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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.

发生了什么事？

安德鲁.恩格尔完全困惑了。刚进入罗格斯大学没几天，他坐在社会学101教室里，听其他同学讨论问题，他不知道他们在说什么。他完成作业，把注意力放到讲座和做笔记上，可周围的一切如此陌生。他心想：“每个人都比我聪明。”这是一种从未有过的感觉，因为他一直以来都是个好学生，并且以3.9分的平均分从高中毕业。

接下来的日子简直就像电影《阴阳魔界》的故事情节一样。他再一次在去自助餐厅的路上迷路了，尽管几个小时前他还在那儿。回到宿舍，他一面对舍友打招呼：“HI，怎么样啊？”又一面在想：“他叫什么来着？”

他的行为像得了老年痴呆症，可他只有17岁。到九月底，他退了课请了家教，但症状依然没有减轻。无奈之下，他只好辍学，他告诉一脸困惑的父母，大学生活不适合他。

安德鲁一直以来都想拿到学位然后在医疗保健中心工作，梦想破灭令他懊恼不已。同样令他烦恼的是第一次要与自己的同胞兄弟詹森分开，詹森也就读于罗格斯大学。在去位于马里兰州父母家的长途路上，安德鲁不停的哭泣。

安德鲁的父母认为他得了焦虑症，就带他去看了精神科医生。医生不能准确的找到问题所在，便把问题归咎于压力过大。但此后安德鲁的行为依然古怪，在说话的时候都不能找到准确的词语来表达。他会在吃完晚饭后问“晚餐吃什么？”。他在熟悉的路上开车会分不清东西南北，在帮别人跑腿的途中又想不起自己为什么要出门。安德鲁说：“这太奇怪了，我从未有过健康问题，我觉得是心理问题。为此我深受打击，而且不知所措。”

安德鲁的妈妈对他的怪异行为感到越来越不安。当他开始出现生理症状，包括无时无刻的口渴和尿频，她才赶忙带他去看了医生。脑部扫描得出了原因：安德鲁得了恶性脑肿瘤，这个肿瘤像桃核一般大小，它压迫了大脑中制造新记忆的部分，如果不及时治疗，后果不堪设想。安德鲁被吓到了，但他也松了一口气，因为他的怪异行为终究是事出有因。

“他主要是得了健忘症，随着人们年龄增大，记忆会逐渐消失，特别是患有老年痴呆的人。”安德鲁的神经心理医生，巴尔的摩约翰霍普金斯医院的David Schretlen博士如是说。

毁灭性的诊断

大脑里的记忆就好比硬盘里的数据。安德鲁在患肿瘤前脑中所“下载”的所有信息（关于自己的一切，车技，和他先前在学校所学）都完好无损。但脑肿瘤损坏了储存新信息的“软件”， 这就是为什么只有在大学这个陌生的新环境里，安德鲁的健忘症表现的特别明显。

医生取出肿瘤的一部分，用放射治疗把剩下的部分消除，安德鲁的身体相当吃不消，体重狂减30磅。癌症消除了，但喜悦如此短暂，安德鲁被告知他再也不能回到学校学习了。他的语言智商高达120，他的记忆输出只有68，和一个发育不健全的人相当。他唯一的职业选择就是在高度监督下的手工体力活。

安德鲁说：“即使他们这样告诉我，我知道我还想要试着重返校园，我不知道我能否做到，但我的的确有这种强烈的愿望，我会尽我所能来寻回我的记忆。”

他的父母担心他无法面的失败，就让他咨询他的神经心理学医生——Dustin Gordon，然后和他的同伴——一位博士后研究员以及他的导师—— Schretlen，一起商量。安德鲁一直在寻找一种重新训练大脑和提高记忆的方法。医生们很少见到意志如此坚决的人，因此他们决定制定策略，来帮助安德鲁在课堂上和学习中获得信息，同时找出让他构建思想的方法，这样一来，他就可以写作了。他必须付出多于常人十倍的努力，如果他不能成功，就很可能被退学。

安德鲁开始先在附近的霍华德社区学院听英语课。最后他发现，阅读至少五遍以上能增强他记住的机率。在学校，他作详尽的笔记，另外还有一个记录器来补充他所遗漏的内容。他每天都要把他的笔记读上好几遍，然后重新打出笔记和教材内容。他每天忙碌十二小时，一周七天，只有在上课，吃饭和健身的时候才有片刻休息。为了记住列表和数据，他用了缩写字和助记术的方法。

他为了下半个学期的学分上课，并且得了A。他说：“我太高兴了，但不知道在其他课程上我的表现如何。”他进了巴尔的摩的马里兰大学，专修卫生政策和管理科学学士学位，每个学期修一门或两门课。

当他找到了在教室里能全神贯注的方法后，日常生活仍然是个挑战。他去商店的时候会随身携带地图和清单，但有天晚上，从巴尔的摩一家酒吧出来之后，他在街上游荡了好几个小时。当他最终找到他的停车位时，已经是凌晨三点了。现在他的手机装上了GPS，并随身携带用来提醒的数码装置。

安德鲁坚持着他的计划，在2007年5月，他29岁的时候，他以4.0的学分绩毕业，获得了巨大的成功，这距离他开展计划已经超过10年了。

6个月之后，安德鲁在巴尔的摩，Catonsville的Erickson退休社区的办公室里工作，他是一名操作员。在面试的时候，他把自己的记忆问题告诉了他未来的老板Russ Caccamisi，Caccamisi说：“对此我并不担心，他在学校里的10年经历已经证明了安德鲁的毅力。”他还在使用在大学里制定的策略，以及电子日历和其他我们都依赖的用来组织我们纷乱生活的工具。安德鲁说：“效果最显著的就是重复和使用多种方法来记住某样东西。我会把它写下来，说出来，录下来然后拿来听。”

当然，不完整的记忆仍然令人沮丧。他喜欢看电影但总会忘掉一些故事情节。他隐隐约约记得去夏威夷的家庭旅行，但又向父母证实他们应该是回来了。然后是他最爱的红人队，即使他记不住比分， 但他能告诉你他们是不是赢了，如果输了怎么办呢？他说：“有时候，忘记也是件好事。”

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