Tuesday, November 06, 2007

Al Martinez Interview of Alzheimer's Victim Superb

If there was ever reason to be thankful Al Martinez's termination as a columnist for the Los Angeles Times was reversed, it was the venerable Martinez's column in the Times yesterday, Nov. 5, on an interview he had with attorney Buddy Epstein on Epstein's slow, agonizing sink into dread Alzheimer's disease.

There have, of course, been countless columns on Alzheimer's, but this is the first I can ever recall in which the writer actually asked the victim what it was like to know that he has actually contracted the disease, and, at length, explored with him his experiences with it.

It was courageous of Epstein, who is only 58, to speak so frankly, and it was sensitive and courageous of Martinez to write it.

Epstein, who has practiced law for 32 years, told Martinez, "I have clear days and I have unclear days. I am not as competent as I used to be." And, he explained, "I was the kind of guy who could remember every phone number. I could do four things at once. Then it stopped. I knew something was clearly wrong."

Martinez observed of the interview in Santa Monica, "Epstein was able to articulate his thoughts, although hesitantly and often with a stammer, as though a connection between ideas and words had been impaired, and that's essentially what the disease is, a failure of neurons in the brain to make synaptic connections. There is no cure and very little relief. Even the cause is in question."

Alzheimer's does sometimes run in families. Epstein's mother, father and grandfather all had it in their later years.

Martinez's sister, Dolores, three years ago, the columnist writes, "vanished into the darkness that is Alzheimer's, gradually becoming a part of the gloom that embraced her. She was two years younger than I . Her last words were that she wanted to go home, that place in the dwindling light of her heart that represented a prior existence she couldn't remember.

"It is for her, in a way, that I write this column," he adds. "She was my little sister, the one I watched out for, protected against bullies and helped with schoolwork. In the days before she died, all I could offer was the comfort of my presence."

What particularly marked this column, which, as usually with Martinez these days, the Times stuck back in the California section, was its eloquence and the feelings it evoked.

Martinez began his extraordinary column, "There will come a point in the life of Buddy Epstein when the world around him will dissolve, taking with it has history and his identity."

And he ended it with this paragraph: "As our conversation ended, I could almost visualize the man disappearing before me. The basic elements that compose him will vanish in the sunlight that illuminates the beach, the man and all that he is. There will no longer be a Buddy Epstein, only a silhouette of the person that used to be."

Of course, this is not the only great work the L.A. Times has done on the brain. Who can forget Lee Holz's brain series? (Holz is now with the Wall Street Journal). That work, I believe, won a Pulitzer prize.

Gradually, discoveries are being made about brain abnormalities. Sometimes, they come through the study not only of Alzheimer's, but other strange diseases. I've had classmates die in recent years from both Lewi Bodies Dementia, and, in September, from Progressive Supranuclear Palsy.

Lewi Bodies Dementia, a combination of Parkinson's and Alzheimer's, caused my classmate to , suddenly in his late 40s, be unable to speak in anything but numbers. He lingered on for years, gradually losing his ability to speak at all, while his loyal, loving wife agonized over his condition.

I didn't even know what Supranuclear Palsy was until, after my classmate died of it Sept. 11, I looked it up on the Internet. It is a degenerative brain disorder manifested, at first, by an uncertain gait and blurry vision.

Recently, it was reported, doctors have found a new cause for the high blood sugar, and especially the blood sugar fluctuations, suffered by diabetics. Apparently, it is not just the pancreas, but also signals sent by the brain through the skeleton that partially controls the blood sugar. This, of course, opens up a whole new range of possible treatments of diabetes, although, so far, the only treatment known for these symptoms seems to cause more of the heart attacks that often mark progression of diabetes.

The brain, of course, remains in important particulars, a mysterious organ, about which much more must still be discovered. Reporters like Martinez and Holz, who write about it, it hardly needs be said, are doing a public service.


Both the New York Times and Los Angeles Times implicitly recognize in editorials today that we have little choice but to support Pakistani dictator Pervez Musharraf's attempts to defeat Al-Qaeda and the Taliban in the country, despite our dislike of Musharraf's undemocratic methods.

The Los Angeles Times observes, "The United States is increasingly left with bad options. Cutting off aid would only make it harder to enlist Pakistan's military in the anti-extremist fight and renew doubts about American's reliability as an ally."

The New York Times declares, "The truth is that all of the choices in Pakistan are bad. "

The bottom line here is very simple: We cannot do anything that gets in the way of the vital necessity of preserving Pakistan's nuclear arms free of Al Qaeda and Taliban control. Were Musharraf to fall, and an unstable "democratic" regime replace him, it ultimately could prove necessary for the U.S. and India to intervene with force to take control of these nuclear weapons. That would undoubtedly intensify the crisis, but the alternative could easily be worse.



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