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Creativity, the brain, dementia

In 2010, I became my mother’s caretaker. My father had just passed away, at age eighty-nine. They were still living in their home, so I got the house ready to sell, and moved my mother, who was eighty-eight and suffering from some dementia, into an elder care facility.

I never had Mom diagnosed for the kind of dementia she was experiencing, but she hit most of the Alzheimer’s early stage predictive symptoms: she repeated questions multiple times, called me time and again with the same information or questions, would hold onto incorrect information for dear life, left things on her stove with the burner on, etc. Fortunately, the facility she was in was set up for this kind of behavior, and they took most of it with professionalism and good humor (except the stove, which they turned off permanently).

But she was also still capable, at this point, of enjoying social activities, and was frequently the life of the party at dinners we had at my home. And, after some time went by, I heard from the people running her facility that she was entertaining residents at dinner by playing the piano!

Now, Mom was a very accomplished pianist in her younger days, easily making her way through Frédéric Chopin’s gnarliest pieces. She was my accompanist for all my high school competitions, repertoire that was far from easy. But, I hadn’t heard her play in years, even though the same Kimball piano was sitting in her living room when I began to prepare the house for sale that had been there since my childhood. So this was a revelation, of sorts.

After she had been there a few months, the staff asked if I’d bring my violin and do some pieces with Mom for a little show they were putting on. I agreed, and went over to her place to practice. But, unfortunately, the repertoire (some Broadway musicals) wasn’t familiar to her (she knew the songs, but couldn’t jump from that to actually playing them), and she no longer had the ability to translate what musicians call sight reading into something performable. And doing things like repeats, which would necessitate quick page turns, was completely beyond her ability or understanding. So, I brought in a pianist friend so the show could go on. Mom seemed relieved.

Over the next two years, her brain continued to degenerate, and she slid into extreme paranoia. We had to move her out of her facility and into one designed for cases such as hers, where over the next several weeks, she freaked out with anger and resentment. I went to visit her the first night she was there, and found her in the cafeteria.

She was picking at her food, looking angry, blaming me for this new turn of events that she had no way of understanding. However, there was a piano at one end of the room, and without saying a word, she got up and went over to it and began to play “Country Gardens”, a folk song arranged by Percy Grainger.

So. Through all the pain, anger, confusion, and just plain unfairness of life, somehow that urge to recreate had pushed its way through to her consciousness. I say “recreate” because, as performing musicians, we’re not really creating in the purest form of the word. Our job is to interpret, and in that way give a new spin on an idea someone else created. But still, my mother’s feat was pretty mind blowing. For all the deterioration her brain was experiencing, something was still making a connection and attempting to communicate…what? Or maybe she just had to connect with something familiar, and was reaching back through time to a place where she was in control. In my mind, that is creating - conjuring a situation where things are more to your liking.

Alzheimer’s is a disease of the left side of the brain, the side that deals with language. The right side handles our social cognition, and can be affected by frontotemporal dementia, a less common type of dementia that will eventually destroy the sufferer’s ability to speak and connect with others. Either one of these diseases can be devastating to the patient and anyone in their first or second party relationships, typically about 150-200 people. Clearly, creativity will be one of the casualties of both of these conditions.

However, in frontotemporal dementia (FTD), some patients have exhibited explosions of intense creativity, as their loss of language progressed. Sometimes, ironically, poetry and other kinds of wordplay such as punning became important. But more often, the person would exhibit visual creativity that they may never have shown an interest in before the disease.

Artwork by Anne Adams, who suffered from frontal-temporal dementia.

It may be that when a person is experiencing FTD, their inhibitions controlled by the frontal lobes (e.g. “I could never be an artist”) are dampened, it occurs to them to create, and in fact, creating becomes essential. The ones with more atrophy in their left temporal lobe, which controls speech production, were the more artistic group when compared to people with no brain atrophy. This suggests that somehow, speech production inhibits our artistic and creative impulses.

It could be that our self-talk, which is often negative and self-critical, is shut down in FTD, and therefore there’s nothing standing between ourselves and the urge to create. Could this be a hint that we’re missing out on a lot of creative problem solving because of the way we think of ourselves and our fear of how others will regard us? Is our desire to belong holding us back from becoming our best creative selves?

I would not wish this disease on anyone. However, this could be a fascinating revelation in how we progress as a species, and one of the best arguments I’ve yet heard in putting the arts front and center in childhood education, something I believe is currently lacking, at least in my experience in the United States. Children who learn to create - confidently, freely and joyfully - may grow up to help move humanity forward in ways we can’t yet imagine.

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