"The Forgetting" by David Shenk

A brilliant and quirky new book on Alzheimer's offers food for thought on the unthinkable and a new, deeper understanding of the coming epidemic.

By Pam Rosenthal

Aug. 29, 2001 | "Senile dementia," the doctor told us. Hospital tests had revealed no abnormalities; my mother-in-law's growing tendency to repeat a story several times in an hour was merely a regrettable, predictable aspect of aging. We shrugged: too bad she'd had to endure an MRI just to be told that she was getting older.

"Well, at least we know it's not Alzheimer's," my husband concluded. His mother was still living independently; we'd simply have to make frequent cross-country visits to help out and keep tabs on her condition.

The Family Leave Act entitles me to eight days a year paid sick time to care for an in-law. Writing "senile dementia" on the application, I rather enjoyed the words' archaic cadence, their lowercase modesty. No, it's not Alzheimer's, I told my boss. She's got a condition, not a disease.

What I've learned since then is that a physician who's still using the outmoded term "senile dementia" probably doesn't know much about Alzheimer's.

My mother-in-law's situation worsened. We spent an anxious, ill-informed year before finally receiving an Alzheimer's diagnosis -- from a facility specializing in the aging brain -- and then some fraught weeks trying to learn what the diagnosis might mean. But this time we lucked out; one evening my husband, a bookseller, brought home a prepublication copy of "The Forgetting," David Shenk's compelling new book on Alzheimer's disease.

I was already familiar with Shenk's "Data Smog," an informed, eminently sensible work on the information society we live in.

"Could be interesting," I said. "Let me take a look."

A chapter later -- two chapters later, I still didn't want to give it back. The publisher's rep sent us another copy. Gratefully, hungrily, we read it in tandem.

"The Forgetting" isn't a caregivers' reference. If you need one, get "There's Still a Person in There," by Michael Castleman, Dolores Gallagher-Thompson and Matthew Naythons. Shenk doesn't explain durable power of attorney or the difference between a nursing home and an assisted living facility. His book doesn't contain an "experts' 10-step program for caregivers," and it won't provide the guidance through the diagnostic process that my husband and I had so sorely needed. Castleman's book, which also contains well-chosen portraits of families coping with the disease, is an unimpeachable guide. It could have saved us a lot of anxiety during the year before the Alzheimer's diagnosis, and now that we've got it on our shelves I know we'll keep consulting it.

But Shenk's wide-ranging, discursive meditation on Alzheimer's is something else: By turns science popularization and cultural history, it's written for a general audience and narrated with a storyteller's urgency. His speculations about medical research sometimes wander into futurist, Wired magazine territory, but his quirky intellectual excitement adds to, rather than detracts from, the pathos of his story. In the end, like many great storytellers, he becomes part of the story himself. For what could be more tragically human than a human mind striving to comprehend the possibility of its own dissolution?

Next page: Did Alzheimer's strike Emerson and Swift?