Forget (Almost) Everything

   News came out recently (again) that a possible vaccine had been developed to prevent or at least delay the onset of Alzheimer's, a study which would be a boon to the 43 million people now facing the slow loss of oneself and a story so bravely told by David Milch in The New Yorker (also linked in my earlier post).  It'd be difficult to be that person, a witness really, observing yourself as if in a dream, parts of you just ebbing away like a sand castle that you've spent a lifetime building now being lapped at by an oncoming tide.  Mentally you're there but along with that comes the realization that soon even that will disappear; physical movements, decisions, even recognizing people and things will likely leave you wondering what world you may be entering, a black hole pulling you in but keeping you alive.  I've written about dementia many times (Alzheimer's disease is a sub-category of the broader field of dementia) but recently there have been more and more personal accounts appearing, some coming from the person to which it is happening as with that of David Milch, and others being written by a spouse or sibling or child.

   This was the case of Joanna Biggs in her diary entry in The London Review of BooksWhen I was with her, there was always something happening.  It would be days later, in the middle of my life in London, that I would find myself crying.  I started to dread the day she wouldn’t recognise me.  ‘Janet! Joannet! Janetta!’ she would call out, not quite finding on her tongue the name she had given me.  Who am I if my own mother doesn’t recognise me, I wondered.  Who was I anyway?  I began to question everything: did I want to have this sort of life, be in this sort of marriage, even be this sort of writer?  Did I want this sort of mother?  I went home less often.  I spent my time writing and rewriting the non-fiction book about working lives I’d taken on the year she was diagnosed...I got scared of her: she began having jerks which meant she would spill her coffee mid-cup; she got unpredictably angry and could not be soothed; she would cry and no one would know why.  I didn’t enjoy my impatience in moments like these.  I didn’t enjoy seeing her in confusion.  ‘Why is it that anyone likes me?’ I remember her once crying out.  I couldn’t see the effort she was making to talk, only that I couldn’t speak to her in the way I was used to.  And there were moments when I experienced this loss as a kind of freedom.  Freedom from criticism –she had once asked me if a university boyfriend had left me because I didn’t wear lipstick– as well as from certain pressures: she’d cried with joy when I told her I was getting married; she was hotly expecting a grandchild. (One of my thoughts after discovering she was so ill was that I should have the child I wasn’t sure I was up to having, while she could still be a grandmother.)  But I knew the freedom to disappoint her was a cowardly one, because it was unearned; I wouldn’t have to defy her...Sometimes the only cause that makes sense to me is my carelessness as a daughter: the times I drove across the country to visit a friend and didn’t bother to call to say I’d got there safely; the moment on my wedding day when she gave me a garter for luck in the loos and I didn’t wait for her so we could go back out to the wedding together.  There are a thousand things like this and many days when I think them as good a reason as any to take a mother from a daughter.  When her illness didn’t feel like my punishment, it felt, still feels, like a sword hanging over my future happiness.

   Add to all of this the rapid spread of the pork virus and an interactive graphic from Bloomberg Businessweek that is somewhat frightening to watch.  China (the largest breeder of hogs) has already culled over a million pigs, a small part of its 440 million being raised; but more will likely have to follow.   There is no vaccine, and no method to treat it.  The virus can survive acids, heat and spreads via soil or water or touch; said the article: The virus, though, doesn’t need traveling swine to spread.  A single drop from an acutely infected pig can contain 50 million virus particles, and just one of those particles ingested in contaminated drinking water may be enough to transfer the disease to another pig.  Infected blood, or fluids from urine, saliva or feces, can be carried in dirt on truck tires and shoes, allowing the disease to travel hundreds of miles quite rapidly.  Contaminated sources require heating to 60 degrees Celsius (140 Fahrenheit) for 30 minutes to be rendered safe...The germ is hardy, capable of remaining active in water for a month, in meat and blood at room temperature for several months and for six years in cold, dark conditions.  It’s resistant to temperature extremes, and can survive a day in vinegar-strength acids...Studies have found that the animals which recover from an initial African swine fever infection are resistant to some other strains, but scientists aren’t sure what exactly confers that protection or how best to evaluate the potential efficacy of candidate vaccines.  One of their difficulties is that the large, complex DNA virus that causes African swine fever has some 170 genes and 80 proteins, many of them specialized in evading different aspects of the pig immune system.  The virus has NOT spread to humans...so far.  Said a piece in Newsweek that interviewed lead researcher Dr. Scott Kenney: ...a virus can jump across species if it can bind to the receptors on its cells.  "A receptor is like a lock in the door.  If the virus can pick the lock, it can get into the cell and potentially infect the host," he said.  In what is believed to be the first study to indicate that the virus could transfer between species, researchers investigated a receptor called aminopeptidase N, which the virus could latch onto.  They found that the virus was able to bind to the receptor in chicken, cat and human cells.  "From that point, it's just a matter of whether it can replicate within the cells and cause disease in those animals and humans," (but)  Dr. Kenney urged members of the public: "Please don't panic!  Right now normal people don't have to change any aspects of their daily lives, no human outbreak is imminent that we can see.  This virus has been around since at least 2012 and we haven't seen any deaths from transmission to humans."   

