Episode 004 — Cognitive Prosthetics
Welcome to the only Podcast on the web featuring a physician, Dr. Bill Thomas (@drbillthomas), and musician, Nate Silas Richardson, who team up for the #AskDrBill Show. (Click here for download and subscription links)
Dr. Bill and Nate are the stars of the non-fiction theater performance Aging: Life’s Most Dangerous Game as part of Dr. Thomas’ Age of Disruption Tour.
Each episode features intimate conversations, music, updates from the Age of Disruption Tour.
In Episode 004, Nate and Dr. Bill discuss the concept of cognitive prosthetics. Learn about how Nate and Dr. Bill take advantage of this while performing on stage. Dr. Bill explains the ways we are already using a sort of cognitive prosthetics in our own lives.
As a bonus you may even be able to break into Dr. Bill’s high school locker!
Complete Episode Text
Dr. Bill: Hey, everybody. This is Dr. Bill Thomas.
Nate: And Nate Silas Richardson.
Dr. Bill: And if you’re looking for the “Ask Dr. Bill” podcast, you have found it once again. We’re so glad to have you. Really thankful for the time you invest in listening to Nate and I talk about stuff that really fascinates us and hopefully interests you. And today, we have a topic you probably have not ever heard a podcast on before. It’s called “Cognitive Prosthetics.”
Nate: What the heck are “Cognitive Prosthetics”?
Dr. Bill: Well, the thing is, everybody knows prosthetic legs and arms. You’re missing a leg, “Oh, no. I’m missing a leg.” And then you can get a prosthetic leg, which nowadays can be really awesome. It’s not the same as having your regular old leg back, but can be good. Prosthetic arm, prosthetic hand. So we’re used to this idea of making parts.
Nate: I thought that was called “bionic”?
Dr. Bill: Well, it kind of is bionic. If you really want to know the term, it’s like you become a cyborg. You’re a combination of mechanical parts and human parts.
Nate: Do you remember that sound effect?
Dr. Bill: No, which one?
Nate: I’m going to find it and put it in right here.
Dr. Bill: What’s the sound effect?
*Nate plays sound*
Dr. Bill: What the heck was that sound effect?
Nate: It’s the Bionic Man.
Dr. Bill: So lots of attention is paid to physical prosthetics for limbs, especially. But we’re talking about cognitive prosthetics. And I think if we’re going to summarize this: “Hey, I need some help remembering stuff.” And if my need for help remembering stuff gets more and more, someday, I’m going to need cognitive prosthetics.
Nate: Why not cognitive aids?
Dr. Bill: I like the idea that if something is made to fit this emergent need that has come…it’s not like a walking stick or something. It’s more like things that just disappear into my life. I’ll tell you what, sitting in the airport. If you’re a geriatrician and I know some of you are, as people go by, you can pick out people with prosthetic lower limbs because there’s just the tiny change in the gate. But 90% of people have no idea.
Nate: They won’t catch it.
Dr. Bill: They won’t catch it. So I want things that are there that help me remember, but people won’t know.
Nate: Fall into the background, yeah.
Dr. Bill: So that makes me think about musicians and musicianship. Because in my small journey into the life of a musician, I have discovered, you have to remember a lot of things. Oh, my gosh. So I’m interested, Nate, in your take on cognitive prosthetics for musicians.
Nate: For the stage. Well, let’s see. The cheat sheet is my favorite.
Dr. Bill: Yeah, talk about the cheat sheet.
Nate: Okay, so some people will bring a music stand on stage with all the lyrics typed out, and they’ll have a whole book, and that works for some people. I personally dislike the look of a music stand on stage. If it’s a…
Dr. Bill: Because it’s obtrusive.
Nate: Yeah, it’s visually impeding.
Dr. Bill: It’s like, “Hey, hello, he’s reading that off that music stand.”
Nate: Yeah. So not only is it visually impeding, but it introduces this whole element that what’s coming to your ears is coming off of a page and somehow, it interrupts the emotional flow if you ask me.
Dr. Bill: I get that.
Nate: But that’s not to say that it’s invalid or inauthentic if somebody is reading, has…
Dr. Bill: Classical music, they [read music].
Nate: Right. I just tend to prefer to have the page on the floor. And so, when you do that, you either need to take up a lot of space, or you need to do this little trick that I do, which is key words. So if you have four verses, you just need the first important word of the first line of the verse, and then train yourself with that, you know the whole verse. Because hopefully, the lyrics make sense and are kind of written in such a way that the flow, you get…
…the beginning, and “Early one morning…”
Dr. Bill: “As I worked out…”
Nate: “…the sun was shining.”
Nate: “I was laying in bed.” So there’s that.
Dr. Bill: I just want to say to everybody, if you’ve seen the “Life’s Most Dangerous Game,” I’m just telling you, there is a cheat sheet on the floor in front of Nate.
Nate: Yes… I’ve done the show once or twice where I forgot to put it out and I just had to make do. And I think I swapped some things around, but I don’t think I doubled anything up anyway. And I’m pretty much using it as a crutch at this point to just in case my brain wanders and I’m right about to sing, and I forgot, and I can look down and I’ll know.
