Friday, December 18, 2015

Poetry and memory

Back in the late 1990s, a California poet named Gary Glazner obtained a modest grant from Poets and Writers magazine. His intent was to use poetry as a vehicle to engage people at an advanced stage of Alzheimer’s disease. As Glazner recounted many years later in an interview with National Public Radio, “I got hooked on it when one day I was reading Longfellow’s poem [“The Arrow and the Song”] and there was one man, he was pretty much out of it, he wasn’t able to participate, his head was down. And I said, ‘I shot an arrow in the air,’ and he said, ‘And where it land I knew not where’—the precise words of the poem’s next line. Glazner described it as “a marvelous moment for me and the whole group.”
Glazner went on to found the Alzheimer’s Poetry Project, and the Brooklyn-based program has blossomed throughout the United States and beyond. There are now hundreds of “memory cafes”—venues, often in senior centers, that serve as meeting places for people with Alzheimer’s, including those who are far down the road of this typically slow-moving disease. I plan to attend one of these sessions in the Boston area, but for now I’ll settle for highlighting a few of the poems that are part of Sparking Memories: The Alzheimer’s Poetry Project [www.alzpoetry.com].
There are fifty poems in all, starting with “The Tyger,” by William Blake, the first of the great British Romantic poets. Here are the first five stanzas:

Tyger! Tyger! burning bright
In the forest of the night,
What immortal hand or eye
Could frame thy fearful symmetry?

In what distant deeps or skies
Burnt the fire of thine eyes?
On what wings dare he aspire?
What the hand dare seize the fire?

And what shoulder, & what art,
Could twist the sinews of thy heart?
And when thy heart began to beat,
What dread hand? & what dread feet?

What the hammer? What the chain?
In what furnace was thy brain?
What the anvil? what dread grasp
Dare its deadly terrors clasp?

When the stars threw down their spears,
And watered heaven with their tears,
Did he smile his work to see?
Did he who made the Lamb make thee?

The poem, which opens like a nursery rhyme, appears to be a meditation on the introduction of malevolence into the world. Was it necessary to include vicious predators into the natural order? The poem is also about the Lamb of God (and Blake’s creative interpretation of Christianity). But knowing this is not a prerequisite for appreciating the poem. Much of the pleasure is in its sharp images and rhyme scheme.
Here is another example, from Blake’s younger contemporary William Wordsworth:

I wandered lonely as a cloud
That floats on high over vales and hills,
When all at once I saw a crowd,
A host of golden daffodils;
Beside the lake, beneath the trees,
Fluttering and dancing in the breeze.

Continuous as the stars that shine
And twinkle on the Milky Way,
They stretched in never-ending line
Along the margin of a bay;
Ten thousand saw I at a glance,
Tossing their heads in a sprightly dance,

The waves beside them danced, but they
Outdid the sparkling waves in glee.
A poet could not but be gay,
In such jocund company!
I gazed, and gazed but little thought
What wealth the show to me had brought;

For oft, when on my couch I lie
In vacant or pensive mood,
They flash upon that inward eye
Which is the bliss of solitude;
And then my heart with pleasure fills,
And dances with the daffodils.

A formal analysis of this poem would note its rhyme scheme: In the first four lines of each stanza, the last word or syllable of the first line rhymes, or almost rhymes, with the last word or syllable of the third line; the same is true for the fourth line. In the last two lines of each stanza, the rhyme is direct, as in: “And then my heart with pleasure fills, / And dances with the daffodils.” But a formal analysis only gets one so far. It’s the music of the words that matters.

In deference to the holiday season, my next post will appear on New Year’s Day.

