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Ghajini and Loss of Memory
Dr Alok Ranjan
 
Amir Khan’s Hindi Ghajini is a remake of Suriya’s Tamil Ghajini, which is a remake of Christopher Nolan’s Memento. And yet, the movie raked in money, third time round.
 
movie raked in money, third time round. The Hindi film’s disclaimer says that because their film’s protagonist suffers from a little-known medical disorder called anterograde amnesia, it is likely that their story could feature elements common to other stories and films. Ok, so apart from not wanting to own up to any “inspiration”, does this also mean that it is common for people suffering from anterograde amnesia to tattoo their bodies or scribble reminder notes on walls, and to take Polaroid pictures of people they want to remember beyond 15 minutes?

According to what one sees in the movie, the protagonist Sanjay Singhania’s (Aamir Khan) anterograde condition kicks in every 15 minutes, which means he remember things for a limited timeframe of 15 minutes only. His memory needs refreshing after that time limit, therefore the tattoos, the scribbled notes and the Polaroid shots. He doesn’t actually remember his girl - Asin’s - death. He comes to know of it when he reads the tattoos on his body every morning after he wakes up.

Now here start the list of questions: How does he remember to read or write out those notes? How does he remember to take Polaroid pictures? How is anterograde amnesia different from amnesia and how are the two different from Alzheimer’s, which also causes memory loss?
Most importantly, if the guy can’t remember anything beyond 15 minutes, how the heck does he remember he has anterograde amnesia? Of course, he has his scribbled notes and tattoos to rely on when he gets up in the morning, but he does spend quite some time outside his house – spells that go far beyond 15 minutes, trying to track down the killer.

Surely, he can’t access his notes outside his home? But he seems extraordinarily well able to cope with the city layout and traffic for someone who can’t remember anything at all beyond 15 minutes. Now these certainly seem to be inconsistencies with either the story logic or the film-makers’ interpretation of the condition of anterograde amnesia.

We decided to delve deeper and directed our queries to Dr Alok Ranjan, Consultant Neurosurgeon at Apollo Health City, Hyderabad, and here’s what he has to say:
Memory loss is a symptom that can be variable in magnitude or in duration, i.e., it can be temporary or permanent, and can last from a few hours to some years. There are two major types of memory loss caused by disease or injury to the brain. These are:
  • Anterograde amnesia, which is  the inability to store or recall new events and information pertaining to those occurring after the moment of brain damage. Patients with anterograde amnesia typically struggle to remember day-to-day events, but have less difficulty remembering events from their childhood.
    Anterograde amnesia can occur following damage to at least three distinct brain areas. The first and the most well-studied is damage to the hippocampus in the medial temporal lobes of the brain. The hippocampus, which seems to be important for new learning ability and recent memory, acts as a "gateway" through which new facts of information must pass before being permanently stored in memory. Any damage to the hippocampus impairs new information that cannot now enter the gateway, but older information that has already passed through remains safe.
  • Retrograde amnesia is the inability to recall events and information that occurred prior to the moment of brain damage, which is different from anterograde amnesia where the patient forgets things after the brain damage. Patients with retrograde amnesia cannot recall events with variable durations of the past, depending on the severity of the damage.
So how is this different from the Alzheimer’s disease which too causes loss of memory?
According to Dr Alok Ranjan, Alzheimer’s disease causes dementia that worsens progressively. The condition involves death of neurons or nerve cells in the brain, and differs from anterograde amnesia in respect that it is progressive, eventually leading to complete loss of memory. Also, anterograde amnesia is induced by a trigger such as head injury, whereas Alzheimer’s does not have a trigger, but is associated with gradual physiological breakdown of the brain that is irreversible.

As regards treating memory loss, many cases of temporary memory loss resolve without treatment after a period of time. These mostly pertain to incidents caused by mild to moderate head injuries. But in cases of greater memory loss, apart from medication, patients are advised use of memory aids. These can include using beeping watches or sticky notes as reminders for certain tasks.

So that explains Ghajini’s scribbled notes. But surely, if the tattoos were an excuse to showcase Amir’s six or eight packs, then they did a pretty good job of it. (Seriously, apart from doing some 2,300 push-ups and ab crunches a day, what else did Amir do to get a body like that?!)
And Dr Alok confirms that the time period of fifteen minutes for the memory loss is pure cinematic license. The process of remembering something is completely based on internalizing an event so it becomes a memory. Now whether that memory remains, and if it does, then for how long it will remain, is very variable.

For instance, if a name or a sequence of numbers like 15-28-73-108 is continuously repeated by the person, it will stay in memory until broken by another new sequence. This is because when a new sequence is given, it affects what the person was earlier trying to memorize. This is the reason, writing out notes is recommended for people trying to cope with anterograde amnesia.
Aha, so the tattooed notes do have a rationale after all, apart from serving to showcase Amir’s body!
Dr Alok Ranjan is Senior Consultant Neurosurgeon, Apollo Health City,
Hyderabad

  
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