After simple dental surgery, William lost his ability to form new memories

http://www.bbc.com/future/story/20150630-my-dentist-saved-my-tooth-but-stole-my-memory

by tchalla • 11 years ago

202 131 11 years ago

Foy3• 11 years ago

he wakes up every morning believing he is still in Germany in 2005, waiting to visit the dentist. Without a record of new experiences, the passing of time means nothing to him. Today, he only knows that there is a problem because he and his wife have written detailed notes on his smartphone, in a file labelled “First thing – read this”.

Literally 50 First Dates...

TazeTSchnitzel• 11 years ago

Much like the movie, yes, though in her case it was a daily, not an hourly, thing. It's nice that the film seems to be based on a real-life condition and portrays it fairly accurately.

jedberg3• 11 years ago

I mentioned this to a psychologist and she laughed at me very hard. She was a professor and said that she uses the movie 50 First Dates in her class -- by having them write down everything that is wrong. She says it's so horribly inaccurate that it makes for a good long discussion.

RexRollman• 11 years ago

His daily reaction to the appearence of his aging wife, and his own aging appearence, must be interesting.

rev_bird• 11 years ago

That's the part about this I'm so hung up on -- that this poor guy not only has this crippling condition, but that he has to come to terms with it every hour and a half, forever.

harryjo2• 11 years ago

Memento

iopq2• 11 years ago

This is the condition that was described in Memento. Really fascinating stuff. It makes me want to keep notes on everything, because most people rely on their memory for a lot of things. When we forget something we are frustrated "Oh darn, I forgot it again!". Imagine not being able to remember anything at all...

userbinator• 11 years ago

Imagine not being able to remember anything at all...

...including the fact that you can't remember anything? That would certainly be scary.

rusabd3• 11 years ago

I once lost a memory for couple hours - I was fully aware that I don't remember anything

exizt88• 11 years ago

A comparably horrifying experience: https://en.wikipedia.org/wiki/Clive_Wearing

yoha• 11 years ago

Previous discussion: https://news.ycombinator.com/item?id=9810025

noblethrasher• 11 years ago

In a talk that I attended, Steve Wozniak mentioned that he studied a lot of psychology when he returned to the university after leaving Apple. He thinks that he may have been the first person to have come up with idea that we lose our memories with our teeth, and that researchers later discovered a link between the loss of our early autobiographical memories and the loss of our baby teeth.

rayalez4• 11 years ago

He says in his autobiography that he was in a plane crash. That was the reason for leaving apple. He suffered from memory loss, so probably that is the reason for his interest in psychology.

From wiki:

"Wozniak sustained severe face and head injuries, including losing a tooth, and also suffered for five weeks after the crash from anterograde amnesia, the inability to create new memories. He had no memory of the crash, and did not remember his name in the hospital or the things he did after he was released from the hospital."

MichaelCrawford3• 11 years ago

Was that in Scotts Valley? Ive flown over that strip (as a passenger). the neighbors forced it to close, the strip is still there but there are big red Xs painted all over it. I expect its intended for use in emergencies.

I understand he didnt set the trim, which adjusts the balance of the plane for the distribution of passenger weight.

realityking• 11 years ago

My Mom's got only three teeth left. Going by this theory, she should remember barely anything. But she does remember a lot.

ams61104• 11 years ago

Well Woz is a brilliant guy in many respects, but even highly intelligent people get the occasional wacky idea.

thescriptkiddie• 11 years ago

He's talking about milk teeth, not adult teeth. There is no implication that teeth are related to memories, just that your milk teeth come out at around the same age that your memories are wiped.

HappyTypist• 11 years ago

Most people took a little bit of time to get familiar with smartphone UIs, especially for someone who's jumping from no smart phone at all to the latest version of iOS and Android. I wonder if he has been slowly learning how to use a smartphone like the other condition, or if he has to rediscover the UI every time.

bashinator• 11 years ago

I believe the memory used to retain skills is separate from other types of memory. There was a famous patient, Henry Molaison[0] who was the first person to suffer this condition and participated in some really amazing research. He was able to learn new skills, albeit slowly.

"His ability to form long-term procedural memories was intact; thus he could, for example, learn new motor skills, despite not being able to remember learning them."

[0] https://en.wikipedia.org/wiki/Henry_Molaison

timcederman• 11 years ago

If you read the article, it says the patient mentioned can't form procedural memories.

csomar• 11 years ago

The doctors initially suspected that he’d reacted badly to the anaesthetic, causing a brain haemorrhage – yet they failed to find evidence of injury. So he was discharged with the mystery still hanging over him, and the family moved back to England, where he was referred to the office of Gerald Burgess, a clinical psychologist in Leicester.