Friday, December 11, 2015

A different kind of war movie

Back in 1998, two notable films about World War II were released within several months of each other. The first was Steven Spielberg’s Saving Private Ryan, which grossed almost half a billion dollars in its first six months, and, for its depiction of the U.S. landing in Normandy, won plaudits as the most realistic battle scene ever produced. The second was The Thin Red Line, directed by Terrence Malick, his first movie in two decades.
The two films have little in common. Spielberg’s movie is broken into distinct sections. Act One: the heroic securing of the beachhead. Act Two: A mission to locate a missing private whose three brothers have already died. Act Three: a firefight in a village in which the unit’s heroic commander (Tom Hanks) is killed. The movie ends with an image of Private Ryan as an old man, weeping over the grave of the man who saved his life.
Malick’s film, which is nominally about Guadalcanal, the pivotal battle in the war in the Pacific, is the visual equivalent of a tone poem. Time is disjointed. It appears that the film’s central character, Private Witt, played by Jim Caviezel, has deserted and is living among the natives. Edenic images abound. Angelic children swim naked over coral reefs. Witt helps out with tribal tasks, such as basket-making. Sunshine slants through the jungle canopy. In a voice-over, Witt comments, “I asked my mother if she was afraid of dying, and she just shook her head. I wonder how it would be when I died… I just wonder if I can make my death mean something.” When he sees his ship offshore, he hides.
Most war movies can be sorted as anti-war or pro-war, but this is not the case with The Thin Red Line. It is true that the Sean Penn character, a jaded, weary sergeant, remarks of the war, “It’s all just real estate.” And there is a good deal of cynicism among the soldiers, understandable given the circumstances. An ambitious colonel (in a manic performance by Nick Nolte) is more concerned about winning medals and advancement than sparing his men’s lives. In a key scene, Witt refuses to obey orders, which the private correctly understands will lead to unneeded casualties.
The death scenes in the film–and there are many–are also notable, both among the Americans and their Japanese adversaries.  You can hear the screams and confusion of the wounded and the dying. One solider vomits, and the Sean Penn character sharply admonishes him. In a convincing cameo role, Woody Harrelson plays a dying soldier who bares his teeth in rage and, to his horror, muses about not being able to “fuck anymore.” (The wound is below the belt.) He dies staring blankly at the sky, in the arms of Witt. A much younger soldier, more a boy than a man, dies in a way that suggests Christian iconography, a beatific glow on his pale face.
Much later, Witt stares down at a dead Japanese soldier and then sees an apparition of the Buddha, posing the question: “Are you righteous and kind? Does your confidence lie in this? Are you loved by all? Know that, I was too. Do you imagine your sufferings will be less because you loved goodness?”
Good question. The movie also includes a number of flashbacks to Witt with his wife stateside, in foreplay. But these pleasant memories collide with a terrible letter: His wife has fallen in love with someone else, and demands a divorce. Presumably, the news is the final blow to Pvt. Witt’s overburdened psyche. The logic of the movie demands that he will not survive.
An honest war movie is almost impossible without a clear-eyed understanding of the passions that combat releases, and Malick’s film does not flinch from the brutality. The author of the novel on which the movie is based, James Jones, fought in the Guadalcanal campaign, and I suspect that the depiction in Malick’s film of U.S. soldiers’ treatment of malnourished Japanese prisoners is close to the historical truth.
But this is no anti-war movie. The comradeship among the soldiers feels more genuine than in any other film I have seen, including Saving Private Ryan. I regard The Thin Red Line as a work of existential philosophy, depicting complicated quandaries.
There is, of course, a reason that war films (and war literature, going back to antiquity) remain relevant: They depict the imminent threat of death. Most of us benefit from the luxury of time, whether we are conscious of this bounty or not.

