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Author Topic: EP546: Recollection  (Read 941 times)
eytanz
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« on: October 21, 2016, 03:51:59 PM »

EP546: Recollection

AUTHOR: Nancy Fulda
NARRATOR: Trendane Sparks
HOST: Alasdair Stuart

---

The dream is always the same. You are a tangled mass of neurons, tumbling through meteors. Flaming impacts pierce your fragile surface, leaving ragged gouges. You writhe, deforming under bombardment, until nothing is left except a translucent tatter, crumbling as it descends. Comets pelt the desiccated fibers. You fall, and keep falling, and cannot escape the feeling that, despite your lack of hands, you are scrabbling desperately at the rim of a shrouded tunnel, unable to halt your descent. Glimmers crawl along the faint remaining strands, blurring as you tumble…

You awaken to warmth and stillness. Gone are the soulless tiled floors of the seniors’ home. Sterile window drapes have been replaced by sandalwood blinds. Fresh air blows through the vents, overlaying faint sounds from the bathroom and from morning traffic on nearby canyon roads. You clutch the quilted blankets, stomach plummeting. This cozy bedroom, with its sturdy hardwood furnishings, should be familiar to you; but it isn’t. Two days, and still nothing makes sense. You feel as though you’re suffocating. Tumbling…

Your wife has heard you gasping for air. She comes running, nightgown flapping behind her. Her face is creased in overlapping furrows. Your mirror tells you that the two of you are a match: the same fading hair, the same shrunken hollows along the eyes. Laugh lines, she calls them, but you cannot manage to see them as anything except deformities, in your face and hers both.

“Elliott?” She grabs your hand and kneels at the bedside to look in your eyes. “It’s me, Elliott. Everything’s fine. Everything’s going to be ok.”

Her name, you recall, is Grace. She told it to you two days ago, and is irrationally elated that you are able to repeat it to her upon demand, any time she asks. You feel like a trained puppy, yapping for treats, except there aren’t any treats.

There’s just Grace, and this room. And before that, the seniors’ home. And before that…? You’re not sure. You flail at the bedside for your notebook, thinking it might offer continuity. But there are only a few shaky scribbles, beginning the day before yesterday.

Grace pulls you upright, propping pillows against your spine. She fusses over you, adjusting your hair, prattling off questions. She seems to think you’re in pain, but you’re not. Not any more than you’d expect of a man with joints and bones as old as yours. She tries to kiss your forehead, and you recoil.

It’s a cruel gesture, pulling away like that, but you can’t help it. She’s a stranger, and despite the anguish in her eyes, it feels wrong to pretend otherwise. You can’t feign love. You won’t. Not to please her, not to please anyone.


Listen to this week’s Escape Pod!
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shazdeh
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« Reply #1 on: October 23, 2016, 07:56:27 AM »

First let me say, what a fantastic story. The only other work of Fulda that I have read is a short story named Movement (published also in EP I believe) and I think both stories were in similar veins, in that both try to see the world from the perspective of someone with a different brain. Both brilliantly fantastic!
I just have a small nitpick, I apologize in advance if this is a forbidden question but was this story sci-fi? The only thing I could point to was the procedure he went through ("Someone had to be first..."), but the story didn't provide more details on that and I wish it had, it would be more grounded I guess.
Really enjoyed this one, thank you Nancy for writing this and EP for sharing it.
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DerangedMind
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« Reply #2 on: October 23, 2016, 11:21:17 AM »


I just have a small nitpick, I apologize in advance if this is a forbidden question but was this story sci-fi? The only thing I could point to was the procedure he went through ("Someone had to be first..."), but the story didn't provide more details on that and I wish it had, it would be more grounded I guess.
Really enjoyed this one, thank you Nancy for writing this and EP for sharing it.


While the story is certainly more character driven than technology driven, this certainly is sci-fi to me.  It deals with the consequences of a new technology that clears the plaque from the brain of an Alzheimer's patient.
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DerangedMind
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« Reply #3 on: October 23, 2016, 11:22:59 AM »

I enjoyed the story.  I liked the fact that it didn't end with all the memories streaming back, but rather hope that maybe they could make new memories together.
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Wilson Fowlie
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« Reply #4 on: October 23, 2016, 02:57:38 PM »

I loved this story. It was heartbreaking and then hopeful, and Grace did exactly what I hoped she (or someone) would do, and my eyes teared up at the end.

