A legion of lesions in his brain

A 50 year old businessman with a bachelor's degree in theology from the Baptist University of America and a doctorate in theology from Bob Jones University was brought to the emergency room by his friends because of severe progressive memory problems.

At baseline, the patient had normal cognition, exercised regularly, and maintained an active schedule, driving himself to appointments with friends and business associates. Ten days prior to admission he met a friend for lunch and had a normal, clear, precise conversation, except that he did remember the name of the hostess, whom he had known for years. Four days later, the same friend spoke with the patient on the phone and discovered that the patient had no recollection of having lunch or in fact any of their conversation. He seemed normal otherwise. The next day the patient missed an important business meeting. When the patient's son contacted him over subsequent days, his conversation seemed appropriate except that he was totally unaware of current events including the BP oil spill.

On examination patient was normal except for profound problems with recent memories and milder problems with remote memories. He said the year was 1990 and realized he was in a hospital but did not know which one. Attention and immediate recall were normal with a digit span forward of 7 and backward of 5. He was able to repeat three words immediately when asked to memorize them. After 5 minutes, however, he did not even recall the task, and he got zero out of three words correct even with multiple choice. When the examiner left the room and came back 5 minutes later, the patient had no recollection of having met him before.

One week later, the patient had no knowledge of recent current events and was completely unaware of the highly publicized health care reform bill signed by President Obama. More remote memory was better but still not perfect. For example, he was able to describe his hometown, childhood, family members, marriage, and the fact that he had left his religious beliefs behind and become an agnostic-atheist. However, he could not recall let alone formulate any logical reasons or give any sort of evidence for why he no longer believed in God. When he tried to offer reasons for no longer believing in the existence of God, he was surprised to hear that his objections had already been answered years ago. With some prompting, however, he was able to generate a couple of names in response, although he couldn't do much more than name names: Dawkins, Hitchens, Dennett. In addition, he confused John Loftus with a cowboy in Brokeback Mountain, Dan Barker with the former host of The Price Is Right game show, and Ed Babinski with the Chacma Baboon.

There was also an increasing tendency to confabulate. For example, when asked why he was in the hospital, he said he was "here to research the connection between religious experiences and brain science." When asked if anyone had visited him while he was lying on the hospital bed, he mentioned several prominent atheists including Robert Price and Richard Carrier, despite having had no visitors. He reminisced about going through NT manuscripts looking for errors with Bart Ehrman. When Ehrman was contacted, he had no idea who the patient was.

At this point his mental status exam results were within normal range but gradually falling. That is, although he had a normal attention span, pleasant affect and behavior, normal language, average calculations, slight but not significant difficulty with elementary reading comprehension and writing, as well as interpretation, and normal drawing of three dimensional objects, his condition began to worsen.

As his condition progressively and then severely depreciated over the next several weeks, he reached and then crossed a critical threshold when he no longer perceived himself as a human being. Instead he thought he was an ox and began eating grass and straw. He spent his days in the hospital courtyard, with his head planted in the soil. At first the hospital orderlies attempted to bring him inside, but, when physicians and other staff determined he could not be restrained without routine difficulty and more importantly there was no harm to the patient involved in leaving him outside during daylight hours, they left him alone during the day and brought him back when he was tired at night. Eventually he became unshaven and unkempt. His hair grew as long as eagles' feathers, and his nails were like birds' claws. Finally, the epidermal layer of his skin metamorphosed into something resembling straw.

In short, he went from this:



To this:



Perhaps because of too much of this: