Saturday, October 6, 2007

Holding On

Human relationships are a curious thing. We find ourselves caught up in a web of interactions, sometimes with no idea of how we came to be there. Our convictions are strong, but sometimes for no logically justifiable reason. The decisions we finally make are products of an innumerable confluence of forces that we call the mind. The only thing that allows a brain within a body to become a true person is memory.
It is easy to see, then, why any damage to the fragile structure of memory is immediately recognizable to a family member or a loved one as an upheaval. When someone you love loses their memory, or a part of it, so suddenly, there is no longer any rational way to view the world. There are only coping mechanisms.
Jonathan, in The Missing World, feels that somehow the erasure of Hazel’s most recent three years will mean a fresh start. Jonathan wants to time-travel in a very literal sense, but he is only ever traveling with himself and Hazel. And, as Hazel put it before her accident, “There are things you can’t apologise for. They change who you are, and you can’t change back.”
After reading the fifth chapter of LeDoux’s synaptic self, I’m inclined to agree with her. So much of who we become is subconscious, a result of implicit functions. There are so many subtle facets to memory that change people in ways they aren’t even aware of. We are always aware of declarative memory, by its very nature. But nondeclarative memory gives us our smile, our laugh, and our mannerisms. Neither Jonathan, nor even Hazel, can become the same person they were three years ago. Life moves on and there are no fresh starts.
Still there is a pull toward clinging to the familiar. I sensed a great deal of this in Floyd Skloot’s writing. He seems relatively comfortable with the man he has become today—thinking of his math as “having an accent”—but his reflections of his first experiences immediately following his contraction of the virus are much more desperate. For instance, he wants to relearn as much as he can about history as quickly as he can. He tells us that, for him, “Gaps exist in the historical record. Surrounding myself with reference books helps to fill them, and so does reading, but I am apt to forget what I have learned that way.”
But Skloot finds in Beverly a companion with whom he can share his rebirth. She says that she loves who he is now even better than who he was before. This is a very healthy way of viewing things, much in contrast to Jonathan’s attitude. But we all try to find ways to adapt that will make sense in our shaky construct of a world, and surely this is understandable. For were we to completely let go of all that we know, we might lose ourselves just as much as Skloot or Hazel.

The Seven Thousand Sins of Memory

It’s convenient that Dan Schacter put labels on the failure of memory—transience, absent mindedness, blocking, misattribution, suggestibility, bias and persistence—but we have learned that nothing with the brain is ever as clear cut as that. Everything is twined together, memory, a convoluted mass of infinite possible failures, rather than just those seven.

The brain has various areas that contribute to memory, but the separate parts work as teammates. It is completely understandable that H.M. lost his ability to form new memories after a part of his brain was removed to relieve him of his epileptic fits. The LeDoux reading explored the scientific part of memory loss, explaining how scientists would tweak the brain to provoke memory failure in animals (was I the only one saddened at the thought of the animals having their brain functions stolen from them?). It made me wonder about memory versus learning. Some things we know are innate and others are escorted by memory to be processed, like learning preference of taste and being conditioned. But how much of learning has to do with our memory? And concerning, let’s say, schoolwork, where does memorizing information transfer into having the information be learned? It’s like no matter how far our research and data advances, we would still never know enough about how our brains work.

“In the Shadow of Memory” and “The Missing World” dealt with the much more humanistic side of injury/disease/illness and helplessness of memory loss. Floyd Skloot can find the humor in his predicament and on occasion, use it to his advantage (he’s a writer and his word substitutions are really quite poetic) but I suppose he would have to be after such a long time. I was only two days old when his brain infection set in and began to morph his life, so I keep trying to fathom the length of my life being the length of readjustment to his memory loss and it seems impossible. Despite living the healthiest life he could, (he ran like five miles a day without any problems!) he still was affected by some unexpected variable, which reinstates how frightening life can be; things just come at you without warning. He transformed completely, not necessarily for better or worse (although I find it incredibly interesting that his wife likes the newer version of her husband), but it’s like having a second life. He became slower-paced, calmer, more relaxed, and extraordinarily sensitive— completely opposite of his first self.

