Into the Silent Land - Travels in Neuropsychology

Into the Silent Land Paul B r o k s trained as a clinical p s y c h o l o g i s t at O x f o r d U n i v e r s i t y and went on to specialize in n e u r o p s y c h o l o g y . He has p u r s u e d a career c o m b i n i n g b o t h clinical p r a c t i c e and fundamental b r a i n r e s e a r c h . H e lives i n C o r n w a l l a n d is currently a S e n i o r Clinical L e c t u r e r in N e u r o p s y c h o l o g y at P l y m o u t h University. He w r i t e s a r e g u l a r c o l u m n for Prospect m a g a z i n e a n d his w o r k h a s a p p e a r e d in the Sunday Times, Sunday

Telegraph,

Guardian, Daily

Telegraph a n d

Granta. Into the Silent Land w a s shortlisted for the G u a r d i a n First B o o k A w a r d 2003.

F r o m the r e v i e w s : 'Into the Silent Land is a s m a l l , s t r a n g e , beautiful g e m . . . B r o k s i s a s m u c h p o e t a s s c i e n t i s t . . . Indelible.' A t u l G a w a n d e , author of

Complications

'Beautifully written a n d beautifully t h o u g h t t h r o u g h . ' P r o f e s s o r S t e v e n R o s e , a u t h o r of The Making of Memory

'Into the Silent Land is a s t o n i s h i n g - a m i x of real-life n e u r o l o g i c a l c a s e s , science f i c t i o n , r a n d o m q u i p s a n d d e e p l y p e r s o n a l r e v e l a t i o n s . . . T h e b o o k h a s n o right t o h a n g together, but s o m e h o w it d o e s , quite beautifully.' S i m o n H a t t e n s t o n e , Guardian

' R i v e t i n g . ' T o n y G u i l d , Independent

' I m p r e s s i v e . . . B r o k s ' s b e s t s t o r i e s . . . p r o v e that all h u m a n b e i n g s a r e , a s h e p u t s it, ' s t o r y - t e l l i n g m a c h i n e s ' . F a c e d with the material reality of the b r a i n a n d the infinite configurations o f the m i n d , w e realize that w e are "at o n e level, n o m o r e than m e a t ; a n d , o n another, n o m o r e than f i c t i o n " . ' G a b y W o o d , Observer

' A d e b u t o f c o n s i d e r a b l e quality.' R o b e r t M a c f a r l a n e , Sunday

Times

' B r o k s h a s e x p r e s s e d w h a t will s u r e l y b e the twenty-first c e n t u r y ' s central a n g s t with sensitivity and e l e g a n c e . ' Jeffrey G r a y , TLS

'Into the Silent Land s h o w s h o w p e o p l e a d a p t to extraordinary circumstances... Fascinating.' K a t h M u r p h y , Scotland on Sunday

' B r o k s enters the silent land with arc lights b l a z i n g . . . C o n f r o n t e d with b r a i n s a n d relationships that are fragile a n d p r o v i s i o n a l , B r o k s kindles c o m p a s s i o n a n d inspires.' Clive Coen,

Times Educational Supplement

'Into the Silent Land outlines what c a n h a p p e n after s e v e r e brain-injury — a n d I am n o w i n c r e a s i n g l y fascinated b y what the b r a i n i s c a p a b l e o f a n d w h y ' S h e e n a M c D o n a l d , Sunday Herald B o o k s of the Y e a r

' A rare b o o k o f s t a g g e r i n g brilliance, l e a v i n g r e a d e r s with m u c h to c o n s i d e r a b o u t their o w n l i v e s . ' Good Books Guide

' S t u d d e d with dazzling insights a n d a g r e a t deal of f o o d for thought.' T e s s T a y l o r , San Francisco Chronicle

' B r o k s is a gifted w r i t e r . . . H i s d e p i c t i o n s of patients is heart-wrenching.' B e t h G r e e n b e r g , Boston Globe

'Writing beautifully a b o u t o u r m o s t unbeautiful c o g n i t i v e a p p a r a t u s , B r o k s d e s c r i b e s its r u m p l e d s u r f a c e s , its n e t w o r k of neurons, its d e e p , secret s p a c e s with s u c h c a r e that the act itself powerfully illuminates the b r a i n ' s creative c a p a c i t i e s . ' L a u r e n Slater, Elle

Into the Silent Land Travels

in Neuropsychology

PAUL B R O K S

Atlantic B o o k s London

F i r s t published in h a r d b a c k in G r e a t Britain in 2003 b y Atlantic B o o k s , a n imprint o f G r o v e Atlantic L t d T h i s p a p e r b a c k edition published by Atlantic B o o k s in 2004 C o p y r i g h t © Paul B r o k s 2003 T h e m o r a l right o f Paul B r o k s t o b e identified a s the author o f this w o r k has been asserted in a c c o r d a n c e with the C o p y r i g h t , D e s i g n s and Patents A c t of 1988. T h e author and publisher wish to thank the following for p e r m i s s i o n to q u o t e f r o m copyrighted material: D a n n i e A b s e for 'In the T h e a t r e ' from Collected Poems, 1948-1976(London: Hutchinson

1977); the Estate of Gilbert Ryle

for The concept of mind ( L o n d o n : H u t c h i n s o n 1949). All rights reserved. N o part o f this publication m a y b e r e p r o d u c e d , stored in a retrieval s y s t e m , or transmitted in a n y f o r m o r b y a n y m e a n s , electronic, mechanical, p h o t o c o p y i n g , r e c o r d i n g or otherwise, without the prior p e r m i s s i o n of both the c o p y r i g h t o w n e r and the a b o v e publisher of this b o o k . E a r l i e r drafts of a n u m b e r of chapters have a p p e a r e d in Prospect m a g a z i n e . ' T h e S e a h o r s e a n d the A l m o n d ' w a s published in earlier f o r m in Granta m a g a z i n e . 9 8 7 6 5 4 3 2 1 A C 1 P c a t a l o g u e record for this b o o k is available from the British Library. I S B N 184354 0 3 4 7 Printed in G r e a t Britain by M a c k a y s of C h a t h a m pic, C h a t h a m , Kent Atlantic B o o k s A n imprint o f G r o v e Atlantic L t d Ormond House 2 6 - 2 7 Boswell Street London W C 1 N 3JZ

For Sonja, Daniel and Jonathan

The brain is wider than the sky, For, put them side by side, The one the other will include With ease, and you beside. Emily Dickinson

C O N T E N T S

ONE Swallowing the Dark Different Lives

3

The Space behind the Face

17

The Seahorse and the Almond

22

The

Sword

of

the

Sun

39

Soul in a Bucket

42

In the Theatre

57

A-Z

65

The Mirror

67

The Visible Man

71

TWO The Spark in the Stone I

Think

Therefore

I

Am

Dead

89

Vodka and Saliva

105

Body Art

114

The Story of Einstein's Brain

117

THREE

No

Articles of Faith

123

Right This Way, Smiles a Mermaid

132

Water,

No

Moon

The Ghost Tree (1)

147

The Ghost Tree (2)

158

The Dreams of Robert Louis Stevenson

171

Voodoo Child (Slight Return)

181

Mr Barrington's Quandary

196

Out of Darkness Cometh Light

200

To

Be

Two

or

Not

to

Be

204

Gulls

226

Further Reading

237

Acknowledgements

246

ONE

Swallowing the Dark

Different

Lives

'Why does raw meat give me a hard-on?' T h i s i s Michael, c h o p p i n g sirloin r e a d y for the stir-fry. T y p i cally, he is g o i n g to the trouble of p r e p a r i n g a g o o d lunch: b e e f i n hoi-sin s a u c e . H e ' s b o u g h t s o m e beer, too. W e ' r e d r i n k i n g straight from the c a n . A m y , his girlfriend, sits at the kitchen table r e a d i n g a m a g a z i n e . 'Michael,' s h e s a y s , w i t h o u t l o o k i n g u p . Michael slides the d i c e d b e e f into the w o k w h e r e it sizzles in the hot oil. ' E a s y , A m y . O n l y a twitch.' H e w i n k s a t m e , then d r o p s w h a t he is d o i n g and strides o u t of the r o o m . ' H a v e a listen to this,' he calls o v e r his s h o u l d e r and s o o n the p l a c e is a w a s h with c a s c a d e s o f s o u n d - brittle a r p e g g i o s , t u m b l i n g f r a g m e n t s o f m e l o d y . I t is v e r y l o u d . Michael returns, fingertips to t e m p l e s , h e a d tilted b a c k . 'Koto,' he says. 'Japanese. Astonishing.' F r o m this a n g l e the dent i n his h e a d , a b o u t three inches u p from the right e y e b r o w , is m o r e n o t i c e a b l e .

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N e x t d a y I ' m o v e r at S t u a r t ' s . We sit in his stuffy front r o o m . A n o r n a t e b l a c k c l o c k (his early-retirement p r e s e n t ) c l i n g s t o the wall like a h u g e fly. As I s t r u g g l e with milky tea, Stuart locks me in his g a z e . He is a b o u t to s a y s o m e t h i n g , b u t d o e s n ' t . It is a long pause. Eventually he speaks. 'I don't love you any more, do I, love?' T h e w o r d s a r e intended for his w i f e , H e l e n , w h o sits b e s i d e h i m . ' N o , l o v e , ' she replies. ' S o y o u say.' T h e r e is silence a g a i n , except for the tick of the insectoid c l o c k . T h e dent in S t u a r t ' s h e a d is a b o v e the left eyebrow.

Michael h a d c l i m b e d a tree to retrieve an entangled kite. He n e e d n ' t h a v e b o t h e r e d b e c a u s e the w i n d g u s t e d and the kite drifted d o w n o f its o w n a c c o r d , b u t h e w a s h i g h u p b y then. H e w a s c a l l i n g s o m e t h i n g t o A m y , but s h e c o u l d n ' t m a k e i t out. H e r d r e a m s recall h o w a b r u p t l y his v o i c e w a s stifled b y the c r e a k a n d c r a c k o f a b r a n c h , a n d the w i n d - w h i p p e d silence o f the free fall as his b o d y cleared the b o u g h s . C o n c e a l e d within thick tufts o f m e a d o w g r a s s w a s a s p u r o f r o c k . A m y ' s d r e a m s a l s o r e c o r d the c r a c k o f h e a d hitting s t o n e . T h a t ' s what w a k e s her. T h e fall fractured M i c h a e l ' s skull a n d released a flash flood of b l e e d i n g into the right frontal l o b e . 'I t h o u g h t his n u m b e r w a s u p , ' the s u r g e o n told m e , a n d h a d s a i d a s m u c h t o A m y a s she kept v i g i l o v e r M i c h a e l ' s c o m a t o s e b o d y . ' N o point b e a t i n g a b o u t the b u s h , ' s a i d the d o c t o r . B u t , after three d a y s and nights, Michael c a m e b a c k to life — with a different n u m b e r . S t u a r t ' s twist of fate w a s a m o t o r w a y pile-up. A b o l t s n a p p e d a n d b l a s t e d like a bullet from the vehicle in front. It c a m e

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t h r o u g h the w i n d s c r e e n , t h r o u g h his forehead a n d t o r e d e e p into the left frontal l o b e . D e s p i t e the i m m e d i a t e d i s p l a c e m e n t o f s o m e b r a i n matter, l o s s o f c o n s c i o u s n e s s w a s brief, a s i s s o m e t i m e s the c a s e with penetrating m i s s i l e w o u n d s . H e told the p a r a m e d i c s h e w a s fine and h a d better get h o m e now, b u t they s a w the b r a i n stuff gelling his hair and put h i m in the a m b u l a n c e . S o o n the s u r g e o n s w e r e w o r k i n g t o extract the foreign b o d y from the interior o f S t u a r t ' s h e a d , a p r o c e s s that a l s o m e a n t d i s p o s i n g o f s o m e adjacent brain tissue. Part o f S t u a r t w e n t w i t h it. B y these m e a n s ,

Providence

has

created

mirror-image

lesions o f the b r a i n . A s a n e u r o p s y c h o l o g i s t , m y r o l e i s t o c o m p a r e the c o n s e q u e n c e s . S t u a r t n o w h a s t r o u b l e g e t t i n g started. Helen e n c o u r a g e s him out o f b e d i n the m o r n i n g , p o i n t s him i n the direction of the b a t h r o o m , h a s his c l o t h e s ready, a n d g e t s him breakfast b e f o r e g o i n g t o w o r k . S h e l e a v e s h i m lists o f things t o d o a r o u n d the h o u s e , and m a g a z i n e s and p u z z l e b o o k s to fill the h o u r s . B u t w h e n s h e returns she often finds him w h e r e she left him, sitting i n silence. S h e ' l l g o o v e r a n d h u g h i m a n d h e ' l l return the e m b r a c e , b u t i t ' s perfunctory. H e d o e s n ' t l o v e her a n y m o r e . I t ' s the plain truth a n d s h e a c c e p t s it. Stuart is not to b l a m e . W h a t he feels t o w a r d s H e l e n is what he feels t o w a r d s all other p e o p l e , i n c l u d i n g himself: indifference. T h i s a b s e n c e of e m o t i o n frees him to tell the truth: 'Helen, I don't love you any more.' Stuart can read p e o p l e ' s m o o d s a n d m o t i v a t i o n s , b u t l a c k s the e m o t i o n a l c h a r g e of empathy. I a s k w h a t he feels a b o u t the little girl w h o w a s a b d u c t e d a n d m u r d e r e d last y e a r . H e k n o w s i t w a s a dreadful thing t o h a p p e n . T h e y s h o u l d h a n g the m u r d e r e r

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or c h o p his b a l l s o f f b u t , no, it d o e s n ' t m a k e him feel anything v e r y m u c h . T h e n , h e s a y s , i t ' s funny but h e never u s e d t o b e l i e v e in capital p u n i s h m e n t .

Michael, o n the other h a n d , h a s trouble s t o p p i n g . A m y h a s t o rein h i m in. H e ' l l talk to s t r a n g e r s in the street, he'll tell them t h e y ' r e beautiful, or their children a r e , or their pets. He wants to t o u c h . H e w a n t s t o c e l e b r a t e . B e g g a r s b r i n g a tear t o his e y e . H e o n c e g a v e a m a n his c o a t a n d a £10 n o t e . P e o p l e take a d v a n t a g e . M i c h a e l ' s e m p a t h i c r e s p o n s e i s hair t r i g g e r e d , but m o r e complex social calculations befuddle him. W h e n he first came h o m e f r o m the rehab centre his tastes w e r e plain. A m y said h e lived on fish fingers a n d L e d Z e p p e l i n . Michael said it w a s like g o i n g b a c k i n t i m e . H e ' d a l w a y s liked these things and n o w h e d i d n ' t feel h e s h o u l d p r e t e n d o t h e r w i s e . F i n e , s a i d A m y . B u t she w o u l d n o t tolerate the p o r n v i d e o s . L i k e Stuart, Michael n o l o n g e r feels the n e e d to d i s s i m u l a t e . ' H o w d o y o u feel i n y o u r s e l f , S t u a r t ? ' I a s k . 'All right.' 'Are you miserable?' 'No.' 'Are you happy?' ' I d o n ' t think s o . ' H e t u r n s t o H e l e n . ' A m I h a p p y ? ' H e l e n l o o k s a t m e . I l o o k a t Stuart. T h e q u e s t i o n g o e s r o u n d in a circle. Michael s a w m e o f f a t the front d o o r . H e w a s c l o s e t o tears. H e p u l l e d m e t o him a n d k i s s e d m e o n the cheek. F o r a n instant I thought he w a s g o i n g to say he loved me.

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T h e b a l d head s w i v e l s . T h e v o i c e h o n k s like a k l a x o n a c r o s s the senior c o m m o n r o o m : ' I n e v e r m a k e m i s t a k e s . ' T h e r e i s a rustling o f n e w s p a p e r s a n d c l e a r i n g o f t h r o a t s . Martin has s u p e r i o r intelligence - my tests confirm it, a n d he h o l d s a m a s t e r ' s d e g r e e in m e c h a n i c a l e n g i n e e r i n g — b u t he h a p p e n s to be autistic a n d h a s a p r o b l e m with v o l u m e c o n t r o l . Is that a r e a s o n t o b a r him from the S C R ? N o . W e ' l l enjoy o u r coffee. H e ' s b e e n d o i n g o n e o f his p a r t y p i e c e s : c a l e n d a r c a l c u l a t i o n . Martin can g i v e y o u the d a y o f the w e e k for a n y d a t e y o u c a r e t o mention, a n d h e ' s s p o t o n e v e r y t i m e , s e l d o m t a k i n g m o r e than a couple of seconds. H e ' s happy to oblige and seems d i s a p pointed w h e n I s o o n run o u t of d a t e s I can v o u c h for. ' H o w d o y o u d o it, Martin? Y o u d i d n ' t e v e n think a b o u t the last o n e . ' T h e target d a t e w a s 1 8 M a r c h 1988 ( m y s o n ' s b i r t h d a y ) . ' F r i d a y ' w a s the instant r e s p o n s e . ' T h a t w a s easy,' h e s a y s , ' I w e n t t o the dentist the d a y b e f o r e . ' H e g r i n s with satisfaction. I t ' s hard t o tell his a g e . T h e f a c e i s lined b u t u n w e a t h e r e d . H e ' s w e a r i n g a silver puffa jacket, s t a - p r e s s e d t r o u s e r s at halfm a s t , and trainers. F o r t y - e i g h t g o i n g o n fourteen. T h a t s h o u l d be 'trainer' in the singular. I t ' s on his right foot. 'I s e e y o u ' r e w e a r i n g o d d s h o e s , ' I say. ' Y e s , ' he replies. ' I t ' s W e d n e s d a y . ' I w a i t for further e x p l a n a tion, but n o n e is f o r t h c o m i n g . W h e n I first s a w Martin, for clinical a s s e s s m e n t s , he t u r n e d up with his p a r e n t s a n d t h e y ' d p u t him in a suit. H i s s h o e s w e r e polished, a n d m a t c h e d . He h a r d l y s a i d a w o r d . T o d a y , in his

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c a s u a l attire, h e i s v o l u b l e . B e f o r e l o n g , inevitably, h e d r o p s into the g r o o v e o f his special interests. T h e r e are s e v e r a l . O n e i s the B e a t l e s . H e k n o w s the r e c o r d i n g a n d release d a t e s o f e v e r y r e c o r d . A n o t h e r i s the r a i l w a y s . H e h a s m e m o r i z e d the regional t i m e t a b l e , o f c o u r s e , b u t w h a t really fascinates him i s the m o v e m e n t o f c o a l freight w a g o n s . T h e n there i s a s t r o n o m y , which, currently, is his m a i n p r e o c c u p a t i o n . ' D o y o u k n o w h o w m a n y stars there are i n the u n i v e r s e ? ' h e a s k s . ' T e n t o the p o w e r o f t w e n t y - t w o . ' I m a k e a little b l o w i n g s o u n d a n d s h a k e my h e a d . He l o o k s pleased. 'Actually,' I say, 'I r e a d s o m e w h e r e that if y o u think of each star as a g r a i n of s a n d it w o u l d take all the b e a c h e s a n d deserts on the planet to m a t c h the n u m b e r of s t a r s in the u n i v e r s e . ' I t h o u g h t this w o u l d i m p r e s s h i m , but h e i g n o r e s m e . H e b e c o m e s a g i t a t e d , starts r o c k i n g b a c k a n d forth o n the e d g e o f his s e a t . W h e n h e s t o p s h e s a y s , ' I d o n ' t think s o . ' I a s k h i m if he thinks there is intelligent life o u t there a m o n g all t h o s e g r a i n s o f s a n d . H e l o o k s p u z z l e d a n d I realize h e ' s taken the q u e s t i o n literally, so I clarify. A g a i n , the grin. ' Y e s , ' h e s a y s , 'there i s . ' T h e s m i l e i s s u s t a i n e d . I t i s evidently a consoling thought. B e t h j o i n s u s . S h e ' s o n e o f o u r r e s e a r c h assistants. I t ' s time t o g o t o the lab for the testing s e s s i o n . M a r t i n ' s face lights up. H e h a s taken a shine to B e t h . 'And what have you been up t o ? ' she asks him. ' I ' v e b e e n m a s t u r b a t i n g quite a lot,' he replies, as if t h r o u g h a tannoy. I p r e s s m o u t h a g a i n s t k n u c k l e s to b l o c k the laughter. I t ' s n o g o o d . I s n o r t and c o u g h .

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' E x c u s e m e , ' I s a y a n d c o u g h a g a i n for g o o d m e a s u r e . I t ' s u n p r o f e s s i o n a l , I k n o w , b u t he c r a c k s me up. I ' m o n l y h u m a n . I'm not trying to m a k e Martin l o o k r i d i c u l o u s . He is r i d i c u l o u s . L o o k a t him i n his daft clothes, b o o m i n g o n a b o u t m a s t u r b a t i o n and coal freight w a g o n s a n d the n u m b e r o f s t a r s i n the u n i v e r s e . I t ' s undeniable. A n d I reckon i t ' s a s n u b if y o u don't a c k n o w l e d g e his absurdity. I f y o u are t o e n g a g e with Martin y o u m u s t , to s o m e extent, enter his w o r l d . 'Martin,' I say. ' T h i s is funny. Do y o u m i n d if I l a u g h ? ' 'No,' he says. 'Please laugh.' But, g i v e n p e r m i s s i o n , I find the h u m o u r s o o n d i s s o l v e s , a n d I'm left sitting r e d - f a c e d with tears o n m y cheeks a n d e v e r y o n e l o o k i n g a t m e instead o f h i m . I even f i n d m y s e l f p o n d e r i n g Martin's confident assertion o f the existence o f extraterrestrial life. We are alone in the universe or we are not, I think. Either way, how astonishing. We g r i n at each other. H i s head is a b n o r m a l l y l a r g e , as is the b r a i n that fills it. My c o l l e a g u e s and I h a v e taken m e a s u r e m e n t s . We are profiling his c o g n i t i v e strengths a n d limitations a n d setting these a g a i n s t detailed m a g n e t i c r e s o n a n c e o b s e r v a t i o n s o f his b r a i n . H e i s a n enthusiastic research participant a n d h a s c o m e t o s e e h i m s e l f a s a neuro-engineering problem. He has a theory. In his v i e w a u t i s m is all a b o u t flow d y n a m ics. M o s t of the time his t h o u g h t p r o c e s s e s are stuck in the left hemisphere o f his brain. C o n s e q u e n t l y , his thinking i s r i g i d , categorical, and analytic. I f h e c o u l d u n b l o c k the channel o f the c o r p u s c a l l o s u m , which links the t w o s i d e s , then the s t r e a m s o f the left and right b r a i n w o u l d m e r g e a n d h e w o u l d b e whole. Ordinary consciousness would flourish. T h i s happens

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s o m e t i m e s , h e b e l i e v e s . F o r b r i e f p e r i o d s the w o r l d takes o n a different a p p e a r a n c e . He is m o r e relaxed and it is less of an effort t o c o n n e c t with p e o p l e . T h i s i s w h e r e masturbation c o m e s in: o r g a s m d e t o n a t e s a d a m - b u s t i n g e x p l o s i o n in the right h e m i s p h e r e . As B e t h s e e s Martin to the d o o r , I catch a f r a g m e n t of their conversation. 'But if your boyfriend leaves you . . . " he says. 'We'll see,' says Beth. M a r t i n ' s g r i n h a s a n u n w o r l d l y beauty.

* * *

It w a s her s e v e n t h birthday, E l l i e ' s father is telling m e , a clear m o r n i n g in A p r i l . T h e y h a d s t o p p e d to chat to a neighbour. E l l i e w a s l o s i n g p a t i e n c e . S h e w a n t e d t o ride her n e w b i c y c l e . He c a n s e e it now, b l u e and silver c h r o m e , d a z z l i n g in the s u n light. A n d then, ' S h e w a s l y i n g i n the m i d d l e o f the r o a d , d e a d still. It w a s like the w o r l d h a d s t o p p e d , except for m e . W h e n I g o t c l o s e the rest c a u g h t u p ; the screech o f tyres, the bicycle s c r a p i n g a c r o s s the r o a d . S o m e o n e s a i d , " O h m y g o o d L o r d ! ' " H i s m i n d held a c o n t r a d i c t i o n as he l o o k e d d o w n on his d a u g h t e r ' s b o d y : She's not badly injured a n d , at the s a m e time, She's dead. N e i t h e r w a s the c a s e . N o t the latter b e c a u s e , of c o u r s e , s h e i s h e r e , a y o u n g w o m a n now, s q u e e z i n g his elbow; a n d n o t the former. H e r a r m s w e r e g r a z e d , n o t h i n g s e r i o u s , and her f a c e w a s u n b l e m i s h e d . B u t w h a t her father c o u l d not s e e w a s the fractured parietal b o n e a n d the s l o w s e e p a g e o f b l o o d into the right h e m i s p h e r e o f E l l i e ' s b r a i n .

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It w o u l d be a w e e k b e f o r e s h e o p e n e d her e y e s . B u t s h e w a s not d e a d . A n d t h r o u g h the tunnel of intensive c a r e — s h e in c o m a , he c o n s c i o u s n e s s flayed — E l l i e ' s father f o u n d the strength not t o pray. H i s p r a y e r l e s s v i g i l w a s r e w a r d e d . E l l i e r e c o v e r e d a n d , m o n t h s later, returned t o s c h o o l . H e d r o p p e d her o f f a t the g a t e a n d s a y s h e b l u b b e r e d s o m u c h o n the d r i v e t o w o r k h e h a d t o stop the car. J o y c a n b e s o p r o f o u n d i t b o r d e r s on grief. Ellie n e v e r r e g a i n e d the full s t r e n g t h of her left a r m a n d l e g , and she tired easily, b u t it d i d n ' t s t o p her j o i n i n g in with the other children. S h e s t r u g g l e d t o c o n c e n t r a t e a n d k e e p p a c e i n s o m e l e s s o n s , but that w a s t o b e e x p e c t e d . N o o n e p u s h e d her; she p u s h e d herself. S h e found a talent for l a n g u a g e s a n d is n o w p r e p a r i n g t o g o t o university. S o w h a t ' s the p r o b l e m ? 'Parallel p a r k i n g , ' s a y s E l l i e , ' a n d o v e r t a k i n g . ' S h e has difficulty j u d g i n g s p e e d s a n d d i s t a n c e s . S h e ' s t w i c e failed the d r i v i n g test. Is it a n y t h i n g to do with her b r a i n injury and, if s o , can I help? I finish my a s s e s s m e n t s at the next a p p o i n t m e n t . E l l i e h a s w o r k e d h a r d a t tests o f spatial a w a r e n e s s , m o t o r c o - o r d i n a t i o n , concentration, and reaction t i m e . T h e results s h o w p r o b l e m s consistent with her b r a i n injury. S h e s e n s e s this a n d , with a kind of d e s p e r a t i o n , offers to take me for a d r i v e . I a c c e p t . ' D o y o u w a n t m e t o c o m e ? ' a s k s her father. ' N o , ' I tell h i m , ' g o a n d h a v e a c u p of tea.' A t f i r s t E l l i e s e e m s u n s u r e w h e r e the car i s p a r k e d . I t ' s a n o l d C i t r o e n , the c o l o u r o f t o m a t o s o u p . ' W h e r e shall I g o ? ' s h e s a y s . ' A n y w h e r e . J u s t d r i v e a r o u n d . G o left h e r e , then next right.'

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A n d s o w e g o , m e g i v i n g directions. I h a v e t o admit s h e ' s pretty g o o d . T e n m i n u t e s into the d r i v e n o t h i n g u n t o w a r d has h a p p e n e d a n d I ' m b e g i n n i n g t o q u e s t i o n the v a l u e o f m y tests. T h e r e ' s n o d o u b t s h e h a d p r o b l e m s , b u t here w e are i n the real w o r l d a n d s h e ' s d o i n g fine. E l l i e h a s s t e e r e d the car into the m i d d l e of the r o a d ready to turn a c r o s s the o n c o m i n g traffic b a c k into the hospital car p a r k . T h e indicator clicks as we wait. I t ' s a c o m f o r t i n g s o u n d . Tick, tick, tick. A l m o s t h y p n o t i c . T h e r e ' s a s t e a d y flow of traffic, so E l l i e w a i t s . Tick, tick, tick. T h e n a g a p ; n o t h i n g for fifty y a r d s , s p a c e e n o u g h to g e t a c r o s s . B u t we d o n ' t m o v e . Tick, tick, tick. A n o t h e r line of traffic d r a w s t o w a r d s u s , h e a d e d by a white r e m o v a l s v a n with tick, tick,

Y O U R

Y O U R M O V E !

s p l a s h e d a c r o s s the front. Tick,

M O V E !

