An Anthropologist on Mars (1995) (46 page)

In his autobiography, The Making of Mind, A.R. Luria traces his own intellectual development in relation to the changing moods of neurology throughout his long lifetime,—his chapter on “Romantic Science” particularly brings out his sense of the indispensability of case histories, and how the narrative is crucial to medicine. His own two “romantic” case histories—The Mind of a Mnemonist and The Man with a Shattered World—are the finest contemporary examples of such histories. A fine critical essay on “inside” narratives of illness is Anne Hunsaker Hawkins’s Reconstructing Illness: Studies in Pathography.

Kurt Goldstein’s general discussion of neurological health, disorder, and rehabilitation is to be found in his remarkable 1939 book, The Organism (especially Chapter 10).

The postwar rationalist thinkers on health and disease have been especially Georges Canguilhem and Michel Foucault. Central books are Canguilhem’s The Normal and the Pathological and Foucault’s Mental Illness and Psychology.

Gerald Edelman has published five books on his theory of neuronal group selection; the most recent and most readable is Bright Air, Brilliant Fire. Israel Rosenfield’s The Invention of Memory gives a clear history of classical, localizationist neurology, and a sense of how radically neurology may have to be revised in the light of Edelman’s theory. I find Edelman’s ideas extremely exciting, providing a neural basis, as they aim to do, for the entire range of mental processes from perception to consciousness, and for what it means to be human and a self. An entire new theoretical neuroscience seems to spring from them. I have published two essays on Edelman’s work myself in The New York Review of Books: “Neurology and the Soul” and “Making Up the Mind.”

In a more general way, I have very much enjoyed Freeman Dyson’s Infinite in All Directions (originally entitled, when given as the Gifford Lectures, “In Praise of Diversity”). The sense of nature’s richness and complexity and creativity is also conveyed in all of Ilya Prigogine’s books—my favorite is From Being to Becoming—and in a book of extraordinary range, Murray Gell—Mann’s The Quark and the Jaguar: Adventures in the Simple and the Complex.

A charming early book (it contains the report on the achromatopic surgeon who fell off his horse, and other gems) is Mary Collins’s 1925 Colour-Blindness. Arthur Zajonc’s Catching the Light: The Entwined History of Light and Mind is a beautifully researched and written book, especially interesting in its consideration of Goethe’s ideas on color and their relation to Land’s. (Zajonc also speaks of the case of Jonathan I.)

Though Schopenhauer wrote a youthful essay “On Vision and Colour”, this is not readily accessible in English. But thoughts on color vision punctuate his magnum opus, The World as Will and Representation, and increased with every edition in his lifetime.

The nineteenth-century debate between different theories of color vision and their advocates comes to life in Steven Turner’s In the Eye’s Mind: Vision and the Helmholtz-Hering Controversy, and in an excellent essay-review of this by C.R. Cavonius.

Semir Zeki has been the pioneer investigator of mechanisms of color perception in the monkey; a synthesis of his work and its relation to current neuroscience is provided in his book A Vision of the Brain. A grand synthesis at a higher level, the level of visual awareness, is given by Francis Crick in The Astonishing Hypothesis: The Scientific Search for the Soul. Both of these books are quite accessible to the general reader. (And both discuss at length the case of Jonathan I.)

Antonio and Hanna Damasio and their colleagues have published many minute clinical studies of cerebral achromatopsia. Antonio Damasio has given a very full, if somewhat technical, account of this and other visual disorders in his chapter in Principles of Behavioral Neurology, and a more general account, coupled with reflections on the theoretical and philosophical importance of such observations, in his recent book, Descartes’ Error.

Edwin Land’s papers have recently been published in their entirety, but one of the most vivid of his accounts is “The Retinex Theory of Color Vision”, in Scientific American. An excellent essay on Land is “I Am a Camera”, by Jeremy Bernstein (this, too, refers to the case of Jonathan I.). And a fascinating film showing the chaos that would result if we did not have color constancy is Colorful Notions, originally broadcast by the BBC’s Horizon Series in 1984.

The Oxford Companion to the Mind, edited by Richard Gregory, is an indispensable reference on all sorts of neurological and psychological topics. It includes very good articles by Tom Troscianko, “Colour Vision: Brain Mechanisms”; by W.A.H. Rushton, “Colour Vision: Eye Mechanisms”; and by J.J. McCann, “Retinex Theory and Colour Constancy.”

