Health

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Metanoia

In a quasi-dream state.

I was resting in bed around 10:30 AM. I had arisen at 06:30, had eaten breakfast, and had performed a few communication and organization chores using my personal computer.

As happens more often in the last few years, I needed to take a brief rest from the many tasks I continue to assign to myself, from the increasing tension in trying to comprehend them all and to assign priorities. I imagine this ‘rest’ approximates a meditation, with my eye mask on and my hearing aids in their recharger.

Random thoughts, almost dreams appeared. I was not asleep but not awake.

After around thirty minutes the word ‘metanoia’ appeared to me, not visually, but as a soundless spoken word, but the spelling was clear.

The unexpected appearance of a word I can’t remember ever using felt important enough to arise and look for a definition, using the iPhone lying nearby. From Wikipedia:

An Ancient Greek word (μετάνοια) meaning “changing one’s mind”, may refer to:

I don’t feel the need for repentance, nor am I consciously employing rhetoric. Therefore, the ‘psychological’ definition seems the most apt.

I haven’t had a ‘breakdown,’ but I have experienced a significant event, about which I have written here: Blanking out for Thirty Minutes, as Gurdjieff’s “Robot” Takes Over.

Due to this event, I have experienced a loss of confidence in certain of my abilities and powers. I intend to regain confidence in them, if possible, and in any case, it is in my nature to at least try.

What loss?

Memory. Along with others who are aging, it grows more difficult to remember even simple words, names, or places when pressed to do so. I say, and others have said, this is due to having already stored so much information it’s ever harder to recall any given datum from the mass of data stored in various organs of the brain and nervous system.

The problem I now have is: is the current memory lapse due to this ordinary reason, or has it to do with the incident of my memory loss of 30+ minutes a few days ago? Probably it’s ordinary, but I cannot be sure. In other words, have I lost something vital? Am I deteriorating?

Balance. People get dizzy occasionally, due to dehydration, conflicting visual and/or aural clues, and transient internal processes. But now I wonder, is any dizziness I may experience ordinary, or due to deteriorating physical abilities?

Rational faculties: I am a highly rational person. I have called my brain my sword and my shield. (To be sure, I have emotions also, but they need to be strong to overcome my rationality; e.g., love, fear.) If my rational faculties are deteriorating, how can I live my life in confidence; that is, without fear, and with reasonable certainty, I am contributing sufficiently to justify my existence?

I suppose, taking this last question as an indicator, I may be in a ‘breakdown,’ but I don’t feel that way. I feel unsteady, uncertain, too much aware of my every neurological / psychological / physical process.

How to deal with this?

I thought of talking with a friend who recently has had a series of fainting spells. Perhaps we could form our own support group? I perceive she and I as having similar characteristics: interested in many things; driven to accomplishment; sometimes impatient and overloaded.

We’ll meet in a few days to be good to each other and ourselves. I have confidence there will be a good outcome.

But… I haven’t examined how it is the word ‘metanoia’ came to me, unbidden, unsought.

Carl G. Jung

I can’t help but invoke the spirit of Carl Jung at this point. My unconscious reached out to me, that is, to my conscious self, during the quasi-dream state I was in.

I have read and written much about Carl Jung. I feel I know him, almost as an acquaintance. He advocated ‘integration’ of the conscious and the unconscious to reach ‘individuation’—to be more oneself.

Was my sub-conscious reaching out, or was my conscious reaching in, to alert me to the opportunity to learn and grow from this unsettling experience?

I’ll ask my friend what she thinks.

Her response:

I think, right now, we have to accept we do not have control over what our brain does. I guess no-one really does. We like to think we are in control, we are rational human beings, interested in so many things that go on around us. We can control to a certain extent how healthy we are by eating well and exercising. But our brain? It goes its own way. My main change after the first black-out was that I became unable to deal with difficult situations, particularly emotionally difficult ones. It was odd, because I have always been very strong in that area. But I was skating around difficult issues, avoiding them, I just couldn’t deal. This did get better after a few months.

I often find myself taking a nap around 2 or 3 pm and have begun to love it. I literally snuggle up in the sofa with a podcast in my ear and just enjoy. There HAVE to be some good parts to growing older …

Please don’t tire your brain too much by worrying about what’s what. Perhaps we need to tread the path of acceptance gracefully.

