Author Archives: jmzm

Regarding Henry

Most of us know the story of Phineas Gage. The “most famous patient in neuroscience” because he was the first noted case suggesting a “link between brain trauma and personality change.” In his case, He went from what sources claim as well-liked, “model Foreman” to having “little deference for his fellows”. In many reports, a popularly repeated quote was that “he was no longer Gage.” What reasons are there for why this was said? Dr. David Ferrier was a scientist looking to study localization in the brain and used Gage’s accident as a means to prove the prefrontal cortex was not a “non-functional” brain area. In fact, Ferrier’s studies showed that “injury to the prefrontal cortex of the frontal lobes of the brain can cause profound personality changes, without other apparent neurological deficits.”

With this in mind, let’s take a look at the film Regarding Henry, a 1991 drama whose cast and dialogue reflect its era of film-making. In this film, Henry Turner, played by Harrison Ford, was a cold, distant father and husband. He lived life lavishly (and uptight if you ask me) thanks to his job as an efficient corporate lawyer. In an attempted dramatic twist by filmmakers, Henry comes home from the hospital essentially as a completely new person after being shot twice. Particularly emphasizing the bullet to the forehead going straight through his right frontal lobe. Henry’s doctor told that he was incredibly lucky to have the minimal damage he had, as he suffered damage in “the only part of the brain that has redundant systems.” Explicitly adding that, “If you’re going to get shot in the head, that’s the way to do it.” Now as a “new man” Henry becomes an easy going and loving family man. The audience celebrates this as a triumph despite the trauma and difficulty of the circumstances this change arose from. In all its respects, this film is basically a modernized and dramatized Phineas Gage story. While both experienced a dramatic personality shift, instead of having been the ideal man to a problematic one, Henry did the opposite.

Something the film portrayed that was different from Gage’s story, was Henry’s gunshot wound to the chest.  While at first the audience seems to find it irrelevant, it was that very wound that led to the majority of his cognitive issues such as retrograde amnesia. Unlike Henry, Phineas Gage’s original report stated he had no extensive damage to his memory. Henry’s bullet wound to the chest ruptured his subclavian vein which caused excessive internal bleeding, cardiac arrest and ultimately Anoxia. Many critical parts of the brain are extremely sensitive to anoxia which brought about his brain damage and memory loss. These damages led to Henry’s required physical and cognitive rehabilitation throughout the bulk of the film. Something important to note, was that the doctor in this film made it clear to the audience (as well as to Henry) that we barely understand much about the brain, and there are only estimates for most medical conditions involving the brain because of how little we fully understand it. Despite the film being directed in 1991, this information about the brain is still very relevant.

The information portrayed in film was done as close to accurate as could be done for the time and style of the film. However, I personally felt the whole thing to be extremely rushed and choppy in its transitions, because everything happened very fast and some major milestones of the film did not flow as easily. They tried to put too many plot points and “twists” into an already long film. I honestly think they could have done better as a film if they had focused on critical key points in a deeper manner rather than so many key and dramatic points in a very shallow manner. Henry walked and spoke again after a few months in the film, after not being able to do them at all post injury. Though it is possible to have shorter recovery times, I think it would have been better to prolong Henry’s recovery time in the film. This would allow for a more accurate understanding of how people in physical therapy re-learn specific milestones over the course of longer amounts of time. Harrison Ford in hindsight, did a good job through subtle body language and gestures that someone with such an injury could be experiencing. However, I do not really think the film fully highlight the frustration and difficulty many people have in recovery, which in my opinion is a very important aspect to accuracy and depth of such a film.

For More information: 

https://docs.google.com/document/d/e/2PACX-1vQm1wG9hizpfDo9AkUHUh3QbhZyET85Mx_9Pu6jYVKaWb6poM_JDZNYXWaR7INOaG-5pgBfZbw-Lhkg/pub

 

The bar code of the Human race

Prosopagnosia, or face blindness, is a condition in which the afflicted person cannot identify faces. For the average person this notion is really hard to imagine because we see faces nearly all day every day, whether it’s our own face, loved one’s, pictures of celebrities or friends on social media. The face is how we differentiate our boss, the bank clerk, and our own children.

