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The Memory Thief and the Secrets Behind How We Remember

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How could you lose your memory overnight, and what would it mean? The day neurologist Jed Barash sees the baffling brain scan of a young patient with devastating amnesia marks the beginning of a quest to answer those questions. First detected in a cluster of stigmatized opioid overdose victims in Massachusetts with severe damage to the hippocampus—the brain’s memory center—this rare syndrome reveals how the tragic plight of the unfortunate few can open the door to advances in medical science.

After overcoming initial skepticism that investigating the syndrome is worth the effort—and that fentanyl is the likely culprit—Barash and a growing team of dedicated doctors explore the threat that people who take opioids chronically as prescribed to treat severe pain may gradually put their memories at risk. At the same time, they begin to grasp the potential for this syndrome to shed light on the most elusive memory thief of all—Alzheimer’s disease.

Through the prism of this fascinating story, Aguirre goes on to examine how researchers tease out the fundamental nature of memory and the many mysteries still to be solved. Where do memories live? Why do we forget most of what happens in a day but remember some events with stunning clarity years later? How real are our memories? And what purpose do they actually serve?

Perhaps the greatest mystery in The Memory Thief is why Alzheimer’s has evaded capture for a century even though it afflicts tens of millions around the world and lies in wait for millions more. Aguirre deftly explores this question and reveals promising new strategies and developments that may finally break the long stalemate in the fight against this dreaded disease.

But at its core, Aguirre’s genre-bending and deeply-reported book is about paying attention to the things that initially don’t make sense—like the amnestic syndrome—and how these mysteries can move science closer to an ever-evolving version of the truth.

295 pages, Kindle Edition

First published June 1, 2021

72 people are currently reading
5951 people want to read

About the author

Lauren Aguirre

3 books41 followers
"The Memory Thief," a story about memory, opioids, and the brain, is my first book. It was shortlisted for the 2022 PEN/E.O. Wilson Literary Science Writing Award. I am so honored.

I grew up loving science and storytelling. In college, I discovered I could live in both worlds by becoming a science journalist. At the PBS series NOVA, I covered human origins, space exploration, art restoration, and much more. But whatever the topic, two themes captivated me; the thrill of finding something out and the challenge of getting others to believe you when your discovery bumps up against conventional wisdom. "The Memory Thief" is just such a story.

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Displaying 1 - 30 of 61 reviews
Profile Image for Petra X.
2,456 reviews35.6k followers
May 4, 2022
Review DNF. I'm on chapter 15 and bored, really seriously would-read-the-nutrition-labels on ketchup bored. The books main subjects - amnesiac syndrome following opioid use, brains frying on Fentanyl, whether legally in hospital or illegally or even unknowingly, mixed with heroin - and Alzheimer's, and the hippocampus role in both memory and amnesia, should have been interesting as a pop science book.

But I struggled from the beginning, to identify with the author, the doctors, researchers or patients. The book was so dry, too many names, not enough progress, the book never seems to get anywhere. I knew a lot of the science of memory from other book, so perhaps someone new to reading about it, might have a much better experience of the book than I did. Bur for me, life's too short...

Great cover though!
__________

Notes on Reading People frying their brain on fentanyl losing their ability to form new memories. The book is very anecdotal with lots of characterisation of the main players doctors and patients, but for some reason isn't compelling at all. It's ok, it's not bad, but not the sort of book you can't put down.
Profile Image for Morgan Blackledge.
817 reviews2,677 followers
August 17, 2021
Science journalist Lauren Aguirre’s account of the fairly recent discovery of opioid associated amnestic syndrome.

The book begins with a case study of a UCLA premed student that overdosed on Fentanyl and subsequently experienced profound anterograde amnesia.

In case you don’t already know:

Fentanyl is an opioid drug primarily used as an anesthetic, and occasionally for pain management of terminally ill patients.

But it is increasingly being diverted for illicit use, and is currently used to lace just about every street drug.

And.

Anterograde amnesia is a condition where by the subject is unable to encode new memories after an amnesia-inducing event.

So what was the amnesia-fentanyl connection?

