05/31/2012 07:43 am ET Updated Jul 31, 2012

Prosopagnosia: What It's Like to Be Face Blind

It happens fairly frequently. I'm at a coffee shop, and a woman I know comes up, says hello and we begin to exchange pleasantries. She's nice enough, but I find myself quickly trying to end the conversation.

Mostly, because I don't know who the f--- she is.

As I mention, I do know her and obviously she knows me, but a part of my brain can't recognize her. I have a disorder called prosopagnosia, more commonly known as face blindness. It's an impairment of facial perception. I can see faces clearly, but as soon as the person is out of sight they are, for me, literally out of mind. I can recall a hair style, eye color, clothing or body type, but the facial features as an organized whole become lost on me within minutes. For example, if we met at a crowded party and you said your name was Dave, and if we bumped into each other again at the same function, unless you are distinct, there's a fair chance I might tell you all about the Dave I had just met earlier.

So far, there's no standard treatment for prosopagnosia, and for a long time it was thought to only be a result of severe brain injury or neurologic disorders. But now a congenital or developmental form is more commonly cited. There are varying degrees, and some theorize up to 10 percent of the population could be affected. Still, as an impairment, it remains relatively unknown.

I didn't even know about the condition until I was in my 30s and saw a news segment about it and, ironically, recognized myself. For years, I just thought I was a self-absorbed jerk unwilling to remember the people around me. As the segment detailed, prosopagnosia is a fairly pliable disorder -- with some forgetting the face of casual acquaintances and others who can't discern family members or their own image in the mirror.

I'm somewhere in the middle, to the point where it can put me in a real fix on occasion. Like in the case of the coffee shop.

To give you an idea, here is what goes on in my head during such an encounter. It unfolds not unlike a transcript of Sherlock Holmes and Mr. Magoo teaming up to solve a mystery:

Woman: Hey, Mary!

Me: Hey... you! ("You" is my polite go-to. She's wearing workout clothes so maybe she's someone from the gym. Too old to be one of the parents in my kid's class.)

Woman: Sorry I'm a mess. I'm just back from the gym. (Okay, now the gym is very possible. And it's not far from coffee shop. Warmer.)

Me: Yeah, I should get down there. (Still searching face for a hit. Colder. Start focusing on laptop since I'm not getting an I.D. on this one.)

Woman: Well, off I go. Have a good day!

Me: You, too! (Whoever you are...)

Like I say, this happens fairly frequently.

I can tell you she's brunette. I can tell you she's probably in her 50s. But you know her face as well as I do.

I guess I've had it from the beginning. As a child, I had terrible vision that went uncorrected until the 6th grade. I recall borrowing a friend's glasses on the bus and for the first time, realizing you could see individual leaves on trees. So initially, I blamed my poor sight for my inability to pick out friends in the hallway or anyone out of context. To adapt, I learned to identify people by the way they walked, their voices or other distinguishing characteristics. As a result, I became an extremely good mimic. Capping my palm over my hairline, creating a higher forehead while hissing, "You damn kids!" I became the angry version of my mother, sending my siblings into hysterics. Occasionally, I was even pulled out of my elementary school class and into the smoke-filled teacher's lounge to impersonate a coach or hapless substitute and was rewarded with brays of laughter between their mouthfuls of Bundt cake and drags of Virginia Slims. So coping was not without its upside.

But when I left home for college, I traded the familiar cast of a small town for a sea of unknowns, and my memory would constantly betray me. Contact lenses in place for years, I could no longer blame my poor sight. I merely assumed I was shy and must not be concentrating enough when others spoke to me.

And it's not like forgetting a name, where you can apologize and ask again. In some cases, I can't recall people I've known for months or years. Basically, if someone is out of place or I don't see them on a usual basis, I am often stumped. There's simply no way of explaining myself. Except perhaps claiming to have been clobbered over the head and mugged moments before and feigning temporary amnesia. At least that scenario would make sense to most.

Once I figured out I had the disorder, I attempted various approaches to compensate for and quell these awkward exchanges. One time, I tried being completely honest with a woman whom I had displaced. She backed away from me very slowly. She was blonde and in Texas, where I live, there are a million of them, and these are the hardest ones for me. Between the blonde women and the Lululemon yoga outfits that dot my neighborhood, it's not unlike living in my own version of Tron. Men are much easier for me to identify. They are less apt to follow trends and adopt such uniforms. (Unless they do adopt a uniform, which gives me another handy tool to identify them.) When I manage to remember a remote individual, it's almost impossible for me to contain my excitement, giving various benign acquaintances -- like my FedEx delivery guy -- the false impression that they mean much more to me than they ever realized.

My husband has learned it's just part of living with me, like the stray spoons he finds laced with residual Nutella. When I attend his larger work functions, we use code phrases. "You remember Mary..." he'll say to someone as we approach, which is my signal that I've met this person. Once they begin to speak, the conversation will often cue genuine recognition, and I'm no longer forced to wing it. He must also endure my cluelessness during movies where I sometimes lose track of characters. An hour into the feature, I'll squeeze his arm. "Who's that guy?" I'll whisper. "They call him The Terminator," he patiently replies.

And if someone slightly resembles another person, there's a pretty good chance I'll mix them up. For example, if I were friends with Zooey Deschanel, I'd undoubtedly offer her condolences over her divorce to Russell Brand while gushing to Katy Perry that she's simply adorable in The New Girl.

For a while, Facebook saved me. As I discovered, seeing a photo of a "friend" somehow aligned the features for my brain. One picture, and I forever owned this person's image in my mind's file. (In fact, if I have easy recall of someone, I can trust that I've seen a photo of them at some point.) Then when I deleted my Facebook account, Twitter and Google images became my mental crib notes. I tested this theory via a close friend. I had known him for almost 20 years, but I still couldn't imagine his face. To me he was a beard, brown eyes and a warm sense of humor. It occurred to me I had never seen a photo of him. So I snapped an iPhone picture while we were at lunch. And ever since, I can remember him -- forever devouring a plate of enchiladas -- but his face as clear as I need it to be.

At times, it can be a bit sad for me. I'll meet an interesting person on a plane or in another city and know quite literally I'll never see them again. They will be reduced to bits of a conversation, a feeling or an impression with no mental picture attached. Sometimes I will catch myself staring really hard hoping to make it register. But try as I might, I can't will them to stay. As soon as they walk away, they disappear around the corner of my mind's eye. In public, I occasionally resort to a slightly aloof stance as to not endure an unnecessary unfamiliar encounter. Either that or I'm generally friendly as to not offend. When out alone, I find I gravitate toward isolated areas or sit facing walls or windows. I've told myself it's so I can concentrate on my book or laptop, but in part, I know it's to avoid the pop quizzes my visual deficit relentlessly assigns. To fail is to fail others, for fear they will think I don't care enough to remember them. That is probably the worst part.

No one else in my family seems to have any of the tell-tale signs of prosopagnosia. But in this day and age of visual documentation, I wonder if technology has unwittingly masked or delayed the on-set of symptoms. So at the age of 3, before my daughter could go online or be iPhone-nundated, I asked her, "When there are a lot of mommies at the pre-school, how do you know which one is yours?"

"You're Mama!" she replied to my relief. "And you have black hair and pointy shoes like a Halloween witch."

So long as she can spot me, I'll take it.

And if you spot me, and I say, "Hey, you" just know deep down, I really want to mean it.

For more by Mary K. Moore, click here.

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