Memories

It’s funny, I have just nipped-up my garden path after experiencing a memorable event – well, that is, an event that should be memorable – something that is out of the ordinary, different to my usual routine.

The ‘Tour de Yorkshire’ hurtled past my house, preceded by a cavalcade of police motorbikes and support cars.

As I was standing there, in the sun, with Maisie by my side, I wondered whether and what I would remember of this event in days, weeks, months to come – should I take-out my phone and record some video, capture a photo, or should I try to absorb as much of the moment as possible – the swish of the peloton as it flies past, the sunlight through the clouds, the wind, the people cheering, helicopter overhead.

Would the recording of the event detract from the memory? Would the fact that my family are away for the weekend and it’s just me and the dog detract from the imprinting on my consciousness?

I spend much of my life surrounded by the concept of memory, given, that as an aspect of dementia that is most familiar to many people, it is often what people talk about when they discuss dementia – focusing less, on the personality or behavioural changes that can be as devastating.

Memory, what I remember, what others retain and interpret from past events is an endless fascination to me – I, for example, struggle to remember much of my recent or even distant past. This was brought into sharp focus today when Facebook reminded me it was my brother’s birthday*. My dad famously struggled to remember his children’s birthdays – fortunately I only have two offspring or else I would probably be in a similar place.

In most instances I am orientated to the day of the week, but beyond this, the date or the month is an effort, I often falter over the year – as to when things happened or what was happening when things happen, I am usually lost.

I do seem to have an ability to remember patient’s names, and their conditions, although generally when I can link that recollection with a personal aspect, it helps. (On my ward we have developed (with Helen & Co) a modified version of ‘This is me’ – it is a document that helps patients, their families and carers tell the staff more about the person, indeed, through working with Helen’s team, we have stretched this model for patients and relatives to know about the staff as well.)

It is easier for me to remember that Mrs X, who worked in the WLA during the war, has family in Devon and doesn’t like peanut-butter than Mrs X who is anaemic. The process of personalising care, moving the person into the centre and creating a deeper relationship, helps paint a picture and layer the events in our memories.

Perhaps, had I known more about the cyclists – their likes and dislikes, the books they read, music they listen to, or political affiliation, I would have taken-away more from the moment than the rubberised swoosh of tires on the road.

Perhaps, the act of this writing will help embed the moment more firmly in my psyche, although, from past experiences, I doubt it.

I often take pictures of places I visit and people I know, for that is a way I can help hold on to the past as it fragments with time.

There is a neurological condition, Hyperthymesia, whereby some people are unable to forget; they forever retain vivid memories of their thoughts, feelings and insights of the past, they struggle to overcome trauma or upset, for them, relationship breakdowns, pain or grief is constantly in the present.

Part of our evolutionary ability to forget is no doubt an adaptation for humans to move-on to overcome past pain, past challenges.

And so, with many of my patients, it seems a lottery whether as part of the disease process that is their dementia, they are able to contentedly live in the moment, or are pulled-back to darker times. In most instances, it is the former that I encounter, the mindful pleasure of the moment which allows people to interact in response to events that are before them, with the connections to past sorrows broken – indeed, this is a core tenet of therapy in dementia, where we seek to deflect those people who are upset into psychological states that are less traumatic.

Back to the cyclists and my standing on the kerbside with my dog.

Does it really matter whether I remember the event, the moment, the feeling? I know people who in twenty years time will be able to recall the colours of each cyclist as they fly past, who will be able to hold-on to details that were beyond even my first perceptions.

I think the key, is, and this is essentially a human thing, to hold-on to each other’s diversity, and not judge, not determine that this is good or bad, that one is better than another – instead to accept that some of us experience life one way, others, differently.

I often wish I could remember where I parked my car, yet, I am also glad that I can focus on the moment and engage with the flow, like waking early, with blue skies and sunlight streaming through the window.