About a Girl
She can barely see, she doesn't like to be hugged, and she's already forgotten most of what happened last winter. Which is why, just maybe, Audra Thomas has such a strong sense of the world around her—and of herself.
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In certain cases of brain dysfunction, it's thought that significant neural pathways have somehow been broken or blocked, but the how and the why of this aren't well understood. For instance, there are people, like Audra, who experience severe memory losses in the absence of obvious structural damage to any one area of the brain. Might a cascade of stress hormones in the brain somehow sever synaptic connections that are crucial to recall? It's a plausible hypothesis but no more than that. Especially knotty are cases of amnesia when both a potential physical cause (such as a head injury) and a potential psychological cause (such as severe stress) are present. Sometimes those two factors appear to work in concert: A man falls from a scaffold not long after his girlfriend leaves him, and suddenly he can't recognize his family members; a woman is hit in the head at work after discovering her fiancé is living with another woman and loses years of her life.
The ancient Greeks deified memory as the goddess Mnemosyne, mother of the nine Muses, and many of us continue to worship memory, if the popularity of Ginkgo biloba is any indication. Yet much as we may prize it (or at least, worry about losing it), and much as we may have an intuitive sense of what it is, based on our experience of remembering, the concept itself is elusive. In ordinary speech, the term "memory" has multiple uses, referring at times to a particular recollection or else to the act of recalling, to our general ability to recall things or to the entire store of our recollections. For centuries, humans have hit upon artistic and technological ways of supplementing memory—through writing, theater, computers—and then theorized that memory in the brain is somehow like the invention: a wax tablet, a mental theater, an inner data-storage site. It's a curiously backward tendency, which seems to confirm that even though we consider memory to be essential to our personhood, we don't have a clear sense of what sort of thing memory is. That's a mystery we live with, one that most of us are forced to confront only if our own memory, or that of a loved one, fades away.
IF YOU WERE TO MEET Audra and didn't know about her memory loss, you probably wouldn't be able to tell unless you happened to ask her whether she remembers some particular incident or person from her past. The second time I was at her house, I inquired about a photograph taped to the wall. "What's it of?" she asked, and I told her it looked like a family: a man and a woman and two teenage girls. "Oh. That man's our dentist," Audra said, "and the girl on the left was my best friend from kindergarten to fifth grade."
"Do you remember her at all?" I asked.
"No."
Another time, she and her sisters were eating pizza at the dinner table, and it came up that her sister Mesa was going to be in a cousin's wedding. "Whose wedding?" said Audra.
"Oh, you don't remember him," said Mesa.
Well, protested Audra, they have a lot of cousins.
Her parents, Dave and Nancy Thomas, are both big-boned and brown-haired, as are all their children: Audra, Katie, Adam, Mesa, and Savannah. Dave works as a purchasing specialist for Electronic Data Systems, in Plano, Nancy as a pricing manager at J. C. Penney; when I first visited them, they had recently had foot and ankle surgeries, respectively, and they lumbered around their house in matching surgical boots.
Nancy, who grew up in a large, close-knit family in rural Oklahoma, is the more naturally outgoing of the two, the storyteller, and it's she who cared for Audra full-time after the accident, which has made her the bearer of Audra's story in a way that Audra herself can't be. A former basketball player with serene blue eyes and an open manner, she is chattily stoic, but she does not downplay what happened to her eldest daughter: "I sent one child to school that day and the child I brought back that afternoon was not the same child, and she never was again."
In the spring of 1996, Audra was a stocky fifth-grade girl with long hair and glasses, generally cheerful but also quite stubborn. She played sports and loved country music; in photographs from that time she is almost always smiling. One day toward the end of the school year, Nancy went to Audra's school to help with an afternoon pizza party and upon arriving discovered that Audra had tumbled backward off a swing when the seat became detached from its chain. Another girl on the swings had run to get help, a nurse explained; possibly Audra had lost consciousness in the interim, but now she seemed all right.
That night, however, Audra was dizzy, and the following day she started to see double. Nancy took her to a doctor and to a neurologist, but she tested fine. Over the next month, "we could see her getting a little fuzzier," says Nancy. Then she and Dave overheard Audra asking her little sister Savannah whether some clothes matched. "So I went to Audra and I said, 'Can't you see?' and she said, 'No, Mom, I just don't see anything anymore.'"
It was then that Nancy noticed how Audra would feel her way around the room, touching the walls and furniture. She was constantly dizzy. She seemed to lose interest in music, and one day as a tape was playing, she grew agitated. "She said, 'Mom, I hear a guitar. I hear another guitar. I hear drums,'" recalls Nancy. "She could hear the tape in the tape player, and she knew it was people singing, but it didn't blend for her—it was separate things." Her parents now believe that Audra's memory was deteriorating also, but as with her vision loss, she didn't let on at first.
They consulted a psychologist, who diagnosed Audra with conversion disorder: a psychiatric condition in which severe stress or trauma induces the brain to subconsciously mimic symptoms such as vision loss—the classic example being the witness to a murder who goes blind. Audra didn't take well to the diagnosis, apparently thinking it meant that no one believed her symptoms were real. That summer she grew increasingly depressed, and so dizzy that she couldn't get around by herself. It seemed that she was losing some of the basic functions we acquire as babies: balancing, filtering out stimuli, making sense of noise.
In September Audra and her parents traveled to the Mayo Clinic in Minnesota for another opinion. After several days of MRIs and brain scans, a doctor told them that Audra was, from a physical standpoint, perfectly healthy. Then, to explain what was wrong with her, he pointed a finger to his head and whirled it in a circle: Audra was crazy. "Even though she couldn't see him do that," says Nancy, "I think she knew." Back home, Audra continued to regress, becoming more and more like an infant, forgetting the names of things and playing with big plastic toys. She would forget her own family members, except for Nancy, who was always with her.
Because of her extreme physical sensitivity, she wouldn't let anyone touch her, not even Nancy, and periodically she went into rages, lashing out until someone restrained her. Once, after a rage, "I just sat there and held her and rocked her for the longest time," says Nancy. "All of a sudden I felt tears on my hand, and I realized she was crying for the first time since that accident. She asked me, 'Why, Mommy? Why is this hurting? Why doesn't anyone believe me?'"
Right after Thanksgiving, her parents admitted her to the psychiatric unit at the Children's Medical Center in Dallas. Over the course of a month there, her mood seemed to stabilize, and she didn't get worse, but according to her mother, she didn't really improve either. Nancy wasn't satisfied: She researched; she read; she kept asking questions. She bought her children a Super Nintendo and started playing it herself. "Sometimes, late at night, when I'd got them all to bed, I would sit there and play Super Mario Brothers. It was a major stress relief when I couldn't sleep. I got through about the first five levels. That's how I coped."
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