Scouring the medical literature, he found five similar cases of mysterious memory loss without brain damage. Although none occurred during a trip to the dentist, they do seem to follow other periods of physiological stress during a medical emergency.

That doesn't prove that the anaesthetic isn't the root cause. The article title sounds link-baity.

cristianpascu• 11 years ago

Not only link-baity, but also blaming the doctor. Large percentage of the large percentage of people who won't read the article will move away with a inconsciouss (at least) fear of medical interventions.

bitJericho• 11 years ago

Well yeah all medical interventions have can have side effects; they should be considered.

toolz• 11 years ago

mistakes in medicine are one of the leading causes of death in america. It's not an unwarranted fear.

joezydeco2• 11 years ago

Earlier this year I had a medical procedure and was given "twilight" anesthesia. I was explicitly told "you need to have your spouse or a friend here because we're going to give you instructions afterward and you probably won't remember it".

And, sure enough, my memory was pretty much wiped for the hour or so after the event. Later that evening I had a conversation with my wife that went like this:

"Um, did you help me with putting my clothes back on?"

"Um, no. You did that."

"Did I talk to you and the doctor?"

"Sure. Normal conversation."

I have no recollection of these events at all. It gave me an uneasy feeling for a day or so. Nothing traumatic but every time I tried to reach back and think about that post-op period I drew and continue to draw a complete blank.

saulrh• 11 years ago

Yep, I've had that. Sitting in a hospital bed after my appendectomy:

"Hey, I'm awake! That was easy."

"You've been awake for two hours."

"...Oh. Huh."

kzvezdarov• 11 years ago

That's interesting and supports the idea that it might be related to genetic factors. I've had two twilight anesthesia procedures done about two months apart and remember the events before and after waking up in a lot of detail. I've also had regular general anesthesia once in my life, with the same result. As a bonus, I seem to resist local anesthetics to a degree that requires 2-3 times the amount a normal person does (and even then, the pain finds a way through).

MichaelCrawford3• 11 years ago

I have seizures in which I lose as much as a month of memory. The first one that I know about I suddenly found myself driving a car as if the universe sprang into existence that very instant.

After a while I decided that I dont have month long seizures rather I have brief seizures in which I lose a month of memory.

For this and other reasons I am concerned I have a brain tumour. That would totally suck.

spike021• 11 years ago

I _believe_ I had the same anesthesia done when I went in for an endoscopy procedure roughly a year or so back. Supposedly the doctor had told me how often to take the prescription, I had sent iMessages/SMS' to people as well. Later that day I had nearly no recollection of any of it.

It's a very odd feeling for sure. Nothing serious and I doubt it caused any damage, but it was the first time I'd ever just had a blank set of time that I just couldn't answer for. I did have family nearby though.

bunderbunder2• 11 years ago

This is a problem with some of the drugs they use during C-sections, too. When my son was born by surprise Caesarean, I think that was one of the things my wife and I were most worried about - that she would have no memory whatsoever of our son's first few hours of life.

tptacek5• 11 years ago

The fact that anesthesiologists apparently deliberately induce amnesia with benzos scares the shit out of me, much more so than full general anesthesia does (which seems backwards, right, because general anesthesia is actually dangerous). Why do they want me not to remember anything? Is it that horrible?

beagle3• 11 years ago

Your story (and others in the reply) sound a lot like experiences of people taking Ambien (Zolpidem) - sometime, they "wake up" in the middle of being awake, and more - sometimes, they do things (like eat, drive, email, etc.) without any recollection. Often, just as sharp as when they are really awake, but sometimes, very weirdly (people driving naked, stuff like that).

To me, that (and experiments of Gazanigga etc) indicate that Jaynes was onto something with the "bicameral mind" theory, as crazy as it sounds.

chx• 11 years ago

Oh yeah, conscious sedation. It's 9am, I am in the dentist chair and getting pills. Next it's 5pm and I am in my bed at home and I have zero idea how we progressed from event1 to event2 yet I am told I was talking to people. WTF.

