latecomers were still finding seats and many of the audience were looking around them to see which faces they recognized.
To a scattering of polite applause, the man in the brown suit was introduced as Professor Alaric Churchward. Gaunt and pale, but well in control, Churchward surveyed the audience with pinpoint blue eyes for a few seconds before opening with an attention-grabbing statement. Some four million Americans, he said, could no longer remember the names of their friends and families. They couldn't put names to everyday objects, such as chairs and tables. They were sufferers from Alzheimer's disease and they included people who had held highly responsible and demanding jobs. The roll of victims of Alzheimer's was as impressive as it was distressing, including the actress Rita Hayworth, film director Otto Preminger, mystery writer Ross Macdonald and artist Norman Rockwell. The cause was unknown; it was likely that a number of different areas of the brain contributed to the symptoms. Research scientists the world over had been working intensively for the last fifteen years to find a successful treatment.
He summarized the main targets of the research in a way that signaled something new and revolutionary, describing how the bulk of the work had concentrated on finding ways of increasing supplies of the brain chemical acetylcholine, which has a vital and mysterious process in the functioning of the memory. The brain's supply of this chemical was known to diminish rapidly with the onset of Alzheimer's.
Churchward went on to say that his own approach (and now more pens came out in the audience and tape recorders were switched on) was different because it was directed toward the nerve cells themselves. For twelve years, teams of scientists under his direction based in America, Europe and Asia had made animal studies to test the effectiveness of certain compounds as protective agents that could delay, or even prevent, nerve cell death. In the last eight years their work had been concentrated on a compound known as Prodermolate, or PDM3, that had proved to be something more than a protective agent
Alaric Churchward was quite a showman. Having got to his product, he kept everyone in suspense by introducing film footage of some Alzheimer's patients he had tested five years previously, prior to the administration of PDM3.
The bemused people who were shown on the screen being asked which month it was and when they were born and who was the current president of the United States were not exclusively the elderly that Peter Diamond associated with the illness. There was a woman of forty-seven and a man of fifty-two, although the others were over sixty-five. The spectacle of people of intelligent appearance puzzling over quite basic facts was profoundly disturbing, particularly a couple of men who demanded angrily to be told who they were and where they came from.
'I guess this is the 'before,' ' Eastland commented to Diamond.
'Is it? I don't mink I… Oh-I see what you mean.' In his concentration on the film, he must himself have sounded mentally lacking. These pathetic people moved him more than he had expected. Progressive loss of memory was a deep-seated fear of his own, and he had no difficulty in identifying with their distress.
After the lights were turned up, the professor talked at length about PDM3, a technical briefing couched in scientific terminology that Diamond found increasingly difficult to follow. His attention drifted back to the poignant images of the Alzheimer's patients.
Then the room was darkened for another sequence of film, the 'after' interviews. Introducing them, Churchward explained that some of the volunteers (as he insisted on calling them, rather than patients, or subjects) had been administered with PDM3, and some, as a control, with a placebo.
The film was eloquent. The effects on those who had been given the drug were striking. Not only did they answer the questions they had found so baffling before, but they went on to give unsolicited accounts of the improvements in their lives. They could dress themselves, go for walks, use shops, write letters. In the standard word test, they had averaged a seven-point improvement. The results contrasted cruelly with the steady deterioration of the group who had taken the placebo. For Diamond, cynical as he felt about the sales pitch, it was difficult to remain detached, difficult not to wish that every one of those sad, benighted people had been given the drug.
In a neat
David Flexner stepped up to play his part as Chairman. He invited questions.
A bearded man near the front made the point that certain drugs patented by other pharmaceutical companies had appeared to produce remarkable improvements in Alzheimer's patients, but the effects had proved only temporary. In two years, the deterioration had set in again. Was there any real possibility, he asked, that PDM3 could sustain the improvement?
Churchward answered the question so smoothly that it might have been seeded before the conference, and perhaps it had been. 'Of course I'm aware of the products you're referring to, sir, and I agree that they have disappointed as long-term remedies. There are six drugs to my knowledge that have been undergoing tests intended to give a boost to the cholenergic system that produces acetylcholine. It is beyond dispute that a certain amount of success has been achieved. Unfortunately, as you just implied, the duration is severely limited. The reason-and this is a personal opinion-would appear to be that the nerve cells that produce the acetylcholine continue to die. Our own approach, with PDM3, is quite different, for we are actually regenerating those cells. Our experiments in Indiana and at our other centers in Tokyo and London have been running for seven years, and no significant deterioration has been observed. Clearly the patients get older-let's not forget that we are dealing mainly with geriatrics-but our tests and interviews are consistently encouraging. There is, of course, documentary backup that some of my colleagues will present this afternoon. Next question.'
A woman to the right of Diamond asked if any adverse drug reactions to PDM3 had been reported.
'Remarkably few,' Churchward told her. 'Every drug produces some unwanted reactions, but in this case they are negligible. The majority of volunteers reported no untoward effects.'
'Maybe they forgot,' Diamond muttered to Eastland in a facetious aside. He was becoming irritated by the smoothness of Churchward's presentation.
'Fewer than twenty percent of our volunteers reported mild dizziness, but this is notoriously difficult to assess, and was of short duration,' Churchward added. 'Five percent of those taking the placebo also reported dizziness. It isn't perceived as a serious problem.'
Diamond leaned closer to Eastland and told him in a low voice that he was going out to make a phone call. It may have sounded remarkably like a smoker's excuse for a quick drag outside the room, but it was genuine. He was in the seat closest to the aisle, so he was able to move out without disturbing anyone.
When he returned ten minutes later, the question and answer session was still in progress. Someone asked if PDM3 could be described as a 'smart drug.'
'That's not a term a serious biochemist would use, madam,' Churchward answered, 'but I know what you're referring to, and you have touched on a matter of real significance. It's estimated that up to 100,000 healthy Americans take drugs daily in the expectation of increasing their mental capacity. Call them cognitive enhancers or smart drugs, the point is that their effects are as yet unproven. I read somewhere that as many as 160 cognitive enhancers are under development, many of them being vasodilators. Do you know what I mean by that? A vasodilator has the effect of widening the blood vessels, thus increasing the supply of blood to the brain. However, if your blood supply is normal, there's no evidence that vasodilators will make you any smarter. I have yet to be convinced that any of the so-called smart drugs are effective. And yet…'
The professor paused, smiled slightly, and then leaned forward like a preacher, with one finger raised to focus the attention of his listeners. He need not have troubled, for they were totally attentive. '… PDM3 raises exciting possibilities. This afternoon, I shall give you details of a limited experiment that we undertook with a group of student volunteers. It's well known that certain highly intelligent people have poor memories. We administered PDM3 to twenty undergraduates from the University of Corydon in Indianapolis. Three of them were consistently below average scorers on memory tests and there is no question that the drug produced a marked improvement in their mental performance. We're not talking about forgetful elderly people here. This is something else. And now…' Churchward folded his arms and kept everyone in suspense for a moment. '… I want to take it a stage further. In Phase Three of our tests, I propose to examine in a wide-scale test the ability of this remarkable drug to regenerate and prolong the mental capacities of normal people. If our prehminary findings are right, the implications;-for individuals, for society, as a whole, for the economy, for the welfare of our nation, the progress of mankind, are
