The Hocus Pocus of Focus

April 27, 2015

What is focus and why is it said to matter? From the time we enter elementary school until we find our way into the workforce, we encounter the “pay attention, stay focused” missive, each time implying that by doing too many things at once or by letting our thoughts drift that we are compromising our ability to learn. For those so accused, the response is typically, “don’t worry I’m focused but just not on what you have in mind for me.”

Clearly staying focused matters, but does it really help us more than imaginative or unstructured time to explore? The assertion is that through active concentration we are better at capturing and storing information. But is it true?

Like most things in neurology, the anatomical and biochemical basis of memory is a fuzzy thing.  But, with the use of imaging and some remarkable clinical subjects we are getting better and better at understanding it.

In 1932, a seven-year-old boy named Henry was struck by a motor vehicle while riding a bicycle.  Although Henry fully recovered, by the age of nine he began having epileptic events that increased in frequency and severity. By the time he was 16 these had worsened to tonic-clonic seizures (affecting his entire brain) and were completely debilitating.

In the 1950’s, how best to treat seizures was a contentious topic. William Beecher Scoville, a neurosurgeon at Hartford Hospital believed that surgical intervention was a viable approach and the best option for Henry. At age 27, without much else to turn to, Henry consented to undergo the surgical procedure at Hartford Hospital in Connecticut during which Scoville would separate his right and left medial temporal lobes – a procedure that removed the hippocampal formation and adjacent structures, including most of the amygdaloid complex and entorhinal cortex.

It was clear soon after recovery that Henry’s seizures were cured. But, what was also missing shocked Scoville and the neurologic world. The surgery had resulted in complete anterograde amnesia. Although Henry could remember elements of his life before surgery, he could not record any new memories. Every day was a new day to Henry; in fact, every hour was a new hour. Henry could hold a memory only as long as he remained focused on it, but at the first distraction it was lost – it was if it had never happened.

Over the course of Henry’s life he was the subject of remarkable investigations at MIT and elsewhere. In countless papers and textbooks, Henry was referred to as patient “HM.” For every study and in fact, for every day during which he was studied, Henry re-consented to participate and did so with remarkable kindness and passion – hoping that his participation would serve to help others that struggle with similar challenges.  After his passing in 2008, Henry’s brain was subjected to ultrahigh resolution analysis and three-dimensional reconstruction.

When simplified, memory can be broken into two groups, short and long-term. Short-term memory or so-called “working memory” was intact in Henry.  What Henry was unable to do was convert information into long-term memory; a process that is often called consolidation. Long-term memory is further divided into two groups called explicit (conscious) and implicit (subconscious). Much of our lives are driven by implicit memory, and these are often referred to as habits; behaviors that are triggered by priming events and replay actions that rely on little to no conscious choice or decision. Explicit memory is different. From explicit memory we define who we are in what are called episodic memories (personal story) and semantic memories (learned knowledge).  Henry and others like him have made tremendous contributions toward our understanding of memory.

So how does the schoolteacher’s reprimand to “focus” fit into any of this? What has become clear is that memories for which context (episodic or semantic) can be associated are those that become the strongest. Consolidation, it seems, is a process by which experiences are mapped onto those events for which we have some context; a process by which neural connections are made and recall capabilities strengthen. As we learn about something, it becomes easier to learn more and the more we know about a given thing, the easier it is to recall specific content and generate correlative and creative contributions.

In a world where the amount and diversity of information streaming into our lives is exponentially increasing, remaining “focused” has never been harder nor perhaps more important.

Beyond the level of individuals, organizations can also struggle to stay focused.  Yet in ways analogous to neurologic memory, organizational memory and learning are similar. The capacity to learn, create and innovate is deeply tied to organizational focus with each individual representing a “neuron” connected to another and interwoven in a network of shared and synergistic expertise (or memory).

To recast the question of focus, consider Apple’s corporate journey. After eight weeks back on the job in 1997, Steve Jobs

elected to cut the product line by 70 percent in an effort to “get back to basics to enable us to excel in everything we do.” Recently, Jeff Immelt announced something similar at GE, striving no more to be a Jack-of-all-trades.

The proverbial, prophetic (and now iconic) phrase “less is more” from Robert Browning’s 1855 poem is proving to be both timeless and instructive.