Book Reviews

Abstract

This is a book by an American journalist intended for the general reader, so at first sight would not appear relevant to the dementia specialist worker or researcher. However, as I read it I was increasingly impressed both by its clarity of exposition and the breadth of its scope. The writer started out in ignorance of his subject, and by reading and interviews built up what he calls 'a biography of a disease'. He has achieved a remarkable though precarious balance between the medical and the psychosocial.But first the drawbacks: it is a very American book and there is little awareness shown that insights and breakthroughs could have been achieved anywhere but in the United States. And the author is very hooked on the idea of stages. The book itself is divided into three: Early, Middle and End. These are clearly intended to suggest the build-up of knowledge, and there are also re-visitations of ideas explored earlier and people's research projects, which implant the idea of development. But, of course, the progression of dementia is also conveyed, so the first section has a lot about diagnosis and the last focuses on death. Within the 'Middle Stage' part, the author swallows whole the Barry Reisberg retrogenesis thesis. I was also surprised how such an otherwise precise writer could pepper his text with 'diseases', 'sufferers', 'patients' and 'afflicteds' -very loaded terms.On the positive side there is much to commend. Many of the clinical descriptions are turned into stories, which makes them very readable, and the arts are also given prominence, with accounts of the dementias of Emerson, Swift and de Kooning. Fifteen of the 17 chapters are introduced with quotations from people with dementia and carers. One of these is the remarkable writer with dementia, Morris Friedell, who appears also in each part of the book and emerges at the end as Shenk's key witness: de men tia d e m e n t i a ©    www.sagepublications.com