Spring/Summer 2019 /Medical Mysteries/

A Mystery with a Name

Medical mysteries abound, and not only in the movies and headlines.

About a dozen years ago, on an ordinary workday morning, as I was following my ordinary workday routine, something inexplicable happened. My wife, a teacher, had already left for school. After dressing, I felt a bit odd, so instead of going straight to work, I sat down for a moment and opened my laptop. And discovered that I no longer knew how to open a file.

My mind had become a hopeless jumble. I couldn’t recall the names of the people I worked with, couldn’t formulate a clear thought or even hold a murky one in my head for more than a few seconds at a time. Out of all that confusion, one terrible conviction emerged. This must be what it feels like to have a stroke.

It never occurred to me to dial 911. All I could think of was phoning my wife, but I couldn’t remember the name of the school where she worked. I pawed through our file cabinet, searching through drawers for old pay stubs. Finding a number for the school’s front office, I left what must have been a strange and alarming message for my wife.

I don’t remember how long it took her to come to my rescue or what I did in the meantime or what she said to me when she arrived. All of my recollections from that day are sketchy and disjointed. I remember the emergency room and the neurologist questioning me. I vaguely remember various tests and scans. I recall becoming fixated on the initials “TIA,” which stand for “transient ischemic attack”—a kind of mini-stroke that my father had suffered on a couple of occasions—telling my wife about them over and over, each time the first for my muddled brain.

And I remember the comic relief of the day—the man in the next bed, who looked and sounded like a character right out of The Godfather, asking me what was wrong. I said I was having trouble remembering things, to which he replied with a wise-guy grin, “Well, do you remember the $200 you owe me?”

Eventually, the neurologist returned with a diagnosis and a smile. I hadn’t had a stroke. All my results were normal. The diagnosis: a rare and poorly understood condition with no known cause, called “transient global amnesia.” (I thought at the time—and still think—that “transient global amnesia” sounds like something invented for a soap opera plot. “Now we know why Bryan disappeared. He was suffering from transient global amnesia.”)

The good news, the doctor said, was that I would almost certainly be back to my usual self within a day and never have a relapse. And he was right. By lunchtime, I felt better, and by the time I left the emergency room, mid-afternoon, I was back to normal. And I’ve stayed that way, more or less—so far, anyway.

But I doubt that I’ll ever again have quite the same confidence in my own “normal” cognitive functioning. Since that day, whenever I feel a bit odd or have trouble remembering a word or a name, I go through a careful litany of friends’ and family members’ names and phone numbers in my mind, just to reassure myself that it’s not happening again.

It would be comforting to believe that everything that can go wrong with us has both a label and a clear explanation, but what I learned that day—something every doctor knows, I suppose—is that a disorder can have a name and still be a mystery.

Medical mysteries abound, and not just in the headlines about emerging diseases like Ebola. As you’ll read in Kate Becker’s “The Face of a Pandemic,” a century after the Spanish flu swept away something like 5 percent of the total world population, we’re still trying to figure out why it was so lethal. And almost everyone knows someone suffering from some chronic illness that seems to defy diagnosis and effective treatment.

As I learned later, my own diagnosis that day was made purely by process of elimination. It wasn’t a stroke or a tumor or anything else the doctors could pinpoint, so it must be transient global amnesia—a mystery with a name, but no less a mystery for that.