MollyR• 11 years ago

I've been through that as well. It was incredibly unnerving(to me anyway). The frightening part was more how would I ever know if it happened again. I've been a little paranoid trusting myself after it.

tim333• 11 years ago

Yeah, I've got a friend who had a brain haemorrhage with similar memory effects. It wouldn't surprise me if that had happened on a small scale and they just failed to detect the damage. I presume they use a brain scan and it can only pick up certain types / sizes of damage.

dang• 11 years ago

The article title sounds link-baity

It does. We replaced it with the subtitle, which is more neutral.

cpncrunch2• 11 years ago

That doesn't prove that the anaesthetic isn't the root cause. The article title sounds link-baity.

Agreed, and psychogenic causation seems more likely (see my comment at the previous discussion https://news.ycombinator.com/item?id=9810025).

This seems to be yet another case of HN users upvoting dubious link-bait scientific press-releases. This particular one has been posted 3 times this week.

iGoPro_HD• 11 years ago

I felt the same as well. It was an interesting read, but also felt "link-baity".

(P.S. I will be using that word from now on.)

ioquatix• 11 years ago

There is a Japanese movie about this: https://en.wikipedia.org/wiki/The_Housekeeper_and_the_Profes...

I highly recommend it, especially if you are a mathematician.

bite_victim• 11 years ago

Any chance he suffered a profound trauma being under surgery? I imagine an utter fear of surgery and this could have been triggered by something really insignificant like a small tingling or just the thought of surgery, of a foreign element cutting deep in your tooth canal. That, amplified over and over (he might even have lost conscience if his jaw was being held in place by a device -- the doctor wouldn't have known it this way) could have given birth of some kind of mechanism of memory wipe, sort of like the one victims of rape or horrible accidents develop as a self defence mechanism to (not?) cope with what just happened. Only in this case it went terribly wrong.

rayalez4• 11 years ago

Damaging my mind is my biggest fear. I had a simple surgery a year ago(shoulder arthroscopy), and I specifically said that I don't agree to general anesthesia or any kind of sedatives, because even a small probability of a small brain damage isn't worth it for me.

Doctors tried to push me into accepting the general anesthesia, saying that it's the only option(and that we lose brain cells every day really, so who cares). I went to a different clinic where a doctor agreed to do the surgery under local anesthetics and without sedation without any problems. Said someting along the lines "don't worry, man, your brain is gonna be fine."

He failed to mention that local anesthesia can also lead to neurotoxicity, and I was too ignorant to know about it(for some reason I assumed that local anesthetics are harmless, and didn't do my research).

During the surgery I felt the symptomps(dizziness, difficulty speaking), consistent with neurotoxicity caused by local anesthetics.

I don't notice any permanent damage, though I doubt that I'd be able to tell. 6 months after the surgery I have developed tinnitus, but I can't tell if it's connected to it or not.

Anyway, my point is that no way in hell would I agree to the surgery if I'd have known the risks.

Also, before that, doctors pushed me into unnecessarily taking general anesthesia for a routine procedure. They convinced me that it can't be harmful, and I was too young and socially awkward to ask more questions or argue.

I also fear dental anesthetics. There is research indicating that they can cause neurotoxocity. I can easily sit through filling regular cavities(with a dental laser it really isn't that painful), but I'm not sure what I would do if I have to get root canal. I would take any option over anesthesia, but I don't know of any alternative.

Some doctors say that it's just an irrational fear. But given that there's some research saying that even dental anesthesia can cause neurotixicity, I'm not sure what's so irrational about not wanting my brain cells to die. My brain is what matters to me the most in the world, far more than anything else, it has infinite value, because that's literally "me", so even small chance of small damage is worth avoiding at all cost(in my value system).

It's infuriating how casual doctors are about such risks, especially in cases when they can be avoided. I understand taking necessary risks when it's a life-saving surgery, but when you have alternatives, I think patient should be able to make an informed choice.

DanBC5• 11 years ago

The "irrationality"[1] is the weight you put on the unknown risk of brain-harm from anaesthesia, while not appearing to assign much risk to how you get there.

How likely is it that you're going to suffer brain injury in your day to day life versus from anaesthetic?

[1] irrational is probably a not useful word here. You have real fear of real things.

rayalez4• 11 years ago

    > while not appearing to assign much risk to how you get there.

I'm not sure what you mean by this, can you rephrase it?

If you are saying that I'm not putting enough weight on the risks of avoiding the procedure - let me be clear, I'm talking about cases where anesthesia is optional, and is a matter of pain vs comfort.