T h e i m a g e o f the v a n n o w filling m y retina and flashing into m y b r a i n takes the q u i c k - a n d - d i r t y r o u t e via the thalamus and s t r a i g h t to the s e c u r i t y m o n i t o r s of the a m y g d a l a , d e e p in the t e m p o r a l l o b e . Action stations! No n e e d to trouble the higher cortical centres just yet, b e c a u s e s o m e t h i n g h a s impelled Ellie to turn a c r o s s the traffic a n d we are g o i n g to hit the v a n . C o n s c i o u s deliberation would be a hindrance. T h i s is basic survival. My a r m s fly u p a n d m y h e a d j e r k s s i d e w a y s . T h e a m y g d a l a s c r e a m s i n s t r u c t i o n s t o the b r a i n s t e m , s i g n a l l i n g the release o f c h e m i c a l s into the b l o o d s t r e a m a n d , t h r o u g h a clatter of synaptic activity, g a l v a n i z i n g the a u t o n o m i c n e r v o u s s y s t e m . T h i s is red alert! T h e n I b e c o m e a w a r e o f the p i g s q u e a l o f tyres — the v a n ' s , n o t o u r s . M y cortex i s c o m i n g b a c k on-line; reflective c o n s c i o u s n e s s r e s t o r e s itself. We roll serenely on a n d I g l a n c e b a c k

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to see the v a n p u l l i n g away. Ellie r e m a i n s u n p e r t u r b e d . We are b a c k in my office. 'It w a s a c l o s e call,' I say. 'Oh?' ' I thought that v a n w a s g o i n g t o hit u s . ' 'What van?' I tell her that we c o u l d a r r a n g e for a m o r e a d v a n c e d a s s e s s ment of her d r i v i n g skills, and that s h e is o b l i g e d to i n f o r m the d r i v i n g licence authority o f her c o n d i t i o n . 'I already have,' she says. But I can't e n c o u r a g e her to drive. I s e e a d a m a g e d brain encased in a tonne of metal c r u i s i n g d o w n the m o t o r w a y , t h r o u g h rush-hour traffic, t h r o u g h residential a r e a s w h e r e children are riding their birthday bicycles. T h e d a m a g e i s b e y o n d repair. ' I c a m e t o y o u for help,' s a y s E l l i e . H e r father g i v e s m e a n e m p t y ' T h a n k y o u ' a s they l e a v e . A few m o n t h s later I g e t a call from E l l i e . S h e h a s taken her d r i v i n g test for a third time a n d p a s s e d . 'I t h o u g h t y o u ' d like to know,' she s a y s . I picture her father s t a n d i n g b e s i d e her. W h a t ' s that on his face? A b s o l u t i o n ?

* * * M r s O ' G r a d y i s s h o w i n g m e p h o t o g r a p h s . T h e r e a r e three a l b u m s o p e n e d out o n the coffee table. T h e r e s h e i s a t K a t i e ' s w e d d i n g ; small, n e r v o u s , and neat in a p a l e g r e e n suit. T w o m o n t h s on, there s h e is at S t e p h a n i e ' s . B e i g e this time. ' I feel guilty,' s h e confides. ' I still h a v e n ' t told S t e p h . D o y o u think I s h o u l d ? '

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' Y e s , ' I say. ' S h e ' l l u n d e r s t a n d . ' I d e c l i n e a s e c o n d cup of coffee a n d g a t h e r my stuff to leave, b u t I ' m n o t g o i n g yet b e c a u s e M r s O ' G r a d y h a s g r a b b e d m y a r m . S h e l e a d s m e t o a c o r n e r o f the r o o m a n d s t a n d s b a c k with a n air o f curiosity. S h e s t a r e s , s t e p s f o r w a r d , s t a n d s b a c k a g a i n . S h e c a n ' t m a k e m e out. T h e facial m u s c u l a t u r e s h a p e s a p p r e hension, building to dread. T h e n she g o e s blank. S h e w a l k s t o the other s i d e o f the r o o m , s m a c k i n g her lips a n d t u g g i n g her collar. I follow her to the kitchen w h e r e she s t a n d s b y the s t o v e p i c k i n g her n o s e . T h e n she f i l l s the kettle, but d o e s n ' t switch it o n . S h e fetches m u g s from the c u p b o a r d and p l a c e s t h e m on a tray. F r o m time to t i m e s h e s e e m s to be a w a r e that there is s o m e o n e else in the r o o m . S h e l o o k s at m e , but I am t o o m u c h to f a t h o m . I feel s e m i - t r a n s p a r e n t . I s p e a k , but there is n o r e s p o n s e . A m I really here? S h e fills the m u g s with c o l d w a t e r f r o m the kettle and carries the t r a y into the l i v i n g r o o m . We sit in silence. I ' m thankful this h a s n ' t d e v e l o p e d into a thrashing, f o a m i n g , full-blown fit. After a while s h e r e a c h e s for the third a l b u m . ' T h i s o n e ' s the h o l i d a y s , ' s h e s a y s . ' T e n e r i f e . ' B u t s h e k n o w s s o m e t h i n g i s w r o n g w h e n s h e s e e s plain w a t e r i n the m u g s . M r s O ' G r a d y takes b r i e f e x c u r s i o n s from c o n s c i o u s n e s s . T h e s e a r e k n o w n a s a u t o m a t i s m s , a feature o f her epilepsy. T h e c o n s c i o u s m i n d s w i t c h e s off, but the b o d i l y a p p a r a t u s carries on in a m o r e or l e s s p u r p o s e f u l fashion: f e e d i n g the cat, w a l k i n g r o u n d the s u p e r m a r k e t , b o a r d i n g a b u s . H a d she reached for the b r e a d knife a n d p l u n g e d it t h r o u g h my heart I d o u b t she w o u l d b e c o n v i c t e d o f m u r d e r . T h e law m a k e s p r o v i s i o n for automatisms.

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Watching M r s O ' G r a d y ' s u n o c c u p i e d b o d y scuttling a b o u t I thought of her as a z o m b i e . S t u d e n t s of c o n s c i o u s n e s s are fond o f z o m b i e s . N o t the H a i t i a n l i v i n g d e a d o r s h a m b l i n g g h o u l s of the Twilight Zone, but far s t r a n g e r inhabitants of the w o r l d of philosophical conjecture. T h e s e creatures l o o k and act like o r d i nary p e o p l e ; they w a l k , talk, s i n g , l a u g h , a n d w e e p , h a v e l o v e affairs, raise families, g e t d r u n k , a r g u e a b o u t politics. T h e y a r e , in fact, like us in e v e r y w a y b u t o n e : they l a c k c o n s c i o u s a w a r e ness. T h e i r b r a i n s r e g u l a t e internal states o f the b o d y a n d control o u t w a r d b e h a v i o u r , but that's all. W h i l e the rest o f u s m o v e a b o u t i n a bright p o d o f c o n s c i o u s n e s s , z o m b i e s just m o v e about. T h e i r p h i l o s o p h i c a l p u r p o s e i s t o crystallize the m i n d b o d y p r o b l e m . Is it l o g i c a l l y p o s s i b l e to s u b t r a c t mental life from the w o r k i n g brain, in which c a s e there w o u l d be s c o p e for z o m b i e s ( d u a l i s m ) ? O r are b r a i n activity a n d c o n s c i o u s n e s s o n e and the s a m e thing ( m a t e r i a l i s m ) ? N o d o u b t M r s O ' G r a d y w o u l d h a v e s o m e t h i n g t o s a y o n the matter. T h e trouble i s , not all o f her e x c u r s i o n s are s o brief; h e n c e M r s O ' G r a d y ' s guilt o v e r S t e p h a n i e ' s w e d d i n g . H e r m e m o r y h o l d s n o trace o f the o c c a s i o n . P h y s i c a l l y s h e w a s there. Y o u can see her in the p h o t o s . B u t s h e w a s not there mentally, at least not in full. It w a s t o o p r o t r a c t e d an e p i s o d e to fit the c o n v e n tional s c h e m e o f a n epileptic a u t o m a t i s m . M o r e likely her b r a i n had settled into a stable pattern of d y s f u n c t i o n with l o w - l e v e l epileptic d i s c h a r g e s j a m m i n g the t r a n s m i s s i o n o f s e n s o r y inform a t i o n into m e m o r y . H e r a w a r e n e s s w o u l d h a v e b e e n a fragile membrane of impressions floating between 'now' and 'then', but never quite connecting. T h e r e are other c i r c u m s t a n c e s i n which h u m a n b e i n g s a p p e a r

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t o act p u r p o s e f u l l y w i t h o u t the benefit o f s e l f - a w a r e n e s s . S l e e p w a l k i n g is a g o o d e x a m p l e . I w a s in the C o m b i n e d C a d e t F o r c e in my teens. O n e night, at c a m p , I s o m n a m b u l a t e d t h r o u g h the b a r r a c k s a n d m i s t o o k the N C O s ' q u a r t e r s for the lavatory. I shuffled in a n d urinated o v e r o n e of the officers as he slept. Unfortunately, the f o l l o w i n g m o r n i n g I w a s fully c o n s c i o u s . H o w c o n v e n i e n t i t w o u l d b e s o m e t i m e s t o turn off c o n s c i o u s n e s s a n d c a r r y o n with o r d i n a r y b e h a v i o u r . I m a g i n e flicking a switch on difficult d a y s a n d flipping into oblivion, k n o w i n g that y o u r b o d y will c o n t i n u e g o i n g a b o u t its n o r m a l b u s i n e s s . N o o n e w o u l d notice. A p r e - p r o g r a m m e d w a k e - u p call w o u l d return y o u to sentience in time for a film or the football. C o n t r o l l e d a u t o m a t i s m m i g h t b e preferable t o p e r i o d s o f p h y s i c a l o r e m o t i o n a l d i s c o m f o r t , o r sheer b o r e d o m . I f e v e r y o n e h a d a c o n s c i o u s n e s s switch then the w o r l d , m o s t of the t i m e , w o u l d b e t e e m i n g with z o m b i e s . P e r h a p s i t a l r e a d y is. W h a t t r o u b l e s M r s O ' G r a d y i s that s h e r e m e m b e r s o n e w e d d i n g and n o t the other: K a t i e ' s , but not S t e p h ' s . I t s e e m s unfair. I n truth, s h e s a y s , i t ' s not s o m u c h that s h e can't r e m e m b e r as the feeling that s h e w a s n ' t actually there. L i k e she didn't b o t h e r to turn up. I ' m not g o i n g to d e b a t e it with her a n d , for her o w n p e a c e of m i n d , I think s h e s h o u l d talk it t h r o u g h with her d a u g h t e r s . B u t if they c o u l d n ' t tell, what difference d o e s it m a k e ? L a t e r , l y i n g in b e d , I c o n f e s s to my wife that I am a z o m b i e . We h a d a malfunction with the transcranial m a g n e t i c s t i m u l a tor. It z a p p e d my a w a r e n e s s m o d u l e . I t h o u g h t she s h o u l d know, b u t b e s t not b r e a k it to the k i d s just yet. I s a y I h o p e it w o n ' t c h a n g e the w a y s h e feels a b o u t m e . S h e i s a l r e a d y asleep.

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The Space behind the Face

T h e illusion is irresistible. B e h i n d e v e r y face there is a self. We see the signal of c o n s c i o u s n e s s in a g l e a m i n g e y e a n d i m a g i n e s o m e ethereal s p a c e b e n e a t h the vault of the skull, lit by shifting patterns o f feeling a n d t h o u g h t , c h a r g e d with intention. A n essence. B u t what do we find in that s p a c e b e h i n d the f a c e , w h e n we look? T h e brute fact is there is n o t h i n g b u t material s u b s t a n c e : flesh and b l o o d a n d b o n e a n d b r a i n . I k n o w , I ' v e s e e n . Y o u l o o k d o w n into a n o p e n h e a d , w a t c h i n g the b r a i n p u l s a t e , w a t c h i n g the s u r g e o n t u g a n d p r o b e , a n d y o u u n d e r s t a n d with a b s o l u t e conviction that there is n o t h i n g m o r e to it. T h e r e ' s no o n e there. I t ' s a kind of liberation. T h e illusion i s irresistible, but not i n d i s s o l u b l e . I t i s m o r e than twenty y e a r s since I b e g a n my clinical t r a i n i n g at a rehabilitation hospital for p e o p l e with n e u r o l o g i c a l d i s o r d e r s . I w a s a student o f clinical p s y c h o l o g y , b u t w a s d r a w n m o s t l y t o n e u r o l ogy. F o r as l o n g as I c o u l d r e m e m b e r I h a d b e e n interested in the w o r k i n g s o f the b r a i n a n d , o n e w a y o r another, a s clinician o r

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scientist, I e x p e c t e d to m a k e a career in n e u r o p s y c h o l o g y , the science of brain and mind. Neuro-rehab was a g o o d place to start. O n e o f the patients w a s a s e v e n t e e n - y e a r - o l d b o y w h o h a d s t e p p e d into an e m p t y lift shaft t h r o u g h which he fell three f l o o r s , a l m o s t t o his d e a t h . T h e s u r g e o n s h a d d o n e their b e s t t o p i e c e him t o g e t h e r a g a i n , b u t n o w the d o m e o f his s h a v e n head w a s a s y m m e t r i c a l : c o n v e x on the right, c o n c a v e on the left, with a d e e p o v a l d e p r e s s i o n like the shell of a h a r d - b o i l e d e g g c r a c k e d with a s p o o n . H i s f a c e w o r k e d relentlessly, writhing with a n g e r a n d d r e a d . Mostly anger. He would growl and grunt, and sometimes h o w l , b u t , a p a r t f r o m o c c a s i o n a l v o l l e y s o f obscenity, h e w a s i n c a p a b l e o f s p e e c h . T h i s i s n o t u n c o m m o n . P e o p l e without o r d i n a r y s p e e c h d u e t o b r a i n injury s o m e t i m e s h a v e the c a p a city to s u m m o n up the vilest g o b s of a b u s e . I d i d n ' t k n o w that at the t i m e . It c a m e as a s h o c k . S o m e t i m e s they can a l s o s i n g , but this b o y n e v e r s a n g . H e sat c o n t o r t e d i n his wheelchair, head t u r n e d s i d e w a y s a n d b a c k a t a n u n c o m f o r t a b l e a n g l e , limbs b u c k l e d with spasticity, a s t r e a m of s a l i v a dribbling from the c o r n e r o f his m o u t h . T h e p r i a p i s m w a s a f i n a l , h u m i l i a t i n g twist. D u e t o a quirk o f the d a m a g e t o his n e r v o u s s y s t e m h e w a s continually troubled by a painful erection. T h e y o u n g w o m e n t e n d i n g h i m — n u r s e s , p h y s i o s , a n d o c c u p a t i o n a l therapists — p r e t e n d e d not to notice. I felt pity for h i m , b u t a l s o r e v u l s i o n . As a r a w trainee not yet a c c l i m a t i z e d , I f o u n d him g r o t e s q u e . W h a t d i s t u r b e d m e m o s t w a s the f l i c k e r i n g screen o f his face: b l e a k i m a g e s o f a soul i n t o r m e n t . Or so I i m a g i n e d . T h e n I b e g a n to c o n s i d e r what

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m i g h t remain of a ' s o u l ' or a ' s e l f ' . I b e g a n to d o u b t there w a s a n y t h i n g at all g o i n g on b e h i n d that f a c e . He should be allowed to die, I thought, a n d not just for his o w n s a k e . H o w d i d he l o o k to his m o t h e r ? C o u l d s h e e v e n b e a r t o l o o k ? T h e c h a o s o f his face d r a i n e d m y s y m p a t h y . I t b r o k e the rules. A face s h o u l d a l l o w public a c c e s s to the p r i v a t e self. I t ' s an ancient c o n v e n t i o n of the h u m a n r a c e . T h e r e is a u n i v e r s a l s y s t e m o f s i g n a l s . B u t this y o u n g m a n ' s facial d i s p l a y s w o r k e d like a s u b t e r f u g e , d e n y i n g k n o w l e d g e of w h a t l a y b e h i n d . Perhaps nothing lay behind. T h e n , o n e day, I h a p p e n e d t o b e a r o u n d w h e n the b o y ' s mother c a m e to visit. I w a t c h e d as s h e c r a d l e d his b r o k e n h e a d in her a r m s . F o r the time that she w a s with h i m , b u t not m u c h longer, an e x t r a o r d i n a r y t r a n s f o r m a t i o n c a m e o v e r his f a c e . It b e c a m e still. T h e r a g e s u b s i d e d . H e s e e m e d t o r e g a i n his humanity. H e r e w e r e t w o s e l v e s , not just a m o t h e r a n d a b r o k e n shell o f a s o n . T h e w h o l e w a s g r e a t e r than the s u m o f its p a r t s . M a y b e it w a s a failure of i m a g i n a t i o n that led me to s e n s e a s e e p i n g a w a y o f the b o y ' s s e l f o n c e his m o t h e r h a d g o n e , b u t the capacity I d i s c o v e r e d in m y s e l f to s e e a fellow h u m a n b e i n g as less than a p e r s o n w a s an a p p a l l i n g revelation. In s u c h c i r c u m stances h o w are w e t o d i s t i n g u i s h failure o f e m p a t h y f r o m v a l i d o b s e r v a t i o n ? P e r h a p s they a m o u n t t o the s a m e thing. N o w m y o w n s o n h a s t u r n e d s e v e n t e e n , the s a m e a g e a s the eggshell boy. H e w a s i n the v o i d o f pre-birth w h e n o u r friend m a d e his lonely d e s c e n t t h r o u g h the lift shaft. T o disturb s o m e o n e from a state of n o n - e x i s t e n c e is a terrible responsibility. L o o k a t w h a t can h a p p e n . I h a v e a m e m o r y o f b e i n g with m y s o n w h e n h e w a s four

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y e a r s o l d . I t i s d e e p winter. W e h a v e t o g o out, s o w e leave the w a r m t h o f o u r h o u s e for the freezing night air. T h e r e are few lights in the v i l l a g e a n d the s k y is full of stars. We are hardly b e y o n d the front d o o r w h e n h e starts c o u g h i n g . ' A r e y o u all r i g h t ? ' ' I t ' s o k a y , ' he s a y s , 'I think I just s w a l l o w e d s o m e d a r k . ' He h a s the n o t i o n that d a r k n e s s is a s u b s t a n c e . It will m a k e y o u c h o k e i f y o u s w a l l o w t o o m u c h i n o n e g o . I c o u l d h a v e put h i m s t r a i g h t with s o m e p r o s a i c a c c o u n t o f the c o u g h i n g reflex b e i n g t r i g g e r e d by the s h o c k of the c o l d air rather than a m o u t h ful of d a r k n e s s , b u t I d i d n ' t . I s t a s h e d a w a y the treasured i m a g e a n d left h i m with the v e r s i o n of reality fashioned by his infant brain. R e a l i t y is u n d e r constant review. T w e n t y - t h r e e centuries a g o , A r i s t o t l e b e l i e v e d that the heart m u s t b e the s o u r c e o f mental life b e c a u s e o f its d y n a m i c action a n d its w a r m t h . T h e function o f the b r a i n , h e t h o u g h t , w a s t o c o o l the b l o o d . H e built his c o s m o l o g y o n the b e l i e f that the E a r t h s t a n d s m o t i o n l e s s at the centre of the u n i v e r s e , a fixed point a b o u t which the s u n a n d the m o o n a n d the s t a r s r e v o l v e . A r i s t o t l e w a s w r o n g o n e v e r y c o u n t , b u t his e r r o n e o u s beliefs - the p r o d u c t of intuition a n d illusion — s e r v e d h i m well e n o u g h . A n d t h o u g h w e n o w k n o w i m m e a s u r a b l y m o r e than A r i s t o t l e a b o u t the w o r k i n g s o f the h u m a n b o d y a n d the s t r u c t u r e o f the c o s m o s , w e s h o u l d n o t d e l u d e o u r s e l v e s b y thinking that w e h a v e arrived a t s o m e p r i v i l e g e d e n d - p o i n t o f intellectual e v o l u t i o n . We still live by intuitions a n d illusions, especially w h e n our t h o u g h t s t u r n i n w a r d s . T h e b r i g h t , intangible qualities o f s u b j e c t i v e e x p e r i e n c e h a v e yet t o b e reconciled with the d a r k

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s u b s t a n c e of the b r a i n , but that s p a c e b e h i n d the f a c e is still lit b y the m i n d ' s e y e . Irresistibly, w e still s e e the v i s i o n o f m i n d s i n the light o f other p e o p l e ' s e y e s . C o s m o l o g i e s c o m e a n d g o , b u t i f this illusion b e g i n s t o f a d e then s o d o e s the o b s e r v e r .

* * * I ' v e b e e n t r y i n g t o think o f the e g g s h e l l b o y ' s n a m e . I c o u l d have g i v e n him a n a m e . A l l the others h a v e p s e u d o n y m s . It w a s n ' t deliberate. I d i d n ' t c h o o s e to d e n y h i m a n a m e . B u t w h e n the story w a s finished, I s a w he didn't h a v e o n e . A n a m e w o u l d humanize him,' s o m e o n e said. 'Call him John or Steven or Richard...' On reflection, I t h o u g h t it m i g h t do just the o p p o s i t e .

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The Seahorse and the Almond

W h i s k y o n t o p o f w i n e w a s a m i s t a k e . T h i s m o r n i n g i t h a s left m e feeling fractionally t o o e m b o d i e d ; t o o a w a r e o f the w e i g h t a n d m o v e m e n t o f m y h e a d , the b u l k o f m y t o n g u e . I w o k e l a t e , b r e a k i n g f r o m a thick crust of sleep not m u c h b e f o r e eight. H a l f a n h o u r later, I ' m w a l k i n g t o w o r k , without hurry, b u t k e e p i n g p a c e with the traffic. I t ' s a c o u p l e of miles. It will d o m e g o o d . D o w n p a s t the p a r a d e o f s h o p s , p a s t the o d d j u x t a p o s i t i o n o f c a s i n o a n d funeral p a r l o u r , p a s t the terraced h o u s e s a t the fringe o f the p a r k , and o n u p the other s i d e o f the u r b a n v a l l e y t o w a r d s the d r a b m o n o l i t h o n the b r o w o f the hill. T h e D i s t r i c t G e n e r a l H o s p i t a l i s v i s i b l e from m o s t o f the city. T o d a y i t i s f r a m e d b y a s k y the c o l o u r o f c e m e n t . N a o m i i s d e e p i n s i d e . I t i s her nineteenth birthday. S h e i s o n a b e d b e i n g p u s h e d by a p o r t e r a l o n g s h i n y floors, into lifts and o u t a c r o s s m o r e s h i n y f l o o r s . S h e i s tired, h a v i n g b e e n a w a k e since the b r e a k o f day, well b e f o r e the n e u r o p h y s i o l o g y technic i a n s c a m e to g l u e e l e c t r o d e s to her scalp. T h e y left her with a M e d u s a ' s head of a n g r y serpents.

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A r r i v i n g at nine, I go s t r a i g h t to the a n g i o g r a p h y suite w h e r e p r e p a r a t i o n s are i n hand for N a o m i ' s o r d e a l . T h e central c h a m ber is small, a b o u t the size of a s u b u r b a n l i v i n g r o o m . It is brightly lit and c r a m m e d with X - r a y e q u i p m e n t , m o n i t o r s , a n d control p a n e l s . T h e centrepiece i s the n a r r o w b e d u p o n w h i c h the patient, w h e n s h e arrives, will b e l a i d . T h e w a y i t t a p e r s a t one end r e m i n d s me of an i r o n i n g b o a r d . In the c o r n e r a quiet m a n from Medical Illustrations i s setting u p his v i d e o c a m e r a r e a d y for the show. E E G technicians i n white a n d r a d i o g r a p h e r s in blue filter in and l o o k b u s y . W e are g o i n g t o interfere with the w o r k i n g s o f N a o m i ' s brain, anaesthetizing each h e m i s p h e r e in turn with injections o f A m y t a l , a f a s t - a c t i n g s e d a t i v e . O u r a i m i s t o i s o l a t e a n d interr o g a t e o n e s i d e o f her h e a d a n d then the other.

Strictly,

' a n a e s t h e t i z e ' i s incorrect since the b r a i n h a s n o s e n s o r y r e c e p tors. It is a l w a y s in a state of a n a e s t h e s i a . T h e radiologist appears. ' D o we have a patient?' We do. N a o m i i s sitting u p i n her m o b i l e b e d , w h i c h h a s b e e n p a r k e d just d o w n the corridor, n o w h e r e in particular. It h a s a r r i v e d as if by time-lapse photography m o v i n g from one indeterminate station t o the next, a n d n o w here s h e i s . S h e l o o k s lonely, s o I g o and chat with her for a while. I w i s h her h a p p y birthday. I like N a o m i . I ' v e g o t to k n o w her well these p a s t few m o n t h s , w a t c h i n g her p r o g r e s s t h r o u g h a n o b s t a c l e c o u r s e o f investigations ( E E G , M R I , v i d e o telemetry, n e u r o p s y c h o l o g y ) that will l e a d , s h e h o p e s , to the s u r g e o n ' s list, to the o p e r a t i n g theatre and to the c a r v i n g a w a y of a small s t r e a k of s c a r r e d brain tissue - the s o u r c e of her epilepsy. H e r faith i n the d o c t o r s a n d s u r g e o n s i s a b s o l u t e . T h e f i t s will

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c e a s e . A l l will b e well. A n d w h e n s h e i s seizure-free she will go to university. P e r h a p s s h e will take a g a p - y e a r and travel to A u s t r a l i a . In t i m e , s h e will a p p l y for a d r i v e r ' s licence. A n d so o n . S h e is i n c o r r i g i b l y o p t i m i s t i c . It m a y be a feature of her brain pathology. H e r b o y f r i e n d , w h o s e n a m e I h a v e forgotten, is less s a n g u i n e . U n l i k e N a o m i , h e can s e e the possibility o f failure. H e u n d e r s t a n d s that the o p e r a t i o n m i g h t not w o r k . ' Y o u ' r e such a p e s s i m i s t , ' N a o m i told h i m w h e n I s a w them b o t h in the clinic. I ' d be the s a m e . Be troubled, Naomi. A little. The surgeon, if he gets his hands on you, is going to open your head and take a piece of you away.

Too much faith and expectation can be counter-

productive. I think these things, but this is not the time to v o i c e my c o n c e r n s . It is a time for unconditional r e a s s u r a n c e - not my s t r o n g e s t suit, b u t a n e c e s s a r y part of the repertoire, and well practised. M e a n w h i l e , the r a d i o l o g i s t is sifting t h r o u g h his tray of p a r a p h e r n a l i a a n d realizes s o m e t h i n g i s m i s s i n g . ' D o w e have any A m y t a l ? ' N o , not yet. O u r b a t c h o f the stuff l o o k e d s u s p i c i o u s l y c l o u d y , p o s s i b l y c o n t a m i n a t e d . No p r o b l e m . A call to P h a r m a c y and we a r e a s s u r e d that a s u p p l y of the d r u g is a l r e a d y on its w a y f r o m the R a d c l i f f e Infirmary. W h y it h a s to c o m e all the w a y f r o m O x f o r d I ' v e no i d e a . I d o n ' t enquire. T h i s m o r n i n g ' s p r o c e d u r e — a W a d a test — is the final hurdle. I f N a o m i p a s s e s the test s h e a d v a n c e s t o the s u r g e o n ' s list. S h e i s p r e p a r e d . Y e s t e r d a y she r e h e a r s e d the p r o t o c o l with o n e o f m y c o l l e a g u e s f r o m the N e u r o p s y c h o l o g y Unit. S h e lay o n her b a c k , r a i s e d b o t h a r m s to the vertical, counted up to twenty, i m a g i n e d (at a r o u n d t e n ) that her left a r m had b e c o m e limp and

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let it d r o p to her s i d e . T h i s is w h a t h a p p e n s w h e n the d r u g hits the right side o f the b r a i n . T h e n they w e n t t h r o u g h the m o t i o n s o f testing. N a o m i p e r f o r m e d s o m e s i m p l e a c t i o n s ( ' T o u c h y o u r n o s e . . . c l o s e y o u r e y e s . . . b l o w . . . ' ) ; recited the d a y s o f the w e e k and c o u n t e d b a c k w a r d s f r o m ten. S h e d e s c r i b e d a picture ('A m a n up a ladder, a b o y with a ball, a girl, a kite, a d o g and a cat, a p o n d , d u c k s . . . ' ) ; n a m e d o b j e c t s ; r e a d s e n tences; did mental arithmetic. T h e instructions a n d q u e s t i o n s w e r e rapid-fire. A m y t a l is fast a c t i n g , b u t its effects are s h o r t lived. In the test p r o p e r the injected half-brain will sleep for j u s t two or three m i n u t e s — while we c o n d u c t o u r b u s i n e s s with its wakeful twin. My c o l l e a g u e a r r i v e s c a r r y i n g a c l i p b o a r d , a s t o p w a t c h , a n d two b l a c k r i n g - b i n d e r s . O n her w a y into the a n g i o suite s h e e x c h a n g e s s m i l e s a n d w o r d s with N a o m i , w h o s e b e d h a s n o w m o v e d c l o s e r t o the m a i n d o o r . T h e r e ' s a s m i l e for m e t o o . S h e already k n o w s a b o u t the d e l a y with the A m y t a l . T i m e for a coffee. We sit next to the m a c h i n e that spills o u t the X - r a y n e g atives and flip t h r o u g h N a o m i ' s c a s e n o t e s . H e r h i s t o r y i s u n r e m a r k a b l e . It all started with a fever w h e n s h e w a s s m a l l . S h e ' d b e e n o f f c o l o u r for a c o u p l e o f d a y s , then s e e m e d t o p i c k up. H e r m o t h e r w a s n ' t s u r e , b u t in the end d r o p p e d her o f f at n u r s e r y school o n the w a y t o w o r k . M i d w a y t h r o u g h the m o r n i n g N a o m i fell a s l e e p in the s a n d pit, o r s o the teachers t h o u g h t . W h e n s h e c o u l d n ' t b e r o u s e d they called an a m b u l a n c e . S h e started s h a k i n g b e f o r e s h e fell asleep, the other children s a i d . T h e d o c t o r t h o u g h t i t w a s p r o b ably a febrile c o n v u l s i o n : not to w o r r y , a lot of k i d s are p r o n e to seizures i f their t e m p e r a t u r e c l i m b s t o o h i g h . T h e y m o s t l y g r o w

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o u t of it. A n d s o , it s e e m e d , s h e did. B u t the fits returned on the first tides o f m e n s t r u a t i o n . T h e y w e r e s h a d o w y figures with a p u n g e n t smell o f electricity, a s e n s e d p r e s e n c e , but no o n e there. O d d to identify the s m e l l of a s e i z u r e with electricity, which is o d o u r l e s s , but apt for an electrical s t o r m in the b r a i n . T h e ethereal v i s i t o r s a r e part o f the epileptic a u r a , a state o f altered a w a r e n e s s that s e r v e s t o f o r e w a r n o f a n a p p r o a c h i n g s e i z u r e . It a l s o h a s another, m o r e v i s c e r a l , feature. N a o m i s a y s it feels like a s p a r r o w fluttering its w i n g s in the pit of her s t o m a c h . T h e bird a s c e n d s t o her throat, b e c o m e s t r a p p e d , and s t r u g g l e s t o e s c a p e . U p t o this point, u n d e r the g a t h e r i n g g l o o m o f the b r a i n s t o r m , i n the c o m p a n y o f the e m p t y s h a d o w s and the s p a r row, s h e is fully c o n s c i o u s a n d can articulate her experiences. T h e n the s t o r m b r e a k s and s h e i s s w e p t b e y o n d reflection. H e r e y e s b e c o m e g l a z e d and empty. S h e t u g s a t her clothes, s m a c k s her lips, a n d k e e p s w i p i n g her n o s e with the b a c k o f her hand. I ' v e s e e n her in this state. S h e h a s g o n e with the wraiths. T h e y h a v e left an a u t o m a t o n , acting out a p u r p o s e l e s s , robotic routine. After the t o n e p o e m of the a u r a — the u n f o r m e d i m a g e s , the u n n a m e a b l e scents — a n d after the rhythmic a u t o m a t i s m s , there s o m e t i m e s f o l l o w s a third, c a t a s t r o p h i c , m o v e m e n t . A b o u t o n e in five of her attacks turns into a g e n e r a l i z e d seizure, what w o u l d o n c e h a v e b e e n called a g r a n d m a l . F i r s t , her m u s c l e s contract a n d s h e falls t o the g r o u n d , s o m e t i m e s s p u r t i n g b l o o d as her j a w c l a m p s shut a n d her teeth sink into her t o n g u e . S h e s t o p s b r e a t h i n g a n d , u n c o n s c i o u s , s h e urinates. T h e n c o m e the c o n v u l s i o n s — l i m b s j e r k i n g m e c h a n i c a l l y for several minutes — f o l l o w e d by r e l e a s e into a d e e p sleep.

