You Are the Music: How Music Reveals What it Means to be Human (21 page)

The fact that music memory lasts well for a lifetime is the basis for the popular radio format where a well-known individual tells the story of their life through their favourite music, for example the BBC Radio 4 programme,
Desert Island Discs
. Listening to an individual’s memories told partly through their musical choices provides a unique insight into a person’s experiences but also their personality and outlook.
Over our lifetimes, music becomes a part of who we are because it interweaves so well with our episodic memories for events and people.

In this section we have seen some of the true capabilities of musical memory. It may not be the most reliable memory system when it first hears a piece of music but, given time, it can build durable and long-lasting musical memories that easily mix with our life experiences to become a central part of who we are as people. In the next section I will look at the power of musical memory from a related angle: its ability to survive.

‘The Survivor’

To anyone who has cared for an elderly individual it will come as no surprise that musical memory can often survive when other aspects of memory begin to fade. I have heard many heartwarming stories of individuals with dementia-related illnesses or Alzheimer’s who find comfort in music and who may even manage to retrieve memories in its presence that otherwise appear to be lost.

A favourite anecdote that has stayed with me for a while (such that I cannot recall the source, I am afraid) was of a gentleman in a care home who had become largely immobile and very quiet. Most of the time he sat in his chair or lay in bed simply staring: it had been a while since any of the staff could remember him engaging in conversation. The man valued his privacy and preferred the door to his room to be closed during the day. The nurses were happy to oblige his wishes; they would always knock before entering and wait for his permission to enter.

One day the staff nurse became worried as the man did not respond when she knocked on his door. She tried once, twice, three times. No luck. At this point she decided to go in and make sure he was okay. She was greeted by the sight of
him dancing round the room and singing to ‘Rock Around the Clock’ by Bill Haley and His Comets. Apparently a cleaner had left their radio in his room by accident during morning rounds.

From then onwards the nurses made sure that the man had access to music that he liked. He was still a quiet man but the music often put a smile on his face and encouraged him to chat more with residents and staff. A small difference perhaps, but a positive effect nonetheless.

At this point I would like to make it clear that music is no ‘magic bullet’ or cure for memory loss. Some individuals will never respond to music and others may prefer silence. The point rather is that musical memory can often survive even in extreme cases and can therefore be a method by which to reach someone who has suffered memory loss.

Perhaps the most compelling case of musical memory survival is that of Clive Wearing. In the early to mid-1980s Clive was reaching a high point in his career as a musicologist, keyboardist, singer and conductor. He was the choirmaster of the London Sinfonietta and director of the London Lassus Ensemble. He was a well-respected researcher and expert in early/Renaissance music and was given the prestigious role of managing the music for BBC Radio 3, a UK classical station, on the day Prince Charles wed Princess Diana. Clive was himself newly married to his second wife Deborah.

According to reports, sometime in March 1985 Clive fell ill with a headache and flu-like symptoms. His doctor prescribed painkillers and advised him to rest. His symptoms rapidly worsened and he was found wandering the streets in a confused state. He was taken to hospital where he began to experience seizures and fell into a coma. A brain scan revealed the terrible truth: Clive had contracted herpes simplex encephalitis, a rare but severe virus that attacks the central nervous system from within the brain.

While in a coma, Clive’s brain swelled with infection and was crushed against his skull. For most people this condition is fatal, so doctors were pleasantly surprised when Clive awoke from his coma. However, it quickly became apparent that all was not well. Clive remained confused and did not seem to remember anything about his life. Such confusion is not unusual after a prolonged period of unconsciousness but Clive did not show any signs of recovery as the weeks and months went by. His wife Deborah has said since that ‘the virus caused a hole in his brain and all the memories fell out’.

The swelling in Clive’s brain had deprived several vital neural structures of oxygen and the cells had subsequently died. The most severe damage was within the frontal lobe and the brain areas that support memory function. Like many with frontal lobe damage, Clive’s personality changed and he experiences waves of emotion and anxiety that he is unable to control. Unlike most people, however, Clive has a deep and dense amnesia, or memory loss; arguably the worst case in medical history.

As a result of his illness Clive has lost the majority of his life’s memories and is unable to make any new ones. These conditions are known as retrograde and anterograde amnesia, respectively. In reality this means Clive has little to no idea of his past or conception of the future. He is stuck in a time window of a few seconds – the present moment. You can ask him a question but by the time he gets a few sentences into his answer he will have forgotten what you said. That is the length of his memory span.

Two things seem to have survived this dreadful destruction, nearly 30 years on: Clive’s love for his wife Deborah, and his music. There have been a few documentaries of Clive over the years and if you watch one you will see that he greets Deborah with joy and rapture whenever she walks
into a room, as if he has not seen her for years, even if she has just stepped out to make tea. And Clive still enjoys playing the piano.

The videos I have seen show Clive playing from a musical score, so even though he may not be able to play from memory any more (no one has ever confirmed to me that he can) he retains the memory of how to sight read music. He also plays with emotional inflection, showing that some of the techniques he once learned about the art of musical performance remain with him: all this despite having no episodic memories of his musical training or his illustrious and successful musical career.

Clive may be an extreme case of memory loss but he is not alone. In 2012 Carsten Finke and collagues
²⁴
reported the case of an amnesic cellist. The German patient, known only as ‘PM’, suffered from the same rare illness as Clive and also had severe damage to his memory. His doctors had no idea that he could still remember music until he was spotted playing his cello at home by neighbours. PM had not wanted to play for anyone since his recovery: he felt he was no longer very good. This fact alone suggests that PM had some memory, deep down, for his previous musical abilities.

