by David Shenk
Review by Kevin M. Purday on May 17th 2002
Most of us know or know of someone who has
Alzheimers or a similar form of dementia. It is frightening to be told in this
book that there are about five million people with the disease in the U.S.A.
alone and that worldwide, by the middle of this century, an estimated eighty
plus million will be its victims.
This book is essentially a piece of first-rate
journalism. It is not aimed at the tiny number of professional cognoscenti,
neurobiologists and others, who are immersed in finding the causes of and
devising a cure for the disease. It is intended for the ninety nine per cent of
us who have to cope with a mother or father who has been diagnosed with the
disease, who have seen friends and colleagues reduced to childhood status by
its ravages or who are simply deeply concerned human beings.
There are several strands to this book, all
carefully interwoven to make a cunning tapestry. The first strand has two threads:
the story of Ralph Waldo Emerson, the great American sage, whose slow decline
in his later years was almost certainly due to Alzheimers. His wisdom and
serenity throughout his decline serve as an anchor-thread and leitmotif for the
whole book; and then the story of Ronald Reagan who, in retrospect, showed the
very first signs of the disease while still in the White House. A second strand
is made up of the mini-biographies and personal testimonies of lesser-known
people either suffering from the early stages of the disease or caring for
relatives who are its victims. Many of these testimonies are very moving. A
third strand is the scientific discovery trail that is just a hundred years
old. This starts with the admission to hospital of a fifty one year old woman
on November 25, 1901, continues with Dr. Alois Alzheimers discovery of the
plaques and tangles in the deceased womans brain, takes us through all the
scientific hypotheses since then, leads us up some bizarre alleys and brings us
up to date, as far as is possible for any book, with the possibility of a
vaccine. Like the first two strands, this scientific discovery trail is
revealed through the spoken witness of major participants in the search for a
cure. It is this emphasis on personal testimony which makes this book both a
piece of compelling journalism and a highly readable account of how people are
coping with this spectre which has come to haunt our increased human longevity
or probing into its causes with the hope of finding a cure.
Like all forms of writing where an author dares
to tread outside his area of immediate expertise, there are some mistakes and
ambiguities in David Shenks book. For example, while discussing (p.86) the
Roman general Lucius Licinius Lucullus who died in 57 B.C. after suffering for
some time with an Alzheimers type of dementia, he refers to Lucullus
commanding officer, Lucius Cornelius Sulla, as the emperor. As Sulla died in 78
B.C. and the Roman Empire was not created until Augustus established the
so-called Principate in 31 B.C., the term emperor is clearly an anachronism.
Officially he was a dictator. However, this is basically nit-picking. David
Shenks book not only succeeds in giving us a portrait of the disease but he
also makes us think about a wide range of ethical problems along the way: the
excision of parts of the brain in order to reduce the severity of epileptic
fits at the cost of massive changes to the person; the public versus private
funding of research leading to the assertion of intellectual copyright by the
latter; the creation by transgenics of knock-out mice suffering from a range of
human ailments; the slippery slope of racial hygiene theories; and many more.
His greatest achievement, however, is probably
to remove some of the mystique and its accompanying fear which surround this
disease. He gives us many examples of how people have faced up to the knowledge
that they have the disease with amazing calm and dignity and how they have
maintained that dignity to the end. It is a deeply compassionate book that
everyone would do well to read.
© 2002 Kevin M. Purday
M. Purday is the head of an international school in Jordan, and is currently
a distance learning student on the Philosophy & Ethics of Mental Health
course in the Philosophy Dept. at the University of Warwick.