The Island of the Colorblind

We had been told that Jesus might pass the whole day with scarcely a word. And yet he spoke well, even volubly, when we engaged him in conversation; though, it soon became apparent, he waited for our questions. He could respond quite readily, but could not initiate a sentence. Nor, it seemed, a movement either – he might sit totally motionless for hours, unless something or someone called him to move. I was again strongly reminded of my post-encephalitic patients and how they were crucially dependent on the initiative of others, calling them to speech or action. I tore a page out of my notebook, balled it up, and threw the balled paper at Jesus. He had been sitting, seemingly incapable of movement, but now his arm shot up in a flash, and he caught the paper ball precisely. One of his little grandsons was standing by, and his eyes widened with astonishment when he saw this. I continued playing ball, and then asked Jesus to throw the ball at his grandson, and then to another child, and another. Soon we had the entire family playing ball, and akinetic Jesus, no longer akinetic, kept it going between us all. The children had not realized that their ‘paralyzed’ grandfather could move by himself at all, much less that he could catch a ball, aim it accurately, bluff, throw it in different styles and directions, and improvise a fast ball game among them.

For his grandchildren it was a discovery, and one, I thought, which might transform his relationship with them – but this calling-into-action was well known to his old friends in the community. Once a week, he would go to the senior center – he would have to be picked up and lifted (‘like a corpse,’ he said) into the car; but once there, and seated at a card table, he could play a fast and hard game of gin rummy. He could not start the play – someone else had to do this – but once the first card was slapped down, he would suddenly come to life, respond, pick up another card, and continue the game. The people of Umatac, Merizo, Dededo, and Santa Rita may have little scientific knowledge of parkinsonism, but they have a great deal of informal knowledge, a folk neurology based on decades of close observation of the bodig in their midst. They know well how to unfreeze or unlock patients if they get frozen, by initiating speech or action for them – this may require another person walking with the patient or the rhythmic pulse of music. They know how patterns on the floor or the ground can help the parkinsonian to organize his walking; how patients scarcely able to walk on a flat surface can negotiate complex obstacles, rough terrain, easily (and indeed, fare oddly well with these); how the mute and motionless parkinsonian can respond beautifully to music, singing and dancing, when speech and motion had previously seemed impossible.

But what was it that had caused the lytico-bodig, what was it that had come and gone? There had been a sort of conceptual vacuum, John said, when the cycad hypothesis had collapsed in the early seventies. The disease continued to claim more Chamorros, and patients were treated, when possible, for their symptoms – but there was a marked lull in research for a while, at least in Guam.

And yet in the seventies there was a discovery of great importance. Two pathologists, Frank Anderson and Leung Chen, performed autopsies on two hundred Chamorros, many of whom had died suddenly in traffic accidents. (Agana had been a small, slow-moving town before the war, and transport was leisurely – usually by carts pulled by the big-horned carabao, along the rutted and frequently flooded roads. But following the war, there was a sudden increase in population, especially American military, who brought along with them fast roads and cars; this caused a sudden rise in traffic fatalities among the Chamorros, who were wholly unused to this rapid pace.) None of these people had ever shown any neurological symptoms; yet seventy percent of those born before 1940 showed clear pathological changes in the nervous system similar to the neurofibrillary tangles which Hirano had found in patients with lytico-bodig. The occurrence of these neurofibrillary tangles fell off sharply in those born in the 1940s, and they were not seen at all in anyone born after 1952. This extraordinary finding suggested that the lytico-bodig might have been almost universal among the Chamorros at one time – even though only a small proportion went on to develop overt neurological symptoms. It suggested, moreover, that the risk of contracting the disease was now very much reduced – and that even though cases continued to occur, these had probably been contracted many years before, and were only now becoming symptomatic. ‘What we are now seeing, Oliver,’ said John, pounding the steering wheel for emphasis, ‘are the late effects of something that happened long ago.’[69]