In medical settings, and in psychological assessments, patients are almost always asked 3 important questions: (1) Who are you/What is your name?; (2) Where are you, right now?; and (3) What time is it? People with cognitive impairment are often unable to answer these simple questions and sometimes, they become confused as to why they are being asked something they should, but do not, know. These 3 questions, although seemingly innocuous, inform the medical or psychological care provider with important information regarding whether the patient is responsive to his/her environment. In combination, they are commonly referred to as “Orientation X 3.” Some people apparently live their lives without being oriented times 3. I am not referring to people with cognitive impairment, such as a traumatic brain injury, dementia, or amnesia; instead, I am referring to the average person who goes through life cluelessly, without regard to the who, what, where, when, and why aspects of their world. For example, I have many friends who, although they have been to my house previously (even frequently), have no idea how to get there. They have to use a GPS, an old fashioned paper map, or written directions to find my house, even though my house is located exactly in the same place where it has been since the day it was built. Other people, like me, are oriented times 3. These people know: who they are; where they are; where they have been; where they are going; and they know what time it is (meaning they arrive at my house or wherever we are meeting on time, instead of making me wait while they try to become oriented to their surroundings). GPS devices are a great invention, but in my opinion, they will never replace one’s innate brain power. As with all muscles, using one’s brain will exercise it and enhance one’s chances of always being oriented times 3.
Oriented X3. I’ve certainly seen this concept utilized in the medical arena, especially as it relates to cognitive testing. But, in thinking of the broader context about which Melissa writes, it occurs to me that there is another way we commonly relate to this concept. That is, “the lights are on, but nobody’s home.” We have probably all interacted with individuals who seem to be listening, to be paying attention, but they are not responding as if they heard you, or understood a word that was said. We may call them clueless. We may wonder why they seem impaired. Are they drunk, on drugs, mentally ill, or do they have a brain disease? We usually look for the “why” when someone’s lights seem off. Sometimes these interactions have little impact in the scheme of things, perhaps when a fast food restaurant employee seems clueless. But, we have been surprised when interviewing potential employees how many of them have seemed clueless, despite a resumé that showed significant possibilities. Or, employees who “blank out” and drop the ball. In those settings, one wonders if they are overwhelmed, and if so, why. And, because we all encounter people who are not oriented X3 regularly, when we encounter someone really sharp and on the ball, they stand out. Striving for Orientation X3 consciously is important in many ways. One of our posts involved an encounter we experienced at the Atlanta airport with other passengers who were acting abnormal. As I mentioned, upon boarding the airplane, I encountered a young man who had been “in his own world” in the gate area – he had no situational awareness. An example of how not being oriented X3 or situationally aware can be dangerous. We are all less than 100% aware sometimes, maybe we’re tired, or distracted, but there can be such a downside that being aware of the need to be aware is important.