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Medicine | THE UNREAL WORLD

You can tune out, but not like this

July 31, 2006|Marc Siegel | Special to The Times

"Click," Sony / Columbia Pictures, in current release

The premise

MICHAEL NEWMAN (played by Adam Sandler) is an architect bored with his life. When his TV remote breaks, he goes to a Bed Bath & Beyond store and meets Morty (played by Christopher Walken), a man with mysterious powers. Morty provides Michael with a new remote that enables him to move through time, fast-forwarding through the boring, irritating and routine parts of his life without consciously experiencing them.

The medical questions

WE'VE all had the experience of operating on autopilot. What happens in the human brain when we "space out" like that? How does the human brain work to affect varying levels of consciousness? Can we make decisions and respond to questions without being fully aware of it as the movie suggests?

The reality

HUMANS, while awake, can sometimes exhibit automatic behavior that they don't fully remember later on. Consciousness depends upon a nerve network in the brain -- called the reticular activating system -- that responds to sight, sound, smell and thought by maintaining attention and alertness.

But, as the movie suggests, a person can still be awake without this system being fully engaged, and so not be as aware of his or her surroundings. This is what happens when you are driving along the highway and pass your exit without realizing it. It is sometimes useful to be able to briefly "zone out" while continuing to perform functions you know very well -- such as riding a bicycle or folding laundry. But long periods of mental absence are problematic and often pathologic.

In the movie, during his periods of prolonged mental absence, the automaton Newman develops halting movements and inappropriate social behavior. In real life, symptoms like these can occur when there is damage to the brain's frontal lobe, which is responsible for planning, abstract reasoning, sustained attention and insight, and is needed for full alertness.

When clicker Newman clicks past a period of his life, he leaves the automaton Newman behind, stuck in lesser consciousness, where he continues to ritually move and speak without being fully aware, and later experiences amnesia.

All these symptoms are characteristic of what are known as "fugue states," an abnormal condition where the complex network of consciousness is short circuited and a person experiences a loss of identity, awareness and memory. Such a person may still make purposeful movements and even speak, but he is not completely aware. A fugue state can be caused by an atypical seizure, injury to the brain or as part of a psychiatric breakdown.

But in real life, a normal person is not capable of Newman's prolonged mental absences. Mental dissociation this protracted would certainly lead to irreversible brain damage.

His mindless success in business and his unfeeling pile-driver sex are more believable.

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