Cognitive Impairment or Where Did I Put My Passport?

All of this connects my excursion to LA a few days ago with the loss of my passport a couple of weeks ago. I attended a memorial symposium at UCLA in memory of my recently deceased second-cousin, Dr. Murray Jarvik. Among the entertaining and informative talks given at the symposium by his illustrious colleagues in Neuroscience, Psychiatry, and Psychology, one - rather frighteningly entitled "Pre-Symptomatic Cognitive Impairment" - really captured my interest. It was delivered by Dr. Herman Buschke, a Professor of Neurology and Neuroscience at the Albert Einstein College of Medicine, which Murray had attended many decades ago. Despite the technical title, Dr. Buschke's talk was beautifully accessible. Many of my friends suffer from lapses of memory. We jokingly call them "Senior Moments," but really worry that our memory is failing in ways that could precede Alzheimer's Disease or Senile Dementia. As of now, there seems to be little known about how to diagnose or treat either of those ailments, but Dr. Buschke and his researchers are working away in their labs and at conferences to develop and share their findings.

To sum up in layman's terms, they found that memory involves two different kinds of work: encoding and recall. In my former life teaching systems analysis, we used to call it storage and retrieval. Because we were designing computer systems, there were many levels of encoding involved, but the highest level was naming. Dr. Buschke's human memory impairment screening test calls these names "categories" and tests category-cued recall. [Note: Google uses the keywords you supply as categories and does a nice job of "recall." But if you don't give it good keywords, you won't get it to retrieve what you're looking for.] So an important step in remembering something is assigning it to the proper category, e.g. "What movie made Johnny Depp really famous?" Pirates of the Caribbean can be filed in your memory as a movie, a DVD, a screenplay, a musical, the thing you saw with your boyfriend on his birthday, but way to answer the question is to recall it from the movie category.

I lost my passport because in a way I didn't have it assigned to the right category. I found the passport this morning, now that it's been invalidated and replaced, for an outlay of about $120, including new photos, bus fare downtown twice, and the cellphone storage fee at the coffee shop across the street from the Consulate. When I reported the passport lost, the person at the Consulate said be sure to check all the zippered pockets in my luggage, because it was a common place for passports to hide. I assured her I had. I believed I had. BUT...

My latest skin treatment is something called Enbrel, a product that requires refrigeration. It is dispensed by self-administered subcutaneous injection, so the packaging is quite bulky, what with syringe components encased in plastic and everything supposedly sterile. As a result, the manufacturer supplies a large cooler bag for storage on lengthy trips. With appropriate doctors' letters, the airline security people let you carry this bag on board without counting it in your carry-on limitation. (In the olden days, you could store medications in the plane's refrigerator, but now they just give you a bag of ice cubes.) In said cooler bag there is a nifty little outside zipped pocket for storing doctors' letters.

This is the first trip I've taken with the cooler bag + doctor's letter, so during the trip that involved four airports, I kept moving that letter around from with the plane tickets to with the passport, to a pocket, to the backpack, to the hand. Finally, after going through immigration at my destination 32 hours after leaving home, I stored the passport in the little zippered pocket of the cooler bag. I checked it when I arrived, but the passport slipped down to the bottom and evaded me - the sneaky little devil!