The Body

 

I have been a fan of Bill Bryson for many years now. Starting with "A Short History of Nearly Everything"(2003), I have tried to keep up with his numerous books on popular science that blend hard facts with a wry sense of humour.

"The Body: A Guide for Occupants" is perhaps one of his fattest books. In over 500 pages (excluding the refs and index) it covers not only many parts of the human body but also what happens when things go wrong due to diseases or cancer. 

What fascinated me the most is the number of times he begins a sentence with the phrase "we still don't know", or "It is still a mystery why...".

Take for instance his description of a patient name Frau Deter who approached a psychiatrist complaining of persistent and worsening forgetfulness. She could feel her personality draining away, like sand from an hourglass. The psychiatrist, Alois Alzheimer (1864-1915) now has the disease named after him. Researchers have since figureed out that the Alzheimer's begins with an accumulation of a protein fragment called beta-amyloid in the sufferer's brain. What do these protein fragments do in the normal course? we don't know. Patients also accumulate tangled fibrils of tau proteins about which, once again, we know hardly anything. What we do know is that as these proteins build up in the brain - 

Alzheimer's first demolishes short-term memories, then moves on to all or most other memories, leading to confusion, shortness of temper, loss of inhibition and loss of bodily functions, including how to breathe and swallow...People with the disease die twice - first in the mind, then in the body.

Nobody know why some people get Alzheimer's and others don't. It accounts for 60-70% of all dementia cases, and is thought to affect about 50 million people around the world. Little is known about the remaining 30-40% of dementia cases. We have given some of them unique names and recognise them from typical symptoms but the only thing we know is that is is caused by the "disturbance of neural proteins"! One of them is Lewy Body Dementia which is particularly distressing to loved ones because victims frequently lose inhibitions and the ability to control impulses, so they tend to do embarrassing things - shed clothes in public, steal from supermarkets, etc.,  

BB also has something to say about the limits of "modern medicine". Alzheimer's drugs have a 99.6% failure rate (!), one of the highest in the whole field of pharmacology. At the same time, most  of the money available for research is skewed towards ailments of the rich. There is a whole category of 'neglected tropical diseases' that affect more than a billion people worldwide. One of them, Lymphatic filariasis, affects more than 120 million people. Ditto for leishmaniasis, trachoma and yaws.

Perhaps it takes a kind of mad obsession to tackle diseases of this magnitude, and we owe much of what we know to those who paid with their lives. A German parasitologist, Theodor Bilharz (1825-62) wanted to have a better understanding of a tropical disease called schistosomiasis (akal Bilharzia or Snail Fever), so he bandaged the pupae of cercaria worms to his stomach and took careful notes as they burrowed through this skin en route to invading his liver. He survived this experiment but died at 37 (!) while trying to stop a typhus epidemic in Egypt.

So, as Max Ehrmann says in his Desiderata, "with all its sham, drudgery and broken dreams, it is still a beautiful world!". For the human body, it is still an extraordinary fact that having good and loving relationships alters your DNA...and conversely, not having such relationships doubles your risk of dying from any cause!