Memory, sourdough, and blackouts.


A kindness that stuck in my head

No more than two loaves of bread,

But still I remember,

Five years now September

For the graciousness of having been fed.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  In May 2010, I left my position of 23 years, and honoring my non-compete clause, traveled for a year doing locum tenens work.  In June of 2011 I joined up with the Community Health Center, which provides care for the underserved.  I’m now working part-time, which, for a doctor, means 48 hours a week

I run into a lot of patients from my former practice who remember the good deeds of mine that I’ve usually forgotten.  This last week I met a person who did me a kindness that stuck in my memory.

When a person averages 84 hours of work per week, little time remains to do the necessary things in life.  One summer, five years ago, while my wife Bethany visited her aging father, I found myself on call on a weekend, sprinting from the time I awakened at 530AM till I dropped into bed at unpredictable hours.  A key part of my survival strategy at the time involved bread from Panera, but I arrived on a Sunday at five minutes past closing.  An employee, who didn’t have to, very graciously opened the doors, and I left with not one but two loaves of sourdough. 

Half a decade later, I cared for a critically ill patient while on call this week, who casually mentioned that a family member had been that employee, and did I remember the incident?

Heck, yes, I remembered it.  It might have seemed a small kindness to the person who performed it, but it mattered an awful lot to me.

High emotions, whether positive or negative, make for high memory.   Learning comes easier if a hungry person eats and then studies.

We don’t understand memory.  We know that our minds consolidate memory on several different time scales: less than a minute, less than five minutes, less than a day, and long-term; in order to make it into long-term storage, the memory has to get through the first stages. 

I took care of a patient once whose B12 deficiency destroyed long-term memory.  The patient could carry on conversation but couldn’t remember being married and having children.  Yet most dementia patients, including those with Alzheimer’s, remember events from their childhood.

Too much alcohol disrupts the consolidation of short-term memory.  The experience of awakening one morning and not being able to remember what happened the night before should frighten the gin out of a person.  Yet most people who get to that point continue to drink, and will tell you, eventually, that if they didn’t black out they didn’t have enough.

I cared for a patient during a prolonged hospitalization for problems related to alcohol consumption to the point of malnutrition.  When the dust settled and the failed organ systems which could be restored had been, the person could talk intelligibly but couldn’t remember the date for a minute.  Able to remember a few names and faces but stuck forever on September 25 of an unknown year, the person achieved the lifelong goal of a cancelled memory.  Yet that prize left confusion and the confusion left fright.

Consider the irony.

 

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2 Responses to “Memory, sourdough, and blackouts.”

  1. offshore bank account Says:

    The storage in sensory memory and short-term memory generally have a strictly limited capacity and duration, which means that information is not retained indefinitely. By contrast, long-term memory can store much larger quantities of information for potentially unlimited duration (sometimes a whole life span). Its capacity is immeasurably large. For example, given a random seven-digit number we may remember it for only a few seconds before forgetting, suggesting it was stored in our short-term memory. On the other hand, we can remember telephone numbers for many years through repetition; this information is said to be stored in long-term memory.

  2. silver price Says:

    Working memory involves the manipulation of information that is being obtained, and then using this information to complete a task. For example, the ability of one to recite numbers they have just been given backwards requires working memory, rather than just simple rehearsal of the numbers which would require only short term memory. One’s ability to tap into their working memory declines as the aging process progresses.

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