If there was one disease that was truly terrifying from a philosophical perspective, Alzheimer’s is an indisputable contender. Neurodegenerative, the disease slowly but surely robs victims of their dignity, destroying the very essence that years of invaluable experience culminated into.
Philosophy takes for granted that the human condition cannot meteorite: presumably our minds continue to pulsate and change, and that these pulsations result in our very being – a unique entity within the blistering swarm of the universe. Philosophers took for granted that uniqueness could not somehow be degraded from its essence, that it was an all-or-nothing relationship: existence or death. Yet Alzheimer’s has proven otherwise, manifesting into one of the slowest and cruelest ways of degeneration. Most other diseases eat away at your body, some perhaps resulting in insanity or dementia; Alzheimer’s, however, simply does not destroy you physically, but it must also shed away your personality and mind until nothing is more than sensationless pulp.
There have been books written and films made about Alzheimer’s – perhaps the most famous and critically acclaimed is Away from Her – but I have always been curious about the sort of despair and devastation a patient feels when the very characteristics that defined them become impossible to act out. Most of the time the patient is unaware of their own degeneration; some know their predicament, and that it is only a matter of time before their own sense of being is really no more. I know families of patients perhaps suffer more than the patient (especially since in the worst stages, they are blissfully ignorant of their state of being), but I do wonder – what on earth is it like to suddenly realize you’re falling down, down and down from a pillar you once proudly stood upon, the pillar which effectively defined your own existence?
Such is a question beautifully and poignantly explored in the novel Flowers for Algernon. The premise is this: a mouse, called Algernon, successfully undergoes experimental surgery to artificially improve its intelligence. Charlie, a mentally disabled man, volunteers for the treatment in hopes of becoming more intelligent. Charlie’s treatment is also successful, and he becomes exponentially intelligent to the point of outclassing the finest minds in the world. However, Algernon begins deteriorating, and very soon it’s obvious that Charlie will also meet the same fate.
The book is exceptional not only because of the moral and ethical dilemmas it presents such as treatment of the mentally disabled or how academia interacts, but especially by how it is written and presented. The book’s structure is one of a journal, supposedly maintained by Charlie when he first opts for the treatment all the way to his fantastic intellect and then to the beginnings of his decline, where he eventually stops writing because he is afraid and devastated by the idea of documenting his deterioration any further.
I can only imagine that perhaps Charlie’s fall from intellectual greatness experience is perhaps analogous to that of an Alzheimer’s patient. For the first time in his life, Charlie exudes a intellect so utterly spectacular, so magnificent that he truly feels a sense of pride in himself. However, the side effects of the experiment kick in, and like the plaque and dying neuron effects of Alzheimer’s Charlie finds himself losing more and more of himself everyday; more horrifying is the prospect of falling from greatness and back into state even more mentally handicapped before, and possibly brain death for the matter. These last journal entries are devastating: the anger, the despair, the desperation, and finally the acceptance – there’s almost a cruel irony that the greatest genius on earth should perish as a vegetable. Understandably, Charlie leaves his journal before he begins documenting in a more degenerated state. This last move is Charlie’s desperate effort to maintain himself somehow, to leave a documentation that chronicles the intelligent Charlie did exist, and while his now handicapped self can still remember such; further recording would only show how this Charlie was replaced by another Charlie, and another, and so on. Denial? Perhaps, but in his situation wouldn’t you opt for the same thing?
Perhaps a more interesting question to consider is this: is there a certain point where our physical or mental degeneration effectively makes us a completely different person than previous? That is, is our existence an all-or-nothing or gradient? With Alzheimer’s, I feel that the all-or-nothing model fails to account to the nuances and accumulating changes an afflicted individual encounters; many of the earliest symptoms are mistakenly attributed to senility, but as the symptoms become more and more frequent it becomes obvious that something is amiss – and that’s when the diagnosis comes in (interestingly, doctors can only confirm Alzheimer’s by autopsy). By the time a diagnosis is made, it’s only a matter of time until the person you know and love is no longer there, effectively snuffed out of their existential essence and ghost.
The analogy of Flowers for Algernon to Alzheimer’s is nothing else than my own projecting. I’ve never had relatives or friends afflicted with the disease; the closest experience I had with Alzheimer’s was back in July 2009 when I volunteered at an Alzheimer’s clinic, where I simply kept patients company and interacted with them so they wouldn’t be left all day to watch nothing but television. Yet I still wonder the sort of distress (or lack of) one feels when slowly but surely they become less and less themselves.
I recently read a Times magazine article titled “Alzheimer’s Unlocked.” Detailing current developments and advances against the disease, the article optimistically stated that with recent medical imaging techniques like advanced MRI machines, doctors and researchers were now able to visualize pieces of anatomy and physiological pathways in the brain that before, were completely out of the question with traditional dissection techniques. The biggest hope is that more avenues of research will open up, and that now we can really see what else we might have missed in researching the disease: traditionally, many believe that plaques formation corresponded to Alzheimer’s development, but to what extent this relation is (direct or indirect) or if there is another (or several other) physiological mechanisms at hand is the more recent question at hand.
Surprisingly, the article did not state perhaps why Alzheimer’s occurs in the first place, beyond the physical fact that some are genetically predisposed to it. I wonder, though, if the disease itself is perhaps a natural, inherited mechanism to shut down the human body when it begins to seem that our physical forms are no longer reproductively viable or as energetically sustainable – possibly, Alzheimer’s is almost a way of slowly shutting down a physical system that is simply too old.
This is all theory, of course. The only basis for it is that Alzheimer’s is considered a disease of the elderly, while other diseases like Parkinson’s, Tuberculosis and cancer can afflict anyone at any point in life, and afflictions at birth such as Down Syndrome are the effects of genetics seen immediately. Perhaps Alzheimer’s is just a genetic affliction triggered by the mere physical state of being elderly, and that if certain aspects of the environment trigger chronic stress (a constant firing of the sympathetic nervous system with little chance of the parasympathetic nervous system to balance it out) only accelerate the aging process, Alzheimer’s manifests as a way to simply shut down the now overworked body.
We may not know for many more years, or very easily a finding could reinforce or completely disprove what I’ve just out here. However, I’m sure we all agree on one thing – that Alzheimer’s unequivocally destroys any sense of being we might have ourselves, ghost and all.
Recommended Reading
• Flowers for Algernon – Daniel Keyes
• Away from Her – Roger Ebert movie review
• Charly – Roger Ebert movie review
• Away from Her – A.O. Scott movie review
• New Research on Understanding Alzheimer’s – Alice Park of Time Magazine