Russia Hotel, Tzaghkadzor, Armenia. The guests line up for the nice buffet breakfast. Queuing up is not such a strong tradition in Armenia, and I don’t want to step on anyone’s toes. “Sorry, were you next?” “Voch-eench,”–“it’s OK, whatever.” “Voch-eench” is a kindly, assertive caption to a small favor. The closest translation may be “forget-about-it.”
Tell me about it–I’m wired to forget no less than most folks I know. There is some comfort in a handful of neuroscience papers attesting that my brain has a dedicated, calorie-consuming, forgetting system, somehow promoting my survival. So it’s not just entropy: every day, on some sub-conscious bridgehead in your brain, without so much as a “Let it be so,” a switch gets thrown, another memory is jettisoned.
Emotions, especially strong, negative ones, have a way of tying a double-knot on memories. Perhaps the trickiest memories our forgetting system has to deal with are the ones laced with fear. In neurology, we get to meet people whose forgetting system has gone haywire tangling with fear-laden memories. These are people with Conversion Disorders–apparently neurologic incapacities that are based in “psychological problems.” Back around 1880, the French neurologist Charcot couldn’t show Freud where the brain lesion was in patients with “hysteria,” which seems to have been a similar condition. Like twins separated at birth, the two parted ways, and left two schools in their wake: neurology and psychiatry. We neurologists still commemorate that historical split by drawing an imaginary line around Conversion disorders, saying “that’s not neurological, that’s mental, that’s a case for Freud”–we somehow forget that Conversion Disorder is still a brain disorder.
People with Conversion Disorder are not fools, and they are not lying. In a contest between some horrific memory (or in some cases, some dreadful prospect), and forgetting, their brains are simply unable to announce a winner. The inner waffling short-circuits volition, self-control. The prescription: remember history, what you dread, lest it repeat itself, ever biting back.
History can be a difficult topic in Armenia. After a month here, it’s clear that the citizens don’t forget the massacres and atrocities to which their hundreds of thousands of grandparents, aunts, uncles, cousins, were subjected in 1915, just a few generations ago. Next door, in Turkey, denial of this genocide is wired into national policy. Meanwhile, an increasing number of vocal Turks are challenging this systematic forgetting.
Perhaps you’ve heard the joke that for some people, denial is a river in Egypt. How to paddle up that river with the deny-er? As a neurologist, I tread lightly, and try not to confront my patent’s denial too forcefully: some deep instinct to forget is at work. We neurologists are all over the place in how effectively we respond to the blunt inconsistencies of patients with Conversion Disorder: we disdain, we lose trust, we dismiss, we condescend, we stumble. We somewhere wish that memory was all-or-nothing, forgetting the kaleidoscopic, incremental thing that it is.
Perhaps some day the writing of history will be a joint venture, and the authors will reconcile their varying needs to forget, to remember, to celebrate love, to reckon with dread. Such collaboration doesn’t come easily. One neurologist had a suggestion for how to help the person with Conversion Disorder: gently point out inconsistencies. “Look, you moved your leg just now, when you couldn’t move it before!” As though we could guide reconstruction, support bridge-building back to integrity. But even with the best intentions, we often lose these patients, having again, 130 years since Charcot, failed to find the lesion in our clinical laboratory. We see their anger as they walk out the door, feeling misunderstood, judged. A sad little microcosm of misunderstanding, we make. Forget the damn lesion, Charcot.
Once, I heard someone’s intelligence complimented with the backhand: “that guy forgot more than I ever knew.” I am still working on my forgetting skills. They lack a certain … je ne sais crois.
Sides’chun for now!
Song: I don’t forget you (recorded at Russia Hotel, Tzaghkadzor, 2/22/13.)