The Names I Forget: A Confession, a Dogma, and Some New Wiring
My wife gives me a look across the school playground. Patient. Tired, but trying not to show it. I have just done another stealth greeting. Warm, friendly, no name. Her daughter has been in Karla’s class since they were three. I have eaten her cake. The name is gone, as always.
I have always been bad with names. Not just a little forgetful. Catastrophic.
I spent over a decade in management consulting, a job where you are supposed to know everyone’s name. I still managed to forget. That is its own kind of achievement.
A man I have worked with for ten years shakes my hand at a Christmas party. I know him instantly. I remember the projects, the dinners, the flights. His name is gone. My wife has given up trying.
We have known some couples for over a decade: birthday parties, sleepovers, all of it. I still walk in and cannot remember a name.
So I work around it. I say, “It’s the mom of the girl in Magnus’s class, the one with blonde hair.” My wife sighs. “That’s <any name>. We have known her for eight years.” Right. I’m sorry, <any name>.
In public, my wife steps in. She says the name first so that I can follow. I use “good to see you” and “hello again” like someone who remembers everything. At home, I ask, “What was the name of that guy again? The one who works in film and writes books?” Another small tax on the marriage.
Here is the absurd part. I can name the GLP-1 receptor agonist subclass that includes tirzepatide. Instantly. I can recite the carnitine shuttle pathway. The biochemistry of cortisol release. Drug names, molecules, signaling cascades. All memorized.
People’s names? A polite white screen.
This is not decline. My brain has always been wired this way. The real question is different. Can the brain grow into a place it has never been?
For most of the last hundred years, the answer was no. Read Cajal.
The Argument That Just Ended
Santiago Ramón y Cajal won a Nobel Prize for figuring out, almost by hand, that the brain is made of individual cells called neurons. His ink drawings of nerve tissue are still in textbook chapters today. He had an iron pen and an iron certainty. In 1928, he wrote the sentence that closed the field for seventy years. “In the adult centers, the nerve paths are something fixed, ended, immutable. Everything may die, nothing may be regenerated” [1]. The brain you had at twenty-five was the brain you would die with. The verdict held.
It started cracking in the 1990s. Rodent studies kept finding new neurons in animal hippocampi, and the rodents were stubbornly refusing to be wrong.
Then 1998. A Swedish neurologist named Peter Eriksson got hold of brain tissue from cancer patients who had been injected with BrdU, a chemical that labels dividing cells. He sliced their dentate gyrus, the curved ribbon of tissue inside the hippocampus where memory gets made. Under the microscope, lit up by the BrdU label, were brand-new neurons. Born after the patients had become adults. In human brains. The Nature Medicine paper that came out of this was the first hard evidence that Cajal had been wrong [2].
The field was not happy. Some senior careers depended on the idea that no new neurons grew.
In 2013, Kirsty Spalding’s group in Stockholm used carbon-14 from atmospheric nuclear-test residues, absorbed by every human alive in the second half of the twentieth century, as a biological clock. Their estimate: 700 new neurons per day in the adult hippocampus. Annual turnover of 1.75% [3]. The brain was not a fossil. It was a slow stonemason.
Then, in 2018, it got ugly. Two papers, weeks apart, in the same family of journals. Maura Boldrini at Columbia: neurogenesis persists into the eighth decade [4]. Shawn Sorrells in San Francisco: undetectable in adults [5]. Scientists publicly accused each other of degraded tissue, dirty antibodies, and sloppy staining.
A 2019 Madrid paper from María Llorens-Martín’s group reaffirmed neurogenesis in healthy older adults and showed it collapses in Alzheimer’s [6]. Evidence kept stacking on one side. Objections kept coming from the other.
Science journalists called it the neurogenesis war. Neuroscientists called each other worse. The fight lasted almost a decade.
In February 2026, Ahmed Disouky, Tamar Gefen, and Orly Lazarov published a paper in Nature that put an end to the argument [7]. Multiomic single-cell sequencing on 355,997 hippocampal nuclei. They could read the molecular signatures of neural stem cells, neuroblasts, and immature granule neurons across adult brains of every age. The evidence was no longer arguable.
