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Monday, March 19, 2007

Whos Minds

Several weeks ago I spent the weekend video taping Mom as she talked
and wandered and shared stories and banged on doors and chatted with
herself in the mirror. Since that weekend my fingers have been
paralyzed and unable to share my thoughts as to what I saw, what is
happening in her brain and what future Dad is ultimately faced with.

As I watch and listen to Mom wandering the house I find myself
profoundly uncertain regarding the concepts of, mind, self,
consciousness, self awareness, person hood and ultimately sanity.
While it is simple and quick to point out the obvious reality that
Alzheimer's is chewing away at her physical brain I had no idea it
would manifest itself in such mind-body disconnected symptoms mixed
in with existing memories of old family stories.

When a kitten is frightened and fascinated by the view in the mirror
we smile and say, "look at that, see, the cat does not have a
developed sense of "self"". It sees itself in the mirror and does
not, at first, realized that it only sees an image, not another cat.
It looks behind the mirror to find the other cat and when no other
cat is found, gradually the behavior goes away and the kitten ignores
the mirror since it has learned at some level that it is not "real".

So, when Mom talks to her face in the mirror, poses questions for the
image, answers questions not spoken aloud and generally chats and
gets frustrated with her mirror image, what connection has failed in
the brain? When Mom introduces me to the person in the mirror, tells
the image my name and relationship to her (the speaking "her", not
the image) and expresses appreciation for my presence, who is
appreciative of my presence, the persona in the image or the
breathing Mother? When the image in the mirror is told lengthy family
stories (of mixed fact and fantasy) but Mother does not recognize the
man in the other room as her husband, what explanation is there? When
Mom is petulant, frustrated, miffed and downright angry at the mirror
image because it will not follow her to the kitchen for a meal, what
is going on? Where does the brain end and the mind begin?

The brain/mind, physical matter/memory debate has raged for over a
hundred years. I certainly have nothing but questions. But they are
questions that live rather close to home. If the physical brain
matter connection between the memory storage location and the
"thinking, sentient" portion of the brain is broken, is the memory
actually gone? It the "sense of self" is lost but many of the learned
behaviors of drinking water and holding a spoon remain, what
connection was broken? How is it possible for Mom to speak with me
(in this reality) and turn to the mirror and speak to "her" without
her mind catching the obvious confusion point that I see plainly? If
Mom recognizes me, but not Dad, and discusses with the mirror who the
man in the house is, yet is not troubled by his presence, what
connections are working or broken?

Knowing that we have regions of the brain, for memory, for decisions,
for pleasure, for unconscious functions, it seems that the damage
happening to Mom seems to be at the connection points between memory
and self and function. I know that is a completely unscientific
description but it is the best I have right now and I don't feel
like digging up all the region names and functions for this posting.

And not surprisingly, trying to describe the physical changes,
detailing the behavior changes, cataloging the losses, it sounds like
coping.

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