“Sure, it’s not like I’ve got a busy day.”
The tiny woman with translucent skin smiled up at me from her hospital bed. Finally, I’d successfully recruited another study participant. But, she informed me, “No research should be done without proper introductions.” The woman before me shook off her role as Participant #14 and became simply who she was. Let’s call her Eleanor.
Eleanor lowered the volume of the opera she was listening to, as I sat down and scanned her room. There were no get-well cards or flowers. There was simply Eleanor, humming quietly to the music. Before I had a chance to ask, she said the songs allowed her to remember Vienna. She’d spent a year there as an opera singer, performing with her late husband at Austria’a largest opera house. As I told Eleanor of my own travels to Vienna, her smile widened, color flooded her ashen skin, and she began to map out the city’s streets. I smiled to myself at our shared memories. Then I began to guide Eleanor through the Montreal Cognitive Assessment (MoCA) test.
The results were striking. Eleanor’s score indicated severe cognitive impairment, lower than any score I’d seen so far in my research on cognitive decline in patients with congestive heart failure. This made no sense to me. How could someone who’d called to mind street names she hadn’t traversed in 40 years, as easily as song lyrics, not recall the name of the hospital she now lay in? I’d learned in neuroscience courses that musical memories, stored in the temporal lobe, often degrade much slower than newly acquired spatial memories, but that one’s sense of direction and place, housed in the hippocampus, is often the first target of dementia. I knew this and yet wished that the information had remained true only in textbooks. I wished that Participant #14, who could sing every word of her favorite songs, had not met the inclusion criteria for my study on cognitive impairment.
Eleanor had entered the hospital because of the stories she could, and could not, tell. She found joy in watching the sun set over the East River from her hospital bed, as if each day’s view were her first. Yet she hummed opera tunes without forgetting a single note. Eleanor’s failing memory told a story not communicated by her MoCA score alone. She beckoned visitors in with her toothy grin and made fun of my nervous trepidation, urging me to unearth her medical narrative.
I left Eleanor wanting to know more—more about the science of dementia, more about the significance of the select memories that remain in a degenerating brain.
Sheila T. Moran
The Bronx, New York