6 months ago

SW_1-36v3 (dragged) 2

SW_1-36v3 (dragged)

NEW AND OUTSTANDING “Humans – they went to all this trouble building us just to have someone to play chess with.” THE BOOK THAT ASKS THE BRAIN JUST WHO IT THINKS IT IS “Who do we become when we are no longer ourselves?” wonders Dr Jules Montague, in an excellent meditation on how the brain can’t always be trusted to look after our memories and identity properly Capgras Syndrome is a psychiatric condition in which sufferers become convinced that someone they know – or their pet – has been replaced by an identical impostor. It is very rare, but it has an even rarer variant, in which sufferers believe that they themselves have been switched for a double. Among the countless useless facts I have been exposed to, this one has stuck, easily retrievable without recourse to a scratched head or thinking-hard face. For some reason, the brain finds the gothic horror of a person turning into someone else quite irresistible and impossible to forget. Consultant neurologist Dr Jules Montague is a specialist in early-onset dementia and other neuro-degenerative diseases, so has spent her career wondering just what is going on in other people’s heads, especially when the great unknowable sponge is at its most puzzling. Her book, Lost and Found, blends several instances of Hollywoodon-line-three strangeness with more quotidian examples of the brain plotting a solo mission – through dementia for example – and no less heartbreaking events of severe brain injury. Who do we become when our minds misbehave? is the question she sets out to answer, and her cast of misbehaving minds is strong. Here is Charlie, an alcoholic Dublin tramp who had to fire his butler the previous day – after 12 years loyal service – for stealing a combine harvester. Here is Hillary Clinton, who remembers landing in Bosnia in 1996 “under sniper fire” and having to run for it, when television pictures showed her chatting to an eight-year-old girl who presented her with a poem. Here is “Benjaman Kyle”, found unconscious and semi-naked by the bins behind a Burger King in Georgia. When he comes to, he has no idea who he is – the initials of the restaurant where he was found are used to begin construction of a temporary name while he searches for his own. And here is Kevin, with his LOVE and HATE tattoos right where you’d expect them, but who had woken in the middle of the night to find himself Hillary Clinton remembers landing in Bosnia “under sniper fire.” Television showed her chatting to an eight-year-old girl LOST AND FOUND by DR JULES MONTAGUE Sceptre, £20 “drifting mid-air...staring downwards at his own physical body – motionless, still lying in bed.” This is not Dr Montague’s Big Book of Enigmas, however. Each of these instances serve as part of a meditation on what we can learn from the brain at its most idiosyncratic. Extremes of behaviour help illuminate the ordinary. Early on, she quotes the philosopher John Locke, who said “without memory, there is no person,” which is perhaps the most agonising aspect for those caring for loved ones with dementia. But Dr Montague notes that it’s not primarily the sufferer who has an issue with their gibberish: “what if even these seemingly chaotic and repetitive stories cement rather than decimate identity in Alzheimer’s?” she speculates. “What if they allow those with dementia to make sense of themselves and others? The chaos and repetition might be our problem, not theirs.” And anyway, it’s not like our own power of recall is so University-Challenge fierce either. She quotes a study of “flashbulb memories” of adults recalling the September 11 attacks. “After a year, participants’ memories were consistent with their original accounts only 63% of the time. That figure was 57% at three years. Even their memory of emotions changed over time.” What we remember, apparently, is not the original event, but the last time we remembered it. She also discusses the inability to measure awareness in those who have suffered terrible brain injuries, the kind of people who are talked about in terms of whether they should be kept alive or not. In 2005, neuroscientist Adrian Owen placed a patient in a vegetative state in an MRI scan and asked her to imagine that she were playing tennis. Activity was noted in the department of the brain that handles sport. She was then asked to imagine wandering around her house. Activity was registered in a different part of the brain, the bit responsible for spatial imagery. It appeared the patient could understand spoken instructions and respond to them, and therefore must be conciously aware, said the scientists. They then had the inspired idea of conducting a yes/no conversation with the patient – think “tennis” for yes and “house” for no. An undreamt of communication channel appeared to have opened up. But critics claimed it was just a “purposeless reflex action”, indicative of nothing, and it brought an Everest of moral questions and a fresh set of dilemmas. “We’re not at a point where we can reliably make decisions based on these techniques, no matter how intriguing they are,” she writes. “But that does not mean that I don’t want to. As I stand there with my reflex hammer and my ophthalmoscope, as useful as they are, I am a doctor woefully ill-equipped.” The more we know, it seems, the more we don’t. 04 STRONG WORDS APRIL 2018 SUBSCRIBE AT: STRONG-WORDS.CO.UK