A Terrible and Meaningful Loss
The slow peeling away of the self caused by Alzheimer's opens a window on what it means to be human.
BY: Interview by Elizabeth Sams
The Forgettinghas been called "the definitive work on Alzheimer's"-the story of the disease, its impact on patients and families, and the search for a cure. A few days after the death of Ronald Reagan from Alzheimer's, David Shenk spoke to Beliefnet's executive editor Elizabeth Sams about the trajectory of the president's illness and the spiritual meaning of the disease.
Everyone is of course wondering what impact his Alzheimer's may or may not have had on Reagan's time as president. Given that he died in 2004-and was diagnosed in 1994-what would our general knowledge of the disease say about that?
The first thing to say is that Reagan did not have Alzheimer's as president. It's more complex than that, but if you have to answer "Did he or did he not," he definitely did not have Alzheimer's, despite what some of his critics want to believe.
Reagan was very aware of senile dementia. Two members of his family had had it and he had been asked about it as he was running for president. He joked about it quite a bit as President-and I think he intuitively knew that if he lived long enough, he was headed in that direction.
He definitely joked about it while he was president. I have no doubt he was having some kind of what I would characterize as annoying memory issues-probably in his second term. And there's the suspicion that "Oh, they didn't want to admit it." And I'm sure theywouldn't
have wanted to admit it if it had been there. But I think it's pretty clear from looking at the evidence that he could not have been diagnosed with Alzheimer's at that point. I don't think he had any real disorientation. I don't think his memory problems were anything really out of the ordinary for someone his age.
have memory problems as we get older. We also, more to the point, all have memory complaints as we mature, as we have higher and higher expectations of what we want to remember in this world. As we get older we meet more people, we learn more things, we want to remember it all. And it's not that the brain doesn't have the capacity to do that-it does. But the brain is actually built to help you forget a lot of the minute details so you can form executive summaries of things. That's really what intelligence comes down to-the ability to take a step back and not remember every tree and leaf in the forest but to recognize the shape of the forest-to be able to characterize it.
After [Reagan] left the Presidency I think it's clear that he had progressively more difficulty with his memory and started to have issues of disorientation in the early '90s. And I think by the time he was diagnosed [in 1994] there wasn't any doubt. He probably could have been diagnosed a little earlier.
Alzheimer's is a very predictable disease. It can vary in how long it actually takes to completely overcome you. It can range from say five to even 15 or 20 years, but Reagan's ten years from diagnosis to death is right there in the average.