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D e s p i t e inventive c o c k t a i l s o f anti-epileptic m e d i c a t i o n , w i t h d o s a g e s a l m o s t t o toxic levels, the f r e q u e n c y o f N a o m i ' s seizures h a s steadily i n c r e a s e d . N o w she g e t s t h e m a l m o s t e v e r y day. S h e is d e s p e r a t e for a c u r e a n d w i l l i n g to take risks. T h e planned operation has an ungainly n a m e : a m y g d a l o h i p p o c a m p e c t o m y , s o called b e c a u s e i t i n v o l v e s r e m o v a l o f the a m y g d a l a (from the G r e e k for ' a l m o n d ' ) a n d p a r t o f the a d j a cent structure, the h i p p o c a m p u s ( ' s e a h o r s e ' ) . E a c h h a l f o f the brain contains a n a l m o n d a n d a s e a h o r s e . T h e p u r p o s e o f the W a d a test is to clear a w a y for the o p e r a t i o n . We k n o w it is the right side o f N a o m i ' s b r a i n that b e a r s the scar t i s s u e a n d d r i v e s the seizures b e c a u s e w e ' v e s e e n the b r a i n s c a n s a n d w e ' v e l o g g e d the clinical s i g n s . B u t w e a r e a l s o m a k i n g a n a s s u m p t i o n , p o s s i b l y u n w a r r a n t e d , that her left h e m i s p h e r e , w h i c h l o o k s n o r m a l , is functioning n o r m a l l y . O u r test will help d e t e r m i n e whether this i s true. (It i s ' W a d a ' , b y the w a y , not ' W A D A ' a s I ' v e just b e e n r e a d i n g i n the c a s e n o t e s ; a c o m m o n error. T h e p r o c e d u r e i s n a m e d after J u h n W a d a , the J a p a n e s e - C a n a d i a n n e u r o l o g i s t w h o f i r s t p r o p o s e d its u s e . I t m u s t b e d i s a p p o i n t i n g t o b e elevated t o the status o f a n e p o n y m o n l y t o b e m i s t a k e n for a n a c r o n y m . ) W e n e e d t o b e a s s u r e a s p o s s i b l e that there i s n o 'silent l e s i o n ' on that healthy s i d e ; in other w o r d s , a m a l f u n c t i o n that h a s n ' t s h o w n u p o n the b r a i n s c a n s . A p p e a r a n c e s c a n b e deceptive. B r a i n tissue can l o o k clean a n d p l u m p , b u t w i t h o u t putting it to the test o n e c a n ' t be s u r e of its integrity. O n e of the t a r g e t s for s u r g e r y , the h i p p o c a m p u s , is a vital c o m p o n e n t o f the b r a i n ' s m e m o r y circuitry, essential for l a y i n g d o w n n e w traces. We n e e d to k n o w , a b o v e all, whether the left h e m i s p h e r e o f N a o m i ' s b r a i n i s u p t o the t a s k o f s u s t a i n i n g b a s i c

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m e m o r y functions. T o the extent that each o f u s i s the s u m o f o u r m e m o r i e s , the h i p p o c a m p u s i s the instrument b y m e a n s o f w h i c h w e a s s e m b l e o u r s e l v e s . E v e r y t h i n g accessible t o c o n s c i o u s recall h a s b e e n r e g i s t e r e d and r e c o r d e d t h r o u g h its channels. W h a t w e r e y o u d o i n g ten m i n u t e s a g o ? W h o w a s the last p e r s o n y o u s p o k e t o ? W h a t did y o u h a v e for b r e a k f a s t ? W h a t d i d y o u d o yesterday, last w e e k e n d ? W h e n w a s the last time y o u w e p t , a n d w h y ? C o n j u r e a n i m a g e o f y o u r f i r s t s c h o o l , the face o f y o u r teacher, y o u r b e s t friend. R e m e m b e r y o u r f i r s t kiss. A n d then, stretching to the mental horizon, rising t h r o u g h the s q u a l l s and s u n s h i n e o f p e r s o n a l e x p e r i e n c e , picture the toweri n g s t a c k s of i n f o r m a t i o n in the public d o m a i n ; the raw m a t e r i a l s o f culture. W h a t d o e s the w o r d ' e n t r o p y ' m e a n ( o r ' t h e ' o r ' w o r d ' o r ' m e a n ' ) ? H o w d o y o u u s e a telephone? W h o i s the p r e s i d e n t o f the U n i t e d S t a t e s ? A t what temperature d o e s w a t e r freeze? W h o w r o t e King L e a r ? W h a t is the function of the liver? All this i n f o r m a t i o n , p e r s o n a l and p u b l i c , finds its w a y into m e m o r y b y w a y o f the h i p p o c a m p u s . A s a n aid t o recall, m e d i e v a l scholastics d e v e l o p e d elaborate, architectural

systems

of

mental

imagery

—

'Theatres

of

M e m o r y ' o r ' M e m o r y P a l a c e s ' - t h r o u g h which they w o u l d take i m a g i n a r y strolls, d e p o s i t i n g o r retrieving n u g g e t s o f i n f o r m a t i o n at s t r a t e g i c l o c a t i o n s . I like the idea that the K e e p e r of the G a t e s is as fragile a creature as the s e a h o r s e . It d o e s n ' t take m u c h — a stroke of the s u r g e o n ' s knife — to finish it off and c l o s e the entrance for g o o d . T h e f l o w o f information s t o p s . If, as p l a n n e d , the s u r g e o n w e r e to r e m o v e the right h i p p o c a m p u s , b u t it t u r n e d out that N a o m i had no s p a r e capacity in

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the left, then the o p e r a t i o n w o u l d , in a s e n s e , c a u s e N a o m i herself t o stop. S h e w o u l d f o r m n o n e w m e m o r i e s o f e v e n t s o r facts b e y o n d her present a g e o f nineteen. I t w o u l d not p r e v e n t her from g r o w i n g o l d , but her a g e i n g b o d y w o u l d f o r e v e r h o u s e the m i n d of a nineteen-year-old girl. S u c h things h a p p e n e d in the e a r l y d a y s of e p i l e p s y s u r g e r y . A handful o f p e o p l e , m o s t f a m o u s l y a y o u n g m e c h a n i c k n o w n a s patient ' H M ' , e n d e d u p with d e n s e a n d i r r e v e r s i b l e a m n e s i a , unable to retain n e w i n f o r m a t i o n for m o r e than a few m i n u t e s at a time, and s o u n a b l e t o establish m e m o r i e s . Y o u c o u l d visit H M e v e r y d a y for a y e a r and each time he w o u l d g r e e t y o u as a stranger. L e a v e the r o o m for ten m i n u t e s a n d o n y o u r return h e w o u l d h a v e n o idea w h o y o u w e r e . Since then s u r g e o n s h a v e restricted their interventions to just o n e side o f the b r a i n , but e v e n s o there h a v e b e e n s i m i l a r d i s a s ters w h e r e it w a s not established p r i o r to s u r g e r y that the other side w a s i n g o o d w o r k i n g order. T h a t ' s the r e a s o n w e ' r e h e r e today, I remind myself, g o i n g t h r o u g h these a r c a n e rituals. We want N a o m i t o continue i n m i n d a s well a s b o d y . I f the h i p p o c a m p u s i s the g a t e w a y t o m e m o r y , o n e c a n p i c ture the a m y g d a l a as h o u s i n g the l e v e r s of e m o t i o n . It links the i n f o r m a t i o n - p r o c e s s i n g activities o f the higher, cortical a r e a s o f the brain — the m a c h i n e r i e s of l a n g u a g e , p e r c e p t i o n , a n d rational t h o u g h t — to d e e p e r , o l d e r structures c o n c e r n e d with the regulation of e m o t i o n and m o t i v a t i o n . In short, it tells us h o w t o feel a b o u t what w e are thinking a n d p e r c e i v i n g , a n d h o w to act on those feelings. Patients with d a m a g e to the a m y g d a l a on both sides of the b r a i n inhabit a w o r l d d e v o i d of e m o t i o n a l contour and colour. D i m i n i s h e d insight into their o w n feelings

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a n d b e h a v i o u r is m i r r o r e d by a distorted p e r c e p t i o n of the e m o tional lives o f o t h e r s . S o the s t a k e s are h i g h for N a o m i : m e m o r y and e m o t i o n . W e n e e d to g e t this right. T h e A m y t a l a r r i v e s , d e l i v e r e d b y m o t o r c y c l e courier. H e h a n d s o v e r a Jiffy b a g that a n u r s e o p e n s to find two phials c o n t a i n i n g a plain liquid, the stuff that will shortly w o r k its spell o n N a o m i ' s b r a i n . O u r patient i s n o w stretched o u t o n the s p e cial b e d , at the centre of things, w a i t i n g . H e r head rests on a s m a l l s q u a r e c u s h i o n . S h e is c o v e r e d to the neck with a g r e e n s u r g i c a l sheet e x c e p t for an e x p o s e d patch a r o u n d her g r o i n , w h e r e , h a v i n g a d m i n i s t e r e d a local anaesthetic and m a d e a small incision, the r a d i o l o g i s t is w o r k i n g to g a i n a c c e s s to the femoral artery. N a o m i ' s face at the top of the sheet a n d this framed e x p a n s e o f p a l e f l e s h and p u b i c hair ( a n d n o w b l o o d from the c u t ) s e e m quite unrelated. M a n y p e o p l e are s u r p r i s e d t o learn that the m o s t feasible r o u t e to the brain for these p u r p o s e s is by w a y o f the g r o i n . T h e catheter, a l e n g t h of ultra-fine plastic t u b i n g , is inserted a n d p u s h e d , inch b y inch, a l o n g the f e m o r a l artery, u p t h r o u g h the a b d o m e n a n d into the chest. Its j o u r n e y is v i s i b l e , magnified g r a i n i l y in spectral s h a d e s of g r e y , on the X - r a y m o n i t o r s . I w a t c h as it finds its w a y to N a o m i ' s heart a n d from there to the j u n c t i o n with the internal c a r o t i d . S h e , too, is w a t c h i n g . S h e can s e e her i n s i d e s o n the m o n i t o r s s u s p e n d e d o v e r h e a d which, with e x q u i s i t e i n t e g r a t i o n o f hand and e y e , the r a d i o l o g i s t u s e s t o find his w a y f r o m g r o i n to g u t to heart to b r a i n . N e x t , a r a d i o o p a q u e d y e i s p u m p e d t h r o u g h the n e w l y installed plastic p i p i n g t o f l o o d the b l o o d v e s s e l s o f the b r a i n .

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T h e r a d i o l o g i s t takes a few X - r a y s n a p s t o confirm that w e have reached o u r intended destination o n the c e r e b r o v a s c u l a r m a p . Stationed a t N a o m i ' s midriff, h e offers a n o c c a s i o n a l w o r d o f r e a s s u r a n c e , and g l a n c e s n o w a n d then i n her direction. H e m e a n s well, but the e x c h a n g e s b e t w e e n t h e m are perfunctory. S h e , for her part, is b e i n g a g o o d patient. H e r b o d y is p a s s i v e , receptive. H e r face s h o w s b a r e l y a trace o f e m o t i o n , b u t w h e n the n u r s e b r u s h e s a strand of hair f r o m her f o r e h e a d , N a o m i ' s eyes moisten. W e h a v e here N a o m i the b o d y , N a o m i the m i n d , a n d N a o m i the p e r s o n . T h e s e , a t least, are the differences o f e m p h a s i s a c r o s s the p r o f e s s i o n a l d i v i s i o n s o f l a b o u r . T h e r a d i o l o g i s t w o r k s i n the realm o f the flesh. H e k n o w s the intricacies o f the v a s c u l a r s y s t e m a n d i s o n g o o d t e r m s with the g h o s t s o f his X - r a y m a c h i n e . I, the n e u r o p s y c h o l o g i s t , will s h o r t l y s i g n a l a pharmacological invasion and deconstruction of N a o m i ' s mind. T h e n u r s e , for now, i s with N a o m i the p e r s o n . We are all set to start. N a o m i h a s her a r m s r a i s e d a n d b e g i n s to count. I l o o k to my c o l l e a g u e s t a n d i n g o p p o s i t e with her black folders, s t o p w a t c h , and c l i p b o a r d , r e a d y to a s s i s t with test materials and r e c o r d r e s p o n s e s . T h e n e u r o p h y s i o l o g i s t s a r e a few feet b a c k m o n i t o r i n g e v e r y s q u i g g l e o f b r a i n w a v e activity siphoned t h r o u g h the l o n g bridal veil o f m u l t i - c o l o u r e d l e a d s attached t o N a o m i ' s h e a d . After a n o d from m e , the r a d i o l o g i s t starts to inject the A m y t a l . It takes effect in a few s e c o n d s a n d I g r a b N a o m i ' s a r m as it s w o o n s , g u i d i n g it to rest at her s i d e . At that m o m e n t of c o l l a p s e , the catching o f the lifeless a r m , s o m e t h i n g c o l l a p s e s inside me t o o a n d I catch m y s e l f thinking, What am I doing here f

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I ' d rather b e s o m e w h e r e e l s e , well a w a y from this u n w h o l e s o m e m i n d m e d d l i n g . B u t here lies N a o m i . T h e r e i s w o r k t o d o and, after all, better to be d o i n g this to a relative stranger than to someone you love. T h a t would be unbearable. She looks r e m a r k a b l y c a l m a n d o r d i n a r y g i v e n that her right cerebral h e m i s p h e r e , h a l f her b r a i n , i s n o w t e m p o r a r i l y defunct. H o w ordinary she l o o k s . I am clear a b o u t the p u r p o s e of the test, but c u r i o u s to k n o w w h a t is h a p p e n i n g to ' N a o m i the p e r s o n ' , a question entirely p e r i p h e r a l t o the i m m e d i a t e m e d i c a l c o n c e r n s . O u r p r o c e d u r e i s p h a r m a c o l o g i c a l , not s u r g i c a l ; the altered state is transient. But while the d r u g w o r k s its influence w e h a v e , effectively, a m p u tated o n e s i d e of her b r a i n . I w o n d e r if, with half of the brain c l o s e d d o w n , w e a r e e n g a g i n g with just o n e h a l f o f the p e r s o n . P s y c h o l o g i s t s u s e d t o b e o b s e s s e d b y the duality o f the brain. ' F u n c t i o n a l a s y m m e t r y ' w a s a hot topic w h e n I w a s an u n d e r g r a d u a t e i n the 1970s. T h e b e l i e f w a s that the t w o halves o f the b r a i n p e r f o r m distinct, t h o u g h c o m p l e m e n t a r y , functions: left h e m i s p h e r e for l a n g u a g e , right for spatial a w a r e n e s s ; left for rhythm,

right

for

melody;

rationality / intuition;

analysis /

synthesis, and so on. A t the centre o f attention a t that time, scientifically and i m a g inatively, w e r e the s o - c a l l e d ' s p l i t - b r a i n ' studies. Split-brain s u r g e r y w a s a radical m e t h o d o f treating p e o p l e w h o suffered f r o m s e v e r e a n d intractable e p i l e p s y — patients t o r m e n t e d by frequent, debilitating s e i z u r e s that c o u l d not be controlled by a n y other f o r m o f treatment. E p i l e p t i c s e i z u r e s a r e c a u s e d b y a b n o r m a l b u r s t s o f electrical activity in the b r a i n . T h e r a t i o n a l e for split-brain s u r g e r y -

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c o m m i s s u r o t o m y — w a s that cutting the c o r p u s c a l l o s u m , the main channel o f c o m m u n i c a t i o n b e t w e e n the t w o h e m i s p h e r e s , w o u l d confine the a b n o r m a l electrical activity to o n e s i d e of the brain and s o prevent the d e v e l o p m e n t o f m a j o r s e i z u r e s . I w a s not m u c h c o n c e r n e d with the clinical a s p e c t s of this operation.

I

had no particular interest in epilepsy.

What

intrigued me w a s that the split-brain patients w e r e thought experiments made flesh. T h e y fell into the c a t e g o r y of p h i l o sophical c o n u n d r u m that a l s o i n c l u d e s the ' b r a i n in the v a t ' , the 'brain t r a n s p l a n t ' , and science fiction fantasies a b o u t t e l e p o r t a tion and mind duplication. T h o u g h t e x p e r i m e n t s are ' I m a g i n e i f . . . ' s c e n a r i o s d e s i g n e d to challenge our o r d i n a r y intuitions. In the seventeenth c e n t u r y J o h n L o c k e e x p l o r e d the c o n c e p t o f p e r s o n a l identity b y i m a g ining an e x c h a n g e of b r a i n s b e t w e e n a prince a n d a cobbler. It is p s y c h o l o g i c a l continuity that c o u n t s , h e c o n c l u d e d . T h e p r i n c e ' g o e s with' his b r a i n and n o w f i n d s ' h i m s e l f i n the b o d y o f the cobbler (and v i c e v e r s a ) . M o r e recent v a r i a t i o n s o n the t h e m e , s o m e inspired directly b y the split-brain c a s e s , a r e less s t r a i g h t forward. W h a t i f s o m e o n e ' s cerebral h e m i s p h e r e s are d i v i d e d a n d transferred s e p a r a t e l y ( m e m o r i e s , character traits a n d all) to the heads o f t w o different p e o p l e ? W h a t i f y o u s w a p a h e m i s p h e r e with y o u r best friend, o r y o u r w o r s t e n e m y ? W h i c h o f y o u i s which? T h e r e w o u l d b e s o m e continuity i n these c a s e s , b u t not unity. C o n v e n t i o n a l n o t i o n s o f p e r s o n a l identity w o u l d b e seriously challenged. B u t the split-brain c a s e s w e r e not flights o f p h i l o s o p h i c a l fancy. T h e y w e r e real p e o p l e with a real a n d irreversible s u r g i -

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cal d i v i s i o n o f the brain. Inevitably they p r o v o k e d a s m u c h p h i l o s o p h i c a l interest a s scientific. L i k e m a n y others, m y o w n i m a g i n a t i o n w a s c a p t u r e d by the s u g g e s t i o n that, in d i v i d i n g the b r a i n , the s u r g e o n ' s knife w a s a l s o d i v i d i n g c o n s c i o u s n e s s and therefore d i v i d i n g the p e r s o n . T h e v e r y idea o f bisecting the l i v i n g , c o n s c i o u s b r a i n clean d o w n the m i d d l e w a s bizarre and a b s u r d . It h a d a t o u c h of the m a c a b r e , a whiff of the c h a m b e r of h o r r o r s . T h e r e are m a n y w e i r d creatures i n the m e n a g e r i e o f n e u r o l o g i c a l d i s o r d e r , but the split-brain patients w e r e o f the p u r e s t s t r a n g e n e s s . I w a s d r a w n in. ' S t r a n g e c a s e s ' , c l o s e l y o b s e r v e d , h a v e a n important p l a c e i n the n e u r o l o g i c a l literature. A l e x a n d e r L u r i a , a m a j o r figure in the h i s t o r y o f n e u r o p s y c h o l o g y , w a s a m a s t e r o f case d e s c r i p tion a n d a p e r s u a s i v e a d v o c a t e o f ' r o m a n t i c s c i e n c e ' . ' W h e n done properly,' he said, 'observation accomplishes the c l a s s i c a l a i m o f e x p l a i n i n g facts, while not l o s i n g sight o f the r o m a n t i c a i m o f p r e s e r v i n g the manifold richness o f the subject.' I d o n ' t hesitate to r e c o m m e n d the p o p u l a r writings of L u r i a , O l i v e r S a c k s , a n d o t h e r s t o students a s a w a y o f i n t r o d u c i n g t h e m to the field, b u t I r e c o g n i z e that part of the a p p e a l , part of that ' m a n i f o l d richness of the s u b j e c t ' , h a s little to do with s c i e n c e or p h i l o s o p h y .

It h a s m o r e to do with the intrinsic

f a s c i n a t i o n of the a b e r r a n t and the b i z a r r e . Morbid fascination w o u l d n o t b e t o o w i d e o f the m a r k . In this light, n e u r o l o g i c a l c a s e histories h a v e a certain G o t h i c a p p e a l . R e p l a c e the d a r k forests, the c r a g g y m o u n t a i n s , the ruined a b b e y s , a n d the elemental s t o r m s o f the traditional G o t h i c tale with a d e s o l a t e u r b a n l a n d s c a p e . L e t a dilapidated

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m o d e r n hospital stand for the c r u m b l i n g m e d i e v a l castle with its labyrinthine p a s s a g e s , g l o o m y d u n g e o n s , a n d torture c h a m b e r s . T h e w h i t e - c o a t e d , m a d scientist i n his c o b w e b b e d l a b o r a t o r y , a m i d v a n d e G r a a f g e n e r a t o r s , l i g h t n i n g c o n d u c t o r s , a n d the p a r a p h e r n a l i a o f alchemy, b e c o m e s the g r e e n - g o w n e d s u r g e o n in the sterile g l e a m of the o p e r a t i n g theatre, knife in h a n d , r e a d y to r e w o r k the b r a i n ' s s l i m y fabric. At the centre of it all is the monster, w a i t i n g for the life force f r o m the h e a v e n s to jolt its d e a d limbs, and the patient, b r a i n e x p o s e d to the air, w a i t i n g for the b l a d e . A n d here I a m now, i n the s h a d o w o f D r F r a n k e n s t e i n , h a v i n g isolated o n e half o f N a o m i ' s b r a i n , a b o u t t o e n g a g e i n a d i a l o g u e w i t h . . . what? A p e r s o n ? A h a l f - p e r s o n ? H a l f a b r a i n ? It d o e s n ' t feel as if I ' m d e a l i n g with s o m e f r a g m e n t of a m u t i lated self. N a o m i ' s spirits s e e m to lift. S h e a n s w e r s my q u e s t i o n s o b l i g i n g l y and follows instructions with h a r d l y a m o m e n t ' s hesitation. T h o s e three short m i n u t e s f l y by. ' Y o u ' v e d o n e v e r y well,' I tell her. T h e d r u g w e a r s off. T h e left a r m h a s returned t o life a n d the E E G trace i s b a c k t o n o r m a l . H e r e y e s are c l o s e d a n d N a o m i l o o k s a s i f she i s asleep. W e k n o w she isn't from the r h y t h m s o f the E E G - her b r a i n is idling in a c o m f o r t a b l e alpha r h y t h m , indicating relaxed wakefulness. It is time for the next s t a g e of the p r o c e d u r e , t o s e e whether s h e r e m e m b e r s a n y t h i n g f r o m the d r u g p h a s e . F o r N a o m i , this element o f the ritual i s crucial. Failure here w o u l d o u t w e i g h s u c c e s s a t a n y other s t a g e . I f s h e i s t o p r o c e e d t o s u r g e r y s h e m u s t p a s s m y m e m o r y tests. S h e ' s not d o i n g so well. Come on, Naomi, come on, I ' m thinki n g . ' T h e picture, N a o m i , w h a t can y o u r e m e m b e r ? '

35

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B R O K S

Perplexity, then a b u r s t of information: 'A m a n on a ladder, a d o g c h a s i n g a cat, a p o n d with s o m e d u c k s on it, a girl with a kite, a b o y with a b a l l . ' A l l , unfortunately, from the picture she w a s s h o w n a t y e s t e r d a y ' s rehearsal. F o r m a l testing c o m p l e t e d , I a s k N a o m i h o w s h e found the experience. ' N o p r o b l e m , ' s h e s a y s . 'It w a s a b r e e z e . ' T h e b r a i n ' s l a n g u a g e circuits are u s u a l l y located o n the left s i d e , s o d i s t u r b a n c e o r c o m p l e t e l o s s o f s p e e c h i s the typical r e s p o n s e to injection of the left h e m i s p h e r e . In other w a y s the effects a r e less p r e d i c t a b l e . S o m e patients a p p e a r confused and d i s o r i e n t e d , s o m e b e c o m e a g i t a t e d , s o m e disinhibited. O t h e r s , like N a o m i , just l o o k d e s o l a t e . H e r h e a d is still, but her e y e s flash left and right. S h e will not respond to my simple commands: 'Touch your nose, Naomi, t o u c h y o u r n o s e . ' N o t h i n g . W h e n w e g e t t o D a y s o f the W e e k s h e tries v e r y h a r d , b u t all we g e t is ' F a - f a - f a - f a - f a . . .' On C o u n t i n g B a c k from T e n s h e a p p r o x i m a t e s the n u m b e r w o r d s , b u t g e t s l o c k e d in a p e r s e v e r a t i v e l o o p : 'Tern, nipe, a p e , a p e , a p e , a p e . . . ' S h e l o o k s a t the picture and h a s a n u r g e t o point a t things: ' D a , da.' F o r a while s h e s e e m s to be w a r m i n g to the task, a p p e a r s e n g a g e d , b u t her c o n c e n t r a t i o n s u d d e n l y fades. A t o n e point she l o o k s m e i n the e y e a n d c h u c k l e s wickedly, then another w a v e o f e m o t i o n s e n d s her in a different direction. H e r e y e s dart left and right a g a i n . S h e l o o k s terrified; s h e l o o k s feral. ' F i n e , N a o m i , just f i n e , ' I s a y a s w e c o m p l e t e the routine. ' R e l a x , w e ' r e n e a r l y there now.' We retire to a side r o o m l e a v i n g N a o m i t o rest a n d r e c o v e r from the d r u g .

36

INTO

The

speech

disturbance

confirms

T H E

for u s

S I L E N T

that

L A N D

Naomi's

l a n g u a g e control centres are l o c a t e d p r i m a r i l y in the left h e m i sphere. T h i s i s i m p o r t a n t for the s u r g e o n t o k n o w , g i v i n g h i m greater licence for e x c u r s i o n s into the right t e m p o r a l cortex if necessary, with m i n i m a l risk o f d i s r u p t i n g l a n g u a g e functions. A n d w h e n i t c o m e s t o m e m o r y testing there are n o s u r p r i s e s . H e r failure to recall or r e c o g n i z e m o s t of the test i t e m s confirms that w e w e r e p l a c i n g u n r e a s o n a b l e d e m a n d s o n the d a m a g e d right h i p p o c a m p u s : taunting the crippled s e a h o r s e . T h e o n e exception is her a c c u r a t e recall of the mental arithmetic task. U n d e r the d r u g she h a d s t a r e d at the s u m printed on the test card and s a i d , ' S e b b e r , seffen, fife, fife, five.' N o w , correctly, she recalls, ' F o u r p l u s f i v e e q u a l s n i n e . ' I ' v e s e e n this b e f o r e . S o m e h o w , I think, numerical i n f o r m a t i o n m u s t g a i n b a c k - d o o r a c c e s s to the left h e m i s p h e r e in a w a y that verbal information cannot. Recall of the experience of left h e m i s p h e r e s u p p r e s s i o n is a l s o less predictable than for shutting d o w n the right h e m i s p h e r e . S o m e patients h a v e no recollection of events at all, at least n o t h i n g they can put into w o r d s . O t h e r s h a v e at least partial insight into the frustrations o f their t e m p o r a r y l o s s o f s p e e c h . S o m e , like N a o m i , just tell tales. ' O h , it w a s o k a y , ' she s a y s . Well, p e r h a p s she did h a v e s o m e slight p r o b l e m s with her s p e e c h at first, but after that she w a s fine. M a y b e it w a s a bit different to the f i r s t time a r o u n d , but not m u c h , not really. Q u i t e enjoyable. T h i s is the left h e m i s p h e r e c o n f a b u l a t i n g . It d o e s this for all of u s , every w a k i n g m o m e n t . It edits o u r c o n s c i o u s e x p e r i e n c e s , m a k e s them c o m p r e h e n s i b l e and palatable. It is the b r a i n ' s s p i n - d o c t o r .

