A PET scan of a brain with Alzheimer's disease. (Gary W. Small )
"Hello Mr. Lopez, I would very much like to meet with you. I think you will find that I have some pertinent things to say."
The email was from Dr. Arthur Rivin, 89, professor emeritus of medicine at UCLA. Rivin said he had been diagnosed in September 2009 with Alzheimer's disease, but then, something rare and amazing had happened. Using a program of therapy he developed himself, he claimed, he was now greatly improved. If I took the time to meet with him and hear all about it, Rivin suggested, together "we will do something big!"
If there's a cure for Alzheimer's, news of the breakthrough somehow eluded me. There are drugs and therapies that can help some patients a bit, but the majority of the 5.4 million Americans with Alzheimer'sand other dementias are sadly destined to get worse rather than better. So I was a little skeptical about Dr. Rivin's claims, and reminded of my own father, whose dementia made him unaware that he had dementia — it was the one merciful aspect of an otherwise horrible disease.
But I was impressed by Dr. Rivin's persistence and his determination to help others deal with the disease. He was a doctor, and quite a respected one at that, advising older patients on the importance of advance healthcare directives before it was commonplace. He had practiced internal medicine but also studied cardiology and was particularly interested in medical ethics.
Dr. Rivin's wife, Fritzi, answered the door at their Pacific Palisades home. She and Dr. Rivin offered a warm greeting and led me into a dining room where Mrs. Rivin had set out plates of poached salmon and summer salad. But Dr. Rivin wanted to first show me his backyard, where he follows the comings and goings of butterflies and birds and tends to a garden on a heavenly precipice overlooking Will Rogers State Park.
When we sat down to talk, Mrs. Rivin said her husband started having speech difficulties a few years ago, after a couple of mini-strokes, or TIAs.
"Transient ischemic attack," Dr. Rivin explained in speech that is still halting and soft.
But Mrs. Rivin suspected the TIAs were only part of the problem. Her husband had also become increasingly impatient, a marked character change, and one that troubled her greatly.
"And little by little," she said, "his memory got worse."
When they took a memory class together at Emeritus College in Santa Monica, Dr. Rivin's problems became sharply evident. For example, Mrs. Rivin said, there'd be a list of words and the task was to find one associated with a holiday. But Dr. Rivin either couldn't understand the instructions or didn't catch the obvious answer — Halloween.
A medical exam confirmed Alzheimer's, and he was put on two drugs, which produced obvious improvement.
"He started remembering things, doing things, and he was almost back to normal," Mrs. Rivin said.
Dr. Rivin conceded that the drugs helped initially, but he is convinced that his own therapy program — not the drugs — has made the biggest difference.
Well, Mrs. Rivin observed in the voice of diplomacy, maybe the advance of Alzheimer's has slowed a bit.
"The problem is solved," insisted Dr. Rivin.
When I asked to learn more about his program, he kept saying everything would be revealed in his home office, and he couldn't wait to finish lunch so he could lay out his case.
The office is a small, carpeted sanctuary off the two-car garage. On the wall is a photo of a younger Dr. Rivin, along with proof that he was a member of Phi Beta Kappa and that he graduated from the University of Nebraska medical school.
When he had my attention, Dr. Rivin laid out several documents for me to look at. One was titled "A Healthy and Happy Life," and it contained the gist of what he has come to believe about fighting back against Alzheimer's.
In essence, his advice is to sleep well, eat smartly, exercise regularly, socialize, consider your neighbor and the world around you, celebrate nature, do some gardening, read, watch educational programs on TV, challenge your intellect and stay as active as you possibly can.
Dr. Rivin has also assembled a guide, complete with illustrations, to his recommended exercises. He demonstrated one, taking me to the kitchen, where he leaned against the counter and rocked from toes to heels, then slowly raised his arms in a yoga-like maneuver while snapping his fingers.
In his office, he files things in binders with headings such as "Thinking About Many Things" and "Big Things to Ponder." For his 65th wedding anniversary in 2010, Dr. Rivin wrote this for family members:
"In my senior year I meet my wife. She is very pretty, fun loving, a smart and sweet girl. I was smitten. I still am."
Dr. Rivin also showed me a copy of the program for his parents' 60th anniversary, in 1978. Together, Dr. Rivin and I sang the chorus of the first song in the program. He had a smile on his face the whole time, and he sang with perfect pitch.