Remember - Lisa Genova - E-Book

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Lisa Genova

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*A New York Times bestseller* 'Using her expertise as a neuroscientist and her gifts as a storyteller, Lisa Genova explains the nuances of human memory' - Steven Pinker, Johnstone Professor of Psychology, Harvard University, and bestselling author of How The Mind Works 'No one writes more brilliantly about the connections between the brain, the mind, and the heart. Remember is a beautiful, fascinating, and important book about the mysteries of human memory - what it is, how it works, and what happens when it is stolen from us. A scientific and literary treat that you will not soon forget.' - Daniel Gilbert (New York Times bestselling author of Stumbling on Happiness) Have you ever felt a crushing wave of panic when you can't for the life of you remember the name of that actor in the movie you saw last week, or you walk into a room only to forget why you went there in the first place? If you're over forty, you're probably not laughing. You might even be worried that these lapses in memory could be an early sign of Alzheimer's or dementia. In reality, for the vast majority of us, these examples of forgetting are completely normal. Why? Because while memory is amazing, it is far from perfect. Our brains aren't designed to remember every name we hear, plan we make or day we experience. Just because your memory sometimes fails doesn't mean it's broken or succumbing to disease. Forgetting is actually part of being human. In Remember, neuroscientist and acclaimed novelist Lisa Genova delves into how memories are made and how we retrieve them. In explaining whether forgotten memories are temporarily inaccessible or erased forever and why some memories are built to exist for only a few seconds while others can last a lifetime, we're shown the clear distinction between normal forgetting (where you parked your car) and forgetting due to Alzheimer's (that you own a car). Remember shows us how to create a better relationship with our memory - so we no longer have to fear it any more, which can be life-changing.

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First published in the United States in 2021 by Harmony Books, an imprint of the Crown Publishing Group, a division of Penguin Random House LLC, New York.

Published in trade paperback in Great Britain in 2021 by Allen & Unwin, an imprint of Atlantic Books Ltd.

Copyright © Lisa Genova, 2021

The moral right of Lisa Genova to be identified as the author of this work has been asserted by her in accordance with the Copyright, Designs and Patents Act of 1988.

Photograph on p.31 of the United Kingdom one-penny coin © 2020 The Royal Mint, reproduced with their kind permission.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of both the copyright owner and the above publisher of this book.

10 9 8 7 6 5 4 3 2 1

A CIP catalogue record for this book is available from the British Library.

Trade paperback ISBN: 978 1 83895 415 4

E-book ISBN: 978 1 83895 416 1

Printed in Great Britain

Allen & Unwin

An imprint of Atlantic Books Ltd

Ormond House

26–27 Boswell Street

London

WC1N 3JZ

www.allenandunwin.com/uk

For Alena, Ethan, Stella, and Peanut

Contents

 

Introduction

PART I

How We Remember

1. Making Memories 101

2. Pay Attention

3. In the Moment

4. Muscle Memory

5. Your Brain’s Wikipedia

6. What Happened

PART II

Why We Forget

7. Your Memories (For What Happened) Are Wrong

8. Tip of the Tongue

9. Don’t Forget to Remember

10. This Too Shall Pass

11. Fuggedaboutit

12. Normal Aging

13. Alzheimer’s

PART III

Improve or Impair

14. Put It in Context

15. Stressed Out

16. Go to Sleep

17. Alzheimer’s Prevention

18. The Memory Paradox

Appendix: What to Do About It All

Suggested Reading

Acknowledgments

Introduction

Picture a penny in your mind’s eye. Because you’ve probably encountered a penny hundreds if not thousands of times over the years, you should have no trouble remembering what one looks like. You’ve committed this image to memory.

Or have you? What direction is the queen facing? Are you sure? Where is the date? What’s pictured on the tail side? Could you draw both sides of a penny with total accuracy from memory right now? How can you both remember a penny and yet remember so little about it? Is your memory failing?

It’s not. It’s doing exactly what it’s supposed to do.

Your brain is amazing. Every day, it performs a myriad miracles—it sees, hears, tastes, smells, and senses touch. It also feels pain, pleasure, temperature, stress, and a wide range of emotions. It plans things and solves problems. It knows where you are in space so you don’t bump into walls or fall down when you step off a curb to cross the street. It comprehends and produces language. It mediates your desire for chocolate and sex, your ability to empathize with the joy and suffering of others, and an awareness of your own existence. And it can remember. Of all the complex and wondrous miracles that your brain executes, memory is king.

