What's Going On?

    Andrew Engel was completely confused. Just days into his freshman year at Rutgers University, he was sitting in Sociology 101, listening to other students chime into a discussion. He had no idea what they were talking about. He had done his homework, paid attention to lectures and taken notes, but nothing was familiar. Everyone is so much smarter than I am, he thought. It was a foreign feeling, as he'd always been a good student and had graduated high school with a 3.9 GPA.

    The rest of his day progressed like an episode of The Twilight Zone. He got lost, again, on his way to the cafeteria, even though he'd been there a few hours earlier. Back at his dorm, he greeted his roommate with a "Hi, how's it going?" all the while thinking, What the heck is his name again?

    He was acting like a person with Alzheimer's disease -- but he was only 17. By the end of September, he'd dropped a class and was studying with a tutor, yet he was still struggling. He decided he had no choice but to drop out, telling his bewildered parents he wasn't cut out for college.

    Andrew had long wanted to get a degree and work in health care, and was crushed that his dream had been derailed. He was also distraught about being separated for the first time from his identical twin brother, Jason, also a student at Rutgers. He cried for most of the long ride to his parents' house in Maryland.

    They thought it was anxiety and took Andrew to see a psychiatrist. The doctor couldn't pinpoint a cause and blamed stress. But Andrew continued to act strangely and had trouble finding the right words when speaking. He asked, "What's for dinner?" after he'd just eaten. He got disoriented driving the streets he knew so well and, while running errands, forgot why he was out. "It was weird. I'd never had health problems before," Andrew says. "I felt it had to be psychological. That I was overwhelmed and it was clouding my mind."

    Devastating Diagnosis

    Memories are imprinted on the brain like data on a hard drive. All the information Andrew had downloaded before the tumor （autobiographical details, motor skills and what he learned in school） was intact. But the tumor had damaged the software used to save new information, which is why the amnesia became glaringly obvious only when he was at college, in an unfamiliar environment.

    Doctors removed part of the tumor and zapped the rest with radiation, leaving Andrew so sick that he dropped 30 pounds. The cancer was gone, but his relief was short-lived, as he was told he'd probably never return to school. He had an above-average verbal IQ of 120, but his memory recall score was 68, comparable with that of a person who is developmentally challenged. His only career option would likely be a highly supervised manual-labor job.

    "Even as they told me this, I knew I wanted to try to go back to school," Andrew says. "I didn't know if I could do it, but I was really motivated. I wanted to give it all I could to get my memory back."

    His parents feared he was setting himself up for failure and asked him to check with his doctors, neuropsychologist Dustin Gordon, then a post-doctoral fellow, and his supervisor, Schretlen. Andrew was looking for a way to retrain his brain and improve his memory. The doctors had rarely seen someone so determined, so they agreed to devise strategies to help Andrew absorb information in class and while studying, as well as techniques for organizing his thoughts so he could write papers. He would have to work ten times harder than other students and, if he became overwhelmed, possibly have to quit school.

    Andrew began by auditing an English class at nearby Howard Community College. Eventually he discovered that reading things at least five times increased his chance of retaining information. In class, he wrote detailed notes, and a note taker supplemented what he missed. He reread his notes several times a day, then retyped them and the textbook material. He crammed 12 hours a day, seven days a week, breaking only for class, meals or a workout. To remember lists and data, he used acronyms and mnemonics.

    When he took the class for credit the next semester, he got an A. "I was happy," he says, "but unsure how I'd do in my other classes." He enrolled at the University of Maryland, Baltimore County, taking just one or two courses a semester toward a bachelor's of science in health policy and administration.

    While he'd found a way to compensate in the classroom, everyday life was still a challenge. He carried maps and lists when he went to the store, but one night, after leaving a Baltimore bar, he roamed the streets for hours. It was 3 a.m. when he finally found the lot where he'd parked. He now has a GPS on his cell and carries digital devices for recording reminders.

    Andrew stuck with his program, and in May 2007, at age 29, more than a decade after he began, he got a standing ovation as he graduated with a 4.0.

    Six months later, Andrew is at his desk in the offices of Erickson Retirement Communities in Catonsville, Baltimore, where he works as an operations associate. He'd told his future boss, Russ Caccamisi, about his memory problem during the interview. "It didn't concern me," Caccamisi says. "Those ten years in school showed Andrew's perseverance." He still uses the strategies from college, along with computer calendar reminders and the tools we all rely on to organize our frenzied lives. "What works best is repetition and using more than one way to remember something," Andrew says. "I'll write it, say it, record it and listen to it."

    Of course, an imperfect memory is still frustrating. He likes movies but loses track of plots. He vaguely remembers a family trip to Hawaii and is trying to convince his parents that they should return. Then there are his beloved Redskins. Though he can't remember scores, he could tell you if they won. And when they lose? Sometimes, he says, it's good to forget.