The film, Faces in the crowd, directed by Julien Magnat, depicts this very condition in a murder- mystery thriller of a woman who was in the wrong place at the wrong time. The young woman Anna (actor Milla Jovovich) was living her best life with her boyfriend who was climbing up the corporate ladder.  One night she walks home after girls night only to be the center of a notorious serial killer’s hunt. She escapes the encounter with a one major injury. She cannot recognize the faces of those around her. The doctor explains her condition and she is faced with the burden of being the only person to have seen the killer, yet she cannot identify him. The killer could be anyone, he could even be right in front of her, and she wouldn’t even know.

How can we image the concept of seeing no-faces, are they blurred, empty?  This is a misconception for most of those living with prosopagnosia. Karl Kruszelnicki, Carol Kennedy and Lucy Barnard are three people living with prosopagnosia being interviewed on an a segment of an Australian Sunday night TV program.  Generally, with this condition, you can still see the features of a face, a nose, mouth, eyes, the issue lies when trying to piece those bits of information together to create one uniform image. Our recognition systems are hierarchical in nature through feature nets. Prosopagnosia afflicts the paths connecting features to the higher levels of processing. Thus, a failure of facial recognition.

https://www.researchgate.net/figure/Localiser-scan-A-Location-of-face-selective-regions-FFA-fusiform-face-area-OFA_fig1_41760722

The philosophical specialist in the film claimed “Faces are the bar code of the human race… we are constantly looking at each other’s faces, trying to decide whether they’re friends, foes or lovers.” In a sense, she is right. Humans evolutionarily developed the ability to recognize faces to the point that we have it localized. When looking at a face, there is high levels of activity in the part of the brain called the FFA (Fusiform gyrus) located in the temporal lobe. This is the place in which the lead Anna suffered a lesion to the night of her attack. Something important to make clear is that acquired and developmental prosopagnosia are different in its effects of the people afflicted. Those with developmental prosopagnosia (face blindness from birth) while reporting the same feelings of social isolation as those with acquired prosopagnosia, have had to learn coping mechanisms from the very start. They already been navigating the world in this way and sometimes people don’t realize they even have this condition.Those with the acquired version have never known what prosopagnosia is like. This can be something traumatizing especially because everyone you are close to is now unrecognizable in one hit.

The movie does a great job in bringing uneasiness and frustration to the audience by changing the actors and changing their faces so you get a glimpse as to what Anna is seeing. It was something about the movie I appreciated as a unique way to engage the audience and give a visual example to a condition most consider as abstract. Unfortunately, my intrigue really stops there. Her difficulties and social isolation due to her acquired prosopagnosia is the thing I think the movie did a good job on. For someone who had the ability to use faces in their everyday life and suddenly has to learn to cope with something as traumatic as losing the ability to see and connect with the people around her through recognition is an extremely difficult hurdle to get through. The vulnerability in which prosopagnosia brings is what makes this movie a “thriller” and that’s about it. There are many… many foreshadows and cliches in the film along with a not so surprising twist romance plot that in my opinion brings the movie down.

Overall, I think that the film should’ve worked more on its plot as a story line to be stronger than it was. However, I am very glad to have seen a film in which they have displayed a cognitive condition in a realistic light (for the most part). The parts of the “hidden sense” and “recognition in dreams” are questionable concepts, but for those of you interested feel free to do some research. Prosopagnosia is unique and relatively rare. If you’re interested in learning more, see the link below.

https://docs.google.com/document/d/e/2PACX-1vRl5PtHA3vX0H_v-iBCN3Bpc3yYg1XfrNvgB6hhhuSa7oIplObOVCFLoa35uOJPxaEH4tADDqgUuuNq/pub

 

The Story of Luke

“Sheltered by his grandparents, Luke, a young man with autism, is thrust into a world that doesn’t expect anything from him. But Luke is on a quest for a job and true love. And he isn’t taking no for an answer.” —Alonso F. Mayo

The story of Luke is a coming of age story celebrated by multiple film festival awards all over the country. It starts off with the death of his grandmother who was his primary caregiver. From the very first scenes, we realize his grandfather expresses symptoms of dementia which leaves Luke getting thrusted into a family who doesn’t really know want him nor know what do do with him. This change leads to Luke’s turning point in life and through his grandfather’s words. He begins his journey to find a job, find a girl and “screw”.

