This week I thought I'd write about - forgetfulness.
I did something very stupid this week, or maybe I was just forgetful. It could have happened to anyone... I think ?!
I have a friend I'll call Karen because that is not her name. We've been friends for 17 years since we met at Parent's Group with our first-born babies. When we both joined the Parent's group her boy Karl was 11 weeks old and my baby Bella was 4 weeks old.
Parent's group initially helped us as new mothers with things like settling crying babies, introducing solids and also it gave the four mothers in our group general support for the huge changes in our lives that motherhood brought.
Beyond these early years as the friendships with the other mothers in our parent group gradually fell away Karen and I remained good friends. In all these years we've watched each other's children grow up and our own lives change. We still meet regularly for coffee and cheesecake and a nice chat - and I think we always will.
Well, it was Karl's birthday last Friday. He turned 17. Karen and I have made it a tradition over the years to buy presents for each other's children at every birthday and christmas. This year I bought Karl a lovely silver pen which I had engraved with his name. My husband David has told me that a 17 year old boy wouldn't find an engraved pen lovely. Although I think - what would he know? I'm sure Karl will love his new pen! I also gave Karl the obligatory present of money. Ho-hum.
Anyway, I was meeting Karen for dinner with our husbands last Saturday - a week before Karl's birthday. I had Karl's present wrapped, his card written and it was all sitting neatly in a blue gift bag on my bed ready for me to pick up as David and I left for the restaurant to meet our friends. My friend Karen could then give Karl his birthday present during the week.
However, I forgot the present. When I arrived at the restaurant I realised that I'd left Karl's gift at home... on my bed.
"Oh dear, another 'senior's moment'," I apologised to Karen. "Don't worry," I said, "I'll post the present to Karl this week and he'll still have it for his birthday on Friday".
Karen lives an hours drive from my house so to drive the present to her son would take two hours as a round trip. Not an option I'd choose.
As promised I diligently went to the post office last Wednesday and bought an Express Post bag to ensure that Karl's gift would arrive for Friday. I congratulated myself on how very organised and reliable I am as the Express Post bag disappeared over the counter. I smiled as I walked home and I reminded myself that I really do remember things well; the last Saturday had been only a brief lapse in my concentration and completely our of character for reliable me.
Friday came and my daughter Bella and I both went out to check our mail box at home. I'd heard our postman's motorbike arrive and stop at my house so I knew I'd have some mail. The usual boring bills and advertising I thought. However as I opened the mail box I was pleasantly surprised to see an Express Post bag was stuffed tightly into the small metal compartment. I wondered who might be the recipient of the parcel. Excitedly I pulled the yellow and white plastic bag from the tight chamber. I turned it over to see to whom it was addressed. Confusion hit me. It was addressed to me however the handwriting was very familiar. Too familiar. It was my handwriting! I turned the parcel over and there also in my handwriting was the name Karl -, my friend Karen's son - and her address.
I was confused. This was his present; but how did it get returned to me? I was sure that Karen hadn't moved house. Then why was his present not sent to him? Today was his birthday and he wouldn't get his present, I thought. Darn it!
Gradually the realisation dawned on me as my teenage daughter stood next to me laughing having already worked out what I'd done. I'd addressed Karl's present to myself and put his name and address in the sender section on the Express post package.
I had posted the present for Karl to myself!
A senior's moment. Actually, a second 'senior's moment' in one week - with the same present! My daughter was still laughing and shaking her head as she walked back into the house. I sheepishly followed.
However dear reader I did re-post the present last Friday. The new Express Post bag is almost certainly on its way to Karl right now. I'm pretty sure that I probably addressed it correctly this time.
Later on Friday when David got home from work I told him about what I'd done - as eventually I could see a slightly funny side to the events.
David, like my teenage daughter, laughed ... a lot ... in fact a little too long I thought.
So I took the opportunity to remind David of the time when he was a teenager at university he drove his car to uni but then caught the bus home later that day. He'd forgotten that he'd taken the car on that day. Then to make matters worse when he couldn't find his car the next morning he thought it had been stolen.
That little story I learned from his University of Tasmania year book in 'funny stories about students'. For some reason David didn't think it worthwhile telling me that story?! I was left to find out by reading it in a Uni year book I found by accident one day - hidden somewhere.
David stopped laughing quickly, suddenly remembering that he had something to do somewhere else in the house with something or other... so I couldn't discuss the car incident at uni with him further.
I will admit here that my episode of forgetfulness this week was not an isolated event. I do forget things regularly, repeatedly and it often costs me a lot of money.
For example I realised a couple of weeks ago that I have now lost all three of my new expensive SPF 50, 95% bamboo fibre, Cancer Council cardigans which I bought a few months ago - costing $100 each.
