Our Brains Keep Working, Even in Illness

I made a special trip to see my Mother for a few days around her birthday. Her brown eyes always get big and round with excitement when I walk into the Renaissance wing of Remington House, the assisted living facility where she lives in northeast Georgia about fifty miles from Atlanta. She usually walks herself, using her blue aluminum walker for support, around and around and around the nurses' station in the center of the wing and is often seated at one of the colonial-style sofas in the entrance way, watching all the comings and goings of visitors, residents, and staff. She concentrates, intently, purposefully. Her back is bent with severe arthritis but she lifts her upper body and chin and manages to seemingly observe everything and everyone. She never speaks except when spoken to although she is always polite, her good Southern upbringing never failing her.

I asked her, very specifically, "what would you like for your birthday? Something special to eat?" I imagined myself running all over Atlanta trying to find gourmet goodies. Mother always enjoyed trying new things and loved good food.

She wrinkled her brow and whispered, simply "oysters, fried oysters." Whenever I'm there, I always ask, "want to go to a movie, want to go for a ride, want to go to a restaurant, want to go to an art museum?" And my mother always nods yes, her eyes brightening.

So I did race all over Atlanta to find fresh, shucked oysters, along with tartar and tangy tomato sauce. And we had really fresh, lovely oysters breaded in corn meal and fried in the Remington House kitchen. A very special birthday dinner.

When I left the next day, Mother escorted me, slowly moving her walker along, to the double doors of the entrance way and stood there, balancing one hand on the walker and raising the other. She waved as I drove down the long drive to the highway, until we could no longer see each other. Just as she always used to, my entire life, as I have returned and left again, over and over. I've missed her sweet waving, I realized, in these last years. And this time, more poignantly, I felt the familiar tear well up in the corner of my eye. I was seeing a remnant of my deeply feeling, emotional, articulate, intelligent, creative Mother, who loved me with great affection and suppport. I was remembering that person, who I haven't seen in a long time.

My mother has frontotemporal dementia, or FTD, little known by the general public but well known among physicians as the second most prevalent kind of dementia, trailing only Alzheimer's in the US with as many as 4.5 million people afflicted. A recent article in the San Francisco Chronicle Magazine stated: "Though many similarities with Alzheimer's disease exist, the key difference is that FTD patients display only limited memory loss. Results of intelligence tests can remain normal, and individuals with unimpaired motor control can stay athletic for a long time, conveying the illusion of good health." My mother has almost perfect long-term memory, even today. She can look at a photo and tell you the time of day it was taken (along with the date and the middle names of the people in it).

In typical FTD pattern, my mother was struck in her early 60s (many show signs in their 40s and 50s). Always an excellent money manager, my mother began compulsively subscribing to magazines, with piles of at least 30 different ones around the house; she became positive she would win Publishers' Clearinghouse. She then began writing checks for every imaginable contest on TV and in the mail, followed by checks to anyone who asked. She supported Democrats and Republicans, pro-life and pro-abortion, and orphans in Central America.

My mother had a wry sense of humor and loved all things intellectual and artistic. She rarely missed giving a strong opinion, which she voiced, in most conversation. We noticed that for a person who always laughed and cried easily, she began to have little facial affect, no sense of humor, and in fact, very little emotional reaction to anything, no matter how deeply it must have affected her. She simply stared at the casket when my father was buried, never shedding a tear, never reacting at all in any way. We thought she was depressed, as many family members and even doctors do when FTD appears.

Dr. Bruce Miller at the University of California at San Francisco has been studying FTD for a number of years and has found another interesting pattern in many patients with FTD, one which my mother also experienced. His team's research has found that FTD ". . . has been traced to a mutation in a gene called tau, which leads to the destruction of a part of the cortex used for speech and social skills but which may spare regions for visual perception." As a result, "patients stopped talking, withdrew socially, became irritable, developed odd obsessions and failed at memory tests. But . . . the most severe problems were preceded by a period of exceptional creativity. " Dr. Miller notes that many people with FTD became prolific artists in many different media.

