It can be very socially awkward when you fail to recognize someone who clearly knows you from somewhere, sometimes they even know your name. This has happened to most of us, a smile and a faked familiarity usually smoothens the situation. Imagine you have a high school reunion but you have no idea what your high school friends look like, or you get home from work and you find strange faces in your home, except it’s your family, and it happens every day.
Prosopagnosia – [noun] the inability to recognize faces of familiar people.
There is a neurological condition that results in the inability to recognize people’s faces. Like most medical conditions, there is a spectrum of symptoms, ranging from a mild form, to a severe form where one fails to recognize their own face in a mirror. Traditionally this condition has been known to result from injuries to the brain (acquired) but some people are now known to have been born with this condition (congenital). In both cases, a part of the brain called the fusiform gyrus is affected, this is the area responsible for facial recognition.
I knew about prosopagnosia when I was in secondary school, years before the neurology lectures in medical school. I have always struggled with remembering people’s faces since I was young. Unless I have met someone several times, I cannot remember their face out of context. This has annoyed a lot of people after I fail to recognize them in the street or on a second encounter. The worst is the distant uncle or aunt with an exaggerated sense of self importance who thinks everyone should know them and they give you a lecture if you can’t recognize them, and unfortunately I have a lot of those.
My curiosity to find out the reason made me stumble onto some really fascinating neurological conditions. It also enhanced my passion for medicine. Growing up I had already diagnosed myself of prosopagnosia. Knowing what I know now, I probably have a very mild form of it. I was always nervous when we visited relatives, in my mind I had a flurry of fears
- What if I forgot someone “important”
- What if I called someone the wrong name
- What if they made a big deal out of it
I developed some coping mechanisms over time, for example I would let my older brother do his greetings first and listen to how he addressed the people. That was the easy way, sometimes my brother would not be there and I would be with my dad instead. In that case I would have to work out what ti call someone based in what my dad would have called them. If you are familiar with the complexity if African relationships you would know that this is not always an easy task for a child under pressure. Most of the time I would end up mumbling the last part of the greeting and hope to get away with it, sometimes I did.
In the end I resorted to avoiding social events and people in general. I was labeled very shy or just odd, which worked well for me.
What made me write this post is that recently I met a patient with prosopagnosia, a severe form. Society failed to help him cope with his condition to the extent that he has been in and out of psychiatric institutions several times. It is very difficult to have normal relationships with people who become strangers the minute you turn your back. He explained how he tries to use voice, height and dressing style to identify people but it’s not always ideal. I could only imagine how he goes through life trying to make his way in the midst of a faceless crowd, a crowd that will only regard you an equal if you can remember them.
African societies are quick to shun what they do not understand. This includes neurological disorders and psychiatric conditions. This Previous Post still makes me emotional years after I wrote it. Everything that we do not understand is associated with evil spirits and consequently feared. We rarely seek to enhance our understanding.
If you meet me in the street and I ignore you, do not take it personally it’s just my fusiform gyrus not functioning well. Your face looks like everyone else’s to me. But do say hi, I will appreciate it.
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