What am I doing?

I have been too afraid to ask this question, and delibrately too busy to ask it, because I am apprehensive about the blank space that lies ahead, where the answer will grow. It will. I will have to grow it. I will have to sow the seeds I stored from my voyages, and plant them, and see them grow. I will have to monitor the soil conditions, till and hoe, and water and prune and clean and fortify and nourish it. And I will have to make sure I protect it from storms and floods, both external and internal.

And hence I have been afraid to ask that question, and I tried to keep doing it without really knowing how or why, and never factoring in the most important variable :’when’…..


….and the word ‘when’ implores me thus, that NOW is the only time I have, so I have to address it now.

I recently met a gentleman, 83 years old, wisdom incarnate, adorned with beautiful articulation, and within the first 5 minutes of talking to him, I was already seeing things more clearly. He said, merely elucidating to the method that he assumed was followed by everyone (not), that there are three important questions that you must ask before you begin a task.

The first one is “why”. Why do you need to do it. Are you better off not doing it at all. If you can satisfactorily answer that question then move on to the next one….’How will you do it. Is your method the best one available. And given the room of maneovering in this question you go on to the third, most important question, namely “when”…. Is this the right time to do it?

I was introduced to the concept of “controlled ignorance” which is in total contrast to the information overload we are bombarded with, and the breath of knowlege we are expected and supposed to have. Controlled ignorance means you chose the rate at which you receive information. This puts the reigns in your hands and the influence of expectations is nullified.

So here I am just going to try and answer these quesitons for myself. And hopefully resuscitate this blog and recalibrate its direction.

Before I ask the why, how and when, I must clarify WHAT….

I’ve spoken about it extensively, used it in practice, and here I will catalogue its development. The study of the interface of neurology and creative arts. My aim is not only to study the brain and the mind (which some theorists assume to be the product of the brian), but also study the products of the mind, i.e, its creative output. The creative output of the mind is a universal phenomenon. Any form of expression or interaction is the creative output of the brain/mind complex. But a few tiers higher, we look at more advanced creative endeavors of this combination, which constitute art and literature and design and technology. As a student of neuroscience, I am interested to see how the brain/mind consortium devises its products and how the products in turn reshape the brain/mind.

At some point on this pathway I have to look at the evidence base, the theory, and my own experiences, but today I just have to answer these basic questions.

Why do I need to do it? Well, why not? I am already fully immersed in both neurology and creative arts, so bringing both together is the most natural thing for me to do.

How will I do it? (and this is going to be ammended and revised several times). Tis blog is one step, where I will think out loud. Record my ideas and thoughts and learn from them. Study, reflect, research, (reflect), record…. I guess thats how it goes.

And when is the right time to do this…. probably yesterday, or 5 years ago. But better now than naught.

So here.

Who am I

I’m not a huge fan of labels , because they’re restrictive, but I like analogies and metaphors because they are like the stroke of the brush where paint ends and it frays into the imagination.
I’m not a fan of definitions because they’re divisive, but I like stories because they include the recipient to become part of them.
So am I a neuroscientist or an artist or writer?
I’m a mirror because what you see in me is yourself. I’m water because i take the shape of whatever vessel I’m in and can be gentle as a dew drop or viscous like the storm.
I’m a taster , a sifter and an explorer
I’m a taster because I can tell if there’s more salt in that person, and I’ll remedy it by adding water. I can tell bitterness that sits at the end of sweetness.
I’m a sifter because I can appreciate the markings of these two. I can tell sand from water and when they both refuse to leave each other on the shores
And I’m an explorer because I know I have to lose sight of one shore and embrace the uncertainty of deep oceans and risk drowning before I can spot another land on the horizon. I’m the primitive life on that land. I’m the roots and the fruit and the cells and the molecules.
I’m like that amoeba who extends their podocyte to walk ahead and takes the shape of the path and keeps changing its shape
But I’m also human, a sentient being so I know I have to work hard and find or carve a path to get to where I want to be
So I’m shireen and farhad also, and I’m the cliff that he dug up and I’m khosroo, too. I’m sohni maheval, and I’m the heer and ranjha. I’m Laila. I’m majnun. I’m all the stories that have made me and all the stories I make. I’m all my creativity and I’m the art that I create. I’m the anecdotes that I narrate. I’m the criticism that I get. I’m the praise that I debate. I’m all of that.
And yet I’m nothing. I’m here,
witnessing myself through all of you
and remaining unaffected by it.
Apr 8, 2017 am I

What is APHASIA: not deafness, not muteness, so what is it?

