Fits and Starts

Although I desired to keep posts on this section of the site from reading like journal entries, perhaps that is an unreasonable goal when discussing the matter of my recovery and evolving mental state. Nearly a month has elapsed since I last wrote here, perhaps the break was necessary. The month has been turbulent, characterized by leaps forward and steps backwards.

After several months in which I somewhat despondently attempted to regain some form of technique musically, I finally reached a point physically where I am able to play with sufficient stamina, both physically and mentally that I can work seriously towards musical goals. Still my attention span, mental quickness and memory are shadows of former years, but progressing steadily.

An interesting cycle has emerged. On the way down (as my disease progressed), I would lose ability, then work harder to accomplish the same tasks. I continued performing the same sorts of tasks but with far greater difficulty. Now, on the way up, as my mental faculties reemerge, I re-calibrate my expectations, performing the same tasks but shifting my expectations regarding the degree of ease with which these tasks can be performed. The fascinating feature of this pattern, to me, is that overall the level I demand of myself exists mostly independently of my ability at any moment.

This idea, that changing mental abilities and the level of activities – what books I read, which music I listen to, the food I attempt to cook – are largely independent raises an important question. What determines them if not who I actually am and of what I am actually capable at the moment?

I believe this sense of what I can and should do flows not from my actual abilities at any given moment but instead from a deeply ingrained sense of self. Upon further investigation, this idea makes fantastic amounts of sense. Perhaps my personal fluctuations in mental ability are extremely rare in any person of my age, and most of those who do experience a rapid deterioration of mental capacity probably never experience any recovery that would allow them to talk (or think) about it. But, on a much smaller scale, every individual has substantial shifts in capacity from day to day. It then must be necessary for pragmatic reasons for each person to have a sense self that exists independently of the actual 'self of the moment'. How else could someone decide at any moment what long-term responsibilities to take on? People require a sense of self that is considerably more stable than the self itself,

When I reached my deepest trough of cognitive decline and still forced myself to read, I didn't revert to the books on which I learned to read as a young boy, even though they would probably have been better suited for my level of comprehension at the time. Instead, I attempted to read Dostoevsky's The Brothers Karamazov, continuing with the last book I had been reading before my sickness began to rage in January. Only much later, weeks into my recovery and after considerable conscious deliberation did I recognize that I had to read books more suitable to who I was at the moment and not who 'I really was'.

What then is the nature of this more permanent self-image? How quickly does it evolve? Can it be altered? Does it settle in at a certain age, condemning all of us to spend the rest of our lives as whatever we have determined ourselves to be?

As I reclaim my brain, gradually bringing old activities back from the brink and into the possible, even easy, I aspire to re-calibrate my sense of what I can and ought to be doing to more fully use all of my mental capabilities than I did before embarking on this flirtation with dementia.