My first semester at Rollins College I took a required introduction to the liberal arts class. Through various readings, films, music, and art we spent the semester exploring the topic of "freedom." It was the first time I had taken a really deep dive into what on the surface looks like a simple topic. The first evening the professor said, "if you really think you are free, try walking down Park Avenue in the nude." Not for the first time, I have to say the most important thing I learned at Rollins was how to learn, to cultivate curiosity and take a deep dive into issues or topics. My time there changed me as a person.
Over the years I have read thousands of books. For several months one year I took a deep dive into the differences between being alone and loneliness. So much so that the clerks at Park Avenue Books started suggesting new books, based on what I had bought before. (Sadly they lost their lease and faded out of existence in the late 1990s.) I read cookbooks, like others read romance novels. I own a couple hundred of them. When I see an ingredient, I most often know what it is, and how to cook with it.
Lately I am taking a deep dive into biomarkers and Alzheimer's disease. 25 years ago, I asked a medical school professor how to determine if someone had Alzheimer's. His answer was "we don't while they are still alive, a definitive diagnosis requires a brain biopsy and the risk of doing on a live patient is not worth the risk, especially when we have no effective treatment." Today the answer is, we start by screening for elevated proteins in the blood, if we find them, we do a PET scan to look for plaques and tangles in the brain. That along with a clinical evaluation showing a marked decline in memory and cognitive function and we can get a reliable diagnosis. The blood tests for abnormal proteins are the latest addition. And a clear diagnosis is becoming more and more important. Clinical trials are showing effectiveness for therapies to slow or stop the growth of those proteins that either cause the formation of plaques and tangles or are produced by the plaques and tangles. And there are trials showing that new therapies are effective and reducing plaques and tangles in brain tissue (though it is not clear if this stops the progression or reverses the damage that has been done.) Blood tests for biomarkers of these proteins are essential for this research. There is more than a glimmer of hope for treatment, and possibly prevention in the future. Two of my four grandparents died living with dementia. This is personal, and professional.
I have been asked to draft policy encouraging extending medical privacy laws to prevent discrimination based on the biomarker test results. Diagnosis relies on multiple factors, a clinical evaluation showing a marked decline in cognitive ability, plus evidence of plaques and tangles in brain tissue, and elevated protein levels. If is possible to have elevated proteins, and even the presence of plaques and tangles in brain tissue, and not show a significant decline in cognitive ability. These tests are not like x rays of a bone to see if it is broken. The risk of discrimination based on the results leads to a reluctance to consent to the tests. Even more important into the future, the blood test could be an early warning sign, leading to therapies that could stop Alzheimer's in its tracks before it damages cognitive ability.
And here I go. That intellectual curiosity that was ignited in college classroom all those decades ago, is leading me to a deep dive into yet another topic.
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