I do have one question that's more meta than about the story itself, though: what happened to Robot Lady??
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A_Grue
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« Reply #5 on: October 25, 2016, 02:57:45 PM »

Crawling out of the shadows to comment on this one.  My god, this story broke my heart.  I lost my grandmother to Alzheimer's in early 2001, and one of the worst parts was not the two years where she needed full-time care, but when she remembered just enough to recognize that she couldn't remember.  That is the heart of the belligerent stage.  She pushed us away because she couldn't remember why she should know us, *and she hated herself for that.*  Nancy Fulda got to the inside of that feeling with a laser precision.  Thank you for the tears, Nancy.  It was an honor.
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Fenrix
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« Reply #6 on: October 25, 2016, 04:06:39 PM »

This was a great story. Heartfelt without being sappy.

The science in this one felt pretty strong to me as it seemed to extrapolate the science of other brain damage. It also does a great job of pointing out that once the medical engineers have finished solving their technical problem, there's still the rest of the recovery that needs to be accommodated.
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Wilson Fowlie
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« Reply #7 on: October 25, 2016, 04:30:08 PM »

The science in this one felt pretty strong to me as it seemed to extrapolate the science of other brain damage. It also does a great job of pointing out that once the medical engineers have finished solving their technical problem, there's still the rest of the recovery that needs to be accommodated.

There's already progress being made in mice on this front (this is from 2015, so presumably there's been even more progress since then).

http://www.sciencealert.com/new-alzheimer-s-treatment-fully-restores-memory-function

(Talk about yer misleading headlines!)

Hmm, I wonder if Ms. Fulda based her story on this (or similar) research.
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"People commonly use the word 'procrastination' to describe what they do on the Internet. It seems to me too mild to describe what's happening as merely not-doing-work. We don't call it procrastination when someone gets drunk instead of working." - Paul Graham
chromeratt
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« Reply #8 on: October 26, 2016, 06:35:44 AM »

I really enjoyed this story for the way it portrayed Elliott's frustrations with pretending fit in and live up to others expectations.  I related to it in a social integration point of view.  Then the scene with the toaster drove home how we are a sum of our past experiences, emotionally and mechanically.  

I develope software professionally, mainly in Java.  But if I was in Elliott's shoes, you couldn't just give me a month or six worth of training and drop me back at my desk.  I MIGHT be able to do the same work.  To be even close to the same level, I'd need to go back and learn BASIC, Pascal, Fortran and the rest.  Need to have some of the same conversations, the same discoveries.  When Elliot struggled with the toaster oven even after watching Grace operate it with the realization that there was something missing from his memories, it made all that run through my mind.

And then when Grace walked out of the bathroom and intended herself, I realized that this was a love story. And I got kicked guts emotionally.  And this coming from a guy who picked his finger nails in boredom watching the season opener for TWD the other night.

Thank you to Nancy for the great story and Trendane for capturing the Elliott's frustrations so effectively. Thank you to everyone at Escape Artists for bringing the story to the audience.  Thanks also Alasdair fit the great closer.  You always seem to the perfect closing for each story you host.
« Last Edit: October 26, 2016, 07:29:16 AM by chromeratt » Logged
Thunderscreech
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« Reply #9 on: October 26, 2016, 05:08:11 PM »

I burst into tears suddenly and unexpectedly at the end of the story.

I don't know for sure why.  Is it because I lost a grandparent to this terrible condition?  Could it be because I feel empathy for the terrible pain and obvious affection this woman has for her husband?

A it because I love my wife deeply and cannot imagine putting her through this or losing her and her memories of our decades together?

I am emotionally compromised. 

Pulling back onto the highway after a cry, I am in the middle of Florida in an empty rental car with a wet face and a nose that needs blowing. My wife is 140 miles away and more than ever I want to hold her tight then make more memories together.

Thank you and damn you.
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acpracht
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« Reply #10 on: October 26, 2016, 07:30:54 PM »


Thank you and damn you.

Consider yourself fortunate... In the production process, I think I listened to this gem at least 10 times (just from necessity).

Might have listened to it 10 times anyway. The combination of Nancy's storytelling and Trendane's ability to nail a narration turned me into a wet noodle each time.

