The Island of the Colorblind

John has a low, comfortable house, a little to one side of the main village, sheltered by palms, banana trees, and cycads. He can retreat to his study and immure himself among his books – or, in a minute, be with his friends and patients. He has a new passion, beekeeping; hives, in wooden hutches, stood by the side of the house, and I could hear the murmur of bees as we pulled up.

While John went to make tea, I waited in his study and glanced at his books. I had seen a Gauguin reproduction in the living room above the sofa, and now my eye was instantly caught by seeing Gauguin’s Intimate Journal, wedged between copies of the Annals of Neurology. The juxtaposition was striking: Did John see himself as a neurological Gauguin? There were hundreds of books and leaflets and old prints of Guam, especially relating to the original Spanish occupation – all mixed, higgledy-piggledy, with his neurology books and papers. John returned as I was looking at these, with a large pot of tea and a strange, phosphorescent purple confection.

‘It’s called Ube,’ he said. ‘Very popular here. Made from the local purple yams.’ I had never had an ice cream so mealy, so mashed potato-like, nor one of so extraordinary a color; but it was cool and sweet, and grew on me as I ate it. Now that we were in his library, relaxing over tea and Ube, John started to tell me more of himself. He had spent his formative years in Toronto (indeed we had exchanged letters when he was there, more than twenty years earlier, on the subject of children’s migraines and the visual hallucinations which sometimes accompany them). When John was a resident, in his twenties, he and his colleagues had discovered an important neurological condition (progressive supranuclear palsy, now called Steele-Richardson-Olszewski syndrome). He did further postgraduate work in England and France and a brilliant academic career seemed to be opening for him. But he also felt obscurely conscious of wanting something quite different and had a strong desire to care for patients as a general physician, as his father and grandfather had before him. He taught and practiced in Toronto for another few years, and then in 1972 he moved to the Pacific.

Arthur Grimble, whose book had so excited John, had been a district officer in the Gilbert and Ellice Islands before the First World War, and the picture he gave of life in these islands determined John to go to Micronesia. Had he been able to, he would have gone to the Gilberts, like Grimble – for though these islands had changed their name (to Kiribati), they remained otherwise unchanged, hardly contaminated by commerce or modernization. But there were no medical postings available there, so John went instead to the Marshall Islands, to Majuro. In 1978, he moved to Pohnpei, his first experience of a high volcanic island (and it was here that he learned of the maskun, the hereditary colorblindness among the Pingelapese, several of whom he saw in his practice at this time). Finally, in 1983, having sampled the Marshalls and the Carolines, he went to the Marianas and to Guam. He hoped he might settle here and live the quiet life of a country doctor, an island practitioner, surrounded by community and relationship – though also, at the back of his mind, there was always the riddle of the Guam disease, and the thought that he, perhaps, might be the one to solve it.

He had lived first in noisy, Westernized Agana, but soon felt an overwhelming need to move to Umatac. If he was to work with the Chamorros and their disease, he wished to be among them, surrounded by Chamorro food, Chamorro customs, Chamorro lives. And Umatac was the epicenter of the disease, the place where it had always been most prevalent: the Chamorros sometimes referred to the lytico-bodig as ‘chetnut Humatag,’ the disease of Umatac. Here in this village, within the span of a few hundred acres, the secret of lytico-bodig must lie. And with it, perhaps, the secret of Alzheimer’s disease, Parkinson’s disease, ALS, whose varied characteristics it seemed to bring together. Here in Umatac is the answer, John said, if we can find it: Umatac is the Rosetta Stone of neurodegenerative disease, Umatac is the key to them all.

John had sunk into a sort of reverie as he recounted the story of his wandering, lifelong passion for islands, and his finally coming to Guam, but now he suddenly jumped to his feet, exclaiming, ‘Time to go! Estella and her family are expecting us!’ He seized his black bag, donned a floppy hat, and made for the car. I too had sunk into a sort of trance, but was precipitated out of this by the urgent tone of his voice.