The adult human brain grows new neurons. All through life. Cajal was wrong. We have known this for about ten weeks.
What the SuperAgers Have
The same paper carried a second finding, just as interesting.
Northwestern has run a program called SuperAging for 25 years. The criteria: you are over 80, and your memory performance matches that of healthy people in their fifties [8]. Imagine an 84-year-old who can hold fifteen new words for an hour and out-recall your colleague in marketing.
Disouky’s team looked specifically at the hippocampi of these SuperAgers. They were producing roughly twice as many new neurons as their healthy age-matched peers. Two and a half times more than peers with Alzheimer’s [7]. Their hippocampal microenvironment, the chemical soup these neurons grow in, carried what the researchers called a resilience signature. A pattern of gene activity that supports the birth and survival of new cells.
SuperAgers are social. Curious. Physically active. Many still work at 80. They challenge their brains every day, not with brain training, but by learning instruments, arguing at dinner, and showing up.
This is not just genetics. Their brains are shaped every day by what they do.
Two people, both 47, both with the same job, can have very different brains at 77. The difference is invisible now. It is obvious later.
What Is on the Other Side of That Fork
Cortisol shrinks the exact tissue SuperAgers are growing.
Robert Sapolsky has spent decades documenting this at Stanford. Chronic exposure to glucocorticoids damages hippocampal neurons. CA1 and CA3 regions get smaller. Dendrites retract. New neuron production stops [9]. Even short bouts of stress suppress neurogenesis in the dentate gyrus [10].
Hippocampal volume in depressed patients is consistently 10 to 15% smaller than in matched controls [9]. Treat the underlying stress, and some of that volume comes back [11].
Bruce McEwen called the cumulative effect allostatic load. The wear and tear of cortisol that never fully comes down [12]. Sonia Lupien has shown the hippocampus is exquisitely sensitive to chronic stress across the lifespan, including the decades when most executives are running hardest [13].
A 60-hour week. Broken sleep. Alcohol to wind down. Colleagues as your only social life. This is how you shrink your hippocampus.
Most executives I know in their late forties live this way. Then they buy a brain supplement.
The wellness industry has it exactly backward.
What Actually Works
The four things that work are boring.
Aerobic exercise. In 2011, Kirk Erickson published a randomized trial in PNAS. 120 sedentary older adults. Half put on a walking program: 40 minutes, three times a week. Just walking. After 1 year, the walkers had increased their hippocampal volume by 2%, reversing 1 to 2 years of shrinkage. The control group kept losing [14]. Aerobic exercise increases BDNF (brain-derived neurotrophic factor), a key signal that supports the survival of new neurons [15].
Sleep. Slow-wave sleep, especially in the first half of the night. This is when memory consolidates, waste is cleared, and new neurons survive [16]. Neurogenesis drops fast with sleep loss. The third whisky takes this from you. So does Netflix at midnight.
Effortful thinking. The Rush Memory and Aging Project tracked older adults for years. People who read hard books, wrote, or worked through tough problems every day declined more slowly, no matter their education [17]. The key was doing hard things often, not just trying something new once in a while.
Social complexity matters. Not just how many people you know, but the different roles they play. People with more diverse social ties get sick less often [18]. Social connection is as important as not smoking [19]. SuperAgers stay engaged with people. It is not extra. It is essential.
What the Industry Sells You Instead
In 2016, Daniel Simons and a team of leading psychologists reviewed the entire evidence base behind brain training programs. 130 pages, Psychological Science in the Public Interest. Their conclusion: people who train on these games get better at the games, and almost nothing transfers to real-world cognition [20].
The same year, the FTC ordered Lumosity to pay $2 million for deceptive advertising. The agency’s words: the company “preyed on consumers’ fears about age-related cognitive decline” [21].
The cognitive supplement market is no better. Lion’s Mane, alpha-GPC, modafinil microdoses, nootropic stacks in tubs. Most studies are small, short, and funded by the sellers. The people buying these are the same ones sleeping six hours, drinking wine on a Tuesday, and working weekends. The real problem is high cortisol. The industry gets the diagnosis wrong and sells the wrong fix.