Credit this to Elizabeth, but isn’t it ironic that “In the Shadow of Memory” is a memoir by someone that lost his memory? It’s interesting to read his rich language and try to decipher what is reality and what seems like fantasy or a product of his own failure to reproduce memories. Also, it is really comforting to finally see the personal side of these horror stories because Luria and Sacks focused mostly on the patient-doctor clinical version of brain dysfunctions. Hazel in “The Missing World” barely seems affected (due to her lack of awareness) in comparison to how the lives of her friends and family have been drastically altered. I will admit, I felt the way Matt did at first, trying to sift through the narratives for concrete facts because I had grown accustomed to the style that Luria and Sacks executed stories in. But I finally relaxed and took a backseat to witness the seven thousand sins of memory, because so much more than one person or life is at stake when it comes to living after an “insult”.

The loss of Memory

The Shadow of Memory, by Floyd Skloot, is a beautifully written memoir about his life after dementia. After first being struck with brain damage in 1988, Skloot writes smoothly and eloquently about the hardships and the newfound advantages of his new life. It is amazing that Skloot was able to write such a book, considering all the things that prohibit him from leading a so-called "normal" life. Although Skloot's IQ dropped considerably and he was impaired in logical thinking, he describes a new found emotional freedom, which I found fascinating. "It was apparent in small, everyday experiences that had never touched me deeply before, such as being moved to tears by seeing an outfielder make a diving catch, hearing the opening melody of Max Bruch's "Kol Nidre" etc..." Skloot describes how his love for his wife deepend, his connection with his daughter grew, and how he was finally able to face his brother's advancing terminal illness. He writes: "love and passion entered my life for the first time in decades".
An interesting connection that I found in Skloot and in Sach’s account of the colorblind painter was that both Skloot and Mr. I, adapted and found a new kind of lightness of being through their disability. Skloot writes: “I have changed. I have learned to live and live richly as I am now. Slowed down, softer, more heedful of all that I see and hear and feel, more removed from the hubbub, more internal”. When Skloot ponders the idea of returning to how he once was, there is a similar fear within him that correlates to the other readings. I think that when you have learned to live with a “new” form of yourself, the idea of returning to your old self is a frightening and unsettling thought.
In both Skloot’s memoir and in the chapter by LeDoux it is clear that memories are not controlled by one specific region in the brain, but that the whole system functions together. Skloot describes how his eyesight, hearing, smell, and speech mechanisms are all in place, but that it is “putting things together” that is the real challenge. It is obvious that both H.M and Skloot's hyppocampus are impaired and similarly can practice tasks and get better at them but cannot necessarily remeber doing them. For example when H.M. learns to copy a picture of a star, he learns how to do it and "retained the learning", but when asked about the drawing he has no recollection of ever doing it. Skloot, is also liable to forget things he has just thought or just read. It is tragic and horrible, because one feels that Skloot is able to reflect and ponder his illness but has no control over it. Without memory, our whole world as we know it becomes vague and dreamlike. The frustration and the fear of not knowing if you are supposed to remember someone or something. Even my memory is impaired sometimes, and it is embarrasing when I meet someone who knows me and I cannot remember their face or name. To constantly be living in doubt of yourself is a very scarry thought. All the readings we have studying, make me feel so blessed to be in a sound and coherent state of being.

Friday, October 5, 2007


I saw some connections between the Livesey novel and the other readings, but I found that Skloot and LeDoux seemed to relate more to each other. In terms of Livesey, the most obvious connection is LeDoux's explanation of retrograde amnesia (which Hazel suffers from) and antegrade amnesia (which Skloot suffers from). I noticed that when Jonathan is trying to "adjust Hazel's memories," this relates to the suggestibility of memory as described in the end of the LeDoux chapter. There were also a lot of references to implicit memory, like when Hazel doesn't consciously remember the Indian food she likes, but when she tastes it, she remembers that she likes it. Is this a transition from implicit to conscious memory? Also, the fact that Hazel didn't remember her parents but certainly warm feelings for them seemed to be a feature of her implicit memory. Another connection between Livesey and some older readings is Charlotte's confabulation. I couldn't tell if she was consciously lying to better herself or if she actually began to believe some of her lies. Anyway, I just wanted to mention this briefly, but what I really want to discuss is the Skloot and LeDoux readings in relation to each other.

I think that the Skloot reading helps humanize people with "insults to the brain," as he might put it. The LeDoux chapter fits in nicely, serving as a resource to help better understand the biological explanations behind the seemingly bizarre behavior of people with brain damage, which might help outsiders to become more tolerant.

