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Novelist and science writer Halpern (Four Wings and a Prayer) wades bravely into the morass of modern memory research to sort the truth from a wide assortment of "hyperbole and promises and platitudes." The news is mixed: most of us won't develop Alzheimer's, but everyone will suffer some memory loss. After describing the different types of memory, Halpern gamely undertakes a series of brain scans used to reveal brain damage and tries diagnostic tests that measure memory through the ability to recall words, images and smells. Researchers have identified a gene closely linked with Alzheimer's, but drugs to treat or prevent memory loss are still far from reality, Halpern says, adding that for many drug companies, the success of a remedy is measured only by how quickly it moves off the shelves. Armed with a mix of hope and healthy skepticism, the author also examines claims that eating chocolate (among other things) or solving puzzles can improve brain function. "So much of who we know ourselves to be comes from what we remember," Halpern writes, and her timely book offers a vivid, often amusing introduction to a science that touches us all. (May)Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
Halpern's three-year inquiry into research on memory, aging, and Alzheimer's disease is an investigation of modern brain science rendered in creative nonfiction. Halpern gets to know a prominent neuroscientist, subjects herself to multiple tests (from paper-and-pencil tests to nuclear brain imaging), visits businesses involved in the quixotic race for memory-fixing drugs, and attends the Memory Olympics. She explains in plain English what science has discovered about learning and memory, what is currently agreed to improve memory, and what remains to be seen. No self-help book writer, Halpern has published four well-received books (e.g., Four Wings and a Prayer; Migrations to Solitude) and written for the New York Times, the New York Review of Books, and Slate magazine; she is frank and funny about her own fears and memory lapses and gently debunks memory-boosting fads, leaving the reader with few suggestions of what the ordinary person can do. Her book documents (with references) the great strides that have been made and holds out hope for real treatments for Alzheimer's and age-related memory loss. Educational, fabulously well written, and on a hot topic. Highly recommended for both public and academic libraries. [Halpern is married to nature writer Bill McKibben-Ed.]
On the canted ceiling above my desk is a map of the brain. It shows the frontal lobe and temporal lobe and parietal lobe and occipital lobe as if they were places to visit–Rome, Milan, Trieste,
San Remo. The map, of course, is dumb. It says nothing about what goes on in those places: that deep in the middle of the temporal lobe, which itself is deep in the middle of the brain, there is a tiny,
cashew-shaped region called the hippocampus that is essential to forming new memories, or that the prefrontal cortex, which sits behind the eyebrows, is vital to foresight and being polite and paying attention, or that the occipital lobe, which brings up the rear of the brain, is central to sight itself.
I look at that map sometimes and think about how it is my own brain apprehending it, and that to do so, it is traveling express. And then my mind, declaring its independence from my brain, begins to wander among the events of the day, past and future, and plans for summer vacation, and concern for a friend who is sick and the dog in the yard, but never getting so far afield that it doesn’t heed its own call back.
Near the map, tacked to the wall, is a picture of the brain that is doing all of that and all of this–this writing, thinking, typing,
seeing–my brain, in bright colors, which was taken a few years ago in California. When I look at that picture I am not only seeing it,
but recalling that day, or aspects of it, so much has gone out with the tide. I took notes on that trip, and carried a digital recorder, and have read and reread those notes over the years, and listened to the conversations, so I remember that day better than most, and what I remember comes with a certain confidence, but even so it is fuzzy. I cannot say, for instance, what kind of rental car I drove, or what book I was reading later that afternoon when I went to the beach,
or which beach, specifically, it was.
We rely on memory not only to remember, but to walk and dream and talk and smell and plan and fear and love and think and learn and more and more and more. Memory is how we know the world–
that is a tree, this is a sentence–and know ourselves–I like chocolate ice cream, I am a singer–and know ourselves in the world. Amnesiacs make the case well: it is not, simply, that they don’t remember their name or where they live, it is that absent memory, they are strangers to themselves. The English philosopher John Locke believed that we came into the world with our mind a blank slate, a
“tabula rasa,” ready for the pen of experience to inscribe. It’s a perfect metaphor (even if it’s not exactly true), because it works to describe what it’s like to gain knowledge, and what it’s like to lose your mind.
Stroke by uneven stroke, the eraser plies the board.
My father, before he died at the age of seventy-seven, had begun to know this intimately, though never to the extent that the board was wiped so clean that he approached Locke’s natal state. He knew, and he talked about it–about how frustrating it was to read the newspaper and then have to read it again, or to stare at a can opener, not knowing what it was for, or to pick up the phone to call a friend, whose funeral he’d attended two years earlier.
While it might have been natural for me to worry that my father’s fate someday would be my own, I didn’t, really. The doctor said he didn’t have Alzheimer’s disease, and since Alzheimer’s disease tends to run in families, I figured I was safe. This was not one of those calculate-your-odds kind of conclusions. It wasn’t a calculation at all. At best it was a passing thought. Call it denial, call it repression,
or maybe arrogance, I just figured that if he didn’t have AD, what was it to me?