Capacity, Built Decades Before You Need It
In the Upward ARC framework, this is Capacity. The long-term reserve. Activate is the stimulus. Recover protects the gains. Capacity is the brain you will need at seventy-five.
The 80-year-old SuperAger did not start last week. They built that brain in their forties and fifties. The heart, the hippocampus, the social network. None of it was bought at the last minute.
The brain you will have at 75 is being built now. I don’t say this like a motivational slogan. I point out biology.
Try This Today
Follow Erickson’s protocol. Walk briskly or cycle in Zone 2 for at least 150 minutes a week. The PNAS trial used walking and still grew hippocampal volume [14]. You do not need a coach.
Protect your slow-wave sleep. Get seven hours without interruption, especially the first three. No alcohol within four hours of bed. No phone in the bedroom. Deep sleep is when new neurons survive.
Spend twenty minutes a day on something that makes you concentrate. Trade news scrolling for a harder book or a course in something new. The Rush study found that doing hard things consistently matters, not just trying something new once [17].
Cut two stressors that do not matter. Most executive stress comes from a few things that are not important. The pointless status meeting. The check-in that became mandatory. Remove or buffer two of them. Your hippocampus depends on it.
The Names
I still forget names. The mom of the girl in Magnus’s class is still a workaround. My wife is not expecting a change.
But I see it differently now. This is not a flaw to hide. My brain is just wired this way, and the science says I can keep building. 700 new neurons today. Another 700 tomorrow. Into my eighties, if I do the work. The question I have carried finally has an answer.
Pray for me that I use it for name recalling.
Cajal was wrong. The brain is not fixed at twenty-five. Not at forty-seven. Maybe not even at eighty-seven, if you look at SuperAgers.
The hundred-year argument is over. Build your brain accordingly.
Stay healthy.
Andre
References
[1] Ramón y Cajal, S. (1928). Degeneration and regeneration of the nervous system (R. M. May, Trans.). Oxford University Press.
[2] Eriksson, P. S., Perfilieva, E., Björk-Eriksson, T., Alborn, A. M., Nordborg, C., Peterson, D. A., & Gage, F. H. (1998). Neurogenesis in the adult human hippocampus. Nature Medicine, 4(11), 1313-1317.
[3] Spalding, K. L., Bergmann, O., Alkass, K., Bernard, S., Salehpour, M., Huttner, H. B., Boström, E., Westerlund, I., Vial, C., Buchholz, B. A., Possnert, G., Mash, D. C., Druid, H., & Frisén, J. (2013). Dynamics of hippocampal neurogenesis in adult humans. Cell, 153(6), 1219-1227.
[4] Boldrini, M., Fulmore, C. A., Tartt, A. N., Simeon, L. R., Pavlova, I., Poposka, V., Rosoklija, G. B., Stankov, A., Arango, V., Dwork, A. J., Hen, R., & Mann, J. J. (2018). Human hippocampal neurogenesis persists throughout aging. Cell Stem Cell, 22(4), 589-599.
[5] Sorrells, S. F., Paredes, M. F., Cebrian-Silla, A., Sandoval, K., Qi, D., Kelley, K. W., James, D., Mayer, S., Chang, J., Auguste, K. I., Chang, E. F., Gutierrez, A. J., Kriegstein, A. R., Mathern, G. W., Oldham, M. C., Huang, E. J., Garcia-Verdugo, J. M., Yang, Z., & Alvarez-Buylla, A. (2018). Human hippocampal neurogenesis drops sharply in children to undetectable levels in adults. Nature, 555(7696), 377-381.
[6] Moreno-Jiménez, E. P., Flor-García, M., Terreros-Roncal, J., Rábano, A., Cafini, F., Pallas-Bazarra, N., Ávila, J., & Llorens-Martín, M. (2019). Adult hippocampal neurogenesis is abundant in neurologically healthy subjects and drops sharply in patients with Alzheimer’s disease. Nature Medicine, 25(4), 554-560.
[7] Disouky, A., Gefen, T., Lazarov, O., et al. (2026). Human hippocampal neurogenesis in adulthood, ageing and Alzheimer’s disease. Nature.
