After another long sequence I now wrestle with the concept of two lists: a symbolic one in my head, a real one in the outside world, and the relational linking of the two together. I struggle with the concept of mapping analogue symbols for items in the real world—my children—into the empty list I’ve created in my head. Inside I am creating, dreaming, making things up; outside I am seeing, recalling, perceiving. I move my visual/spatial representation back and forth between the two, and as I do so, my eyes actually move, and refocus, following my thoughts.
This difference in perspective between two such lists is significant. You can see it with the following exercise: Imagine, in your head, a word list—the names of places you have lived; now imagine those same places on the grid of the earth and mentally point in the direction of each of them as you work through the list. These are two entirely different representations. The first is purely symbolic, but the second is a real-world corollary of the first, with spatial sense, and direction, and geometric relationships between each of the cities and your current location on Earth. And once we have established the two lists, we can link them together: the city-name words in the internal list each to a real city on the face of the earth in the external list.
This linking between the real, physical world and our internal, symbolic representation of it is something that we ordinarily manage with intuitive grace. We move elegantly along the mappings from one to the other, and switch with ease between the quite different representations. But here we see that I’ve lost that ability. Instead, I must explicitly define the relationship between the two.
At this point we come to an interesting revelation, and I want to call special attention to it. I had, by this time in my life, come to believe that I had no hope of ever recovering from the brain damage. Instead, I focused on trying to improve my effectiveness by being clever with the limited brain resources I retained. As part of my efforts, I had decided it was important to recognize when to give up. This was an entirely foreign concept to me, but under the circumstances was appropriate, and necessary. The mantra went something like, You have brain damage, Clark. There are things that you simply can no longer manage, so don’t try to. Don’t push yourself too far! I had practiced “giving up” for several years now—letting go of some of my responsibility—but it was contrary to my nature and never came naturally. At this point in the exercise, the intensity of my mental work is grinding my tired brain down, and I start to experience head pain and nausea. I’m perspiring from the effort. Several times I am reminded of the rule:
Clark, you are in pain, so now YOU MUST STOP.
This is annoying. I know intuitively that it will take up precious resources to figure out what stopping means, and how to integrate stopping with reaching my goal. I don’t have time for that. But as I continue, and my distress level rises, my need to address the rule becomes overwhelming. I finally pause to briefly mull this over.
But now something really interesting happens: in considering “Should I stop now?” another absolutely clear, elemental rule pops up:
Clark NEVER GIVES UP.
So who am I? I ask myself.
I can’t get it. I have two conflicting rules. It’s too much work to figure out, and is draining too much energy from the problem at hand. In the end I stop trying to be someone I don’t understand, and just continue instead with solving the problem. The increasing pain, and the well-intentioned new rules, are nothing next to who I am.
But what are the implications here? This core identity—the guy who just never gives up—is integrated into my being at the lowest level of cognition—the same level at which the concepts of left and right and inside and outside are stored. This is not part of some narrative personal story, nor is it some high-level learned trait. It is a most basic, elemental, cognitive part of me.*
Over the next sixty seconds I work through—among other concepts—the idea that I have a set of children that will be mapped one-to-one into the slots in my internal list; that sets have cardinality (the countable number of items in the set); that children have ages; and so on. I get stymied waiting for a number to rise up out of the ether that will set an upper limit on the range of elements in my list. I get tied up with the idea of a zero-length list, and the Assumption Daemon leaps out to claim this as an instance of the failed assumption that I have children.
At one point I simply wait, perched, doing nothing at all except letting the mysterious cauldron of my brain boil away. After a while, and after I’ve clearly formed my question, some hidden process takes place, and the number “5” floats up out of the ether: I have five children. There is no association to be made. The process is atomic: one moment there is nothing, the next moment the visual image of the number “5” is floating across my internal field of vision.
I don’t fully know what “5” means, but five is like the five fingers on my left hand, facing me. Fingertips, like ovals, like faces, people, the history of primitive people, tribes, families, parents, children, oldest children, first children, biggest, oldest on the left. Reversed list. Oldest child, oval face, flesh-colored, like the thumb on my left hand facing me. I see the face of my oldest daughter, superimposed. I can’t access her name, but I do know that I know her name.
I’ve gone back to refresh sixteen times at this point.
I release many items, partial results that I have stored in working memory. The Assumption Daemon dies off, because having seen one child, I know that I have children: I no longer have to consider taking an alternate path that would have been necessary had my assumption turned out to be false. I release the marker that I am still unclear about what binary means (yes/no—do I have children?). I let go of the ordinality and cardinality properties of numbers, because I need only the one number: five. My refresh list gets much shorter. I feel tangibly energized as my cognitive resources are freed up.
