One Brain's journey

My father’s mother, my grandmother, developed dementia in her 80′s, I was about 14 at the time. It was not a pretty sight. She didn’t know me, she didn’t know my father and most of the time she didn’t know where she was. She was in a Salvation Army Home For The Aged and, I might add, well looked after. I also have a vivid memory of a neighbor trying to break down our front door, with her caregiver trying sesparately to prevent her, while I cowered just inside trying to remain invisible. She was calling out to be let in and I was trying to give the impression that no one was home. This time I was about 10. I know times have changed since those times and there is better care and better medication for what we used to call senility but better still would be not to have it at all. New studies in neuroplasticity indicate that it can be avoided and, if you do get it, you might be able to overcome at least some of the symptoms. This is reported in an earlier post in the blog referring to the Nuns’ Study. This study reported, amongst other things, that nuns who showed physical symptoms of Alzheimer’s Disease but no neurological symptoms had been active in teaching right up until they died. This would tend to indicate that keeping the brain active is good but engaging with other humans is even better. A post yesterday in the Huffington Post authored by Dr. Marie Pasinski, a neurologist at Massachusetts General Hospital suggest that activites present us with new ideas and challenges and require us to adapt in new and different ways are best to keep the brain healthy. She also emphasizes eating right, particularly foods rich in antioxidants such as Omega 3′s. She suggests seeking things that ignite passion which enhances our brains ability to learn and remember. “By enriching your mind each day with new experiences and information you are building up what is called ‘cognitive reserve’. It’s like putting money in the bank–the more information you have stored over time, the more resilient your brain will become.”

My earliest impressions of dementia are from a time when there was little that could be done about it.  Those impressions need to be brought forward and rexamined in light of what medicine can accomplish now.  But more importantly, there is much I can accomplish now and the time to start is today.  Apparently reading posts on blogs is good.  Writing them is even better.

It has been far too long since my last post. This post represents my re-dedication to this blog and will be about what has provided much pleasure and insight over the past four months. Since I purchased it on March 16th, I have ridden over 3,000 miles on my Aprilia Scarabeo 50 motor scooter. Today, November the second, it is six degrees Celsius outside and I have to meet a friend for lunch. Almost certainly, I will be riding to the restaurant on my scooter. Why? There are many reasons. I like riding it. I like the feeling of connection, of being part of the surrounding landscape as opposed to just an observer. I like the fact that I can park for free and in fact, as per current Toronto municipal bylaws, will be able to park it on the edge of the sidewalk right in front of the restaurant. It will be cold, particularly on my hands although I will be wearing a pair of North Face gloves intended for expeditions to places such as Mount Everest. I will be wearing blue jeans but my legs will be cold. I will be wearing a full-face helmet which quite frankly I should wear more often but it is awkward to get into and will not fit in my top box so I will have to take it with me into the restaurant. But I will be content. The ride is only five minutes. It is sunny and crisp and the sky is that sort of late-fall blue, silhouetting some brightly colored leaves that still remain on the trees. I will probably burn about 10 cents worth of gas getting there and I will arrive cold but happy.

Why is all this important? Primarily, it is the reason I started this blog in the first place and that is to begin a journey to understand how my brain works.

A short time ago, a friend of mine who rides a bike, told me that she enjoys riding but only when she has a destination. The only exception was on Sunday when she seemed to be able to just ride around aimlessly and enjoy the surroundings. This interested me because when she articulated this, I realized that I felt the same way about my scooter. Rides with no destination during the week were not as enjoyable as rides where I was going somewhere specific. On Sunday, or on statutory holidays, I could ride without any more destination in mind than to head north out of the city.  I had thought the no destination thing was just me until my friend shared her thoughts and now I wonder if this is more general.  I also wonder what it is about my brain and my friend’s, that the a destination makes a big difference in terms of the enjoyment of a ride.

What do you think?

Are you a bike rider, either powered or not, and can you just go for a ride without worrying about where you are going?  I would love to get feedback from you in the comments section if you have a moment.

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.