In fact, your last sentence is pretty much what I wrote to Tren after I posted the episode.

A note about Tren - I've worked with him for several years now across three podcasts. The first one I handed to him was basically beat poetry in short story form and he nailed it.

He's made me weep uncontrollably with a vocoder laid over part of his narration.

I recently asked him to narrate a story involving a fog-form Corleone and a female Alexander the Great.

Nailed it. Nailed it. Nailed it.

Tren's work makes me cry. Not sure why I keep going back to the bastard except that he reliably makes me cry. He inhabits his characters so completely that I suspend all disbelief.

He has that rarest of skills - to transport.


I do have one question that's more meta than about the story itself, though: what happened to Robot Lady??

Please see: http://forum.escapeartists.net/index.php?topic=9899.msg156705#msg156705

For the full explanation.

RIP.

-Adam
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cwthree
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« Reply #11 on: October 26, 2016, 07:32:20 PM »

I'm not entirely sure how I feel about this story. My mother-in-law has Alzheimer's disease for the last decade of her life. Her distress at not knowing where she was or who some of us were was heartbreaking. On the other hand, I'm not sure that she'd have been any less distressed had she suddenly become able to form new memories, like the protagonist in this story. The character's anger, after all, comes not simply from the loss of his memories, but from the  other people's inability to accept that the now-lost memories made him the person that they knew. That is,  that he was his accumulated experiences, not just his current likes, dislikes, opinions, favorite food, etc.
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acpracht
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« Reply #12 on: October 26, 2016, 07:34:32 PM »

I'm not entirely sure how I feel about this story. My mother-in-law has Alzheimer's disease for the last decade of her life. Her distress at not knowing where she was or who some of us were was heartbreaking. On the other hand, I'm not sure that she'd have been any less distressed had she suddenly become able to form new memories, like the protagonist in this story. The character's anger, after all, comes not simply from the loss of his memories, but from the  other people's inability to accept that the now-lost memories made him the person that they knew. That is,  that he was his accumulated experiences, not just his current likes, dislikes, opinions, favorite food, etc.

So, yes... but also...

Given this is a new procedure, they probably didn't know all the possible consequences.

I'd imagine that - as the test case - what they have learned about how to handle the human element will continue to improve the treatment.

-Adam
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Not-a-Robot
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« Reply #13 on: October 27, 2016, 09:51:31 AM »

I'm not entirely sure how I feel about this story. My mother-in-law has Alzheimer's disease for the last decade of her life. Her distress at not knowing where she was or who some of us were was heartbreaking. On the other hand, I'm not sure that she'd have been any less distressed had she suddenly become able to form new memories, like the protagonist in this story. The character's anger, after all, comes not simply from the loss of his memories, but from the  other people's inability to accept that the now-lost memories made him the person that they knew. That is,  that he was his accumulated experiences, not just his current likes, dislikes, opinions, favorite food, etc.

So, yes... but also...

Given this is a new procedure, they probably didn't know all the possible consequences.

I'd imagine that - as the test case - what they have learned about how to handle the human element will continue to improve the treatment.

-Adam

I think that I can clear this up a little. This might sound a little cold, but just keep in mind that I am clearing up the clinical trial process.

From the sound of it, this would be classified as a Phase II clinical trial. Normally with new treatments there are Phase I trials first. These are safety assessments normally performed in healthy volunteers, but since this seems to be a high-risk, life-saving treatment, they may have forgone the Phase I and combined it with Phase II (a Phase I/II trial).

A Phase I/II trial would be to mainly assess two endpoints:

1) Safety (are there adverse events or serious adverse events?)

2) Efficacy (How well the treatment performs at the dose/s it have been given)

So basically, the Dr.s will be assessing a number of point throughout the trial, as well as monitoring the patient for adverse events. Unfortunately, once a trial has begun, they are not allowed to change much in the methods without removing the patient from the trial completely (which they do usually in the case of serious adverse events or when a patient refuses treatment).

In other words, how this would hypothetically look in the end publication would be:

"The treatment was effective eliminating 70% of amyloid plaques in 80% of patients with end-stage Alzheimer's disease. 90% of patients had a restoration in memory capacity as shown by XY test, but long-term memories formed previous to treatment were not restored. 5 year mortality caused by complications from Alzheimer's disease was reduced to 5%. Adverse events included frustration, aggravation... we would suggest counseling or psychological treatment of the patient to reduce the severity of such events in patients with end-stage Alzheimer's disease..."

