One Brain's journey

Dr. Atila Turgay, one of the leading experts in Canada on ADD/ADHD passed away in April.  He had been Chief Of Staff at Toronto’s Scarborough Hospital, although recently he had returned to private practice.  He was also on the faculty of medicine at the University of Toronto.  You can read more about Dr. Turgay at Dr. Kenny Handelman’s blog here. I saw him just before he left his post at the hospital and set up his office at Davisville and Yonge in the heart of Toronto.  My reason for being there was a review of medication I had been prescribed for ADD since the physician who was currently writing the prescriptions had not originally either prescribed them nor done the diagnosis.  Dr. Turgay performed the shortest test I had ever encountered for the three aspects of working memory.  The first two were not uncommon.  He asked me to remember a string of seven numbers and then repeat them backwards.  He did a similar one for verbal working memory.  Then he sat right opposite me and asked me to observe him, without moving, until he asked me to replicate what he did with his fingers and hands.  What he did seamed simple enough.  His hands were reversed with one finger on one hand touching a finger on the other.  But when my turn came to replicate it I could not–even after a couple of tries.  I had seen Dr. Turgay describe this test in several lectures sponsored by the Attention Deficit Resource Network but this was my first opportunity to actually do it.  His conclusion, after these three short tests, was that I had an impairment in visual/non verbal working memory.  Some years ago I did a completed psycho-educational assessment valued at close to $2,000 and a similar component, lasting at least half an hour, had reached the same conclusion.

My visit only lasted a few minutes and the medical part of it was over before I knew it.  He concurred with the medication I was taking and with dosages and schedules.  Then he quizzed me on my background and interests, as it turned out, to see if I might be of service to the ADD/ADHD community.  It wasn’t his suggestion but this meeting was one of the reasons I started this blog.  I heard him speak on a couple of times and my appointment with him two years ago only lasted perhaps 20 minutes but I will miss him.  Not only was he a great resource to the ADD/ADHD community he was, in my experience, a kind and caring individual.

It was on reading his obituary and remembering his visual/non-verbal working memory test that led to a mini-ah ha moment.  I had always marveled that one of the profound and noticeable effects of even a small dose of ritalin would lead to a great improvement in my hand-writing.  I’m no expert but I would bet that there is a large component of visual/non-verbal working memory skill in handwriting.

I went through a long period, up until just two years ago, when I had a lot of trouble reading books–fiction not non-fiction. The difference being that with fiction you more or less have to read in a linear fashion or you get lost. Sometimes I would put a book down for a few days, or a week, and try to resume. Almost invariably I would have forgotten who the characters and what had happened up to the point I was trying to pick it up again. Non-fiction was different because you don’t have to read in a linear fashion. AS—pointed out in Information Anxiety some decades ago you can jump in anywhere and read until you are bored and then jump somewhere else.

I had come to the conclusion that my ADD was getting worse and I had lost the ability to read long-form narratives. Having read about about a new book, The Shallows: What The Internet Is Doing To Our Brains I’m now not so sure about the ADD being the culprit.   Author Nicholas Carr says that the Internet has changed our brains to the the point where we can’t concentrate on most deep-thinking tasks without seeking distractions.  See The Glove and Mail website here for more about Carr’s thesis.

I feel a bit vindicated that the problem may be our modern world and not the disorder I thought I had wrestled into some form of manageability.  One thing I do know, as I am now in the middle of the third novel this year, is that things started to change two years ago. Why then?  I was making frequent trips to a lodge in Algonquin Park where the only distractions were the forest, the other guests, the animals, the odd canoe and some of the best cooking I have ever tasted.  I did take up my notebook computer and once every evening I would watch a DVD on it. Most of the rest of the time I read novels. I knocked off about four that summer and although I only went up half the time last summer I completed a couple more.  Two summers ago those novels were the first I had read to completion in more than a decade. With no distractions it seemed my brain was content to revert to a state where it didn’t require new and novel distractions every couple of minutes.

Now don’t get me wrong I’m not complaining and I don’t think the Internet is the end of the world as we know it. I’m just observing. I’m also aware of a quote from Canada’s premier literary critic Northrup Frye who said,”The book is the most technologically advanced communications medium ever invented because it moves at precisely the speed of the reader.”  Frye died before the Internet reached its current level of penetration into our lives. I wonder if he would agree with those words today.

Carr says that long-form narratives are not the way our brains have always worked.  To the contrary, according to him we are programed to be easily distracted.  He goes on to say that gathering information from Google or other methods on the Internet, take in information from many different sources at a fairly shallow level and the information never makes the transition in our brains from short-term memory to long-term.  With print there are no distractions and we get much more information more deeply into the brain and thus into long-term memory.  That information can then connect in our brains to other information, other material we have read, or even with our own experience.  Using the Internet  information is held and manipulated mostly in short-term or working memory but then it is gone or is not available to connect with our own experience or learning.  In other words, I guess, we don’t learn at depth.