Dr. Bill: But what’s interesting about the prosthetic part is that sheet on the floor, the audience can’t see it…
Dr. Bill:…and number two, it just gives you enough info at the right moment to kick you into that next verse.
Nate: Right. It’s not the full verse, not the full chorus, and I don’t usually even bother with writing choruses down, because who forgets the lyrics to the chorus?
Dr. Bill: And when you’re doing this, imagine being on stage having somebody standing next to you whispering the lyrics into our year would just destroy that whole performance.
Nate: Yeah. And then there’s the idea of exercising that muscle. Just practicing without the sheet. Memorization. Muscle memory is very powerful, and in fact…
Dr. Bill: So talk about muscle memory for a second as a musician. What does that mean to you? You’re using that term, but what does it really mean?
Nate: It means that the more you repeat a pattern, the more it becomes automatic. So a C-major scale…when you first learn it, you are thinking about “What’s the next note? What’s the next note? Oh, this is a half step? Oh, a whole step.” And you kind of…you need the map to get through it. But then after you play it a bunch, your fingers take over. You don’t think about it as much anymore. And you can think about things like, “How loud do I want to play this note as opposed to that note?” Do I want to give it a vibrato? Or different ways that you can embellish the skeleton, put different flesh on the bones, I guess you could say.
Dr. Bill: I want to point out, you’re saying that the fingers take over? And I’m just putting on my doctor hat here and assuring our listeners, the fingers do not take over. It’s a different part of the brain… the muscle has no memory. Not the way we’re talking about it.
Nate: I see. So we call it muscle memory…
Dr. Bill: But it’s the brain.
Nate: …but it feels like your fingers are just doing it because they’ve done it, and it feels like your fingers are taking over, but okay. I can see that.
Dr. Bill: Yes. And I’ll tell you, from myself as a musician, what I’ve experienced at some times is in songs…and I have issues very different than yours because I’m an amateur. I have a lot of business going on in my head when I’m playing. And sometimes, I can lose track of where the next chord change is. So there’s sometimes the feeling in my hand is actually the reminder of where to go next. So what you’re saying, muscle memory…
Nate: Yeah. And that goes just as much for the tongue and the lips, for doing words as it does for doing scales or chords or whatever. So the repetition and practice, huge…I would put that before the cheat sheet. It’s about practicing. Any musician will tell you, you’ve got to practice until you master it. And then once you master it, you can choose to practice or not. A lot of us…I don’t consider myself a “practicing…” I play a lot, but I don’t consider it practice anymore, really. Occasionally, I’ll actually practice something, but for the most part, it’s figuring things out, learning them, and…
Dr. Bill: Well, I’ve seen you warming up before the doors open at LMDG…actually running through little transitional points. And here’s something I want to say. In music, there’s parts that stay pretty much the same, and where the memory comes in is during the parts where there’s a lot of changes. Whether they come fast or slow. And I see you rehearsing some of those changes, especially when you’re using some of the foot pedals and stuff.
Nate: Yeah, some of the moves are complex. Like, “Play this riff,” “Hit the looper,” “Play another riff,” “Hit the other looper,” “Put the instrument behind me,” “Turn the transmitter off,” “Put the pick down,” “Pick up the drum,” “Pick up the beater for the drum.” “Try to do it on the beat… right when the looper comes around and you’re working with me, and it’s all…” we’re lucky when we get it right, and we probably get it exactly right like one out of every four or five shows, I think.
Dr. Bill: I know.
Nate: When it’s not exactly right, it’s usually pretty close and it’s still pretty effective. But yeah. Sometimes, those moves require repeated…just do it a few times. I can think about it a million times, but if I don’t do it, I’ll be less likely to nail it.
Dr. Bill: That’s what’s interesting.
Nate: That’s where I think of it as muscle memory. You actually have to go through the motions…
Dr. Bill: The motion.
Nate:. ..like when you learn somebody’s name. If you say it three times with your mouth and your voice, you’re way more likely to remember it next day.
Dr. Bill: So there’s all kinds of things like memnomics or memory aids that we use in daily life. All kinds of little tricks that we routinely use to try to just bump our memory up a little bit. In fact, before we started the podcast, we both turned our phones off. But these phones we’re walking around with, they’re like cognitive prosthetics.
Nate: Oh, yeah.
Dr. Bill: And they help you remember a lot of stuff. And actually even weirder, they help you not remember, if I could just say.
Nate: Well, they cause you the thinning of your brain of the information that you have in your mind at any given time. You don’t need to know it because you have it right by your thumb.
Dr. Bill: I’ll tell you, when I was a kid, my home phone number was 3016. My grandmother’s number was 7920. My best friend, who lived down the road, his number was 7916…
Nate: Everyone’s going through their minds right now…
Dr. Bill: Yes, remembering numbers… And I’ll even tell you, so my high school locker combination was 2 to the right, back to 26, and back to 8. Locker 171.
Nate: Aren’t you afraid you’re giving away your security codes – Because you know, you’re probably using that somewhere…
Dr. Bill: You could call my grandmother’s house.
