Young man seeking to solve an age old disease

By Brian Goslow

Max Wallack, 17, has chosen a career path inspired by his great-grandmother.

While others his age were working in summer jobs or preparing for their senior year of high school, Wallack of Natick, adorned in a white lab coat, was retrieving refrigerated test materials at the Boston University School of Medicine’s Molecular Psychiatry and Aging Laboratory.

“I’m just starting a test block for the presence of proteins in samples,” explained Wallack, who is about to begin his junior year in BU’s College of Arts and Sciences. A Department of Pharmacology and Experimental Therapeutics research intern at Boston University’s Alzheimer’s Disease Center, he’s working on a project to observe any correlations between the Alzheimer’s biomarkers in the brain and in the blood.

Wallack’s always been a fast learner, having started grade 1 at the age of 5. After attending grade 4 at a private school, he jumped a year, moving to grade 6 at the Advanced Math and Science Academy in Marlborough, and when he entered grade 10, he transferred to Boston University Academy. “As a junior and senior at BU Academy, I took most of my classes at BU, so that by the time I entered BU officially, I had sufficient credits to be a second semester sophomore,” he said.

His interest in finding a cure for — and assisting those affected by — Alzheimer’s disease and other dementias began when he first started to notice the condition affecting his beloved great-grandmother, Gertrude Finkelstein (AKA “Getgrams”).

“She would do everything for me and she was an amazing person,” Wallack remembered fondly. “When I was around 4, I started noticing she got increased paranoia. And when I was 6, she was diagnosed with Alzheimer’s.”

Suddenly, their roles changed, going from parent and child to brother and sister as Finkelstein and her husband moved in with Wallack’s parents. “There were a lot of times my parents had to go out of the house,” he said, “and they would leave me with her. They would tell her, ‘You’re going to be babysitting Max’ and then they pulled me aside right before they left, and they’d say, ‘You’re going to be babysitting Getgrams.’ ”

As her dementia worsened, family members would sleep on the floor outside Finkelstein’s room to prevent her from leaving the house. Wallack’s parents educated him on what was going on with his great-grandmother so he could assist with her care.

“There are a lot of parents that don’t want to expose their child to the horrible aspects of the disease,” he said, “but I lived with her full-time so I saw everything. I was always asking questions and my parents were always willing to answer them for me so that (looking after her) was something I was able to really help with.”

Finkelstein spent her final months in a nursing home and hospitals, where Wallack made an invaluable observation in residents and patients doing jigsaw puzzles.

“They seemed calm and less agitated with some sense of achievement,” he said, noting many Alzheimer’s and dementia sufferers are also depressed and don’t feel that anything they do is worthwhile. Completing a puzzle gives them the feeling that they accomplished something. “It really makes them happy and fills them with a sense of pride. Even if they can’t remember they did a puzzle five minutes later, the sense of achievement still stays with them.”

Thus, at the age of 12, Wallack came up with the idea for Puzzles to Remember. He sent requests to puzzle manufacturers asking them to contribute puzzles to be distributed at local nursing homes and hospital facilities; many positive responses — and puzzles — followed.

As he went around dropping puzzles off and occasionally working on them with some of the residents, Wallack noticed people with later stages of Alzheimer’s couldn’t do complex puzzles. “They need fewer and bigger pieces and most of the puzzles like that, which were available, were Sponge Bob and Dora puzzles,” he said. “Adults with Alzheimer’s are still adults and don’t really want to do Sponge Bob and Dora puzzles.”

He contacted Springbok Puzzles, the first company that responded to his original call for donations, and asked them if they could make adult-themed puzzles for his project, which had become a 501C non-profit organization. “They said, ‘We can and we will get this done.’ And this is what came out of it,” said Wallack, pulling a collection of the puzzles out of a shopping bag.

“Max sold us on the project,” said Katie Saylor, director of marketing for Allied Products, which produces the Springbok Puzzle line. “Springbok president Steve Pack and Max worked closely together to create a special die that would be used to create fewer puzzle pieces. It was a collaborative effort to develop and design the right piece count that Alzheimer’s patients could complete without frustration.”

The Puzzles to Remember puzzles include 12 or 36 pieces with subjects ranging from “Springtime Cardinals” and a “Cobblestone Village” to “Colorful Fruit” and “Candy Galore.”

“The design work for the photographs and illustrations used for these amazing puzzles is created by nationally known photographers and illustrators in partnership with Springbok puzzles,” Saylor said. Such national illustrators as Greg Giordano and Lynn Bywaters have contributed their artist skills in their development. “We always run the images by Max to make sure the subject matter is on target,” said Saylor.

Wallack, Saylor said, brings great insight into the image selection process. “We launched an image that had food on it and he quickly pointed out that some patients might be confused and try to eat the puzzle,” she said. “This was not something that ever crossed our minds.”