Skloot speaks of feeling vulnerable, embarrassed, and out of control. He gives striking examples of how people fear, villify, and mock that which they don't understand.I'm not sure that most people would realize that someone with severe brain damage could retain this kind of self awareness. I feel like the common perception of someone with brain damage is usually the opposite: that when they are lost in thought, like Skloot "staring into space... with [his] jaw drooping," they are unaware of their own actions. But both Skloot and LeDoux demonstrate that this is not the case. I feel so pained reading about the guilt and shame that Skloot experiences, because this happened at no fault of his own. I think that by writing his story and making people aware of his struggle, he will help develop an understanding and empathy in people. There are so many more variations of brain damage than I ever realized, and LeDoux does a good job of explaining how interconnected and yet separate implicit and explicit memories are.

Something that comes up in both Skloot and LeDoux is the idea that memories are not controlled by one specific part of your brain but actually depend on whole systems and circuits to function. Therefore, damage to a certain area might affect many different brain functions in subtle ways. LeDoux mentions how these systems are not even necessarily designed to remember things, but instead for other specific functions, and memory is just a side effect, in a way. Skloot describes how each of his senses work well on their own but fail "in putting things together." I wonder if his convergence zones in the rhinal areas are damaged, making it impossible to integrate his experiences into a unified representation, or if this is something different.

I saw some connections between H.M. in the LeDoux reading and Skloot, especially when LeDoux describes how H.M. was able to learn a task, "and he retained the learning. But if asked about the drawing, he had no conscious memory of having made it." LeDoux refers to this as priming, which uses implicit memory and does not depend on the hippocampus, which may be damaged in Skloot's brain. Skloot says that he has "gotten more adept at tying [his] shoes, taking a shower, driving for short periods." Is this because it is stored in his implicit memory? His explicit memory seems to fail him a lot, even within 20 seconds of repeating information he wants to remember, so it seems like his hippocampus is probably damaged. However, he mentions that his "memory for doing is compromised," that he repeats things but never learns them. So maybe his implicit memory is damaged as well, but only slightly, because he can still improve some tasks by practicing them.

On a final note, I have been thinking a lot about the collusion of art and pathology that we spoke about in class, but I did not consider that this may work against itself, too. Skloot spoke about his newly heightened emotions, and the joy and sorrow they brought to him. This connects with the original idea. However, he had trouble retaining a "flash of inspiration" and would often lose the meaningful idea that had come to him, rendering it nearly impossible to actually create the art (in the form of poetry or writing) that he was inspired to make. He quoted Yeats as saying, "The artist assembles memories," which became nearly impossible for Skloot, despite the depth of emotions he felt. He did manage to write this memoir, though, which is a testament to the positive results of perseverence and determination. It's interesting how this fits in with the idea of the brain, adapting for its survival but then aiding in its own destruction.

A New Style of Writing

Hey Everyone,

I feel that we have entered new territory in this class. We have moved away from the more scientific case study style of writing of Sacks and Luria (as poetic as they are), which are laden with scientific data, history and findings, and have moved to accounts that truly belong in the memoir section of the bookstore. So I wanted to offer you some talking points on this new subject. Please, feel free to take one and run with it or give me an answer for most of the questions. It's up to you. Use this as an opportunity to give your self a change to really digest these new readings.

This past week we have had the opportunity to read “In the Shadow of Memory” by Floyd Skloot and “The Missing World,” authored by Margot Livesey. In both we were privy to not only the situation of a patient but their family, the suffering it caused “the family unit” and how disease “insults” time. I believe that Skloot offered us a really humane depiction of his disease, a first count depiction of his life and his struggle. I think that it drove the point home because it wasn’t being delivered via a third party. Skloot was directly connecting with the audience. Very different from what we had seen in Sacks and Luria, in which they were the storytellers. Sacks worked with these people and tried as he may, it still wasn’t a first person narrative. His ideas, perceptions and medical background removed the reader from the story. Now I know that we got a fantastic sense of the character anyways (and this is NOT an attack on his prose because it is beautiful) but there is something to be said when a man (or woman) sits down, especially when they are injured and must slave over their work, and crystallizes their thoughts in writing. We did see more of this struggle to express oneself in Luria (and many parallels can be drawn between S and Skloot) but the sheer fact was Luria still had to deliver the story of S because he was unable to express himself in an organized matter.

