Thursday, November 09, 2006

The Missing Past, the Unrememberable Present

Melissa is increasingly frustrated with me around my memory problems and my inattention to detail and inability to complete tasks and remember to follow-up with things. You have to understand…I’ve always been (until the last 9 months) a perfectionist, detailed, organized and in control. Example: Melissa makes me a list of things to do. I do them, but one of the items can’t be done completely right away for some reason. I often forget to go back and finish that item once it can be finished. Her frustration with me causes frustration for me. I write things down and I do the best I can do. I’ve tried different ways of staying organized, all with some degree of success. The “best I can do”, however, doesn’t meet my standards, just like it doesn’t meet hers. I feel embarrassed of my shortcomings and useless and upset with myself for failing to be reliably able to get things done. My frustration leads to mood changes, which further frustrate Melissa. When she reminds me of things, I’m often short with her because I’m embarrassed that I’ve forgotten or because I feel insulted that she thinks that I might have forgotten (if I haven’t.) Then, she feels like she can’t talk to me about things without upsetting me. On top of that, my talking to her about my mood and the problems I am having on some days overwhelms her, with everything else that's going on in life. So, the end result is a communication break-down wich we have to find a way to avoid.

This continued and increasing realization that I can no longer do things I used to be able to do gnaws at me constantly. My mental capacity isn’t getting better. My memory isn’t improving. Its as though when I elected to undergo ECT to relieve depression, I unknowingly (I know, Sally T, some of you told me) elected to change who I am, what I am capable of doing, and what contribution I can make to my family, my community and the world. I knew about the possibility of lasting memory loss. I didn’t understand that ECT would create a new “me.” ECT did improve my mental illness. At the point in my life at which I chose ECT, my options for a future were limited. And in my case, I had a family pleading with me to undergo ECT before I elected to leave them via suicide.

What if I had just, on my own, decided to undergo ECT, side effects be damned, without my family’s support and encouragement? A novel by Keith Ablow, “Murder Suicide”, poses an interesting philosophical question. In the story, there is a brilliant scientist who suffers from a seizure disorder manifesting itself at times when he pushes his brilliant mind the hardest (or maybe too hard). While he is a brilliant man, his own brain limits the usefulness of his mental capabilities, leaving him unable to fully tap into his intellect. He is contemplating undergoing elective and experimental surgery which would remove the part of his brain responsible for the seizures, leaving him to live a life free of this ailment and free to use his brilliance to its fullest. The surgery would, however, almost certainly leave him with a nearly complete amnesia, removing any memory of his former life or his family and friends (while, presumably, leaving his learned knowledge intact.) In the man’s journal, he asks the following question: (Those that I know personally, please understand that the book poses an interesting question, but I do not seek to abandon my life or my loved ones. The scenario is just so closely relatable to that of a person undergoing ECT, assuming the worst case side effects, that the philosophy is interesting. The facts specified in the passage below do not match my own situation.)

Does a [person] have the right to begin life anew? Is he the full owner of his existence, or is he merely a limited partner? Example: A woman is married 20 years with teenage children and a husband. A home. Pets. Photo albums and scrapbooks brimming with memories. What happens when this woman no longer feels any passion for a shared future with her husband and children? What if she feels non-existent?

Is she depressed? Does she need Zoloft? A higher dose? Or is it possible her life has carried her so far from her internal truth that she is, for all intents and purposes, a zombie – one of the living dead?

Is that woman within her rights – morally and ethically – to leave her home and friends, leave them so completely that she has no memory of them? Having brought her children into the world, does she owe them the rest of her life or is she free to celebrate the past and move on to create a new future without them [but congruent with her true destiny] ?

A person can be spiritually deceased, the carcass of his soul adrift inside a cage of skin and bone that has outlived him. What sort of mother or father, sister or brother, husband or wife would put his or her attachment to a shared past [with a loved one] above [the loved one’s] future, [forcing him or her to continue this soulless life of the living dead]?

True love would never exact such suffering.

