I am writing this post in my kitchen, the same kitchen where I just had my coffee and toast, the same kitchen where I had supper last night. I can tell you that I had pasta for supper and that it was delicious. I can remember what my husband and I discussed. How I do this is still somewhat of a mystery. A biochemical physiological mystery. Chemicals can distort memory, can temporarily disrupt memory. Breathing or , digesting, or absorbing certain chemicals, .voluntarily or through exposure, can cause involuntary changes to memory [eg.lead, mercury, recreational drugs, medicines, air containing asphyxiant gases]. . Lack of certain chemicals [eg. thiamine, iron ] can also affect memory. Hormones can affect memory too, cortisol, steroids, etc.. Memory is complex.
It helps that the kitchen itself acts as a visual cue, a cue reminding me of what always occurs in the kitchen; it is where I prepare and cook the food the food I eat every day with my husband. My memory of these things is intertwined with my kitchen and my actual presence in my kitchen. When I opened my fridge this morning to get the butter, I saw the leftover pasta, another visual cue reminding me of what we ate last night. Seeing my husband reminded me of last nights discussions and prompted me to discuss other things. So many things occur in my brain as I remember and think of these things, some out of my conscious awareness [such as neural signalling and such] and some I am more consciously aware of.
When Paula lost her memory overnight, she retained the meaning of the visual cues around her, she knew that the kitchen meant food, making supper, a shared meal with family. She forgot details and content: how to make the rice she made yesterday and everyday before that. She knew that this was strange. She was extremely puzzled. She knows how to make rice. So why didn’t she know? …. She had to look for a cookbook in order to know the steps. Even then, she forgot to add salt and so the rice was not as tasty as usual. She was worried, she did not understand why she did not remember and she was worried because she wanted to have supper ready for the family and this was turning out to be unexpectedly hard.. They would be coming home soon. Paula had to look up how to bake the fish she had bought [she made this fish all the time] and she managed get some semblance of supper ready for the family, but something was clearly wrong with her. She didn’t know what. No one noticed much, because she was able to figure stuff out eventually, even though it was stressful. She did not even know that she was amnesic – forgetting things that normally should not be forgotten. She did not realize yet that she no longer knew her address, her phone number, even though she still recognized her family and friends and could drive her car to work. She seemed to retain the mechanical memory to work the car. Once at work she did not know how to do her work. Her work involved teaching students study skills. Not a mechanical task and not an especially hard “knowledge – based” task. Her “knowledge” went missing. She looked like an idiot. She did not like looking like an idiot. She also felt guilty about not being able to help the students who clearly needed her help. Teaching students how to study is not that hard. She could not teach anyone anything anymore. What kind of amnesia is that? She did not even remember the word amnesia and did not relate it what was happening to her. Instead, she worried and looked scared and upset [for good reason] and could not find the words to explain.
Amnesia cannot be explained, it can only be experienced, I think. Paula was lost. She could no longer carry a conversation, somehow she didn’t know how anymore. She looked at the person speaking with her and was very aware that normally she automatically and involuntarily understood conversations and sentences and words and normally “knew” what to say, how to respond: all of that was suddenly and inexplicitly gone. She had not ingested poisonous mushrooms or anything, she had not drunk alcohol, she did not take weed, she took no medicines, there was no explanation for what was happening to her.
She’d lost her mind, but not all of her mind, just some important parts. It was like she had woken up on anther planet with all of the people she knew, yet she had no idea how things worked or what she should do or say. It was so strange. And how to explain? What to say? What was happening to her? Her private thoughts and words were gone. She felt like a zombie yet outwardly she looked much the same except more quiet. She was also pretty incompetent suddenly, since she forgot how to do anything [except how to drive]. You could not see that she was suddenly incompetent unless you watched her try and fail and then cry [when realizing how badly her performance was ] .
She didn’t know what was wrong and so she said nothing, but she worried…a lot. She simply could not function. It was very upsetting.
It took us a long time to realize that what Paula was describing was amnesia. I don’t know why I did not understand immediately when she told me that she couldn’t remember how to do her job; yet I didn’t get it.
Neither did the doctor she saw. She told him also and he did not understand either. It was as if her ignorance was infectious.
I do not understand why scientists don’t ask people if they had ever experienced an attack of amnesia and loss of personal memory. They would have to have recovered in order to talk of it, since amnesia and loss of personal memory is profoundly incapacitating and distressing, while it is happening.
I do not know why scientists are not more interested in learning what interferes with someone’s personal memory and how their function, albeit mediocre function, continues even when memory is greatly impaired. Paula’s outward behaviour did and yet did not differ from her usual, it differed in quality- the quality was very mediocre. . Her professional performance at work was poor. But only the students witnessed this directly. Her colleagues couldn’t figure out what was different about her…most of behaviour was the same, it seems that a lot of routine behavior, is formed by the structure of the environment and unconscious responses to visual cues, resulting in predictable movements and activities. Personal memory is necessary to do a good job, though. Lack of personal memory is very upsetting and completely puzzling to the person experiencing it.
“As in the kitchen example, Paula “knew” that the kitchen meant preparation of food, which she attempted to do, and family supper time, and discussions with each other…..she understood all that still…she just did not remember how she did this, even though she never had to think about such things before, since her brain knew automatically” before, but not anymore.
Paula not only forgot her address, her phone number, the birthdays of her kids, how to do her job, how to cook her usual foods, she also forgot to eat breakfast or lunch or supper. This was especially unusual, since Paula usually felt very hungry every couple of hours and ate food all day long. During this attack of amnesia, she did not seem to have her normal pangs of hunger, and she was not thirsty. Her body did not produce the usual cues. How could that be? She lost her appetite and her thirst and her awareness of most of her bodily functions. She did not feel like she had to move her bowels or urinate. She really had become a zombie. The only thing she felt was anguish, a sensation of fear and distress she had never experienced before.
Dr Arthur Guyton, writer of a famous medical physiology textbook, first published in 1955 and still published today [with updates], suggested that dyspnea is the distress felt when one cannot breath normally, and that this distress is felt as “anguish”. He would know. Guyton was partially paralyzed after being infected with polio. He suffered from this infection in 1946 during his final year of residency training in cardiovascular surgery. This is why he had to become a scientist instead of a surgeon. Guyton understood this sensation of anguish from personal experience. Personal experience that results from experiencing problems with one’s respiratory muscles and nerve fibres, Insights that can only come from personal suffering. I do not believe that anyone else has referred to dyspnea as a sensation of “anguish” since. It is something which has to be experienced in order to know what it feels like.
To be continued……
The theme of this post is to ask why researchers do not ask real people who have recovered from this kind of experience in order to better understand memory and loss of memory and return of memory that seemed lost forever but wasn’t.
Why make up all these tests having nothing to do with personal experience of this.
Apparently many people recover their memory of their loss of memory due to syndromes such as delirium, although many do not . I would bet that those who do remember will describe similar experiences as that of Paula.
How can we explain this kind of disruption of memory, how is it so profound and yet reversible…to the point of remembering one’s personal knowledge again and remembering what happened during the period of amnesia, once one recovers?
When Paula recovered, she remembered what it was like when she was amnesic. . How is it possible that the memories of amnesia were laid down, during the very period she was unable to remember.
How can we explain this?
No one even realized that this is possible.
I only realized by talking to Paula. Even she did not realize this stuff till she talked with me.
Kraepelin basically reported spontaneous recovery of memory in thousands of people experiencing this syndrome.
Why are we not investigating what happens during these kinds of reversible attacks?
still working on this…far from complete…..