Thursday 24 September 2015

Memory: the elephant in the room



When he noticed that song lyrics seemed immune from memory loss following brain injury, Billy Mann got to wondering what it is exactly that stimulates our ability to recall and recollect



There are advantages to having a brain injury. At social and formal gatherings you are allowed to forget things. You can walk into a room, be introduced to half a dozen people and instantly forget their names. Then, when you bump into one of them later, they forgive you when you whimper, pathetically, “I’m sorry, but I’ve forgotten your name.”

Memory problems are very common among people with brain injuries. One day a week, I attend Headway East London in Hackney. Some of my fellow members there cannot remember my name from one moment to the next. One of them, Sharon, who I have now been happily greeting each week for around two years, stares at me, her face screwed up in quizzical concentration. 
“It begins with a B...” she says. 
“Yes,” I answer, and wait a few beats. 
“Bobby?" 
"No. Billy." 
That we have arrived at B in two years is, I like to think, some kind of minor miracle.

Another member I see regularly is Stuart, who also suffers from acute memory problems. Stuart and I have a part-share in a backstory. We are both a similar age and we both lived in Liverpool during the late 1980s. Like Sharon, Stuart greets me each week with a confused and inscrutable look. He will then take a guess at my identity. 
"Scouser?"

What both Sharon and Stuart share, other than their difficulties with short-term memory, is a love of music. In Sharon's case, this comes down to a girlish infatuation with The Osmonds, an American family group popular in the 1970s. They were five brothers — Alan, Wayne, Merrill, Jay and Donny. Other Osmonds (Mormons, big family, etc) also enjoyed some commercial success on the 1970s music scene, notably Marie with a memorable song, Paper Roses, and Little Jimmy Osmond with a cheeky number titled Long Haired Lover from Liverpool. The Osmond Brothers themselves had many hit records, but the one that comes to mind right now is 1974’s Love Me for a Reason. It comes to mind because with those five words Sharon's memory is thrown on to some kind of neurological dancefloor and the words come flooding back: 

Don't love me for fun, girl
Let me be the one, girl
Love me for a reason
Let the reason be love

In 1995 the boyband Boyzone attempted their own version of the song, but as Sharon is quick to remark, it was nothing on the Osmonds’ rendition. She might have put it less politely.

The routine with Stuart is similar. In his case we have an ongoing exchange relating to music from 1970s-80s Liverpool (Stuart was a performing musician in the city then). Our first meeting point each week normally involves an exchange of lyrics from a band associated with Liverpool called The Scaffold, a trio that actually started in the heady days of the 1960s and enjoyed notable success during that swinging decade. They were a performing ratatouille of comedy, poetry and music featuring Mike McGear (real name Peter Michael McCartney and brother of Paul McCartney), Roger McGough (he’s that Poetry Please guy off the radio) and madcap funnyman John Gorman. Each week Stuart will smile brightly in my direction and say “Thank you very much for the Aintree Iron” (a line from the Scaffold song Thank U Very Much), to which I will reply “Did you get your medicinal compound, Stuart?” (from the Scaffold song Lily The Pink). Stuart catches on to this game without hesitation and answers with another lyrical reference to Lily The Pink. 
“Yes, most efficacious in every way.”

Clearly both Sharon and Stuart have a thing about song lyrics that makes words stick in their heads. It is a joy to witness, and obviously a potential open door for therapists. But part of me wonders what other memory triggers are sitting hidden in damaged brains everywhere. Could I, for example, attempt a not-so controlled experiment in which I appear casually to mention the character Boss Hogg from the 1980s US TV show The Dukes of Hazzard while actually fishing for a bit of anecdotal evidence on the importance of popular culture in understanding a badly misfiring memory.

Memory is a strange fruit. It is part of that thing we would like to call our soul, but we know little about it. At best I am prepared to stick my neck out and say that memory is the slippery customer that skates the thin ice that separates the neuro from the psycho. There is also something about memory that repels fiddling. Mess around with it and you risk the wrath of the gods, etc.

Which draws me back to where I started. There is another advantage to having a brain injury. I call it the Automatic Exit Strategy (AES). When you are at a social or formal gathering and starting to glaze over with boredom right in front of someone, you can just say, “Sorry, I have to go now” and they won't turn to the person next to them and say, “How rude was that?” I have an agreed version of this with my wife. I say, “I’ll just go and sit down and shut up, shall I?” to which she replies, “Yes, please.” 

OK, then, that's my cue to leave the table. Bye for now. And don’t go trying to tinker with any of those memories while I’m gone.
Sharon is not her real name.


Tuesday 15 September 2015

Club 300 Closes: but did it work?

A project to test the theory that 300 repetitions results in improved performance has come to an end. And the results are in. By Billy Mann


The Occupational Therapy project at Headway East London I posted about a while back has now finished. To recap, Club 300 as we cheekily called it, brought together four members of Headway East London, each of whom wanted to gain some improvement in the execution of an everyday task. Two members wanted to improve their handwriting, another wanted to cut up food on a plate more confidently, and I tasked myself with the mission impossible of walking without a stick while holding a cup of water in my weaker left hand. 

If you want detailed information on the results of this exercise, the OT in charge was Natasha Lockyer. I cannot discuss how others performed, but to finish the analysis, the tests we performed at the start were repeated at the end and the change recorded. At the start, I had walked a given distance (not sure what it was) holding a cup in my left hand filled to near the top with water in 46 seconds, and I spilled around 10ml in the process. At the end, I walked the same distance in 18 seconds and spilled no water. Get me, eh? Top of the world, Ma.

In my daily executions of these 300 steps, I determined to make the task more difficult as my performance improved. This, I am afraid to say, has fallen by the wayside in favour of basking in the success of spilling no water. Still, I do continue to perform the routine every day (or thereabouts) and continue to notice a difference. I shall report on my progress as and when something of interest happens, and I will ask Natasha if a re-run of the test in, say, 6 months is possible. Only then will I be able to declare Club 300 a giant leap for mankind.