How do I lose so many cardigans when I go out? I suppose I'd have more explaining to do if I was losing skirts or dresses or underwear when I go out !?! But it's expensive replacing these things. And I won't even begin to discuss how many pairs of sunglasses I lose.
So when I realised how often I forget things I thought I'd write a blog about forgetfulness this week and I have written a short story involving a forgetful incident with potentially fatal results - inspired again by my work in medicine over the years.
Firstly to discuss the topic of - forgetfulness.
The Oxford dictionary defines forgetfulness (noun) as being apt to forget, absent-minded, to not remember.
Wikipedia defines forgetting as the apparent loss of information already encoded and stored in an individual's long term memory(LTM).
Psychologists have found that short term memory (STM) is very distractible. Your brain knows that you are unlikely to need to remember a menial task - so it erases the memory to make room for more important things. The brain needs to decide if things are worth remembering. If it is - the memory is stored in the LTM; if not the memory is deleted. So some trivial events are not ever stored in your LTM and are hence they are forgotten.
Memory 'performance' is usually related to the active functioning of three stages: encoding, storage and retrieval.
It is a fairly common event that a person can walk into a room, say the kitchen, and forget what they came in there to do. The reason that this happens is that memories are stored as separate files and when walking into another room, the doorway serves as an 'event boundary' in the mind.
Starting a new memory when walking into another room - means that the memory of why you went there is in the previous memory file stored before you walked through the door; this memory must therefore be retrieved and that is not always easy to do.
Scientific studies have found that perfectly healthy people can have up to 30 mental lapses per week. It is normal to experience things such as:
- forget why you walked into the kitchen
- take a number of minutes to recall where you parked the car
- forget to call a friend back when you're busy at home
- put things down and can't find them soon after
- forget something trivial that a friend mentioned the day before
- forget the name of someone you just met
- briefly forget the word for something (i.e. a 'what's it's name')
Some things that can increase forgetfulness include: lack of sleep, hypothyroidism, anxiety/stress, depression, alcohol and some medications.
More serious forgetfulness, due to things like dementia and severe depression, include things like forgetting the names of close relatives, problems negotiating familiar places, changes in personality etc. These types of memory problems should prompt a visit to the local GP for further assessment.
* * *
My short story (fiction) for this week:
Changes
Jodi walked into the kitchen. Another school day and the same breakfast routine. She got her bowl and her favourite cereal from the cupboard. She poured the cereal, got some juice and sat down in her usual spot at the kitchen table. It was then that she realised something wasn't right.
Jodi, 12 years old and an only child living in a middle class family; mother - Mary, father - David, nice beach side suburb, nice bungalow house and nice predictable routine to their lives. The same routine day after day and week after week. Just the way Jodi liked it. However today felt different. Maybe, she thought, it was because her parents were standing across from her at the table silently staring at her.
Finally her mother, after looking to her father seemingly for support, broke the silence.
"We have some news for you Jodi."
Silence again.
Gee whiz, Jodi thought. What kids had to put up with from overly dramatic parents. What news could they possibly have that is so important? A new toaster? A new breakfast cereal we're going to try? No, maybe something different for dinner tonight from the usual Monday night casserole.
Jodi waited - bored and impatient.
"You're going to be a sister," her mother seemed somewhat nervous and excited at the same time; her voice was a higher pitched than usual and her smile seemed weak and awkward. "We're having another baby!"
Both parents were staring intently at her now smiling...and waiting as if for her to say something.
Jodi choked on her mouthful of cereal. Milk spluttered from her mouth and nose simultaneously over the table and her lap. Struggling she managed to swallow what still remained of her cereal in her mouth. Her mind was spinning.
What the...? Was this a joke, she wondered. Are they kidding me? She looked closely into her parents faces for of any sign of teasing or smirking. Surely not! They were surely not serious!
"We hope you're pleased, Jodes" her father said. He was smiling at her and using that annoying nickname that she had told him repeatedly not to use any more.
Jodi sat there. Silent. Motionless. Finally she got up from the table, shoving her chair backwards so violently that it hit the wall behind her; she stomped across the room, grabbed her school bag from where it sat near the back door, threw the door open and made sure that she slammed it behind her as she left the house.
"You better be joking!" she called out as she stormed off.
No! she thought. I'm not pleased. I don't want a vomiting, screaming, pooping, stinky baby in my house. I like things as they are and just as they've always been. Only three of us! And no stupid babies!
The months dragged by, the seasons changed and more and more the conversation centred around babies to Jodi's dismay. She thought she'd go mad with it all. Her house and her life had been so predictable and so organised until now. She alone had been the centre of everyone's attention. Now it had all changed and Jodi didn't like that at all. She felt that her importance in the family was disappearing down the toilet.