But later, after he was gone, and all that was left were my memories,
some photos, and the key-chain recorder my mother made him carry like a pair of military dog tags at the end in case he got lost, into which he spoke his name, his phone number, and his street address in the flattest of voices, I began to wonder. What if the doctor had been wrong? Almost everyone I knew had a parent or an in-law or a favorite aunt or a colleague or a neighbor or a grandfather or a friend or a friend of a friend who had Alzheimer’s,
as if the standard six degrees of separation had been universally abridged to one or two. But another question bothered me more:
what if the doctor had been right? What I mean is: what if my father hadn’t been sick?
This was not a wishful fantasy about what my father’s last years would have been like if, when going to the basement to sort the recycling,
he didn’t lose track of which items went in which bin and stood there, paralyzed by confusion, for half an hour, or if he hadn’t thought he’d filed his income tax when he hadn’t. He knew who his children were. He remained interested in politics. He had never needed to activate the key-chain recorder. The question, rather,
was a kind of private, one-person, one-vote referendum on sickness and health: if he wasn’t sick, what was going on?
Since it is the nature of questions to beget more questions before they yield answers, I soon stopped thinking about my father,
specifically, or about myself, even when I wondered why, for instance,
the memory of a forty-four-year-old was generally better than the memory of a seventy-seven-year-old (or was it?), and why the memory of a twenty-six-year-old was better than both. The answer to this was not as obvious as it might appear. If age were the culprit, what, precisely, was it stealing?
In the popular literature I kept coming across references to the brain that made it sound like a muscle. “Use it or lose it” was the standard dogma. I read countless self-help books that promised to help their readers “use it,” and compiled a stack of newspaper articles that touted crossword puzzles and sudokus as the mental equivalents of jogging and strength-training, and the more of these I looked at,
the more curious it all seemed to me: I understood that these activities were supposed to be good for you because, apparently, they built mental muscle, but why was that? Was there a physiological response to crossword puzzles, something that happened to the body by doing them, and just whom did they help? Anyone of any age?
People with mild memory problems? The worried well? People who were sick? And if they were beneficial for people who were sick as well as people who were not, was that because the same thing was going wrong in the healthy brains that had already gone awry in pathological ones?
The questions piled up in my notebook, a sign, perhaps, that I was using my brain, but to what end? Books evolve idiosyncratically,
their single law of natural selection being, it seems, that they choose you. I began calling up neuroscientists and spending time with doctors and sometimes their patients. They were in New York,
New Haven, San Francisco, Minnesota, Massachusetts, Chicago,
Los Angeles, and Irvine. They were in England and the Dominican Republic and Canada and Italy and Iceland. To friends or acquaintances who, upon hearing what I was doing, told me their particular memory complaint or expressed a more generalized worry, I could tell them how many smart and committed people were out there looking for genes and molecules, developing drugs and vaccines,
searching out cures and therapies in plants and minerals already at hand. These bench scientists and clinicians were making headway.
Moore’s law–the one about the speed of microprocessors doubling every eighteen months–didn’t quite apply, but there was progress being made and I was seeing it. (I was also seeing rogues and patent medicine salesmen, but doesn’t every court have its jesters?)
The other thing I kept running into was lots of exclamations. A week couldn’t go by, it seemed, without an announcement of a breakthrough drug, a breakthrough gene, a breakthrough gene mutation, a breakthrough cognitive therapy, a breakthrough food, a breakthrough herb–so many breakthroughs that it seemed as though whatever wall there had been between us and the dark should have come down already, letting us bask in the sunshine of the eternal mind cure. But hey, not so fast.
Before a drug can come to market, before a therapy can be designed,
and (more often than not) before a body can be healed, you have to know where the problem lies. In medicine that knowledge is often found at the cellular or molecular or genetic level, somewhere in the mix of proteins of which we are made. To get through the hyperbole and hype and promises and platitudes that now attend to most public discussions about memory (which almost always,
these days, seem to be about memory impairment), I had to find out what the molecular biologists and cell biologists and biochemists and geneticists knew. This meant spending time in brainscanning suites and chemistry labs and mice nurseries and hospitals and pharmaceutical companies, and attending scientific meetings,
and reading research papers with unintelligible titles. Because there are now many ways to look at the brain, I also made sure mine was examined using each of them, in honor of one of the first scientists of memory, Hermann Ebbinghaus, who made it a point to experiment upon himself. Still, as a neuroscientist at Yale pointed out to me, “you can’t tell much from an N of 1.”
In our own lives, by definition, we are always Ns of 1, which is one reason why the prospect of getting sick can be so scary, and why being sick is scarier still, especially if either of those conditions entails the loss of self. (Can there be an N of −1?) If we’re lucky,
of course, our Ns connect–directly, contiguously, through each other–which is how families and communities are formed. It is also how, in science, evidence mounts and findings are made and then confirmed.
In the years that I was writing this book, crucial findings about memory loss and Alzheimer’s and normal memory and medicines and cognitive therapy were made and confirmed, and even where they were not, the ball was pushed farther up the pitch. From my seat the view has been outstanding, and from what I have seen there are many reasons to cheer.
Ripton, Vermont November 2007
Posted March 14, 2009
No text was provided for this review.
Posted October 16, 2009
No text was provided for this review.