The film is marked by crude humour and unfiltered comments as we follow along from the point of view of someone with higher functioning autism who has to face the world that demeans him in every way. Not only can people by quite impatient but also tend to be very mean when faced with situations they don’t understand and have pre-existing concepts about. The cruel and low-expectational responses some people take towards people living with autism is no different. I urge you to watch this film and use it to re-imagine some of the misconceptions you may have or have witnessed of people with disabilities. Try to see this film through Luke’s eyes and find the important lessons and benefits he brings despite the many misinformed ideas people have about autism.

Regarding the overall film, I have to say I was thoroughly engaged with the film and Luke’s journey. So much so, that its abrupt ending stunned me and made me wish there was more “filling to the pie”. Despite my dissatisfaction with the ending, The leading actor Lou Taylor Pucci did a wonderful performance in this film and did a great job portraying someone on the higher functioning end of the spectrum. I appreciated the film’s ability to bring forth a viewpoint of Autism we don’t really get to see very often. Luke was someone who through being himself and with his autism transformed the lives of those around him along with his own transformation transitioning into adulthood. Luke wanted the things that everyone else had. His autism made his wants a challenge because in our world, people try to limit and erase the expectations and desires of those on the spectrum and with other disabilities. Luke faced these challenges in his own unique way and shut down some of these limitations. An example of this lies at a pivotal point Midway in the film. After Luke’s boss Zack, actor Seth Green, tries to essentially claim that he [Luke] has no place in the world other than that of pity and sorrow for others. Luke takes a stand and held himself high by basically telling his boss that he does have a purpose and that his boss is wrong.

This leads to a discussion about the film’s use of antagonizers for Luke. To my understanding, the film creators did what they did to show the crueler side of what people with disabilities face in a crude humour sort of way. Personally, I feel that his boss could have done with less abusive tactics and less of the derogatory terms. It felt very intense for the type of film being presented, however, I do understand that their dramatics was to emphasize that there are people who really do treat people with disabilities in such an awful way. There are other elements of cognitive functioning in those with ASD I believe the film creators included to try to give a more accurate portrayal of the disorder in media. Some of the topics the creators hit on in the movie are: systemization, the use of heuristics, and affective forecasting in neurotypicals and those on the spectrum.

Systemization is a way of brain functioning that involves processing and analyzing of “systems” such as machines compared to humans. Systems have rules that lead to predictive behavior. There are many instances in the film in which Luke expresses his need for rules and systems. A strong example from the movie being that Luke was left a set of rules on the fridge and clearly saying she’d be back at 2 pm. Luke set his watch with specific hours everyday marking things he needed to do paying close attention to exact times and repetition of steps and directions aloud to help him remember. People on the autism spectrum use these systems and rules to predict behavior and outcomes. However, most human beings, especially neurotypical people, aren’t always predictable. Someone can be extremely upset one moment and fine the next, which can be hard for people (with or without disabilities) to follow. The concept of emotionality is well understood by people who use the system of empathizing. Most neurotypicals have the ability to switch between these two systems – they understand when it is appropriate to think of things concretely/logically compared to with emotions and abstract understanding. Feelings, empathy, body language, facial expressions are all interrelated, and are very difficult for most people on the autism spectrum to understand and recognize.

There are multiple instances in the film showing Luke’s initiative to better understand social interactions, body language, and facial expressions as well as socially appropriate phrases such as “the weather is very nice today” and “thank you.” These are things he doesn’t quite understand but knows are important to communicating with people. There is a particular event in the film regarding Luke 

meeting his mother that ties well the concept of Luke’s systemizing and deficit in understanding emotional expression. Throughout this event, Luke works really hard on learning the things listed above and follows each social rule he learned about. He got a new outfit and tried to look his best and act his best to attempt to reconnect with the mother who left him when he was younger. When he finally gets his meeting, she gets overwhelmed and leaves him once again marking the end of Luke’s meeting with his mother. He cries out “Please don’t go I don’t understand I followed all the rules!” as she walks away from him. This is a very clear portrayal of the disconnect between those with autism’s ability to empathize and deal with unpredicted behavior as well as their vulnerability to obstacles because their systems to solve problems are based on their mental sets that rely heavily on routine.

