Living with short-term amnesia

She can remember her childhood - but forgets things that happened just a few minutes ago. Karina Chandler tells Genevieve Roberts how she has learnt to live with short-term amnesia

For the last 15 years, she has battled with anterograde amnesia, a loss of short-term memory. The condition, the same one that afflicted Guy Pearce in the thriller Memento, means she is trapped in the present, unable to recall her recent history. Her long-term memories are intact, so she can talk about her life prior to being ill, but she cannot remember what she has already told you. She also finds it hard to recall the time or her age.

Chandler's condition is the result of a devastating illness when she was a teenager. At 19, just as she was about to go to university to read clinical psychology, she contracted encephalitis, a viral infection of the brain, and her family was told she was unlikely to live. She pulled through, but spent five months in hospital and had to use a wheelchair for a further 18 months.

Now 33, Chandler goes to college where she studies computer technology and drama, accompanied by her friend and supervisor, Julie Reynolds. They go shopping and out to lunch, and used to work together in a Cancer Research charity shop. She lives with her parents.

In order to lead a normal life, Chandler must keep a meticulous diary to help jolt memories and remember forthcoming events. Her bedroom is scattered with notes: "Check diary", "52 weeks, 365 days". Often she repeats the notes over and over, forgetting that she has already tried to prompt herself to remember. In her bedroom, she also has pictures of Tony Blair and Charles Kennedy. Below she describes their roles. For the first time, she voted in the general election in May.

She lays her clothes out each night, so when she wakes up she can remember what she is doing, whether she is going swimming, to the gym or to college. "It is very frustrating, hunting for lost words and thoughts," she says. "But I don't give in. My memory has been hell for me, as has my fitness because I was in a wheelchair for a long time, and I suffer from epilepsy since having encephalitis. But I have quite a bit of my life left, don't I? If I can control my epilepsy then I hope to work with young people. I am lucky that I have got a wonderful family."

Clive Wearing, the Radio 3 music producer and conductor, suffers from the same condition. He remains a flawless conductor, but is liable to get angry afterwards because he cannot remember. His wife Deborah portrays their relationship in the book Forever Today. Despite struggling to cope with the disappearance of part of his brain, the couple have made their marriage work, renewing their vows in 2002, although Mr Wearing cannot remember the service.

Dr Andrew Worthington, consultant neuropsychologist at West Heath House in Birmingham, says that anterograde amnesia is a challenge to the sense of self. "While people remember most things up until the point of their illness or accident, they find it very hard to assimilate new experiences." He looks after 25 patients at West Heath, part of the Brain Injury Rehabilitation Trust. He says that patients can feel isolated, because they may forget that friends and relatives have been to visit them. He encourages relatives to keep a visitors' book, so that patients have a record of who has been in.

Dr Worthington teaches people to remember through procedural learning, which does not require reflection. Skills such as swimming and playing the piano can be learnt, but sufferers find it very hard to absorb knowledge that can be applied in different situations.

He says that certain triggers can help the memory of an amnesia patient. "Smell is a powerful cue to memory, there is a direct link between the olfactory bulb and the memory part of the brain," he says. Chandler remembers tunes from the radio, and her mother, Marianne, finds it encouraging to hear Karina humming a song that she has heard perhaps only twice.

Dr Worthington says this is not surprising. "The melodic memory creates a chain through time, which may explain why people with speech problems can sing more fluently than they can speak. We check whether patients are humming tunes they may have heard on the radio recently, as evidence that they are taking in new memories."

He helps patients to re-establish a pattern, re-teaching basic routines of getting up, getting washed and dressed. Some patients learn to reflect on why they are doing this; for others, it will never be more than a habit.

Karina is clever and stubborn, with a very dry sense of humour. But as I leave I know that any impressions that she may have formed of me will soon fade and disappear. If she saw me on a street she would perhaps think I looked familiar, but would be unlikely to place me. In her mind, our meeting has never happened.

Need to know

* Anterograde amnesia is a selective memory deficit, the inability to remember events, resulting from brain injury or disease.

* The individual finds it difficult to learn new information. Memories for events before the injury may be retained, but events since are lost.

* Very short-term memory is spared, which means that the individual may be able to converse, but the memory of the discussion soon fades.

* Anterograde amnesia may, however, spare memory for skills or habits. So someone with amnesia can be taught to play the piano.

* Heart attacks, when the brain is starved of oxygen, can cause amnesia, as can encephalitis, when a variation of the herpes virus (most commonly associated with cold sores) attacks the brain.

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