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Although it was repeated ad nauseam that we were going to come out of Covid better, and although many people think just the opposite, the neuropsychologist Saúl Martínez-Horta maintains that we have not come out worse either: "We are what we are".

And what are we exactly?

"I think we all know what, when we close the door and no one is looking, we think, do, wish, etc., and that reality is normality;

. In the world in which

that we live nobody t

He takes drugs, nobody goes with prostitutes, nobody watches porn... We know that reality is different and absolutely nothing happens.

That's normal."

No half measures.

And there is more: "We are a species that when things work from the point of view that we have our needs covered and we don't feel attacked or harassed, we behave according to the rules where everything is fine, but

and that is a reality.

It is very nice to say that we are very concerned about the Iberian lynx or anything else, it is correct and we must do it and say it, but the human reality is something else.

What we have seen with Covid and what we see constantly throughout the history of humanity is that when things happen we see a reflection of our reality, of who we are.

And nothing happens,

", Add.

That makes us capable of the best and the worst, as they say.

From a young woman who lies and pretends to have a neurological disorder, amnesia, which prevents her from remembering anything about her past and current life;

even a man who pretends that he is sick, when he is not, so as not to scare her wife who is sick by taking her to the consultation.

And all this with full cognitive capacity.

When something breaks in the brain and we lose certain functions, sometimes even the awareness of who we are, as well as the best and the worst, unlikely and wonderful things can happen.

This specialist tells us about all this in his first book that has just come out,

(Kailas Editorial), a compendium of some of the cases he has seen working in the Movement Disorders Unit of the

Hospital of Santa Creu i Sant Pau

and in the Department of Neuropsychology of the

Neurocognitive Diagnosis and Intervention Center (CDINC)

from Barcelona.

Cases that he has chosen for a double aspect: "On the one hand, from a neuropsychological perspective

.

And, on the other, by an almost pedagogical component to the

", explains Martínez-Horta. That impact led him to write threads on Twitter that gave rise to this book.

What exactly is a neuropsychologist?

dropdown

We all understand the role that a psychologist or psychiatrist plays.

Also that of a neurologist, but what exactly is a neuropsychologist?

"It is true that in Spain he is a lesser-known figure. He is a branch of psychology that focuses on how to understand cognition and human behavior from the study of the brain and traditionally focuses on the study of brain damage,

", explains Martínez-Horta.

In other words, the neuropsychologist is the specialist who, when a disease in the brain is suggested or when it is known that there has been damage to the brain, evaluates what the consequences have been.

"I usually say in a simple simile that what the optometrist is to the ophthalmologist, perhaps the neuropsychologist is to the neurologist. The neurologist is going to deal with a possible brain disease, but

", adds the specialist.

Not many of them, yes, with a happy ending.

"Unfortunately we are dedicated to neurodegenerative diseases, by definition, it is difficult for the happy ending that we would all like to happen. But I have seen happy endings. I think that those of us who dedicate ourselves to this have to change our way of understanding what it is to do well things:

.

If I understood my work as simply helping to diagnose the disease and I went home, this would be very simple.

I like to try to contribute something to the families of patients, a place from which to understand why things happen, a place from which to anticipate and

.

For me that is a good and beautiful result", she underlines.

For most people, thinking of a happy ending in cases of dementia, Alzheimer's or Huntington's disease, Parkinson's,

primary progressive aphasia

... it seems impossible.

They are pathologies that terrify us because they take everything away from us, that's why

so i can get out.

Martínez-Horta adds another fear: loneliness.

"When people are still well, one of the most excruciating fears they often have is not that they stop being who they are, but the certainty that the world will abandon them when they stop being who they are. The feeling of

, I will not realize it, but I will be isolated', it is a fear that is there".

That is why the neuropsychologist emphasizes the value of preparing for what is to come and dignifying the process, important to understand the 'happy ending'.

Like Joan's, the only patient with a real name in the book (in addition to asking permission, the names are invented so that the patients cannot be identified).

Joan is the last story in the book, that of someone whose illness would have a

.

"Joan's entire process, not the day of euthanasia, emotionally it was a catastrophe, although in the end it has a happy ending in quotes, it is the calmest day I saw it. I recently spoke with her mother because I write to her regularly to know how they are and it is very reassuring to see that they are well, the peace they breathe".

Few requests for euthanasia

Is it usual for people with this type of disease to request it?

Martínez-Horta assures that in the year and something that legalized euthanasia has been in Spain it has not ceased to be a

.