Friday, December 4, 2015

A healthy skepticism

Last week my cousin Jackie, a retired schoolteacher, mailed me a copy of Life Extension magazine. The publication targets the Baby Boom generation, of which I am nominally a part. (Like Douglas Coupland, the Vancouver writer who coined the term Generation X, I was born in 1961.) Jackie, who noted that she receives Life Extension because her education association sends it to her, highlighted two articles, one about walnuts, the other about benfotiamine, a B1 vitamin. Under the magazine’s monthly feature “Super Foods,” walnuts are touted not just for reducing the risk of heart disease and some forms of cancer, but also for boosting cognitive function. According to the article, walnuts can limit vulnerability to “oxidative stress”—defined as an imbalance in the body’s ability to detoxify or repair cellular damage.
The article notes that in a study involving young and old rats, researchers concluded that eating walnuts regularly may confer “protective effects” on an aging brain. The key word is may. The word appears again in the article a few paragraphs later. Michael Downey, who wrote the article, suggests that walnuts “may have a beneficial effect in reducing the risk, delay the onset of, or preventing” Alzheimer’s disease.
My advice: If you like walnuts, and you can afford to buy them regularly—I just picked up a pound bag still in their shells at my discount supermarket for $4.50—eat them plentifully. But don’t expect miracles.
In a separate article, Downey touted the B1 vitamin benfotiamine.
“When benfotiamine was used for treatment for eight weeks in a mouse model of Alzheimer’s disease, researchers found that it reduced both amyloid plaque numbers and phosphorylated tau protein levels in the brain,” Downey wrote. Backing up this assertion is a 2013 paper in the journal Molecular and Cellular Neuroscience, noting that “Thiamine-dependent processes are highly correlated to the decline in clinical dementia rating scales. In animal models, thiamine deficiency exacerbates plaque formation, promotes phosphorylation of tau and impairs memory.” (Phosphorylation can turn protein enzymes on and off, altering their function.)
The paper goes on to note that related mechanisms “may lead to reversal of plaque formations in animals. If so, the use of benfotiamine could provide a safe intervention to reverse biological and clinical processes” related to Alzheimer’s.
This is encouraging, though Downey’s conclusion to his magazine article strikes me as wildly optimistic: “In the process of helping neutralize the adverse impact of after-meal blood glucose,” he writes, “benfotiamine can prevent Alzheimer’s disease, vision impairment, cardiovascular disease—and possibly even aging itself!” [The italics are his.]
As I was reading this article, my mind drifted to Ernest Hemingway’s novel The Sun Also Rises, about a group of expat Americans and Britons in Paris and Spain in the 1920s. The book’s narrator, Jake Barnes, has been rendered impotent by a war wound. Jake is in love with Brett Ashley, and Brett with him, but consummation is not possible. On the surface, the expatriate life is gay (in the now-defunct sense of the word). But several of the characters are miserable. Jake finds respite from his anguish in fishing in Spain, but he also drinks heavily and teeters on the edge of despair. The novel begins as it ends, with Jake and Brett in a taxi, discussing their plight.
“Oh, Jake,” Brett said, “we could have had such a damned good time together.”
Jake’s reply: “Yes. Isn’t it pretty to think so.”

Wednesday, November 25, 2015

'The writing makes me whole again'

As I noted in a recent post [A kitchen accident, November 13], I discovered that my short-term memory is even less reliable than I had assumed. The accident, which ended up destroying a large Pyrex lid, was recalled by Paula and me in very different ways. In my version, it was Paula who discovered the red-hot burner, turned it off, and poked the Pyrex top with a dinner knife, causing the top to disintegrate. But Paula was not even in the room at that time. She had helped out with the peeling and cutting of a small pumpkin, the central ingredient in our dinner, then left the room to attend to other matters. The glass lid had shattered in the kitchen sink when I apparently immersed it in cold water.
When Paula proofread the blog post a couple days later, her reaction to my memory of events was halfway between amusement and horror. The most charitable interpretation is that a prosecuting attorney might want to think twice about calling me to testify–unless his intent was to mislead the defense.
One of the odd things about Alzheimer’s is that someone can have a piss-poor short-term memory and still write as well as ever, though at a slower pace. This is less surprising in my case, since I’m still at an early stage of the disease. But the book I recently read by Greg O'Brien, On Pluto: Inside the Mind of Alzheimer’s, is a revelation and an inspiration.
The revelation is that as this illness follows its meandering path, some people are able to tap into what is called “cognitive reserve” – the ability to maintain core professional and vocational competencies. In O’Brien’s case–and in mine–that core competency is writing.
This can be true deep into the middle stage of the disease when certain everyday activities become challenges, if not adventures.
O’Brien describes an unsettling trip through an automated car wash and, in the same afternoon, his decision to use his lawn tractor in the Cape Cod town of Brewster not only to mow his own land but also the properties of his neighbors.
The confusion didn’t end there.
“As I headed down the steep hill on Stony Hill Road, whizzing by, often at close to 50 mph, something in the deep recesses of my brain told me this was a bad idea, a very bad idea,” O’Brien writes. “My attention was then drawn to a neighbor’s lawn through the back woods behind our house where a delicate man in his 70s was placidly cutting with a push mower. The old way. Without rational thought, I took a hard right into the scrub pines, blades aglow, cutting through the underbrush—saplings of oaks, pines and a few maple trees. The piercing grinding echoed throughout the neighborhood. Sounded like screams of mercy. My neighbors must have thought I was Freddy Krueger from Elm Street. I never made eye contact with my elder neighbor, just trimmed his lawn in perfect parallel lines, then sharply hung a left back through the woods, the grinding of the underbrush again intense. The poor man fled into his house, probably scared shitless.”
I quoted this lengthy passage for two reasons. The first is that it’s an example of vibrant prose. Everything is vividly specific—the types of sapling trees, “the piercing grinding” of the mower, the old man fleeing to the shelter of his house.
The second reason is that it demonstrates how Alzheimer’s, over the years, corrodes judgment, sometimes in bizarre ways. Elsewhere in his book, O’Brien describes episodes of mistaking a stranger for a friend, and his wife for a stranger. “I knew I was supposed to be in the bed with this attractive woman,” he writes, “but I wasn’t sure who she was. She looked familiar, but I had no understanding for several minutes of the relationship with the woman I have slept with for 37 years.”
This is evidence that, despite experiencing hallucinations and bouts of confusion, it is possible to write well deep into the middle stages of this disease. As O’Brien observes, “The writing makes me whole again—until the confusion takes over.”
The explanation for this disconnect—lucid prose on the one hand, dementia on the other–can be described as a kind of mental bank account, or tank of gas, that allows some people to continue to function at a high level in certain realms, even when short-term memory and executive functions are deeply compromised.
What a strange, vaguely comic disease I have.

Friday, November 20, 2015

Parallel lives

Soon after I announced on Facebook this past summer that I’d been diagnosed with early-onset Alzheimer’s, I heard from Steve DeWitt, who, in the late 1970s, was one year ahead of me at Sehome High School in Bellingham, Washington. Steve, it turned out, also was ahead of me in being diagnosed with this disease. Each of us played on our football team.
Prior to his diagnosis, Steve worked on high-end home projects, almost all of them in San Francisco. One of the homes was featured in a prestigious architecture magazine. But the severe recession that began in the fall of 2008 had a serious effect on his livelihood. “I was, for a year, unemployed…. It was just me and my wife, puttering around, doing odd jobs around the house.”
Soon the news got much worse. Steve linked up with an electrician he’d worked with previously. “The guy called me in, and hired me, and said I could start tomorrow,” Steve recalled. “It seemed like a great thing. But a few days later, the guy said, ‘You’re not cutting it.’”
Like many of us at a very early stage in the disease, Steve was not ready to acknowledge that the problem was his. He continued to bid for contracting jobs.
“I still had all the confidence in the world then. I just figured that I would just stop drinking wine, and eat better, and everything would come around fine.”
Steve added, “I was stubborn then. I kept on thinking that it was everyone else’s problem, not mine.
“I knew what I had done in the past. I had been on the cover of Architectural Digest. Those weren’t just dingbat ranchers I was building.”
During our conversation, Steve and I swapped stories of the fear we faced being sophomores on our high school football team and having to scrimmage against the varsity. Many of the seniors were grown men. Steve recalled getting hit helmet-to-helmet by Lance Neubauer, a huge specimen of a man who looked like a living version of Michaelangelo’s statue David, but with larger thighs.
“He was on offense, and I was on defense—I was skinny then—and if I could have, I would have just got out of his way,” Steve said. “We hit helmet to helmet on the top. It was–wow—the hardest hit I ever felt. I remember we had the green helmets at that time, and it was like I was wearing green sunglasses.”
Our coach was something of a free spirit, a far cry from the stereotype of the overbearing football taskmaster. His creative game tactics sometimes backfired, in one case leading to a loss to our crosstown rivals by a single point. But in terms of the treatment of concussions, our coach was like most, maybe all, high school football coaches of that era. After the blow from Neubauer, Steve remembers the coach telling him, “Just walk it off.”
Neither Steve nor I are aware of any instances of early-onset Alzheimer’s in our extended families. Both of us believe that our cognitive difficulties are at least partly a consequence of playing football. Steve has been examined by two neurologists, but neither is confident that the hit by Neubauer led decades later to Alzheimer’s. (One doctor was skeptical. The other ruled it out entirely.) Another factor in Steve’s health is a work-related concussion in 1988.
Because of a seizure some years back, believed to be connected to Alzheimer’s, Steve no longer drives. Living about 25 miles west of San Francisco, he feels isolated at times. But he is active in his local Alzheimer’s support group, and he is also enrolled in a clinical trial about ten miles from his home. At fifty-four, he is the youngest person in the study. The others are in their sixties and seventies.
But there is an encouraging sign: The trial medication appears to be helping.
“I do feel a lot better now than when I was diagnosed,” Steve said. “I was really confused all the time.”
I also asked Steve a question about surviving into the terminal stage of dementia, by which time our faculties may be severely compromised.
 “Yeah, there is an 800-pound gorilla around the corner,” Steve said. “My deal is, I just don’t look too far down the road. I know it’s out there. This is kind of a cliché, but I just try to enjoy the day. I do organic gardening. I try to keep busy.”