Friday, December 26, 2008

The Algernon-Gordon effect

Who will remember to lay those flowers for Algernon?

The moving science-fiction story of the experiment
that artificially rises the intellectual capacities of
both the underachieving young man named Charlie
Gordon and the laboratory rat Algernon is manifestly
a metaphor of well known degenerative neurological
disorders. In the story, the rat and the human being
are subjected to an experimental surgical treatment
that will drastically increase their mental abilities.

The story is written in the form of a series of diary
entries filled by Charlie Gordon, at first barely able
to read and write, and slowly progressing, as the effects
of the treatment begin to take place, to a sophisticated

The parabola of ascent reaches its peak
when Charlie, having become a scientist himself,
discovers what he labels the "Algernon-Gordon effect",
namely that the enhancement process eventually
reverts, and moreover, that the higher the mental
capacity grew, the faster and the more devastating
the final collapse will be. Upset both by the discovery
and by being treated as a laboratory animal by those
who are now his colleagues and who performed
the original brain altering procedure, Charlie runs
away from the scientific conference that was supposed
to announce the successful experiment to the world,
and escapes together with the rat Algernon, whom
he has grown to consider a friend.

Unable to reconcile his previous and current life,
and aware of the impending reversal of the transformation,
Charlie embarks on a voyage of self discovery. Soon enough
Algernon begins to deteriorate, turning aggressive and
confused, and eventually dies. Charlie also begins his
decline, which constitutes the most interesting and touching
part of the novel.

Charlie's shock at discovering that he is no longer able to read a
paper in German that he quoted in one of his own papers, because
he no longer understand the many languages he was fluent in
at the height of his intellectual peak, is something one can easily
identify with. It resonates deeply with anyone who has seen the
effect of neglecting languages learnt in one's youth and suddenly
discovering one is no longer able to speak them.
There is a deeply felt sense of fear that accompanies
any such event, where one realizes that it is possible to
lose important parts of what we are.

This is the ultimate reason why degenerative neurological
conditions like Alzheimer disease evoke such fear (in a recent
survey most people described this illness as "more frightening
than cancer"): we identify whom we are with what we know
and remember. The loss of cognitive abilities and memory
are perceived by most as one and the same thing as the irreparable
loss of oneself.

In the final stage of the story Charlie Gordon no longer remembers
anything about his experience and shows up, once again illiterate,
at the school for retarded people where he once took classes,
unable to remember that the young woman who had been his
teacher at the school in the beginning of the story, had in the
meantime become his friend and his loved one in the time of his
heightened intellectual capacities. When Charlie is finally confined
to an institution, the last entries in his diary, once again written
in broken language, ask people to remember to bring flowers on
the grave of Algernon. The ascending and descending of linguistic
faculties of Charlie Gordon, evident in the changing style in which
the story is told, are also a good reminder of the fact that
linguistic skills are the other main area after memory that is
affected in patients with Alzheimer, and often a good citerion
for differential diagnosis between Alzheimer and other milder
form of age related memory loss.

Alzheimer's disease currently affects 27 million people worldwide.
The descending parabola of Charlie Gordon is clearly a portrait of
the descent into the progressive and irreversible cognitive impairment
produced by Alzheimer, as many references in the story clearly point
to, from the sudden aggressive behavior exhibited by Algernon
shortly before dying, which is reminiscent of the emotional tantrums
and that people with dementia typically exhibit, to the encounter
of Charlie still in the early stages of his descent with his mother,
who rejected him on the ground of his poor cognitive abilities
as a child, and who is now herself suffering from moderate
dementia, the nearly final stage of Alzheimer disease.

Recent studies on Alzheimer's disease also observed an analog of the
Algernon-Gordon effect at work. Apparently, the more developed
and highly connected one's brain is before the onset of the illness,
which means the more years of educations one had, the more
intellectually challenging a job one did through most of one's life
and the more one kept intellectually active until old age, the more
rapid the decline of cognitive faculties is after the symptoms
of the illness become manifest. What seems to explain this
Algernon-Gordon effect is the fact that, people with higher
intellectual achievements have a higher level of "connectivity" in
the brain, so that the amount of damage to brain tissue has to
accumulate a lot more heavily before the first symptoms of
Alzheimer become visible, since for quite a long time the brain is
still able to compensate and bypass the damaged connections.
At the time when the illness becomes manifest in such people
the damage is already so extensive that the decline from that
point on is much more rapid than it would be in people who
start to exhibit symptoms at an earlier stage.
The other frightening aspect of illnesses like Alzheimer is
the fact that they have a strong genetic component: people
wonder about genetically inherited bombs ticking away in
their brains waiting to go off at the right time.

Charlie Gordon decides to live his descending parabola to
the end. In the "Flowers for Algernon" story, of course, one
main aspect of Alzheimer is missing, the one that links it
to old age. Charlie Gordon goes through his ascending
and descending phases in a relatively short span of time
still during his young age. In real life, for many people with
late onset neurological disorder, the question of how much
of the descending curve they will have to go through before
other age related complications might take over is an
entirely different one. That's where the Algernon-Gordon
effect becomes more difficult to evaluate: is the advantage
of warding off the early symptoms compensating for the
more rapid decline after symptoms appear? Is it in fact
granting people with a more highly functional brain a
longer span of "quality" living? With the global aging of
population in most of the developed world these are
questions with an important range of consequences.
Will anyone still remember to lay those flowers for Algernon?

William Utermohlen’s self-portrait with Alzheimer, 2000.