When asked how he managed to keep from being distracted enough to write the book, Carr said it took him two weeks before he could overcome the panic of not checking his email or other activities on his computer.

What’s my point? Well it comes back to the up side and the down side of neuroplasticity again. If you think reading long-form narratives is a good thing then the Internet can change your brain for the worse.  The up side is that you can change back if circumstances, or desires, warrant it.

Ever so often my life gets thrown out of whack by a car that won’t start or a check not received or even just some bad weather that seems to be preventing me from whatever personal plan I am trying to execute at the moment. I get angry or depressed or some similar expression of unsettledness. And then, hopefully before too much time has elapsed, I remember what happened to my friend Brendan. He had a long stay in the hospital with stomach cancer and, after most of his digestive system was removed his friends and family were warned that the end was near. It wasn’t and Brendan survived. As he made the gradual re-entrance back into his life there was one particular thing that bothered him for some time and it revolved around some person, any person, describing how their day was ruined because their car wouldn’t start or some other such annoyance. Brendan told me this on my last visit to London where he lives and I vowed that I would try not to ever be one of those people.

I found that, with a little practice, I could put such an occurrence aside and move on with life most of the time. It echoed Abraham Lincoln’s comment that most people are about as happy as they choose to be. The promise of neuroplasticity is that your can exercise some control over what your brain does. Now that’s not to say that it is easy. It isn’t but it is possible. The promise too is that not only can you change your brain you can change it by yourself.

Last winter, one 20 degrees-below-zero night, I was on my way to meet some people and, after driving a few blocks in my car, it started to run, roughly, on three cylinders with a lot of noise and smoke. I immediately drove home parked it and called the friend I was supposed to pick up at her home to say I couldn’t make it. She said she wanted to see the movie we and our friends had planned to see and was going to go anyway–on public transit. To my own amusement, I found myself feeling disappointed that she wasn’t going to just spend the evening at home as I thought I was about to do. As I was on the phone, talking to her, standing on the street, my local bus appeared in the distance, headed to a stop right where I was standing. I thought of Brendan, and how I had resolved not to have a day ruined by just the sort of occurrence I was experiencing. I told my friend I would meet her at the theatre and got on the bus and turned my attention to how I would complete the journey; meet up with her and our friends. It was magic. It worked and really wasn’t that difficult. After the movie our friends drove us home. We had seen the film we had intended to see, spent time with good company and the only bump in all of this was that my car still didn’t work.

Arriving home I typed the symptoms of what the car was doing into Google, fearing that it was something really expensive, my head now back into the problem and what I got back was that the symptoms matched that of a part that I had received a recall letter for but hadn’t got around to attending to.

The next day I called my auto service and had the car towed to the dealership and a few hours later they called to say the part was repaired under the recall as I had suspected. They even came, picked me up and drove me to the dealership to retrieve my car.

I try to remember this not just when my car won’t start or run right but whenever there is any kind of glitch in my plans and try to ask myself the question, “Do I want to deal with the problem the best I can and get on with my day?” Life’s too short, as they say. But more importantly, I know I have it within me to change the way I react to such event. A good friend once asked me the question: “How many of the things you have worried about have actually happened?”

The humorous answer is: “Hardly any of them and so I guess worrying about them has a positive effect.” But the true answer is just the first part of that statement…hardly any of them. How upset would I have been about my car breaking down had I known how easily it would be dealt with? Not much. I’m at a point in my life where I can see the end of it and how I spent that time is incredibly important. I want that time to be filled with moments with my friends enjoying mutual interests not stuck at home brooding about a broken car.

For the last few weeks I have been engaged in writing a proposal for a television series about traffic of all kinds:  automobile, bicycle, pedestrian, airplane.  A few days ago I came across the story of the town of Drachten, in The Netherlands  where they have taken down all the traffic signs and traffic signals and reduced both traffic deaths and accidents.  Why?  Well it seems when the roads might be shared by bicyclists and pedestrians people drive more carefully.  Drachten has been such a success story that there are at least six other communities in Europe that are trying out the idea. I like stories like this because they indicate a success that is counter-intuitive or, put quite simply, goes against the flow.

It seems that there is another community in New Jersey where, in the 1920’s, the community leaders decided to design the town to be car friendly.  There were no traffic engineers back then (there was hardly any traffic) and so the idea was turned over to, well ordinary engineers.  They went about building a system that mimicked the flow of water and in hydraulics, if you want the water to flow nicely, yoiu remove any obstacles that might slow it down.  You know–things such as cyclists, animals or people.  Hence the idea of sidewalks elevated just a bit above the roadway where the pedestrians could carry on whatever they wanted to: walking, sitting, eating along with their dogs and whatever other encumbrances they might want but where it would not hinder the progress of automobiles and trucks.  Of course, at certain points these pedestrians might want to get to the other side and since they were tax-payers you had to at least pretend to accommodate them, traffics signals were developed to allow them across the streets (quickly) and then the cars could go back to racing on to their various destinations unimpeded.