An interesting account of the beginnings of color photography, “The First Color Photographs”, by Grant B. Romer and Jeannette Delamoir, was published in the Scientific American of December 1989. I published a letter on the subject, with reminiscences of color photography in the 1940
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, in the March 1990 issue. A centenary article, “Maxwell’s Color Photograph”, by Ralph M. Evans, appeared in the November 1961 Scientific American.

The personal experiences of a congenitally achromatopic man (who is also a vision scientist) are beautifully described in Knut Nordby’s “Vision in a Complete Achromat: A Personal Account.”

Finally, Frances Futterman, the achromatopic woman whose letters I have excerpted here, has started publishing the Achromatopsia Network Newsletter and hopes to network with achromatopic people all over the world. She may be contacted at Box 214, Berkeley, CA 94701-0214.

The grand describer of both frontal lobe and amnesic syndromes was A.R. Luria, in (respectively) Human Brain and Psychological Processes and The Neuropsychology of Memory. Both of these books are somewhat academic; it was Luria’s last wish to supplement them with “romantic” case histories. François Lhermitte’s two long papers entitled “Human Autonomy and the Frontal Lobes” give a vivid picture of his sympathetic and naturalistic approach to such patients.

By contrast, the ruthlessness that characterized the lohotomy era is described in a frightening book, Great and Desperate Cures, by Elliot Valenstein. A superb essay review of this was written for The New York Review of Books by Macdonald Critchley.

The case of Phineas Gage has excited unceasing neurological interest for nearly 150 years and even now is being re-explored using the most sophisticated techniques of reconstructive neuroimaging (see Damasio et al.’s Science article). The deepest exploration of the case, and its relevance to all nineteenth-century theorizing about the nervous system from Gall to Freud, has been provided by Malcolm Macmillan in “Phineas Gage: A Case for All Reasons” and by Antonio Damasio in Descartes’ Error.

Two of my earlier studies on memory, referred to in this chapter—“The Lost Mariner” and “A Matter of Identity”—are reprinted in The Man Who Mistook His Wife for a Hat.

The field of memory research is extremely active now, and it is almost invidious to single out names. But Larry Squire and Nelson Butters are certainly leaders in this field and, individually and jointly, have written innumerable papers over the years, as well as edited the volume The Neuropsychology of Memory. Other suggested readings on the subject of memory are included in the suggested readings for “The Landscape of His Dreams.”

There is also an explosion of interest in the neurology of music and all its therapeutic powers in patients with neurological disorders. Anthony Storr, the psychiatrist, has written a beautiful book, Music and the Mind, which touches on every aspect of human response to music. In a chapter entitled “Music and the Brain”, in the forthcoming book Music and Neurologic Rehabilitation, I have focused more narrowly on the possible ways in which music can affect the brain.

Mickey Hart has written about percussion and rhythm in many cultures, in Drumming at the Edge of Magic.

Gilles de la Tourette’s two-part paper, “Étude sur une affection nerveuse”, was published in 1885, and a partial translation is included, with a commentary, in “Gilles de la Tourette on Tourette Syndrome”, by C.G. Goetz and H.L. Klawans. Meige and Feindel’s great book, Les Tics et leur traitement, was published in 190a and translated by Kinnier Wilson in 1907. This book is remarkable not only for its comprehensiveness, but for its tone-the authors’ respect for their subjects and the real conversations between them and their physicians. It includes a unique, early autobiographical narrative, “Les Confidences d’un ticqueur.”

It is only in the last few years that there have been more accounts from the inside about what it can mean to live with Tourette’s. A series of such inside narratives, edited by Adam Seligman and John Hilkevich, was published as Don’t Think About Monkeys.

I have written a number of papers on Tourette’s: “Witty Ticcy Ray”, originally published in 1981, was republished in The Man Who Mistook His Wife for a Hat, along with “The Possessed.” A general overview of the subject is given in “Neuropsychiatry and Tourette’s”, published in 1989, and more briefly and recently in “Tourette’s Syndrome: A Human Condition.” A particular aspect of Tourette’s that has always fascinated me was presented in “Tourette’s and Creativity”; and research on the speed and accuracy of Tourettic movement, “Movement Perturbations Due to Tics”, appeared in the 1993 Society for Neuroscience Abstracts.