When medical clinicians reviewed the fMRI imaging, they discovered that the case subject’s hippocampus had been completely destroyed.

FYI:

The hippocampi are bilateral deep brain structures that play a major role in learning and memory.

A lot of research later, and the consensus is that opioid use damages hippocampal structure and function, eliciting subsequent memory impairment, representing a significant risk factor for developing Alzheimer’s and amnesia, particularly in vulnerable populations.

The exact mechanism of damage is still unclear, but the primary hypothesis is that the inhibitory effects of opioids on certain neuromodulator chemicals in the brain elicit intense seizures localized in hypocampal regions.

And the effects are dose dependent.

A little opioid use does a little damage.

A lot does a lot.

And fentanyl use does an extra lot.

So don’t use opioids if you can avoid it.

Particularly fentanyl.

You should steer clear of heroin because most of it is cut with fentanyl.

And you should also avoid street benzodiazepines because most of them are simply pressed fentanyl.

Since identifying opioid associated amnestic syndrome (OAS) in 2017, many more individuals like the original case study have been diagnosed.

Which is pretty awesomely bad news by any measure.

The only possible good thing to come of it is that research into OAS has lead to a better general understanding of memory loss, and may eventually lead to more effective treatment for Alzheimer’s.

In the meantime, the best way to avoid that tragic fate is to (a) exercise, (b) get enough sleep, (c) limit or avoid sugar intake altogether, and (d) DON’T DO DOPE!

This book is terrifying.

I hope it helps stem the tide of this god awful situation.
Profile Image for Mark.
533 reviews21 followers
January 28, 2022
Thank goodness for scientists! Thank goodness for their frequently obsessive curiosity and their mulish determination to follow that curiosity to either victoriously confirm a theory or objectively refute one. An instance of such curiosity being piqued occurs in October 2012, when neurologist Jed Barash stares at an MRI brain scan of a young man, and says out loud to his empty office, “Whoa, this is weird.” It turns out that this patient overdosed on opioids and damaged his hippocampus in a way Barash had never seen before.

The hippocampus is the memory center of the human brain: damage to the hippocampus means damage to everything related to memory—encoding, storing, and retrieving. In this case, the terrifying result of the damage (terrifying to this reviewer, at any rate!) is the inability to make new memories. As more overdose cases emerge, Barash homes in on fentanyl as the common culprit. But proving it is a whole different matter. It acquires a formal name—amnestic syndrome—and becomes the focus not just of Barash’s work, but of numerous other people, who Barash skillfully cajoles into a virtual team of forensic opioid detectives.

Lauren Aguirre, author of The Memory Thief and the Secret Behind How We Remember, has done a heroic and exhaustive job of talking to all the stakeholders in this hunt for proof of the opioid use/memory loss connection. The implications of such proof, says Aguirre, can be massively impactful, with the possibility of it turning out “to be a tiny piece of the giant puzzle that is Alzheimer’s disease.” Aguirre’s sources included doctors, patients and their family members, government agencies, and a variety of health experts. From a vast amount of information, she assembles critical pieces to tell a breathtaking story.

Along the way, readers get a penetrating insight of what it takes to pursue important research when, in fact, not many others think it is important. The writing of applications for research grants and lobbying successfully for national public health announcements consume enormous and lengthy efforts, and demand considerable stamina to stay the course. But Barash’s zeal and devotion to truth-seeking is infectious, and the other experts he rallies to the cause exhibit a remarkable spirit of collaboration and willingness to search energetically for answers to vexing questions.

Though the storytelling necessarily includes complicated medical and biological explanations, readers are in safe hands with Aguirre. Her narrative never loses its accessibility, and her helpful glossary plus the timeline built into chapter headings (why, oh why don’t more popular science writers do this!) are perfect for keeping readers on track. And she never misses an opportunity to acknowledge the work of the hero-scientists of this story. This is a fabulous book on an urgent topic that could impact millions of people.