*** 37

PAUL

B R O K S

T w o t h i n g s disturb me d u r i n g the night. O n e is the h o a r s e , sotto voce b a r k of an u r b a n fox, r e c e d i n g in triplets d o w n the street. T h e other is a f r a g m e n t of d r e a m , s h a r p e n o u g h to w a k e m e . I s t a g g e r , g i d d y f r o m b e i n g s p u n in a l a r g e m a c h i n e they called an A c c e l l o t r o n . It h a s m a d e me invisible, temporarily. I s e e my d a u g h t e r sitting in the g a r d e n and a p p r o a c h her. I s p e a k . S h e l o o k s at m e , but her e y e s c o n t i n u e s e a r c h i n g . I h a v e , truly, b e c o m e invisible. T h e r e ' s no w a y I can r e a s s u r e her. S h e is terrified w h e n I t o u c h her h a n d . I ' m terrified. N e x t day, first thing, I ' m sitting in my office w a t c h i n g the v i d e o o f N a o m i ' s W a d a test. I t ' s e a s y t o m i s s important details i n the p a t i e n t ' s r e s p o n s e s s o w e a l w a y s check the v i d e o . T h e r e w a s s o m e t h i n g I failed to catch. T h e left h e m i s p h e r e is s u p p r e s s e d a n d the o r i g i n o f N a o m i ' s f r a g m e n t e d , m u m b l i n g s p e e c h is uncertain. It c o u l d be the left h e m i s p h e r e running on e m p t y or p e r h a p s it is c o m i n g from the other side of the brain. Either w a y it's hard to make out what s h e ' s saying. For a m o m e n t , her c o n f u s i o n s e e m s to s u b s i d e a n d there is a l o o k of a c c u s a t i o n in her e y e s . 'Watafam,' she says, 'dooneer.' I listen c l o s e l y a s e c o n d a n d third time a n d realize it's a q u e s t i o n : ' W h a t the fuck am I d o i n g h e r e ? '

38

The Sword of the Sun

I had never b e e n m u c h a w a r e of my father's g l a s s e y e , just as I had never really noticed his foreign accent. We w e r e s w i m m i n g s o m e distance from the s h o r e . F o u r t e e n y e a r s o l d , I w a s w a y ahead. He called and I turned to find him t r e a d i n g water, right hand c o v e r i n g the e m p t y c a v e o f his e y e - s o c k e t , g o o d e y e exploring the g l i m m e r i n g depths. T h e fugitive e y e stared u p a t us from the s e a b e d . I p l u n g e d like a pearl diver, f o l l o w i n g its g a z e all the w a y d o w n , and snatched it up with a handful of s a n d . T h a t e v e n i n g , s k i m m i n g s t o n e s into the s u n s e t , I returned in i m a g i n a t i o n to the o c e a n floor. It w a s a c o l d a n d lonely p l a c e . T h e n i t o c c u r r e d t o m e that, d e p r i v e d o f a n o b s e r v i n g e y e , the ocean w a s nothing. S u c h p o w e r ! I c l o s e d m y e y e s a n d i t w a s gone. Y e a r s later I read Italo C a l v i n o ' s Mr Palomar. It stirred m e m ories. T h e e p o n y m o u s h e r o g o e s for a n e v e n i n g s w i m . A s the sun g o e s d o w n it s e n d s a d a z z l i n g b a n d of light a c r o s s the s e a . L o o k i n g b a c k t o the s h o r e , M r P a l o m a r s e e s the s u n ' s reflection as a shining s w o r d in the water. He s w i m s t o w a r d s it, b u t the

39

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B R O K S

s w o r d retreats with e v e r y s t r o k e a n d he is n e v e r able to overtake it. W h e r e v e r he m o v e s he r e m a i n s at the s w o r d ' s tip. It follows h i m , ' p o i n t i n g h i m o u t like the h a n d of a w a t c h w h o s e p i v o t is the s u n ' . H e realizes that e v e r y bather e x p e r i e n c e s the s a m e effects of the light. S a i l b o a r d s c h a n g e their a p p e a r a n c e as they c r o s s the reflection, c o l o u r s a r e m u t e d , b o d i e s silhouetted. W h a t if all the s w i m m e r s a n d s a i l b o a r d e r s return to the s h o r e , h e w o n d e r s , w h e r e w o u l d the s w o r d e n d ? Mr P a l o m a r u n d e r s t a n d s that n o t h i n g he s e e s exists in nature. N a t u r e is a b u n d l e of a b s t r a c t i o n s — particles in fields of force. T h e s u n , the s e a , the s w o r d , a n d the s a i l b o a r d e r s are inside his head. He floats a m o n g phantoms. T h e s w o r d o f the s u n c l e a v e s the u n i v e r s e i n t w o : there i s o b j e c t i v e reality — r e m o t e a b s t r a c t i o n s w i t h o u t point of v i e w — a n d there i s P a l o m a r ' s p r i v a t e u n i v e r s e , the m i r a g e o f h u m a n p e r c e p t i o n . ' I a m s w i m m i n g i n m y m i n d ; this s w o r d o f light e x i s t s o n l y there.' B u t w h a t kind o f thing i s M r P a l o m a r , the P e r c e i v e r ? No d o u b t he w o u l d s e e himself, as I s e e myself, as a s i n g u l a r , unified b e i n g , c o n t i n u o u s with his child s e l f as I am c o n t i n u o u s w i t h the b o y d i v i n g for his father's e y e , m o v i n g f r o m fixed p a s t to uncertain future. L i k e the s u n ' s reflection, this is an illusion. In the a n g i o g r a p h y suite, p e r f o r m i n g a W a d a test, I w a s the illusionist. O u r b r a i n d r u g cleft the y o u n g w o m a n i n two. T h e left-brain v e r s i o n o f N a o m i w a s different from the right. M s L e f t - b r a i n w a s talkative and cheerful. M s R i g h t - b r a i n w a s unsettled,

mute,

morose.

When

the

words finally broke

t h r o u g h , she h a d n ' t a clue w h e r e she w a s . ' W h a t the fuck am I d o i n g h e r e ? ' I ' v e n e v e r h e a r d M s L e f t - b r a i n swear. A f t e r w a r d s ,

40

INTO

T H E

S I L E N T

L A N D

when the d r u g w o r e off, Ms L e f t - b r a i n s p o k e for the w h o l e p e r s o n . 'It w a s a b r e e z e , ' s h e s a i d . T h e r e w a s n o recollection o f M s R i g h t - b r a i n ' s d i s c o m f o r t . I t h a d b e e n edited out o f the story. O n e m i g h t think that the s e l f is d i v i d e d in s u c h c i r c u m stances, but this w o u l d be to s w a l l o w the illusion of unity; to i m a g i n e in the first p l a c e that there is s o m e ' w h o l e t h i n g ' to be fractionated. T h e r e isn't. F r o m a n e u r o s c i e n c e p e r s p e c t i v e w e are all d i v i d e d a n d d i s c o n t i n u o u s . T h e mental p r o c e s s e s u n d e r lying our sense of s e l f — feelings, t h o u g h t s , m e m o r i e s — are scattered t h r o u g h different z o n e s o f the b r a i n . T h e r e i s n o special point o f c o n v e r g e n c e . N o cockpit o f the s o u l . N o s o u l pilot. T h e y c o m e together in a w o r k of fiction. A h u m a n b e i n g is a story-telling m a c h i n e . T h e s e l f is a story. T h i s i s not t o s a y that o u r lives a r e f i c t i o n s . U n l i k e R o b i n s o n C r u s o e o r E m m a B o v a r y w e are e m b e d d e d i n a u n i v e r s e with physical and m o r a l d i m e n s i o n s w h e r e e v e r y t h o u g h t a n d action splinters into a million c o n s e q u e n c e s . R e a d e r s of F l a u b e r t ' s Madame Bovary will v a r y in their reactions to its h e r o i n e as s h e m a k e s her w a y t h r o u g h the n o v e l , b u t her life and t h o u g h t s are f i x e d . S h e will a l w a y s m a r r y C h a r l e s , fall p r e y t o the a b o m inable R o d o l p h e , a n d d i e her horrible death. I t ' s different for us meat p u p p e t s . We d o n ' t k n o w w h e r e o u r lives are g o i n g . What the fuck am I doing here? I often w o n d e r . W h o tells the s t o r y o f the s e l f ? T h a t ' s like a s k i n g w h o thunders the thunder or rains the rain. It is not so m u c h a q u e s t i o n of us telling the s t o r y as the s t o r y telling u s . N o t so l o n g a g o I a s k e d my d a d if he r e m e m b e r e d the time I rescued his eye from the b o t t o m of the s e a . ' N o , ' he said.

41

Soul in a Bucket

I o n c e m e t a y o u n g m a n w h o w a s c o n v i n c e d his head w a s full of w a t e r a n d c o n t a i n e d a fish rather than a b r a i n . It w a s quite a l a r g e fish, s o m e t h i n g like a trout, a n d it unsettled him to think o f i t l i v i n g i n s u c h c r a m p e d c o n d i t i o n s . H e n o l o n g e r had need of a b r a i n since all his t h o u g h t s and b e h a v i o u r w e r e under the c o n t r o l o f the C I A . M o s t of us b e l i e v e that the h e a d contains a p e r s o n : a self. H e r e ' s o n e , at the front of a lecture hall, spilling w o r d s that s e e m t o c o m e from n o w h e r e . T h e r e , i n the a u d i t o r i u m , are 200 other s e l v e s . R o w s o f h e a d s . F o r each head t o represent the l o c a t i o n of a c o n s c i o u s s e l f r e q u i r e s a further, inferential, step, a m e n t a l p r o c e s s I am p o w e r l e s s to resist. T h e s a m e a p p l i e s w h e n w e reflect o n o u r o w n identity. W e create o u r s e l v e s by inference: a u t o m a t i c a l l y and irresistibly. In d o i n g s o w e ride the rails o f the d e e p e s t h u m a n c o n v e n t i o n , but, at r o o t , it is just that: a c o n v e n t i o n . T h e s e l f is not an intrinsic feature of the b r a i n a n d it is p o s s i b l e to b e c o m e derailed — t h r o u g h p s y c h o s i s , like the m a n with the fish in his h e a d , or as

42

INTO

T H E

S I L E N T

L A N D

a result o f b r a i n d a m a g e . T h e d e g r a d a t i o n o f p e r s o n a l i t y i s a neurological commonplace. M a r y h a d suffered a b r a i n h a e m o r r h a g e ; to be p r e c i s e , a ruptured anterior c o m m u n i c a t i n g a r t e r y a n e u r y s m . T h e arterial wall had a l w a y s b e e n defective ( t h o u g h s h e w a s n o t t o k n o w ) and now, in her fiftieth year, the s a c h a d b u r s t , p o u r i n g b l o o d into the frontal l o b e s . T h e s u r g e o n s o p e n e d u p her h e a d a n d fixed a clip to s t e m the flow. S h e h a d b e e n c l o s e to d e a t h . T h r e e w e e k s later, sitting in my office, it w a s difficult to s t e m the flow of words. ' I ' v e g o t a p o e m I w r o t e it y e s t e r d a y well I h a v e n ' t written it d o w n it just c a m e to me w h e n I w a s sitting l o o k i n g o u t the w i n d o w a t the lawn and these m a g p i e s c a m e v i c i o u s t h i n g s y o u w o u l d n ' t w a n t to l e a v e a b a b y o u t s i d e t h e y ' d p e c k its e y e s o u t like they do the sheep they attack in p a i r s they s w o o p d o w n a n d confuse the sheep o n e then the other we h a d a kitten c l i m b e d an apple tree it did they flapped a r o u n d her p o o r t h i n g w a s terrified I threw a stone we s h o o k the biscuit b o x to g e t her d o w n . ' S h e p a u s e d . S h e h a d forgotten the p o e m . ' W h e r e w a s I ? ' she s a i d . I d i d n ' t s a y a w o r d as I r e a c h e d for the b l a c k c a s e c o n t a i n i n g my test e q u i p m e n t , a n d a v o i d e d e y e contact. If I d i d n ' t s p e a k and I didn't l o o k , M a r y w o u l d s t a y silent. W i t h o u t the t r i g g e r of a w o r d or a g l a n c e she sat, if not exactly still ( s h e w a s a l w a y s fidgeting with the b u t t o n s on her b l o u s e ) then at least quiet. B u t to let slip a c a r e l e s s w o r d or g l a n c e w a s to o p e n the s l u i c e . I quickly released the c l a s p s o n the c a s e a n d t o o k s o m e c l e a n h i s tory sheets from a tray on my d e s k . M a r y d i d n ' t m o v e a m u s c l e . S h e w a s not e v e n fiddling with her b u t t o n s . I w o n d e r e d h o w

43

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B R O K S

l o n g w e c o u l d sit there like this, m o t i o n l e s s and quiet. T h e silence d i d n ' t t r o u b l e her. S h e s e e m e d a b s o r b e d by a picture p o s t c a r d pinned to the b o a r d b e h i n d my d e s k . It s h o w e d a M e d i t e r r a n e a n s c e n e , a s e a s i d e t o w n with a pine-fringed g o l d e n b e a c h and blue s e a , and a seafront p r o m e n a d e with M A J O R C A

colourful

s h o p s and

restaurants.

b l a z e d d i a g o n a l l y , u p p e r left, in curly y e l l o w letters. It

h a d b e e n there since the s u m m e r and n o w l o o k e d i n c o n g r u o u s b e n e a t h the s e a s o n a l tinsel and plastic holly my secretary had s t u c k a b o u t the p l a c e . A little C h r i s t m a s tree sat on the filing cabinet in a clutter of c a r d s . W e b e g a n with q u e s t i o n s a b o u t orientation. T i m e , p l a c e , and p e r s o n : the w h e n , w h e r e , and w h o c o - o r d i n a t e s o f p e r s o n a l a w a r e n e s s . I t ' s i m p o r t a n t t o e x e r c i s e discretion. O n e d o e s n ' t w a n t to insult the patient by a s k i n g o v e r l y simplistic questions. B u t , with M a r y , it w a s a p p r o p r i a t e to start with the b a s i c s . P e r s o n a l orientation w a s o n e o f her p r o b l e m s . 'What day is it?' 'Wednesday' ' G o o d . A n d the d a t e ? ' ' I s it the t w e n t y - f o u r t h ? ' ' A c t u a l l y i t ' s the sixteenth. W h a t m o n t h i s i t ? ' 'July' ' W h a t m a k e s y o u think i t ' s J u l y ? ' ' I t ' s w a r m in h e r e . ' S h e u n d o e s a b u t t o n , then another. 'I s h o u l d k e e p y o u r b l o u s e o n , M a r y , ' I tell her. We m o v e on. ' W h e r e are w e n o w ? ' 'At the hotel.' ' A n d w h a t i s the n a m e o f the t o w n w e are i n ? '

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' I d o n ' t know,' she s a y s . ' M a j o r c a , s o m e w h e r e . ' I a s k her n a m e . S h e g i v e s me a p i t y i n g l o o k . ' M e ? I ' m M a r y M a g p i e . W h o d i d y o u think I w a s ? '

* * * I ' v e b e e n p r o j e c t i n g i m a g e s o f the b r a i n o n t o a l a r g e s c r e e n . A t f i r s t they w e r e hyper-real 3 - D i m a g e s , labelled a n d c o l o u r c o d e d t o illustrate the a n a t o m i c a l l a n d m a r k s . T h e cerebral h e m i s p h e r e s l o o k e d like they w e r e m a d e o f shiny plastic. B u t n o w I am w o r k i n g on a m o r e s c h e m a t i c picture. A l a r g e b l o c k of c o l o u r — hot m u s t a r d y e l l o w — slides d o w n b e h i n d m e , c a s t i n g a trompe l'oeil s h a d o w a g a i n s t the p a l e screen. It b e a r s the l e g e n d CEREBRAL

CORTEX

and signifies the a p p a r a t u s o f the c o n s c i o u s

self. T h e hall is full a n d the students are attentive. T h e y s e e m to have enjoyed w a t c h i n g the s h a p e s and w o r d s g l i d e a c r o s s the screen, falling into p l a c e with PowerPoint p r e c i s i o n as the b r a i n a s s e m b l e s itself. I am p l e a s e d with my picture. It is like a w o r k of art. T h e lecture hall as gallery. In the s h a d o w s , on a table next to the illuminated s c r e e n there is another exhibit. It is h i d d e n from view, b u t in a few m i n u t e s I shall take it from its container a n d h o l d it aloft for the a u d i e n c e to a d m i r e . F o r now, we c o n t e m p l a t e the d i a g r a m . It p r o v i d e s a standard

representation

o f the

major anatomical

divisions

(hindbrain, m i d b r a i n , forebrain) a n d s o m e o f the c o m p o n e n t structures ( c e r e b e l l u m , t h a l a m u s , b a s a l g a n g l i a , n e o c o r t e x ) . T h i s is an i n t r o d u c t o r y lecture. I k e e p it s i m p l e , b u t m o v e swiftly t h r o u g h the lower structures like a child a s c e n d i n g a

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c l i m b i n g f r a m e , e a g e r to reach the top. I am m o s t interested in w h a t g o e s on in the higher reaches, the z o n e s containing the interlinked s y s t e m s o f p e r c e p t i o n a n d thought, m e m o r y and e m o t i o n . C o n s e q u e n t l y , m y a c c o u n t o f the hindbrain and m i d b r a i n s t r u c t u r e s is crisp. I e n c o u r a g e the students to i m a g i n e that w e a r e c r a w l i n g t h r o u g h the b a s e o f a g a r g a n t u a n skull and c l a m b e r i n g u p the b r a i n s t e m . I t h a s the girth o f a n o a k . W e p r o c e e d u n d e r the s h a d o w o f the g r e a t l o b e s o f the cerebral h e m i s p h e r e s that l o o m like t h u n d e r c l o u d s .

I t ' s the higher

b r a n c h e s we a s p i r e to, w a y up in the g l o o m . I a s k them what they think they w o u l d s e e . ' N o t h i n g , ' o n e o f them a n s w e r s correctly, ' i t ' s pitch b l a c k . ' ' S h i n e a light,' I say.

' H o w old a r e y o u , M a r y ? ' 'Twenty-four.' ' A n d y o u r children, h o w old are t h e y ? ' ' E m m a ' s t w e n t y - t w o , T o m ' s nineteen.' I e x p l a i n e d to M a r y that we w e r e in a hospital. D i d she k n o w w h y s h e w a s there? Y e s , she told m e . S h e ' d h a d a n a n e u r y s m , b u t t h e y ' d put i t right. S h e w o u l d b e g o i n g h o m e s o o n . I n fact she w o u l d l e a v e as s o o n as we h a d finished. It w a s a pity her sister h a d t o s t a y b e h i n d . H e r sister? Y e s , s h e ' d had a n a n e u r y s m t o o , b u t s h e w a s n ' t d o i n g s o well. S h e w o u l d h a v e t o stay o n the w a r d a little l o n g e r . M a r y w a s b e c o m i n g agitated now. S h e s t o o d u p and m a d e for the d o o r . ' G o t t o g o , ' s h e s a i d . ' I left the b a b y ' 'What baby?'

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' M y baby,' she s a i d . 'I left it in the g a r d e n . T h o s e m a g p i e s will h a v e its e y e s out.' T h e b a b y w a s b o r n last m o n t h . T h e y o p e n e d M a r y ' s h e a d , and then they delivered her baby. It w a s a beautiful little girl, b u t there w a s a p r o b l e m with her b r a i n . It c o u l d be an a n e u r y s m . P e r h a p s they'll o p e n her h e a d as well.

Shine that light at the g l o s s y u n d e r s i d e of the t e m p o r a l l o b e , directly a b o v e , and y o u will s e e that the outer s u r f a c e is w r a p p e d in a sheet w o v e n from an e x q u i s i t e material. N e x t slide: T h i s i s the ' g r e y matter'. I t c o v e r s all o f the m a j o r l o b e s . In reality the c o l o u r w o u l d be a dull, g r e y - b r o w n , b u t here w e ' l l g i v e it a silver sheen. D i s s o l v e into the fibres of this material. Picture an exotic, illuminated g a r d e n . S e e w h a t m a k e s it glisten. T h e objects all a r o u n d ( ' n e u r o n s ' ) a r e certainly plant-like — r o u g h l y spherical p o d s with slender, b r a n c h i n g tendrils (the ' d e n d r i t e s ' ) and a l o n g e r p r o c e s s (the ' a x o n ' ) e x t e n d i n g f r o m o n e end. T h e a x o n s , too, c a n b e s e e n t o b r a n c h into a n u m b e r o f finer s t r a n d s , each with a b u t t o n - s h a p e d e n d f o o t that attaches to a dendrite, or to the cell b o d y , of another n e u r o n . It is a dense matrix of interconnection. A b o v e and below, near and far, the neurons p u l s e and g l o w in a silent, iridescent f u g u e as electrochemical signals traverse the l o n g a x o n s and influence the target cell. N e x t slide: H e r e , for o u r benefit, packets of light s h o o t a l o n g the axons and c a u s e the cells to which they are linked to g l o w either red or blue. R e d s i g n a l s a state of excitement. T h e target cell itself is n o w e n c o u r a g e d to fire p u l s e s a l o n g its o w n axon to cells further a l o n g in the network. B l u e s i g n a l s inhibition and the target cell s t o p s firing. In effect, each n e u r o n is either ' o n '

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o r ' o f f ' , g e n e r a t i n g p u l s e s o r c e a s i n g t o generate pulses. N e u r o n s are the b a s i c functional units of the brain and that is their task: to fire or not to fire. I t ' s all they do. W h i c h e v e r region of the cortex y o u p l u n g e into, the scene is the s a m e . W h e r e i s the m i n d i n this t a n g l e d w o o d o f n e u r o n s and nerve fibres? It i s n ' t a n y w h e r e . A n d the s e l f ? W h a t did y o u expect? A g e n i e in a b o t t l e ? G o t t f r i e d L e i b n i z , the eighteenth-century p h i l o s o p h e r and m a t h e m a t i c i a n , p e r f o r m e d a similar t h o u g h t experiment. He i m a g i n e d ' a m a c h i n e w h o s e c o n s t r u c t i o n w o u l d enable i t t o think, to s e n s e , a n d to h a v e p e r c e p t i o n ' a n d , further, that the m a c h i n e i s ' e n l a r g e d while retaining the s a m e p r o p o r t i o n s , s o that o n e c o u l d enter into it, j u s t like into a w i n d m i l l ' . W h a t d o e s he find in the interior of the m i n d - m a k i n g m a c h i n e ? '. . . only p a r t s p u s h i n g o n e another, a n d n e v e r a n y t h i n g b y which t o explain a perception'. T h e e n i g m a o f p e r s o n a l identity m a y h a v e a d a r k s i d e . I n his e s s a y ' S o r r y , but Y o u r S o u l J u s t D i e d ' T o m Wolfe i m a g i n e s a n a p o c a l y p t i c near future w h e r e a d v a n c e d m e t h o d s o f brain i m a g i n g will strip a w a y the illusion of self. P e o p l e will realize that all they a r e l o o k i n g at is a p i e c e of machinery, d e v o i d of self, m i n d , o r s o u l . A t this point, h e s a y s , ' s o m e n e w N i e t z s c h e ' will step f o r w a r d to a n n o u n c e the d e a t h of the s o u l and 'the lurid c a r n i v a l that will e n s u e m a y m a k e the p h r a s e "the total e c l i p s e o f all v a l u e s " s e e m t a m e . ' It is true. N e u r o s c i e n c e is fast d e v e l o p i n g the technical and c o n c e p t u a l wherewithal to reveal in fine, b a r e detail the n e u r o b i o l o g i c a l s u b s t r a t e s of the m i n d . P e r h a p s it will despoil a s a c r e d m y t h — the m y t h of selfhood and s o u l s . A n d , if s o ,

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w e m a y b e w a n d e r i n g innocently into the o p e n i n g p h a s e o f a d a n g e r o u s g a m e . O u r ethics and s y s t e m s o f j u s t i c e , o u r entire m o r a l order, are f o u n d e d on the n o t i o n of s o c i e t y as a collective of individual s e l v e s — a u t o n o m o u s , i n t r o s p e c t i v e , a c c o u n t a b l e agents. If this self-reflective, m o r a l a g e n t is r e v e a l e d to be illusory, what then? Values m a y h a v e m o r e to do with primitive i d e a s a b o u t ghosts in machines than we care to think, a n d p e r h a p s by u s i n g the t o o l s o f n e u r o s c i e n c e t o d e c o n s t r u c t the s e l f w e run the risk o f splitting a social a t o m and r e l e a s i n g forces b e y o n d o u r p r e s e n t c o m p r e h e n s i o n . C o u l d 'the century o f n e u r o s c i e n c e ' really signify the death of the s e l f and the c o l l a p s e of all v a l u e s ? I think Wolfe h o n o u r s n e u r o s c i e n c e unduly. H e i s s e d u c e d b y the g a d g e t r y and the g a u d y i m a g e s . Y o u d o n ' t n e e d futuristic n e w t e c h n o l o g i e s to e x p o s e the b r u t e fact that t h e r e ' s n o t h i n g b u t meat inside o u r h e a d s . W e ' v e k n o w n this d o w n the a g e s . I t d a w n e d o n m e s o m e time a g o that I w a s n o l o n g e r e s p e cially interested in the brain. Or rather, that my interest w a s e x p a n d i n g o u t w a r d s from the b r a i n itself. It w a s as if I h a d b e e n in a c o n g e s t e d city, g a w p i n g at the c r o w d s and the architecture and the traffic from g r o u n d level. A n d n o w I w a s r i s i n g a b o v e the b u i l d i n g s and the streets to take in a different p e r s p e c t i v e . I could see s u b u r b s and fields and rivers b e y o n d a n d , in the d i s tance, other t o w n s and cities. C i t i e s d o n ' t float in a v a c u u m , a n d neither d o b r a i n s . W h a t b e c a m e clear w a s that the b r a i n c o u l d not be fully u n d e r s t o o d if y o u treated it as an isolated object. I h a d u n d e r e s timated h o w tightly the b r a i n ' s functions are b o u n d to the rest of the b o d y and, a t the s a m e t i m e , h o w d e e p l y they a r e e m b e d d e d

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i n the w i d e r p h y s i c a l a n d social l a n d s c a p e . N o b r a i n i s a n island. W h e n M a r y ' s h u s b a n d c a m e to visit he had a c a l m i n g effect. T h e y s e e m e d t o function a s a unit. M a r y ' s b e h a v i o u r m e s h e d into the n e t w o r k s o f p a r t n e r s h i p a n d s o b e c a m e m o r e coherent a n d c o n s i s t e n t . In a n y relationship e a c h p e r s o n is partly defined i n t e r m s o f the other. S o , for M a r y , her h u s b a n d ' s p r e s e n c e w a s a g u i d e to self-definition. He p r o v i d e d a t e m p l a t e . He d r e w f r o m her a b e h a v i o u r a l repertoire a n d a mental structure to c o m p l e m e n t his o w n , a n d the centre o f g r a v i t y l a y between t h e m . T h e r e w a s stability, a kind o f e q u i l i b r i u m . T h i s effect w a s not o f his d e l i b e r a t e d o i n g . T h a t ' s j u s t the w a y i t h a p p e n s . I f M a r y ' s heart o r l u n g s o r liver h a d b e e n the p r i m a r y site o f p a t h o l o g y , rather than her b r a i n , it w o u l d be p o s s i b l e to d e s c r i b e the d i s e a s e in t e r m s of its effects on that particular o r g a n s y s t e m in relation to the o v e r a l l functioning of the rest of her b o d y . T h e function o f the heart i s t o p u m p b l o o d , the liver secretes b i l e , the l u n g s e n a b l e the s u p p l y o f o x y g e n t o the b l o o d , and i n e a c h c a s e the f r a m e of reference for a description of function is the i n d i v i d u a l o r g a n i s m . In defining b r a i n function we h a v e to g o b e y o n d this, e x t e n d i n g the f r a m e o f reference b e y o n d the s y s t e m s o f the b o d y . T h e brain evolved as a means of orchestrating adaptive interaction b e t w e e n the o r g a n i s m a n d the w o r l d . T o a c h i e v e this it m u s t m a i n t a i n b o t h an i n w a r d a n d an o u t w a r d orientation, m o n i t o r i n g a n d r e g u l a t i n g the state o f v a r i o u s internal s y s t e m s , while at the s a m e t i m e r e s p o n d i n g to the flow of events in the external w o r l d . In fact, as well as p l a y i n g its part in m o n i t o r i n g the b o d y ' s internal milieu, the b r a i n m u s t control interactions with t w o k i n d s o f external e n v i r o n m e n t .