Do you agree with this? Could you argue that Luria and Sacks are even more humane because they have the medical experience and bedside manner to write these books? No confabulation necessary. It is hard to tell in our day and age when plots are exaggerated and heightened for effect just to sell more copies—think of James Fry and “A Million Little Pieces.” Can we really trust our writers anymore? Even still, to me, the fact that Skloot sat down although he was personality incapacitated with disease and turned out the prose that he did is astonishing.

Which leads into my next point: the interesting style of Skloot's book. It was almost hard for me to shift back into novel mode after reading Luria and Sacks that almost spoon-feed you the material. They explain a disease and it’s history. That did not happen with Skloot. In fact if you didn’t really understand how the back of the brain progresses forward to the forehead and that brain function heightens to more advanced levels, you must not have completely understood how a virus decomposed a lot of Skloot’s brain. How effective was this, letting you figure out exactly what was wrong? I know that I struggled with it.

As I was reading the trilogy of stories, it actually could have been based on different families on different parts of the illness spectrum. Once I realized, it had a rather intense cohesion. It was interesting how he started at the end of his life out on the North Sea; traveled back to his childhood and that of his patients; then he went to discuss his brother and his middle-aged life. How did you feel about this disjointed method of story telling? Was it effective or confusing? Personally, I love this idea of fragmented moments, because that’s all these brain-damaged people have—that’s what we all have: a string of moments. Some are longer and a little bit more tightly woven together. He would weave pages of moments from the past and then with the accuracy of a doctor he would diagnose the problem at the end of it or explain why his family acted the way he did. He was almost the personal doctor/historian of the family, cataloguing their actions (from what he remembered) and giving them justification.

I feel that Skloot really took a dynamic, shattered it and froze it in time. You see how a son’s memory and life is “changed” by a virus; how a mother copes with her existence by confabulating a life of “royalty,” how a father is starved of love; and a brother is ignored and ignores his own health. They were all starved of the lives they wanted. They were “together without togetherness,” (126). It’s hard to tell if illness took that away from them or their own devices did. Opinions?

As a final point, this is something that has been interesting me. Has anyone else noticed that in many of the books we’ve read so far about the deterioration of disease, the author tends to deconstruction words down to their etymological basis? To their root words? Take page 21 for example when he breaks down the word “dementia.” This is only one example of several that we’ve seen over the past few weeks. Can you name any others? In this book even? What do you feel is the writerly effect of such a thing? Is it to run words on a parallel basis with a patient, to strip them of added components that time gave them? Can you find any truth in that statement? Simply to fill space? What?

Thanks for stopping by,

Sunday, September 30, 2007

The Case of the Colorblind Painter

Sack's account of the case of Mr. I, the painter who loses his color vision, really struck a chord with me. To lose something that enables your artistic life is frightening and devistating. Mr. I's whole life and career was built around the richness of color and using color in his paintings to express himself. It made me think of what it would be like if I lost my hearing. As a singer I couldn't imagine my world without music; without being able to hear what was coming out of my mouth. It's a nightmarish thought and I don't know how I would react if something like that happened, especially late in life. What was facinating about this particular case was how Mr. I adapted after some time to his new condition: his world in shades of grey. Sachs writes how Mr. I gradually became a "night person" and would travel to different cities and explore the world at night. Mr. I's color memory quickly began to disolve and he learned to see in a whole new way. In a way that was "highly refined". Mr. I describes how textures now stood out to him, he could read licence plates from four blocks away, and enjoys the richness of his new world. What was extremely interesting to me was, three years after his injury, when Isreal Rosenfeld suggested that Mr. I might be able to restore his color vision, Mr. I declined. "...he found the suggestion unintelligible, and repugnant. Now that color had lost its former associations, its sense, he could no longer imagine what its restoration would be like. Its reintroduction would be grossly confusing, he thought, might force a welter of irrevelant sensations upon him, and disrupt the now-reestablished visual order of his world". Sachs also writes of other cases of people who grow to embrace their deformity, as in the case of John Hull who loses his sight completely. A couple years after he went blind he came to see his condition as " a dark, paradoxical gift". These different cases that Sachs writes about really inforces the strenght of human beings and people's will to live and accept their circumstances.