Thanks, friend.

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Blanking out for Thirty Minutes, as Gurdjieff’s “Robot” Takes Over

Two days ago I experienced an episode of transient global amnesia (TGA). It is a most curious syndrome.

A part of the brain is disabled so that one’s immediate memory is permanently lost during a limited period of time. Yet, another part of the brain is aware of this sensory loss. During this episode I kept asking my wife Eva (as she later told me) why was I here, why was I holding a bag of gardening tools, and other questions regarding my immediate environment and circumstances.

This approximately thirty-minute episode occurred while Eva and I were returning from work in our small plot in the communal garden, walking toward the entrance to the building containing our apartment.  My memory stops around 100 meters from the door of the building until I was talking with an EMT in the ambulance, parked outside. According to Eva I was aware the ambulance was coming and I left our apartment to wait for it in the driveway.

My robot had taken over.

George Ivanovich Gurdjieff
1846 – 1949

G.I. Gurdjieff was of the opinion that we should try to remember oneself. He believed that during most of our lives it is the machine or the robot who sees and experiences whatever is there.

Gurdjieff … asked, “Why should we experience so much, only to forget it immediately afterwards? Half our experience rolls off us like water off a duck’s back. Yet experience is food, whose purpose is to enable is to evolve.”

Lots of what we do is carried out without proper thought, almost with robot like routine. I realised this (recently) when I had been out somewhere in my car and then for a moment wasn’t too sure where I was on my journey. I had no awareness of having driven a certain distance. (Source: Mike Perry)

I was examined by the EMT in the ambulance, and then by the emergency department physician at the Akutmottagningen of Sankt Görans Sjukhus. I had become mostly conscious by the time I underwent the EMT exam (that is, able to retain most of my current experiences in conscious memory), and felt the trip to St. George’s Hospital and my examination there to be an interesting adventure.  Eva accompanied me the whole way, including during the CT Scan of my head and its contents.

I seemed to be in no immediate danger, but the protocol is to observe the subject (now a hospital patient) overnight, and to await the results of the scan. Eva left as I was escorted to the observation room (No. 11) of the Neurology unit on the fifth floor, to cohabit with three other patients. It was a comfortable enough bed, but I was restless and spent most of my time in the cafeteria across from the nursing station.  Good food, snacks, juices, and coffee were available, and in the traveling library bin there happened to be a thriller in English I could read (Children of the Revolution, by Peter Robinson).

I had been admitted to the Neuro Unit after the day shift had gone home, so there was late-hours staffing until 0700 the next morning. I was aware of several others as mobile as I, but we kept to ourselves until breakfast time in the cafeteria.

Hippocampus within the brain

TGA can be viewed as an illness of transient hippocampal insufficiency. It is a clinical syndrome with no clear aetiology identified. Most symptoms are transient and resolve within a few hours. The incidence of TGA is approximately 2.9 to 10 people per 100,000 worldwide. It typically affects patients between 50 and 80 years of age, at an average age of 61. [Note: I am in my 81st year]

The clinical presentation of TGA is anterograde and partial retrograde amnesia lasting less than 24 hours without any other neurological or congestive symptoms. Most cases show complete resolution of symptoms within a few hours from onset of symptoms. Brain CT scan and conventional sequences of MRI brain show no abnormalities. The underlying cause of transient global amnesia remain unknown. There appears to be a link between transient global amnesia and a history of migraines, though the underlying factors that contribute to both conditions aren’t fully understood. [Note: I experience migraine auras without headache periodically and, perhaps significantly, more than usual for 36 hours around a week before this TGA incident].
Sources:
https://radiopaedia.org/articles/transient-global-amnesia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911939/
http://www.mayoclinic.org/diseases-conditions/transient-global-amnesia/basics/causes/con-20032746

As alluded above, after the day shift began two other patients under observation gathered at the table where I was eating my breakfast. They were men, one between 65 and 70, the other perhaps nearer my age. Both were world travelers with many stories to tell. We told each other about our condition and experiences, and complimented members of the staff who visited us for services (food, medications, information—they unexpectedly gave me my daily dose of blood pressure medication which I had not brought with me.)

