The Foreign Service Journal, January-February 2016

THE FOREIGN SERVICE JOURNAL | JANUARY-FEBRUARY 2016 53 she prepared for assignment to Pakistan she was struggling with her memory. We thought it was stress, and she started mental exercises and medicines to cope. I noticed some slippage in Zan- dra’s spelling (an early indicator, had we known), but she contin- ued to perform at a high level. In Islamabad she earned Ambassa- dor Ryan Crocker’s respect, won a Superior Honor Award for her role in the aftermath of the October 2005 South Asia Earthquake, handled two very sensitive visa cases under congressional and press scrutiny and oversaw the administrative arrangements after a fatal terrorist attack. In 2006, Zandra joined the Office of the Inspector General, where she performed effectively. As she contemplated the 2008 assignment cycle, she was conscious of memory loss but confi- dent she could continue to manage this condition. We did not suspect Alzheimer’s. Her logical assignment was another tour as a consul general. For family reasons, she chose a domestic assignment as State’s deputy director of the Terrorist Screening Center, an FBI-run interagency facility. The job seemed ideal, drawing on Zandra’s law enforcement background and 30 years of State Department experience includ- ing running interagency visa screening programs in Pakistan and South Korea, establishing a multinational anti-visa fraud working group in London, and extensive counter-narcotics experience in Pakistan and the department. But Zandra’s advancing Alzheimer’s compromised her ability to perform at a level expected of a Senior FSO. She was resorting to “management by sticky,” using extensive post-it notes to jog her memory. At the outset, she represented State on a series of quick trips to European capitals to negotiate information-sharing regimes. Zandra thought she was effective; the director did not, and stopped sending her. I believe her mem- ory loss rendered her unable to realize her ineffectiveness. She was low-ranked by the 2009 Promotion Board. The thrust of the counseling statement was that she was not coming up to speed, was passive and did not pull her weight in negotiations. A Relentless Hollowing Out We finally realized in spring 2009 that the severity of Zandra’s accelerating memory loss required consulting a neurologist. After a battery of tests, she was diagnosed as suffering from progres- sive and irreversible memory loss. At that point the neurologist did not give us a diagnosis of early-onset Alzheimer’s. She did tell Zandra she was putting her on the standard course of medica- tion for an Alzheimer’s patient, Namenda and Aricept, and that it might slowmemory loss but could not reverse or stop it. I do not know whether the neurologist thought an Alzheimer’s Above: Secret Service Agent Zandra Flemister (left) escorts Prime Minister of Jamaica Michael Manley (far right) during his visit to Washington, D.C., in December 1977. Inset: Zandra Flemister in Havana during a 2007 inspection team visit. COURTESYOFJOHNCOLLINGE