Ian McEwan and HD

I saw a review in European Neurology about a popular novelist who has written about Huntington's disease. Ian McEwan is a Booker Prize-winning author who wrote a book three years ago called Saturday that contains a character with Huntington's disease.

This is from the review:

Saturday is a novel about a single day in the life of neurosurgeon Henry Perowne. The setting is pessimistic, in post 9/11 London, with crowds massing to protest against impending war in Iraq. On his way to a squash game a minor car accident brings Perowne into a confrontation with a local thug, Baxter.

Perowne notices Baxter’s gait: ‘His gait is distinctive, with a little jazzy twist and dip of his trunk, as though he is punting along a gentle stretch of river’, and his restlessness: ‘He is a fidgety, small-faced young man.’ Perowne is more and more certain about Baxter’s disease:

'It isn’t simply a tremor, it’s a fidgety restlessness implicating practically every muscle… As Baxter stares at the marchers, he makes tiny movements with his head, little nods and shakes. Perowne suddenly understands – Baxter is unable to initiate or make saccades, those flickering changes of eye position from one fixation to another. To scan the crowd, he is having to move his head.'

Interpreting fidgety as chorea and noticing head thrust eye movements Perowne is certain that Baxter suffers from Huntington’s disease. In the lines that follow McEwan gives a literary description of Huntington’s disease:

'If a parent has it, you have a fifty-fifty chance of going down too. Chromosome four. The misfortune lies within a single gene, in an excessive repeat of single sequence – CAG. Here’s biological determinism in its purest form. More than forty repeats of that one little codon, and you’re doomed. Your future is fixed and easily foretold. The longer the repeat, the earlier and more severe the onset.'

This isn't the first reference to HD in the arts, of course. Wikipedia mentions Jacqueline Susanne's 1966 novel Valley of the Dolls (1966), Arlo Guthrie's 1969 film Alice's Restaurant (which has Arlo Guthrie in one scene facing his father, Woody Guthrie, who died of the disease), and a host of more recent television mentions (ER, Private Practice, Everwood, All Saints, and House). I'm also aware of (and have seen) a rather regrettable scene from Baywatch featuring a suicidal character at risk for HD.

I think I'll have to give Saturday a read!