Once again, thank goodness for scientists! Thank goodness for their courage in proposing bold, new, and hard-won wisdom in the stubborn face of legacy thinking. One wonders what kind of primitive world we might be living in that constantly relies on looking backward and clinging to beliefs past their expiration dates, instead of taking intelligent, calculated risks while using science to create a better future for humankind.
Profile Image for Mary.
856 reviews14 followers
December 17, 2021
The Memory Thief may just be the most important book that I read this year. Lots of information on how your memory works. One of the people focused on in this book is a young man who was a drug user but also very intelligent. After almost dying after taking an illegal substance that was tainted with Fentanyl, he loses a great deal of his memory capacity. He has to make detailed notes to guide him through his day.

Intrigued a scientist and a physician begin to look for more people who have suffered memory loss under these circumstances. They believe studying this group of people will lead them to a greater understanding of how the hippocampus works. I learned that when you have surgery you are most likely put under a sedation that contains Fentanyl.

The book also delves into some of the research that is being done in the search for the cure for Alzheimer’s disease. This book is fascinating reading!
Profile Image for Sue Pit.
213 reviews13 followers
September 25, 2021
This is a potentially fascinating topic: how perhaps an overdose of Fentanyl may cause long term anterograde amnesia. If that does not sound interesting, this book may not be your cup of tea. This follows a certain discovery of this possible connection and proceeds with an attempt to further study this possibility and see how wide spread it may be, and details some of the difficulties of doing so. It proceeds along rather interestingly but only gets so far when Covid strikes and thus the process stalls and the book concludes with explaining other memory and such related studies and then has the main characters each provide their own synopsis thereof. So it seems to rather fizzle as to the subject matter/ story telling of the main topic in the last quarter or so. Having said that, it is a quick read and has interest value to it but clearly could have had much better editing, etc..
Profile Image for Holly.
1,069 reviews289 followers
August 10, 2022
A medical mystery that takes the reader into the behind-the-scenes work of neuroscience researchers across many years working to uncover the link between opioids (esp. fentanyl) and amnesia. It's also the stories of patients, the biology of addiction, the hippocampus, Alzheimer's, and the scientific method itself. I notice that a few of the people I follow here thought this was dull, but I disagree. Listened to the audiobook.
19 reviews
February 20, 2024
While I own a hard copy, I listened to The Memory Thief through Audible - and it was quite an enjoyable 9 hours and 21 minutes. The story was written artfully, almost as a mystery (which is, personally, appealing), as Aguirre describes the efforts of the doctors and scientists to uncover opioid-associated amnestic syndrome. I was drawn in by the science of it all and my attention was kept by the pure grit of the team researching this new syndrome. It was interesting to see how clinical research worked, the hierarchies it followed, the challenges it faced--especially when focused on marginalized populations. Overall, a captivating read - one I would recommend, for more than one reason and to more than one type of person.
Profile Image for Angie Boyter.
2,301 reviews95 followers
May 8, 2021
3+ rounded up to 4.
How scientists solve mysteries, and the mystery of memory
In 2017 fourteen opioid overdose survivors awoke with significant and persistent amnesia and damage to the memory section of their brains. This “amnestic syndrome” attracted the attention of the national media and inspired the writing of this book. Serious memory loss has attracted the attention of scientists, though, for many years, and it is the story of their quests for knowledge in this field that Lauren Aguirre tells in The Memory Thief.
Narrative nonfiction is popular and can give wonderful insights into a subject, but it is not an easy way to write, having the dual objectives of being informative and entertaining. The Memory Thief does an excellent job of showing how science is done through the stories of several of the investigators involved in the study of memory loss, especially Dr. Jed Barash. We see the sometimes small details that spark new ideas and follow the researchers’ difficult quests to pursue those ideas successfully by means of collaboration and contacts, grants, and, ultimately, publication. It helped me understand that the difficult subject itself is not the only major obstacle to progress.
There are also sympathetic and heartwrenching portrayals of the overdose victims themselves, especially young Owen Rivers, whose journal entries reveal the almost unbelievable effects of his amnesia and his attempts to cope with it.
Although the emphasis is on the scientists’ work, there is also interesting science in The Memory Thief, and I learned a lot about the brain, especially the hippocampus. There are some excellent pictures of the brain, including MRI results, and I would recommend that you read the book in a medium that can handle color to get the full effect.
Much as I enjoyed and learned from the book, the writing itself showed some roughness, some of which I hope will be smoothed before publication, beginning with the title, which has two colons (!), i.e., The Memory Thief: And The Secrets Behind How We Remember: A Medical Mystery. There are also seemingly inexplicable tense shifts in the middle of paragraphs that are jarring. Although the narrative technique was overall very effective, there was too much extraneous detail. Knowing which journals are important and how one tries to get published is useful information. When Jed Barash’s son takes his nap or what pictures are on someone’s wall is not, and these details are distracting rather than supplemental to the picture.
Memory is crucial to who we are and how we navigate life, and this story of how scientists really work to uncover its mysteries is overall a fascinating read, well worth remembering.
I received an advance review copy of this book from Edelweiss
Profile Image for Dr. Dima.
111 reviews6 followers
December 23, 2021
In a combination of skilful medical writing and engaging storytelling, science journalist Lauren Aguire presents us with a non-fictional medical mystery that involves drug addiction, memory science, medical research, and Alzheimer’s.⁣

