Oliver Sacks

The Man Who Mistook His Wife For A Hat and Other Clinical Tales

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    Zhenya Chaikahar citeretfor 22 dage siden
    This brings us to our final question: is there any ‘place’ in the world for a man who is like an island, who cannot be acculturated, made part of the main? Can ‘the main’ accommodate, make room for, the singular?
    Zhenya Chaikahar citeretsidste måned
    I’m like a sort of living carpet. I need a pattern, a design, like you have on that carpet. I come apart, I unravel, unless there’s a design.’ I looked down at the carpet, as Rebecca said this, and found myself thinking of Sherrington’s famous image, comparing the brain/mind to an ‘enchanted loom’, weaving patterns ever-dissolving, but always with meaning. I thought: can one have a raw carpet without a design? Could one have the design without the carpet (but this seemed like the smile without the Cheshire cat)? A ‘living’ carpet, as Rebecca was, had to have both—and she especially, with her lack of schematic structure (the warp and woof, the knit, of the carpet, so to speak), might indeed unravel without a design (the scenic or narrative structure of the carpet).
    Zhenya Chaikahar citeretfor 2 måneder siden
    The brain’s record’ of everything—everything alive—must be iconic. This is the final form of the brain’s record, even though the preliminary form may be computational or programmatic. The final form of cerebral representation must be, or allow, ‘art’—the artful scenery and melody of experience and action.
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    And I myself was wrung with emotion—it was heartbreaking, it was absurd, it was deeply perplexing, to think of his life lost in limbo, dissolving.
    ‘He is, as it were,’ I wrote in my notes, ‘isolated in a single moment of being, with a moat or lacuna of forgetting all round him . . . He is man without a past (or future), stuck in a constantly changing, meaningless moment.’
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    Angrily he threw the magazine down.
    He was becoming fatigued, and somewhat irritable and anxious, under the continuing pressure of anomaly and contradiction, and their fearful implications, to which he could not be entirely oblivious. I had already, unthinkingly, pushed him into panic, and felt it was time to end our session. We wandered over to the window again, and looked down at the sunlit baseball diamond; as he looked his face relaxed, he forgot the Nimitz, the satellite photo, the other horrors and hints, and became absorbed in the game below. Then, as a savoury smell drifted up from the dining room, he smacked his lips, said ‘Lunch!’, smiled, and took his leave.
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    On intelligence testing he showed excellent ability. He was quick-witted, observant, and logical, and had no difficulty solving complex problems and puzzles—no difficulty, that is, if they could be done quickly. If much time was required, he forgot what he was doing. He was quick and good at tic-tac-toe and checkers, and cunning and aggressive—he easily beat me. But he got lost at chess—the moves were too slow.
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    ‘What year is this, Mr G.?’ I asked, concealing my perplexity under a casual manner.
    ‘Forty-five, man. What do you mean?’ He went on, ‘We’ve won the war, FDR’s dead, Truman’s at the helm. There are great times ahead.’
    ‘And you, Jimmie, how old would you be?’
    Oddly, uncertainly, he hesitated a moment, as if engaged in calculation.
    ‘Why, I guess I’m nineteen, Doc. I’ll be twenty next birthday.’
    Looking at the grey-haired man before me, I had an impulse for which I have never forgiven myself—it was, or would have been, the height of cruelty had there been any possibility of Jimmie’s remembering it.
    ‘Here,’ I said, and thrust a mirror toward him. ‘Look in the mirror and tell me what you see. Is that a nineteen-year-old looking out from the mirror?’
    He suddenly turned ashen and gripped the sides of the chair. ‘Jesus Christ,’ he whispered. ‘Christ, what’s going on? What’s happened to me? Is this a nightmare? Am I crazy? Is this a joke?’—and he became frantic, panicked.
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    This moving and frightening segment in Buñuel’s recently translated memoirs raises fundamental questions—clinical, practical, existential, philosophical: what sort of a life (if any), what sort of a world, what sort of a self, can be preserved in a man who has lost the greater part of his memory and, with this, his past, and his moorings in time?
