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A Sign of Memory Loss
by Virginia T. Sherr, MD
The sign-display artist and business owner had sought psychiatric help for increasing panic, exhaustion and an atypical lack of initiative. Usually a vivacious, energetic type, he had gotten so he would just sit and stare out the window in the afternoons, doing nothing productive, just ruminating on how he wasn't motivated any more. The more he thought about it, the more it occurred to him that he was abnormal as well as depressed. It wasn't that he felt so totally depressed as much as he just felt desperately overwhelmed by his lack of focus and his readiness to sit and stare at nothing. He tried to analyze it himself. He recalled some childhood trauma and wondered if that had finally caught up with him.
As his business began to falter and he could see himself and his business moving from the winner to the loser column, he decided to explore his psyche with me. In the first interview, it became clear that he had a number of physical symptoms for which his doctors had found no explanation. He had been reassured that his sweats, headaches, aches, pains, irritability, insomnia and what he described as mild memory loss were all part of the stress he was experiencing. Because he was a happy man with a wife whom he adored, two sons who were the apples of his eye and a business that was beginning to really take off, he believed that the only stress that could be causing all this must be internal. What did I think?
What I thought of immediately was what I had been dealing with in our aptly named Bucks County, Pennsylvania for several years: cryptic, unrecognized, persistent Lyme disease and/or other deer tick-borne diseases that locally were showing up first as psychological problems. Unlike Lyme, CT, where the infamous causative spirochete caused swollen, inflamed knees, in Pennsylvania the disease very often was first manifested by personality changes. The usual test, the Elisa, was negative but more sophisticated, advanced testing by a research-quality laboratory, revealed strong evidence of Lyme disease and several other tick-borne diseases.
Steve was shocked. His wife was relieved that there was hope for the recovery of his former self. He was soon under treatment for his infections, but we began to realize that the memory loss was more than a small part of his problem. His withdrawal and sense of lack of ambition had been, in part, a reaction to the fact that Steve could not remember what he was doing from one minute to the next. The resultant effort to keep track of things was exhausting and he constantly felt overwhelmed. As he began to understand the reality of his memory loss, Steve was frightened. Everything he had worked for was about to go down the tube. He tried hard to resurrect the notion that this was just a psychological problem that analyzing would cure. My experience with Lyme patients allowed me to reassure him that this would improve over time as his antibiotic treatment continued. Then I warned him: "At first you have to protect yourself from the bruising that your brain's memory center has been taking. I call this protection the "Post-it Maneuver" because, to survive successfully in this campaign, you will have to plaster your surroundings with notes and reminders. The memory loss can be temporary but the damage from things forgotten can be permanently troublesome." He complied.
Next session, Steven came in laughing. "Well, I took your advice. The job I had yesterday called for a big custom-made sign that needed a sturdy base. Because I know I keep losing things, I decided to tape the brand-new sign I had brought to the job onto the wall over the site where I was working. That way I couldn't forget it. I finished the sign base, caught my breath and began to look around for the sign. It was nowhere to be found. A sense of panic swept over me. Oh, my God, I'd gone off and left it at home. I called my wife, alerted my craftspeople to the crisis, and sped home cursing my stupidity. No one had a clue to the sign's whereabouts. I searched my other trucks - no sign! In deep despair and confusion, I trudged back to the worksite prepared to tell my client that I could not make his deadline, when what to my wondering eyes should appear? The sign! Big as life and right over where I had been working. Then I remembered where I had made a giant 'Post-it' of it."
Despite his laughter, Steve felt desperate. "How will I know if what you say is true - that my memory will come back?"
"Steve, just wait for a moment of surprise. One day, you will be minding your own business when suddenly you will recall something totally irrelevant and generally unimportant. It will occur as an intrusive thought. An example would be a sudden awareness that you left the toothpaste tube cap off last night. At first, you will think, so what? But then you will do a double-take and say, "I REMEMBERED THAT!!" Steve left looking incredulous.
The artist had a terrific sense of humor so I was not surprised that when he came in several sessions later, he was chuckling as he said, "It happened; it happened just the way you said." I asked his meaning. "You'll never believe this. I was at work when an irrelevant memory intruded, just like you told me it would. I suddenly recalled that I had been the one to invite my friend to dinner!" He looked at me knowingly.
"And..?"
"Don't you see, it made all the difference. So I called my friend and explained it to him."
"I still don't understand."
"It happened months before I knew I had Lyme; my wife and I went out to dinner with our closest friends. At the end of the meal, he didn't reach for the check or even offer to split the bill with me. I felt devalued and angry that he'd treat such old friends that way. I've been angry with him ever since `tho I never said anything to him. As soon as I remembered I had been the one who had asked him to be MY guest, I rushed to the phone and called him and said, "It was MY bill!" He was pretty surprised because he had no memory of the event at all. When I explained it, he thought it was all pretty cool."
"And so far as I am concerned, every time I drive by my big billboard, it makes me remember what it is like to forget ... I guess you could call it a sign --- of memory loss!"
-- Previously published in The
Lyme Times.
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