So basically, they would use this data to improve treatment. Furthermore, they would probably start Phase III trials (a trial designed to show that the treatment is more efficacious than what is already on the market) with a group of patients at the beginning of Alzheimer's onset as a preventive treatment (they even say that they are in the story).

But in the end, you always have the human element. Some people may not be grateful. But, in the state they are in, they cannot make the decision for themselves, and the relatives have to try the best that they can to make the right one.

Anyway, the story was well written. I usually get all nitpicky about the science in these types of sci-fi stories, but I have no complaints here.

Well done.
 
« Last Edit: October 27, 2016, 10:00:56 AM by Not-a-Robot » Logged
acpracht
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« Reply #14 on: October 27, 2016, 11:28:00 AM »

I'm not entirely sure how I feel about this story. My mother-in-law has Alzheimer's disease for the last decade of her life. Her distress at not knowing where she was or who some of us were was heartbreaking. On the other hand, I'm not sure that she'd have been any less distressed had she suddenly become able to form new memories, like the protagonist in this story. The character's anger, after all, comes not simply from the loss of his memories, but from the  other people's inability to accept that the now-lost memories made him the person that they knew. That is,  that he was his accumulated experiences, not just his current likes, dislikes, opinions, favorite food, etc.

So, yes... but also...

Given this is a new procedure, they probably didn't know all the possible consequences.

I'd imagine that - as the test case - what they have learned about how to handle the human element will continue to improve the treatment.

-Adam

I think that I can clear this up a little. This might sound a little cold, but just keep in mind that I am clearing up the clinical trial process.

From the sound of it, this would be classified as a Phase II clinical trial. Normally with new treatments there are Phase I trials first. These are safety assessments normally performed in healthy volunteers, but since this seems to be a high-risk, life-saving treatment, they may have forgone the Phase I and combined it with Phase II (a Phase I/II trial).

A Phase I/II trial would be to mainly assess two endpoints:

1) Safety (are there adverse events or serious adverse events?)

2) Efficacy (How well the treatment performs at the dose/s it have been given)

So basically, the Dr.s will be assessing a number of point throughout the trial, as well as monitoring the patient for adverse events. Unfortunately, once a trial has begun, they are not allowed to change much in the methods without removing the patient from the trial completely (which they do usually in the case of serious adverse events or when a patient refuses treatment).

In other words, how this would hypothetically look in the end publication would be:

"The treatment was effective eliminating 70% of amyloid plaques in 80% of patients with end-stage Alzheimer's disease. 90% of patients had a restoration in memory capacity as shown by XY test, but long-term memories formed previous to treatment were not restored. 5 year mortality caused by complications from Alzheimer's disease was reduced to 5%. Adverse events included frustration, aggravation... we would suggest counseling or psychological treatment of the patient to reduce the severity of such events in patients with end-stage Alzheimer's disease..."

So basically, they would use this data to improve treatment. Furthermore, they would probably start Phase III trials (a trial designed to show that the treatment is more efficacious than what is already on the market) with a group of patients at the beginning of Alzheimer's onset as a preventive treatment (they even say that they are in the story).

But in the end, you always have the human element. Some people may not be grateful. But, in the state they are in, they cannot make the decision for themselves, and the relatives have to try the best that they can to make the right one.

Anyway, the story was well written. I usually get all nitpicky about the science in these types of sci-fi stories, but I have no complaints here.

Well done.
 

Wow...

Thanks for the detailed analysis.

-Adam
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Wilson Fowlie
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« Reply #15 on: October 27, 2016, 11:47:06 AM »

I do have one question that's more meta than about the story itself, though: what happened to Robot Lady??

Please see: http://forum.escapeartists.net/index.php?topic=9899.msg156705#msg156705

For the full explanation.

RIP.

RIP indeed. :sniff: Thanks for the link.

(Now I just have to figure out how I managed to miss the change last episode.)
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« Reply #16 on: November 05, 2016, 01:19:16 AM »

Just chiming in to say: I loved this one, and found it deeply moving on several levels. Probably not least because I fear loss of mental function far more than I fear death. So, my morning commute was narrated try the slaying of a personal demon. Sort of.

