- Forgotten: Narratives of Age-Related Dementia and Alzheimer's Disease in Canada by Marlene Goldman
In Forgotten: Narratives of Age-Related Dementia and Alzheimer's Disease in Canada, Marlene Goldman explores the history and representation of dementia across the disciplines, from early case studies that led to the postulation that Alzheimer's was an illness separate from senile dementia to Canadian literary texts that explore stories of Alzheimer's and present alternative models for understanding dementia, personhood, and vulnerability. Drawing on Susan Sontag's insight that illness can function as a social metaphor, Goldman investigates reasons why research and writing on Alzheimer's often present this condition in apocalyptic terms, even spilling into the realm of the Gothic, a moralized universe in which dementia is equated with fears about aging and the loss of identity.
Goldman's ambitious study contributes to the cultural history of Alzheimer's and dementia, particularly in a Canadian context. It offers an extensive examination of historical theories of cognitive decline as well as relevant archival material from institutions such as the nineteenth-century asylum. Goldman's attention to historical detail complicates present-day received wisdom about Alzheimer's. Chapter one, "A Forgotten History: The Late-Nineteenth and Early Twentieth-Century Construction of the Disease Concept," traces the history of Alois Alzheimer's work with his client, Auguste A., whose case records were rediscovered in Germany in 1977. Goldman notes, for instance, that both Alois Alzheimer and Gaetano Perusini resisted Emil Kraepelin's contention that Alzheimer's was a new disease, distinct from that of later onset dementia. Her analysis also uncovers historical ironies in Kraepelin's proposed treatments for dementia, stemming from prevailing views of the female body, in which dementia intersects with hysteria.
Goldman contends that current popular fears regarding dementia may be better understood and critiqued when seen as reflecting long-standing myths about demographic threats posed by an aging population. Rather than being a fixed Gothic formulation with no way out, such perceptions ebb and flow in time, as Goldman demonstrates through her nineteenth-century case studies. She observes a similar complexity in her investigation of perceptions of aging and dementia in nineteenth-century Canadian journalism. In this material, Goldman identifies two narrative stances towards dementia. One is primarily elegiac, with its origins in a religious acceptance of dementia and aging; the other comprises emerging scientific or biomedical discourse, in which one finds a particular kind of narrative of decline. In this context, Goldman offers a novel reading of various Canadian literary texts that touch on dementia, from Stephen Leacock's Sunshine Sketches of a Little Town (1912) to Alice Munro's "The Peace of Utrecht" (1974) and Margaret Laurence's The Stone Angel (1964), which she sees as alternating between the Gothic and elegiac in attitudes to aging. [End Page 212]
The prime question for Goldman becomes why does a particular apocalyptic mode of viewing dementia come to dominate present-day perceptions, when competing models have long existed in popular representations. Goldman offers one answer – namely, a narrowing in the cultural understanding of dementia, such that a disease model comes to prevail. In the chapter "From Psychological and Stress-Based Theories of Dementia to the Triumph of the Biomedical Paradigm," Goldman explores the medical history of approaches to dementia. Distinguished early Canadian-based researchers Hans Selye, David Rothschild, and V.A. Kral, as well as British researchers J.A.N. Corsellis and Martin Roth, are some of the figures who Goldman considers in this fascinating survey of work leading to neuroscientist Robert Katzman's breakthrough contention that early onset dementia and senile dementia represent the same disease process.
While individual chapters in Forgotten offer unique contributions to gerontology, the history of medicine, and cultural studies, Goldman also interleaves readings of Canadian literary texts within this socio-cultural history. Literary chapters connect phenomena like the de-institutionalization of individuals with mental health issues in the 1960s with works like Alice Munro's "Powers" (2004). In another chapter, Goldman outlines the history of the formation...