Finally the day came when baby Michael was born. It was all just as bad as Jodi imagined it would be. Screaming and crying throughout the house; although Jodi had to admit that the screaming and crying was mostly from her and not Michael. Actually the baby was pretty good. But the nappies and the mess and the goos and the gaas and all the cute baby stuff were enough to drive her insane. She tried to stay away from the annoying pest called Michael as much as she could.
Before long Michael could crawl and babble. He would often crawl about after Jodi and sometimes he would put his wet dummy in her lap; she thought that he wanted to share it with her. But Yuck! His wet old dummy!
OK. She had to admit that he was a bit cute. However she still thought that things were better before he came along and it would have been better if the family had gotten a cat rather than a baby.
The noise in the house increased dramatically the morning of the Australia Day bar-b-que. Jodi's parents were exceptionally busy preparing the house for the many friends and relatives coming over. Food was still being prepared in the kitchen and a hundred other last minute jobs still needed to be finished.
Jodi wandered outside to get some peace and have a quiet read somewhere away from the chaos in the house.
Walking into the garden she noticed a strange old sack floating in the pool. She wondered what it was and how it got there. Her gaze then drifted over to the gate of the pool-fence. It was open. Someone had forgotten to shut the gate - which was unusual as her parents were usually so careful. It was probably because they were so busy today she thought.
As she continued to stand there a terrible realisation came to her. The pool gate was open, a 'sack' was floating in the pool and she hadn't seen baby Michael in a while. The horror of the situation hit her. This was no sack! It was Michael and he was floating face down in the pool!
Jodi dropped her book and she ran through the open gate to the pool. She scooped up the lifeless bundle from the water, rolled him over and lay him on the warm cement in front of her as she knelt beside him. She rolled his cold body onto the side and scooped out any vomit that may be in his mouth. It was empty. She was remembering everything she'd learned in Scouts. She held her ear to his mouth. No breath. She filled her lungs with air and blew into his little mouth as she pinched his nose shut with her left hand. She could feel her own heart pounding. Her head was screaming out "Don't be dead, Michael". But she had to concentrate. Concentrate! She felt for a pulse in his neck. None. Oh, my God, she thought. OK. OK. I put the heel of my hand over his lower sternum. The instructors words were all she could think of. The most important words in the world to her right now. Fifteen compressions. She felt again for any breath. None. Two more breaths.
Jodi was about to scream for help when she felt water on her cheek as Michael spluttered and choked. She rolled him on his side to help drain out any water from his mouth. His eyes were now open and he was looking at her. A beautiful pink colour was returning to his blue face. He was now smiling; his arms stretched up to her.
"Oh Michael!" Jodi held the little boy tightly to her chest. Tears filled her eyes. "Oh Michael. Don't ever do that again! " She held his cold, wet body to herself to warm him and she pulled her woollen cardigan about his little frame.
"I do love you Michael. You're my beautiful little brother and I love you so much".
Jodi looked up to see her shocked parents standing next to them - looking down bewildered at the two children holding each other.
As Jodi brought her warm cheek down to her brother's cold little face while she still held him tight she said quietly to her parents, "I'll explain in a minute, guys. I have to hug my little brother a bit longer. My darling little brother I love so much".
The End
The inspiration for this story was a very sad medical case I was involved in - twenty four years ago during my first resident year in a major teaching hospital. It was such a sad case that I will never forget it. I was so sad for the child who drowned but also very sad for the mother who blamed herself for the child's death.
The year was 1990 and I was a first year resident medical officer (RMO) working in Paediatrics in a major teaching hospital in Adelaide, South Australia.
I was in the A&E department, Casualty as we used to call it, when an ambulance officer radioed in to give an ETA (expected time of arrival) for a priority one, or code blue, case - an emergency. The ETA was five minutes.
The Trauma team call was activated and specialty consultants and registrars from many different departments in the hospital rushed to A&E. They now waited in the treatment room: paediatric physicians, surgeons, Intensive care specialists and the A&E staff.
The case: a two year old girl, near drowning in a bath. The child was not breathing and she had no pulse. The ambulance officers were performing CPR (cardiopulmonary resuscitation) en route.
The ambulance arrived. The small child lay flaccid on the trolley as staff moved at lightening speed all around me. I was a very junior doctor and so I stood out of the way of the senior doctors, at the back of room. I was ready to do any menial tasks asked of me. Requests such as rush blood samples to a lab - which meant to run with the pathology specimens to the labs which were a distance from A&E, put labels on the pathology samples handed to me, call the radiologists and write the request forms and so forth.
I caught a glimpse of the distraught mother when the ambulance officers arrived. As ambulance crew ran up the A&E corridor to the treatment room with this critically ill child she had run along beside them.
