Blink and forget everything: The case of Clive Wearing.

Imagine that with every blink of an eye, you forget almost everything you know, and you can´t remember anything new. You have a constant impression of being just awoken from a  long-term coma, and this happens every 30 seconds of your life. This nightmarish conception is exactly what happened to Clive Wearing, once a successful composer and musician. At the age of 47, he was struck down by a herpes simplex virus, normally a rather harmless one, which in Wearing resulted into a bad case of encephalitis. As a consequence, his both hippocampi (playing a major role in the transfer of information from short-term into long-term memory), but also surrounding areas of his temporal lobes as well as portions of his left frontal lobe got badly damaged, which has manifested in profound changes in his memory. Actually, it is the worst case of amnesia ever recorded.

Ever since his condition started, Wearing has been unable to form any new memories and recall majority of the past ones. This means he suffers from an extreme case of both retrograde and anterograde amnesia. He can remember some fundamental facts, like the fact he has been married (but doesn´t know for how long) and that he has children (not knowing how many and who they are) (Sacks, 2007). Apart from these few facts, his long-term memory has been completely erased.

Clive´s wife Deborah has documented their life together, affected by this condition, in her book "Forever Today"

Even though his perception as such is unimpaired, he can only remember information up to 7 to 30 seconds (short term memory), and after that, with a blink of an eye, everything elapses and nothing is stored. With every blink, his eyes part to reveal a completely new scene, and he quickly forgets about topics he spoke about or experienced just moments earlier. It is probably like waking up from an intense sleep, when you can´t firstly orientate yourself and you´re confused; or better like waking up from a long-term coma. In the beginning of this condition, Clive was under the continuous impression that he had just emerged from unconsciousness or that he has recovered from being dead, because he had no evidence of ever being awake before. He couldn´t remember any sights, smell or sense. As a result, he is literally waking up every twenty or so seconds, restarting his consciousness, which lasts only moment-to-moment. As terrible as it sounds, he is able to function quite normally, and his wife gladly accepts the fact he´s always welcoming her in a hearty matter as if they haven´t seen each other for ages (even though she has e.g. only gone to the other room to bring a tea).

He used to write a diary where he wanted to record his most important life event, „waking up for the first time“, as he has called it. As a result, his diary is full of phrases like „I am awake” or “I am conscious“ in different variations. The following statements always contradict the previous ones, as e.g. firstly claiming „This time finally properly awake“ while in few minutes opposing this with „I awoke for the first time, despite my previous claims“. These assertions and denials have filled up the whole diary, making it similar to a dreadful scene from a science-fiction movie. Also, because he almost imediately forgets what he has been pondering about, there seems to be no lingering mood. Moreover, he can´t control his emotions very well, as a result of a damage to the inferior frontal lobe (Sacks, 2007)

Procedural memory

Even though he´s having a complete amnesia, the procedural memory (the one for „actions“) is well preserved (Sacks, 2007), mostly because it involves different brain areas (incl. basal ganglia and the cerebellum) than those impaired in Wearing. He is not able to remember almost anything  unless he is actually doing it; then it may come back to him (France, 2005). He still remembers how to play the piano for example, even though he doesn´t remember anything about his education. There is some basic learning possible, mainly by repetition, which is a way how to acquire new procedural memories. However, he once said to his wife that he is „completely incapable of thinking.” Normally, amnesiacs will try to infer things and hypothetise what has happened. But Clive wasn´t even able to make plausible inferences. Because of the lack of the time he always had before he has forgotten, he perpetually came to the conclusion he must have just been „awakened“(Sacks, 2007).

Wearing´s procedural memory, as manifested e.g. during playing the piano, remained untouched

Semantic vs. episodic memory

Also, the semantic (for stable facts about the world ) memory seems to be largely intact. Even though, it seems he is „stuck“ with his semantic memory before year 1985, when his ilness started; for example he was astounded by the fact that hybrid cars already exist, as if he thought it´s a promising future possibility (Sacks, 2007). On the other hand, his episodic memory (a subjective record of the past (Tulving 1983) is not functional. All the personal episodic memories are embedded in a framework of semantic knowledge, and are related to the self in a subjectively sensed time. This enables to store the personal memory of an event separately from the semantic system, and retrieved in what Tulving called ‘episodic retrieval mode’. There is a degenerative condition known as semantic dementia, where a semantic memory is markedly impaired, leaving episodic memory surprisingly unaffected. Yet, in Mr. Wearing, the damage is reversed (Suddendorf et al., 2009).

Episodic memory shares a main neural network with the simulation of future episodes, enabling mental time travel into both the past and the future. The semantic memory may serve as a base to retrieve the episodic memory. There have been opinions that there could be something peculiarly human about being able to mentally travel in time. For example, human language may have evolved for the sharing of past and planned future events, not necessarily only those based on reality. Also, the ability to simulate possible future events may have enhanced the survival and reproduction chances of the mankind. There are further questions regarding evolutionary considerations, for example to which extent is episodic memory linked with instincts and learning in general? (Suddendorf et al., 2009). Till what level is human nature shaped by our memory?

(To find out more, this video is a good introduction to Wearing´s case; starts at 0:30)

Many interesting details of this unusual case shed a new light upon the nature of our realities and the level of certainty we perceive the everyday world with. As we can see, even just one reported case, as that of Clive Wearing (who has turned, by the way, 74 these days), can lead to many scientifically and humanly enriching realizations with yet unknown implications.