Emotions and clear processing of our own and others’ emotions is also a huge factor in our ability to make clear decisions. For a lot of people, we predict our future emotions to help us make decisions. This can be difficult in people with ASD as well, because their decisions on what to say to others and what to do in public settings are dependent on how well they are able to read the emotions of around them. This is known as affective forecasting. For most people, this is often inaccurate, because people under and overestimate how much things will affect them later. I believe the movie did a good job at showing that someone with ASD also has this struggle of making decisions based on poor predictions. There were multiple times Luke tried to think about his future and the things he valued, and compared them to how they would make him feel later. Using the same example of his interaction with his mother, Luke believed it would make him feel good in the long run to make the decision to push his interaction with his mother after not seeing her for most of his life. However, when he was actually put in that position, he did not respond in anyway as he predicted he would prior.

Expectations are a huge part of how people view and process the world, disability or not. We make judgments, decisions, and encode based off of the knowledge we already have in store. Our thinking is driven based on our knowledge of the world and its context and is facilitated by our ability to use heuristics. In representative heuristics we expect people to resemble other people in a category meaning we expect each each person to be representative of the overall category. As one can imagine, this leads to many errors in judgement and thinking. A great example being the way Luke’s family and others saw and talked about him. They expected nothing more other than their preconceived idea of what they expect autism to look like. His boss showed his heuristic to make judgements and act cruelly towards Luke and none of his family nor boss thought he was capable of anything. They all expected him to act “all autistic” and have no ability to care for himself nor work. This misconception is based off of lots of negative misconceptions about autism spectrum disorder and the many variations in function for a person with ASD. Another type of heuristic error can be the opposite, expecting an entire category will have the same properties as one individual. One of the businessmen Luke has a meeting with asks him “Can you multiply huge numbers or memorize entire books? Do you have any special abilities?” This expressed his belief that those with autism are always exceptionally gifted in some “abnormal” way because some people with autism happen to have these abilities. These are two main ways people in the film approached Luke’s autism.

For now, we’ve looked at the film in the light of Luke and his ASD along with his relationships with systemizing, empathy and problem solving. We’ve further delved into expectations related to heuristics and the two main ways people approached Autism and people with disabilities in the film. It’s important to learn more and think for meaningfully when confronted with different people. You may not realize the challenges and scrutiny people face. knowing about one’s own expectations and thought processes can help lead to better realizing that your way of seeing the world can be completely different to someone elses and that they may not be able to do the things you take for granted. The film helped me learn more about my role in societal expectation of people with disabilities, I hope you can learn more too.

Sources and more information:

https://docs.google.com/document/d/e/2PACX-1vSnCZV9w8HCkBU3Z9HjgBHeLrfOUOVz7AGfyKu6zPBhNXPLV6c3Qb8hUlTJ6duKPDYgJ6oCznpVwE6e/pub

 

Remember Sunday

To quickly summarize, in the film Remember Sunday, Actor Zachary Levi plays as Gus, a current jeweler and former astronomer living in New Orleans, who suffered from a brain aneurysm that gave him anterograde amnesia. He was able to retain his already grounded Long-Term memories prior to the incident however, he cannot form any new memories. Alexis Bledel plays as Molly, a waitress who’s been unlucky in love and financially shaky as she awaits for an inheritance to come her way. As any love story, she and Gus are designed to be together, but how can someone love a person who will forget them every day for the rest of their lives?