In "The Memory Thief", the author relates the unfolding story of a group of doctors, researchers, and public health officials that have set out to investigate a cluster of patients presenting with a puzzling "amnestic syndrome" of memory loss connected with drug overdoses. Along the way, the author intertwines human stories with the science of how memory works (including history into memory research and the story of patient HM), insights into Alzheimer's disease, and the process of medical research. Included in the book are colourful and vivid pictures of the brain and the hippocampus and MRI scans.⁣

Readers might find the ending somewhat frustrating, as this medical mystery is yet to be solved. But, that is not the author's fault. Unfortunately, as the COVID-19 pandemic hit, the investigation took a stall. The book concludes with short essays written by the main characters (including one of the patients), each providing their own perspective of the amnesic syndrome.⁣

This book reads like a mystery detective novel, but one that is real. Threaded within the story are insights into the science of memory and what happens when memory fails. I highly recommend it for anyone interested in a unique account of the intersection between opioids, the brain, Alzheimer’s, and medical research. ⁣
Profile Image for Barb.
1,925 reviews
September 5, 2025
Although not what I expected (or hoped for), this book was good in that it explained a lot of things about how the human brain works on remembering things. There was a lot of scientific jargon, making it sometimes tedious and difficult for this non-scientist to follow, but the parts I understood were fascinating.

The emphasis that spanned nearly the entire book was on how the human brain changes following a fentanyl overdose. In a nutshell, the hippocampi are usually destroyed, making it nearly impossible for overdose survivors to be able to learn - and more importantly, remember! - new things. It also introduces a significant risk for developing Alzheimer's, that scary disease nobody wants to think about, especially as we get older.

I'm not sure I'd recommend this to a casual science-book reader, but it might provide new insights to those wanting to learn a bit more about how our brains function, and some of the things that cause it to malfunction.
Profile Image for Stephanie.
92 reviews7 followers
July 15, 2021
A Nonfiction medical mystery page turner that reads like fiction! What a great read. Easy to read for the layperson. Which I found to be impressive based on the complex topic of memory and the brain. Her investigation into the mysteries of these amnesiac cases was truly fascinating.
Profile Image for Donna.
285 reviews7 followers
July 25, 2021
Opioids, fentanyl, memory loss all the hallmarks of the latest news headlines. What this well written and easy to understand book adds is adds is the incredible challenges researchers and Drs must overcome to raise the alarm and gain the appropriate resources to investigate and hopefully address health crisis.

At times, this story makes you feel hopeless to see the years it takes and challenges faced to investigate such health crises as opioid addiction and Alzheimers. Compound this with some public belief that science doesn’t evolve and new learnings don’t happen and mature as new insights are gained. Thankfully seeing and reading the dedication of these wonderful Drs and researchers overshadows these moments.
Profile Image for Jeanne.
1,504 reviews
July 7, 2021
I slogged through the first half of this book and then gave up. It seemed as if it would never get to the point.
Profile Image for Rubi.
2,610 reviews13 followers
May 24, 2023
VERY scientific!

