Plaques and tangles | Carole Woddis

Royal Court Jerwood Theatre Upstairs (****)

This is the second play in as many months about the onset of Alzheimers. Florian Zeller’s The Father is still in the West End (at Wyndhams Theatre). And at the end of last year, Barney Norris’ Visitors was a wonderfully quiet and subtle reflection on a slow decline into dementia as well as a harrowing account of family dysfunction.

Given our ageing population, the number of plays coming our way dealing with the subject is only likely to increase in the future. If so Nicola Wilson’s Plaques and Tangles will be right up there as a moving, if slightly over-complicated anatomy of Alzheimers’ devastating effect not only on the individual undergoing it but the trauma it produces on their nearest and dearest.

Like Alzheimers, Plaques and Tangles (the title is taken from the aberrations that happen to an Alzheimers affected brain) is a challenge. Wilson’s approach is hardly plain sailing, over-loaded with drama, scientific and linguistic terms and female functions from puberty to decrepitude all given full sway!

Wilson’s protagonist Megan happens to be a lexicologist and a dab hand at scrabble. She loves words as clearly does Wilson. The exchanges are fast and furious, time scales move backwards and forwards, every-day wit competing with neuroscience to describe the brain undergoing bombardment from the Alzheimer disease.

And there are at least three central protagonists. Monica Dolan’s middle-aged Megan – face screwed up in child-like ecstasy or pleading bewilderment – her deceased mother Barbara (Brid Brennan), neat, caustic – and young Megan (Rosalind Eleazar), learning at 21 that she may have inherited the Alzheimers gene, causing her, sozzled at a party, to end up with a passing malacologist, Jez (a delightfully downbeat Robert Lonsdale), with whom she will spend the rest of her life.

There’s a little confusion here in structure since midway through proceedings, Wilson provides a family scene of recrimination, prompted by Ned, Jez and Megan’s son’s announcement that his girl-friend is pregnant.

Cue perhaps the play’s most important passage: Megan revealing her family’s vulnerability to FAD – Familial Alzheimers Disease. She has taken the test, she has the gene for Alzheimers; there is a 50/50 chance Ned and Lila, their daughter, will have inherited it, too – a development that resonates with a whole host of other medical conditions and the tests that can now be performed.

To have the test or not to have the test? Is it better to know or not to know? As Megan says when confronted by her family outraged at not being told earlier, `we had a right to know’. `And I had a right not to tell you; she replies. `We deserved to know the truth,’ they say. No, says Megan, `what you all deserve is comfort and security.’

Brave words from Megan. And for all his protestations, Jez it seems, did know from the beginning that there was a chance Megan could have inherited it from her mother who died from it. She had told him – a fact only confirmed right at the end of the play in a replay of their meeting at the party when she is 21. Jez clearly put the matter to the back of his mind.

All the same, despite it’s over-complications, there is enough in the inter-play of character, the humour Wilson somehow creates out of Megan’s plight and the delicacy and control director Lucy Morrison brings to the production to make Plaques and Tangles profoundly moving and important.

As Megan descends into childhood, the pain engendered first by Jez’s realisation, then his inability to cope, then his coming to terms is achingly conveyed by Ferdy Roberts, as is Dolan’s withering portrait of her descent.

Not an easy play to watch, but for those who dare to confront these things head on, one of exemplary sensitivity and robust beauty.

Warmly recommended.

Plaques and Tangles runs at Royal Court Jerwood Theatre Upstairs to Nov 21, 2015

This review first published in Londongrip, Oct 2015