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A c c o r d i n g t o W e s t e r n intellectual tradition, w h i c h distinguishes between Nature and Culture, we have a curious, duplex kind o f existence. W e m o v e i n a natural r e a l m o f t i m e , s p a c e , and matter a n d , concurrently, t h r o u g h a s o c i o - c u l t u r a l d i m e n sion of p e o p l e and i d e a s , a w o r l d s a t u r a t e d with c u s t o m s and beliefs, rituals, traditions, l a w s , c o n v e n t i o n s , f a s h i o n s , l a n g u a g e , arts, and s c i e n c e . I n the f i r s t w o r l d w e are s u b j e c t , ultimately, to the l a w s of p h y s i c s a n d , in the s e c o n d , to the influence o f c u s t o m s , beliefs, rituals, traditions, etc. A n e m e r g i n g t h e m e i n n e u r o p s y c h o l o g y i s that, j u s t a s i t h a s functional s y s t e m s d e v o t e d to p e r c e p t i o n of, a n d interaction with, the physical e n v i r o n m e n t , s o the b r a i n h a s e v o l v e d s y s t e m s dedicated to social c o g n i t i o n a n d action. It c o n s t r u c t s a m o d e l of the o r g a n i s m of w h i c h it is a p a r t a n d , b e y o n d this, a representation of that o r g a n i s m ' s p l a c e in relation to other, similar, o r g a n i s m s : p e o p l e . A s part o f this p r o c e s s i t a s s e m b l e s a ' s e l f ' , which can b e t h o u g h t o f a s the d e v i c e w e h u m a n s e m p l o y as a m e a n s of n e g o t i a t i n g the social e n v i r o n m e n t . T i g h t l y b o u n d t o l a n g u a g e , these b r a i n m e c h a n i s m s are the channels t h r o u g h w h i c h b i o l o g y finds e x p r e s s i o n as culture, a m e a n s o f distributing m i n d b e y o n d b i o l o g i c a l b o u n d a r i e s . B u t i f culture is in this w a y an extension of b i o l o g y , an i m p o r t a n t question arises: m u s t w e a l s o accept that n e u r o s c i e n c e h a s b o u n d a r i e s which d e n y full a c c e s s t o a n u n d e r s t a n d i n g o f b r a i n function? In other w o r d s , is n e u r o s c i e n c e a d e q u a t e to its p r i m a r y task — u n d e r s t a n d i n g the b r a i n — or, to tackle the ' b i g ' questions (relating t o s e l f - a w a r e n e s s a n d p e r s o n a l i d e n t i t y ) m u s t w e turn t o other f o r m s o f s c i e n c e a n d s c h o l a r s h i p ? T o achieve s o m e u n d e r s t a n d i n g o f M a r y ' s c o n d i t i o n w e are

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o b l i g e d t o skirt these fuzzy b o u n d a r i e s o f b i o l o g y a n d society. B e y o n d a c c o u n t i n g for her illness in t e r m s of physical patholo g y a n d a p p r e c i a t i n g its c o n s e q u e n c e s a t the p e r s o n a l level, w e m u s t try t o u n d e r s t a n d w h a t m e c h a n i s m s m i g h t b e o p e r a t i n g a t the intersection of the b i o l o g i c a l (the b r a i n ) a n d the social (the s e l f ) . A m a j o r c h a l l e n g e for n e u r o s c i e n c e in the twenty-first century will be to try to figure o u t h o w b r a i n s and selves go together. We build a s t o r y of o u r s e l v e s from the r a w materials of lang u a g e , m e m o r y , a n d e x p e r i e n c e . T h e idea o f the 'narrative s e l f h a s a l o n g history, with r o o t s in B u d d h i s t teaching. A c c o r d i n g to the d o c t r i n e of Anattavada, the s e l f is no m o r e than the a g g r e g a t e o f a n i n d i v i d u a l ' s t h o u g h t s , feelings, p e r c e p t i o n s and actions. T h e r e i s n o central c o r e o r ' e g o ' . D a v i d H u m e , i n the eighteenth century, t o o k a strikingly similar line. F o r him, the e x t e n s i o n o f the s e l f b e y o n d s u c h m o m e n t a r y i m p r e s s i o n s w a s a fiction. D a n i e l D e n n e t t h a s offered a c o n t e m p o r a r y v e r s i o n , e m p h a s i z i n g the p o w e r o f l a n g u a g e i n g i v i n g coherence t o our e x p e r i e n c e o v e r e x t e n d e d p e r i o d s . A c c o r d i n g t o D e n n e t t , the s e l f i s b e s t u n d e r s t o o d a s a n abstract 'centre o f narrative gravity'. C o n f a b u l a t i o n is the inadvertent construction of an e r r o n e o u s self-story, s i g n i f y i n g the n e u r o l o g i c a l b r e a k d o w n o f the storyteller. I t takes different f o r m s , s o m e t i m e s m u n d a n e , s o m e t i m e s fantastic. As in M a r y ' s c a s e , it is typically a s s o c i a t e d with d a m a g e to the frontal l o b e s and is p r o b a b l y d u e to a c o m b i n a tion o f t h i n g s . M e m o r y d i s o r d e r i s o n e ingredient. I n particular, c o n f a b u l a t o r s h a v e p r o b l e m s with contextual m e m o r y . T h e y m a y retain the kernel o f s o m e a u t o b i o g r a p h i c a l event o r

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e p i s o d e , but fail to a n c h o r it in a specific t i m e or p l a c e . M e m o r i e s drift l o o s e , i m a g e s c o l l i d e . T h e n there i s disinhibition o f a s s o c i a t i o n s . W o r d s , t h o u g h t s , and m e m o r i e s reach c o n s c i o u s n e s s t h r o u g h a p r o c e s s o f natural selection. F o r e v e r y item o f a w a r e n e s s there i s a m u l t i t u d e o f s u p p r e s s e d alternatives r e v e r b e r a t i n g t h r o u g h the neural nets. T h e c o n f a b u l a t o r ' s theatre o f c o n s c i o u s n e s s i s c r o w d e d with g a t e c r a s h e r s ( i m a g i n a r y b a b i e s , m a g p i e s , the n u m b e r t w e n t y four).

The

reduplication

of

relatives

or

the

creation

of

i m a g i n a r y children is a c o m m o n t h e m e . Finally, there is a d i s t u r b a n c e of the n e u r o p s y c h o l o g i c a l m e c h a n i s m s r e s p o n s i b l e for m a i n t a i n i n g a distinction b e t w e e n the external w o r l d

and internally g e n e r a t e d t h o u g h t s

and

actions (falling into the frame of a s e a s i d e p o s t c a r d , y o u a r e transported t o the island o f M a j o r c a ) .

I reach into the s h a d o w s b e h i n d the s c r e e n a n d retrieve a s m a l l , semi-transparent plastic bucket. I dip into the b u c k e t a n d fish out a h u m a n b r a i n . I h a v e no idea to w h o m the b r a i n b e l o n g e d . I can't tell if i t ' s m a l e or f e m a l e , b l a c k or white, or, with a n y reliability, its a g e . I m a y e v e n h a v e p a s s e d this p e r s o n on the street. In its natural state, e n c a s e d within the skull, b r a i n matter is g e l a t i n o u s . T h i s b r a i n , fixed in f o r m a l i n , h a s a s o l i d , r u b b e r y feel and w o u l d c a r v e like a v e r y tender t u n a s t e a k . It l o o k s small and lacklustre after the b r i g h t pictures on the screen, but i t h o l d s the interest o f m y a u d i e n c e . T h e end-oflecture rustling o f p a p e r s s t o p s . A l l e y e s turn t o w a r d s the g r e y b r o w n object as I p o i n t o u t the m a j o r l a n d m a r k s . In t e r m s of i m p a r t i n g factual k n o w l e d g e a b o u t the structure a n d functions

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o f the b r a i n , the m a i n p u r p o s e o f m y lecture, this little c o d a a d d s n o t h i n g . Yet the students l e a v e with s o m e t h i n g they w o u l d n ' t o t h e r w i s e h a v e h a d : a clearer s e n s e of the brain as a b i o l o g i c a l object; a p h y s i c a l m a s s as well as a t e x t b o o k c o n c o c tion of c o l o u r s

a n d neat

abstractions.

It will

help

them

a p p r e c i a t e the distinction b e t w e e n the b r a i n and the self. W h e n the A p o l l o a s t r o n a u t s w e n t t o the m o o n a n d b r o u g h t b a c k p i c t u r e s o f o u r planet o f o c e a n s a n d c l o u d s h a n g i n g over a g r e y m o o n s c a p e in the m i d d l e of a b l a c k n o w h e r e , it c h a n g e d the w a y w e s a w o u r s e l v e s . W e k n e w a l r e a d y that w e inhabited the s u r f a c e of a s m a l l , s p i n n i n g s p h e r e that rolled a r o u n d an o r d i n a r y star, a t the e d g e o f a n u n r e m a r k a b l e g a l a x y , just o n e o f i n d e t e r m i n a t e billions in a v a s t , indifferent c o s m o s . B u t now, o c c u p y i n g a few d e g r e e s o f retinal s p a c e , c o m f o r t a b l y a b s o r b e d in the f o l d s of the v i s u a l cortex, a m e r e p o r t i o n of the visual f i e l d , w e s a w o u r h o m e i n its true c o l o u r s . I t w a s p r e c i o u s and v u l n e r a b l e , a s m a l l fragile object, a thing we s h o u l d take care of. I t w a s , i n d e e d , o u r h o m e . W e m i g h t h a v e e x t r a p o l a t e d these s e n t i m e n t s from the k n o w l e d g e w e a l r e a d y p o s s e s s e d , but the i m a g e s set o f f a n interplay o f intellect a n d i m a g i n a t i o n that m a d e the n e w p e r s p e c t i v e irresistible. S o m e t h i n g similar h a p p e n s w h e n y o u s e e a b r a i n . I m a g i n a tion infiltrates intellect.

Y o u g e t a s e n s e of location and

vulnerability. O u r h o m e . T h e hall e m p t i e s , b u t a few s t u d e n t s stay behind for a c l o s e r l o o k . T h e y w a n t t o t o u c h it. A y o u n g w o m a n a s k s i f she m i g h t h o l d the b r a i n . S h e d o n s r u b b e r g l o v e s a n d takes the s p e c i m e n i n her c u p p e d h a n d s . T h e r e i s w o n d e r a n d a p p r e h e n s i o n o n her f a c e . Y o u s e e this l o o k o n the faces o f small children h o l d i n g

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caterpillars. A y o u n g m a n turns the b r a i n o v e r to e x a m i n e its u n d e r s i d e . He p i c k s at the s t u m p of a s e v e r e d artery. A n o t h e r tests the w e i g h t , feeling the d r o p of the object first in the left hand then the right. H e s a y s it's o d d , b u t y o u r h e a d d o e s n ' t feel this heavy.

Six m o n t h s later M a r y c a m e t o the o u t p a t i e n t s ' clinic. I t w a s a routine follow-up. S h e d i d not r e m e m b e r me but, a l t h o u g h her m e m o r y w a s still p o o r , s h e h a d m a d e g o o d p r o g r e s s i n other areas. T h e r e w a s n o l o n g e r the p r o l i x i t y o f s p e e c h o r the f r a g mented attention that h a d characterized her b e h a v i o u r b e f o r e . I n particular, o v e r a p e r i o d o f t w o h o u r s o f i n t e r v i e w i n g a n d n e u r o p s y c h o l o g i c a l testing, I d e t e c t e d no s i g n s of c o n f a b u l a tion. T h e n , w o r k d o n e , idly chatting a s w e w a i t e d for her h u s b a n d to collect her, I a s k e d w h a t p l a n s s h e h a d for the w e e k end. ' O h , ' she s a i d . ' I ' d like t o w a t c h the b a d g e r s a g a i n . ' 'Really?' ' Y e s , in the field o v e r the b a c k w a l l . Y o u can s e e t h e m f r o m the g a r d e n s h e d . ' S h e w a s l o o k i n g a t m y n a m e - t a g . ' B r o c k the b a d g e r , ' she s a i d . M a r y ' s h u s b a n d arrived a n d they left together. I n e v e r s a w them a g a i n and I d i d n ' t a s k h i m a b o u t the b a d g e r s at the b o t t o m o f the g a r d e n . L i k e the s u r f a c e o f the E a r t h , the b r a i n i s pretty m u c h m a p p e d . T h e r e are n o secret c o m p a r t m e n t s i n a c c e s s i b l e t o the s u r g e o n ' s knife o r the m a g n e t i c g a z e o f the b r a i n s c a n n e r ; n o m y s t e r i o u s h u m o u r s p e r v a d i n g the cerebral ventricles, n o s o u l in the pineal g l a n d , no vital s p a r k , no spirits in the t a n g l e d

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w o o d . T h e r e i s n o t h i n g y o u can't t o u c h o r s q u e e z e , w e i g h and m e a s u r e , a s w e m i g h t the p h y s i c a l p r o p e r t i e s o f other objects. So y o u will s e a r c h in v a i n for a n y s e m b l a n c e of a s e l f within the s t r u c t u r e s of the b r a i n : there is no g h o s t in the m a c h i n e . It is time t o g r o w u p a n d a c c e p t this fact. B u t , s o m e h o w , w e are the p r o d u c t o f the o p e r a t i o n o f this m a c h i n e r y a n d its p r o g r e s s t h r o u g h the p h y s i c a l a n d social w o r l d . M i n d s e m e r g e from p r o c e s s and interaction, not substance. In a s e n s e , we inhabit the s p a c e s b e t w e e n things. We subsist in e m p t i n e s s . A beautiful, liberating, t h o u g h t and nothing to be afraid of. T h e n o t i o n of a tethered s o u l is c r u d e by c o m p a r i s o n . S h i n e a light, i t ' s o b v i o u s .

56

In the Theatre

In the d a y s b e f o r e b r a i n s c a n s it w a s i m p o s s i b l e to l o c a t e t u m o u r s beneath the s u r f a c e o f the b r a i n with a n y p r e c i s i o n . S u r g e o n s blindly p o k e d a r o u n d in the soft t i s s u e s , c a u s i n g untold d a m a g e in the p r o c e s s . T h e p o e t - p h y s i c i a n D a n n i e A b s e w r o t e a p o e m , ' I n the Theatre',

in

which

he

recounts

a

harrowing

experience

described by his father, Dr Wilfred A b s e . I first r e a d this p o e m when I w a s a student and it raised the h a i r s on the b a c k of my neck. It c o n c e r n s an e p i s o d e that o c c u r r e d in 1918 while A b s e senior w a s a s s i s t i n g at a b r a i n o p e r a t i o n . H i s v o i c e i n t r o d u c e s the p o e m . T h e patient, h e tells u s , i s fully awake t h r o u g h o u t the o p e r a t i o n u n d e r a local anaesthetic, while the fingers of L a m b e r t R o g e r s , the s u r g e o n - ' r a s h as a blind m a n ' s ' — crudely s e a r c h for the t u m o u r in the b r a i n t i s s u e s - 'all s o m e w h a t hit a n d m i s s ' . T h i s , s a y s D r A b s e , i s o n e o p e r a tion h e will never forget. T h e p o e m , a n d the o p e r a t i o n , o p e n s with r e a s s u r i n g w o r d s for the patient:

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Sister saying — 'Soon y o u ' l l be back on the ward,' sister thinking — 'Only two more on the list,' the patient saying — 'Thank you, I feel fine'; small voices, small lies,

nothing untoward,

though, soon, he would blink again and again because of the fingers of Lambert Rogers, rash as a blind man's, inside his soft brain. If items of horror can make a man laugh then laugh at this: one hour later, the growth still undiscovered, ticking its own wild time; more brain mashed because of the probe's braille path; Lambert Rogers desperate, his dresser thinking,

fingering

still;

'Christ! Two more on the list,

a cisternal puncture and a neural cyst.' Then, suddenly, the cracked record in the brain, a ventriloquist voice that cried,

'You sod,

leave my soul alone, leave my soul alone,' the patient's dummy lips moving to that refrain, the patient's eyes too wide. And, shocked, Lambert Rogers drawing out the probe with nurses, students, sister, petrified. 'Leave my soul alone, leave my soul alone,' that voice so arctic and that cry so odd had nowhere else to go — till the antique gramophone wound down and the words began to blur and slow,

'.. . leave

.. . my... soul... alone ...'

to cease at last when something other died. And silence matched the silence under snow.

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T h e p o e m n o l o n g e r chills m e . W h y ? P e r h a p s I a m a m o r e sophisticated reader o f p o e t r y n o w a n d s e e t o o c l e a r l y the b o a r d s and b a c k d r o p of a m e l o d r a m a . B u t I d o n ' t think s o . It is o b v i o u s l y m e a n t t o b e theatrical a n d , t o m y m i n d , c o n v e y s authentic d r a m a . It is a fine p o e m . It still p a c k s a p u n c h . B u t it d o e s n ' t unsettle me as it o n c e d i d . Perhaps my e x p e r i e n c e s as a clinician o v e r the y e a r s h a v e left me desensitized to h u m a n suffering or l a c k i n g a p p e t i t e for the bizarre and extraordinary. I h o p e not, a n d d o n ' t think s o . Inevitably,

one

develops

strategies

for

self-preservation.

A n y o n e w h o h a s w o r k e d with patients o n a c u t e hospital w a r d s will tell y o u that y o u cannot r e s o n a t e with e v e r y t r e m o r of feeling, and that s o m e t i m e s there are v i s i o n s o f h o r r o r a n d r a w fear that can only be o b s e r v e d obliquely. Perfect, constant e m p a t h y i n s u c h c i r c u m s t a n c e s w o u l d b e suicidal. B u t it is less a p r o c e s s of desensitization than o n e of b e c o m i n g acclimatized. T h e r e i s a difference. T h e f o r m e r s u g g e s t s a n a t r o p h y o f feeling, the latter i s m e r e l y t o b e c o m e a c c u s t o m e d to different c o n d i t i o n s .

W h e n the p r o f e s s i o n a l

f a c a d e slips in the p r e s e n c e of p e r s o n a l suffering, as it d o e s f r o m time to time, the p a i n still penetrates. A n d as for indifference to the bizarre and extraordinary, the v e r y o p p o s i t e i s true. F r o m where I stand, in early m i d d l e a g e , the u n i v e r s e l o o k s as m y s t e r i o u s a n d a b s u r d a s ever - h u m a n b e i n g s especially. T h e older I g e t the m o r e a s t o n i s h e d I am by the plain fact of my o w n existence and c o n s c i o u s n e s s , let a l o n e s t r a n g e a n d d i s t u r b i n g neurological cases. T h e r e a s o n the p o e m h a s lost its p o w e r t o g i v e m e g o o s e p i m ples c o m e s d o w n , I think, to that w o r d ' s o u l ' . F o r full effect it

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r e q u i r e s an a c c e p t a n c e , at s o m e level, that s o u l s exist. C o n s i d e r the p i v o t a l m o m e n t w h e n , defenceless a g a i n s t the s u r g e o n ' s frantic fingers, the d y i n g b r a i n a s s e r t s itself: Leave my soul alone, leave my soul alone. T h i s feels like the intrusion of a s u p e r n a t u ral force. S o m e t h i n g other than the brain, and s o m e t h i n g other than the patient e v e n , s e e m s to h a v e entered the scene. It is hard to identify the v o i c e with the soft m a s s of the inert brain, and it is d i s t a n c e d from the patient, w h o s e b o d y n o w b e c o m e s a v e n t r i l o q u i s t ' s d u m m y , m o u t h i n g w o r d s as if to the s o u n d of a c r a c k e d r e c o r d . T h e y are w o r d s o f despair. T h e eerie intruder w a s reluctant to manifest itself, o n e feels, b u t h a d no choice. N o w , i f y o u h a d a s k e d m e t w e n t y - o d d y e a r s a g o whether I t h o u g h t there w e r e such things as s o u l s I w o u l d h a v e said that of c o u r s e there w e r e not. U n d e r g o i n g training in clinical and s c i entific disciplines, I w o u l d h a v e c o n s i d e r e d such talk to be p r i m i t i v e a n d pre-scientific. ' S o u l ' implied a spiritual substance of s o m e kind, a mental e s s e n c e or e g o acting behind the material s c e n e s o f b r a i n structure a n d function, g u i d i n g and controlling a n d , if y o u c h o s e to b e l i e v e it, s u r v i v i n g the death of the body. It carried c o n n o t a t i o n s of the s u p e r n a t u r a l , representing ideas that I f o u n d at b e s t m i s g u i d e d or intellectually inelegant, at w o r s t sinister and r e t r o g r e s s i v e . I t o o k the v i e w that the mind w a s the p r o d u c t of the brain in its interactions with the physical and social w o r l d . I still hold that view. T h e difference i n m y e m o t i o n a l r e s p o n s e t o the p o e m then a n d n o w r e q u i r e s a m o r e subtle explanation. I think it h a s to do with a c h a n g e in b a c k g r o u n d intuitions, as o p p o s e d to f o r e g r o u n d beliefs. W h e n I first encountered the p o e m I explicitly d e n i e d the existence of s o u l s , but there w a s a

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part o f m e still b e g u i l e d b y the i m a g i n a t i v e p o w e r o f the t e r m . It feels natural to b e l i e v e that s o m e t h i n g like a s o u l exists. It m a y indeed be natural in the s e n s e that e v o l u t i o n h a s s h a p e d o u r c o g nitive architecture in w a y s that p r e d i s p o s e us to b e l i e v e in the separation o f mind a n d brain. We live in a social as well as a p h y s i c a l w o r l d , a n d n e g o t i a t i o n o f our c o m p l e x social e n v i r o n m e n t r e q u i r e s the attribution o f mental states (feelings, beliefs, d e s i r e s , intentions) to o u r s e l v e s and others, p e r h a p s inevitably inclining us to b e l i e v e that the w o r l d contains t w o sorts o f stuff, material a n d i m m a t e r i a l . D u a l i s m m a y h a v e d e e p e v o l u t i o n a r y r o o t s . W e all feel that, a s well as a brain, s o m e t h i n g else o c c u p i e s the interior of o u r h e a d and the h e a d s of other p e o p l e — an irreducible mental c o r e , the origin of t h o u g h t s and actions. It is a p r i m i t i v e belief, b u t it is compelling. It m a y follow that a b e l i e f in s o u l s ( o r implicit b e l i e f or halfbelief or q u a s i - b e l i e f ) is a n e c e s s a r y c o n d i t i o n for o r d i n a r y h u m a n interaction. W e v i e w o u r s e l v e s a s i n t e g r a t e d mental entities with a n a g e n d a o f intentions a n d actions, a u t h o r s o f o u r o w n destiny. In a m o r a l u n i v e r s e , p e r h a p s that is the o n l y c o n ceivable w a y t o v i e w other p e o p l e too. A l l I can s a y is that now, w h e n the b r a i n / s o u l / p a t i e n t p l e a d s Leave my soul alone, it s e e m s to me less like the intrusion of a supernatural force. N o t h i n g h a s entered the s c e n e . T h e r e is still a desperation for s u r v i v a l , b u t this, I n o w s e e , e m a n a t e s f r o m a stark n o m a n ' s land b e t w e e n the m u t i l a t e d tissues o f the b r a i n , the s o u n d w a v e s o f 'that v o i c e s o a r c t i c ' , a n d the horrified r e s p o n s e o f the o n l o o k e r s . T h e r e i s h o r r o r still, b u t n o t s u p e r natural horror.

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P e r h a p s , o v e r the y e a r s , my i m m e r s i o n in the rationalism of clinical science h a s rusted t h o s e machineries o f i m a g i n a t i o n that g e n e r a t e b e l i e f in s u p e r n a t u r a l s o u l s — or half-belief or quasi-belief. P e r h a p s this s h o u l d w o r r y m e ; I m a y h a v e lost s o m e t h i n g . B u t I prefer to think that the screen between the t w o d o m a i n s — scientific u n d e r s t a n d i n g and primitive i m a g i n a t i o n — h a s b e c o m e m o r e transparent, a l l o w i n g a clearer v i e w in both directions. Certainly, I feel better able to c o p e with ambiguity. T h e r e is scientific rationality a n d there is i m a g i n a t i o n . S o m e t i m e s they c o i n c i d e , a n d all p e o p l e h a v e elements o f both. T h e p o e m b e t r a y s a n a m b i g u i t y a b o u t the reality o f s o u l s . T h e fearful w o r d s c r a n k o u t t h r o u g h the a n t i q u e g r a m o p h o n e o f the v o c a l a p p a r a t u s , b l u r r i n g a n d s l o w i n g , ' . . . leave . . . my . . . soul. . . alone...' - an i m a g e of a s o u l l e s s m e c h a n i s m - but they are said to c e a s e at last o n l y 'when something other died'. S o , it d o e s n ' t chill me as it u s e d to, but I feel another r e s p o n s e . B e h i n d the h o r r o r I s e e m o r e clearly n o w there is a l s o pity. T h e b r a i n thinks i t ' s a s o u l . T h e r e is real p a t h o s in that. I m a y not b e l i e v e in s o u l s , b u t I still find brain s u r g e r y d i s c o n certing, and this i s partly w h y A b s e ' s p o e m retains s o m e o f its original p o w e r . T h e experience o f w i t n e s s i n g a n operation o n the b r a i n is, in certain respects, quite different from other kinds o f surgery. A l l s u r g i c a l p r o c e d u r e s are i n v a s i v e , but n e u r o s u r g e r y s e e m s like the ultimate intrusion. In a b d o m i n a l and c a r d i o t h o r a c i c o p e r a t i o n s y o u s e e the s u r g e o n b u r r o w into the p a t i e n t ' s b o d y , e x p o s i n g the inner w o r k i n g s - the p u m p s , the filters, the p i p e s , the v a l v e s . It c a n be s h o c k i n g , but we h a v e this w a y o f s e p a r a t i n g i d e a s o f 'the p e r s o n ' from what i s h a p p e n i n g

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t o 'the p e r s o n ' s b o d y ' . T h e p e r s o n , o n e t e n d s t o i m a g i n e , i s elsewhere d u r i n g the i n v a s i o n o f her i n n a r d s ; s h e h a s w i t h d r a w n to a s a f e , anaesthetized p l a c e ( s o m e w h e r e in the h e a d , o u r intuitions tell u s ) . It is a different matter w h e n the contents of the skull a r e o p e n for inspection a n d p r e y t o the s u r g e o n ' s knife. T h e r e c a n b e n o question o f a n y ' r e l o c a t i o n ' t o another p a r t o f the b o d y . I t w o u l d b e a b s u r d t o think o f the g h o s t l y s e l f retreating t o s o m e other o r g a n o r limb. A t the s a m e instant o n e u n d e r s t a n d s that there is, o f c o u r s e , n o g h o s t l y s e l f i n the first p l a c e . W h e n w e see the b r a i n w e realize that w e a r e , a t o n e level, n o m o r e than meat; a n d , o n another, n o m o r e than fiction. T h e s a m e insight — at o n c e m u n d a n e and m y s t e r i o u s — is a potent element o f the f a m o u s Z a p r u d e r f o o t a g e o f the K e n n e d y a s s a s s i n a t i o n . Recall the i m a g e s a n d y o u will k n o w w h a t I m e a n . J a c k i e K e n n e d y in the D a l l a s s u n s h i n e , in her pretty p i n k , pillb o x hat, s c r a m b l i n g t o retrieve the d e b r i s o f her h u s b a n d ' s shattered head from the b a c k of the l i m o u s i n e . S h e finds a p i e c e o f s o m e t h i n g and tries t o replace it. O r s o i t a p p e a r s . W h a t g r i m d e s p e r a t i o n ; what a p p a l l i n g intimacy. T h o s e g l i m p s e s o f n a k e d b r a i n are a n epiphany. T h e M o s t Powerful M a n in the W o r l d , s m i l i n g i m m o r t a l l y a n d w a v i n g to the c r o w d s just now, h a s h a d the top of his h e a d b l o w n a w a y . It is not just that h e , like all of u s , is v u l n e r a b l e , or that his p h y s i cality is so brittle. N o r is it e v e n the s u d d e n n e s s of his transition from h u m a n b e i n g t o inert s u b s t a n c e . W h a t l o c k s these i m a g e s into place i s the e x p o s u r e o f the g r e y - p i n k b r a i n . I f that i s w h a t T h e M o s t Powerful M a n i n the W o r l d c a n b e r e d u c e d to, i f that is what he is, then there is no h o p e for the rest of u s . We k n e w it

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a n y w a y , b u t o u r a w a r e n e s s of the fact is intensified by the d r a m a a n d the m y t h i c status o f the a c t o r s . T h a t i s the h o r r o r o f the f i l m . A n d w h e n y o u w a t c h , d o y o u not s e n s e a f l i c k e r o f selfp i t y ? D e s p i t e myself, I fear for my s o u l .

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A-Z

A former n e u r o s u r g e o n c o l l e a g u e , r e c a l l i n g his training d a y s , has a s t o r y a b o u t w a l k i n g t h r o u g h the streets of L o n d o n with a fellow student o f s u r g e r y . H i s friend s t o p p e d , m i d - c o n v e r s a tion, evidently troubled. T h e y h a d r e a c h e d a s m a l l s i d e street. T h e m a n w a s b e c o m i n g a g i t a t e d a n d kept l o o k i n g u p a t the street n a m e . ' T h i s street,' h e s a i d , 'is not i n the A - Z . ' A n d it wasn't. T h e y checked. T h e would-be surgeon had a remarkable visual m e m o r y . F o r n o particular r e a s o n h e h a d set h i m s e l f the task, successfully a c c o m p l i s h e d , o f m e m o r i z i n g the entire A - Z street m a p o f L o n d o n . A n d n o w h e h a d s t u m b l e d u p o n a m i s m a t c h . T h e m a p o f his i m a g i n a t i o n w o u l d h a v e t o b e a m e n d e d in o n e small detail, e n o u g h to m a k e it s u p e r i o r to the published v e r s i o n . H i s p r o b l e m t h o u g h ( a n d ultimately w h a t b a r r e d his w a y to a career i n n e u r o s u r g e r y ) w a s that his exceptional p o w e r s o f v i s ual i m a g e r y w e r e exceptional o n l y i n two d i m e n s i o n s . A m o n g other attributes o f intellect a n d t e m p e r a m e n t , the p r a c t i c e o f

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n e u r o s u r g e r y d e m a n d s an ability to think in three d i m e n s i o n s . T h i s m a n w a s like M r S q u a r e , the lowly, t w o - d i m e n s i o n a l c h a r a c t e r in E d w i n A b b o t ' s nineteenth-century satirical tale Flatland: A Romance of Many Dimensions.

Mr S q u a r e h a s no

i n k l i n g of a g e o m e t r y b e y o n d the p l a n e of Flatland until, one night, he is visited by L o r d S p h e r e , a b e i n g from the land of three d i m e n s i o n s ( a p p e a r i n g to h i m as a circle, m a g i c a l l y c h a n g i n g s h a p e ) . F a i l i n g t o c o n v i n c e b y explanation, L o r d S p h e r e p e e l s his h u m b l e a c q u a i n t a n c e from Flatland and f l i n g s h i m into S p a c e l a n d , p r o v i n g that there is, indeed, a w o r l d of t h r e e - d i m e n s i o n a l o b j e c t s . It is a revelatory, life-transforming e x p e r i e n c e . B u t , of c o u r s e , on his return, he fails m i s e r a b l y to p e r s u a d e his fellow F l a t l a n d e r s o f the existence o f this other w o r l d a n d the H i g h P r i e s t s ( w h o are circular) c o n d e m n him as a d a n g e r o u s heretic. T h e trainee s u r g e o n ' s A—Z o f the b r a i n lacked the n e c e s s a r y third d i m e n s i o n . H e w a s n ' t able t o inhabit the m e t r o p o l i s o f the b r a i n in the w a y a n e u r o s u r g e o n m u s t . N e u r o p s y c h o l o g y r e q u i r e s four d i m e n s i o n s . A t least.