Spurred on by this discovery, the doctors carried out tests on PM’s musical memory to see which elements may have survived. They played him two pieces of music at a time and asked him which he recognised. One of the two pieces was always a well-known concerto or sonata that he would have heard before his illness, such as the first movement from Mendelssohn’s Violin Concerto in E minor (1843). The other was a more recent piece, similar in style and instrumentals but composed after his illness, such as the Andante/Reflection piece from Max Richter’s
Waltz with Bashir
soundtrack (2008). PM successfully identified 93 per cent of the older pieces of music.

The doctors then played PM the new pieces later that same day. Even though he had no episodic memory of having heard them before, he was able to identify 77 per cent. This result suggests that not only has PM retained memories of music from his past but he is also capable of learning new music. This latter ability has been described as ‘astonishing’ by his doctors.

Finally, just to show that tales of music memory survival are not limited to cases of herpes encephalitis patients, Séverine Samson and her colleagues have reported relatively spared memory for music in two different brain disorders, medically intractable epilepsy and Alzheimer’s, despite both populations having severe verbal memory impairments.
²⁵

The burning question is: how and why does musical memory survive in these and other cases of memory loss. Is musical memory special?
²⁶

There are a number of reasons to suspect that the answer to this question is ‘yes’. Some of these reasons have to do with the memorable structure of music, which I have already outlined in the section on musical memory as ‘The Star’ (
page 171
). I also believe that musical memories survive because of the way they are processed in our minds.

Firstly, for many people music is a motor skill (as for Clive and PM), like riding a bike. Not a great deal is known about what happens to memories when a skill moves from requiring great demands on our attention and focus (when we first learn to walk or drive a car) to being more automatic; from being conscious to non-conscious. But we do know that memories move from the systems that demand heavy resources, episodic and semantic memory, into the more lowdemand implicit memory system.
²⁷
This means that when music becomes a skill, when it becomes a habit, it gains a great deal of power in the mind in terms of longevity and resistance to decay.

For someone who has had a degree of musical training, musical memory also becomes partly procedural – a term used to refer to the motor- or movement-based aspect of memory. Amnesia and other memory disorders are characterised by the loss of conscious memory processes while the implicit procedural memory systems are, by comparison, spared.
²⁸

Clive and PM may have lost access to the episodic memories of their music lessons and careers but they do not need to access these conscious memories in order to be able to play their instruments. The rest of us do not need to remember our childhood cycle lessons in order to be able to ride a bike.

Another reason why musical memories survive is again linked to the implicit memory system but has to do with emotional reactions. Our emotional responses to music are often formed through conditioned responses; for example, I am more likely to have a positive emotional reaction to music in a major key as my memories of happy music, as a Western tonal music listener, have been mostly linked to music in the major key. Conditioned emotional responses such as this also tend to survive in memory disorders.

There are some physical clues in the brain as to why the implicit memory system survives well in extreme cases of memory loss. Emotional reactions are at least partly driven by the activity of central brain systems such as the amygdala. In previous chapters we discussed how amygdala activation has frequently been measured in response to hearing emotional music.

The amygdala, with its central location, has a higher likelihood of surviving brain damage as compared to an area such as the frontal cortex when it comes to brain swelling or a blow to the head. Therefore an individual may lose the conscious memories of why a piece of music causes them to feel a certain way (thanks to the destruction of areas around the
frontal cortex) but still experience the core feeling (thanks to the activity of the amygdala).

So, to sum up, apart from the nature of music itself, musical memories survive at least in part because music activates brain systems that 1) are more likely to survive the more common types of brain damage, and 2) drive non-conscious and conditioned implicit responses to stimuli, such as motor and emotional behaviours. Musical memories really do, in every sense, become part of our inner being.

‘The Miscreant’

So far in this chapter I have talked about the great and good of musical memory; the natural learner and the strong survivor. In the interests of fairness and giving a balanced view, it is only right that I finish this chapter with a discussion of the naughty side of musical memory.

Ever had a tune stuck in your head? A little ditty or perhaps even a longer song or musical piece that goes round and round in your mind’s ear? If the statistics are right then over 90 per cent of you should be nodding ‘yes’ at this stage.
²⁹
If you have never experienced a tune stuck in your head then you are in rare company. Some people experience repeating music in their minds so frequently that they claim to have an almost constant musical soundtrack to their daily lives.
³⁰

We currently refer to this phenomenon as involuntary musical imagery, but in everyday lingo it is most commonly known as an ‘earworm’, a translation of the German term
Ohrwurm
. This experience has had many labels in the past, including ‘brain worm’, ‘sticky music’,
³¹
‘cognitive itch’
³²
and ‘stuck song syndrome’.
³³
In my lab, day in and day out, we call these stuck tunes earworms, so I will use that term from now on. Let’s blow a few false assumptions out of the water first.

Fact 1:
Earworms are not always annoying. When you first ask people about their earworms they will often tell you about
the experiences or episodes that get on their nerves. However, if you look at large population surveys or take diary studies of people’s reactions at the time of each episode, you find that the majority of earworms are actually not bothersome (rated as ‘neutral’) or are even enjoyable.
³⁴

In my own research I ask people how they control or try to cure their earworms. I have a sizeable number of responses that say something akin to ‘Why would I want to control my earworms? They don’t bother me and sometimes they keep me company.’

Fact 2:
Earworms are not always pop songs or jingles. As much as the advertising industry would like to believe that we only get short, catchy tunes stuck in our heads, I can give you hundreds of examples of people who get complex music stuck in their heads, including classical works, modern jazz and new age music. It is true to say that the majority of earworms that I have been told about to date are melodic, vocal and simple, but to deny the existence of other kinds of earworms would be to ignore important information about the possible causes of the experience.