Lisa's Post

An Exploration of Memory in Tell Me Everything You Don’t Remember: The Stroke that Changed My Life

Christine Hyung-Oak Lee’s stroke has brought her face to face with how her brain and especially her memory function. 

In Tell Me Everything You Don’t Remember: The Stroke that Changed My Life, the author recounts the story of her stroke, her struggle to understand what has happened to her and her long uphill battle to regain some sense of normalcy.  Interspersed into this narrative are detailed medical explanations of how the brain functions, and how memories are formed, accessed and experienced.  While such a book could be a dry recounting of facts and events, much like a treatment summary, Christine’s book is a deeply personal, unflinching look at what it means to experience a stroke and learn to live in its aftermath.  After all, the medical accident that we call a “stroke” and the brain damage it leaves behind are a devastating personal experience, often causing irreversible changes to the patient’s thought processes and memory, and consequently to her relationships and her sense of self.

Key to the book are the author’s experience and understanding of memory.  What is the nature of short- and long-term memories?  How are they formed, and how may they be experienced and accessed?  Where are they stored?

Initially it would appear that memory resides in the brain.  Christine’s stroke damaged her left thalamus — leaving her with impaired executive function and short-term memory loss.  As the author explains, the thalamus is the area of the brain that takes outside information and determines where in the brain it should be routed for processing.  By relaying messages from one part of the brain to another, the thalamus “plays a role in controlling the motor systems of the brain responsible for voluntary body movement and coordination” [p. 50].  These patterns of interaction create short-term memory which “dominates all tasks” [p. 60], organizes related movements and tasks, and stores information on a short-term basis. The thalamus may also be where short-term memories are converted into long-term memories, via the phenomenon of neuroplasticity.  After her stroke, as Christine explains, “I could not convert short-term memory into long-term memory for some time.”

The specific location of Christine’s stroke and its consequent impact on her short-term memory suggest then that memory exists in the brain.  As described in the studies of Dr. Eric Kandel [see p.131 ff], these are “explicit” memories that are formed in the brain after 24 months of age.  They include specific facts, and events, can be put into words, and require conscious recall.

“Implicit” memories on the other hand are elusive, impossible to specifically identify and express, and do not require conscious recall [see the Dr. Kandel’s findings, pp 131-132].  They are the first type of memory to be formed in the young brain, and may be created before 24 months of age. “Implicit” memories may be embedded early on as a result of early childhood trauma and may be triggered by other events or situations.  “They never go away, even though they cannot be recalled, articulated or explained [p. 132].”  Yet their emotional impact can be felt physically i.e. as a tight feeling in the chest, a quickening of the heart rate, or an inexplicable visceral fear of certain settings or situations.  It is here that the reader comes to understand that these longer-term memories exist in a much more complex physical and emotional space, and may be experienced as much in the body as it is in the brain.

Even without any understanding of the neuroscience behind memory, we know that we may experience it as a physical sensation, even if we cannot name the exact memory that elicits it.  These emotional memories are visceral and may be more powerful than the memory of which pocket our keys are in, or how to cook oatmeal, of the name of the student who just left the room.

While an exhaustive scientific understanding of neuropathways and electrical activity may point to the brain as the primary creator and storehouse of memory, the sensory physical manifestations of memory can’t be denied.  Our physical bodies can be a powerful unconscious guide to our past — a repository of experiences and sensations that we have imbedded in our very tissues.

Lisa Patten