My current favorite song is “Still Here” by Caitlin Canty:

She’s kinda like Marie De Salle, but you know, real… (10 points if you get the reference without clicking on the link).  There’s one haunting verse halfway through the song:

I’ve forgotten now

What i came to talk about

I remember how

Every memory’s slippery now

Stronger than skin and bone

Time will distill you down

What are you made of?

We will all find out 

What you’re made of.

For the recently cognitively impaired, this hits close to home.  Shortly after emerging from the ICU, an occupational therapist asked me to recite the months of the year backwards.  Under normal circumstances, I could spell the months of the year backwards using the ASCII code for each character, but at the time, Jing had to provide prodding hints to get me past the finish line.  It was a bad moment for everyone.  A couple weeks later, a different therapist asked me to remember and recite a short paragraph-long anecdote.  I recall winking to Jing before I began my recitation.  That was a good moment.  Not only did I do the task correctly, I knew I was going to do the task correctly.  It felt good to be confident.

My cognitive rehab has mainly comprised of music, Lumosity, and reading good books and science articles.  Lumosity is a web-based series of games that challenge different aspects of your cognitive abilities.  Two examples are shown nearby: MemoryMatrix“Memory Matrix” flashes up a pattern of blue squares for a few seconds in a matrix, then you’re asked to recall the pattern you saw.  “Feeding Koi” has a number of animated fish that you need to track and feed once and only once.  KoiThe first is a pretty straight-forward spatial memory task; the second is a working memory / attention task.  Both were damn near impossible for me when I first started, and all my memories were slippery.  I’ve been hitting Lumosity hard, about two hours per day.  So much of my identity is built around being clever and creative, and my wife and daughters deserve to have me back in full.  I’m delighted to say that my aggregate Lumosity score for all games played has now exceeded the 90th percentile!  Note that my strongest categories are processing speed and problem solving — the two categories identified as weak spots during my neuropsych evaluation, and therefore the subject of the most intense training.  Lumocity_Scores1

It’s impossible to say what I would have been at before the seizure and surgery, but I know for a fact that shortly after starting this process, all I wanted was to be in the top half of all performers.  More recently, I declared preliminary success when I cracked the 70th percentile.  70th percentile isn’t much to brag about, but it’s a damn sight better than being impaired.  Although I’m not giving up on continued cognitive rehab, I’m happy to declare myself to be approaching my pre-surgery baseline, and thus, effectively back to normal.  We’ll see how that holds up when I start doing some proper creative science again.

So what exactly happened?

I think that most of the deficits I was experiencing immediately after surgery were due to trauma from the surgery and associated reversible damage.  At the time, this damped my executive functioning severely, but it has resolved in due course.  Also, my left brain probably took over some of the tasks previously performed by my right pre-motor cortex.  Neuronal plasticity is awesome, and I will do everything to encourage continued flexibility.

The big picture:

Just like dentists nag about flossing our teeth, and our physicians chide us about getting regular exercise, I predict that a generation from now, physicians will encourage patients to get appropriate levels of cognitive stimulation.  As I’ve written previously, mice housed in enriched environments — novel stimulation and opportunities for learning — have enhanced immune functions and thereby fight glioma more effectively than mice housed in normal environments.  This general principle holds for many other cancers as well as neuro-degenerative diseases, normal aging, depression, and a variety of related psychiatric issues.  I predict that an entire science of mental fitness will emerge in the coming years, and people will engage in these sorts of training activities the way we go for a run or go to the gym today.  Lumosity is the leading edge of this wave.  Take it from me, it’s no fun when memories are slippery, and it feels a lot better to realize that when you distill your mind down, there’s a reserve of cognitive abilities that can compensate for damage and dysfunction.

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