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The Lost Mariner

You have to begin to lose your memory, if only in bits and pieces, to realize that memory is what makes our lives. Life without memory is no life at all…. Our memory is our coherence, our reason, our feeling, even our action. Without it, we are nothing…. (I can only wait for the final amnesia, the one that can erase an entire life, as it did my mother’s….)

Luis Buñuel

This moving and frightening segment in Buñuel’s recently translated memoirs raises fundamental questions—clinical, practical, existential, philosophical: what sort of a life (if any), what sort of a world, what sort of a self, can be preserved in a man who has lost the greater part of his memory, and, with this, his past, and his moorings in time?

It immediately made me think of a patient of mine in whom these questions are precisely exemplified: charming, intelligent, memoryless Jimmie R., who was admitted to our Home for the Aged near New York City early in 1975, with a cryptic transfer note saying, “Helpless, demented, confused and disoriented.”

Jimmie was a fine-looking man, with a curly bush of gray hair, a healthy and handsome forty-nine-year-old. He was cheerful, friendly, and warm.

Hiya, Doc!” he said. “Nice morning! Do I take this chair here?” He was a genial soul, very ready to talk and to answer any questions I asked him. He told me his name and birth date, and the name of the little town in Pennsylvania where he was born. He described it in affectionate detail, even drew me a map. He spoke of the houses where his family had lived—he remembered their phone numbers still. He spoke of school and school days, the friends he’d had, and his special fondness for mathematics and science. He talked with enthusiasm of his days in the navy—he was seventeen, had just graduated from high school when he was drafted in 1943. With his good engineering mind he was a “natural” for radio and electronics, and after a crash course in Texas found himself assistant radio operator on a submarine. He remembered the names of various submarines on which he had served, their missions, where they were stationed, the names of his shipmates. He remembered Morse code, and was still fluent in Morse tapping and touch-typing.

A full and interesting early life, remembered vividly, in detail, with affection. But there, for some reason, his reminiscences stopped. He recalled, and almost relived, his war days and service, the end of the war, and his thoughts for the future. He had come to love the navy, thought he might stay in it. But with the GI Bill, and support, he felt he might do best to go to college. His older brother was in dental school and engaged to a girl, a “real beauty,” from California.

With recalling, reliving, Jimmie was full of animation; he did not seem to be speaking of the past but of the present, and I was very struck by the change of tense in his recollections as he passed from his school days to his days in the navy. He had been using the past tense, but now used the present—and (it seemed to me) not just the formal or fictitious present tense of recall, but the actual present tense of immediate experience.

A sudden, improbable suspicion seized me.

What year is this, Mr. R.?” I asked, concealing my perplexity under a casual manner.

Forty-five, man. What do you mean?” He went on, “We’ve won the war, FDR’s dead, Truman’s at the helm. There are great times ahead.”

And you, Jimmie, how old would you be?”

Oddly, uncertainly, he hesitated a moment, as if engaged in calculation.

Why, I guess I’m nineteen, Doc. I’ll be twenty next birthday.”

Looking at the gray-haired man before me, I had an impulse for which I have never forgiven myself—it was, or would have been, the height of cruelty had there been any possibility of Jimmie’s remembering it.

Here,” I said, and thrust a mirror toward him. “Look in the mirror and tell me what you see. Is that a nineteen-year-old looking out from the mirror?”

He suddenly turned ashen and gripped the sides of the chair. “Jesus Christ,” he whispered. “Christ, what’s going on? What’s happened to me? Is this a nightmare? Am I crazy? Is this a joke?”—and he became frantic, panicky.

It’s okay, Jim,” I said soothingly. “It’s just a mistake. Nothing to worry about. Hey!” I took him to the window. “Isn’t this a lovely spring day. See the kids there playing baseball?” He regained his color and started to smile, and I stole away, taking the hateful mirror with me.

Two minutes later I reentered the room. Jimmie was still standing by the window, gazing with pleasure at the kids playing baseball below. He wheeled around as I opened the door, and his face assumed a cheery expression.

Hiya, Doc!” he said. “Nice morning! You want to talk to me—do I take this chair here?” There was no sign of recognition on his frank, open face.

Haven’t we met before, Mr. R.?” I asked casually.

No, I can’t say we have. Quite a beard you got there. I wouldn’t forget you, Doc!”

Why do you call me ‘Doc’?”

Well, you are a doc, ain’t you?”

