Sunday, June 19, 2016
We Are What We Were–Memory, Alzheimer’s And Suicide
In the movie Still Alice, a brilliant linguist and professor at Columbia discovers at 50 that she has early onset Alzheimer’s. Although at first she does her best to ignore the symptoms of a failing memory, it soon becomes clear to her that it is not forgetfulness or distraction that are behind her cognitive issues but something far more serious.
In the early stages of the disorder, she still functions well, manages socially, and even – with a few aide-memoirs and mnemonic aids – continues teaching. Soon, however, family, friends, colleagues and supervisors see that she is no longer the sharp, perceptive, and lively intellect that she was only a few months ago. Neurological tests and clinical diagnosis reveal what she had suspected – Alzheimer’s.
As she becomes more and more disoriented – she can’t find her way back from campus, can’t remember where the bathroom is nor the names of her colleagues – she makes a video of herself. She speaks into the camera and tells herself that if she cannot answer the three questions on the screen (questions a child could answer), she is to go to the bathroom, take all the pills in bottle marked ‘Take these’, lie down on the bed, and go to sleep.
She has understood that memory is the only thing that defines her; and without it, she is nothing. Her academic career, her prizes, her status and influence in the professional community; her life as a child, a young adult, a mother and a wife will all disappear as her brain disassembles and functions only as a limbic organ.
Whether her brain has lost the ability to recall events and people from her past or whether the memories of them have dissipated somewhere or throughout the cerebral cortex, she feels that slowly but progressively she ceases to exist. Before this can happen and while she still has enough memory to realize, understand, and appreciate who she is and what she was, she decides to end her life. She will die a whole person, intact, and with all the memories which define her. If she clings to life and slowly disintegrates into nothingness, she will negate everything she was.
The arguments over the nature of self, being, and nothingness have been debated for hundreds of years. Descartes said “I think, therefore I am”, placing cognition squarely at the center of being. The fact that one can think – remember, observe and process, categorize, analyze, and describe – one can prove one’s existence.
Descartes did not consider the obverse but equally true – if one cannot think, reason, reflect, and synthesize, one does not exist.
Vladimir Nabokov was a self-described ‘memorist’. He understood the importance of memory as the defining essence of human life, and developed techniques to fix events in his memory and devised ways to recall them from his mental archives and replay them like a movie. The more he could remember, he said, the more complete he was as a human being.
The present, Nabokov observed is nothing more than a millisecond of existence before becoming the past. The Higgs boson once produced has a lifetime of less than one sextillionth of a second; and this is slow compared to the passage of the present to the past.
The future is only possibility. Only the past has provides definition, integrity, and above all meaning.
Yes doesn’t Nabokov devalue the present? Even though in philosophical terms it barely exists, its temporal parameters are much broader. The ‘present’ for most of us is breakfast, a board meeting, or shaving. Even though such events are accretive – one fractional moment displacing another – we don’t see it that way. The ‘present’ is more real and substantial than Nabokov suggests.
Be that as it may and however one chooses to define the present, it quickly becomes the past, archived in our memory, and without curation can disappear. If we cannot remember the beach at Deauville - the umbrellas, the silhouette of the cliffs of Dover on the English side of the Channel, the seagulls, the chill, and the dresses of young girls – then it never happened. Even if the events of that day had subliminal effects – our preference for colored dresses or our dislike of the chill – if we cannot remember them, they have lost their meaning, integrity, and substance.
An aunt of a close friend of mine had Alzheimer’s and a few years before her death, she had lost her grip on ‘reality’. She could not remember her past nor her children, nor even who she was, but she substituted bits and pieces of dreams, television shows, and movies. One day she told my friend that she had met the Pope who had come to her convalescent home, that he danced well even though his cassock got in the way and his miter kept falling on the floor, and he forgave all her sins. Another day she quilted reruns of Star Trek, American idol, and As The World Turns and told fantastical stories of travelling in outer space with her talented shipmates and how she had to mediate their romances.
While neither her sister nor her children could face her – it was too depressing to be with a woman they didn’t know and who had become someone else – for her nephew, my friend, it was easy. He entered her world, he told me, never challenged her version of reality and in this strange fantastical world found that his aunt was still his aunt. The same humor, puckishness, and impatience.
So perhaps the woman in Still Alice was very selfish in considering suicide. Although she might no longer know who she was, her family – with a little patience and willingness to leave logic aside – might still be able to enjoy her as much as they did before her debility. As importantly, wasn’t the woman taking a far too narrow view of being? Why, despite Descartes, was cognition the only reality? What about the soul? And how might it express itself? In other words, why should she – or any of us – need Nabokov’s vaunted ‘past’?
This reasoning, of course, is not so easy. Cognition, logic, rationality, insight, and intellectual rigor were what defined her. She was neither a poetic nor a spiritual person. The thought of a life after cognition and memory never occurred to her, nor could it have.
Despite all these caveats, conditions, and speculations, Nabokov was right. The past is what defines us, and the more memories we have, the more complete and substantial we become.
Nabokov’s Speak, Memory is an autobiography which was written not as a historical record of the author’s life, but as a pastiche of those memories which define him. There was no reason to order them chronologically, to link them to future events citing cause and effect, only to celebrate them for what they were – integral and indispensable parts of him.
There can be no consignment worse than Alzheimer’s. No physical disease, no misfortune, no disaster can match the erasure of a personality. It is not surprising that the woman in Still Alice considered ending his life, and I would not be surprised if Nabokov thought the same way.
Few of us have the determination, the philosophical certitude, and the willpower to commit suicide deliberately – i.e. not in a moment of depression or agony – but the onset of Alzheimer’s should give us all pause.