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Saturday, August 23, 2014

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How vivid are your memories?

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I have noticed in my medical practice and my own life experience that some memories, even those very distant, when recalled are almost as vivid as when they first occurred.

When I wrote some of my life stories, which ultimately became my memoir, Brooklyn Beginnings: A Geriatrician’s Odyssey, many of the experiences I recounted were so vivid that I could almost hear the voices, smell the smells and taste the flavours that accompanied the experience.

In my geriatric medical practice, which focuses heavily on patients with some degree of cognitive impairment and dementia, memories that do get recounted from the distant past sometimes appear to the person to be almost occurring in the here and now. Family members often remark that the person cannot recall what they had for breakfast but recall in vivid detail the Atlantic crossing from Europe in 1905.

Many of my patients are Holocaust survivors. They are often plagued with distant horrific memories that are so vivid when recounted or when they intrude into consciousness that they become agitated, fearful and panicked, as they believe they are reliving the painful associations with that previous part of their life, which they may have spent many years trying to forget.

The husband of one of my patients once explained the pale faded number on his left forearm to one of my medical residents. The student was from Eastern Canada and had never met a Holocaust survivor. The man described the process of being tattooed with the number and then explained how he survived the “selection” at the concentration camp after having been transported in the cattle car from his Polish town.

He explained that the “selection” by an SS guard was the way, “it was determined who would live and who would go directly to the gas chambers.” Two parallel lines were moving toward the SS officer, and the man realized that his was the gas-chamber line. When the officer turned his head, the man leaped from his line to the one next to him. As he explained, he stood up and leaped halfway across the examining room, demonstrating what he did with the fervour of his action so real that you could see that he was experiencing the act with such vividness that for the moment he was again there, making the leap that saved his life.

With this awareness of how some people, including myself, seem to have the propensity to relive some experiences with great vividness, I was excited to see a report in the Journal of Cognitive Neurosciences describing a study using complex imaging techniques that explains the neurophysiology of vivid memory recall. From this study, undertaken at the Rotman Research Centre of Baycrest with Dr. Bradley Buchsbaum as the primary investigator, it appears that the brain keeps in its memory the pathways of different experiences. These, when accessed, can repeat the circuitry of the original experience so that the memory is as if that sequence of events is taking place as vividly as in “real time.”

If this is shown on further studies to be the mechanism for vivid memories, it potentially opens up new ways to treat or prevent vivid memories of terrifying experiences and perhaps even play a role in addressing the mental experience of post-traumatic stress disorder. I will follow this research story with great interest.

 

 Dr. Michael Gordon is medical program director of palliative care at Baycrest. His latest book is Late-Stage Dementia, Promoting Comfort, Compassion and Care. His previous book, Moments that Matter: Cases in Ethical Eldercare, follows his memoir, Brooklyn Beginnings: A Geriatrician’s Odyssey. All can be researched at his website: http://www.drmichaelgordon.com.

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