You need memory to learn anything. Without it, information and experiences can’t be retained. New people would remain strangers. You wouldn’t be able to remember the previous sentence by the end of this one. You depend on memory to call your mother later today and to take your heart medication before you go to bed tonight. You need memory to get dressed, brush your teeth, read these words, play tennis, and drive your car. You use your memory from the moment you wake up until the moment you go to sleep, and even then, your memory processes are busy at work.

The significant facts and moments of your life strung together create your life’s narrative and identity. Memory allows you to have a sense of who you are and who you’ve been. If you’ve witnessed someone stripped bare of his or her personal history by Alzheimer’s disease, you know firsthand how essential memory is to the experience of being human.

But for all its miraculous, necessary, and pervasive presence in our lives, memory is far from perfect. Our brains aren’t designed to remember people’s names, to do something later, or to catalog everything we encounter. These imperfections are simply the factory settings. Even in the smartest of heads, memory is fallible. A man famous for memorizing more than a hundred thousand digits of pi can also forget his wife’s birthday or why he walked into his living room.

In fact, most of us will forget the majority of what we experience today by tomorrow. Added up, this means we actually don’t remember most of our lives. How many days, in full, specific detail, can you remember from last year? Most people recall an average of only eight to ten. That’s not even 3 percent of what you experienced from your recent past. You remember even less from five years ago.

And much of what we do remember is incomplete and inaccurate. Our memories for what happened are particularly vulnerable to omissions and unintentional editing. Do you remember where you were, who you were with, and what you were doing when the space shuttle Challenger exploded, or when the Twin Towers collapsed on September 11, 2001? These recollections for shocking and emotional events feel vividly remembered even years later. But if you’ve ever reminisced about that day or read or watched a news report about it, then I’d bet every penny I’ve got that your confidently held, highly detailed memory is loaded with stuff you never actually experienced.

Accuracy aside, what does your brain remember?

Your first kiss

The answer to 6 × 6

How to tie your shoes

The day your son was born

The day your grandmother died

The colors of the rainbow

Your address

How to ride a bike

What does your brain most likely forget?

Your tenth kiss

What you had for dinner last Wednesday

Where you put your phone

The name of your Year 6 teacher

The name of the woman you met five minutes ago

Algebra

To take out the trash

The Wi-Fi password

Why do we remember our first kiss but not our tenth? What determines what we remember and what we forget? Memory is quite economical. In a nutshell, our brains have evolved to remember what is meaningful. They forget what isn’t. The truth is, much of our lives are habitual, routine, and inconsequential. We shower, brush our teeth, drink coffee, commute to work, do our jobs, eat lunch, commute home, eat dinner, watch TV, spend too much time on social media, and go to bed. Day after day. We can’t remember anything about the load of laundry we did last week. And that’s OK. Most of the time, forgetting isn’t actually a problem to solve.

We would probably all agree that forgetting our tenth kiss, last week’s laundry, what we ate for lunch on Wednesday, and which way the queen is facing on a penny isn’t such a big deal. These moments and details aren’t particularly significant. However, our brains also forget plenty of things we do care about. I would very much like to remember to return my daughter’s overdue library book, why I just walked into the kitchen, and where I put my glasses. These things matter to me. In these instances, we often forget not because it’s efficient for our brains to do so but because we haven’t supplied our brains with the kinds of input needed to support memory creation and retrieval. These garden-variety memory failures are normal outcomes of our brains’ design. But we seldom think of them this way because most of us aren’t familiar with our memory’s owner’s manual. We would remember more and forget less if we understood how the process works.

Most of what we forget is not a failure of character, a symptom of disease, or even a reasonable cause for fear—places most of us tend to go when memory fails us. We feel worried, embarrassed, or plain scared every time we forget something we believe we should remember or would have remembered back when we were younger. We hold on to the assumption that memory will weaken with age, betray us, and eventually leave us.

As both a neuroscientist and the author of Still Alice, I’ve been talking to audiences around the world about Alzheimer’s disease and memory for over a decade. Without exception, after every speech, people wait for me in the lobby or corner me in the restroom to express their personal concerns about memory and forgetting. Many have a parent, a grandparent, or a spouse who had or has dementia. They have witnessed the devastation and the heartache caused by profound memory loss. When these folks can’t remember their Netflix password or the name of that movie starring Tina Fey, they worry that these failures might be early signs that they, too, are succumbing to inevitable disease.

Our fears around forgetting aren’t only about a dread of aging or Alzheimer’s. They’re also about losing any of our memory’s capability. Because memory is so central to our functioning and identity, if you start becoming forgetful, if you begin forgetting words and start losing keys and glasses and your phone, the fear is this: I might lose myself. And that’s justifiably terrifying.

