Ask HN: At 45, I can't seem to read as well anymore
I've gone back to school into a medical degree.
However, I am realizing that I have trouble reading well. I used to not have trouble with any topic, but now I have to re-read text several times, I have to take a ton of notes, I am skipping lines and transposing characters.
I went to a specialist for academic learning and they did a battery of tests and told me my reading level is very low and were surprised I am even in a medical program.
I went to a development/behavioral ophthalmologist and they prescribed new lenses and cognitive eye therapy. The lenses seem to help but the eye therapy isn't.
I am at risk of needing to withdrawal. Perhaps pausing this education is the best thing while I get this under control, but I don't see a path to start on.
Any advice?
On a more active path, you might also consider consulting a neurologist and describe to them your the differences between past and current reading performance as well as observations of the problems you're having now.
I realize that doesn’t solve your problem if the meds give you undesirable side effects.
As an aside, one thing I have noticed is that focusing on print vs screen is way easier for me.
Coincidentally, they call me "boomer" and have adopted me as group "mom".
You case sounds different though, like it might be something organic. Are you taking a medication that makes you less sharp? Bipolar meds certainly do that. Do you have headaches that might indicate some problem? Have you had Covid so maybe have brain fog from long Covid? Are you depressed and anxious? Do you drink a lot? Etc... Good luck figuring it out.
I swear, if a genie gave me three wishes, concern about being able to properly craft the wish would be the only thing that'd keep me from burning one of them to permanently eliminate the Internet.
Yet you participate in society. Curious!
> likely alive due to medical knowledge that could only exist through the internet
Definitely not true yet. Maybe some day. Maybe never.
You didn't say "the internet sucks", you said "I'd get rid of it if I could".
> Definitely not true yet. Maybe some day. Maybe never
Medicine has come further since the internet than it did in 50 years prior, imagine the hit COVID would have had if nobody fucking knew about it until someone they knew got it.
So many things depend on global information sharing, saying "blow it all up" because you don't like TikTok or Instagram is so ignorant it's unreal. The internet isn't just cat videos and short form content, it's the backbone of the last 50 years of innovation.
I'd be much happier if I could have an internet free room or two near my family. In fact, if I ever move back, I might seriously work on that. Bedroom and a study/library if I can afford the place, no internet.
I think it was actually better with a fair bit more friction. Most of the good stuff was still possible. It couldn't be as big a distraction as it is now. You had to decide to use it, then go to the place where you can use it, then wait a bit.
[EDIT] "So why don't you just live like that?" unfortunately, the entire world now assumes you have fast Internet available everywhere, at all times. Schools, employers, banks, everyone. Living like that today would be far more inconvenient and come at a higher cost than living like that back when it was the norm (or, before it was the norm, even—most households in the US weren't "online" at all until 2000 or so) due to changing expectations.
PCR goes back to the mid-80s before the internet became common at all. The news of a novel virus in China was all over the mainstream media outlets back in Jan 2020. Publication of the identification of the viral sequence happened in Nature, that could have still all happened over phone calls and fax machines.
The internet makes that all decentralized and faster, and now anyone can look up that information without going down to the medical library, and there's videos on youtube about virology where the average person can find good information (although you have to run the gauntlet of a plague of bad information without any training as well, so its kind of 50/50).
We still would have responded to the virus and developed the vaccines, and people still would have been able to be informed by the media. The ability of the average person to find out better information is also somewhat balanced by the ability of the average person to find out worse information.
It wasn't entirely the dark ages back in the 80s though and medical science still progressed.
In a "3 wishes" scenario, use the first wish to wish for additional wishes, then for each concrete wish in a 2 part process wish for a written quote that includes a no-harm rollback clause and a penalty clause granting more wishes describing how the genie will execute the wish, then wish for the genie to execute the steps described in the quote.
Any genie must be treated as a hostile counter-party.
In order to read like I read as a teenager, I now need to be on a beach and have detoxed from work/responsibility for a day or so.
I suspect the two are strongly linked. I.e. my subconscious at most times is actually continually running "normal adult life/parent shit" in the background, versus teenager-me had those cycles free.
updated the main post as well to reflect this..
My suggestion is to try to relax. I find it gets worst when I'm stressed because "I have to finish this chapter today". Pressure is my worst enemy. Also what helps me, is going to a park, or a place where I feel very good, that stimulates my good mood to read.
(That's not sarcasm. I'm genuinely agreeing with you and mocking my short attention span.)
I remember seeing kids with reading problems doing this in grade school.
Much to my chagrin (and amusement!) I now find it very useful for myself. Prevents me from reading so quickly that I absorb nothing.
On another note, have you tried any text to speech software? I used to do that in school when my eyes were tired or I just felt like listening.
Disclosure: I am the founder (and am happy to send you a free pass to our Chrome extension, if you find it helpful).