If ECT could ease the suffering of depression and remove a patient from the verge of certain suicide, but with side effects of total memory loss: Ethically/morally/philosophically, where does a person’s (the “Patient”) right to begin life anew, free of the constant pain of depression, end? With respect to those sharing the Patient’s life, where do their rights to continuity begin? Consider the comparison between the “beginning life anew” scenario and one in which the Patient elects suicide instead. Does the Patient violate the rights of those sharing his life when he abandons all hope and commits suicide? Would suicide be easier for “those in one’s life” to handle, knowing that the Patient left life, as a whole, rather than abandoning the people in his life for a new life without suffering (and without them?) How does choosing amnesia for the sake of obtaining a life worth living (without depression) differ from just deciding to leave your old life behind and start another (for example, just moving to a different city and leaving your family and “life” behind)?


Anonymous Anonymous said...

Hey Mike -
Well, for someone struggling to finish "to do" lists you certainly have retained the capacity to write with clarity and reason. I always enjoy your writing.

You ask (via Ablow?) How does choosing amnesia for the sake of obtaining a life worth living (without depression) differ from just deciding to leave your old life behind and start another (for example, just moving to a different city and leaving your family and “life” behind)?

I would answer that choosing amnesia creates a totally different person, while changing locales doesn't change the person, only the scenery.

I'm sure you recognize your own situation in the question - you moved for a fresh start AND chose the possibility of post-ECT amnesia as a tradeoff for no more depression.

Give yourself some credit and time - you are doing everything you know to do to get better. That's all we can ask of ourselves or others.

Bill from the 'hood

4:09 PM  
Anonymous Anonymous said...

Some very interesting questions and perspectives. I do feel like I (the old Sally) died after ECT. So in a way it was suicide (albiet at someone elses hands).

I hate to say it but I really feel I would have been better off having ended my life. This life I have now is a daily struggle for myself and my family/friends. So why don't I do it now? I can't answer that. Maybe because, while there are times I do not want to be alive, I also do not necessarily want to "kill myself".

And I have this kind of nagging feeling that maybe I'm now supposed to have a purpose in life that involves trying to make a change regarding ECT. I don't know how, and it's probably a pipe dream that I could have any impact, but it keeps me going some days.


7:15 PM  
Blogger Grandma said...

Interesting, but the problem is no one "chooses" amnesia because no one is fully informed of the nature and extent of ECT deficits. You weren't, though you thought you were. You are only discovering them now.

Most things in life are easier to bear if you feel you've had some choice---ECT is so difficult because the choice was made for you without your knowledge or consent.

But having chosen amnesia, you wouldn't remember that you had chosen it so it wouldn't feel like a choice!

3:05 PM  
Blogger Tomas said...

How many of us haven't died when the electrodes were attached to our heads, to give place to bits and fractions of self futilely pieced together, like reflections of what was in a cracked mirror.

Bill, it's not just amnesia. It's everything. Amnesia is just what's most well-known.

1:15 PM  
Anonymous janet said...

Have just been diagnosed(again & differently) today with BPD and cronic depression. My own suicidal ideation consumes a great amount of my thinking capacity. The idea that shock treatments work to erase the brains memory is something that I am seriously considering now. I don't really want to commit suicide. I don't have a problem with dying though, I would like to be dead.

But this, perhaps, is the answer I have been looking for. To not be me anymore. Not to have to live with it all the time, 29.5 hours a day. (Fast thinkers get more time I figure.)

However what if the new me ended up like the old me in time. This ill again. Would I be able to go through it again? Is it worth the risks? These are very interesting thoughts I now have.

Good on ya for doing it!!! Thanks

10:57 PM  
Blogger Polar Bear said...

Some very good questions you raised here. I've never been a "believer" of ECT. Having had it myself about 10 years ago and still suffering from memory loss, I feel as though I have lost a big partr of myself.

I don't think there is much difference in suicide and having ECT which erases such a big significant part of myself. I did die, about 10 years ago. Who I am now is a completely different person. I grieve everyday for that loss.

6:03 PM  

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