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The Mirror

J u d y g e t s h o m e from w o r k . S h e p o u r s h e r s e l f a m a r t i n i , p u t s a record on the hi-fi a n d d r o p s into a soft leather chair. God s h e ' s t i r e d . . . S h e s l e e p s . A n d y can read the b e d t i m e s t o r i e s . T h e little girl k i s s e s her s l e e p i n g m o t h e r a n d , reluctantly, g o e s t o b e d . W h e n J u d y w a k e s , the r o o m i s s e m i - d a r k . S h e sits b o l t upright and flinches from the p a i n in her h e a d . T h e r e is no m u s i c . S h e tries to fix her p o s i t i o n . I m a g e s of the d a i l y routine tumble together: get u p , g o t o w o r k , c o m e h o m e . A cat stretches o n the b a c k o f a chair b y the w i n d o w . T h e r e i s e n o u g h o f the f a d i n g light to b r i n g its g i n g e r fur to life. B u t J u d y ' s cat is a tabby. A n unfamiliar m a n enters the r o o m : late m i d d l e - a g e d , g r e y hair. He g l i d e s by, g l a n c i n g briefly in her direction, a n d s w i t c h e s on a l a m p in the corner. It c a s t s a c o n e of light u p w a r d s to the ceiling. ' D i d you say something, J u d e ? ' N o w that the light i s o n s h e s e e s that the r o o m i s a l s o unfamiliar.

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Where am I? Who is this? J u d y h a s a habit of twisting and p u l l i n g at her w e d d i n g ring when s h e ' s stressed. T h e ring has gone. ' J u d e , ' the m a n s a y s , ' I d o n ' t k n o w what y o u ' r e o n a b o u t . ' S h e i s a s k i n g for her d a u g h t e r and h u s b a n d . T h e m a n leaves and a w o m a n enters. S h e k n e e l s by the s i d e of the chair and takes J u d y ' s hand. It's a gentle interrogation. ' I ' m J u d y J e n k i n s . I ' m thirty-nine — and I d o n ' t k n o w where the b l o o d y hell I a m ! ' B u t s h e k n o w s the y e a r : 1976. T h e P r i m e Minister? ' H a r o l d W i l s o n . ' T h e m a n ' s v o i c e b r e a k s in, but J u d y cuts him short. ' D o n ' t tell m e I ' m g e t t i n g m i x e d u p ! ' s h e s n a p s . ' I k n o w what y e a r it i s . ' N o w h e ' s i n front o f her h o l d i n g u p a n e w s p a p e r , pointing t o the d a t e at the top of the p a g e : S a t u r d a y , 10 April 1999. A shaft o f l o g i c b r e a k s the frame. ' F e t c h me a m i r r o r . '

* * *

1999 ' A n d then I s a i d , " F e t c h me a m i r r o r . " I s a i d I'd be an old w o m a n i n 1 9 9 9 . . . ' S h e ' s telling m e the s t o r y a g a i n . I t m u s t b e the fourth or fifth t i m e . I ' m not really listening. I d o n ' t need to. I t ' s the s a m e story. T h e n e u r o s c i e n t i s t Michael G a z z a n i g a q u o t e s J o h n U p d i k e a n d R a l p h W a l d o E m e r s o n : 'A thread r u n s t h r o u g h all things: all w o r l d s are s t r u n g on it, as b e a d s : and m e n , and events, and life c o m e t o u s , o n l y b e c a u s e o f that thread.' I n other w o r d s

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( s a y s U p d i k e ) o u r subjectivity d o m i n a t e s outer reality, ' a n d the u n i v e r s e has a p e r s o n a l structure'. A c c o r d i n g to G a z z a n i g a , the b r a i n h a s a d e d i c a t e d s y s t e m for b i n d i n g the s t r a n d s o f a multitude o f specialized b r a i n m o d u l e s into a single thread of p e r s o n a l e x p e r i e n c e . He calls it 'the Interpreter' and locates it in the left cerebral h e m i s p h e r e . T h e Interpreter identifies patterns o f c o n n e c t i o n b e t w e e n d i s p a r a t e brain s y s t e m s and correlates these with e v e n t s in the external w o r l d . T h i s g i v e s unity a n d continuity a n d e n a b l e s each o f u s t o create a p e r s o n a l life story. J u d y ' s m i r r o r arrives. S h e s e e s that her face i s w r i n k l e d a n d g a u n t , her hair short a n d grey. It must be a dream, s h e thinks. I t ' s too m u c h to take in all at o n c e . S h e p a n i c s a n d tries to s t a n d , b u t her left l e g is p a r a l y s e d by the s t r o k e . S h e l o s e s c o n s c i o u s n e s s . W h e n she w a k e s there is a m a n l e a n i n g o v e r her, p r e s s i n g a m a s k to her face; a soldier p e r h a p s , t h o u g h his u n i f o r m is t o o g a u d y for the military. S h e s e n s e s m o v e m e n t a n d v i b r a t i o n a n d r e c o g n i z e s the s o u n d s o f a n e n g i n e g o i n g t h r o u g h the g e a r s . S h e is in s o m e kind of vehicle. ' T a k e i t easy, J u d y , ' s a y s the m a n i n u n i f o r m , ' y o u ' r e g o i n g t o be just fine.' T h e r e are red and g r e y blankets a n d c y l i n d e r s , t u b e s a n d l e a d s , plastic b o x e s , instruments with d i a l s , a n d other i t e m s o f equipment. A n d there, sitting o p p o s i t e , i s the g r e y - h a i r e d m a n . He leans in c l o s e r to her. ' W h a t ' s t h a t ? ' he a s k s . ' H a s a n y o n e told A n d y ? ' s h e m u m b l e s . T h e e r a s u r e o f twenty-three y e a r s i s r e m a r k a b l e e n o u g h . J u d y ' s p e r s o n a l life o v e r that p e r i o d is a c o m p l e t e b l a n k . S h e c a n only c o m p r e h e n d the bitterness o f her d i v o r c e f r o m A n d y i n the abstract, and the g r e y - h a i r e d m a n , with w h o m she h a s b e e n

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l i v i n g for the p a s t e i g h t e e n y e a r s , is a stranger. T h e s a m e g o e s for p u b l i c events. ( ' M a r g a r e t T h a t c h e r ? ' ) B u t e q u a l l y striking i s the w o r k o f J u d y ' s Interpreter, her teller o f tales. Its s t r u g g l e for continuity is h e r o i c . W i t h n o t h i n g else to h a n d , it reaches b a c k m o r e than t w o d e c a d e s to find material for a story. It b r i d g e s the twenty-three y e a r s a s i f they w e r e twenty-three minutes.

* * * 2002 ' A n d then I s a i d , " F e t c h m e a m i r r o r " . . . ' B e a t e n into s u b m i s s i o n b y the l o g i c o f a n u n k n o w n present, p l u s the irrefutable e v i d e n c e in the mirror, J u d y ' s Interpreter h a s reset the c l o c k a n d set a b o u t the b u s i n e s s of r e g u l a t i n g a different life. V e r y little m e m o r y h a s returned, but things are g o i n g fine with the g r e y - h a i r e d m a n , a n d J u d y is a g r a n d m o t h e r now. T h i s kind o f a m n e s i a i s e x t r e m e l y r a r e . I h a v e c o m e a c r o s s o n l y o n e other c a s e that b e a r s c o m p a r i s o n t o J u d y ' s . T h a t patient, t o o , m a d e a n a s t o n i s h i n g l y s m o o t h adjustment t o her n e w c i r c u m s t a n c e s . H o w resilient p e o p l e are. I f o n e d a y y o u w o k e up to find that y o u h a d b e e n t r a n s f o r m e d into a g i g a n t i c insect, the c h a n c e s a r e y o u w o u l d j u s t g e t u p a n d c a r r y o n with y o u r n e w life.

* ** 2003 ' A n d then I s a i d , " F e t c h m e a m i r r o r " . . . '

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Visible Man

A s J a m e s M o o n a w o k e o n e m o r n i n g after d i s t u r b i n g d r e a m s , h e found h i m s e l f t r a n s f o r m e d into a n a n a t o m i c a l illustration. H e r o s e from his b e d thinking all w a s as it s h o u l d be a n d h e a d e d for the b a t h r o o m , the first routine act of a n o t h e r r o u t i n e day. B u t , l o o k i n g in the mirror, he noticed that the d o m e of his h e a d h a d b e c o m e transparent. T h e r e , b a t h e d in a g l o s s y light, w a s his b r a i n , l o o k i n g like a vivid picture from the p a g e s of a t e x t b o o k or a h i g h - r e s o l u t i o n c o m p u t e r g r a p h i c . T h e outer s u r f a c e s , the g r e a t c o n v o l u t e d l o b e s o f the cerebral h e m i s p h e r e s , w e r e r e n d e r e d i n pastel s h a d e s with sculptural clarity: c o m p a c t , r o u n d e d , s o l i d , with sharp c o n t o u r s defining the m a j o r a n a t o m i c a l d i v i s i o n s . T h e frontal l o b e s ( p a l e m a u v e ) w e r e p a c k e d just b e h i n d the forehead. T h e t e m p o r a l l o b e s ( p o w d e r b l u e ) w e r e t o either s i d e a t the level o f the e a r s . A b o v e and s o m e w h a t b e h i n d these w e r e the parietal l o b e s ( c h a m p a g n e ) a n d , at the b a c k , the occipital l o b e s ( j a d e ) . T h e n , a s y o u w o u l d e x p e c t , there w e r e c u t a w a y v i e w s from the s i d e , from a b o v e , a n d f a c e - o n , r e v e a l i n g s t r u c -

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tures d e e p b e n e a t h the s u r f a c e . T h e s e w e r e c o d e d with b o l d e r c o l o u r s : c o b a l t b l u e , l e m o n , cherry red, o r a n g e , p u r p l e . T h e c l o s e r h e l o o k e d , the m o r e J a m e s saw. N o t just the b u l b o u s , fruit-like f o r m s o f the p u t a m e n and the g l o b u s pallidus, and the

flat-topped

o v a l of the t h a l a m u s at the centre, or the

s w e e p i n g , o v e r a r c h i n g c u r v e s o f the fornix and the caudate. But there, like b r i g h t clusters o f j e l l y b e a n s , w e r e the s u b c o m p o nents of these structures: the pulvinar, the lateral geniculate b o d y , the d o r s o m e d i a l n u c l e u s . H e d i d not yet k n o w the n a m e s of these things, but he would. Of course, it's a dream, he t h o u g h t , I'm still asleep. B u t the m u n d a n e objects o f the b a t h r o o m s t o o d i n their usual places a n d on the sill w a s a c o p y of y e s t e r d a y ' s n e w s p a p e r , just as he h a d left it, a picture of a w o m a n s m i l i n g on the front p a g e . W i n d a n d rain b e a t a g a i n s t the w i n d o w p a n e . H e w o u l d seek a d v i c e w i t h o u t delay. S o , littering c r u m b s o f b r e a k f a s t toast a s h e went, J a m e s g r a b b e d his hat ( a g r e e n c a n v a s o n e like a n g l e r s w e a r ) , s l a m m e d the front d o o r b e h i n d h i m , a n d set o f f for the medical centre. O n e c o r n e r o f the w a i t i n g r o o m w a s partitioned a s a child r e n ' s p l a y a r e a . It w a s strewn with soft t o y s and plastic bricks in p r i m a r y c o l o u r s . A s m a l l child sat in the m i d d l e , t u g g i n g a string f r o m the b a c k of a p i n k doll. ' I ' m s o h a p p y , ' s a i d the doll. T h e child chuckled a s the string slid b a c k i n s i d e . All the while G r e g k n e w that, b e n e a t h the hat, his head w a s still g l o w i n g like the a u r o r a b o r e a l i s . And wouldn't that amuse the child, he t h o u g h t . He resisted the temptation, however, and w a s s o o n called t h r o u g h .

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' H o w can I h e l p ? ' said D r V e s a l i u s . J a m e s r e m o v e d his hat. ' W e l l ? ' h e a s k e d . ' H a v e y o u e v e r s e e n anything like i t ? ' T h e m u l t i c o l o u r e d r a d i a n c e s e e m e d b r i g h t e r than b e f o r e . I t shone like a halo. If Dr V e s a l i u s w a s s h o c k e d he d i d n ' t s h o w it. A true p r o f e s s i o n a l , he just leaned f o r w a r d , p r e s s i n g t o g e t h e r the tips of his fingers. ' Y e s t e r d a y all w a s well,' J a m e s e x p l a i n e d . ' T h e n this m o r n i n g I w a k e up to find my h e a d transparent a n d my b r a i n a firework display' ' I s e e , ' said D r V e s a l i u s . H e s a i d h e w o u l d m a k e a r r a n g e ments for J a m e s to m e e t a specialist. O n the w a y out there w a s another child p l a y i n g with the d o l l . S h e pulled g r i m l y a t the string. ' I ' m s o happy. I ' m s o h a p p y . . . ' the doll kept s a y i n g , t h o u g h the child w a s n o t a m u s e d . J a m e s lifted his hat briefly, b u t it m a d e no difference.

*** W h a t had c a u s e d those n i g h t m a r e s ? T h e p r e v i o u s e v e n i n g , J a m e s had eaten a light s u p p e r a n d d r u n k no m o r e than a finger of whisky. B o r e d with T V , he had searched for s o m e t h i n g to read and found an old illustrated e n c y c l o p a e d i a , which he t o o k to b e d . Idly turning the p a g e s , he c a m e a c r o s s a picture of a r o c k p o o l . H e r e m e m b e r e d i t well from his c h i l d h o o d . T h e w a t e r w a s clear a s g l a s s . B l u e - g r e y r o c k s thrust u p t h r o u g h a b e d o f s m o o t h p e b b l e s and s a n d t o w a r d s a s u m m e r sky. A b o v e the water-line there w e r e b a r n a c l e s b a k i n g in the s u n s h i n e , a few limpets and whelks — snail-like things with curly shells.

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M u s s e l s clustered and t u m b l e d t h r o u g h the f i l m y surface o f the w a t e r a n d into the p s y c h e d e l i c w o r l d below, which w a s b r i m m i n g with all k i n d s o f life: c r a b s and s h r i m p s , s l u g s and starfish, s e a a n e m o n e s , s p i n d l y p r a w n s , and g r i m - f a c e d little fishes d a r t i n g t h r o u g h the b l a d d e r w r a c k and b r o w n s e a w e e d . It still f a s c i n a t e d h i m , still d r e w him into the s c e n e , but not quite t h r o u g h the p a g e a n d into the w a t e r a s b e f o r e . L o o k i n g a t the picture now, t h r o u g h adult e y e s , w a s o d d l y d i s i l l u s i o n i n g . H e h a d often w a l k e d a l o n g the b e a c h a t l o w tide a n d h a d yet to find a r o c k p o o l so stuffed with life and colour. B u t i t w a s n ' t j u s t d i s i l l u s i o n m e n t . T h e r e w a s s o m e t h i n g else e q u a l l y unsettling. H e c l o s e d the b o o k and w a s s o o n asleep. I n o n e d r e a m h e found h i m s e l f tightly b o u n d , head t o toe, s c a r c e l y a b l e to b r e a t h e . A w a r e of a slight s w a y i n g m o t i o n , he h a d the s e n s e that he w a s l o d g e d h i g h in the b r a n c h e s of a tree or s u s p e n d e d in a net of s o m e kind. T h e r e w a s a n a u s e a t i n g jolt, a n d another, as if he w e r e b e i n g d r a g g e d a l o n g like coal in a s a c k . O n e particularly violent jerk p u l l e d the b i n d i n g from his e y e s a n d w h a t h e s a w w r e n c h e d his g u t . W h a t h a d a p p e a r e d t o b e the s h a d o w o f a black a w n i n g t u r n e d o u t to be the b e l l y of a m o n s t r o u s spider. He tried to b r e a k free, b u t i t w a s u s e l e s s a n d h e w a s s o o n e m b r a c e d b y the b e a s t ' s s l a v e r i n g m a w . T h e r e w a s n o pain, just w a r m t h and m o i s t u r e . A s the b o n d s b r o k e h e s a w his o w n disintegrating b o d y : his s e g m e n t e d b r o w n belly, his six trembling l e g s , the m e m b r a n e s o f his b u c k l e d w i n g s . H e called out, but his v o i c e w a s a twittering s q u e a k . A n d n o w this. J a m e s s t a r e d , without e x p r e s s i o n , a t the m i r r o r , then s a n k into an armchair. He felt inordinately weary.

***

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It w a s d a r k w h e n the d o o r b e l l r a n g . A pastel g l o w f o l l o w e d J a m e s d o w n the d i n g y hallway, r e m i n d i n g him o f the state o f his skull. He t o o k the f i s h e r m a n ' s hat f r o m the c o a t - h o o k a n d p l a c e d i t o n his head b e f o r e o p e n i n g the d o o r . T h e r e s t o o d Millie, in a swirl of rain a n d a u t u m n l e a v e s . S h e had b r o u g h t with her t w o b a g s full o f b o o k s , which s h e w a s n o w stacking u p o n the kitchen table. ' T h e s e are from the library,' s h e s a i d , ' a s r e q u e s t e d . ' A m o n g others, there w a s a m e d i c a l t e x t b o o k , an atlas of n e u r o a n a t o m y , and a m a s s i v e t o m e called Elements of Cognitive Neuroscience. ' A n d this o n e I b o u g h t . ' S h e h a n d e d o v e r a s l i m p a p e r b a c k : Neuroscience for the Brainless. T h e y sat a t o p p o s i t e e n d s o f the s o f a , Millie with a r m s folded, J a m e s g r i p p i n g the b r i m o f his hat. S h e w a s l o o k i n g a w a y a s s h e s p o k e : ' A l l right, k e e p i t o n . ' H e r c h e e k s w e r e red. After u n p a c k i n g the b o o k s she h a d c h a s e d J a m e s a r o u n d the flat, snatching at his hat. It w a s a g a m e at first, s h e t h o u g h t , b u t then he s h o u t e d at her to l e a v e h i m a l o n e . T h e y s a t in silence. ' O k a y , ' he s a i d , 'I'll take it off.' T h e delicate s p r a y o f light d a n c e d a b o u t his h e a d a n d h e w o n d e r e d w h y h e s h o u l d h a v e b e e n s o c o y with Millie. W h y should s h e not s e e this m o s t enchanted part o f h i m , this m a g i c a l w e l l s p r i n g - the s o u r c e of his t h o u g h t s , his h o p e s a n d beliefs, and of his l o v e for her? 'Well,' she s a i d , 'what w a s all the fuss a b o u t ? '

H e m i g h t h a v e b e e n c o m p a r i n g fossil s p e c i m e n s o r s e m i p r e c i o u s s t o n e s . ' T h e c o l o u r s are different,' h e n o t e d , 'but the s h a p e s are the s a m e . '

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Elements of Cognitive Neuroscience was propped up on the kitchen table next to a shaving mirror. A picture of the brain filled most of one page. Millie stood behind him, her eyes roving from the picture to the face in the mirror to the top of James's head. He watched her reflection looking down on to the shimmering surface of his cerebrum, her eyes wide, transfixed, confused. 'I can see it's going to take me a while to find my bearings,' said James, staring at his hand, but Millie had already left the room.

Make a fist with fingers wrapped around thumb. This is the brain. Palm upwards, the outer ridge of the forearm becomes the spinal cord. It turns into the brainstem at the wrist. Now look at the fleshy part leading up to the base joint of the thumb. This is the hindbrain. The protruding base joint itself represents the cerebellum, which is the most prominent feature of the hindbrain. In reality it looks like a kind of vegetable outgrowth at the brain's rear underside. Moving upwards and into the tunnel of fingers, the shaft of the lower thumb bone represents the top end of the brainstem. This is known as the midbrain. Finally, there is the forebrain — the upper thumb bone, hidden under the fingers, and the fingers themselves. Each finger stands for a division of the topmost part of the brain — the cerebral cortex. Starting with the index finger, we have the occipital lobe (ok-SIP-itul), the parietal (puh-RYEetul), the temporal and the frontal lobe. The upper thumb bone represents various forebrain structures that lie beneath the cerebral cortex (the amygdala and hippocampus, for example).

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There you have it. The gross anatomy of the brain — or half of it. The brain is a double organ with two mirror image sides. Put both fists together to get the full picture. Bruno Aldaris, Neuroscience for the Brainless

T h o u g h it w a s plain to s e e that his b r a i n w a s a p h y s i c a l m a s s , like a hand or a foot, J a m e s found the c o m p a r i s o n of b r a i n a n d fist mildly d i s c o n c e r t i n g and s o o n returned to o b s e r v i n g the real thing. I t w a s M i l l i e ' s idea t o g o t o the C h i n e s e restaurant. J a m e s w o r e a baseball c a p . ' Y o u need t o g e t y o u r s e l f out o f yourself,' s h e s a i d . T h e y d r a n k white w i n e a n d J a m e s b e g a n t o u n w i n d . H e e v e n s q u e e z e d her k n e e u n d e r the table. ' I t ' s g o i n g t o b e all right,' h e s a i d o n the w a y h o m e . ' Y o u ' l l see.' T h i s b e i n g a Friday, Millie s t a y e d the night, but w a s t o o tired to m a k e l o v e .

* * * T h e d a w n light s e e m e d t o g r o w i n s t e p s a s i f the E a r t h ' s rotation had d e v e l o p e d a fault. J a m e s lay listening to the rain, d i p p i n g in and out o f sleep. Millie lay b e s i d e him. H e w a t c h e d her d r e a m i n g t h r o u g h the blind s a c c a d e s o f her l i d d e d e y e s . H e r b r a i n w a s i n d a r k n e s s , but the d r e a m s , n o d o u b t , w e r e a s b r i g h t a s day. H e m u s t h a v e drifted o f f a g a i n b e c a u s e , next, h e w a s a w a r e of the smell of fresh coffee. Millie h a d b e e n o u t for c r o i s s a n t s and n e w s p a p e r s . J a m e s d i d n ' t think his b r a i n w a s a sight for

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the b r e a k f a s t table a n d r e m e m b e r e d to put on his hat before g o i n g t h r o u g h to the kitchen, but Millie, t h r o u g h a mouthful of c r o i s s a n t , told him instantly to take it off. S h e returned t o her n e w s p a p e r . H e picked u p the medical t e x t b o o k , s c a n n i n g the list of contents as if r e a d i n g from a menu:

Dementia;

Epilepsy;

Extrapyramidal Disease;

nating Diseases;

Cerebrovascular

Diseases

of

the

Disease;

Cerebral Spinal

Hydrocephalus;

Tumours;

Demyeli-

Cord; Motor Neurone

Disease. T h a t ' s just N e u r o l o g y . N o t even half o f N e u r o l o g y . T h e n there's

Cardiovascular Disease; Endocrine Disease; Haema-

tological Disease;

Gastrointestinal Disease;

and

Cancer.

H e w a s i m p r e s s e d b y the m y r i a d f o r m s o f d e m i s e . G o d w a s an inventive d e s t r o y e r as well as an artful creator. It had never o c c u r r e d t o J a m e s that the w o r k i n g s o f the b o d y c o u l d b r e a k d o w n i n s o m a n y w a y s . B u t his condition w a s n a m e l e s s . He h a d t w o m i r r o r s now, u s i n g them in c o m b i n a t i o n for the difficult s i d e a n d rear v i e w s , and w a s t r y i n g to match the textb o o k d i a g r a m s with the p o l y c h r o m a t i c c o n t o u r s o f the object filling his h e a d . ' I t ' s a beautiful m a c h i n e , ' he said a l o u d , t h o u g h there w a s no o n e else a r o u n d . Millie h a d left him to it. ' O r is it a p l a c e ? ' T h e b o o k s differed i n e m p h a s i s . S o m e w e r e concerned with s y s t e m s a n d functions, o t h e r s , especially the atlas o f n e u r o anatomy,

concentrated

more

on

the

brain's

geography,

c o n j u r i n g s t r a n g e u n d u l a t i n g l a n d s c a p e s . C o m b i n i n g the different i m a g e s , J a m e s pictured a m e t r o p o l i s , at o n c e futuristic (full o f m y s t e r i o u s m a c h i n e s ) and ancient (the G r e e k and L a t i n n a m e s e v o k e d classical t i m e s ) . S e e n this w a y , his brain b e c a m e a labyrinthine structure with vaults and c h a m b e r s , floors and

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screens, c o l u m n s , p a t h w a y s , b r i d g e s , c a n a l s and a q u e d u c t s , with streams of information flowing in e v e r y direction. Am I in there or out here? he w o n d e r e d . ' A m I out here or in t h e r e ? ' First

the

thought,

then

the

words.

Thought.

Speech.

T h o u g h t . S p e e c h . A l t e r n a t i n g b e t w e e n the two, e y e s fixed on the i m a g e in the mirror, he noticed a pattern, an e b b i n g a n d flowing of activity on the outer s u r f a c e of the left frontal l o b e . A s h e s p o k e , the soft m a u v e l u m i n e s c e n c e s e e m e d t o h a r d e n m o m e n t a r i l y into a brighter g l a z e that d i s s o l v e d as the u t t e r a n c e s t o p p e d . L o o k i n g closer, h e s a w s t r a n d s o f light c a s t i n g b a c k and forth between the frontal a r e a a n d the b l u e r e c e s s e s of the temporal l o b e . A n d w a s that a fainter p u l s e , d e e p d o w n ? Probably the thalamus, he thought, c o n s u l t i n g the atlas. Am I in there or out here? T h e m o r e J a m e s stared into the mirror, the m o r e p e r p l e x e d h e b e c a m e .

H e b e g a n t o feel

detached from his brain — a r e m o t e o b s e r v e r . It a c q u i r e d the aura o f s o m e t h i n g alien, a n object quite s e p a r a t e from h i m . H e w o u l d concentrate on a patch of c o l o u r or listen to a s o u n d or p e r f o r m an action or think a t h o u g h t — Elephants are large mammals. Six sevens are forty-two. Democracy is a good thing. I love Millie — and there, plain to s e e , w e r e the c o r r e l a t e d b r a i n patterns. But the activity a s s o c i a t e d with t h o u g h t s a n d actions w a s not the s a m e a s his c o n s c i o u s a w a r e n e s s o f t h o s e t h o u g h t s a n d events. H o w c o u l d i t b e ? H e w a s l o o k i n g i n from the o u t s i d e , like w a t c h i n g goldfish in a b o w l . G o l d f i s h a n d o n e ' s p e r c e p t i o n o f them are not the s a m e thing. T h e m o r e h e g a z e d u p o n it, the m o r e J a m e s felt that he w a s s o m e t h i n g other than his b r a i n .

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A n d w h e r e do t h o u g h t s a n d feelings c o m e f r o m ? Not me, he t h o u g h t , b e c a u s e he s a w that e v e r y fluctuation in the flow of e x p e r i e n c e , e v e r y intention a n d action, w a s anticipated by d i s tinct t r e m o r s of activity a c r o s s the b r a i n ' s s u r f a c e . It w a s not a c a s e o f thinking o r d o i n g s o m e t h i n g and w a t c h i n g the brain follow step o r d a n c e i n synchrony. H i s brain w a s ahead o f him. I d e a s w e r e b u b b l i n g up in the n e u r o n a l c a u l d r o n a g o o d halfs e c o n d b e f o r e they a p p e a r e d in c o n s c i o u s n e s s , even thoughts a b o u t thinking t h o u g h t s , and t h o u g h t s a b o u t thoughts about thinking t h o u g h t s . S o w h o w a s stirring the mental b r o t h ? A n d i f he w e r e a m e r e spectator, w h a t exactly w a s his v a n t a g e point? B u t then, just as a d r a w i n g of a c u b e s e e m s to c h a n g e pers p e c t i v e , continually j u m p i n g i n w a r d s a n d o u t w a r d s , h e w o u l d switch to a different view. T h e object in his h e a d w o u l d a b s o r b a n d b e g u i l e h i m , a n d h e w o u l d identify m o r e c l o s e l y than ever with its w o r k i n g s . That's it, he thought. That's what I amount to. This is my sum total. There is no one stirring the broth. The functions of the brain have a life and logic of their own. feelings,

Thoughts,

and intentions produce me, not the other way around.

He c a m e to the c o n c l u s i o n that he w a s neither in there nor out here. B o t h p e r s p e c t i v e s w e r e false. H e w a s n ' t a n y w h e r e . I n the e v e n i n g J a m e s a n d Millie w e n t t o the c i n e m a . J a m e s kept his hat p u l l e d firmly d o w n . It w a s hardly the p l a c e to h a v e o n e ' s h e a d b l a z i n g like a b e a c o n .