In Drachten, the only accommodation to making a change in direction whether you are a driver, a cyclist or a pedestrian, is a roundabout in the middle of town.  Cars must enter from the left but cyclists and pedestrians can enter wherever they want.  It would be chaos right?  Well that’s the point.  Since it is chaotic drivers tend to be more mindful and to drive more cautiously.  I have a number of friends who are fire-fighters.  They  hate speed bumps.  Some of them are paramedics and they tell of back injuries made worse by speed-bumps.  Studies now show that speed-bumps actually cause drivers to speed up, almost as if they were making up the time lost going over the bumps.  So why do homeowners still insist on having them installed on their streets?  Because intuitively they understand that the bumps will slow traffic even if they don’t.

Why is this discussion taking place in a blog that is primarily about neuroplasticity?  For one thing if you want to get your brain to change a habit, you must first get it to break the routine, to know what it is you want to accomplish.  Vision is absolutely essential to changing habit.  So is perseverance and so is thinking it through with all the facts you can find.  But there is another reason I have written about this.  I don’t like control freaks.  I particularly don’t like control freaks that haven’t thought it through where the issue is not getting you to do something differently but getting you to do it there way.  And then were are back to neuroplasticity again because almost everything we know about this topic has been discovered in the last ten years, where most of the knowledge in this fields is still undiscovered, we must question everything.  This consumes both time and energy and beyond that…it is just hard.  But if you want to change, successfully, you have to do it just as the people in Drachten had to do it.  But if you do do it, the results might just amaze you.

Recently, I came cross a reference to the Mozart effect and, although the term sounded vaguely familiar, I really didn’t know what it meant and had to read a definition. That was illuminating as it lead back to a reference to a physician named Alfred A. Tomatis and his work with children  with learning disorders and some other crippling neurological problems by improving listening skills.  I was quite familiar with Tomatis. But first to back to the Mozart effect which says that listening to Mozart’s music will increase intelligence by eight to nine points–even if just temporarily. This caused quite a stir in the educational community when it was first revealed some years ago. One State Governor in the U.S. even had each pubic school student in his state supplied with a CD containing classical music. Okay, you run into claims like this on the general topic of education almost every day. However, when I found out much of the original research (actually clinical experience) was performed by Alfred Tomatis who was an ear, nose and throat specialist and used listening therapies (some involved listening to Mozart) to improve learning disabilities in children I became quite intrigued. Some 15 or so years ago when I was working as a management consultant, my firm was contacted by The Listening Centre in Toronto to request some pro bono consulting. I was chosen and went for an initial meeting with the two people who ran the centre. I have forgotten what services they required but I do remember how impressed I was with them as people and the passion they had about their mission to treat children with learning disorders using methods developed by Tomatis. Soon after I left the firm and performed the work for them as an independent consultant waiving any fees. Some time later, a friend came to visit, a man I had shared a flat with many years previous in London. He had become quite a famous actor (instantly recognizable in Dublin if not Toronto or New York) and had actually been passing through Toronto on his way from Vancouver back home to Dublin. Ray suffered from Tinnitus and I knew this was one of the disorders The Listening Centre claimed to be able to treat so I called them and asked if they would see Ray.  They agreed to do the assessment for free but since Ray did not live in Toronto and there were no Tomatis practitioners in Dublin they could only recommend alternative treatment to the “electronic ear” that was at the heart of their regular program.  Well to cut to the point it worked.  Ray went home to Dublin, did the things they recommended (most of which I don’t remember save some things about diet) and got relief from a disorder that had been plaguing him for years.

Now, I know that there are a lot of treatments out there they looked like quackery even a few decades ago that utilize neuroplasticity to effect cures, or at least relief, for ailments that were thought to be permanent.  Why am I writing about this in this post on this blog?  The Mozart effect did not really go anywhere and I’m sure that almost no one now remembers Alfred Tomatis.  The Listening Centre in Toronto fell on hard times, could not pay their rent and closed.  One of the practitioners took up another career while the other followed some interest in the method to Mexico where there was a supportive clientele.  But these days I read daily about miracles involving neuroplasticity. There are people blinded by strokes who can see again, Alzheimer’s patients that have no neurological symptoms, schizophrenics who improve their working memory and become symptom free.  We are on the frontier of many great discoveries but to get there we might have to put away our skepticism and allow ourselves to experience awe and wonder without the dash of skepticism so many of us have developed as adults to prevent disappointment in chasing down blind channels or after miraculous cures.  I say us and I mean me and if I write it hear perhaps I will be a little more likely to follow the advice of Herbert Spencer who wrote:  “There is a principle which is a bar against all information, which is proof against all arguments and which cannot fail to keep a man in everlasting ignorance–that principle is contempt prior to investigation.”