Most of us paint forgetting as our mortal adversary, but it isn’t always an obstacle to overcome. Effective remembering often requires forgetting. And just because memory sometimes fails doesn’t mean it’s in any way broken. While admittedly frustrating, forgetting is a normal part of being human. By understanding how memory functions, we can take these inconvenient gaffes in stride. We can also learn to prevent many episodes of forgetting by eliminating or artfully navigating around common errors and bad assumptions.

When I explain to folks why they forget things like names, where they parked their car, and whether they already took their vitamin today, when I describe how memory is created and retrieved and why we forget—not because of disease pathology but because of how our brains have evolved—they audibly exhale. They look relieved and grateful, changed by this information. They leave me unafraid, holding a new relationship with their memory. They are empowered.

Once we understand memory and become familiar with how it functions, its incredible strengths and maddening weaknesses, its natural vulnerabilities and potential superpowers, we can both vastly improve our ability to remember and feel less rattled when we inevitably forget. We can set educated expectations for our memory and create a better relationship with it. We don’t have to fear it anymore. And that can be life changing.

While memory is king, it’s also a bit of a dunce. There’s a reason that you remember the words to every Beatles song and forget most of your own life or that you remember the Hamlet soliloquy you learned for GCSE but forget what your spouse told you to pick up from the store five minutes ago. We both remember and forget what a penny looks like. Remembering pervades and facilitates everything we do. As does forgetting.

In this book, you’ll learn how memories are made and how we retrieve them. Not all memories are created equal. There are many flavors—memories for the present moment, for how to do things, for the stuff you know, for what just happened, for what you intend to do later—and each memory is processed and organized in your brain in distinctly different ways. Some memories are built to exist for only a few seconds (a temporary passcode), whereas others can last a lifetime (your wedding day). Some are easier to create (your to-do list), others are easier to retrieve (what your daughter looks like), and still others are more likely to be forgotten (last Thursday’s commute). You can depend on some kinds of memory to be highly accurate and reliable (how to drive your car). Others, much less so (everything that has happened).

You’ll learn that attention is essential for creating a memory for anything. If you don’t pay attention to where you park your car in the multistory car park, you’ll struggle to find it later, but not because you’ve forgotten where you parked. You have forgotten nothing. Without adding your attention, you never formed a memory for where you parked in the first place.

You’ll learn whether forgotten memories are temporarily inaccessible, waiting to be unlocked with just the right cue (you can’t remember a single word to “Bohemian Rhapsody” until someone else sings the first lyrics, and then you can belt out the entire song), or if they are erased forever (you remember nothing about the Peloponnesian War, no matter how many details are shared). You’ll come to appreciate the very clear distinction between normal forgetting (you can’t remember where you parked your Jeep) and forgetting because of Alzheimer’s (you don’t remember that you own a Jeep). You’ll see how memory is profoundly impacted by meaning, emotion, sleep, stress, and context. And because of this, there are many things you can do to influence what your brain remembers and what it forgets.

Memory is the sum of what we remember and what we forget, and there is an art and science to both. Will you forget what you experience and learn today by tomorrow, or will you remember the details and lessons of today decades from now? Either way, your memory is miraculously powerful, highly fallible, and doing its job.

PART I

How We Remember

1

Making Memories 101

When Akira Haraguchi, a retired engineer from Japan, was sixty-nine years old—an age most of us associate with senior discounts and a less-than-optimal memory—he memorized pi, a nonrepeating, infinite number with no pattern, to 111,700 digits. That’s the number 3.14159 . . . carried out to 111,695 more decimal places. From memory! If this sounds completely mind-blowing, I’m with you. Surely, you’re thinking, Haraguchi must have been a child prodigy. Or perhaps he’s a mathematical genius or a savant. He’s none of these. He’s a regular guy with a healthy, aging brain, which means something maybe even more mind-blowing—your brain is also capable of memorizing 111,700 digits of pi.

We can learn and remember anything—the unique sound of your child’s voice, the face of a new friend, where you parked your car, that time you walked to the market all by yourself to buy sour cream when you were four years old, the words to the latest Taylor Swift song. The average adult has memorized the sound, spelling, and meaning of 20,000 to 100,000 words. Chess masters have memorized in the ballpark of 100,000 possible moves. Concert pianists who can play Rachmaninoff’s third concerto have committed the coordination of almost 30,000 notes to memory. And these same folks don’t need the sheet music to play Bach, Chopin, or Schumann, either.

Our memories can hold information that is deeply meaningful or nonsensical, simple or complex, and its capacity appears to be limitless. We can ask it to remember anything. And under the right conditions, it will.

How can memory do all of this? Neurologically speaking, what even is a memory? How is a memory made? Where are memories stored? And how do we retrieve them?

