Progressive. Irreversible. Incurable. The same three adjectives describe both my father’s disease and my own. He and I are traveling toward the same destination, though by different routes and at different speeds. Dad is walking into a dense and darkening fog, I into a clearing. He is becoming more confused and disoriented, I more focused. He has forgotten who I am; I am adjusting to who he is. He has outlived his story, I my expiration date. My father is losing his mind. I am merely losing my kidneys.
Loss of memory is a telltale of dementia, manifesting itself in narrative disintegration. Not the loss of semantic, procedural, or working memory—respectively, the recall of words and facts, operations, and data manipulation. I refer instead to episodic memory, the remembrance of things past. Symptoms include the inability to recognize people or recall events, confusion about places, and misconceptions about time. In the end, dementia obliterates an individual’s entire story, supplanting even the identity of its teller. This loss amounts to a narrative clearance sale. Everything must go: I, you, here, now, there, and then.
My father and I never hit it off, not for as far back as I can remember. Over time, our mutual wariness metastasized into reciprocal animosity. One night, about 10 years ago, he phoned. I was living on the East Coast, he in the Midwest. He sounded surprised when I answered, as if he’d dialed the number by mistake. Always efficient, he redeemed the occasion by announcing a decision he’d made. Henceforward, I should cease calling him and sending him cards or gifts of any kind. I thought this was a lousy idea and told him so.
Skip ahead six years to another phone call, also at night, this one from my sister. She told me that Dad had driven off the road some 90 miles from home. The Illinois state police had found him unhurt inside his wrecked car. The passenger seat was littered with traffic tickets and summonses to appear in court. Dad told the troopers he was on his way to visit his son, a professor, in southern Illinois. (I hadn’t lived in Illinois for many years. Neither had he ever visited.) By the time my sister arrived at state police headquarters, Dad had changed his story. Now, it seemed, he was going to an unspecified destination to inspect a motel, a job he’d once held several careers before.
The gradual diminution of my father’s memory and, ultimately, of his thinking may be explained variously. For reasons of my own, I happen to have been looking into this subject at the very time Dad reentered my life. Like many other know-littles, I had been seduced by neuroscience, its allure beginning with Charlie Rose’s PBS series on the brain, then progressing to books by Eric Kandel and Oliver Sacks. Sue Halpern’s Can’t Remember What I Forgot: The Good News From the Front Lines of Memory Research tightened the grip on me. Margaret Lock’s The Alzheimer Conundrum: Entanglements of Dementia and Aging has kept me coming back. My favorite writer on this subject remains Jimmy Breslin, who reported on his own brain surgery in I Want to Thank My Brain for Remembering Me.
Here’s what I have learned so far: the part of our brains responsible for episodic memory is located smack in the middle of the temporal lobe, itself located smack in the middle of the brain as a whole. It’s called the hippocampus, and it looks not unlike a shelled cashew, although the name comes from the Greek word for seahorse. This brainy nut, essential to the formation of memories of events, turns out to be better at constructing stories than warehousing them, at inventing narrative than indexing it. Discovering this put me back on terra cognita.
I’ve devoted my entire adult life, 40-odd years, to the study of narrative, to the fusion of story and storytelling. It’s been the one constant in an otherwise hodgepodge CV that includes actor, children’s novelist, professor, and dean. As an actor, I inhabited the narrative structures of Shakespeare’s tragedies and history plays. As a novelist, I became a co-conspirator with young readers while simultaneously managing to offend more than a few librarians. (I’m grateful still to the middle schoolers in Sheboygan, Wisconsin, who mounted a spirited defense of one of my titles before their town’s school board.) As a dean, I wrote the college’s story while reading its balance sheet.
Over time, I have ceased to view narrative primarily as a performance and see it now more as an epistemology, a way of knowing. Narrative is one way that we learn stuff, remember and retrieve that stuff, validate or invalidate it, and pass it along to others. Narrative thinking differs from mathematical, scientific, or philosophical thought because it favors the senses over formulas, experiments, or logical arguments as modes of inquiry. Mathematics reasons deductively from axiom to theorem. Science reasons empirically from hypothesis to proof. Philosophy reasons rationally from proposition to claim. Narrative reasons mimetically from plausibility to belief.
Few others can have benefited from a parent’s dementia as much as I have from my father’s. One of Dad’s earliest losses of episodic memory was his dislike of me. When I would phone him in the progressive-care facility into which he moved, I could detect few, if any, signs of his cognitive impairment—except for one that stood out dramatically. He would greet me, every time, with enthusiasm and without irony. Jim, you son of a gun. Thank you for calling. Thank you for calling. Thank you for calling. I would reply warmly and genuinely. Dad, you sound terrific. How’s the new place? He and I had little else to say to each another, mind you, but we were talking.
Dad’s memory diminished spasmodically. Plot elements of his personal experience became confused. Parts of one story began to pop up in another. Characters migrated from world to world. Collages emerged from the mix-and-match details of his free-flowing memory. His brain’s hippocampus was, apparently, doing its creative thing.
