May 21, 2000
The Vanishing Self
A study of Alzheimer's disease and an account of how it affected the author's family.
First Chapter: 'Hard to Forget'
By AMANDA FORTINI
HARD TO FORGET
An Alzheimer's Story.
By Charles P. Pierce.
213 pp. New York:
Random House. $25.
lzheimer's is the pathological version of our culture's obsession with memory as the root of identity, an ailment for an age teeming with memoirs. Yet the culture's fascination with Alzheimer's can be explained by numbers alone: more than four million Americans have the terrible illness, and by the middle of the next century -- as ''Hard to Forget,'' Charles P. Pierce's account of his father's (and his family's) struggle with the disease, relates -- the figure will rise to an astounding 14 million. What is as likely, however, is that Alzheimer's has captured the public imagination precisely because the constituents of the imagination are what it destroys. It abducts personality, consuming the essence of self while leaving the physical proof of self behind.
Pierce's family memoir recounts his personal experience of the illness that first killed his father by silencing his spirit, and it mourns the kind of loss that, for a victim's family, is perhaps more shattering than actual death. In May 1985, John Pierce, a retired schoolteacher, got in his car, drove off to buy some flowers and did not return for three days. John Pierce began wearing multiple pairs of pants; he screamed for his dead mother; he lost his command of language; he ceased to recognize Charles as his only son, creating three fictional children in his place. John Pierce's three brothers also developed Alzheimer's; in the space of nine years, all four men died.
For Pierce, then, coming to terms with such tragedy meant more than grieving. It meant confronting his own genetic legacy. Pierce, a writer at large for Esquire, immersed himself in the science of genetics, the engrossing exposition of which makes up a substantial part of the book. These two narrative strains, one objectively scientific, one deeply personal, intertwine to create his story's double structure, which in a sense reflects the dual nature of the disease itself.
The book's strength lies in Pierce's skillful explanation of the scientific history of Alzheimer's. With a reporter's eye for detail, he takes us back to 1906, the year Alois Alzheimer, a Bavarian neuropathologist, discovered the disease while performing a brain autopsy on a woman he called Frau August D. Pierce has a gift for laying out complex issues. He makes us visualize the intricacies of Alzheimer's, like the way the deteriorating brain of a victim is characterized by ''tangles'' -- thick, proteinaceous neurofibrils -- that arrange themselves in dense bundles called plaques, which destroy the surrounding neurons until they appear as if they had been ''burned away.''
Yet to write a memoir about illness requires that a writer convey the naked human suffering when illness is stripped of all its scientific specifics and symbolic meaning. In his attempt to put words to his painful experience, Pierce sometimes founders. At highly emotional or psychologically troubling moments, the details he wields so expertly in his scientific explication give way to a series of self-consciously literary leitmotifs.
When his father is missing, Pierce experiences what he calls ''the waking dream . . . of a dead city,'' in which he ''can see the smoldering skyline, smoke rising from faceless buildings.'' Later, when he visits a group of Alzheimer's patients at a nursing home and feels suddenly comforted by his easy manner with them, Pierce writes, ''I saw the ruined city in the country of my disease, but, this time, there were landmarks, and signs of human passage.'' This seems too much like a defensive poeticism. ''Hard to Forget'' intelligently and absorbingly clarifies a disease obscured by ignorance and fear, and yet the personal side of the story too often feels like a rhetorical shelter.
Ultimately, the book's flaw is the source of its necessarily bemused vitality: it is a memoir about an illness that destroys memory. Only someone suffering from Alzheimer's could convey the inner nature of the disease. But until scientists discover a cure, no Alzheimer's victim ever will.
Amanda Fortini is on the staff of The New York Review of Books.
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