Since the project’s inception, Allied Products has distributed over 26,000 of the puzzles. When Wallack first started, he would look up the names of area nursing homes and hospitals and call them or just send them the puzzles. He’s now looking to get them into adult day care centers, veteran facilities and memory–strength-building locations. If people from outside the region contact him about donating puzzles, he goes online and researches the names of places in their immediate area that would be a good fit.

Earlier this summer, Wallack released his first book, Why Did Grandma Put Her Underwear in the Refrigerator? A Book Explaining Alzheimer’s Disease to Children, co-written with Carolyn Given, a local writer.

“Some of the purpose of my book is to show kids that a person who’s affected with Alzheimer’s is still that person they grew up with and loved,” he said. “Even though there can be scary moments, there’s still humor and joy in life and that person’s still there and can be happy.

“For parents to have to explain to their child what that person is going through is really hard but, if you can explain it well, the child can understand and can be better able to help with the person.”

Wallack hopes his book will instill the understanding that no one should get mad at Alzheimer’s sufferers for not remembering something and that even if they speak aggressively, they need to be responded to gently. “If you’re calmer, they’ll be calmer,” Wallack said. “If you’re agitated, they’re going to get even more agitated and it’s going to be a downward spiral.”

He hopes his book will show people that enduring Alzheimer’s is not an entirely bleak process but one with memorable shared loving moments and that it will help pique some children’s interest and maybe encourage them to consider a career in geriatrics.

Wallack is working toward becoming a geriatric psychiatrist and plans to go to medical school upon graduation from Boston University, where he’s a member of the Class of ’15, and perhaps on to earning a Ph.D. afterwards. He wants to continue to do research as well as develop programs that would be helpful to caregivers.

“This is a really important disease to combat and to combat on multiple fronts. Having people who know about it and who are able to support people who are going through it is a really important thing to do,” Wallack said.

“In the next 50 years, it’s only going to grow,” he said, noting that Alzheimer’s is one of the leading causes of death for Americans and its prevalence is predicted to increase because there is no good treatment or cure and the population is getting older.

With reports finding there isn’t a huge influx of medical students moving into geriatrics, having a person like Wallack as an example for young students could be invaluable in attracting new interest in the field.

“It is very important to have Max’s generation care about Alzheimer’s research because they are energetic, creative and innovative,” said Dr. Wendy Qui, an associate professor of Psychiatry and Pharmacology & Experimental Therapeutics at BU and Wallack’s principal investigator and mentor. “We probably will have a long battle to fight on the disease.”

Asked how Wallack’s experience with his great-grandmother and his observations on how Alzheimer’s sufferers reacted to doing puzzles are applicable to his clinical work, Qui said, “Any brain exercise like puzzles will be beneficial to the patients before we can find effective drugs (for treating them).”

While Wallack said he has talked with his teenage counterparts about following in his footsteps, he has found that most of them are passionate about other things. “The field needs more people who are passionate about this because as long as you’re passionate about something, that’s when the job gets done,” he said. “It needs a lot of people, but it’s better to have passionate people then to have people who don’t really care.”

Qui said Wallack not only brings intelligence and passion to his Alzheimer’s research, but a spirit of caring to the patients he assists and the society at large.

Which is why, along with spending the summer getting word out on his book, continuing work on Puzzles to Remember and spending his weekdays in the lab as part of a team studying cells, doing clinical tests and developing a way to diagnose pre-clinical Alzheimer’s, he’s investigating ways to help caregivers as well.

“It’s a really hard job, but the people who are doing it are amazing people and they need to be recognized and supported,” Wallack said. One idea he feels needs greater acceptance is that of Memory Cafes, which he said are very popular in Europe and becoming more popular in the United States.

“Basically, the patient and the caregiver go and meet with other patients and caregivers,” Wallack explained. “Even though the caregivers are still watching the person, they’re getting time to interact with others and some sense of relaxation and time off, which is really important for caregivers, especially those who cater to Alzheimer’s patients.”

Few know better than Wallack the value of those sometimes brief, but invaluable moments. He balances memories of his great-grandmother battling paranoia, even among her closest family members, to the look in her eye when he’d walk into her room.

“Whenever she saw me, her eyes would light up and she’d always want to play these little games,” he said. “Every time I was there, she was so happy. The rest of the time, she was very paranoid, thinking that everyone was trying to kill her and that everyone was trying to take her money. It was really bad, but there were still times that were very nice and happy.”

One would suspect Finkelstein would be enormously proud of her great-grandson and how passionate he is about devoting his life to doing what he can to help others not suffer the way she did.

“My great-grandmother really exposed me to my calling in life,” Wallack said.