Wednesday, July 20, 2016

Cognitive Dysfunction

“Cognitive dysfunction (also known as brain fog) is the loss of intellectual functions such as thinking, remembering, and reasoning of sufficient severity to interfere with daily functioning. Patients with cognitive dysfunction have trouble with verbal recall, basic arithmetic, and concentration.”  [The Marshall Protocol Knowledge Base, Autoimmunity Research Foundation]

Cognitive dysfunction. They are just two words - until you meet them face-to-face in daily life, that is. As a classic symptom of MS, cognitive dysfunction can become a defining characteristic of self – a new self which, like it or not, has been conferred by the destructive processes of the disease, MS.  Where once you may have been verbally sharp and articulate, now you find yourself slow and clumsy. It is like a closed door between your mind and its interaction with the world, and the door is often locked from the outside. You know what you are thinking, and you know the form that you want your thoughts to take in communication, but suddenly you find that a fatal short circuitry has interrupted the path between the mind and the tongue. The eloquence of thought stumbles on the dysfunction of mind, and what tumbles out on your tongue is often but a vague shadow of what you meant to say – or, worse yet, so completely disjointed that it becomes little more than gibberish.

And so you keep it simple. You learn to hold your peace in intelligent, demanding discourse, because the alternative, as you have now learned from experience with your new self, is that you may well end up looking like a complete idiot. The well ordered, well considered thought in your mind has been lost in translation from brain to tongue. You wait till later, when you can write the thing down – when you have the time to pick the lock from the inside and turn the knob.

For someone like me, who has spent his life working with the English language, this failure to be ready, to cogently produce a complex thought in speech, is particularly frustrating. The inclination to share my viewpoint has not left me, but the ability to do so has. It is something I have faced little by little over time. You don’t get around it by trying harder. You get around it by acknowledging the fact, learning patience, learning to defer.

Difficulty with verbal recall is just one facet of cognitive dysfunction, but it is the one that bothers me most. The others, as described in our quote above, are not fun either. The inability to remember details, names, events, people, how to get to where you had gone just the day before – or even to where you had gone many times before – these are all bothersome in their own way – and yet when the transmission of language, this essential means of interacting with ideas and with the people around us, is compromised, something essential seems missing from personality itself.

And the silver lining? Yes, there’s always a silver lining. For just as the nervous system in MS finds ways around the short circuits to accomplish its goals, so we find ways around the deficits. We learn to be patient with ourselves. We learn humility. We learn to practice nonverbal expressions where words fall short – and the truth is, words often fall short, no matter how eloquent or  well informed they may sound. And in learning these things for ourselves, we ultimately share something new and, in its own way, more meaningful with others.

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