On my first trip to Chicago to visit Dad, he and I sat next to each other on the sofa in his room. I took his hand in mine, a thing that would never have occurred to me to do before. He did not pull it away. We were holding hands. All the bad parts of our overlapping stories had disappeared. He had forgotten them. I had no further use for them.
On another visit, Dad was sitting in a wheelchair, recovering from a broken hip. He was in a different world, invisible to me but clearly vivid to him. The brake on his wheelchair had transformed into a car’s gearshift. He was agitated because he couldn’t find his keys. He snapped at me, “Did you take my keys? Where did you put them?” Then he wanted to know if his car was parked in a legal space. What disturbed him most, though, was the absence of a steering wheel. He shouted at me, repeatedly, “Where’s the steering wheel? Where’s the steering wheel?” and he wasn’t buying my assurance that this particular car didn’t require a steering wheel. “How am I supposed to drive without a steering wheel?” I told him he had made a very good point there, but he wasn’t interested in scoring points. He was interested in scoring a steering wheel. The experience was perfectly vivid to him. It just wasn’t accurate.
Here’s the narrative conundrum: can a world that exists within a person’s mind, constructed from bits and pieces of that person’s episodic memory, be both valid (true) and invalid (false) at the same time? The car my father had manufactured was demonstrably false to me, because inaccurate. To him, it was painfully true, because vivid. Validity, in narrative terms, would seem to depend more on vividness than on accuracy. Vividness, in fact, appears to substitute for accuracy, becoming the gold standard for episodic memory. We acknowledge this distinction whenever we say, “I remember that vividly” rather than “I remember that accurately.” The more important a memory is, the likelier our brains are to revise it—embellishing here, downplaying there, creating new scenes while leaving others on the cutting-room floor. To put it another way, the more important a memory is, the likelier we are to fictionalize it. This helps to explain the frequent inaccuracy of eyewitness accounts, as well as the impossible recollections of many people in my generation of the day when President Kennedy was assassinated. Today’s undergraduates are already revising their memories of 9/11, the day when history began for them.
Accuracy is the be-all and end-all of semantic, procedural, and working memories. One either can or cannot recall a word, complete a familiar procedure, or execute an abstract process. These other types of memory may be confirmed or disconfirmed by their accuracy or inaccuracy. Not always so with episodic memory.
The validity of episodic memory should be assessed by different standards, I believe, than that of all other types. Likewise, the failure of episodic memory should be determined by its own criteria. Plausibility is what counts here, and the best measure of plausibility is vividness. Vividness provides the rating system for all narrative experiences. Movies. Novels. Historical accounts. Gossip. Dreams. (Dreams may be the only narrative genre more complex, cognitively and aesthetically, than episodic memory.)
The decreasing accuracy of episodic memory provides one way to document the progress of dementia. Accuracy alone, however, is an insufficient measure. Vividness must be taken into account, too. An individual loses accuracy before losing vividness, and eventually the brain creates new stories more easily than it retrieves old ones.
Some of the imagined worlds Dad lived in were unpleasant for him, even frightening. I wish those memories could have been less vivid and, hence, less believable. Others gave him pleasure, affording him contentment. I wish those could have stayed vivid longer. My father is beyond story now. First he lost the hope of “happily ever after.” Then he lost the promise of “once upon a time.” Dad’s brain was no longer capable of manufacturing story parts—characters, events, places, and times—whether recalled or imagined. As his episodic memory became less accurate, his personal history disappeared. As his episodic memory became less vivid, Dad himself began to vanish.
More than a year has passed since I experienced any real connection with my father. The last time occurred at the end of one of my visits. I had stopped by to see him before going to O’Hare to catch my flight home. He was sitting in an easy chair in his room, staring out the window. He didn’t acknowledge me when I walked in. I crouched down in front of him so that our faces were no more than six or eight inches apart. I put a hand on each of his cheeks and said to him slowly and distinctly, “Did you know, Dad, that you are my father? And I am your son? And my name is Jim?” He worked hard to process this, I could tell. After a long silence, he replied, “Why would I want to know that?” I told him he had made a very good point there.
Brain scientists and narrative thinkers might assist one another, I believe, in their separate probes of episodic memory. I’m not suggesting that an actor scrub in at a neurosurgeon’s operating theater, or that a neurosurgeon take to the actor’s dramatic stage, but it might be mutually beneficial if they began a conversation.
Nobody can know whether my father or I will reach our common destination first, propelled as we are by the failure of different organs. Whenever he arrives at the end, he will not be aware of it. I, on the other hand, wish to arrive with the full nutrient power of my brainy cashew at the ready. I will gladly trade in procedural memory of how to ride a bike for episodic memory of how to create stories. I will happily swap working memory of how to reduce fractions for episodic memory of how to multiply outcomes.