Magazine article The Spectator

Losing the Thread of Life

Magazine article The Spectator

Losing the Thread of Life

Article excerpt

THE FORGETTING: UNDERSTANDING ALZHEIMER'S by David Shenk HarperCollins, L15.99, pp. 290, ISBN 0002571749

Dean Swift, the master of despair, pretty certainly had Alzheimer's disease at the end, when he became incontinent, forgot his friends and frightened his attendants with fits of senseless rage. He had foreseen such a fate 20 years before when, in the least child-friendly episode of Gulliver's Travels, he imagined the Struldbrugs. They were immortals who grow old but cannot die, forced for ever to endure their growing inanity of body and of mind.

`The unique curse of Alzheimer's is that it ravages several victims for every brain that it infects,' says Mr Shenk in his admirable, quite short, American account of the disease. Most of those victims are old women, bereft of their minds in their eighties, and the daughters who look after them. Since modern people in rich countries are better fed, housed and serviced than their forerunners, the numbers trapped in that degradation increase every year.

In 1901 a Frankfurt doctor, Alois Alzheimer, was puzzled by the onset in a 51-year-old patient of the symptoms of what was then called senile dementia. She got worse for three and a half years, then died, whereupon he whipped her brain out. With new-fangled microscopes and specimen-stains he identified a tangle of plaques and threads where healthy tissues should have been - physical damage, not one of the contemporary Dr Freud's life-generated traumas. A few years later a colleague gave the finder's name to that sickness of the mind.

Medical folk, confronted with sicknesses they can't explain, tend nowadays to name them syndromes or disorders. That is harmless enough, since those words mean nothing much. The word disease is weightier. A proper disease has a cause, a diagnosis and a cure. So far Alzheimer's has none of those - no known cause, certainly no cure, and since other forms of age-related degeneration exhibit similar symptoms, the only sure diagnosis is posthumous, by examination of the patient's brain. The living have `probable Alzheimer's'.

On the implicit claim that the word disease carries with it, many honest physicians, a few quacks and a handful of pharmaceutical companies have built a trade that exploits vain hopes and rakes in vast amounts of cash. Mr Shenk rightly insists that `universities do not make drugs; pharmaceutical companies make drugs'. …

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