Nate: I actually use my childhood four-digit phone number as my iPad and my phone password.
Dr. Bill: So do not give that out.
Nate: Well, I’ll just change it tomorrow anyway.
Dr. Bill: There you go. So I think about the phone is I don’t keep those numbers in my head anymore. It doesn’t mean I’m keeping anything any better. And it doesn’t… I don’t think it means that memorizing strings of digits is admirable in any way.
Nate: But it’s exercise though.
Dr. Bill: That’s an interesting thought…
Nate: We’re relying more on technology, and therefore, I think, exercising our brains less. Or differently.
Dr. Bill: I’d say differently….
Nate: It’s shifting the way we process information.
Dr. Bill: Well, that’s it. So we’re processing more information…
Nate: Undeniably true. The amount of things that go across our conscious mind. The amount of pieces of information that we see.
Dr. Bill: It’s crazy. I remember, again, many years ago when my kids were young, one of the pleasures of the end of the workweek is there was this weekly magazine they mailed to my house. And got to the house on Fridays, weekly magazine. And I would come home at the end of the day. And Jude just knew…let him lay down on the couch with the magazine, and I would just read the magazine cover to cover.
Nate: Everything was okay after that. What magazine was it?
Dr. Bill: The New Yorker.
Nate: That’s a lot of words.
Dr. Bill: They went big on words.
Nate: They pack it in there. I remember the first time I ever picked one of those up. I was like, “Whoa. This is going to take me a couple weeks.”
Dr. Bill: Well, it was a real pleasure to read. And yet, if you take the amount of reading I’m doing with my devices and online and the Web and everything, I’m reading a lot more than a weekly magazine. Whether that stuff is quality or not, good question. For example, some people listen to podcasts and they learn a lot of stuff, and sometimes, they listen to podcasts and don’t learn a lot of stuff.
Nate: Some people just don’t enjoy listening to podcasts. It’s just not a format that works for them, right?
Dr. Bill: Some people are like, “Man, podcasts never…I will never listen to a podcast.” And we know that we’re not talking to those people right now. But if I could just say one more thing about cognitive prosthetics, I think if you look at a world where more and more people are going to experience some changes in their memory, where help with location, help with way-finding, help with remembering names. And there’s a thing called executive cognitive function, which means putting things in order. Like, you were talking about it with “I’ve got to hit the looper and then turn off the switch and put the pick down.” That’s executive cognitive function.
I foresee a future where unobtrusive aids to memory are around us and they’re helping people who are living with some memory issues, cognitive issues. Helping them just walk around, living their life, doing their thing. The way the man walking down the concourse is just walking down the concourse, he’s got one leg. Two legs; one is prosthetic.
Nate: Are you thinking kind of like Google Glass, but more like just they look just like regular eyeglasses?
Dr. Bill: Yeah, I would love to see that. Or an earpiece…whatever works for people. So that you get the clues at the right minute, going back to what you were saying, Nate. Your memory…actually, it doesn’t require, and you don’t even want all the lyrics. Because then, you’ve got to be like, “Where am I in this?” When you just have…
Nate: You need the right word at the right time.
Dr. Bill: That’s it. And nothing else. And it’s unobtrusive. So for all the…
Nate: Flashcards? In a way.
Dr. Bill: Well, yeah, right. Get you the info.
Nate: Yeah. Cue the memory.
Dr. Bill: That’s right.
Nate: Cue it. Don’t contain the whole memory. Just cue it. Because your brain has it all up there. It’s just a matter of accessing it.
Dr. Bill: Right. And remembering what order to do things in. I’ll just say, for people looking…and I know our listeners, there are people listening who want to become billionaires. If you’d like to become a billionaire, invent the greatest cognitive prosthetics that can help people living with dementia have a happy, fun life doing what they want to do in the same way that that prosthetic hand helps a person do what they want to do. Have two hands.
Nate: And the iPhone isn’t it?
Dr. Bill: Well, I think it’s a start. And in a lot of ways, it can be…it’s not obtrusive and it’s not stigmatizing. And compared to what we had before, it’s easier to use. So maybe it’s a start. We’ll see. But when you make your billion after listening…I can just…
Nate: Holographic teleprompters.
Dr. Bill: See? Nate’s gone and done it. He’s going to be the billionaire.
Nate: I’ll be the billionaire. I’m going to kill this podcast before it gets out.
Dr. Bill: That’s right. When you read about him on the Wall Street Journal and you go, “Oh, my God. He must have killed that podcast about cognitive prosthetics.” That’s what happened. So here it is. As they used to say on Car Talk, “You’ve wasted a perfectly good 12 minutes listening to Bill and Nate talking about cognitive prosthetics.”
And just want you to know, this is the #AskDrBill podcast and it is brought to you by the Center for Growing and Becoming, and the Age of Disruption Tour. It’s sponsored by lifereimagined.org. Yeah, they got your “What’s next” right there. And produced by the venerable REP Studios in Ithaca, New York.
Nate: Home of the microphone.
Dr. Bill: Home of the microphone. And…
Nate: We’ll see you down the road.