Even the most eloquent of us, are sometimes rendered speechless momentarily in life’s multitude of events. But what to say of something that affects the brain that lasts longer than a moment, when your speech and language which you take so much for granted becomes in-accessible to you? This condition is called “APHASIA” and generally occurs as a result of stoke or injury to the parts of brain that are responsible for storing your language.

To explain this concept better, let us step back a bit and think about the brain. This organ, this soft, delicate mass of cells called neurons is protected in our thick bony box of skull and controls our whole body: our actions, our movements, responses, senses, what we feel and even what we think, intend, decide. It is the master computer. Since it is small area with so many tasks, many of the parts of the brain evolve in such a way that they become super specialized in a particular function. In other words, most tasks have designated parts of the brain responsible for their function. Just like a switch controls a particular bulb. This is a simplified manner of looking at the brain like a control panel to make it easier to understand it (where as in reality, the control systems are much more complex than this).

Using the simplified metaphor, aphasia can be seen as the language switch going off. Even if the bulb is there, the switch going off means that it can not be lighted. A simple conversation is in fact comprised of several steps: understanding what is being said to you, then processing that information, then thinking of a response, then formulating the answer and using the appropriate words, phrases to answer back…. this whole network of tasks that is contained in designated areas of the brain, and if a stroke or injury damages these areas of the brain, then these seemingly simple tasks can not be done.

Language is an acquired trait of the brain, that is why when a baby is born it learns the language of its surrounding. This is evident from the fact that babies who are brought up in a household with a different language from their birth parents will adopt the language of the household. The acquisition of language requires an intact hearing system, which is linked to language areas of the brain. Whatever the child hears is stored in the language areas, and since the language areas are linked with other areas of the brain, the language is used to give identity and make sense of the world and self. As development proceeds, this learnt language is reproduced by the child, whereby his mouth, tongue and voice box learn to formulate the words, phrases, sentences to express himself.

The two important points that can be clearly seen from this description is that:

  • Our identity and sense of the world and self are closely integrated into our language. In other words, language is not only a tool of expression, rather it is a formative tool in making us what we are, developing our concepts, thinking, opinions….. everything, actually.
  • Language is a complex thing, and a dynamic one. It is not like a dictionary or a glossary of terms that is stored in a part of brain, rather, it comprises active aspects, three of which are
    1. Understanding: ie. Making sense of what is being said (by others and even what we are saying)
    2. Processing: organizing the information received and preparing an appropriate response, utilizing information from the brain including stored vocabulary, experiences and what the person desires.
    3. Expressing: merely stating what one wants to say, or to answer a question requires a person to have an intact language center, and the words need to be formed by the tongue and mouth while sound is expressed from the sound box, comprising the speech. (Not having the intact language center results in aphasia, where as problems with the other components of speech result in other speech deficits like dysphonia, dysarthria, etc…. which are beyond the scope of this article).

It is important to mention that depending on the injury or insult to the part of brain, there are different types of aphasia. For instance, there can be people who mainly have problem in understanding speech and their spoken speech is not affected, this is called Receptive or Sensory Aphasia. On the other hand, some people can understand what is being said to them, but expressing their response is a challenge, this is called Expressive or Motor Aphasia. The people who suffer from both deficits, understanding as well as expressing, are said to suffer from Total or GLOBAL APHASIA.

