Reading Group Guide

Just in case you don't have enough to worry about, consider
Alzheimer's disease. Over five million Americans currently suffer
from this degenerative disease that attacks the neurons in the
brain, slowly erasing memory, verbal skills, motor skills and the
basic elements of identity. It is lethal, incurable and only
negligible treatments are available. Now think about the baby
boomers, currently poised on the brink of the years when
Alzheimer's disease begins to strike. Over the next fifty years,
the number of Alzheimer's patients is expected to triple, resulting
in a crushing burden on the medical community and on family
caregivers, who may suffer more than anyone.

People are scared to read David Shenk's book. In his afterword, he
refers to a family friend who bought it and intended to read it,
but was too intimidated by the subject matter and its implications
to delve into it. It's easy to understand why. If you already
suffer from Alzheimer's, you may think it's too late to learn about
it. If you don't have Alzheimer's and you don't know anyone who
does, you might not want to learn any more about this terrible,
merciless disease. However, as our population ages, it becomes
increasingly likely that everyone will be touched by Alzheimer's
--- as a patient, as a caregiver, or simply as a citizen of a world
wherein a substantial segment of the population can no longer
drive, dress themselves, speak rationally, recognize loved ones, or
remember their own names. It is a social force as strong as any war
--- and information and communication are our greatest weapons
against it.

THE FORGETTING provides a brief history of the disease. Shenk
describes Dr. Alois Alzheimer's first patient, a woman who suffered
from what was believed to be inexplicably premature senility. He
intersperses his accounts of ongoing research with anecdotes of
famous people we now know to have had Alzheimer's disease, great
minds that self-destructed inside otherwise healthy bodies. Ralph
Waldo Emerson's decline was slow and sad. Jonathan Swift died
bitter and thwarted by his waning skills. His last words were, "I
am a fool."

Painter Willem de Kooning had a different experience. He kept
painting, even though his mind was failing and produced some of the
best works of his career. His story is a reminder that some
Alzheimer's patients find a sort of peace through their disease. In
letting go of ordinary habits and concerns, some patients reach a
level of tranquility before their last decline.

The book also introduces us to the research community: an army of
doctors, scientists, independent researchers and pharmaceutical
companies who are working fiercely to find a cure before
Alzheimer's disease overwhelms us. It is heartening to know that
such an effort is in progress, although it's cruel to end Chapter
14 hinting that a vaccine has been found that will prevent
Alzheimer's disease from ever developing and stop existing
Alzheimer's disease from progressing, only to mention in the
afterword that the vaccine never made it past FDA phase 2 trials.
False hope is the last thing these people need.

David Shenk does not mean to be cruel; it's just that research is
moving so quickly that the best prospect for a cure in the
hardcover edition had already been scrapped by the time the
paperback came out. Even so, there's a lot of good information
here. Readers might find the Resources section in the back to be
the most practical help and Chapter 16, "What Not to Do," lists
behavior patterns that researchers (currently) find helpful in
avoiding the disease.