I retrieve the concept of male children (boys) and female children (girls). I bind my daughter, Nell, to my left thumb, palm facing me, which is hard because this is backward—the reversed list, with the oldest (biggest) on the left. I have to physically “look” her into this binding by staring intently at my thumb. I speak her name:
“Um. My oldest child is Nell.”
It has been two and a half minutes of intense concentration and I’ve just named my first child.
I get the sentence out, but the effort of translating thought into speech causes all of my visual memory of the problem I am working on to disappear. I have to go back and retrieve many of the markers again, and recut the channels. I get back the image of Nell, and then, over time, in sequence, the images of my other four children appear. There are two additional difficulties, one primarily linguistic and the other arithmetical: My boys are named Peter and Paul, they are often together—they are very close—and the alliteration of the “P” sound at the beginning of their names further binds them to each other. Because Peter is the second oldest, Lucy the third, and Paul the fourth, I have to slip Lucy in between the two boys. But she is a girl, and she has an “L” sound in her name, so I have to fight against the “P” symmetry, and the “boy” symmetry, to get her into the right place. In struggling with this problem I again lose Nell, and have to go back quite a ways to retrieve her. I have even more trouble with my youngest, Erin. It takes significant time to add her to the list. The children are aged 18, 16, 14, 12, and Erin—3. She is not an even-numbered age. She acts differently from the rest because she is so much younger. There is a gap to get to her. Each of these factors upsets the symmetry of the structures I am building to hold my children—to hold the symbols of them in my mind’s eye—so that I can name them.
My retrieval of the children as I fill in the list also involves partially seeing a visual montage of their life activities—which is part of who they are, like their names.
I say aloud, “My son, Peter.”
As I do so the visual images of Peter, and Nell, fly off like
startled birds. Translating the image of Peter into a physical utterance requires so much cognitive “horsepower” that I cannot maintain the imagery at the same time.
Finally I get to “Erin, age 3.”
I’m exhausted. I’ve named my five children—maybe. I can’t see them all at once, and by the time I’ve named Erin, I can no longer really conceive of having named Nell. I am not able to speak their names and see their faces at the same time. I look at my watch: three and a half minutes. It’s not a good day for taking on challenges.
The assessment test might take me anywhere from 6 to 210 seconds. Because the range of time covered such a spectrum, and because I went through the exercise so many times, I observed the process in many different ways. My strongest intuition is that, except for some of the deficits that coincidentally came with brain fatigue (e.g., the hemispatial neglect, and the synesthesia), the process was the same no matter how long it took, and that this record gives us a unique window into the massive low-level cognitive processing that goes on inside all of us throughout the day, beneath our consciousness—even for what appear to be simple mental tasks.
GETTING HOME / THE DOG THAT WASN’T. At times the juxtaposition of my internal and external lives was startling. An episode that occurred eight years after the crash illustrates how little my surface life—in which I was pursuing such normal activities as going to the movies—reflected the complex processing going on under the hood, which by this time was occasionally so bizarre as to be almost unreal.
At first glance, it might appear that I was finally losing touch with reality. In fact, on closer examination, the case can be made that while I was clearly impaired, I was actually operating closer to the true nature of raw, unfiltered “reality” than normals, doing my best to navigate our world without the powerful cognitive filters that do so much of the work for us by excluding most of our sensory input before it enters consciousness. Within this context, I was entirely lucid and logical.
The following episode illustrates more than a dozen distinct cognitive failures and workarounds, including some interesting ideaesthesia oddities (ideas mixing with senses), and difficulties mapping mental symbols to their real-world analogues, and then ends in a truly strange sequence that highlights an aspect of our inherent linguistic intelligence.
On this particular spring afternoon in 2007, Qianwei happened to be home between business trips—and she could stay with our daughter Erin. I took advantage of the rare opportunity and went to the movies to let the images roll past, with no requirement that I need make sense of them. My “deep batteries” were depleted from the grind of the long school year, and from being a virtual single parent. Going to the movies usually afforded me a little mental break, but for some reason this time the processing of dialogue and the visual input made things worse.
I left the theater’s parking lot as the sun was setting, in the classic Toyota Supra cult-car I was considering restoring, to make the seven-minute, two-mile drive home. I had no trouble managing the car, but soon found that I did not recognize any of the visual landmarks around me. As had occasionally happened to me in the past, neither the streets nor the neighborhoods looked familiar, as though I were experiencing some kind of “building prosopagnosia”—face blindness for buildings. I could read the words on the street signs, but they too were simply empty patterns of letters. I could not figure out how to get home.
