Rudolph E. Tanzi and Ann B. Parson
281 pages
Perseus Publishing, Cambridge Massachusetts, 2000
ISBN: 0-7382-0195-2
Reviewed by: Dr. Barry Goldlist
Clearly, the topic of Alzheimer disease (AD) is always of interest to a geriatrician such as myself. However, this book has a much wider appeal than simply for those with a particular interest in neurodegenerative disease. The book tells the story of Rudolph Tanzi and his part in the hunt for the genetic basis of Alzheimer disease. Since Tanzi started on the ground floor--in fact, he helped construct the ground floor--the book gives a wonderful overview of the development of molecular genetics as it pertains to AD. The structure of the book is superb, and the prose is clear; the author makes complicated concepts intelligible to the average reader, without ever seeming patronizing. The co-author of the book, Ann B. Parson, is an experienced science journalist, and I suspect her contribution to the book can be found in the elegance of the writing.
Why do I feel this book should have wide appeal, even to a lay audience? In addition to the skilled writing, the book can be read as a thrilling mystery story--albeit with the final mystery as yet unsolved. As well, it serves as a description of the process of medical science, from the inspired hunches of well prepared 'amateurs', to the smooth functioning of large academic laboratories, and further to the involvement of huge multi-national pharmaceutical companies and their indispensable role in drug development. Finally, it makes science 'personal' by giving glimpses of the foremost scientists in the field, describing their alliances and feuds, and their reactions to success and failure.
It was this last facet of the book that I found most interesting. The shifting alliances among the investigators (including break-ups within successful labs) remind me of Chaim Weizman's aphorism, 'great powers have no permanent friends, only permanent interests.' Tanzi himself seems like a very appealing individual, with wide interests (especially music) outside of science. He appears to be one of those rare individuals who is able to take his work seriously, without being too serious about himself. In fact, there are no real villains in this book. Tanzi himself hints at a hypothesis that I suspect might be true. The very nature of scientific breakthrough is predicated on competition. One can compare it to putting deadlines on labour negotiations; without them no serious bargaining ever occurs. Similarly, the thought that someone else might publish the 'breakthrough' article is a tremendous stimulus for an ambitious researcher. The big prize in this story was the discovery of the presenilin 1 gene on chromosome 14, the commonest cause of early-onset AD. The intense pressure, media scrutiny and cut-throat competition are clearly, and thrillingly detailed. For a University of Toronto faculty member such as myself, the result of the thrilling race was truly satisfying--the winner was Peter St George-Hyslop, the director of the Centre for Neurodegenerative Diseases at the University of Toronto.
As a preface to each chapter, Tanzi and Parson tell a bit of the story of the Noonan family, a large, Boston area kindred afflicted with early onset AD. This reminds the reader of the urgency that researchers feel in their race to understand the disease. One of the clear heroes in this book is the pathologist George Glenner who first characterized the nature of cerebral amyloid, a tremendous impetus for further research. He and his second wife established day centres to help care for victims of AD. Glenner was continually re-energized by his clinical work in those centres, once again providing a clear reminder that the passion shared by these researchers is not merely intellectual. It is worth reading this book to get a glimpse of that passion.