I also think it is absolutely sic-fi, even by something as restrictive as the Analog definition.

The author added exactly one piece of new technology -- a cure for Alzheimers -- and then stepped back to look at the consequences. The choice to go with a interaction between spouse and a few family members rather than society-wide is was a well-chosen twist that made for a great piece of art. Bravo!
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Anoton115
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« Reply #17 on: November 07, 2016, 08:10:49 PM »

While it is true that we are (mostly) the sum of our memories and experiences, it might sometimes be said that we also possess a certain psychological inertia that, even separated from our memories. leaves us predisposed to the same inclinations even if we cannot remember the reasons for the inclination. This story presents exactly such a situation, and capitalizes on it beautifully to make a compellingly moving tale that kept me riveted.

Elliot's conflict is lacking the memories to be the man he was and being unwilling to simply live a lie. When he finally finds the words (harsh as they were) to express this, it is a testimony to the strength of Grace's love that she doesn't pine for the Elliot she now knows she'll never get back. She simply embraces this strange new Elliot, and does her hopeful best to try to start over with him. Her character is well named indeed. And toward the end, we see just enough of the old Elliot's underlying inclinations shining through that we too can be hopeful on their behalf. If there's a more beautiful way to end a story than with hope, I can't remember at the moment what it is.
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« Reply #18 on: December 01, 2016, 03:26:48 AM »

This was terribly sad, and then soaringly wonderful.
 Cry
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« Reply #19 on: December 01, 2016, 10:46:03 AM »

Oh, dammit, this was a good story.

Admittedly, I have a soft spot for Alzheimer's stories.  I've lost a couple grandparents to it, and I don't think there's anything that terrifies me more in the world (at least nothing that is actually likely to happen to me) than going through Alzheimer's.  This story was inherently hopeful in that THERE IS A TREATMENT.  Alzheimer's, in this world, is not an end-state.  It is a condition that can now be treated, and hopefully in the future people will be able to be treated before they've lost all those memories.  And even for this guy, it's amazing that he's now still got a chance to be mentally healthy even if he has lost so damned much.

But of course the tragedy of it is that... the person that he was is dead.  He is not that person revived, he is a new person, sort of born from the chrysalis of the person he used to be--not better or worse, but very different.  We are defined in large part by our memories of our past experiences.  If you strip that away you'll be very different, and the constant pressure for him to try to pretend to be the same person was horrifying to me.  Imagine if everyone insisted that the only way the world would be right is if you constantly pretended to be someone else--(there are plenty of real life parallels to this!   Which just makes it more powerful.  i.e. keeping yourself in the closet because your family might not accept that you are gay, etc)

I was SO RELIEVED when he laid everything out for his wife and she responded in such a positive way.  She could have insisted that he keep on pretending, acted like his feeling that he was a different person was just a mental defect, a side effect of the treatment that in itself needed to be treated.  She could have left him, on the grounds that he wasn't the man she knew anymore.  But instead, she took a huge step in the only direction I could see them being happy together--to treat this like what it is, a new beginning, and work accordingly.  And, though I would be hard pressed to say that losing most of your memories could ever be a GOOD thing, maybe in this case it has some positive aspect in making them both refresh their effort and interest in their relationship because it is new and fresh and so can have the revivifying effect of new love!  Old love has its own strengths, but it can be easy to take it for granted--you know everything about the other person and there is so rarely anything new to learn, but now they are not the same people--it is new love and they are starting afresh.

And maybe it won't work out, maybe the people they are now are not compatible.  But that's okay.  They are taking steps to give it an honest try, and if they end up breaking up then it would still be better than them basing the rest of their lives together on a false pretense, and is also IMO better than just giving up without doing the work to try it out first.

I wish them the best, I hope the rest of his family gives him the same chance that his wife is giving him--i.e. to treat him like a NEW member of the family and forge a NEW relationship with him instead of insisting that their relationship be based on their memories.  There will understandably be mourning over the loss of the man that he was, and I think that's okay, loss is loss and loss of the loved one you knew is a thing to mourn for.  But I also hope that they can temper that with celebration over this new member of their family who they are just getting to know.

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