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Memory

Does Our Brain Work on a Need-To-Know Basis?

When the brain works on a need-to-know basis.

Recently, I read a book The Man Who Forgot How to Read in which the author, Howard Engel, describes his experiences following a stroke. Regarding his memory loss, he wrote (pg. 40), "Nature has a way of making silk purses out of our sows' ears...For instance, I am not aware as I go through my day that I can no longer remember the name of the author Graham Greene. It is only when I am asked directly who is the author of The Third Man,...that I become aware of my difficulty with the name..." He goes on to say that he is not cognizant of all his defects at once. "I am aware of them only when I reach for a name or an idea and find it missing."

I was very struck by this description because I've seen the same phenomenon in my father. My dad is 88 and recently suffered some sort of neurological event that robbed him of some of his memory. When I took him to the doctor in a nearby town, the physician tested my father's cognition by asking him for the day of the week and the city where the doctor's office is located. My father couldn't answer these questions and was clearly surprised and frustrated. "I'm fine at home; I know where I am." he insisted, referring to the Assisted Care facility where he now lives.

In a way, my father is right. Why should he know the day of the week or the town where the medical facility is located? My dad's been retired since 1982 - the day of the week doesn't matter to him. He hasn't driven in four years so he does not need to remember in which town the doctor's office is located. Better he know where his bedroom, his telephone, and the dining room are in the Assisted Care facility and which of his children lives nearby. He remembers when I am away on a trip and instantly asks me about it when I return. So Engel's writing rings true to me. Sometimes, nature does make a silk purse from a sow's ear. My father's memory may be fading, but to some extent he still knows what he needs to know.

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