I know that avoiding root canal puts me at risk of dying from infection, so of course I wouldn't avoid doing it, and it makes sense to prefer "treating tooth with anesthesia" over "not trating a tooth." But I could have avoided that surgery(it was about quality of life, not survival), and I could've avoided anesthesia if I was willing to suffer some pain/discomfort. And that should be my choice to make.

I think that it is rational to take short term pain over (even small) probability of long term brain damage. If I could take some reasonable amount of pain over brain damage risk, I would take it any time, and it would be the right choice. My problem with root canal is that I don't think I could handle the pain without anesthetics. So I fear that when faced with choice "a lot of pain" vs "safety for my brain" I will fear the pain, take anesthetics, and betray my values.

Do you see my problem here? If brain has literally "infinite" value, then no matter how infinitesimal risks are, it is rational to minimize them at all cost. If doing the procedure minimizes them, it is rational to do it, if it doesn't - the right thing is to avoid it.

Correct me if I misunderstood what you're saying.

    > How likely is it that you're going to suffer brain injury 
    > in your day to day life versus from anaesthetic?

Ehm... Less likely? Possible, but less likely.

GoodOldNe• 11 years ago

You get that "neurotoxicity" in this case is almost exclusively referring to deleterious effects that local anesthetics can have on nerves at the site of injection, right? Subcutaneous injection of local anesthetics will have very little, if any, involvement with your brain.

You did the right thing finding a surgeon that would work with a block instead of GA if you were concerned about the (potentially real, if not that bad, effects of GA) but I think your fears of local anesthetics causing CNS damage are overblown and I wouldn't want others to refuse the use of them in themselves or their children based on your post.

Romme• 11 years ago

I got tinnitus a week after a dental procedure with anesthesia. Don't know how to live with it, to be honest. Your fear is anything but irrational.

rayalez4• 11 years ago

Hey, don't worry about it. Tinnitus fucking sucks, but over time you get used to it. It's hard to believe at the beginning, but gradually it bothers you less and less. Eventually you can focus on whatever you are doing and not notice it anymore.

For now try not to freak out or get depressed about it, turn on air conditioner or running water to mask the noise.

Try taking ginko, try taking melatonin for sleep.

Listen to music or audiobooks when it's too annoying(not too loud to not cause any more damage).

Visit a doctor and get some advice from him. Go to a support forum or subreddit if it gets bad.

If you are lucky enough to be living in US - check out what trials you can enroll in. Some of them can probably help. People are workong on a cure and making some progress.

atarian• 11 years ago

local anesthetic

Local anesthetic is pretty much just a pain killer... it's not supposed to knock you out like GA (general anesthetic). I wonder if the article got the term right.

vvpan• 11 years ago

A few comments in this thread mention "genera anaesthesia side effects" and long-term problems. I have never heard of this and a quick wikipedia/google search is not bringing up good source on the topic. Is this substantiated or another "vaccines cause autism" kind of thing?

VieElm• 11 years ago

There was recent news on the detrimental effects of general anesthesia has on the very young and old. Apparently it can be neurotoxic but healthy adults don't seem to have long lasting problems.

__z4• 11 years ago

A family friend of mine went under general anesthesia and woke up senile. He was in his late-70s, early-80s at the time. Lives in a nursing home now. Once in a while can have some moments of somewhat clarity but they only last for a minute or two.

jsprogrammer• 11 years ago

It seems possible, due to what is used for general anesthesia. However, the person in the story was not given general anesthesia, only a local anesthetic.

imaginenore2• 11 years ago

General anaesthesia is actually somewhat dangerous.

Your chance of dying from anaesthesia is around 1 in 100,000 - 185,000. While it may seem like a safe number, it's orders of magnitude higher than winning a major lottery.

That number also doesn't include medical fuckups during anaesthesia, like overdose, airway obstruction. In that case the number shoots up to 1:2500 - 1:5000.

http://bja.oxfordjournals.org/content/95/1/95.long

1.5 people in 1000 wake up, so the pain shock alone can kill you.

Dental anaesthesia is known to kill, around 2 children per year.

http://www.huffingtonpost.com/2012/07/13/dental-sedation-chi...

jwdunne• 11 years ago

When having staples inserted (and also removed a year later) into the growth plates in my knees, I was given the option of having my legs numbed too for pain relief. I'm glad I took that option now - unless it was post-op only.

