Memory Gaps

The other day, trading book recommendations with a friend, I forgot author Samanta Schweblin’s alliterative name, remembered she was South American but forgot the name of the nation, googled “long country, starts with ahhh” and waited for the broken card catalogue in my brain to figure out where I’d misfiled the “AR” words or Spanish literary translation, to pattern-match geographical borders to names.

Schweblin’s known for short stories that read like fever dreams — claustrophobic domestic horror, fantasy, and sci fi where the genre trappings are often less horrifying than ordinary human behaviour under horrific duress. A Washington Post review of her collection Seven Empty Houses described her “ability to upend readers’ emotional stability with a single phrase”. The phrase in question: “She wanted to die so badly, she’d wanted it for so many years, and yet her body just went on deteriorating, more than she would have thought possible. A deterioration that led nowhere.”

The hippocampus “is a plastic and vulnerable structure that gets damaged by a variety of stimuli”, implicated in learning, memory, spatial navigation, emotional behaviour, encoding working memory into the long-term past, and imagining the future. Named by anatomists for it’s similarity to a seahorse, it sits opposite the twitchy fearful amygdala on the limbic lobe, plugged into the olfactory bulb, richly innervated with neurotransmitter and hormonal receptors, and highly vulnerable to damage. It can atrophy in depression, hyper- and hypotension, head injury, seizures, Cushing’s disease, encephalitis, and viruses. It has a limited capacity to repair itself with neurogenesis, compensating instead with building new hallways in the house of the mind or staffing up processing capacity in other parts of the brain.

Of all the types of post-viral brain damage in Long COVID, memory is one of the strangest. The words and concepts are there, but sometimes gathering them is more like dragging a body down a cobblestone maze than an automated library search function. I mostly know what I don’t know, but I cannot always access it swiftly. When is frequently uncoupled from what and scenes in the same location glue over themselves like wallpaper — a particular hazard for events during lockdown or reciting medical or relationship history. It is a very Schweblin-like plot point; an uncomfortable intimate horror.

Inability to supply specific words is called anomic aphasia, described by the UK Stroke Association as “speech that’s full of vague expressions of frustration”, and quite unlike Wernicke’s aphasia where the speaker can produce long strings of connected speech but with intrusive irrelevant words or incomprehensible meaning. It feels like the cognitive equivalent of a missing stair, the jolt of open air where you thought there was fluency to buoy you. Anomic has a neurological meaning (the inability to remember the names of things) but also an apt sociological one: socially disorganized, disoriented, or alienated.

These days, my recall system mostly functions, but the occasional glitch follows old patterns as though my brain, under stress, ducks into back-alleys and gets lost. Those who talk or text with me when my capacity wanes tease me for my lack of precision and aphasic fumbles, how I repeat myself and use more words to weave a net around the holes and keep from falling in, how my sharp copy-editor’s eyes lose focus and wander off track, repaint lines crossed and dig deeper ditches trying to undo linguistic mistakes with more words. In the worst of the brain fog, I texted in strings of emojis, words chimera-ing together illegibly, misfiled and misfired.

The whole nervous system operates across gaps: nearly innumerable numbers of neural junctions connecting neighbouring cells with electrical communication and shared ions, the storytelling and plate-passing of an imaginary dinner table or block party. Mine rebuilt itself stranger and both more and less efficiently. The deterioration and redecoration of my Memory Palace has made my writing weirder and stronger: every essay is now hybrid, every poem a story, every metaphor a sharper turn.

But it has also caused complications and cascading miscommunications, people talking around me instead of to me, the way family in the hospital is sometimes addressed instead of the patient. I have a lingering amygdallic terror of being incomprehensible again, of being misunderstood or mischaracterized as a social menace. Monsters in fiction, especially those whose monstrosity overtakes their original humanity, are often speechless, signalled through inhuman vocalization and incomprehension, the yowling of a mouth meant for violences other than lies. The entire genre of illness memoir comes in part from the impulse to be heard and to make sense of what happened, so that others do not go through what you did, to describe the ways the body can deteriorate behind closed doors and remain alive undesirably.

Gossip is how we share and echo ideas, compare notes and interpret events, pull the curtain on the private actions of private people and public ones. It is how patients flag problem doctors and clinics and compare probative evidence in treatment plans so full of holes they would not hold up in court. It is currency and culture, documentation and doubt, fact and artifact, but also rumour and mongering, understanding and undermining.

At best, we talk through and about and around things til we understand them and each other. When we chose silence, we’re choosing not to cross those anomic gaps. At scale, Long COVID is causing a measurable rise in interpersonal and information tangles and errors: my typos and miscalculations in early recovery didn’t cause car accidents, but in other jobs they would be far more dire. At worst, we can anticipate higher rates of neurodegenerative disease and more gaps in community and communal memory at a time when we desperately need to not forget what has and will happen to us.

The Impairing Curse is a long-form, serialized experiment in personal essay, science journalism, policy analysis, and poetry. To start at the beginning and read it in order, go to the first essay or read about the aesthetics and labour of illness, and the failures of public health. To support this project, share it online or subscribe. The series is intentionally not behind a paywall, to ensure broad access to patients and timely circulation of information in our evolving public health crisis, but paid subscriptions are welcome.