Aphasia is a difficult neurological condition to explain, and that is why people with aphasia are met with such alienation. People often confuse them for muteness, or deafness, whereas the truth is that their hearing is not affected. Another common public misconception is that people with aphasia should be able to, or learn to communicate with sign language. One way to explain to the lay person of what aphasia is to tell them that it is the “memory loss of language”. Ironically, in aphasic patients, testing the memory is itself a challenge because how can you test memory without language?

Can Aphasia be treated:

In some lucky individuals who have a small area of brain affected, and who receive prompt treatment, their language deficit is completely treated, and they have no residual effects. For others, with larger areas of brain affected, most of language recovery occurs within the first 6 months after the incident, after which the ‘recovery’ is relatively slow. Therefore much emphasis has to be given to proper management of patients with strokes and brain injuries in the initial phases of their event, to minimize further brain damage and to maximize the recovery of language and other faculties. Proper management in this phase of treatment can not be stressed enough, and this should be taken as a very serious commitment on part of doctors, therapists and even patients’ and their relatives.

Unfortunately, many patients are left with lasting effects of aphasia and this makes it very difficult for them to lead independent productive lives. Not only do they find it a challenge to interact with others on a day to day basis, even express their needs or ask for help, it also makes them depressed and frustrated because they feel imprisoned within their minds. What makes this situation even more difficult is that the barrier of language puts hurdles even when and where help can be offered .

There is a lot of research and development going on in leading world centers to try and study how effectively language can be restored even in late stages of injury and stroke. A lot of promising results are seen in these centers. The promise lies in the brain’s incredible ability to transform and acquire new skills, called neuro-plasticity. Harnessing this ability to restore language requires super specialized skills on part of the therapist and a lot of dedication and commitment and motivation on part of patient to endure prolonged, dedicated, time consuming sessions. Late language acquisition is not an easy feat, and results are slow and unpredictable, and only individuals who understand this and persist with it despite all the challenges can get any late benefits.

What can the public do to help people with aphasia:

If you are reading this article then you have done the first step to help people with Aphasia: i.e, you are trying to understand what it is and what challenges it poses. It becomes an intuitive thing after this. Once you are more sensitive to these people, you will find yourself dealing with them better, but just as a guideline, I will enlist a few things:

  • be patient with them, they may take longer to form an answer. Don’t rush them.
  • don’t speak around them in the third person, as if they are not present there or can’t understand you. Even if they really can’t understand you, but including them in your conversation will help them feel accepted.
  • Speak slowly when you are speaking to them. This is very important. Usually people try to say too many things too quickly to put the other person at ease. With people suffering from aphasia, try to use short sentences, easy words and slow pace. You may need to repeat a thing once or twice so they understand it.
  • Speaking loudly will not solve the problem. Remember this is not deafness.
  • Offer to give a pen and paper if you see them struggling to say something, they might be able to write something that makes sense.
  • While it is important that you don’t pretend to understand something they are trying to say, be sensitive about expressing this to them.

ARSHIA. August 4, 2015.

Honor the space between no longer and not yet

Winter didn't seem to want to leave, but I have to admit, spring has definitely started to flow in the branches of the bare trees outside my window. Though they are still without foliage, but one morning, as if all of a sudden, their shriveled brown stiffness seemed plumped up, and they stood prouder against the crisp chilly air. Today I even witnessed birds checking out possible nesting spaces within the boughs, indicating that the real estate market of the avians is going to witness a sharp rise soon. 

Having said that, the traces of chill haven't left completely yet. A stroll outside means nippy fingers and toes and a chilly red nose. The peculiar smell of winter still lingers, and the air cuts through the sun rays surgically on days that the clouds rest at home. 

This twilight zone between seasons, when the baton has to be passed between one runner and the next, this will be fleeting in the grander scheme of things. Nonetheless, I can't help but marvel at the emptiness that this phase holds. It is uncannily similar to the time after a break up, when one finally lets go of the last thread of expectation one was clinging on to and finds one's hands dauntingly vacant. 

Its this space, this distance between 'no longer' and 'not yet', that I'm trying to come to terms with. 

Well, hope springs. Lets see.