Tuesday, April 06, 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 embraces 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 eyes that you were missed by with the intensity of a decades long separation.. how would it feel to see that every day.. every hour... every time he sees you. You are the only person on his tiny platform. You ARE his tiny platform. For 25 years. 

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