After some waiting for the doctor to attend the more seriously affected patients, we were, one by one, told we could go home. One fellow, however, was told to return the next day for an ultrasound examination of his carotid arteries, which indicated to me that he was suspected of having, not TGA, but TIA.

A transient ischemic attack (TIA) is like a stroke, producing similar symptoms, but usually lasting only a few minutes and causing no permanent damage.

Often called a ministroke, a transient ischemic attack may be a warning. About 1 in 3 people who have a transient ischemic attack will eventually have a stroke, with about half occurring within a year after the transient ischemic attack.

http://www.mayoclinic.org/diseases-conditions/transient-ischemic-attack/home/ovc-20314613

Of course, I hope that the ultrasound scan will rule out such a possibility for my new acquaintance. He has said he will contact me by email to invite me to his place in the country for some Mosel wine and conversation. The other fellow seemed interested in reading one or more of my blogs and I may well hear from him also. I hope so.

This experience has brought home to me some notion of the mysteries which remain about the brain and its functions, despite marvelous advances in the various medical sciences. Also, I now have direct evidence of the “robot” that G.I. Gurdjieff identified and warned against relying upon–that is, to be consciously awake to everything one does. (Read Colin Wilson’s “G.I. Gurdjieff: The War Against Sleep).

In addition, I am more alert to possible memory lapses, no doubt overly much right now, to be alert to my aging neurological functions.

As one ages, one’s thought processes may appear, to younger people, to be slow or faulty. Willa Cather had an answer to that notion in her book, Death Comes to the Archbishop:

Sometimes, when Magdalena or Bernard came in and asked him a question, it took him several seconds to bring himself back to the present.  He could see they thought his mind was failing; but it was only extraordinarily active in some other part of the great picture of his life–some part of which they knew nothing.

 

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Tinnitus

I met a man around 15 years ago who, a week after we met, jumped off the Golden Gate Bridge to his death.

We had a mutual friend, Kelly, who asked me to meet with him after I had told Kelly about my tinnitus. Kelly was interested in how I dealt with the constant low hum and high-pitched hissing, and the occasional but temporary loud, clear tone. He said his friend, whom I later met, was depressed about his tinnitus. Kelly thought my meeting with him and talking about our shared affliction might help him.

Upon meeting his friend in San Jose I learned he was, indeed, depressed about his tinnitus, but it was different from mine. He said that, when in conversation, whatever he heard echoed and reverberated.

~1438120515~what did you sayI told him what I had told Kelly—I have found a way, both voluntarily and involuntarily, to ignore the constant hissing and humming. I don’t ‘hear’ my tinnitus unless I consciously think about it, or unless I am in a place where there is almost complete silence. Kelly’s friend was not impressed, saying this way of dealing with it was not available to him.

Kelly’s friend had other problems as well. He had lost a critically important client for his business, and his wife had left him. So, I can’t blame the tinnitus for his unfortunate demise, but it seems a contributing factor.

I began to notice the sounds in my head around twenty-five years ago, when in my early fifties. At first it was the hissing which masked all sibilants and stridents: s/z/f/v. Also, I found myself reading lips, needing to see my interlocutor’s mouth to understand some of the emanating sounds, both heard and unheard. I finally bought hearing aids at around age sixty, but even as the technology has improved (I’m on my third pair) nothing can make me hear s/z/f/v. Except for a few distorted tones in the upper ranges (typically played by flutes and violins), I hear music well-enough to enjoy it fully. I can fill in the blanks when listening to familiar music, just as I interpolate much of the speech directed toward me.

One’s hearing deficit is hard for others to understand, much less be empathetic with. A blind person, or a person with an impairment of the limbs or other parts of the visible body, more naturally evokes sympathetic reactions. The confusion of a deaf person is often perceived as humorous, and it serves one (me, at least) to go along with the humor and even build upon it.

My mother, in her eighties, was concerned about her tinnitus. She took medication to control her paranoid tendencies, so the sounds in her head would evoke confusion and concern. I reassured her that I had the same affliction and, thus, it was a family trait.

I wonder if Kelly’s friend had paranoid or other psychological tendencies which the tinnitus exacerbated. Maybe it was the tinnitus which pushed him over the edge.

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An excellent novel and story to read if you want to enter the world of the partially deaf: Deaf Sentence, by David Lodge.