I thought that if I drove for a while I would start to recognize where I was. The problem was that I already did have a clear visual appraisal of my surroundings, and in one sense I knew exactly where I was—I just could not access that knowledge in any way that was useful. For example, I could have told you, “That’s the YMCA where Paul plays basketball, and where my friend Liam saved a girl from drowning,” but I could not recognize the Y or any other building, or place any of them in a larger visual context in a way that gave me a sense of having seen them before—I couldn’t make a meaningful whole from the various pieces. And, the pieces were useless to me for navigation because without the “thingness” of them I didn’t have any way to place them in the larger geography that made up my local world. When I read the names on the street signs, waiting for the meaning of the streets in the real world to come to me (their placement on the grid of the city, their usefulness in getting me home), nothing happened.
Very strange!
Over the course of the next hour I drove in slowly expanding circles around the downtown area. Finally, to at least get some NSEW grounding I drove (downhill) over to the shore of Lake Michigan, half a mile away, because I knew the lake formed the eastern boundary of the city, giving me a point of reference. Then, because of a 9:00 P.M. curfew along the lakeshore, I drove several blocks west and parked there on a side street. As I did so, I fired up a daemon charged with preserving my geometric orientation relative to the lake. Over the course of the succeeding hour, this Orientation Daemon slowly drained away at my remaining cognitive batteries. Roughly speaking, it was like an annoying voice in my head, interrupting every three or four seconds, quietly reminding me, Lake Michigan is behind you, to the east, so you are now headed west. Don’t forget!
Using speed-dial six on my cell phone, I called Jake in San Diego to ask for help. He was in the middle of a challenging project at work, and impatient to get back to it.
“I don’t get it,” he said curtly. “You’ve never had trouble getting home before. Where are you?”
“I don’t know, Jake,” I said. “I don’t recognize any of the streets or any of the buildings. I’ve driven in circles for an hour and am now facing west, away from the lake, which is several blocks behind me.”
“Okay,” he said, “we can work with that. Get out of the car. Walk to a street corner. Look around at what you see. Memorize the names on the street signs, then call me back.”
It was ten minutes before I could initiate getting out of the car. Once out on the street, I had to hold on to the car, a parking-sign pole, and some hedges, to walk to the corner—seventy-five feet away. Visual, olfactory, auditory, and proprioceptive information was flooding in, but because my sensory filters were not working, I was getting everything all the time, and all at once, in one giant, flattened collection of small features from the environment. I couldn’t form meaningful interpretations of what I was seeing. I was also having trouble extracting visual balance information from the environment, as twilight settled in, making it hard to walk.
So I did my best to simply keep all the objects I encountered in memory. After twenty minutes, exhausted, I got back to the car and reported the data to Jake. “I am next to a big house that has fourteen lights turned on in many rooms with no people, which I can see through the windows, so we know I am in a wealthy neighborhood. The curb has a circle and some orange letters spray-painted on it, probably from a previous street, gas, or water repair. There are tall hedges with thin branches and lots of small leaves.”
Jake said, “Okay. Hedges. Paint. A big house by the lake. That doesn’t help us much. Anything from the corner, where the street signs are?”
I told him, “I could make out what looked like an explosion of green leaves, and some white flowers. Putting them all together, I’m guessing it was a big bush, or a tree. Next to the tree there were signs on a pole.”
“Okay. Good job,” said Jake. “Were they street signs? Were there names?”
“I can’t really say,” I told him. “I am trying to tell you, but I can’t. It is very difficult for me. Yes, there were two street signs. One of them was, well . . . it was . . . Michigan.”
There were two immediate problems that had begun to plague me. The first was that the drain from the Lake Michigan Orientation Daemon (used to remember east) became significantly worse because I now had to disambiguate the internal visual symbol for Lake Michigan (i.e., starting with a capital M) from the nearly identical symbol for Michigan Avenue—the cross-street up at the corner to which I had just walked
. Sorting out the cognitive interference between the two was wearing me down.
The second problem was even more disconcerting, and illustrates a form of ideaesthesia (not to be confused with the less accurate synesthesia in this case) that would sometimes crop up.* The street on which I was parked—corresponding to the other sign at the corner—was “Greenleaf.” But I was having trouble discriminating the street name not only from the sight of the green leaves that were fluttering in the glow from the streetlight, but also from the green spring scent of the (green) leaves themselves and of the flowers, and even from the internal raw shape of greenness in my mind.
Nonetheless, with Jake’s encouragement I might have been able to form the vocalization for “Greenleaf Street” if he had not, ironically, picked the one helping tactic that would put me over the edge. He asked, “Can you tell me what the color of the sign is, and what color the letters are? If you can describe the signs I’ll at least know what city you’re in.”*
The Ghost in My Brain Page 13