1: http://www.beelinereader.com
edit: ah, and only now I noticed you had mentioned that, who needs glasses here ;)
Have you been a lifelong reader? Or did you read a lot, and then stop for a few years, and are now getting back into it and having trouble...?
Are there types of reading that are not so difficult? Can you read articles on your phone or screen without these issues? Do you remember material that you don't directly read such as an audio lectures?
If you are reading in a new field, you might not be used to actually reading every letter of a word. If you only read in a narrow subject matter then your mind can memorize word shapes rather than reading through every letter. When you then switch to a new field with unfamiliar words things slow down as you downshift into letter-by-letter reading. But they will speed up again once you get a grip on those new words. (This is a common law student complaint. The children of lawyers who grew up around words like "constitutionality", "relevancy" or "admissibility" temporarily seem to be faster readers because their brains have already memorized those word shapes. By second year this advantage disappears.)
Have you tried a concentration based meditation such as vipassana?
Sometimes it is 2-3 hours if I am feeling cramped for time, but 3-4 hours 4-5 days a week.
But still, are you burned out? Depressed? Anxious?
I will think about being depressed, anxious, etc. it could be a real possibility.
Finally, I assume you’re male. Have you had your testosterone levels checked?
I do feel joy.
I have an interest in a lot of things and notebooks full of ideas.
I love and listen to music daily.
I am Buddhist and have a daily practice along with prostrations and reading texts, meditation, etc.
There's stigma about self-diagnosing, but if you've got a little sense it's a very good idea to do so. You may well google your exact signs, symptoms, and circumstances and find the doctor's (multiple doctors, even!) failed to rule out the #1 most likely cause, let alone more obscure possibilities.
The good news is, the brain can remap and relearn.
The best reading training was a kind of side scroller which scrolled a text from right to left. You could adjust speed, font, fontsize and the actual text.
This was in the 90s, so I don’t know if there is a program like this now, but it should be easy to build something with JavaScript in the browser.
This happens to me a lot. It's stress related. If I'm really under pressure or burnt out I put 110% effort in and get stuck. That builds impatience with myself and that burns me out even more.
I go through periods when I can't learn a thing I'm just too wired on stress hormones. It normally takes a few months of doing mindless things to come back to normal. Physical work or basic repetitive admin tasks seem to be the best for clearing the burn out. Anything that doesn't require mental clarity or learning but still provides a sense of achievement.
I went from a period where I seriously struggled to learn things like one new git command to picking up functional programming in F# with ease.
I should mention that I have had some auditory hallucinations within the last few weeks.
FWIW, this entire thread is really something you should bring up with your doctor(s), and not rely on people on the internet for anything more than empathy.
Nobody can diagnose you with a brain tumor over the Internet and primary brain tumors are in fact rare - about 1.3% of all cancers.
Edit: I saw that you read plenty for pleasure, so it's probably not this :/
That said, if you don't see (or haven't seen) noticeable improvement over 3-5 months, that is probably a signal to pay attention to.
The solution? It seems to me that the opposite of spreading your attention in every direction is meditation. Sitting quietly and silencing your mind. Perhaps if you can learn and become comfortable in that state of mind, you can evoke it to some degree while you're reading to help achieve focus.
The reading glasses solved that problem, and I was reading again. I also had been in denial and finally got progressive lenses for my glasses.
I know this is not your particular issue, what's happening to you sounds awful.
It sounds like you have a "tracking" problem?
Good luck.
I don't know if there's anything you can do about it. I did start drinking those energy drinks with nootropics, at least the caffeine helps.
Some other suggestions are: get a lot of sleep, cognitively I declined tremendously when I got sleep deprivation. I would also get an MRI. I just read your comment about slurring words and I would spend the money and get an MRI on your own money just to be sure.
Good luck - might take a few months, but with good sleep and restricting phone use, I would imagine you'll see improvements. Med school is also very hard - my wife's a doctor so I see this up close. Don't be too hard on yourself.
I use an iPad also but I don't have any social media apps, etc loaded. Its very strictly used for classwork, research, assignments, etc.
I use a Kobo ereader a lot. It has integration with Pocket[1] which makes it handy for reading a lot of web pages. Then there is Calibre[2] for converting and managing any other documents I may need to deal with.
Good luck!
[1] https://getpocket.com/
[2] https://calibre-ebook.com/
So it wouldn't surprise me if skills like reading also fall under this. But to be fair the stuff you are probably reading is probably really dense and full of lots of medical terminology so it might not be surprising that you have to reread it.
1. Eye glasses. At this age (~ 42-43, more precise) most people start to have degrade vision that requires some correction, mostly for reading. Even if you can read without glasses, it is not really efficient.
2. Information overload in the Internet age made us learn to skim instead of read. This is involuntary and it is very difficult to correct, but at least you can do something about it.
3. Age shows for your brain, this is why we do school very young. There is nothing you can do about this particular point, just learn to live with it and handle the consequences. This applies also to coding, there was a question yesterday about coding and focus at 40 years old.