My mother's decline in judgment, language, and social skills was definitely preceded by a burst of creativity. She had always been creative, playing the piano, writing, decorating, designing, drawing. But she suddenly began obsessively composing music and painting oils, which now decorate the high wall of her Renaissance House room. Experts believe that "creativity may not be so much a direct product . . . but rather part of a person's way of coping with the disease."

How amazing that our brains continue to compensate for weakness, always seeking to learn and grow, even in the midst of grave illness.

Creativity and the Brain

Last night I saw Bobby McFerrin in concert, accompanied by 12-singer Voicestra. Those 12 voices included well-known and great voices, like that of Janis Siegel, one of the original singers in the Manhattan Transfer. As the program stated, "Voicestra serves as rich compositional palate for Bobby McFerrin's expeditions into the musical universe." Every single rendition we saw on the stage was totally improvised, thoroughly entertaining, original, and energizing. For those of you who may not know Bobby McFerrin, he started his career with that very famous tune, "Don't Worry Be Happy" and has gone on to become one of the most original musicians in the world, easily moving from classical to opera to jazz to any other kind of music and using his voice as a musical instrument. Improvisation is clearly his sweet spot. He even included the audience in some of the improvisations. My advice: travel for miles and miles to get a ticket to a Bobby McFerrin concert!

As I watched the energy and expertise and great entertainment on the stage, I couldn't help but think about the part that creativity plays in brain health.

And along those lines--thanks to Dave Munger of Cognitive Daily for pointing me to recent research by Eviatar and Just that looked at how the brain processes irony and metaphor. I think we need creative skills to figure out language puzzles like metaphors and irony. Using fMRI studies, the researchers discovered that our brains process common metaphors and ironic statement differently from ordinary language, going beyond the usual language centers (usually on the left side of the brain if you're right-handed) to include different areas on both sides of the brain. For reference, regular literal language all gets translated in the usual language centers. I'm not surprised, given the research that has already shown that creative endeavors and creative people use many parts of the brain for creative expression.

I suspect that is why creative expression gets good marks for keeping our brain healthy and fit and reducing the probabilities of Alzheimer's and dementia. I'm just trying to visualize the fMRIs of McFerrin and Voicestra's brains during that concert: lots of big splashes of color all over both sides, I suspect. I also wonder what happened to our brains in the audience as we watched this creativity in process. We were not passive. We jumped at the chance to interact when McFerrin pointed to us. I bet our brains were pretty busy, too (on both sides).

How to Be a Working Artist--and Stay Sharp

Instead of declining into retirement with age-appropriate activities like cruises, golf, and watching the world go by, move to a community of like-minded souls focused on active lives of creativity and participation. Add in some professional experts for advice and guidance and you have a shot at a spectacular new career. You'll also start reversing general decline of the body, mind, and spirit and preventing future health issues. And you may very well be paid handsomely for your work as playwright, radio personality, artist, composer, or musician.

A front-page NY Times article today by Patricia Leigh Brown, "At New Rentals, the Aim Is to Age with Creativity" highlights a study jointly sponsored by George Washington University and The National Endowment for the Arts called "The Creativity and Aging Study." As Dr. Gene Cohen, one of the directors of the study, says in a summary of the results of this first two-year research of its kind, "Awareness that there is no age limit to tapping human potential affects not only how we view and prepare for our own future development, but it also influences how society nurtures and benefits from its older human resources." Also interesting is that many of the participants had already lived "normal" lifespans and were in their 80s and 90s at the time of the study. So what will happen when Boomers, the first of whom are now reaching 60, demand to be heard--creatively, politically, and as wage-earners? I think we're in for some exciting times.

Dr. Cohen adds in the NY Times article, “We’re thinking beyond the problems of aging to its potential. . . . What’s emerging is a very talented group of people who are an under-recognized national resource.”

technorati: Boomers, health and wellness, brain, creativity, aging