.
You’ve both gotten past denial.
Khwaja: Dr. Hu? You knew?
Hu: The whole time.
Jay: So what’s next?
Hu: First, we’ll have to test you to see if you
really have Alzheimer’s. I’ll give you a few
neuropsychological exams to assess your
intellectual function, including memory tests
and naming tests. I’ll also see if your
symptoms are so severe that they prevent
you from everyday activities. If these two
steps pass, I will make sure that it’s
Alzheimer’s and not something else that’s
causing you problems; you’ll need blood
tests, x-rays, CT scans, and MRI scans.
[[[1]]]
Alex: Is there a cure for Alzheimer’s?
Hu: Unfortunately, no. But there are
treatments that will slow down brain
degradation and suppress some of the
symptoms.
Khwaja: Ah, yes.
Hu: Donepezil, rivastigmine, and
galantamine are three drugs that will treat
mild or moderate symptoms. They slow
down and inhibit the action of
acetylcholinesterase. [[[11]]]
Jay: Acetylcholinesterase? That word seems
to contain “acetylcholine.”
Hu: Well done, Captain Obvious.
Acetylcholinesterase breaks down
acetylcholine, which is a necessary
neurotransmitter. So by inhibiting
acetylcholinesterase, the drugs maintain a
healthy level of acetylcholine, increasing
brain function.
Jay: It makes sense!
Hu: Of course. Memantine is a new drug
that regulates levels of glutamate, which is
another neurotransmitter involved in
memory. [[[11]]]
Alex: So if I take all of these drugs at the
same time, will it be like a super drug? I
know that AIDS victims take drug cocktails.
Hu: I would not recommend taking multiple
acetylcholinesterases at the same time. With
drugs, it’s not like one plus one equals two.
It could equal three, or fifty, or negative one
million. Confucius said that “To go beyond
is as wrong as to fall short.” I say we start
both of you on donepezil, one of the
acetylcholinesterases, and memantine. A
reputable study has shown the combination
of donepezil and memantine significantly
improves brain function in Alzheimer’s
patients with moderate to severe symptoms.
[[[8]]]
Khwaja: How about Ginkgo biloba? I’ve
heard it helps.
Hu: It may, but scientists haven’t found
anything significant. Drinking green tea may
help though.
Khwaja: Really?
Hu: No, you fool! Well, Dr. Khwaja, I think
you should order the drugs.
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 Kevin Hu, Sadiq Khwaja, Tamer Radi, and Dominic Vitello
Alzheimer’s Disease – Ms. Swiontek’s 5th Period Anatomy
Khwaja: I’ll do that right away.

Hu: Well, I think we are finished here. Let’s

not get too sentimental with goodbyes. Pre-Title: Dominic, with Sadiq filming.
(Tamer voice-over).
Alex and Jay: Thanks Dr. Hu! Scene 1: Tamer and Sadiq
Scene 2: Tamer and Kevin
Hu: Yeah, yeah. Feel better soon. Scene 3: Kevin and Sadiq
Scene 4: Tamer and Dominic
Hu exits, and quickly returns. Scene 5: Kevin and Sadiq
Scene 6: Tamer and Sadiq
Hu: And also, my Pokemon challenge still Scene 7: Kevin and Sadiq
holds. Scene 8: All

Alex: Pokemon?

Khwaja: Long story.

Jay: Tell us!

Khwaja: Oh, I forgot.

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
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

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 Kevin Hu, Sadiq Khwaja, Tamer Radi, and Dominic Vitello
Alzheimer’s Disease – Ms. Swiontek’s 5th Period Anatomy
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.

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