Not asking in a facetious way, but is this medical program a level up from what you've done in the past?
Stress maybe? How's your Maslow's sleep, diet, exercise, and mood?
Also, consider that age comparing now with peak performance of say 15-20's is unfair. Give yourself a break.
Maybe a sabbatical is in order.
Even when the problem might have nothing to do with their age.
I suspect that an effect of headlines like this is that it reinforces ageism in tech.
Ageism has been a problem in tech since the the modern flavor of Internet startups started. (AFAICT, with the "drop out of college to be a founder, because you have fewer commitments, and will work harder" essays.) And we're still seeing mutated versions of that.
Something you can do in the in between time is order a full blood panel, kidney, liver, thyroid, hormones, etc, online or through your doctor's office. Then get a copy of this (you can often download a PDF from the lab company that does your panel, or doctor's office) and visit a natural path (ND). You might be able to find one through your school. Bring up what foods you eat, your lifestyle, exercise, sleep habits. Then, try and see if any adjustments work.
When you finally do get an appointment for a medical doctor (you said in 9 months) bring this information, so your doctor has something to go on. Your MD will probably just re-order the labs again, but now you will have some previous data, and some experience tweaking your lifestyle with what worked and didn't.
Do you have experience with an ND?
What solved the mental focus for me was light movement while reading (walking on treadmill etc) and/or laying down to relax most core muscles. Second, shockingly NOT chewing gum or doing too much downward facing iPhone reading made a massive difference to my vision.
Causality? The impact of posture and/or movement on breathing has a big impact on brain focus. If you have a blood O2 meter you can test this while your are reading. Ironically the more worried you become about not focusing the more you hold your breath and the more clenched your posture. It’s a vicious cycle.
Gum was the shocker, I would habitually chew in the morning for an hour or two (mindlessly) and it turns out it was over taxing the jaw and neck muscles. This caused the eye muscles to be impacted and resulted in blurry strained vision. Cutting out gum for a week almost entirely removed my need for glasses. Lastly, I would still get blurry vision occasionally and finally narrowed it down to iPhone “texting neck”.
I’ll post a couple of refs in a minute. May be unrelated but if there’s a thread to pull on here I hope it helps.
https://news.ycombinator.com/item?id=24102829
I definitely feel like I am back to higher functionality in my 50s, though the reading process is definitely different.
If you are familiar with Kahneman metaphors of System 1/System 2, my reading when I was younger used to be System 1 (quick, ingestion for memory rather than concept, etc) and now it is almost entirely System 2 (slow, conscious, model building). So it is slower, but definitely deeper, and maybe on balance more efficient.
In terms of what helped- I recall noticing this reading issue and being unhappy about it, and making a conscious effort to practice...which means what exactly? Not sure.
I don't experience those seemingly physical issues anymore of transposing or skipping. And while I have had distance glasses since my teens, I still don't require reading glasses. Am sure at some point I will.
One odd association here fwiw is that I am very careful these days about staying fully hydrated when doing intellectual work. I drink very large quantities of water- up to and over a gallon some days. I never feel thirsty but when I start to notice subtle intellectual deficiencies, or my attention is sagging, I go and drink 16 or 32 ounces of water, and then often performance improves. Sometimes I take a bit of salt as well. Seems bizarre to me, I don't understand the biochemistry. But it works like a charm. This is a recent practice for me- last 5-10 years. After sleep, staying very hydrated is the top of the maintenance list.
Good luck to you.
Now, it is hard. I am constantly writing my comments at the end of each page, and pausing to re-read a line.
One thing that helps is to read important content right after working our or meditating, when the mind is at it's most focused. I live close to a park and a river, and leaving my phone behind and reading at either of these places, brings that boy in me back now and then. I also keep a small notepad where I mark down all the distractions that assume fake urgency, and I get back to reading.
However it is not all negative though. I am able to make sense of what I read in a _different_ way than I did when I was in my 20s. I am able question what I read, toss it around, swirl it in my mind more and reflect on what I read. Years ago, what would have appeared as a stand-alone fountain of new knowledge, now gets bunched to an vestibule of other knowledge I have accumulated over years about a field I am reading about. I learn more by contrasting with what I know, than de novo.
All the best.
I’ve had an eye check, a few months back a general medical. Both were fine/no significant changes. I rarely drink, no drugs. I feared a series of migraines might been response but I’ve been assured otherwise.
I so far figured it’s too much skim reading, a lot of very poor sleep, being on the edge of burn out and maybe a touch of post COVID brain fog.
Your post is encouraging me to start doing something about it.
I don’t have much to add but it’s reassuring to know that I’m not alone
Small hardcopy print just gives me a headache.
I find this really helps me both focus and retain what I'm reading, even though it takes a bit longer. It also helps tremendously when reading ancient texts, the Bible, etc.