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    ‘Well, Dr Sacks,’ he said to me. ‘You find me an interesting case, I perceive. Can you tell me what you find wrong, make recommendations?’
    ‘I can’t tell you what I find wrong,’ I replied, ‘but I’ll say what I find right. You are a wonderful musician, and music is your life. What I would prescribe, in a case such as yours, is a life which consists entirely of music. Music has been the centre, now make it the whole, of your life.’
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    Of course, the brain is a machine and a computer—everything in classical neurology is correct. But our mental processes, which constitute our being and life, are not just abstract and mechanical, but personal, as well—and, as such, involve not just classifying and categorising, but continual judging and feeling also. If this is missing, we become computer-like, as Dr P. was. And, by the same token, if we delete feeling and judging, the personal, from the cognitive sciences, we reduce them to something as defective as Dr P.—and we reduce our apprehension of the concrete and real.
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    But in Dr P.’s case it is precisely the cortex that was damaged, the organic prerequisite of all pictorial imagery. Interestingly and typically he no longer dreamed pictorially—the ‘message’ of the dream being conveyed in nonvisual terms.
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    Our cognitive sciences are themselves suffering from an agnosia essentially similar to Dr P.’s. Dr P. may therefore serve as a warning and parable—of what happens to a science which eschews the judgmental, the particular, the personal, and becomes entirely abstract and computational.
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    Manifestly, here, he could not make a cognitive judgment, though he was prolific in the production of cognitive hypotheses. A judgment is intuitive, personal, comprehensive, and concrete—we ‘see’ how things stand, in relation to one another and oneself. It was precisely this setting, this relating, that Dr P. lacked (though his judging, in all other spheres, was prompt and normal). Was this due to lack of visual information, or faulty processing of visual information? (This would be the explanation given by a classical, schematic neurology.) Or was there something amiss in Dr P.’s attitude, so that he could not relate what he saw to himself?
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    I commented on this to Mrs P.
    ‘Ach, you doctors, you’re such Philistines!’ she exclaimed. ‘Can you not see artistic development—how he renounced the realism of his earlier years, and advanced into abstract, nonrepresentational art?’
    ‘No, that’s not it,’ I said to myself (but forbore to say it to poor Mrs P.). He had indeed moved from realism to nonrepresentation to the abstract, yet this was not the artist, but the pathology, advancing—advancing towards a profound visual agnosia, in which all powers of representation and imagery, all sense of the concrete, all sense of reality, were being destroyed. This wall of paintings was a tragic pathological exhibit, which belonged to neurology, not art.
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    He does everything singing to himself. But if he is interrupted and loses the thread, he comes to a complete stop, doesn’t know his clothes—or his own body. He sings all the time—eating songs, dressing songs, bathing songs, everything. He can’t do anything unless he makes it a song.’
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    He could remember incidents without difficulty, had an undiminished grasp of the plot, but completely omitted visual characteristics, visual narrative, and scenes. He remembered the words of the characters but not their faces; and though, when asked, he could quote, with his remarkable and almost verbatim memory, the original visual descriptions, these were, it became apparent, quite empty for him and lacked sensorial, imaginal, or emotional reality. Thus, there was an internal agnosia as well.
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    Again he mentioned only those buildings that were on the right side, although these were the very buildings he had omitted before. Those he had ‘seen’ internally before were not mentioned now; presumably, they were no longer ‘seen’. It was evident that his difficulties with leftness, his visual field deficits, were as much internal as external, bisecting his visual memory and imagination.
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    he construed the world as a computer construes it, by means of key features and schematic relationships.
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    He saw nothing as familiar. Visually, he was lost in a world of lifeless abstractions. Indeed, he did not have a real visual world, as he did not have a real visual self. He could speak about things, but did not see them face-to-face.
    Haydar Anwar Rezahar citeretfor 3 måneder siden
    A face, to us, is a person looking out—we see, as it were, the person through his persona, his face. But for Dr P. there was no persona in this sense—no outward persona, and no person within.
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