Fog, Part I

I promised Sean that I’d explain what I meant by “fog.” He asked, “How problematic is it? As someone who is absent-minded naturally how different is it? One article said you forget why you went to a store. You forget people’s names etc. This happens to me often, so I write everything down. I am assuming there is something much more serious and sinister.”

Yes and no, Sean. It is a very natural response to trying to use empathy to understand the problem (indeed, that act is the very foundation of social science). Moreover, you are right in believing that you have experienced what I experience—indeed everyone does experience absent-mindedness. The practical difference is not qualitative. It’s quantitative. A healthy person does not experience absent-mindedness as many as twenty to thirty times a day. For me, this is quite normal.

Recall not memory

You are right, however, that this is a problem that normal people have. We all experience small recall problems. We search for a word that is on the tip of our tongues. We forget someone’s name. We got to the refrigerator only to forget what it was that we were getting. These are recall problems—the memory is still imprinted in the cerebral cortex, it can still be accessed. If you have a memory problem (an illness such as Alzheimer’s, for example), the memory itself is being destroyed and, as personality is a direct product of memory, your identity is destroyed with it. You know less and less that you have a problem and everyone you love suffers as your personality and every memory you have of them are destroyed and they get to watch the walking corpse.

A recall problem is nowhere near as cataclysmic. You can remind me of what I’m forgetting and, almost without exception, I’ll remember it. While you are out of sight, I may forget that I was supposed to do something with you, but my memory of you and what we were supposed to do is still there. If I have a list of things to buy at the store, it will jog my memory. Someone with Alzheimer’s will not even recall the context of the list or know what to do with it.

I think a good analogy is to think of a computer. A computer has a processor, memory and a hard-drive. My processor is fine. I think pretty quickly and accurately. My hard-drive is fine. People with Alzheimer’s essentially have a bad hard-drive that is destroying all the data on the disk. My problem is that I have shit for memory. Just like a computer that’s running the latest software with low memory, I can still do the task. It’s just slow. I can still do virtually all the things I did before. I simply cannot do them efficiently.

Some of the tricks a normal person uses will work for me too. Writing things down is key. But unlike a normal person, I need to make sure that I get things written down where I can see it when I can actually do something about it. For example, my mom can call me earlier in the day twice to remind me that it’s my father’s birthday. But unless I write it where I can see it in the early evening, I’ll completely space. It doesn’t matter that my mother called me twice to remind me. And it doesn’t matter how important the person involved is or how much I love them. I’ve spaced on Craig’s AA birthday, my mom’s birthday and most of my friends can attest that it’s been years since I remembered their birthday, if indeed, they ever knew me before MS. Plus, recall that multiple sclerosis is a nerve conduction problem. There are good days and bad days. Some days I remember without a reminder. Some days twenty reminders won’t be enough. There’s no way of telling which kind of day tomorrow will be.

Concrete Object fields

Coordinating between different times and spaces is very difficult for me. This is hard to explain. I had to develop a vocabulary to even explain the problem for myself. So that’s how I have to explain it to you. In order to relate to a set of discrete objects or ideas, we construct what I’ll call “object fields.”

Object field: a cognitive “space” delineated by networks of associations that lead the mind to group certain objects together as an interrelated and discrete whole.

Meta-object field: a cognitive object field that contains other object-fields and that is constructed to coordinate between them

The object fields that are the simplest for me to deal with are those that are based on real physical locations where I happen to be. The advantage in this case is obvious—I can see the space and that sensory stimulus is a constant reminder. It’s hard to forget something that you’re looking at. But even when dealing with physical object fields, I have problems, particularly in complex work areas such as the kitchen.

Say I’m making a salad. I leave my cutting board and the knife on the counter and go the refrigerator to get some vegetables. When I open the refrigerator, I’ve entered a new object field. Often, when I move from one object field to another, I forget what I’m doing. So I’ll be standing there looking at the refrigerator trying to remember what I was doing. So I’ll have to look away from the refrigerator and look back at the counter. When I see the cutting board and knife, they jog my memory. So far, so good, right? That happens to everyone.

What doesn’t happen to everyone it that when I look away again, I’ll forget again. Lather, rinse, repeat. On a bad day, it may take three or four repetitions before I get it right. Imagine accruing all of those time losses every time you change object field (if you open a desk drawer, you’ve just changed object field—we change object fields just that often). The time losses rack up. Bottom line: I can still make a great salad, but you can do it faster, especially since you don’t have the recall problem and are likely to be faster with a knife than me. Being slow with a knife, however, has nothing to do with MS. I’ve always been a klutz.

Object Fields and the World of My Imagination

Now, I’m allegedly an intellectual. Lots of what I do happens solely in the mind. There are no physical objects to glance back at to remind you. Yes, there is a physical bunch of people who are the Congress of the United States, but no one who studies them has them all seated in a room. Moreover, certain things like “institutionalization” are rather abstract. Fortunately, most of those object fields are part of my long-term memory. But you see, it’s my job to invent new concepts. Now my imagination still works just fine and that was my real academic asset, as not everyone has one. So I can still do this job. But now, I’m way slower.

In my imagination, there are all sorts of connections. One thing hooks up with another and another. There’s always this huge, amorphous incoherent “structure” that feels like it’s the Theory of Life, the Universe and Everything. Well, back when we were first-year grad students my buddy Peter said (and he had a point), “Talal, you can’t write the Theory of Life, the Universe and Everything. You have to pick one. So what’s it going to be: life, the universe, or everything?”

Well, what I would have done before MS was to loosely define the contours of the whole pseudo-structure in my mind, find the general boundaries of the part I wanted to write up and distill that bit into a coherent, well-crafted theory. But my short-term recall is shot. Trying to cut out the bit in my mind that I want is virtually impossible. I don't know the pseudo-structure very well, so it exists only in short-term memory. I have to do two things at once: recall the whole structure and then step away from it and criticize it. That's too much brain-power at one time. I keep losing focus on the outline of the large structure as I explore it to criticize it. In the seconds in which I lose track of the process, I start following all the luminous connections that my imagination has generated and, as a result, keep losing track of the task.

What I’ve discovered that I have to do is do my best to spend a few months writing a sixty-page document that is a rambling mess but contains a great deal of the amorphous pseudo-structure in my head. Then I can see the pseudo-structure and don’t need to hold it in my head and criticize it at the same time. Yes, I'll still get distracted, but my eyes will still be resting on the same shitty passage I was critizing before and that will pull me back on task. I don't get as lost that way.

After doing the write-up of the pseudo-structure, I need to wait a while before proceeding to criticism, because trying to force that much material out of one’s imagination into the daylight at one time is exhausting and really fucks with your emotions. So a few months later (yes, that long) I can pick up the rambling mess and use all my brain power just for criticism. I don’t need to recall anything, because it’s right there on paper in front of me. Plus, having given birth to far more of the pseudo-structure than I needed, I can probably distill a few papers out of the mess.

But it’s slow. Worse, it looks like you’re not really working most of the time, especially to people who are not writers. That’s pretty humiliating, because I’m trying really hard the whole time. And you burn out several times on the road and wind up playing Civ 3 or Spider Solitaire just to get you mind off of it and let stuff work at the back of your head. That doesn’t build other people’s external confidence either. But you’ve got to take those sort of breaks if you’re to get the job done.

This is quite a mouthful. I’ll start with meta-object fields next time.