Forgetting is what makes us smart

Continuing my efforts to learn more about memory and memory impairments, I just finished The Forgetting by David Shenk. Shenk explores the early, middle, and late stages of Alzheimer’s disease, drawing from history, literature, science, politics, and the personal experiences of people with AD and their caregivers.

Shenk is an excellent reporter as well as skilled writer. Take this description of the brain:

“A coconut-sized clump of grooved gelatinous flesh; an intricate network of prewired and self-adapting mechanisms perfected over more than a billion years of natural selection; powered by dual chemical and electrical systems, a machine as vulnerable as it is complex, designed to sacrifice durability for maximal function, to burn brightly – a human brain is 2 percent of the body’s weight but requires 20 percent of its energy consumption – at the cost of impermanence.”

Shenk weaves into his narrative the stories of many famous and not-so-famous people who have been victimized by AD, and through their stories he paints a vivid if disturbing picture of the relentless course of the neurodegeneration they experience. Among the famous people: Ralph Waldo Emerson, the father of American Transcendentalism; the abstract impressionist painter Willem de Kooning; Jonathan Swift; and Ronald Reagan. De Kooning’s story is particularly interesting. As the disease progressed and his memory declined, his paintings changed, becoming, according to Shenk, “happier, far less angst-ridden.” Shenk goes so far as to suggest that Alzheimer’s disease may have enhanced de Kooning’s art by robbing him of cognitive abilities but leaving his ability to process emotions intact.

“From this vantage, it almost seems as though de Kooning contracted just the right disease, the one neurological disorder that would spare his ability to create as it ate away at most of the rest of his abilities.”

Shenk discusses one of the paradoxes of aging that is too often ignored; that is, that by extending longevity, medical science has altered the “law of mortality,” extending life beyond its own innate limits and allowing illnesses such as AD to reach epidemic proportions. In times past, AD was virtually invisible because so few people lived long enough to develop it. Moreover, he argues that defeating AD would bring with it the danger that we would “lose sight of the disease’s essential humanity.”

“To be human as we know it today is to experience the cycles of life, to experience great loss and pain – not just the pain of tragedy but the pain of inevitability. The essential joy of life is embedded in our mortality, and in our forgetting"

I can't say I necessarily agree with Shenk's somewhat romanticized view of a horrible disease, but his perspective certainly gave me something to think about.