Science & the Brain: You don’t know what you got till it’s gone

Editor’s note: On this Thanksgiving week, here’s a story that brings a message of being thankful for what we have. Hannah Newman is a Middlebury College senior who has been writing neuroscience-related pieces for the Addison Independentfor the past two years. While this story is about a condition called prosopagnosia, it also has a personal message to fit the occasion.
In her 1970 hit, “Big Yellow Taxi,” Joni Mitchell sang it: “don’t it always seem to go, that you don’t know what you got till it’s gone.” Forty-two years later, Tara Fall, a 37-year-old Monticello native and current California resident, is living Mitchell’s message.
Tara Fall was diagnosed with epilepsy in 11th grade. She managed her life with antiepileptic drugs and the support of her family and close friends. Four months after giving birth to her second child, Tara’s epilepsy took a turn for the worse. She failed to come out of a seizure in good health, and in 2002 she realized that either “the seizures would take my life or the surgeons could take my brain” — she chose the latter.
In October 2002, Tara underwent surgery to alleviate her seizures. At the very end of the procedure, she had a stroke.
The stroke took everything. When Tara awoke from surgery, she couldn’t walk, talk, taste, touch, hear or see. After 18 months of rehab, Tara was left with complete hemianopia (loss of 50 percent of her vision) and face-blindness (otherwise known as prosopagnosia).
Prosopagnosia is the inability to recognize familiar faces. It is not a result of a problem with the visual system; Tara’s ability to recognize objects and individual facial features remains intact. The ability to recognize faces is processed in a separate and distinct area of the brain. This facial-processing network stars two key players: the fusiform face area (FFA) and the occipital face area (OFA). Tara’s stroke damaged her FFA, causing her prosopagnosia.
Not long after her stroke, Tara decided to change her look. Armed with a new haircut and color, Tara proudly strolled through the mall eager to enhance her recovery with some retail therapy. As she walked through the mall, she noticed a stranger coming closer and closer. She fidgeted, her heart raced, and her palms were sweating. Agitated, she turned to confront the stranger, but found no one there. Tara had been starting at her reflection.
She had no trouble identifying that the stranger had a face made of individual components, but she failed to recognize the face was her own. Determined to confront her inability to recognize familiar faces, Tara developed an arsenal of coping techniques.
Tara now spends her life playing detective. Every interaction is a mystery, a puzzle to be solved. She is hesitant to use names, and the first few minutes she meets a person are anxious; she spends a lot of energy trying to match unique characteristics she has memorized about individuals to identify the person sitting in front of her. She uses these memorized cues to solve the facial recognition puzzle staring back at her.
“I have a great memory for other details,” says Tara, suggesting things she looks for. “You always wear bright blue nail polish, your tone of voice, hair texture, and skin tone.” This is no easy task, and Tara admits that she finds herself gravitating to those who are unique. It is easier to cling to people who she knows she’ll be able to find again.
While prosopagnosia impacts her life, she says it hasn’t changed her personality. Tara has always been a go-getter. She describes herself as someone who has “always been one to embrace the world and squeeze it.” Acquiring prosopagnosia has made her cling to this personal philosophy even more, and here is where we all need to stop and pay attention.
We don’t have to lose our ability to recognize the ones we love (or the ones we just met) to take time to appreciate our world and those who inhabit it.
“I wish that people wouldn’t have to lose things or not recognize things or miss things to truly find the beauty in it,” Tara told me. “Slow down. Our society moves way too fast. Take a moment and really cherish everything you have in front of you today.”
We live in a society that tells us we don’t have the time to stop and acknowledge those around us. We are so focused on our next goal — the next destination — that we forget to appreciate the journey. We’re so wrapped up in attaining instant gratification that we fail to retain the process of how we got to that point.
It doesn’t take long to stop and ask someone how they are. This gesture is nothing big, it doesn’t inhibit — but, in fact, it may actually make someone’s day brighter. “Most of us have a two-minute break where we can stop and breathe, look someone in the eye, and say, ‘good afternoon,’” Tara said.
Tara’s story is inspirational, but more importantly, it highlights one woman’s effort to change our society’s fast-paced life. Tara’s acquired prosopagnosia left her with an inability to recognize familiar faces, but an ability to recognize a familiar problem. The journey may be more important than the destination — and the people we meet along the way need to be acknowledged and appreciated.
So, let’s slow down. Let’s take a second to open the door for a stranger, engage in arbitrary conversations, and ask someone how he or she is doing — and actually show an interest in their response. Impacting lives isn’t difficult, and it shouldn’t take losing everything for us to realize that we have this ability. This is Tara’s gift to us.
Tara has reminded me that most of us take facial recognition for granted. We all have the ability to stop and recognize someone and use this information to make a positive impact. We have the power to prove Mitchell wrong — things don’t always have to go the same way. We shouldn’t have to “know what (we) got till it’s gone.” 

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