[8] Rogalski, E. J., Gefen, T., Shi, J., Samimi, M., Bigio, E., Weintraub, S., Geula, C., & Mesulam, M. M. (2013). Youthful memory capacity in old brains: Anatomic and genetic clues from the Northwestern SuperAging Project. Journal of Cognitive Neuroscience, 25(1), 29-36.
[9] Sapolsky, R. M. (2000). Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders. Archives of General Psychiatry, 57(10), 925-935.
[10] Mirescu, C., & Gould, E. (2006). Stress and adult neurogenesis. Hippocampus, 16(3), 233-238.
[11] Starkman, M. N., Giordani, B., Gebarski, S. S., & Schteingart, D. E. (2003). Improvement in learning associated with increase in hippocampal formation volume. Biological Psychiatry, 53(3), 233-238.
[12] McEwen, B. S. (2007). Physiology and neurobiology of stress and adaptation: Central role of the brain. Physiological Reviews, 87(3), 873-904.
[13] Lupien, S. J., McEwen, B. S., Gunnar, M. R., & Heim, C. (2009). Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nature Reviews Neuroscience, 10(6), 434-445.
[14] Erickson, K. I., Voss, M. W., Prakash, R. S., Basak, C., Szabo, A., Chaddock, L., Kim, J. S., Heo, S., Alves, H., White, S. M., Wojcicki, T. R., Mailey, E., Vieira, V. J., Martin, S. A., Pence, B. D., Woods, J. A., McAuley, E., & Kramer, A. F. (2011). Exercise training increases size of hippocampus and improves memory. Proceedings of the National Academy of Sciences, 108(7), 3017-3022.
[15] Cotman, C. W., & Berchtold, N. C. (2002). Exercise: A behavioral intervention to enhance brain health and plasticity. Trends in Neurosciences, 25(6), 295-301.
[16] Stickgold, R. (2005). Sleep-dependent memory consolidation. Nature, 437(7063), 1272-1278.
[17] Wilson, R. S., Boyle, P. A., Yu, L., Barnes, L. L., Schneider, J. A., & Bennett, D. A. (2013). Life-span cognitive activity, neuropathologic burden, and cognitive aging. Neurology, 81(4), 314-321.
[18] Cohen, S., Doyle, W. J., Skoner, D. P., Rabin, B. S., & Gwaltney, J. M. (1997). Social ties and susceptibility to the common cold. JAMA, 277(24), 1940-1944.
[19] Holt-Lunstad, J. (2024). Social connection as a critical factor for mental and physical health: Evidence, trends, challenges, and future implications. World Psychiatry, 23(3), 312-332.
[20] Simons, D. J., Boot, W. R., Charness, N., Gathercole, S. E., Chabris, C. F., Hambrick, D. Z., & Stine-Morrow, E. A. L. (2016). Do “brain-training” programs work? Psychological Science in the Public Interest, 17(3), 103-186.
[21] Federal Trade Commission. (2016, January 5). Lumosity to pay $2 million to settle FTC deceptive advertising charges for its “brain training” program. FTC Press Release.
A note for new readers:
I’m a trained reconstructive facial surgeon, medical doctor, and dentist. Before launching this newsletter, I had a varied career: competitive freestyle wrestler, management consultant (McKinsey), entrepreneur (Zocdoc, Thermondo, and docdre ventures), and corporate executive (Sandoz). Today, I’m a Managing Director and Partner at BCG.
Husband of one. Father of three. Split between Berlin’s urban pulse and our Baltic Sea retreat. I’d rather be moving than sitting. Not just hobbies. Research. My body is my primary laboratory; I’ve been conducting experiments for decades.
If this is your first time here, welcome. I’m excited to share what I’ve learned and will continue to learn with you.
DISCLAIMER:
Let’s get one thing straight: None of this, whether text, graphics, images, or anything else, is medical or health advice. This newsletter is here to inform, educate, and (hopefully) entertain you, not to diagnose or treat you.
Yes, I’m a trained medical doctor and dentist. No, I’m not your doctor. The content here isn’t a replacement for professional medical advice, diagnosis, or treatment.
If you have questions about your health, talk to your physician or a qualified health professional. Don’t ignore their advice or delay getting care because of something you read in The Upward ARC. Be smart. Do your research. And, as always, take care of yourself.