    發生了什么事？

    安德魯。恩格爾完全困惑了。剛進入羅格斯大學沒幾天，他坐在社會學101教室里，聽其他同學討論問題，他不知道他們在說什么。他完成作業，把注意力放到講座和做筆記上，可周圍的一切如此陌生。他心想："每個人都比我聰明。"這是一種從未有過的感覺，因為他一直以來都是個好學生，并且以3.9分的平均分從高中畢業。

    接下來的日子簡直就像電影《陰陽魔界》的故事情節一樣。他再一次在去自助餐廳的路上迷路了，盡管幾個小時前他還在那兒。回到宿舍，他一面對舍友打招呼："HI,怎么樣啊？"又一面在想："他叫什么來著？"

    他的行為像得了老年癡呆癥，可他只有17歲。到九月底，他退了課請了家教，但癥狀依然沒有減輕。無奈之下，他只好輟學，他告訴一臉困惑的父母，大學生活不適合他。

    安德魯一直以來都想拿到學位然后在醫療保健中心工作，夢想破滅令他懊惱不已。同樣令他煩惱的是第一次要與自己的同胞兄弟詹森分開，詹森也就讀于羅格斯大學。在去位于馬里蘭州父母家的長途路上，安德魯不停的哭泣。

    安德魯的父母認為他得了焦慮癥，就帶他去看了精神科醫生。醫生不能準確的找到問題所在，便把問題歸咎于壓力過大。但此后安德魯的行為依然古怪，在說話的時候都不能找到準確的詞語來表達。他會在吃完晚飯后問"晚餐吃什么？".他在熟悉的路上開車會分不清東西南北，在幫別人跑腿的途中又想不起自己為什么要出門。安德魯說："這太奇怪了，我從未有過健康問題，我覺得是心理問題。為此我深受打擊，而且不知所措。"

    安德魯的媽媽對他的怪異行為感到越來越不安。當他開始出現生理癥狀，包括無時無刻的口渴和尿頻，她才趕忙帶他去看了醫生。腦部掃描得出了原因：安德魯得了惡性腦腫瘤，這個腫瘤像桃核一般大小，它壓迫了大腦中制造新記憶的部分，如果不及時治療，后果不堪設想。安德魯被嚇到了，但他也松了一口氣，因為他的怪異行為終究是事出有因。

    "他主要是得了健忘癥，隨著人們年齡增大，記憶會逐漸消失，特別是患有老年癡呆的人。"安德魯的神經心理醫生，巴爾的摩約翰霍普金斯醫院的David Schretlen博士如是說。

    毀滅性的診斷

    大腦里的記憶就好比硬盤里的數據。安德魯在患腫瘤前腦中所"下載"的所有信息（關于自己的一切，車技，和他先前在學校所學）都完好無損。但腦腫瘤損壞了儲存新信息的"軟件", 這就是為什么只有在大學這個陌生的新環境里，安德魯的健忘癥表現的特別明顯。

    醫生取出腫瘤的一部分，用放射治療把剩下的部分消除，安德魯的身體相當吃不消，體重狂減30磅。癌癥消除了，但喜悅如此短暫，安德魯被告知他再也不能回到學校學習了。他的語言智商高達120,他的記憶輸出只有68,和一個發育不健全的人相當。他唯一的職業選擇就是在高度監督下的手工體力活。

    安德魯說："即使他們這樣告訴我，我知道我還想要試著重返校園，我不知道我能否做到，但我的的確有這種強烈的愿望，我會盡我所能來尋回我的記憶。"

    他的父母擔心他無法面的失敗，就讓他咨詢他的神經心理學醫生--Dustin Gordon,然后和他的同伴--一位博士后研究員以及他的導師-- Schretlen,一起商量。安德魯一直在尋找一種重新訓練大腦和提高記憶的方法。醫生們很少見到意志如此堅決的人，因此他們決定制定策略，來幫助安德魯在課堂上和學習中獲得信息，同時找出讓他構建思想的方法，這樣一來，他就可以寫作了。他必須付出多于常人十倍的努力，如果他不能成功，就很可能被退學。

    安德魯開始先在附近的霍華德社區學院聽英語課。最后他發現，閱讀至少五遍以上能增強他記住的機率。在學校，他作詳盡的筆記，另外還有一個記錄器來補充他所遺漏的內容。他每天都要把他的筆記讀上好幾遍，然后重新打出筆記和教材內容。他每天忙碌十二小時，一周七天，只有在上課，吃飯和健身的時候才有片刻休息。為了記住列表和數據，他用了縮寫字和助記術的方法。

    他為了下半個學期的學分上課，并且得了A.他說："我太高興了，但不知道在其他課程上我的表現如何。"他進了巴爾的摩的馬里蘭大學，專修衛生政策和管理科學學士學位，每個學期修一門或兩門課。

    當他找到了在教室里能全神貫注的方法后，日常生活仍然是個挑戰。他去商店的時候會隨身攜帶地圖和清單，但有天晚上，從巴爾的摩一家酒吧出來之后，他在街上游蕩了好幾個小時。當他最終找到他的停車位時，已經是凌晨三點了。現在他的手機裝上了GPS,并隨身攜帶用來提醒的數碼裝置。

    安德魯堅持著他的計劃，在2007年5月，他29歲的時候，他以4.0的學分績畢業，獲得了巨大的成功，這距離他開展計劃已經超過10年了。

    6個月之后，安德魯在巴爾的摩，Catonsville的Erickson退休社區的辦公室里工作，他是一名操作員。在面試的時候，他把自己的記憶問題告訴了他未來的老板Russ Caccamisi,Caccamisi說："對此我并不擔心，他在學校里的10年經歷已經證明了安德魯的毅力。"他還在使用在大學里制定的策略，以及電子日歷和其他我們都依賴的用來組織我們紛亂生活的工具。安德魯說："效果最顯著的就是重復和使用多種方法來記住某樣東西。我會把它寫下來，說出來，錄下來然后拿來聽。"

    當然，不完整的記憶仍然令人沮喪。他喜歡看電影但總會忘掉一些故事情節。他隱隱約約記得去夏威夷的家庭旅行，但又向父母證實他們應該是回來了。然后是他最愛的紅人隊，即使他記不住比分， 但他能告訴你他們是不是贏了，如果輸了怎么辦呢？他說："有時候，忘記也是件好事。"