Monday, March 4, 2024

 Monday, March 4, 2024

   I was sort of up by 3:30. I tried the self-compassion meditation I learned yesterday from a YouTube video that popped up while lying in bed. We all need that.

   Brene Brown argues for the banishment of shame. God forbid. But it's certainly out of control in our society now. It isn't new to our age. Buddha and Christ both addressed the issue of shame over 2,000 years ago. We need a highly structured social organization not devoted to punishment, where we know exactly where we should be and what we should be doing at all times to be relieved of excessive shame. We're living in organizational chaos at this point. Too much information with too many options. We live with constant uncertainty. We live in constant awareness of all we don't know. We live in a continual state of anxiety. No wonder there's a craving for a dictatorship. However, whose dictatorship?

   All those seeking a strongman leader assume that the leader will create the order that they want. Sorry folks! That's not an option. Given the range of desired outcomes, I can imagine a world where no one is content, and everyone feels they've been squeezed into a tight pair of shoes.

   What's the option? It is learning to live with uncertainty. Learning to tolerate not knowing. Learning to forgive ourselves and others for being other than perfect. It's hard. It's damn hard. Can we, as a species, rise to the occasion? I think this is the solution, and I find it hard. What about all those for whom this isn't a considered option? They want the world ordered to their specifications.

   John, my Hanai sister's husband, has dementia. This brilliant man has a memory span of three minutes when last checked. The other day, he couldn't remember how to use the key fob to get into his building. He stood in the cold and rain until someone came along to open the door. He's suffering from antegrade amnesia. I know from the studies with HM someone who suffered from this as a young man due to a surgical procedure to save his life. The poor man couldn't remember that his wife had visited him and mourned her absence. So sad. John isn't that bad yet. How can his problem with the building entry be solved?

   He's working with a psychologist who does exercises with him. Since hearing Ellen Langer's lecture on the impact of mindlessness versus mindfulness in teaching, I am ever more alert to the possibility of mindless lesson plans that make no adaptation for the student. Does this psychologist have a list of exercises to do, whether meaningful or not?

   Based on what I know about the experiments with HM, here's one I recommend for John's problem remembering how to get into the building. 

While John's conscious working memory may be shot, it is possible to bypass it and get the information into his unconscious muscle memory.

   Here's the experiment they did with HM, a man who couldn't recognize a doctor he saw every day two minutes after he saw him. The doctor entered the room and greeted HM, shaking his hand. In his hand, he had one of those gadgets that produces shocks. HM responded appropriately to the stimulus. The good doctor left the room and returned in minutes. HM had no conscious memory of the man. However, he refused to take the doctor's outstretched hand when he offered it. The experience penetrated deep into his brain. They did other less stimulating experiments to see what was embedded in the implicit memory.

   Based on those experiments, here is what I recommend: 

John repeats the process of opening the door with his fob five to ten times in rapid succession. Then, do a short walkabout or provide some other distractor and have him open the door with his fob. If that's successful, wait two minutes with a distractor. Since three minutes is the recorded time for retaining a memory, increase wait times and distractors by 30 seconds. The goal is to have him use the fob effectively after five minutes. This should be reviewed daily.

   I had a session with 26-year-old S. I had her read a low third-grade passage. It went much better than the children's picture book we had been using, which had complex language and large words.

   I had first-grade B read the teacher-assigned passage with me for the first time. Up to this point, the teacher sent home the passage on Monday when her mom read it to her, and they spent the rest of the week practicing the passage to be evaluated on Friday. Her word recognition was accurate if slow. Both her mom and I were impressed with her decoding skills. The problem is she can't read the passage fast enough to score well. It's a commercially prepared passage labeled as first grade. it contains multisyllabic words and complex sentences. B's mom said she did so well in Kindergarten. B is a bright child. She may have relied on sight recall and her outstanding story memory. But these passages are far above B's ability. Both Judy and I find the passage unreasonably difficult. You're supposed to give students challenges within their range, not way above their ability level, to prove they can't read.

    I had a follow-up visit with my new primary after seeing Dr. Reed, my old primary, on a same-day basis. Dr. Reed wanted her to check if the 

5-HPT was effective. Reed recommended it. The Lexapro I had been taking before Mike died. I didn't have the symptoms of depression. I could not only function but could enjoy moments of life and feel awe at every sunset. That's not depression. I had anxiety, loneliness, and sadness, all circumstantial. She said 5-HPT would help my body produce serotonin, whereas the Lexapro would prevent serotonin reuptake. The 5-HPT would be less intrusive.

   My new primary care physician, Dr. Scheidt, ordered blood tests and a new bone density test. According to my notes, I had one last year.