Review by Booklist Review
In this thoroughly engaging, remarkably well-written history of Alzheimer's research, journalist Smith takes readers into the lives of the medical professionals, geneticists, and families who sought a cure for early-onset Alzheimer's disease in Colombia. Largely focusing on the period from 1980 to the present, she details the alarming number of patients stricken with the disease in several rural areas, typically suffering initial symptoms in their late thirties and early forties. Doctors and nurses develop relationships, craft painstaking genealogical trees going back centuries, and, in the midst of Colombia's violent drug-war era, build a dedicated program that draws the attention of American scientists and pharmaceutical companies along with their valuable research dollars. Smith's own immersion in this environment is a key part of the narrative, as she established friendships, witnessed autopsies, attended conferences, and noted ways big and small in which hundreds of millions of dollars were spent while finding only the smallest of benefits to the families at the center of the research. The hunt for a cure continues, but the value of this title cannot be overstated. Intelligent, empathetic, and outstanding in its observational detail, Valley of Forgetting is a work celebrating medical research crafted by a writer of extraordinary talent.
From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review
In this powerful report, journalist Smith (Stolen World) details neurologist Francisco Lopera Restrepo's quest to understand the epidemic of early-onset dementia afflicting families in the rural Antioquia region of Colombia. Smith recounts the herculean efforts of Lopera and his team, who began gathering family genealogies and blood samples against the backdrop of the 1980s Medellín drug wars in the hope of "unlocking the disease's secrets." In addition to dodging cartel members, the doctors had to win the trust of afflicted families and counter local beliefs that witchcraft was to blame. The author documents how over the ensuing decades, Lopera helped identify a genetic mutation responsible for the epidemic, compiled a registry of some 6,000 carriers in Antioquia, and conducted a major clinical trial of a potential dementia treatment, though the drug was found to be ineffective. Smith offers an accessible overview of how genetic factors contribute to dementia, but the real draw is the finely observed portrait of Lopera and the heart-rending stories of young Antioquians left to care for dying parents and siblings, whose mental declines start as early as their mid-30s, while grappling with the fear that they might also carry the mutation. It's a poignant depiction of a community in crisis. Agent: Lynn Johnston, Lynn Johnston Literary. (Apr.)
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Review by Kirkus Book Review
The quest for a cure for Alzheimer's in a perhaps unlikely venue. Gabriel García Márquez's novelOne Hundred Years of Solitude detailed a number of genetic consequences of isolation, with hinterland families manifesting odd physical characteristics. The same isolation, Colombian researchers hypothesize, accounts for the pronounced presence of hereditary dementia there. As science writer Smith observes, there was the possibility that the Colombian countryside harbored "many potential triggers of dementia, including chemicals used in mining and agriculture." Yet the fact that so many families had members with early-onset dementia, often setting in before age 50 and even younger, suggested a genetic cause--and one early discovery was that "every sick person had had a sick parent." In a time of civil war and narco kings, medical research in Colombia was a fraught proposition, with investigators including one hero of the piece, a doctor named Francisco Lopera Restrepo, taking shelter abroad for a time as colleagues and students were kidnapped and murdered. When things calmed down, foreign scientists arrived to study the phenomenon alongside homegrown researchers, isolating genes and eventually helping establish clear patterns of inheritance--and, interestingly, also accumulating proof that trauma of some sort often proved a trigger in setting off a patient's decline. Frustratingly, drugs used in extensive trials did not prove efficacious at first, though Big Pharma kept an eye open for the possibilities of a market in Colombia, "a common, and frequently criticized, practice among pharmaceutical firms working in the developing world: testing expensive therapies in poor populations, then passing the costs on to strapped healthcare systems." The quest continues: As Smith writes in closing, the Colombian institute called Neurociencias has been an important pioneer in identifying numerous genetic mutations that may in time yield keys to treatment. Solid medical reportage with a hopeful conclusion that science may soon bring a cure for a devastating disease. Copyright (c) Kirkus Reviews, used with permission.
Copyright (c) Kirkus Reviews, used with permission.