Making a memory literally changes your brain. Every memory you have is a result of a lasting physical alteration in your brain in response to what you experienced. You went from not knowing something to knowing something, from never before having experienced today to having lived another day. And to be able to remember tomorrow what happened today means that your brain has to change.

How does it change? First, the sensory, emotional, and factual elements of what you experience are perceived through the portals of your senses. You see, hear, smell, taste, and feel.

Let’s say it’s the first evening of summer, and you’re at your favorite beach with your best friends and their families. You see, among other things, your children playing soccer on the beach and a spectacular sunset glowing in the sky. You hear “Born This Way,” one of your favorite Lady Gaga songs, playing over a portable speaker. Your daughter runs up to you, wailing, pointing to her bright pink ankle. A jellyfish has just stung her. Luckily, your friend carries a small container of meat tenderizer with her for this very scenario. You make a paste of the tenderizer and rub it on the sting, relieving your daughter’s pain almost instantly (this really works). You smell the salty ocean air and smoke from the bonfire. You taste crisp, cold white wine, fresh briny oysters, and gooey sweet s’mores. You feel happy.

The sight of your children playing soccer has nothing to do with Lady Gaga or jellyfish or the taste of oysters, unless these fleeting, separate experiences become linked. To become a memory that you can later recall—Remember that first night of summer, when we ate oysters and s’mores and listened to Lady Gaga while the kids played soccer on the beach and little Susie Q was stung by a jellyfish?—all that previously unrelated neural activity becomes a connected pattern of neural activity. This pattern then persists through structural changes created between those neurons. The lasting change in neural architecture and connectivity can later be reexperienced—or remembered—through the activation of this now-linked neural circuit. This is memory.

Creating a memory takes place in four basic steps: Encoding. Your brain captures the sights, sounds, information, emotion, and meaning of what you perceived and paid attention to and translates all this into neurological language. Consolidation. Your brain links the previously unrelated collection of neural activity into a single pattern of associated connections. Storage. This pattern of activity is maintained over time through persistent structural and chemical changes in those neurons. Retrieval. You can now, through the activation of these associated connections, revisit, recall, know, and recognize what you learned and experienced.

All four steps have to work for you to create a long-term memory that can be consciously retrieved. You have to put the information into your brain. You have to weave the information together. You have to store that woven information via stable changes in your brain. And then you have to fetch the woven information when you want to access it.

How does a constellation of previously unrelated neural activity become bound together into a connected neural network that we experience as a singular memory? We’re not entirely sure of how this happens, but we know a great deal about where it happens. The information contained within an experience that is collected by your brain—the sensory perceptions, the language, the who, what, where, when, and why—is linked by a part of your brain called the hippocampus.

The hippocampus, a seahorse-shaped structure deep in the middle of your brain, is essential for memory consolidation. What does that mean? The hippocampus binds your memories. It is your memory weaver. What happened? Where and when did it happen? What does it mean? How did I feel about it? The hippocampus links all these separate pieces of information from disparate parts of the brain together, knitting them into a retrievable unit of associated data, a neural network that, when stimulated, is experienced as a memory.

So your hippocampus is necessary for the formation of any new memories that you can later consciously retrieve. If your hippocampus is damaged, your ability to create new memories will be impaired. Alzheimer’s disease begins its rampage in the hippocampus. As a result, the first symptoms of this disease are typically forgetting what happened earlier today or what someone just said a few minutes ago and repeating the same story or question over and over. With an impaired hippocampus, people with Alzheimer’s have trouble creating new memories.

Moreover, the consolidation mediated by the hippocampus is a time-dependent process that can be disrupted. The formation of a memory that can be retrieved tomorrow, next week, or twenty years from now requires a series of molecular events that take time. During that time, if something interferes with the processing of a nascent memory in the hippocampus, the memory can be degraded and possibly lost.

Say you’re a boxer, a rugby player, or a football player, and you sustain a blow to the head. If I were to interview you immediately after you got clocked, you would be able to tell me about the punch, the play, the details of what was happening. But if I were to ask you the next day, you might have no memory of what happened. The information that was in the process of becoming linked by your hippocampus to form a new, lasting memory was disrupted and was never fully consolidated. The blow to your head caused amnesia. Those memories are gone.

Damage to the hippocampus probably explains why Trevor Rees-Jones, bodyguard to Princess Diana and sole survivor of the car crash that killed her and Dodi Fyed all those years ago, still can’t remember any details of what happened leading up to the accident. He sustained a devastating head injury, requiring many surgeries and about 150 pieces of titanium to reconstruct his face. Because the various elements of his pre-crash experience had not been fully linked together by his hippocampus when his brain was injured, they were never stored. Those memories of what happened were never made.