Yes, but if you haven’t met me, how do you know what I am?”

You talk like a doc. I can see you’re a doc.”

Well, you’re right, I am. I’m the neurologist here.”

Neurologist? Hey, there’s something wrong with my nerves? And ‘here’—where’s ‘here,’ what is this place anyhow?”

I was just going to ask you—where do you think you are?”

I see these beds, and these patients everywhere. Looks like a sort of hospital to me. But hell, what would I be doing in a hospital—and with all these old people, years older than me. I feel good, I’m strong as a bull. Maybe I work here…. Do I work? What’s my job?… No, you’re shaking your head, I see in your eyes I don’t work here. If I don’t work here, I’ve been put here. Am I a patient, am I sick and don’t know it, Doc? It’s crazy, it’s scary…. Is it some sort of joke?”

You don’t know what the matter is? You really don’t know? You remember telling me about your childhood, growing up in Pennsylvania, working as a radio operator on submarines? And how your brother is engaged to a girl from California?”

Hey, you’re right. But I didn’t tell you that, I never met you before in my life. You must have read all about me in my chart.”

Okay,” I said. “I’ll tell you a story. A man went to his doctor complaining of memory lapses. The doctor asked him some routine questions, and then said, ‘These lapses. What about them?’ ‘What lapses?’ the patient replied.”

So that’s my problem,” Jimmie laughed. “I kinda thought it was. I do find myself forgetting things, once in a while—things that have just happened. The past is clear, though.”

Will you allow me to examine you, to run over some tests?”

Sure,” he said genially. “Whatever you want.”

On intelligence testing he showed excellent ability. He was quick-witted, observant, and logical, and had no difficulty solving complex problems and puzzles—no difficulty, that is, if they could be done quickly. If much time was required, he forgot what he was doing. He was quick and good at tic-tac-toe and checkers, and cunning and aggressive—he easily beat me. But he got lost at chess—the moves were too slow.

Homing in on his memory, I found an extreme and extraordinary loss of recent memory—so that whatever was said or shown or done to him was apt to be forgotten in a few seconds’ time. Thus I laid out my watch, my tie, and my glasses on the desk, covered them, and asked him to remember these. Then, after a minute’s chat, I asked him what I had put under the cover. He remembered none of them—or indeed that I had even asked him to remember. I repeated the test, this time getting him to write down the names of the three objects; again he forgot, and when I showed him the paper with his writing on it he was astounded, and said he had no recollection of writing anything down, though he acknowledged that it was his own writing, and then got a faint “echo” of the fact that he had written them down.

He sometimes retained faint memories, some dim echo or sense of familiarity. Thus five minutes after I had played tic-tac-toe with him, he recollected that “some doctor” had played this with him “a while back”—whether the “while back” was minutes or months ago he had no idea. He then paused and said, “It could have been you!” When I said it was me, he seemed amused. This faint amusement and indifference were very characteristic, as were the involved cogitations to which he was driven by being so disoriented and lost in time. When I asked Jimmie the time of the year, he would immediately look around for some “clue”—I was careful to remove the calendar from my desk—and would “work out” the time of year, roughly, by looking through the window.

It was not, apparently, that he failed to register in memory, but that the memory traces were fugitive in the extreme, and were apt to be effaced within a minute, often less, especially if there were distracting or competing stimuli, while his intellectual and perceptual powers were preserved, and highly superior.

Jimmie’s scientific knowledge was that of a bright high school graduate with a penchant for mathematics and science. He was superb at arithmetical (and also algebraic) calculations but only if they could be done with lightning speed. If there were many steps, too much time, involved, he would forget where he was, and even the question. He knew the elements, compared them, and drew the periodic table—but omitted the transuranic elements.

Is that complete?” I asked when he’d finished.

It’s complete and up-to-date, sir, as far as I know.”

You wouldn’t know any elements beyond uranium?”

You kidding? There’s ninety-two elements, and uranium’s the last.”

I paused and flipped through a National Geographic on the table. “Tell me the planets,” I said, “and something about them.” Unhesitatingly, confidently, he gave me the planets—their names, their discovery, their distance from the sun, their estimated mass, character, and gravity.

What is this?” I asked, showing him a photo in the magazine I was holding.

It’s the moon,” he replied.

No, it’s not,” I answered. “It’s a picture of the earth taken from the moon.”

Doc, you’re kidding! Someone would’ve had to get a camera up there!”

Naturally.”

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