"The person is lucid when he thinks about euthanasia, but when that moment comes he hasn't been for a long time. And then everything has changed a lot, including his decisions, and

It is very complicated, but in any case there are not so many cases that request it.

Yes, there are many people who are informed, but full requests are few."

How to get involved, but doing it right and not taking all that home is not easy.

The specialist points out that there are professionals with a very cold personality who are capable of doing an excellent job without being shocked and others, as in his case, who are impressed and moved.

"My father always asked me if seeing so much pain and death didn't cause me problems and I told him 'no, it doesn't do anything', but it was a lie, I didn't realize it. It's not about learning not to take it home or that does not affect you,

.

It is true that if you do not do some kind of management with this,

.

After experiencing a very powerful emotional situation, something as simple as taking a break, going out for a walk, thinking about my family or things I like, like surfing, works for me.

Thus, he confesses: "

.

I guess the context helps you, you feel like

, when you are communicating to a father or mother that their child has inherited a genetic disease that has ended the life of the entire family and that we are not going to be able to do anything, the reaction you experience is brutal.

They see that it affects us, that this impresses us a lot, I don't cry or collapse there, but as I was saying, I need to stop for a moment after situations like this".

Memory and aging

One aspect that Martínez-Horta insists on a lot in the book is how

.

"There are diseases that are more prevalent in elderly people, but they are the diseases, when memory or any other cognitive process is impaired, it is not age. Worsening cognitive capacity when getting older is something expected, but within certain limits It's the same as becoming slower, it's expected, but being in a wheelchair all of a sudden is not expected."

We normalize that the grandfather is very old and therefore 'he has those things' or 'he is losing his mind'.

"Yes

, we are making a complete mistake because we are not providing what these people need". And this in an increasingly aging society in which almost all of us are going to grow older (the alternative is not desirable).

Therefore, according to the neuropsychologist, it is important to influence the

.

"Understanding, on the one hand, all the environmental factors that allow us, in some way, to modify the risk of developing such a disease, such as diet, hypertension or stimulating the brain,

: use your head, socialize, have habits that are not always exactly the same routine and incorporate new things..." But also, he highlights, it goes through the

and anticipate severe cognitive changes, "but if we trivialize and normalize situations we do nothing".

From a certain age, revisions

In that sense, he defends making controls and revisions.

"If I don't have freckles or strange spots, it doesn't make much sense for me to constantly go to a dermatologist, but it does make sense for me to get a check-up from time to time. With the same brain,

.

There we would take many surprises, we may request extra tests and we could modify some problems.

In addition to the tests, the neuropsychologist's experience allows him to see if the tasks give normal scores, at the expense of what or how the person manages to perform and if something fails.

That is why "having a check-up is worth it, without fear, it must be normalized, because on many occasions what is behind it has nothing to do with a brain disease".

Namely,

.

The specialist emphasizes that there is

that can contribute and explain that human cognition is altered, some "closely related to the life we ​​lead, with the

that they may have prescribed us, with endless things".

Here the environment becomes very important.

Sometimes one is not aware of these changes, in fact, in some disorders delusions occur or people are convinced that they are dedicated to one thing or do not have children when they are truly dedicated to another or are parents.

For those people it is their reality.

"From his world everything is fine, but from his environment everything is wrong, when talking to the wife or the mother. Many times this information, and more so in this type of patient, does not come from one's conscience, but from what that those around them are realizing", emphasizes Martínez-Horta.

Although much progress has been made in recent years in its study,

.

We may never get to unravel its secrets and what happens so that one day it 'breaks'.

Yet the brain is so prodigious that it adapts to changes and forms new connections (

is named).

"It has an immense capacity for reorganization, for compensation, for managing to find ways, routes or even alternative processes with which to continue performing a certain function well or practically well, despite the fact that it is being damaged," says Martínez-Horta.

So

.

In the book, Martínez-Horta recounts, among other cases, that of a woman who studied, worked and had led a fairly normal life, but as she grew older she presented some problems.

The neuropsychological examination revealed no problems, but her MRI revealed extensive hydrocephalus: her brain had slowly refilled with fluid over the years, so slowly that her brain had adapted.

Also that of a man with atypical parkinsonism, completely demented, who did not recognize the woman with whom he had been married for a lifetime, but who had asked her to marry him because, even without knowing her, he said that he knew she was the woman of his life. .

And the rest of the stories and unlikely moments will have to be read by you.

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