Pharyngula

As you all should know, the inimitable Terry Pratchett has been diagnosed with Alzheimer’s disease. He’s writing about it as long as he can, and so far he’s remarkably lucid and open…and also, you can tell, a bit angry at the sheer arbitrariness of the disease and the difficulty in finding treatment for it.

…it is strange that a disease that attracts so much attention, awe, fear and superstition is so underfunded in treatment and research. We don’t know what causes it, and as far as we know the only way to be sure of not developing it is to die young. Regular exercise and eating sensibly are a good idea, but they don’t come with any guarantees. There is no cure. Researchers are talking about the possibility of a whole palette of treatments or regimes to help those people with dementia to live active and satisfying lives, with the disease kept in reasonably permanent check in very much the same way as treatments now exist for HIV. Not so much a cure therefore as – we hope – a permanent reprieve. We hope it will come quickly, and be affordable.

When my father was in his terminal year, I discussed death with him. I recall very clearly his relief that the cancer that was taking him was at least allowing him “all his marbles”. Dementia in its varied forms is not like cancer. Dad saw the cancer in his pancreas as an invader. But Alzheimer’s is me unwinding, losing trust in myself, a butt of my own jokes and on bad days capable of playing hunt the slipper by myself and losing.

Zeno has also found an appropriate quote from Pratchett’s Unseen Academicals(amzn/b&n/abe/pwll) (I recommend it!). It’s a quote from Havelock Vetinari, one of my favorite characters in the Discworld series, on natural evil.

I have told this to few people, gentlemen, and I suspect never will again, but one day when I was a young boy on holiday in Uberwald I was walking along the bank of a stream when I saw a mother otter with her cubs. A very endearing sight, I’m sure you will agree, and even as I watched, the mother otter dived into the water and came up with a plump salmon, which she subdued and dragged on to a half-submerged log. As she ate it, while of course it was still alive, the body split and I remember to this day the sweet pinkness of its roes as they spilled out, much to the delight of the baby otters who scrambled over themselves to feed on the delicacy. One of nature’s wonders, gentlemen: mother and children dining upon mother and children. And that’s when I first learned about evil. It is built in to the very nature of the universe. Every world spins in pain. If there is any kind of supreme being, I told myself, it is up to all of us to become his moral superior.

The casual cruelty of nature is one example of the absence of a benevolent overseer in the universe. For another, I’d add the fact that Pratchett has been afflicted with a disease with no cure, of a kind that will slowly destroy his mind. We’re left with only two alternatives: that if there is a god, he’s insane or evil and rules the world with wanton whimsy; or the most likely answer, that there is no such being and it’s simple chance that leads to these daily haphazard catastrophes.

That’s so depressing. Here, cheer up, it’s the holiday season — go read Hogfather(amzn/b&n/abe/pwll). You own a copy, right? If not, buy it — the money will go to a good man who has just donated a million dollars to Alzheimer’s research.