From the second op, I had a huge black bruise on my thigh in the shape of a hand print. I couldn't imagine the pain if I'd have woken during the cause of that.

djfm• 11 years ago

If no link can be found between the dental surgery and the memory-forming loss, could it be that there is actually no link? Have any other hypotheses been researched besides the surgery?

imaginenore2• 11 years ago

Exactly. It can be just a coincidence. A blood clot, undetected cancer, genetic disorder, or a million other things.

cpncrunch2• 11 years ago

Or more likely psychogenic, given the recent death of his father.

curiousjorge• 11 years ago

so is root canal dangerous??

__z4• 11 years ago

All medical interventions have the risk of adverse outcomes. Treating a patient is a risk-benefits analysis.

jivardo_nucci2• 11 years ago

Is it necessarily the anaesthesia or a hemorrhage? Have they considered removing the root canal? Sometimes removing the materials from a root canal has improved a patient's health significantly.

Certainly one could understand why the dental industry would avoid the meme "root canal = bad!", but in this case the patient has little to lose, his future being lost already.

duskwuff• 11 years ago

Claims that dental fillings are toxic, and that removing them will provide various health benefits, are a somewhat common medical scam. There is absolutely no evidence supporting these claims.

http://www.quackwatch.com/01QuackeryRelatedTopics/mercury.ht...

jivardo_nucci2• 11 years ago

We're talking about _root_ _canals_, not dental fillings! Other than the anaesthetic, the materials used in root canals are are entirely different from those used in a dental filling.

Furthermore, root canals require different training and are (usually) done by endodontists. Dentists usually handle the more mundane and more tested procedure of dental fillings.

My point is, root canals are much more invasive and have their own problems(not associated with dental fillings).

atombender• 11 years ago

Oliver Sacks, in his wonderful essay collection "The Man Who Mistook His Wife For a Hat" [1], describes a similar case of a soldier, "Jimmy G.", who lost his ability to form memories after being wounded in 1945. Every half an hour or so his memory resets, and so 20 or 30 years later he still thinks that he's an 18 year-old man who just got wounded in the war. There's a particularly poignant moment in the story where his brother comes to visit the man in hospital in the 1970s, and how Jimmy is puzzled why his brother looks so old.

Another well-known case of retrograde amnesia is Clive Wearing, a British pianist who was the subject of a BBC documentary, "Man Without a Memory" [2]. I recommend watching the clip. He describes his "resets" rather terrifyingly as slowly emerging from a sleepless coma. Whenever he sees his wife after such a reset, he leaps up to greet her as if they have been apart for a long time, and his evident happiness and inability to recognize his situation is heartbreaking. (His wife, unbeknownst to him, of course, has since divorced him, which only adds to the poignancy of the scene.)

[1] https://en.wikipedia.org/wiki/The_Man_Who_Mistook_His_Wife_f...

[2] https://www.youtube.com/watch?v=Vwigmktix2Y

neuro_imager• 11 years ago

I would strongly question the idea that he has "no structural abnormality".

It would be very interesting to see exactly what type of imaging they performed on him. Bear in mind, an abnormality in the hippocampus or other memory related structures could be sub-mm in size and result in a significant impairment.

If, for example, he did not have an MRI with diffusion weighted imaging with a sufficiently high B value (gradient value) they may be missing/have missed a very small stroke (this test is also time sensitive -only positive within the first few days of insult).

If they did not perform susceptibility weighted imaging, they may have missed a tiny micro-haemorrhage. Both of these scenarios can result in memory loss if critical structures are involved.

There are also several technical issues that may have resulted in a sub-optimal scan, precluding finding a tiny abnormality. There's also the question of whether the person reading the scan got it right or whether the strength of the magnet/technical parameters of the study were sufficient to resolve a tiny abnormality.

Either of these scenarios could have been a consequence of reduced blood flow (hypoperfusion), a small clot (embolus) or a tiny blood vessel injury (dissection) that could have occurred during the procedure - possibly related to the anaesthetic but not definitively so.

I suspect there is a definitive abnormality that the clinicians that saw him were unable to pick up. This seams a lot more likely than the idea that we need to revise our entire conceptualisation of memory formation to suit a psychological theory.

jczhang• 11 years ago

Not to deny what you're saying, because I believe a key tenet of biology is that structure follows function, but how would the structural abnormality be caused by the operation?

dbrgn• 11 years ago

There's a great movie by Christopher Nolan about exactly this condition: https://en.wikipedia.org/wiki/Memento_%28film%29 http://letterboxd.com/film/memento/ Highly recommended.

dogmati• 11 years ago

There is also a mediocre but surprisingly endearing Adam Sandler movie about this condition.

After simple dental surgery, William lost his ability to form new memories

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