For being basically a book of the scientific study of the brain (specifically on how the brain restores or forgets memories), it was actually not that boring lol
Only thing is....the book is titled "How we Remember" and....I feel that wasn't answered.
The book definitely covers how or more like, WHAT part of the brain forgets and the kinds of things that affect that. Seems drug abuse is a definite factor but scientists don't feel its the sole cause as not ALL cases are with people who overdose.
It also goes into several unique cases of memory lose and how it baffled scientists when they found a person that remembered their past but could not form NEW memories.
Again, all very fascinating stuff but...don't feel it helped me understand How I remember lol
I guess it was my fault for not understanding what the book was actually about before picking it up. I tend to forget things and was hoping to understand how I could retain things more. Alas, while this went deep into the chemical and brain activity that is involved with memory, it doesn't really help ME 😅🙈
Highly recommend to those who love science, health, and/or want to become a neurologist though! Seems something right up that ally! 👍
1 review
June 10, 2021
This is the unusual non-fiction medical book that reads like a fictional thriller. From the first page to the last, I could not put it down. The expository writing is lively and clear; the author explains exceptionally complicated medical and scientific research about how we form and lose memories in a way that anyone can understand. Lauren Aguirre has a rare gift in medical writing. The real-life characters in the book--patients, doctors, scientists, public health officials--come off the pages and into our living room through vivid detail, including conversations with parents, spouses, and scientists. The reader sees how complicated and at times frustrating medical research can be, both for the researchers and the patients whom the doctors are trying desperately to help. The story takes root in the opioid crisis nearly a decade ago and comes all the way to the pandemic. Absolutely must read this book! I bought eight copies and have given them to all my friends. I plan to buy more.
Profile Image for Claude Rothman.
39 reviews40 followers
January 25, 2024
I enjoyed the mystery structure of “The Memory Thief.” Beware, by moments, one can forget it is not fiction.

Lauren Aguirre wrote the medical content so clearly that I followed and understood everything.

More importantly, I have been invested in, associated with, and concerned for every character, touched by their humanity, no matter who they were or their occupation: patients, families, or doctors-researchers.

Lauren Aguirre dived with compassion and intelligence into a world where I knew nothing more than what the media revealed, i.e., very little.

This page-turner ended too soon. And I wish I knew what happened since. Yet, I dare hope because the author, patients, and researchers persist. They want to understand and find a cure. They are resilient and perspire an outstanding and inspiring tenacity.

To consume and spread without moderation.
Profile Image for Hemen Kalita.
160 reviews19 followers
April 2, 2022
The hypothesis is that, Fentanyl- the man made opioid- is the memory thief. While it has been already known that opioid causes memory loss but the strange complete bilateral damage to the hippocampus- the area that creates memory- has not been observed earlier.

There are three reasons for my low rating-

1. There is not enough material for a whole book. Almost 80% of the book is filler including case studies of patients with same memory loss symptoms which become tiresome with time.

2. The core idea- the correlation between overdose of fentanyl and hippocampal damage is still a hypothesis and there are no studies have yet being carried out.

3. I found the animal testings depicted in the book off-putting. Testing of animals for any reason is barbaric and needs to stop.
Profile Image for Ron Willoughby.
354 reviews7 followers
September 5, 2022
Michael Lewis, you may have competition brother. Lauren Aguirre is impressive. At first I thought this book too heady (pardon the pun) or academic. Truth was, I needed to up my game. There was simply too much for which I was ignorant. But Lauren is like a patient tutor moving us along until the light comes on and we think: what a beautiful, fascinating, mysterious organ is this thing called the brain. I have such regard for the researchers and their investments and sacrifice. I have such disdain for Pfizer closing down their Alzheimer’s/Dementia research. And I find myself w genuine compassion for those damaged in some way by Fentanyl.

