Before the Valley

In a talk a few years ago, Alan Lightman underscored an important commonality between science and literature: Both the scientist and the artist are seeking truth.

The tests of the scientist's invention are more definitive; no matter how beautiful a scientific theory is, it has a terrible vulnerability - it can be proven false. A writer's characters or story cannot be proven definitively wrong, but they can ring false and thus lose their power with the reader, and in this way, the novelist is constantly testing his fiction against the accumulated life experiences of his readers.

Today's exhibit that relates to Lightman's point? Alzheimer's.  Well, kind of about Lightman's point, as in the scientific and literary approaches to the disease that I have dreaded about ever since my thirties when I read Sherwin Nuland's How We Die.

Big news from the world of medicine regarding Alzheimer's:

The Food and Drug Administration on Monday approved the first new medication for Alzheimer’s disease in nearly two decades, a contentious decision, made despite opposition from the agency’s independent advisory committee and some Alzheimer’s experts who said there was not enough evidence that the drug can help patients.

The drug, aducanumab, which will go by the brand name Aduhelm, is a monthly intravenous infusion intended to slow cognitive decline in people with mild memory and thinking problems. It is the first approved treatment to attack the disease process of Alzheimer’s instead of just addressing dementia symptoms.

But, there is a reason why this is considered a contentious decision: "the amyloid hypothesis, which pinpoints clumps of the toxic protein as the root cause of cognitive impairment, has yet to be proven."  It reinforces Lightman's point that "no matter how beautiful a scientific theory is, it has a terrible vulnerability - it can be proven false."  

Meanwhile, last night I read this fantastic short story that is set in an old age home.  It is a social commentary on aging and dementia that is presented as fiction.  The truth in the novel is consistent with how I understand life.  It is true.  As Lightman said, we believe in the ending in good fiction:

[We] know that it's true even in fiction because it accords with our life experiences, with our understanding of human nature, and it causes us anguish. ... A writer's characters or story cannot be proven definitively wrong, but they can ring false and thus lose their power with the reader, and in this way, the novelist is constantly testing his fiction against the accumulated life experiences of his readers.

We will find out, sooner or later, whether the amyloid hypothesis and the treatment are proven false.  But, the fact remains that if we are lucky enough, we will become old, and some of us will slip into the netherworld of dementia. Novelist force us to think about that, even as scientists work hard to develop drugs to treat the problem.

We need the novelist and the scientist to help us out.