The Tourette Syndrome Association, 42-40 Bell Boulevard, Bay side, NY 11361, first founded in 1971, disseminates information, gives physician referrals, and sponsors research. It can be contacted at (718) 224-2999 or (800) 237-0717 for information on local chapters.

The restoration of vision to those blinded early in life, though rare, has been documented with great care since Cheselden’s report in 1728. All known cases up to 1930 are summarized in von Senden’s encyclopedic book, Space and Sight. Many of these are analyzed by Hebb in his Organization of Behaviour and form, along with much other observational and experimental data he provides, crucial evidence that “seeing”—visual perception-must be learned.

The single richest and most detailed case study is that of Richard Gregory and Jean Wallace. This was subsequently reprinted, with further additions, including an exchange of letters with von Senden, in Gregory’s Concepts and Mechanisms of Perception. The philosophical background to the Molyneux question and the impact of the Cheselden case are also well described by Gregory in his article “Recovery from Blindness”, in The Oxford Companion to the Mind.

Alberto Valvo’s deeply pondered cases of patients submitted to a new surgical procedure for corneal reconstruction are described in his Sight Restoration after Long-Term Blindness.

The effects of late blindness-most especially its effects on visual imagery and memory, orientations, and attitudes-have been masterfully described by John Hull in his autobiographical book, Touching the Rock. And the restoration of vision after late blindness is finely described in Second Sight, by Robert Hine.

One of the deepest, widest-ranging explorations of what it may mean in terms of identity to be blind, both to the individual and to those around him, was given by Diderot in his great Letter on the Blind: For the Use of Those Who Can See (he wrote a similar Letter on the Deaf and Dumb: For the Use of Those Who Can Hear and Speak). Von Feuerbach’s account of Kaspar Hauser contains a remarkable description of his profound visual agnosia when first released into the daylight, after being kept in a lightless dungeon since infancy (pp. 64-5).

These themes have not only been the subject of philosophical discussions and case reports, but of fiction and dramatic reconstruction, ever since Diderot’s imagination of Nicholas Saunderson’s deathbed. In 1909 the novelist Wilkie Collins based a novel, Poor Miss Finch, on such a subject, and the theme is also central in Gide’s early novel La Symphonie pastorale. A more recent treatment is a brilliant reconstruction by Brian O’Doherty, The Strange Case of Mademoiselle P., very closely based on Mesmer’s original 1779 account. In Brian Friel’s 1994 play, Molly Sweeney, the central character is, like Virgil, blind from early life with retinal damage and cataracts, and, following the removal of the cataracts in middle life, is plunged into a state of agnosic confusion and ambivalence, which is resolved only by a final reversion to blindness.

The original report on Franco Magnani, written by Michael Pearce and illustrated with reproductions of Franco’s paintings and Susan Schwartzen-berg’s photographs in linked pairs, is found in the Exploratorium Quarterly for Summer 1988.

Esther Salaman’s A Collection of Moments provides a beautiful literary and psychological study of “involuntary memories” as they occurred in Proust, Dostoevsky, and other writers. An excerpt from this, and the greater part of Schachtel’s paper on memory and childhood amnesia, Stromeyer’s classic account of an Eidetiker, a segment of Luria’s Mind of a Mnemonist, and much else, are to be found in an invaluable sourcebook, Ulrich Neisser’s Memory Observed.

Frederic Bartlett’s classic book, Remembering, brings together his experiments showing the constructive, imaginative quality of memory.

The eruption of “experiential” memories during seizures (and their elicitation by direct stimulation of the brain at surgery) is described in almost novelistic detail by Wilder Penfield (and his colleague Perot) in a book-length article, “The Brain’s Record of Visual and Auditory Experience”, in Brain. This same volume of the journal also contains a striking account of Dostoevsky’s epilepsy, by Alajouanine. A readable and accessible description of TLE and Dostoevsky syndrome, both in relation to ordinary people and to celebrated artists and thinkers, is given in Eve LaPlante’s Seized: Temporal Lobe Epilepsy as a Medical, Historical, and Artistic Phenomenon.

A good historical discussion and acute psychoanalytic consideration of nostalgia is given by David Werman in “Normal and Pathological Nostalgia.”