She was a medium build, she had dark hair pulled up into a messy bun and her face was streaked with tears. Her eyes were swollen and red from crying. She looked terrified, dishevelled, grief stricken and so guilty of the crime she had committed. She had left her child unattended in the bath for a few minutes when she left to answer the phone. She had stayed talking on the phone for five minutes she told hospital staff. She had forgotten to return immediately to the bathroom as her two year old daughter and her four year old daughter had been left to play together in the bath.
The child's mother was quickly taken away by other medical staff soon after she had arrived. She was taken to a quiet room away from her child so that the doctors could work on her child without any distractions and so she would not have to witness her child in this awful room; doctors working frantically and doing whatever it took to try to save her child.
I stood watching and waiting to help. I watched as the medical experts around me sprung into action. They worked like a single amazing machine - together as a team, professional , skilled and so very experienced and fast. They were desperate to try to save this young life.
I can still see the child now. She was such a pretty little girl. She looked like she was just sleeping - peaceful. Her hair was still wet from the bath when she arrived. It fell down over her shoulders and upper back in wet, blond ringlets. I imagined that only half an hour earlier this little girl was happy and healthy and playing and laughing ... and now... this.
The doctors managed to get the child's pulse back. She was put on a ventilator and then sent off to the ICU (intensive care department). However, the doctors knew what would happen next. Drownings almost always result in only one of two things: death or complete recovery. There is rarely an in-between recovery from drownings. The doctors knew which outcome this would be. Their sad faces watched quietly as the little girl was wheeled from the treatment room.
When we quietly returned to our own paediatric ward the senior registrar told us what would happen from here. The child was thought to be brain dead, he said, and she would be put on a ventilator until the next day as is the policy. She would then be tested again fully by the ICU specialist doctors and if as expected it was confirmed that she was brain dead - which means the cortical or thinking part of the brain has been deprived of oxygen for too long and it is functionally dead and only some vegetative functions are left such as functions to maintain a pulse - then this would be explained to the parents. The parents would then see that everything that could be done to try to save their child had been done and the ventilator would be turned off.
Waiting the 24 hours would allow the parents to more fully understand that no-one stopped trying to save their little girl too soon.
As my colleagues and I sat having coffee later that day still feeling so very sad about the drowned child I found it especially sad to think that had the mother known CPR (cardiopulmonary resuscitation) then she would have been able to perform it on the lifeless child she had pulled from the bath that day. It was possible that CPR performed during the 10 minutes it took for the ambulance to arrive may have saved this child. As it was she had sat helpless in those crucial early minutes while she waited for the ambulance.
I have never forgotten that case, that beautiful little child, her poor mother and that sad day.
* * *
My final words for this week would be - learn CPR - ASAP. Learn as quickly as you can because life is unpredictable and as I tell my patients:
It is best to hope for the best ... but plan for the worst.
CPR is a skill that may save someone's life. It is a skill you need to learn before you need it.
Also it is worth mentioning that drownings of children are almost always silent.
People might think that they would know if a child was drowning as they would hear a lot of splashing and screaming. However that is almost never the case.
I recall a 'near drowning' case when I was working in the A&E where a mother had found her three year old child floating face down in the pool. She managed to rescue the child quickly and he was absolutely fine afterwards. However she had brought him to hospital as a precaution which was the correct thing to do.
She told me that she had been hanging out washing in her backyard and her three year old child was playing near to her. She soon became aware that she hadn't seen him for a few minutes and she remembered that a ladder had been left standing against the above-ground pool as her husband had been cleaning the pool that morning .
She instinctively walked over to check her three year old hadn't climbed in. There she found him silently floating face down in the water.
She was amazed, she told me, that the pool had been not more than 10 meters from where she stood hanging out the washing and yet while her son had lay drowning so close to her there had been no sound. Not a splash or a cry. Nothing. Silence.
We kept her son overnight in the hospital as a precaution. But typical of 'near drowning' survivors he had no neurological sequelae and he was perfectly fine. I hoped that a lesson about fences and ladders near pools had been learned there.
Another warning: if an accident like a near drowning occurs or other accidents for that matter - fix whatever needs fixing now - today - so that it doesn't happen again. Mend the fence, put a lock on the gate or whatever is needed to ensure the accident doesn't happen again.
In a very sad case I saw once a young child survived a near drowning in the neighbour's pool. She was fine until the next week when she again got into the neighbours pool, no precautions or changes were made after the previous 'near miss', and she drowned.
I have been a doctor for over 25 years. My advice: See accidents as things that will often happen again if no changes are made. A foreshadowing you might say.
Heed their warning.
Have a lovely and safe week everyone. I'll write something happier next week. Promise.
PS:
If you liked this blog or found it helpful - please let others know - as it may be helpful to them or just a nice read.