Tuesday, April 6, 2010

A tiny platform above the abyss.

Clive Wearing contracted a virus in 1985, a virus that is pretty innocuous in most people (one of the many that give you sore throats for a few days) but changed his life forever. The virus infected his brain resulting in his getting one of the most severe cases of anterograde "Memento" amnesia known. He hasn't formed a new memory in last 25 years. Moreover, the virus also caused severe retrograde amnesia, meaning that a lot of his memories prior to 1985 also went away. A lot of times he seems to be living in 1960s, if you can call chunks of 7-30 seconds of life "living". That is the extent of his short term memory. Think about it. 7 seconds. What would it be like if everything in your mind gets erased in 7 seconds? It is not just a matter of not remembering what happened in his life at any time during last 25 years. As tragic as that is, one could still sort of imagine living the same day again and again if one has, say, half an hour window of memory... something like Memento. You wake up, you don't know where you are, you see your tattoos, you remember your wife was killed, you make notes, you make a plan that you might forget later but at least you can MAKE it. What can you do with 7 seconds?

He lives at a country residence with other similar "patients" with some caretakers. The caretakers encouraged him to write journals. Perhaps they thought it will give him something to do. Perhaps it would help in objectively following his progress. So, here is what you do with a 7-30 second memory. This is how his journal looks -

9:00 am - woke up after a long sleep.
9:15 am - just woke up
9:30 am - Really, overwhelmingly awake now
10:00am - just waking up, despite my other claims

That is about the extent of his thoughts most of the time. Seriously, how do you even complete a thought in 7 seconds? And if you can't, what does ANYTHING mean anymore? What does even "being you" mean?

Still, he has some memories of 40 years ago. Its not as if he has forgotten what the world around him means. And his procedural memory is intact. Which means that things that are part of a "habit" or "muscle memory", things that have become "ingrained" are accessible even if no "event memory" exists of anything since 1985. So, he talks. And he talks about the same things again and again. Because these are the only things that are accessible to him through his procedural memory. He'll talk about astronomy, Queen Victoria, electricity, etymology of words. But perhaps not a lot other than that. He'll throw in a joke. The same joke after every few minutes.It helps him to see that people around him can get the joke. It reassures him that he still has a connection with the world. He keeps talking from the same ingrained "scripts" to make a tiny platform of reality around his present because beyond that platform there is an abyss... nothingness stretching away... Thats what his wife calls it - "A tiny platform above the abyss".

And he plays music. He hasn't forgotten how to do that. Procedural memory. He even improvises while playing. He just doesn't remember that he had just played some music after he finishes. Or that he has made the same "improvisation" again and again perhaps.

And, he remembers, and still deeply loves, his wife Deborah. He remembers her even though the retrograde amnesia has taken almost all other memories from  much before the time when he first met her. Oliver Sacks writes in his book "Musicophilia", where I found about Clive's case -

"... somehow he always recognized Deborah as his wife when she visited and felt moored by her presence, lost without her. He would rush to the door when he heard her voice, and embrace her with passionate, desperate fervor. Having no idea how long she had been away - since anything not in his immediate field of perception and attention would be lost, forgotten, within seconds - he seemed to feel that she, too, had been lost in the abyss of time, and so her "return" from the abyss seemed nothing short of miraculous."

Deborah writes, "Clive was constantly surrounded by strangers in a strange place, with no knowledge of where he was or what had happened to him. To catch sight of me was always a massive relief - to know that he was not alone, that I still cared, that I loved him, that I was there. Clive was terrified all the time. But I was his life, I was his lifeline. Every time he saw me, he would run to me, fall on me, sobbing, clinging."

How would it feel to be embraced with passionate, desperate fervor many times a day by someone who is honestly, sincerely, deeply in love with you. How would it feel to see in someone's eyes that you were missed with the intensity of a decades long separation.. how would it feel to see that every day.. every hour. That you are the only person on his tiny platform. You ARE his tiny platform. For 25 years.

6 comments:

  1. Sad I guess. But glad that atleast his wife is there. He has her.

    You know.. "people" say that this is how kids are with their Moms when they are really young. When you leave them and go out for even one hour.. they miss you and when you get back they are ecstatic to see you! Like they could never live without you! Atleast, so claims my friend who has a delightful one year old. Platform Mamma.

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  2. How does one go about his/her normal routine i.e. performing the daily chores or even play music etc. if the span of attention/memory is 7-30 seconds? Or are they two different things....he/she can do a chore without thinking about it and finish it and then not remember having done it repeat it again and again and again. Secondly what prompts him to do that particular activity only again? say like he is speaking on a particular topic.....how does he remember what he was talking of to repeat it...or is it subconsciousness at work?
    A very sad situation nevertheless.

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  3. Also.....it must take a great deal of strength to stay with, love and support a family member suffering in such a manner, especially if he/she is your spouse. The sense of happiness and sadness that hits you together each time...

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  4. @SS - that kids thing is surely possible. I'm sure it takes a lot of time for them to form the concept of permanence of objects/persons. Uske pehle they probably feel the same "mom still exists! she isn't lost forever!" thing that you are talking about. That is why most people play the game of "ta!" with their babies.. hide their toy from them and they seem confused. then suddenly show it to them and they are absolutely delighted!

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  5. @pescado, that is exactly the reason why this case is mentioned in musicophilia. The idea is that music (playing, or even imagining) becomes part of your procedural memory (habit) rather than event memory. When I sing a favorite song, I don't have to retrieve the tune or even the lyrics from my memory. All I need to do is start and then it will continue by itself without me spending any part of my conscious memory on it. That is exactly why a lot of times when I sing a song, I don't even know that I'm singing it. Its the same with playing music, or daily chores. Once you repeatedly do something in the same way, it gets stored in the procedural memory and "the zombie in your mind" can do it without needing any trace of event memory associated with it.
    The same thing works for the "scripted" talks that Clive engages in. A lot of these talks follow the same set pattern so that once he starts talking on a subject, it is in some sense like me starting a song. Things continue by themselves.

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  6. This post made me think a lot...I did not realize that music is in such an untouchable memory. But this also made me wonder how we do not even appreciate a lot of things that we all have in day to day basis, which we take it as granted :) Living life for these kind of people is probably very difficult with ambitious people like "us(normal people with memory)"

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