Thank you Ms. Aguirre. You have been a tutor and friend.
Profile Image for Gabby C.
204 reviews2 followers
July 4, 2023
An enlightening book about the terrifying effects fentanyl overdose can have on memory and how doctors and researchers hope to apply research into this area to better understand dementia and Alzheimer’s Disease. Five stars for the scientific content; I can understand people’s gripes with some of the personal details peppered into the book though I think that humanizing the people behind the science never hurts. If you or someone you love has substance use disorder, this will likely be informative but also could be a challenging read, so consider that before diving in.
Profile Image for Jack Cheng.
824 reviews25 followers
Read
August 7, 2021
Excellent science reporting, telling the story of a convergence of amnestic patients following opioid overdoses. There is no conclusion to this story (which I naively was hoping for). Instead, this is a narrative of process, and it's actually quite fascinating and exciting to see how information is published and gathered and consolidated. Along the way, the author describes various historic touchstones in the history of memory science.
21 reviews1 follower
February 4, 2022
Interesting read about medical discoveries from the opioid crisis that is ongoing. Fascinating read detailing how memories are formed and how easily they can be lost with damage to the hippocampus. This book follows a story line that shows how difficult it is to move medical hypotheses and discoveries along, and is also packed with a lot of medical jargon and information (can be a little dense).
Profile Image for Lorette.
465 reviews
April 10, 2022
Written in a compelling narrative style, this was a great read and hard to put down. Mostly set in the Boston area, a loose collection of doctors and public health practitioners set out to establish whether fentanyl overdoses in some people damage hippocampi such that severe amnesia results. This has implications for those with Alzheimer's disease, as well as how anesthesia is administered, particularly for older folk.
Profile Image for Niamh.
257 reviews
December 14, 2022
Zzzzz.... 🥱
Did we really need the never ending descriptions of what pictures are on walls of offices, the piled high laundry baskets, what each person looks like, how they talk or move etc..?
Did we really need to be subjected to the endless tedium of other people's text messages, emails or in person conversations? Word. For. Word.
Luckily I have memory issues myself, so hopefully it'll only be a matter of time for the memory of this book to disintegrate.
Author 2 books4 followers
February 14, 2023
This is an extraordinary book that tracks memory and how it is affected, what affects it (opioids are at the centre of this story) what happens in our brains to interrupt memory, damage it. Aguirre's delivery is extraordinary; it threads astonishing research with the story of real people. It will teach you the stunning lengths doctors and researchers go to understand our physiology, the battle to get research funded, read. I learnt as much about that as I did the place where memories live.
Profile Image for Fatimah Bello.
14 reviews
January 16, 2024
3.5 stars actually. I think I enjoyed this book mostly because I don’t mind learning about the brain and all that. But if I didn’t then this book would’ve been a drag because most of it was educational rather than an update on the progress of the researchers. However, at the end I understood that all the educational part was essential because unfortunately there was no “happy ending” with the researchers work.
Profile Image for Jordan DeMott.
14 reviews2 followers
June 20, 2021
The connection between opioid use and memory loss seems obvious. ...An experiment where an elderly mouse and a young mouse are sewn together like conjoined twins resulting in the old mouse rejuvenated to half its age and the young mouse prematurely aging to twice its age in a parasitized state seemed creepy, but overall an interesting book.
1 review
July 9, 2021
Lauren Aguirre did a wonderful job narrating as well as writing the book. By including moments of the personal lives of those involved she made what could have been a dry report into a fascinating story. It showed how scientific advances are often dependent on the curiosity and persistence of individuals who then reach out to others to advance the research.
376 reviews
September 15, 2021
Kind of disappointed, since this is a very important topic. The book first of all focuses the work on dementia on the opioid users and follows more of a story related to the doctors who are diagnosing the patients. Worst part is that the book showed no new understanding in the numbers of years in research on this issue. Overall average.
Profile Image for Blaise Aguirre.
Author 12 books49 followers
October 29, 2021
Ostensibly, this book is about the connection between opioids and memory loss. But on a much deeper level, it's a compassionate look at the fragility of life and the struggles of people with substance use disorders and other mental illnesses. I highly recommend it.

P.S. -- I'm biased. I'm married to the author.
Profile Image for Jess Daigneault.
2 reviews
May 6, 2023
This one took me a bit to get through. I did like how the information was written like a story which made it easier to read but there was still a lot of medical jargon and I did struggle getting through it in the end. However, I did learn some cool things about the brain and memory and found the overall context interesting!
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