* * * A v a g u e curiosity d r e w him b a c k to the e n c y c l o p a e d i a . T h e r e w a s s o m e t h i n g w r o n g with the r o c k p o o l , h e w a s s u r e . T h e

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plants, p e b b l e s , and fishes w e r e d i s p l a y e d as t r e a s u r e d o b j e c t s in a g l a s s c a s e , the exhibits s e p a r a t e d e v e n l y o n e from another in a perfectly illuminated t h r e e - d i m e n s i o n a l s p a c e . T h e artistry w a s calculated. T h o s e beautiful things w e r e intended t o b e m e m o rable. He k n e w he w o u l d h a v e no difficulty r e c o g n i z i n g a rock goby if ever he s a w o n e , or a cushion starlet or a chameleon shrimp. Yet, a l t h o u g h the picture w a s c r a m m e d with i n f o r m a t i o n , h e c o u l d appreciate what w a s l a c k i n g . T h e r e w a s n o s e n s e o f p r o c e s s or b e h a v i o u r , n o t h i n g of the s t r u g g l e for existence in the w o r l d - b e t w e e n - t i d e s . O n e d i d not see the m o n s t r o u s d o g w h e l k d e v o u r i n g the b a r n a c l e s or b o r i n g into the shell of a m u s s e l to suck out its innards, or the invisible a l c h e m y of the s e a w e e d s , a b s o r b i n g sunshine, s y n t h e s i z i n g f o o d s from w a t e r a n d c a r b o n d i o x i d e , releasing life-sustaining o x y g e n into the water. T h e scene w a s altogether t o o b e n i g n . A r o c k p o o l i s , i n reality, a p r e c a r i o u s p l a c e . To s u r v i v e is to m e s h with c o m p l e x networks o f b e h a v i o u r a n d intricate p a t t e r n s o f p h y s i c s and chemistry, all s h a p e d minutely by the e b b a n d flow of the tides and the rotation of the E a r t h . T h e life of the r o c k p o o l is a fragile p r o d u c t of the m i c r o s c o p i c a l l y small and the a s t r o n o m i cally l a r g e . But that w a s not it. Illustrations o n l y e v e r g i v e a s n a p s h o t . He reached for o n e of the shiny n e w t e x t b o o k s a n d set it a l o n g s i d e the e n c y c l o p a e d i a . T h e b r a i n p i c t u r e s w e r e b r i g h t l y c o l o u r e d like the r o c k p o o l a n d , in the s a m e w a y , w e r e c o n cerned with categorical clarity: this little fishy is the hippocampus, this the medulla, this the cerebellum.

T h e creatures

floated in s u s p e n s i o n beneath the rippling s u r f a c e of the cortex. T h e f l o w o f time h a d s t o p p e d . T h e r e w a s n o hint o f d y n a m i c s

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at the m i c r o s c o p i c level or of forces in the w o r l d b e y o n d the b o u n d a r y o f the skull, b o t h o f which s h a p e d the activity o f the b r a i n , just a s the life o f the r o c k p o o l w a s s h a p e d b y p h o t o s y n t h e s i s a n d the g r a v i t a t i o n a l influence o f the m o o n . I t w a s then that a n u n s t e a d y i n g t h o u g h t s w u n g into J a m e s ' s h e a d . He w a t c h e d it d r o p f r o m the frontal cortex and circle the l i m b i c l o b e . A b r a i n , like a r o c k p o o l , he realized, is a l s o a m o s t p r e c a r i o u s habitat. T h e life o f the s e l f d e p e n d s absolutely o n the integrity o f b r a i n function. A n d then he s a w w h a t it w a s a b o u t the r o c k p o o l that really t r o u b l e d h i m . T h e r e w a s a creature he h a d n ' t noticed b e f o r e , a s q u a t , s p i d e r y thing, d u l l - g r e y a n d u g l y c o m p a r e d t o the rest. It l a y b e n e a t h a brittle star, part h i d d e n by a curtain of brownweed a n d the c l a w s of a shore crab. T h i s little fellow didn't figure in the key. It d i d n ' t h a v e a n u m b e r . P e r h a p s it had crawled from b e h i n d a r o c k . P e r h a p s the picture h a d other d i m e n s i o n s after all. He l o o k e d at the mirror, into his b r a i n . A n d there it w a s , the s p i d e r y thing.

*** D r S t r o o p ' s office o n the fourteenth f l o o r o f the District G e n eral w a s a s h a m b l e s . T h e r e w e r e b o x f i l e s , c a s e notes, b o o k s piled all o v e r the p l a c e , a n d c a r d b o a r d b o x e s full of other stuff. On t o p of the filing cabinet, c a u g h t in a shaft of late afternoon s u n l i g h t , w a s a p l a s t i c m o d e l of the b r a i n , s o m e w h a t larger than life-size. Its c o l o u r s s e e m e d t o f i l l the r o o m and J a m e s felt u n e a s y sitting n e a r to it.

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'I find that m o s t p e o p l e try to i g n o r e it,' he s a i d , r o l l i n g his eyes u p w a r d s , 'but i t m u s t b e o f s o m e p r o f e s s i o n a l interest t o you.' ' O h , what's that?' asked Dr Stroop. ' T h e c o l o u r c o d i n g i s m u c h the s a m e a s y o u r s . D o y o u m i n d ? ' J a m e s lifted the plastic brain from its stand a n d ran his f i n g e r s o v e r the s u r f a c e . ' T h e frontal l o b e s are quite similar, a n d the parietal, but my t e m p o r a l l o b e s are b l u e and these occipital l o b e s are a darker s h a d e of g r e e n . ' He leaned forward for Dr S t r o o p to g e t a better view, b u t the d o c t o r didn't s e e m v e r y interested. R a i s i n g his e y e s , J a m e s caught him l o o k i n g a t his w a t c h . H e w o u l d h a v e a s k e d h i m a b o u t the s p i d e r y thing — p e r h a p s he w o u l d be able to identify it — but c o u l d s e e that he w a s well b e h i n d with his clinic a n d d i d n ' t want to c a u s e further delay. B r i n g i n g the c o n s u l t a t i o n to a c l o s e , D r S t r o o p muttered s o m e t h i n g a b o u t ' d i a g n o s t i c i n v e s t i g a tions' and said that a r r a n g e m e n t s w o u l d be m a d e for a b r a i n scan. Hardly necessary in my case, t h o u g h t J a m e s . T h e next time they m e t , D r S t r o o p h a d a s o m b r e l o o k , b u t h e s p o k e kindly. ' D o y o u h a v e a n y o n e with y o u ? ' ' N o , ' said J a m e s . T h e d o c t o r a s k e d him t o sit d o w n . ' W e h a v e y o u r pictures,' h e said with a n uncertain s m i l e . H e slid a l a r g e s q u a r e film u n d e r the clip of a w a l l - m o u n t e d light b o x and flicked the switch. T h e i m a g e o f J a m e s ' s b r a i n w a s m o n o c h r o m e and murky, except for o n e feature. C o u l d that b e the spider, sitting p l u m p a n d b r i g h t in the m i d d l e ? If s o , it h a d b e e n busy. Skeins o f c o b w e b s p r e a d like the w i n g s o f a n a n g e l , o n e into the right h e m i s p h e r e , and o n e into the left.

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'What is it?' said J a m e s . ' A butterfly g l i o m a . ' T h a t s o u n d e d rather beautiful. 'A tumour.'

T h a t e v e n i n g a s h e s p l a s h e d w a t e r o n his face, J a m e s noticed s o m e t h i n g i n the p a l m o f his c u p p e d h a n d , o r rather s o m e t h i n g about it. It w a s the left h a n d . T h e skin w a s paler, like g r e a s e p r o o f p a p e r . T h e r e w e r e s h a p e s beneath: t r a c i n g s o f t e n d o n s , b o n e s , a n d b l o o d v e s s e l s . H e i n s p e c t e d the rest o f his b o d y . H i s a r m s a n d l e g s l o o k e d f i n e , a s d i d his chest a n d a b d o m e n . H e turned his p e n i s left a n d right a n d lifted it to s e e the u n d e r s i d e . He c a r e fully checked the s o l e s of his feet. E v e r y t h i n g s e e m e d n o r m a l . T u r n i n g a w a y f r o m the mirror, h e l o o k e d a c r o s s his shoulder a n d s a w that his l o w e r b a c k w a s translucent. Spinal c o l u m n , p e l v i c b o n e s , a n d ribs w e r e clear t o s e e . A n d p a r t s o f the internal o r g a n s : s t o m a c h , liver, intestines. H e w a s s t r u c k b y h o w d e n s e l y p a c k e d they w e r e , not f l o a t i n g l o o s e like o d d - s h a p e d b a l l o o n s a s they s o m e t i m e s a p p e a r i n t e x t b o o k s . B u t the c o l o u r s ! T h a t c o u l d n ' t b e right: ice-blue s t o m a c h , c r i m s o n liver, o r a n g e intestines, and the b o n e s w e r e white as a g h o s t - t r a i n s k e l e t o n ' s . I t d i d n ' t s t o p there. T h e f o l l o w i n g m o r n i n g h e sat o n c e m o r e with his m i r r o r s a n d b o o k s . It w a s o d d that he h a d n ' t noticed the butterfly w i n g s b e f o r e , b u t h a v i n g seen t h e m o n the brain scan picture a n d k n o w i n g exactly w h e r e t o l o o k , h e c o u l d n o w trace their outline. Butterfly glioma c a m e u n d e r Cerebral Tumours in the medical t e x t b o o k . T h e p r o g n o s i s w a s p o o r , b u t h o w fortunate h e w a s

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to h a v e b e e n s p a r e d the psychiatric s y m p t o m s that, a c c o r d i n g to the b o o k , w e r e often a s s o c i a t e d with s u c h g r o w t h s . H i s thoughts turned t o Millie. A n i m a g e o f her f a c e s h o n e a s b r i g h t a s stained g l a s s i n his m i n d ' s e y e . W h e r e w a s that, e x a c t l y ? Neither in there nor out here. A n d w h e r e exactly w a s Millie? W a s it d a y s or w e e k s since he h a d seen her? 'Millie, w h e r e are y o u ? ' h e called out. ' I ' m right here, J a m e s , ' c a m e the familiar v o i c e . H e c o u l d s e e her now, in the mirror. ' L o o k , ' s h e s a i d . He s a w b e n e a t h her naked breast a b e a t i n g heart, all bright c o l o u r s . Millie faded. H i s reflection w a s all that r e m a i n e d . S t a r i n g hard into the mirror, his face s o m e t i m e s a s s u m e d a sinister aspect. With no discernible c h a n g e in e x p r e s s i o n , it s u d d e n l y f i l l e d with m e n a c e and c o n t e m p t . H e w o u l d c o v e r his e y e s a n d shake his head to b r e a k the spell. B u t this time he w a s s l o w to react. T h e malice s u r g e d from the m i r r o r a n d p o u r e d t h r o u g h his helpless e y e s . It b r e a c h e d the wall of the retina a n d hurtled d o w n the visual p a t h w a y s d e e p into his b r a i n . H e felt it. H e watched it all the w a y . T o o late. H e w a s g o n e . N o w there w a s n o f a c e i n the m i r r o r , or rather there w e r e r e m n a n t s of a f a c e . T h e r e w a s n e r v e a n d m u s c l e , b o n e and cartilage, lidless e y e s a n d skinless lips. A b s t r a c t s h a p e s . L i g h t and s h a d e . He had searched in vain for a scintillating r o c k p o o l . T h e o n e s he found w e r e bleak p u d d l e s c o m p a r e d to the picture in the e n c y c l o p a e d i a . N o w J a m e s s t o o d naked a t the e d g e o f the s e a , the b o n e s o f his skeletal t o e s s u b m e r g e d i n d a m p s a n d , his s k e l e tal hand outstretched a g a i n s t white w a v e s a n d g r e y c l o u d , salt s p r a y fresh in his transparent nostrils. T h e chill of the w a t e r

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l a p p i n g at his a n k l e s s h o t n e u r o n a l n e e d l e s to his testicles, half p l e a s u r e , h a l f p a i n . He s p r e a d his fingers for inspection — white b o n e , skin, m u s c l e , v e i n s — then b u n c h e d them into fists. 'I am J a m e s M o o n , the V i s i b l e M a n ! ' he said in a half-shout that w a s s w e p t a w a y b y the o c e a n w i n d the m o m e n t the breath left his t r a n s p a r e n t lips. ' T h i s is w h a t I a m ! ' H i s t h o u g h t s leapt a n d curled within the folds o f his brain. S h a r p a s l a s e r s , they w e r e c a s t i n g s h a d o w s a c r o s s the sky.

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The Spark in the Stone

I Think Therefore I Am Dead

I am sitting a l o n e in the small s e m i n a r r o o m on the tenth floor. T h i s i s k n o w n a s ' H a r r y ' s r o o m ' . I a m a t the h e a d o f a l o n g o a k table, w o r k i n g a t a l a p t o p c o m p u t e r . T h e d o o r i s a t m y b a c k a n d the single w i n d o w at the other end of the r o o m s h e d s a thin, early e v e n i n g light. T h e r e are g l a s s - f r o n t e d o a k cabinets a l o n g the walls, left and right. O n the s h e l v e s are r o w s o f d i s p l a y j a r s containing s p e c i m e n s of h u m a n b r a i n , each s u s p e n d e d in a liquid the c o l o u r o f w a t e r y p i s s . T h i s i s H a r r y ' s collection. T h e s p e c i m e n s are a r r a n g e d a c c o r d i n g t o p a t h o l o g y : t u m o u r s , c e r e brovascular disease, degenerative disorders, and so on. T h e r e are w h o l e b r a i n s , h a l f b r a i n s , a n d p a r t s o f b r a i n , sliced a n d s e g mented. C l o s e to my right shoulder, there s w i m s a c e r e b e l l u m . T h e r o o m i s ineffably still. A m o n g the relics o f natural d i s e a s e and d e g e n e r a t i o n sit three v i c t i m s o f u n n a t u r a l v i o lence. T h e i r stories intertwine. T h e f i r s t b r a i n w a s c a u g h t with the s e c o n d b r a i n ' s wife and w a s d i s p a t c h e d with a pistol s h o t to the b a c k of the h e a d . After p u t t i n g an end to its w i f e , the s e c o n d brain f i n a l l y dispatched itself. T h e w o m a n ' s b r a i n , third i n line,

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c o m p l e t e s the set. H e r s is perfectly intact. S h e g o t it in the heart, a c c o r d i n g to H a r r y . I o n c e told him I t h o u g h t she m i g h t h a v e b e e n better p l a c e d b e t w e e n the other two, to keep the rivals apart. ' E v e n in d e a t h , ' I s a i d , ' y o u can s e n s e their c o n t e m p t for one another.' It d i d n ' t s e e m to w o r r y h i m . A n d , a n y w a y , I w o n d e r e d , what w a s she d o i n g here? H e r b r a i n d i d n ' t illustrate a p a t h o l o g y o f a n y k i n d . H a r r y ' s r e s p o n s e w a s that she exemplified the n o r m a l , intact b r a i n . H e w o u l d n ' t c o n c e d e that i n d i s p l a y i n g the s p e c i m e n s in this w a y he h a d a l s o created a tableau, s h o w c a s i n g the fickle heart as m u c h as the fragile b r a i n . A l l the s a m e , it w a s a tale h e s e e m e d fond o f telling. T h e material s u b s t a n c e o f the b r a i n w a s b r e a d and butter t o H a r r y , a n e u r o p a t h o l o g i s t , but not to m e . I r e m e m b e r the a m b i v a l e n c e I felt w h e n I first held a h u m a n brain in the p a l m of my h a n d , the fascination b u t a l s o the distaste. I w a s surprised, a n d m o v e d , b y h o w h e a v y i t w a s . P e r h a p s a part o f m e had e x p e c t e d it to be w e i g h t l e s s , like a mental i m a g e or a train of t h o u g h t . I w a s e a g e r to confirm for m y s e l f that the internal s t r u c t u r e s m a t c h e d the familiar t e x t b o o k pictures but, s o m e how, felt disinclined to start cutting. I i m a g i n e d the w o r l d s it had created: sky, c l o u d s , p e o p l e , p l e a s u r e , a n d pain. E v e r y t h i n g . I t ' s all in there. 'I c o u l d be b o u n d e d in a nutshell and count m y s e l f a k i n g of infinite s p a c e , ' s a i d H a m l e t , ' w e r e it not that I h a v e b a d d r e a m s . ' T h e infinite s p a c e w a s within the shell o f his h e a d . A n d so, i n e s c a p a b l y , w e r e the d r e a m s . B u t l o o k i n g a r o u n d n o w a t these d e a d still, g r e y - b e i g e objects it is h a r d to s e e them as erstwhile

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p r o g e n i t o r s o f infinite s p a c e . T h e y each represent the o p p o s i t e : a singularity. A point at which the u n i v e r s e h a s c o l l a p s e d . I l o v e the stillness of this p l a c e and the h u m of the v o i d — the s e n s e of w o r l d s d i s s o l v e d and d i s s i p a t e d p a s s i o n s . It fills me with a s e n s e of b e i n g . I am not yet p i c k l e d m e a t . T h e light i s f a d i n g a n d the p a l e a m b e r s k y a t the h o r i z o n a l m o s t m a t c h e s the c o l o u r of the liquid in the j a r s . T h e r e is a s i n g l e , bright star. M y a r e a o f s u p p o s e d e x p e r t i s e , n e u r o p s y c h o l o g y , i s the s u b ject a b o u t which I feel the m o s t p r o f o u n d i g n o r a n c e . I am i g n o r a n t o f m a n y things. F o r i n s t a n c e , I k n o w n o t h i n g o f the Russian language. Quantum physics is beyond me. Keynesian e c o n o m i c s ? T h e w o r k i n g s o f the internal c o m b u s t i o n e n g i n e ? Irish political h i s t o r y ? M y k n o w l e d g e c o n s i s t s o f v a g u e n o t i o n s poorly understood, loosely grasped general principles, and collections of disjointed facts. B u t I c o u l d take l e s s o n s in R u s s i a n and m u g up on Irish h i s t o r y a n d the other things. I will n e v e r m a s t e r the m a t h e m a t i c s required for a p r o p e r u n d e r s t a n d i n g of q u a n t u m m e c h a n i c s , b u t I can a p p r e c i a t e s o m e t h i n g of the f l a v o u r o f the subject from the p o p u l a r w r i t i n g s o f e x p e r t s i n the field, and take c o m f o r t from the fact that, fundamentally, it s e e m s t o b e b e y o n d t h e m , too. B u t w h e n i t c o m e s t o u n d e r s t a n d i n g the relationship b e t w e e n the b r a i n a n d the c o n s c i o u s m i n d , m y i g n o r a n c e i s d e e p a n d there i s n o w h e r e t o turn. A n o c e a n o f i n c o m p r e h e n s i o n h e a v e s b e n e a t h the t e x t b o o k confident surface of plain facts a n d technicalities that I p r e s e n t to my c o l l e a g u e s and patients. I h a v e a clear p i c t u r e of the m a t e rial c o m p o n e n t s of the b r a i n a n d am p r e p a r e d to ad lib at l e n g t h a b o u t features of its functional architecture — the i n t e r l o c k i n g

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s y s t e m s a n d s u b s y s t e m s o f p e r c e p t i o n , m e m o r y , a n d action. B u t quite h o w o u r b r a i n s create that p r i v a t e s e n s e o f self-awareness we all float a r o u n d in is a mystery. I h a v e no idea h o w the trick is achieved. W o u l d n ' t it be a b s u r d for an airline pilot to d e n y k n o w l e d g e of the p r i n c i p l e s of flight, or for a p h y s i c i a n to claim i g n o r a n c e o f the b a s i c s o f h u m a n p h y s i o l o g y a n d a n a t o m y ? Yet I , a n e u r o p s y c h o l o g i s t , c a n g i v e n o s a t i s f a c t o r y a c c o u n t o f h o w the brain g e n e r a t e s c o n s c i o u s a w a r e n e s s . W o r s e still, I find m y s e l f e d g i n g t o w a r d s a d o u b t that it m e a n s a n y t h i n g at all to s a y that the brain generates consciousness. H a r d l y a n y o n e visits H a r r y ' s r o o m these d a y s . T h e r e are s m a l l c o m m i t t e e m e e t i n g s o n c e a m o n t h a n d an o c c a s i o n a l j o u r nal club. O t h e r w i s e , it is u s e d as I am u s i n g it now, as a quiet s p a c e for c a t c h i n g up with d i s c h a r g e letters and clinical reports. I t w a s n e v e r u s e d m u c h for s e m i n a r s and H a r r y , o f c o u r s e , doesn't c o m e here any more. I ' v e b e e n t r y i n g to finish a report. T h e patient, J e a n i e , has a d e m e n t i n g illness a n d s e e m s t o b e r a p i d l y f a d i n g away. S h e i s o n l y f i f t y - t h r e e . I t ' s n o t A l z h e i m e r ' s , I ' m pretty s u r e o f that, but we h a v e yet to c o m e up with a firm d i a g n o s i s . I s a w her this m o r n i n g in a s i d e r o o m . S h e h a d b e e n s h a r i n g a b a y with five other b e d s on the m a i n n e u r o l o g y w a r d until a c o u p l e of nights a g o w h e n s h e b e c a m e a g i t a t e d and b e g a n t o d e v e l o p delusional i d e a s a b o u t the other patients. A n u r s e found her at three in the m o r n i n g p a c k i n g a c a s e a n d p r e p a r i n g to l e a v e . 'I d o n ' t w a n t to c a u s e t r o u b l e , ' J e a n i e h a d s a i d in a whisper, 'but I ' m n o t like the rest of t h e m . I s h o u l d n ' t be here. T h e y ' r e all lesbians.'

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T h i s m o r n i n g s h e w a s cheerful. A n o r d e r l y h a d j u s t b r o u g h t her a cup o f tea. H e r d a u g h t e r , L i s a , w a s f e e d i n g her b a b y o n the other side o f the b e d . L i s a visited e v e r y day. W e sat a n d chatted with sunshine s t r e a m i n g t h r o u g h the u n c u r t a i n e d w i n d o w . Jeanie

was

happy,

though

increasingly

preoccupied

with

t h o u g h t s o f death. ' I ' v e often w o n d e r e d , ' she s a i d , ' w h a t h a p p e n s , m e d i c a l l y s p e a k i n g , w h e n y o u d i e . ' S h e w a n t e d t o k n o w the p r o c e d u r e when a patient died o n the w a r d . H o w c o u l d the d o c t o r s b e s u r e s o m e o n e w a s d e a d ? W h e r e d i d the b o d y g o ? W h o t o o k it? ' W e h a v e w o r k t o d o , ' I s a i d , 'shall w e p r e s s o n ? ' F i r s t , I checked her orientation for t i m e , p l a c e , a n d p e r s o n . F i n e . S h e k n e w w h o I w a s , w h e r e w e w e r e , the d a y o f the w e e k , and the m o n t h . S h e w a s q u i c k t o s u p p l y a u t o b i o g r a p h i c a l inform a t i o n and s e e m e d fully a w a r e o f her current c i r c u m s t a n c e s . N e x t , I b e g a n to p r o b e different a s p e c t s of mental function with s o m e s t a n d a r d b e d s i d e tests. O n e o f these w a s a v e r b a l fluency task in which she h a d to g e n e r a t e w o r d s with a d e s i g n a t e d initial letter. T h e first letter w a s 'F'. ' F i r e , flag, funeral,' she s a i d . 'Will that d o ? ' 'Tell m e s o m e m o r e — a s m a n y a s y o u c a n , ' I u r g e d her, b u t the allotted sixty s e c o n d s ran d r y with n o t h i n g m o r e t o show. S h e m a n a g e d just o n e w o r d for ' A ' a n d another three for ' S ' . F r o m letter fluency, w e m o v e d o n t o c a t e g o r i e s . ' L e t ' s see h o w m a n y different k i n d s o f f o u r - l e g g e d animal y o u can think of,' I s a i d , and J e a n i e p i n c h e d the b r i d g e of her n o s e . H a l f a m i n u t e went b y with n o r e s p o n s e . T h e b a b y , n o w asleep in her c a r r y c o t , b e g a n to stir, then settled. I r e m i n d e d J e a n i e o f her task.

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' Y o u k n o w , ' s h e told m e , ' I s e e m t o b e h a v i n g p r o b l e m s with this o n e . F o u r - l e g g e d a n i m a l s ? F o r s o m e r e a s o n I can only think of t h r e e - l e g g e d a n i m a l s . ' I noticed the trace of a smile on L i s a ' s lips, but her e y e s w e r e as dull as lead. I realize that it m i g h t s e e m m a d to q u e s t i o n the role of the b r a i n i n c o n s c i o u s n e s s . T h e r e can b e n o d o u b t that brains and s e l f - a w a r e n e s s are in c l o s e a l i g n m e n t . My brain a n d I are never far a p a r t , a n d I a c c e p t that I am sitting here, in H a r r y ' s r o o m , with m y l i v i n g b r a i n , c o n s c i o u s a n d s e l f - a w a r e , w h e r e a s those lifeless s p e c i m e n s in the o a k cabinets are not. I am thinking t h o u g h t s , listening, and l o o k i n g . I can hear o c c a s i o n a l s o u n d s of traffic from the street far b e l o w a n d , unexpectedly, faint ripples o f h a r p s i c h o r d m u s i c from s o m e w h e r e a l o n g the corridor. T h e taste of coffee is still in my m o u t h and I feel the contact between e l b o w a n d table, k n u c k l e s and chin, as I lean f o r w a r d to read the text on the c o m p u t e r screen. W i t h c o n s c i o u s deliberation I h a v e b e e n s t r i n g i n g w o r d s t o g e t h e r o n the s c r e e n i n front o f m e t h r o u g h the p l a y o f f i n g e r s o n k e y b o a r d , intermittently c a t c h i n g and t u r n i n g over u n s o licited, idle t h o u g h t s a n d i m a g e s . ( A t o n e point, I find m y s e l f h u m m i n g a B o b M a r l e y tune. It drifts in from n o w h e r e . ) A n d there, t h r o u g h the w i n d o w , I s e e a star, a h u n d r e d million miles away, but s i m u l t a n e o u s l y a l s o in my h e a d . Its i m a g e enters my e y e a n d f l o w - c h a r t s t h r o u g h the visual s y s t e m s o f m y brain, finds a link with m e m o r y a n d l a n g u a g e a n d , from outer s p a c e , g a i n s a n a m e and a l o c a t i o n in s e m a n t i c s p a c e : ' V e n u s ' . S o , d o e s c o n s c i o u s a w a r e n e s s h a v e a p h y s i c a l location: m i n e , here a n d now, i n H a r r y ' s r o o m , p r e c i s e l y s o m e w h e r e between my e a r s ? Self-evidently, it s e e m s . B u t then, go into the skull;

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visit the b r a i n ' s interior w o r k i n g s a n d y o u will find that there is nothing m u c h t o s e e . N o t a s p a r k o f c o l o u r o r w h i s p e r o f s o u n d and n o s i g n s o f intelligent life. A s y o u w a n d e r t h r o u g h this silent land y o u can d e s c r i b e its g e o g r a p h y a d e q u a t e l y e n o u g h in the third p e r s o n , but, quite o b v i o u s l y , not the first. F r o m this v a n t a g e point it s e e m s self-evidently true that c o n s c i o u s n e s s d o e s not h a v e a particular l o c a t i o n . It is no m o r e to be found in the hills a n d d a l e s of the frontal l o b e s or on the s l o p e s o f the R o l a n d i c f i s s u r e than i n the chair y o u are sitting o n . T h e m o r e y o u search the terrain, the c l o s e r y o u r a n a l y s i s o f s u b stance and structure, the faster the w i l l - o ' - t h e - w i s p r e c e d e s . We are e m b o d i e d , but n o w h e r e traceable within the physical s t r u c tures of the b o d y . I d o n ' t b e l i e v e in i m m a t e r i a l m i n d stuff or s o u l s detachable from b o d i e s , a n d I ' m n o t s a y i n g that the b r a i n isn't n e c e s s a r y for c o n s c i o u s n e s s . W h e t h e r it is sufficient is another matter. J e a n i e g r e w tired o f m y tests. S h e w a s l o s i n g c o n c e n t r a t i o n . In the m i d d l e of s o m e mental arithmetic, she s l o w e d to a s t o p and I let her sit and stare for a while. L i s a w a s sitting b a c k in her chair, h e a d resting a g a i n s t the wall, e y e s c l o s e d . T h e b a b y w a s fast asleep. H o s p i t a l s are never quiet, b u t y o u f i n d p o c k e t s o f resignation a n d w e a r i n e s s w h e r e time itself s e e m s b e c a l m e d . T h e s o u n d s o f the o u t s i d e w o r l d are distant a n d abstract. W e each w i t h d r e w into our p r i v a t e w o r l d s . J e a n i e , I a l l o w e d m y s e l f t o i m a g i n e , w a s r o a m i n g s o m e high p l a t e a u o f b e w i l d e r m e n t i n pursuit o f t h r e e - l e g g e d a n i m a l s ; the b a b y w a s drifting contentedly on a p o n d of m o t h e r ' s m i l k . B u t I d i d not p r e s u m e to i m a g i n e w h a t L i s a w a s thinking. C o n s c i o u s n e s s is a p u z z l e . F r o m o n e p e r s p e c t i v e it s e e m s that

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it m u s t h a v e a p h y s i c a l location ( p e o p l e ' s p a i n s and p l e a s u r e s go w h e r e p e o p l e g o ) , yet, from another, the s a m e s u g g e s t i o n s e e m s faintly a b s u r d . O n c e inside the head it b e c o m e s clear that c o n s c i o u s n e s s is not a 'thing' to be l o c a t e d . A n d even if we think of it as a 'function' or a ' p r o c e s s ' rather than a 'thing', what sense d o e s it m a k e to s a y that the crucial elements reside in this or that r e g i o n o f the b r a i n ? N o r d o e s c o n s c i o u s n e s s d e p e n d i n s o m e m y s t e r i o u s w a y o n the integrated functioning o f the w h o l e b r a i n . I h a v e s e e n m a n y patients w h o , as a result of surgery, injury, or d i s e a s e h a v e h a d m u c h less than w h o l e brains and they s e e m e d perfectly c o n s c i o u s as far as I c o u l d tell. I ' m s u r e t h e y ' d tell y o u they w e r e . F o r W i t t g e n s t e i n , p h i l o s o p h y w a s not s o m u c h a b o u t finding s o l u t i o n s t o p u z z l e s a s a b o u t c o r r e c t i n g fundamental m i s u n d e r s t a n d i n g s . T h e p h i l o s o p h e r ' s treatment of a question, he s a i d , is like the treatment o f a n illness. O u r m i n d s are knotted with m i s c o n c e p t i o n s a b o u t the w o r l d and the j o b o f p h i l o s o p h y i s t o u n r a v e l the k n o t , or, as he s a i d , to s h o w the fly the w a y out of the fly-bottle. T h e r e w a s a time — b e f o r e the b r a s h intrusion of c o g n i t i v e s c i e n c e - w h e n the ' m i n d - b o d y p r o b l e m ' lived quietly in the c l o i s t e r s o f a c a d e m i c p h i l o s o p h y , n o trouble t o a n y o n e . T h e s e d a y s , the redefined f i e l d o f ' c o n s c i o u s n e s s s t u d i e s ' i s a g a r d e n o f d e l i g h t s , s w a r m i n g with p h i l o s o p h e r s and scientists o f every stripe. D e b a t e is lively, s o m e t i m e s strident, and with the n e u r o scientists s h o u t i n g l o u d e s t of all a b o v e their n o i s y brain s c a n n e r s , m o s t d o n o t notice the f l y b u z z i n g frantically t o e s c a p e the fly-bottle. T h e y a r e e n g r o s s e d . H o w does the mental arise f r o m the m a t e r i a l ? H o w can subjective e x p e r i e n c e be reconciled

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with that s o g g y m a s s o c c u p y i n g the skull? T h e y a r e full o f c o n f i d e n c e , too. M o s t o f t h e m expect a s o l u t i o n . T h e c h i m e r a o f c o n s c i o u s n e s s rises like a v a p o u r a n d entices them to b e l i e v e that it really is just a matter of time b e f o r e a w a y is found of a c c o u n t i n g for s u b j e c t i v e , first-person p h e n o m e n a in o b j e c t i v e , third-person t e r m s . D e s p i t e the p r o d i g i o u s a m o u n t o f intellectual e n e r g y that h a s b e e n driven into this enterprise in recent y e a r s , philosophical a n d scientific, it s e e m s to me that the fly is still stuck in the bottle. Eventually, J e a n i e s a i d , ' A m I d e a d ? ' I d i d n ' t r e s p o n d immediately. L i s a ' s e y e s r e m a i n e d c l o s e d and I let the silence flow. J e a n i e s m i l e d . H e r face w a s lit with a b e n i g n perplexity. ' I ' m just w o n d e r i n g , ' s h e s a i d . ' H a v e I d i e d ? ' T h e r e w a s a s m e a r o f t o o t h p a s t e a r o u n d the c o r n e r o f her m o u t h . S h e d i d n ' t s e e m t o notice the d r o p l e t s o f tea spilling o n t o her d r e s s i n g g o w n . B u t there w a s a glint in her e y e . S h e w a s d e v e l o p i n g her t h e m e . 'In the m i d d l e of the night I w a s c o n v i n c e d , ' s h e s a i d . 'I thought they w o u l d c o m e t o take m e a w a y . N o , I w a s n ' t afraid. I w a i t e d t o see w h a t w o u l d h a p p e n . A n d then s o m e o n e d i d c o m e . It w a s a tall m a n . He j u s t w a t c h e d , a n d I tried to s a y s o m e thing, but m y lips w o u l d n ' t m o v e . T h e n the tall m a n left. H e d i d n ' t s a y a w o r d either.' L i s a s p o k e . ' W e ' v e b e e n t h r o u g h this b e f o r e , M u m . Y o u g e t confused s o m e t i m e s . Y o u ' r e n o t g o i n g t o d i e . N o t for a l o n g time.' G i v e n the uncertainty o f her m o t h e r ' s d i a g n o s i s this w a s , o f c o u r s e , not necessarily the c a s e . J e a n i e g a v e n o indication that she w a s listening.