    There is so much which we have yet to understand.  Even something as complicated as our own immune systems.  Change a little enzyme and thrombotic thrombocytopenic purpura or TPP can occur where one's blood clotting goes awry and clots internally (a quick version of that malady appeared in Discover).  And I've always told my friends that if in some magical afterworld every species could anxiously line up at a massive bulletin board like students of old viewing exam results, a board that showed exactly where our time span happened and its length, why we humans, proud and perhaps as cocky as we are, would be hard pressed to even find our mark, a thin line vastly overwhelmed by ants and bacteria and viruses...even dinosaurs have roamed this planet at least 10x as long.  How much have we learned?  Add to all of this the discovery that there aren't thousands or millions or even billions of other galaxies out there (so far, at least with our meager instruments of detection) but rather trillions of galaxies said a site for scientific news.  As for that blip of a line?  Our planet is barely detectable within our own middle-sized galaxy...so how much understanding have we yet to discover or perhaps accept?

   Wow!  Depressing...or enlightening?  It's all in one's attitude.  We have this moment, this "now" and life is everywhere whether we understand it or not.  And it never hurts to step back and try to view things from afar, to not get so wrapped up in ourselves that we lose sight of the mystery of it all.  To just sit outside and appreciate, to look at your partner or parents or children and just appreciate. to wake up each morning and just appreciate.  So I'll leave you with this letter from James W. Clark, responding to a piece on aging in The New Yorker that began: Aging, like bankruptcy in Hemingway’s description, happens two ways, slowly and then all at once.  The slow way is the familiar one: decades pass with little sense of internal change, middle age arrives with only a slight slowing down—a name lost, a lumbar ache, a sprinkling of white hairs and eye wrinkles.  The fast way happens as a series of lurches: eyes occlude, hearing dwindles, a hand trembles where it hadn’t, a hip breaks—the usually hale and hearty doctor’s murmur in the yearly checkup, There are some signs here that concern me.  Not so fast said Clark.  Here's his letter of rebuttal: As an eighty-seven-year-old, I did not entirely recognize myself in Adam Gopnik’s vivid description of what it’s like to be old.  Gopnik describes how wearing the M.I.T. AgeLab’s AGNES suit, which simulates loss of mobility and acuity, makes him annoyed and angry.  For me, previously simple tasks have indeed become increasingly hard and deliberate with age, but I don’t usually feel discouraged.  When I reach to a high shelf for my whiskey glass, the act, though effortful, is pleasurable.  My success is accompanied by a small burst of pride. (“You’ve done it again!”)  Indeed, that’s why I keep my whiskey glass almost out of reach.  I know what an AGNES suit feels like, and I am fortunate that it suits me: with all those encumbrances, I feel good.  This must be due, in part, to the fact that we sedentary people are no longer isolated from the wider world.  Next to my evening glass of whiskey are my Kindle, my iPad, and my Bluetooth hearing aids.  The world that I once sought in libraries and in travel is now always by my side.   As the universe would likely respond, even to an 87-year old...Atta Boy!
   

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