This a Hallmark Hall of Fame movie, as such this does deliver the expected romantic drama love story to it. For those in the Psychology major, a feeling of familiarity should be apparent in the movie. I can’t say that this movie is particularly astounding, but I can say that it does its best to be unique and thoughtful about life without something we take for granted everyday, memories. If you have the time, I urge you to think critically about the leading characters in the film and how it translates to the patients we humbly get to study. The film sheds some light onto very real and sometimes very frightening aspects of the human condition while keeping a generally light tone. I think for those of us studying psychology, it’s easy to forget that the patients we read about time and time again aren’t just their brain damage/psychological disorder. What I like about this movie is when you slip into Gus’s shoes, there is a lot of sacrifice and frustration that comes with having to live with a memory impairment like the one portrayed in this film. That premise is what I consider to be it’s strongest point.

 

Spoilers ahead→

While yes I did really like the film and find a lot of lesson in it, I can’t get past some major plot holes regarding Gus’s condition and how it was expressed by the director Jeff Bleckner.

The biggest plot hole is it’s false overarching idea of how short-term and long term memory function in the human brain (as of our current research). In the film at about 36 minutes, Gus, along with his sister go to a doctors appointment where the doctor explains to him, “Most healthy brains use sleep to consolidate short-term memories into long for you it’s the opposite, sleep takes away your short term memories.” Then, throughout the days in the movies it’s understood that he remembers 6am, his usual wake up time, until he goes to sleep.

Here’s why that’s an issue. As of current research, the average short-term memory is 6-7 chunks in capacity according to Miller, while long term memory is immensely vast. The movie is giving the false impression that everything we do from when we wake until we sleep is held in short term and later consolidated and processed into long term. Not all of our day is only short-term memory. A lot of what we do in our day is encoded in a variety of ways. Moving information into long-term memory is process that can be done with consistent memory rehearsal techniques and methods, not only during sleep. However, it is true that for memory consolidation, sleep is quite important. The hippocampus is what decides what information moves into long term, and it does this when the body is asleep or awake. Moving information from short term into long term memory, is a consistent process that can be expressed through primacy and recency tasks like word list recall. This is a task that shows we can move information into long term when awake. When researching cases regarding the idea of losing memory after 24 hours, I found the case of F.L. In this case, a woman was in a car accident and her memory functioned normally throughout the day, until she went to sleep. Unlike the case of F.L., the film makes it clear that Gus’s memory doesn’t work like normal, his hippocampus was severely damaged, therefore he shouldn’t display similarities to F.L. Instead, a more accurate portrayal of Gus would have been if his life was shown similar to H.M., a man whose hippocampus was removed because of his severe epilepsy. The film says Gus’ hippocampus was “destroyed,” so we can only assume it was unable to function in entirety similar to H.M. Therefore, the expression of anterograde amnesia on screen for Gus’ particular case seems very unlikely.

Getting past this main issue, the following are somethings that I believe the movie did well. Gus’s Procedural memory such as working on the jewelry, making origami elephants, and rollerskating are all examples that seemed to hint that Gus’ procedural learning still remained functional despite the amnesia. While these may also be from past experience, he did continue to practice and do better at these tasks.

Furthermore, The bridge scene is something I think is notable. We have to remember that experiencing such an intense event in one’s life such as an aneurysm, is traumatic. Gus’s aneurysm was a traumatic event and we see it more visually when he reaches that bridge in California in front of his former observatory. His breathing changes and the stress in his voice is clear, almost at the verge of panic. He claims that the observatory and the event of what he learns to be his aneurysm, plays in his mind as the very last solid moment he remembers before his memories shut off.

He may not remember the aneurysm himself, though he re-learns everyday that this aneurysm, at the last place he remembers, has derailed his growing career, his life, and his ability to create a future. These feeling can be extremely painful, yet he only has a little less than a day to cope with that pain. We learned from H.M. that grief requires time and memory. He couldn’t cope fully with the news of his uncle’s death, because he couldn’t create any new memories to help him cope. This concept is something I’m sure is very hard for people with a healthy functioning brain to fully fathom. However, I believe it is important to take the time to really try to reflect the weight that H.M and patients with other debilitating conditions had to carry on their shoulders.

For further information on memory and research for this post check  https://docs.google.com/document/d/e/2PACX-1vSFeVHKvsuNj6Mdmz41EgnyYRmNk82llGEl2dOcgn_soTfLnCAxb_ronGDAuv9CAVazTMe0aWx8xuDU/pub