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Authors: Oliver Sacks
Tags: General, sci_psychology, Medical, Biography & Autobiography, Psychology, Literary Criticism, Psychopathology, Mental Illness, Neuropsychology, Social Scientists & Psychologists, Clinical Psychology, Neurology, Physiological Psychology
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patient, unaware, amnesiac for his amnesia, may continue what he is doing, quite unconcerned, and only discover later that he lost not only a day (as is common with ordinary alcoholic 'blackouts'), but half a lifetime, and never knew it. The fact that one can lose the greater part of a lifetime has peculiar, uncanny horror.
In adulthood, life, higher life, may be brought to a premature end by strokes, senility, brain injuries, etc., but there usually remains the consciousness of life lived, of one's past. This is usually felt as a sort of compensation: 'At least I lived fully, tasting life to the full, before I was brain-injured, stricken, etc.' This sense of 'the life lived before', which may be either a consolation or a torment, is precisely what is taken away in retrograde amnesia. The 'final amnesia, the one that can erase an entire life' that Bunuel speaks of may occur, perhaps, in a terminal dementia, but not, in my experience, suddenly, in consequence of a stroke. But there is a different, yet comparable, sort of amnesia, which can occur suddenly-different in that it is not 'global' but 'modality-specific'.
Thus, in one patient under my care, a sudden thrombosis in
the posterior circulation of the brain caused the immediate death of the visual parts of the brain. Forthwith this patient became completely blind-but did not know it. He looked blind-but he made no complaints. Questioning and testing showed, beyond doubt, that not only was he centrally or 'cortically' blind, but he had lost all visual images and memories, lost them totally-yet had no sense of any loss. Indeed, he had lost the very idea of seeing-and was not only unable to describe anything visually, but bewildered when I used words such as 'seeing' and 'light.' He had become, in essence, a non-visual being. His entire lifetime of seeing, of visuality, had, in effect, been stolen. His whole visual life had, indeed, been erased-and erased permanently in the instant of his stroke. Such a visual amnesia, and (so to speak) blindness to the blindness, amnesia for the amnesia, is in effect a 'total' Korsakov's, confined to visuality.
A still more limited, but none the less total, amnesia may be displayed with regard to particular forms of perception, as in the last chapter, 'The Man Who Mistook His Wife for a Hat'. There there was an absolute 'prosopagnosia', or agnosia for faces. This patient was not only unable to recognise faces, but unable to imagine or remember any faces-he had indeed lost the very idea of a 'face', as my more afflicted patient had lost the very ideas of'seeing' or 'light.' Such syndromes were described by Anton in the 1890s. But the implication of these syndromes-Korsakov's and Anton's-what they entail and must entail for the world, the lives, the identities of affected patients, has been scarcely touched on even to this day.
In Jimmie's case, we had sometimes wondered how he might respond if taken back to his home town-in effect, to his pre-amnesia days- but the little town in Connecticut had become a booming city with the years. Later I did have occasion to find out what might happen in such circumstances, though this was with another patient with Korsakov's, Stephen R., who had become acutely ill in 1980 and whose retrograde amnesia went back only two years or so. With this patient, who also had severe seizures, spasticity and other problems necessitating in-patient care, rare weekend visits to his home revealed
a poignant situation. In hospital he could recognise nobody and nothing, and was in an almost ceaseless frenzy of disorientation. But when his wife took him home, to his house which was in effect a 'time-capsule' of his pre-amnesia days, he felt instantly at home. He recognised everything, tapped the barometer, checked the thermostat, took his favourite armchair, as he used to do. He spoke of neighbours, shops, the local pub, a nearby cinema, as they had been in the mid-Seventies. He was
In adulthood, life, higher life, may be brought to a premature end by strokes, senility, brain injuries, etc., but there usually remains the consciousness of life lived, of one's past. This is usually felt as a sort of compensation: 'At least I lived fully, tasting life to the full, before I was brain-injured, stricken, etc.' This sense of 'the life lived before', which may be either a consolation or a torment, is precisely what is taken away in retrograde amnesia. The 'final amnesia, the one that can erase an entire life' that Bunuel speaks of may occur, perhaps, in a terminal dementia, but not, in my experience, suddenly, in consequence of a stroke. But there is a different, yet comparable, sort of amnesia, which can occur suddenly-different in that it is not 'global' but 'modality-specific'.
Thus, in one patient under my care, a sudden thrombosis in
the posterior circulation of the brain caused the immediate death of the visual parts of the brain. Forthwith this patient became completely blind-but did not know it. He looked blind-but he made no complaints. Questioning and testing showed, beyond doubt, that not only was he centrally or 'cortically' blind, but he had lost all visual images and memories, lost them totally-yet had no sense of any loss. Indeed, he had lost the very idea of seeing-and was not only unable to describe anything visually, but bewildered when I used words such as 'seeing' and 'light.' He had become, in essence, a non-visual being. His entire lifetime of seeing, of visuality, had, in effect, been stolen. His whole visual life had, indeed, been erased-and erased permanently in the instant of his stroke. Such a visual amnesia, and (so to speak) blindness to the blindness, amnesia for the amnesia, is in effect a 'total' Korsakov's, confined to visuality.
A still more limited, but none the less total, amnesia may be displayed with regard to particular forms of perception, as in the last chapter, 'The Man Who Mistook His Wife for a Hat'. There there was an absolute 'prosopagnosia', or agnosia for faces. This patient was not only unable to recognise faces, but unable to imagine or remember any faces-he had indeed lost the very idea of a 'face', as my more afflicted patient had lost the very ideas of'seeing' or 'light.' Such syndromes were described by Anton in the 1890s. But the implication of these syndromes-Korsakov's and Anton's-what they entail and must entail for the world, the lives, the identities of affected patients, has been scarcely touched on even to this day.
In Jimmie's case, we had sometimes wondered how he might respond if taken back to his home town-in effect, to his pre-amnesia days- but the little town in Connecticut had become a booming city with the years. Later I did have occasion to find out what might happen in such circumstances, though this was with another patient with Korsakov's, Stephen R., who had become acutely ill in 1980 and whose retrograde amnesia went back only two years or so. With this patient, who also had severe seizures, spasticity and other problems necessitating in-patient care, rare weekend visits to his home revealed
a poignant situation. In hospital he could recognise nobody and nothing, and was in an almost ceaseless frenzy of disorientation. But when his wife took him home, to his house which was in effect a 'time-capsule' of his pre-amnesia days, he felt instantly at home. He recognised everything, tapped the barometer, checked the thermostat, took his favourite armchair, as he used to do. He spoke of neighbours, shops, the local pub, a nearby cinema, as they had been in the mid-Seventies. He was
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