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'I c a n ' t s a y for sure that I am d e a d , ' s h e continued, 'but things a r e n o t the s a m e . I d o n ' t feel real. It s e e m s to me I might be d e a d . ' H e r e x p r e s s i o n d i m m e d . ' H o w w o u l d I k n o w if I w a s d e a d ? ' Jeanie

w a s well oriented for t i m e , p l a c e , and p e r s o n . S h e

k n e w the d a y a n d the m o n t h , the n a m e of the town we w e r e in a n d the hospital, and s h e w a s clear a b o u t her n a m e , a g e , and a d d r e s s . As for b e i n g d e a d or alive, s h e w a s all at s e a . I w r o t e on my n o t e p a d : Cotard's? I o n c e s a w a n old w o m a n w h o w a s p r o f o u n d l y d e p r e s s e d . ' B u r y m e , ' s h e s a i d . ' Y o u m i g h t a s well, I ' v e been d e a d for s o m e time.' S h e b e l i e v e d her insides h a d rotted away. I tried to r e a s o n with her, b u t it w a s u s e l e s s . ' L o o k , ' I s a i d , ' y o u ' r e here talking to m e . H o w can you b e d e a d ? ' ' J u s t w o r d s , ' s h e replied. A w o r l d o f s h a d o w s f l i c k e r e d a r o u n d her, h u m a n figures c a m e a n d went, the curtains bill o w e d , n i g h t s fell, d a y s b r o k e . B u t s h e felt no connection with a n y of this. T i m e h o l l o w e d her c a r c a s s and w o r d s fell d e a d at her feet. J u s t w o r d s . T h a t w a s the f i r s t time I'd c o m e a c r o s s C o t a r d ' s s y n d r o m e , which i s u s u a l l y a s s o c i a t e d with s e v e r e d e p r e s s i o n , b u t i s s o m e t i m e s seen i n c a s e s o f n e u r o l o g i c a l d i s e a s e . T h e p e r s o n sinks into a nihilistic d e l u s i o n a l state, often, as in this c a s e , to the extent that they b e l i e v e they no l o n g e r exist. T h e condition takes its n a m e from the French psychiatrist J u l e s C o t a r d w h o , in 1882, published a series of c a s e studies of p e o p l e suffering w h a t he referred to as le delire de negation. T h e clinical p r e s e n t a t i o n differed s o m e w h a t from patient to patient, b u t d e l u s i o n s o f s e l f - n e g a t i o n w e r e c o m m o n . T h e s e r a n g e d f r o m the b e l i e f that p a r t s o f the b o d y w e r e m i s s i n g o r

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had putrefied, t o the c o m p l e t e denial o f b o d i l y e x i s t e n c e . T h e e x p r e s s e d belief that o n e is d e a d is not a defining feature of the s y n d r o m e . I n fact, o f the eight ' p u r e ' c a s e s r e p o r t e d b y C o t a r d ( e x c l u d i n g a further three with c o n c o m i t a n t p e r s e c u t o r y d e l u sions o r other debilitating illness) o n l y o n e e m b r a c e d d e a t h a s an explanation of her condition. O t h e r s s l i p p e d into n o n - e x i s t ence, or skirted the a b y s s , s o m e h o w d e f y i n g the c o n v e n t i o n a l u n d e r s t a n d i n g that c e a s i n g t o exist m u s t b e t a n t a m o u n t t o death. T h e r e w e r e even s o m e patients l o c k e d i n the p a r a d o x i c a l state of d e n y i n g their b o d i l y existence yet at the s a m e t i m e believing themselves to be immortal. W h a t d r i v e s such s t r a n g e d e l u s i o n s ? D e p r e s s i o n is u s u a l l y a factor, but is not a l w a y s present. J e a n i e , p e e r i n g quizzically into the v o i d , is not d e p r e s s e d . H e r c a s e , at least, calls for a n e u r o b i o l o g i c a l e x p l a n a t i o n . O n e possibility is that the e x p e r i e n c e s arise from a disturbance of b r a i n m e c h a n i s m s w h i c h o r d i n a r i l y bind sensation and t h o u g h t to the neural s y s t e m s u n d e r l y i n g emotion. T h i s ancient d u t y i s p e r f o r m e d b y the l i m b i c s y s t e m , d e e p inside the cerebral h e m i s p h e r e s . A p r i m e function of this s y s t e m , an e v o l u t i o n a r y raison d'etre, is to create states of r e a d i ness for action. It d o e s this t h r o u g h the i m p l e m e n t a t i o n of s o - c a l l e d 'affect p r o g r a m s ' . If y o u r s e n s o r y s y s t e m s i n f o r m y o u that there is a c r a z e d l o o k i n g m a n fast a p p r o a c h i n g with a n a x e , y o u r b o d y will enlist the affect p r o g r a m identified with fear. B e f o r e y o u h a v e t i m e even to experience terror, b e f o r e the e y e - b u l g i n g , v o l t a g e s u r g e o f a w a r e n e s s , v a r i o u s p h y s i o l o g i c a l s y s t e m s will h a v e r e c o n f i g u r e d t h e m s e l v e s in p r e p a r a t i o n for a r e s p o n s e . Y o u will turn a n d run. T h e t h o u g h t ' I a m terrified' will follow hot o n y o u r h e e l s ,

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t h o u g h , m o s t likely, will h a v e entered the p a s t tense by the time it catches u p . 'I w a s terrified,' y o u will later recall. B u t w h a t is this 'I' that c l a i m s the terror, and what is the ' y o u ' that reflects u p o n the e x p e r i e n c e ? It is not a s i n g l e thing, or a thing at all. It is, in its m o s t primitive f o r m , a principle of b i o l o g i c a l o r g a n i z a t i o n . T h e affect p r o g r a m s , s o this story g o e s , n o t o n l y g u i d e a d a p t i v e interaction with the external w o r l d but, as a b y - p r o d u c t of this p r o c e s s , they a l s o f o r m the b i o l o g i c a l p o i n t o f o r i g i n o f the self. B y i m b u i n g p e r c e p t i o n s , thoughts, a n d a c t i o n s with a n e m o t i o n a l h u e ( h o w e v e r p a l e ) they g i v e c o h e s i o n to e x p e r i e n c e . F e e l i n g s a r e g e n e r a t e d which f o r m the b a s i s o f o u r sense o f identity, c r e a t i n g the c o n d i t i o n s for o w n e r s h i p of t h o u g h t s and for a g e n c y

i n the control

of

actions.

T h e s e perceptions,

t h o u g h t s , w i s h e s , beliefs, utterances, a n d actions are mine. I feel it. T h e i r c o m m o n c a u s e i s centred u p o n m y n e e d s and m o t i v a tions, m a d e manifest t h r o u g h the affect p r o g r a m s o f m y limbic b r a i n . I feel I think, therefore I a m . N o t e that this is merely a functional d e s c r i p t i o n o f the b i o l o g i c a l r o o t s o f the self. D o n ' t a s k w h e r e the feeling of the feeling c o m e s from; or the feeling of the feeling of the feeling. S u c h q u e s t i o n s tighten the knot. B e y o n d this u n e l a b o r a t e d , b i o l o g i c a l c o r e there a r e , o f c o u r s e , d i m e n s i o n s of the s e l f with a p a s t a n d a future as well as a r a w present: in n a r r a t i v e t e r m s , the a u t o b i o g r a p h i c a l self. In C o t a r d ' s s y n d r o m e , h o w e v e r , the c o r e h a s d i s s o l v e d . C o g n i t i o n is d e c o u p l e d f r o m feeling a n d , consequently, t h o u g h t s and a c t i o n s h a v e no fixed m o o r i n g s . T h e r e is no 'I' left to claim o w n ership. It d i s i n t e g r a t e s ; the f r a g m e n t s drift apart. O n e patient b e l i e v e d s h e h a d b e c o m e little m o r e than fresh air: ' J u s t a v o i c e ,

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and if that g o e s , I w o n ' t be a n y t h i n g . ' If the v o i c e w e n t s h e w o u l d b e lost and w o u l d n ' t k n o w w h e r e s h e h a d g o n e , s h e s a i d . J e a n i e b e c a m e fascinated with her t e a c u p . ' L o o k at this,' she s a i d . ' I s it real? H o w can I tell? It d o e s n ' t l o o k real.' S h e c o n t e m p l a t e d the object as if it h a d just m a t e r i a l ized out of thin air, then her g a z e t u r n e d to m e . ' A n d w h a t a b o u t y o u ? ' she said. ' A r e y o u r e a l ? ' I had s t o p p e d taking n o t e s a n d s a t , h a n d s c l a s p e d o v e r m y head, p o n d e r i n g the innocent q u e s t i o n . ' B e l i e v e m e , ' I s a i d , ' I ' m real and s o are y o u . T a k e m y w o r d for it.' 'I think I can trust y o u , ' s h e s a i d , but s h e w a s n ' t s u r e . S o m e p h i l o s o p h e r s ( d i s m i s s e d b y others a s ' M y s t e r i a n s ' ) a r g u e that the ' p r o b l e m o f c o n s c i o u s n e s s ' e x c e e d s h u m a n mental capacity in the w a y that differential calculus or the c o n c e p t of d e m o c r a c y are b e y o n d the intellectual s c o p e of a rabbit or a p i g e o n . I find this v i e w curiously c o m f o r t i n g , but then I ' m m o r e of a clinician than a scientist. In my t r a d e , unlike science, i n c o r rigible o p t i m i s m can b e c o u n t e r - p r o d u c t i v e . S o m e p r o b l e m s have no solution. But if there is a w a y to untie this k n o t of k n o t s perhaps the first m o v e is to a c k n o w l e d g e that we are not o n l y physically embodied, but a l s o embedded in the w o r l d a b o u t u s . T h e mind m a y be local to the b o d y and the b r a i n , but it is a l s o , in different w a y s , distributed b e y o n d b i o l o g i c a l b o u n d a r i e s . T h e notion o f 'the extended m i n d ' h a s b e e n g a i n i n g c u r r e n c y i n c o g n i t i v e science, but similar i d e a s w e r e d e v e l o p e d m o r e than f i f t y y e a r s a g o b y the R u s s i a n n e u r o p s y c h o l o g i s t A l e x a n d e r L u r i a . F o r L u r i a , p s y c h o l o g i c a l p h e n o m e n a w e r e part o f the natural w o r l d and s o subject t o the l a w s o f n a t u r e , b u t h e a l s o r e c o g n i z e d that the structure o f the m i n d h a s social d i m e n s i o n s .

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He t h o u g h t that scientific p s y c h o l o g y s h o u l d be a l i g n e d with the b i o l o g i c a l s c i e n c e s , b u t b e l i e v e d that o n e c o u l d never fully u n d e r s t a n d the relationship b e t w e e n the brain and the mind by t r e a t i n g the b r a i n a s a c l o s e d b i o l o g i c a l s y s t e m . T h e w o r k i n g b r a i n h a s to be u n d e r s t o o d not o n l y as part of a larger b i o l o g i c a l s y s t e m (the rest o f the b o d y ) , b u t a l s o a s a c o m p o n e n t o f the w i d e r social s y s t e m . W h a t we refer to as the ' s e l f ' is a p r o d u c t of b i o l o g i c a l a n d social forces a r i s i n g f r o m the interaction of indiv i d u a l , i s o l a t e d , b r a i n s . T h e r e is no s p a r k in a s i n g l e stone but, s t r u c k together, t w o s t o n e s c a n start a b l a z e . T h e c h a l l e n g e for n e u r o s c i e n c e will be to fit the brain (a b i o l o g i c a l o b j e c t ) and the s e l f (a social c o n s t r u c t ) within a c o m m o n f r a m e w o r k o f u n d e r s t a n d i n g . T h e b r a i n sciences m a y h a v e t o o p e n u p t o a ' s o c i a l p a r a d i g m ' . F a r from b e i n g the H o l y G r a i l o f n e u r o s c i e n c e , the s e a r c h for c o n s c i o u s n e s s within the circuitry o f a n individual b r a i n can lead o n l y t o fool's g o l d . S a n t i a g o R a m o n y C a j a l (joint w i n n e r of the 1906 N o b e l Prize for his w o r k o n the structure o f the n e u r o n and o n e o f the f o u n d i n g fathers o f m o d e r n n e u r o s c i e n c e ) o n c e s a i d : ' A s l o n g a s our b r a i n is a m y s t e r y , the u n i v e r s e , the reflection of the structure of the b r a i n , will a l s o be a m y s t e r y ' We a n d the w o r l d are tightly intertwined. T h o u g h we m a y n o t h a v e a special p l a c e in the univ e r s e , the u n i v e r s e , as far as we can e v e r u n d e r s t a n d it, has a special p l a c e i n u s . 'I think I c a n trust y o u . I think. I think . . .' J e a n i e ' s w o r d s w e r e s t r u g g l i n g for life. H e r g a z e drifted o v e r the pale-blue paint on the w a l l . 'I think I c a n . ' M o v i n g with a m o t h e r ' s g r a c e , L i s a lifted the s l e e p i n g b a b y f r o m the cot and p l a c e d the b u n d l e o f b l a n k e t s a n d p i n k f l e s h i n J e a n i e ' s a r m s . J e a n i e kissed her

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g r a n d d a u g h t e r a n d b e g a n t o w e e p . I t w a s time for m e t o g o . ' M u m ' s m o r e h e r s e l f after a g o o d cry,' s a i d L i s a . ' T h a t m a k e s s e n s e , ' I told her. J u l e s C o t a r d died a t the a g e o f forty-nine. H e s u c c u m b e d t o diphtheria after n u r s i n g o n e of his children to r e c o v e r y . I recall this fossilized fact o f b i o g r a p h y a s I s t a c k m y c a s e n o t e s . T h e g l o w o f the c o m p u t e r screen i s n o w b r i g h t e r than the s k y a n d , when the m a c h i n e shuts d o w n , H a r r y ' s r o o m i s a l m o s t d a r k . Paradoxically, a s the g l o o m d e s c e n d s , the j a r s a l o n g the w a l l s g a i n a kind o f l u m i n e s c e n c e , a s i f they h a v e a b s o r b e d s o m e o f the r e c e d i n g light. M y report i s finished. T h e l a p t o p lid c l o s e s with a satisfying click a n d I go a c r o s s to take a c l o s e r l o o k at o n e of the brain s p e c i m e n s . I lean c l o s e to r e a d the printed label: Subarachnoid

haemorrhage.

' H o w ' s it g o i n g , H a r r y ? ' I say.

How's it going,

Paul?

Me? There's no one else. I w a s lost in thought. What were you thinking about? Nothing much. The immensity of the universe, the mystery of consciousness, and the finality of death, no doubt. Yes. Fetch me a Gauloise!

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It w o u l d be g o o d to c a u s e a stink. I'd love a cigarette. I t m u s t b e torture. Tell me more about the woman who thought she was dead. I've nothing to add. There's plenty more you could say. B u t I ' m n o t g o i n g to. Why not? L e t the s t o r y s t a n d . I t ' s truer to life. I d o n ' t a l w a y s k n o w the final o u t c o m e — and that applies to Jeanie. The diagnosis, at least. The prognosis. Hashimoto's disease. Uncertain. So there was hope? I t ' s a n inflammation o f the b r a i n .

Vodka and Saliva

T h i s afternoon I d r o v e to the b e a c h . T h e r e w e r e no takers so I went a l o n e , or rather, it w a s me and the d o g . A d o g is c o m p a n y if y o u d o n ' t think a b o u t it t o o h a r d , which m o s t l y I d o n ' t . It had b l o w n up chilly by the time we g o t there, b u t I s t r i p p e d to my shorts and went in, c a u t i o u s l y at first. T h e w a t e r w a s a g g r e s s i v e l y c o l d . T h e o n l y w a y t o p r o c e e d w a s n o t t o think b u t to act, so I instructed my b o d y to trot f o r w a r d a n d d i v e into the next w a v e . Dutifully, it d i d , a l t h o u g h I w a t c h e d the a p p r o a c h i n g w a v e with trepidation. U n d e r the w a t e r there is actually a dulling o f sensation, a s i f c o n s c i o u s n e s s itself i s m o m e n t a r i l y s u b m e r g e d in the thrum of the o c e a n , then it r e t u r n s with full force. I surfaced a n d rolled on to my b a c k , g a s p i n g with the cold, a r m s and l e g s d r i v i n g the water, intensely a w a r e o f e v e r y startled n e u r o n . I w a s e n v e l o p e d by s e a and sky, b u t n o w felt detached from b o t h . T h e d o g p a d d l e d b e s i d e m e s h o w i n g n o signs o f d i s c o m f o r t . D e s c a r t e s b e l i e v e d that d o g s , i n d e e d all a n i m a l s , are u n c o n scious a u t o m a t a . A n animal s c r e a m i n g i n pain i s like the c h i m i n g

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of a c l o c k . My faithful friend is a m a c h i n e . Its fidelity is merely reflexive. It d o e s n ' t feel the c o l d . I n t r i g u i n g , then, to learn that the g r e a t m a n h i m s e l f kept a pet d o g , Mister S c r a t c h , of which h e w a s v e r y fond. 'I k n o w that I e x i s t , ' s a i d D e s c a r t e s , 'the q u e s t i o n is, what is this " I " that I k n o w ? ' H e w a s quite s u r e the ' I ' that h e k n e w w a s n o t his b o d y . ' I a m n o t this a s s e m b l a g e o f l i m b s , ' h e s a i d , but o f c o u r s e h e k n e w h e w a s . J u s t a s , a t o n e level, h e m u s t have b e l i e v e d that Mister S c r a t c h h a d s o m e d e g r e e o f c o n s c i o u s a w a r e n e s s . He w a s far t o o clever to feel affection for an a u t o m a ton, surely. I m i g h t not be as clever as D e s c a r t e s , b u t I trust my intuitions, and i t s e e m s t o m e that m y b o d y i s a n i m p o r t a n t part o f the ' I ' that I k n o w . It is the p h y s i c a l a p p a r a t u s o v e r which I h a v e direct c o n t r o l , the t h i n g I u r g e to d i v e into i c y w a t e r s , the thing that g o e s to w o r k a n d s e e s patients a n d g i v e s lectures. I n e v e r leave h o m e w i t h o u t it. M y b o d y h a s certain b o u n d a r i e s ( r o u g h l y defined b y m y s k i n ) , w h i c h g i v e it a characteristic s h a p e ; and as I steer it from o n e p l a c e t o a n o t h e r m y t h o u g h t s and e x p e r i e n c e s g o with it. I f y o u are h a v i n g a b a d time for s o m e r e a s o n and I s a y ' M y t h o u g h t s are with y o u , ' d o n ' t b e l i e v e m e . M y t h o u g h t s are v e r y m u c h with me. A l w a y s . B e l i e v i n g that t h o u g h t s are displaced f r o m y o u r b o d y o r that other p e o p l e ' s t h o u g h t s can b e inserted into y o u r h e a d , is a s i g n of mental illness. My b o d y is, w i t h o u t d o u b t , a part of what I think of as my ' s e l f . I t ' s the p a r t o f m y s e l f that can b e w e i g h e d a n d m e a s u r e d ; it c a s t s s h a d o w s , a n d it h a s p r o p e r t i e s in c o m m o n with other p h y s i c a l o b j e c t s like trees a n d filing cabinets, c a r s , and planets.

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' B o d y i s a p o r t i o n o f the soul d i s c e r n ' d b y the f i v e s e n s e s , ' s a i d William B l a k e . I h a v e a s t r o n g s e n s e that I am l o c a t e d in my b o d y . I d r i v e my car to the b e a c h and I d r i v e my b o d y into the c o l d s h o c k of the w a v e s . On the w a y to the b e a c h I s e e h e d g e r o w s a n d trees flash by t h r o u g h the w i n d s c r e e n of the car a n d , trotting into the water, I s e e the w a v e s a n d the s k y as if f r o m b e h i n d the w i n d screen of my e y e s . I feel l o c a t e d in my b o d y a n d I identify with it in other w a y s , too. F o r e x a m p l e , if I s e e it a m o n g other b o d i e s pictured in a p h o t o g r a p h I m i g h t s a y s o m e t h i n g like ' T h a t ' s m e ' or ' T h e r e I a m . ' I ' d s a y s o m e t h i n g similar e v e n a b o u t an o l d p h o t o g r a p h s h o w i n g me as a baby, d e s p i t e the fact that the b o d y b e a r s no r e s e m b l a n c e to the o n e I currently h a v e . I f s o m e o n e p a s s e s m y b o d y i n the street they m i g h t , i f they r e c o g n i z e it, offer a g r e e t i n g , u s i n g my n a m e . A n a m e is a n o t h e r w a y we h a v e of thinking a b o u t o u r s e l v e s - a label to identify our b o d i e s and m a r k their actions. ' T h a t ' s P a u l o v e r there, r u n ning into the s e a . ' O n e c a n c h a n g e o n e ' s n a m e , b u t not o n e ' s body. S o , I feel I o c c u p y my b o d y (there is no s t r o n g e r intuition) and, with that, c o m e s a s e n s e of ownership a n d agency. I t ' s my b o d y and I control it. I m a k e it do things. My b o d y a l s o contributes to my s e n s e of continuity — the feeling that I am the s a m e p e r s o n from o n e d a y to the next. W h e n I l o o k in the m i r r o r each d a y I expect to s e e the s a m e thing, m o r e or l e s s . I ' d be surprised if o n e d a y I l o o k e d in the m i r r o r a n d s a w N e l s o n Mandela or a w o m a n or a g i a n t m o t h . I ' d be rattled. Identifying the s e l f with the b o d y s e e m s r e a s o n a b l e e n o u g h , but there are s o m e p r o b l e m s . F o r e x a m p l e , the b o u n d a r i e s o f

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the b o d y are n o t s o e a s y t o define. H o w m u c h a part o f u s are our hair o r o u r f i n g e r n a i l s ? W h a t a b o u t b o d i l y f l u i d s ? W h a t a b o u t f o o d ? I p i c k a s t r a w b e r r y from a b a s k e t , I s w a l l o w it and i t b e c o m e s i n c o r p o r a t e d into m y b o d y . A t what point d o e s i t b e c o m e a p a r t o f m y b o d y a n d s o a part o f m e ? As a student I h a d tutorials with the f a m o u s psychiatrist A n t h o n y Storr. H e w a s a relaxed teacher, v e r y c h a r m i n g , and I ' m s u r e I l e a r n e d s o m e t h i n g a b o u t p s y c h o t h e r a p y . B u t all I can recall i s o n e o f his t h o u g h t e x p e r i m e n t s . H e a s k e d u s t o c o n s i d e r h o w often w e s w a l l o w o u r o w n s a l i v a . W e d o i t all the t i m e , o f c o u r s e , w i t h o u t thinking. T h e n h e invited u s t o i m a g i n e that, instead o f s w a l l o w i n g , w e spat into a tumbler. H o w w o u l d we n o w feel a b o u t s i p p i n g from a t u m b l e r full of o u r o w n spit? I t ' s the s a m e stuff, b u t no thanks! N o t e v e n with i c e , l e m o n , a n d a l a r g e d a s h o f v o d k a . W h a t ' s the difference? A b o u n d a r y h a s b e e n c r o s s e d . A s the p h i l o s o p h e r D a n i e l D e n n e t t p u t s it, o n c e s o m e t h i n g i s o u t s i d e our b o d i e s i t b e c o m e s alien a n d s u s p i c i o u s , not quite part o f u s , something

to

be

rejected.

The

spit

in

the

tumbler

has

' r e n o u n c e d its c i t i z e n s h i p ' . B o u n d a r i e s a n d b o r d e r c o n t r o l s are important. D e n n e t t a l s o r e m i n d s u s that the s o c i e t y o f the h u m a n b o d y h a s m a n y interlopers — b a c t e r i a , v i r u s e s , m i c r o s c o p i c mites — not all ' e n e m i e s within' or e v e n tolerated p a r a s i t e s . S o m e , like the b a c t e r i a in o u r g u t , are vital to s u r v i v a l . I identify with my b o d y , b u t n o t with a n y o f these b u g s , o r i t e m s o f food p a s s i n g t h r o u g h my d i g e s t i v e s y s t e m or, i n d e e d , with a n y particular part o f m y b o d y o n a l a r g e r s c a l e — m y k n e e s , m y k n u c k l e s , the b l o o d c o u r s i n g t h r o u g h my veins. I c o u l d l o s e an a r m or a l e g or a pint

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of b l o o d and I w o u l d still be m e . P e r h a p s i t ' s the idea of h a v i n g a b o d y that really matters. I m a y feel that I inhabit a n d control a b o d y a n d that s u c h feeli n g s are fundamental t o m y s e n s e o f self, b u t there a r e m a n y features of my b o d y o v e r which I h a v e no direct c o n t r o l . I c a n ' t stop the a g e i n g p r o c e s s . I c a n ' t s t o p it d e v e l o p i n g a t u m o u r or a d e g e n e r a t i v e b r a i n d i s e a s e , i f that's what the g e n e s dictate. A n d there are millions o f p h y s i o l o g i c a l p r o c e s s e s g o i n g o n inside m e that I scarcely k n o w a b o u t , let a l o n e c o n t r o l . A l t h o u g h I can c l a i m a better than a v e r a g e k n o w l e d g e of h u m a n b i o l o g y , I h a v e o n l y a g e n e r a l n o t i o n of w h a t my internal c o m p o n e n t s are. M a n y intelligent p e o p l e with a perfectly functional s e n s e of s e l f h a v e n ' t a clue a b o u t w h a t g o e s on inside them. It is l a r g e l y irrelevant to the e v e r y d a y b u s i n e s s of b e i n g a p e r s o n . J u s t as when y o u d r i v e a car y o u d o n ' t really n e e d to k n o w h o w the e n g i n e w o r k s . E v e n when y o u c o n s i d e r t h o s e t h i n g s that w e directly take c h a r g e of, the activities o f the b o d y t h r o u g h which w e e x e r c i s e our free will ( v o l u n t a r y m o v e m e n t s of the l i m b s , fingers, h e a d , vocal a p p a r a t u s , e t c . ) , even here, the d e g r e e o f control i s s o m e times so p o o r that we achieve effects in the w o r l d quite o p p o s i t e to those we intend. T h e practice of d e c e p t i o n is a c a s e in point. W h e n p e o p l e d i s p l a y e x p r e s s i o n s for e m o t i o n s they are not feeli n g , or s a y things inconsistent with their actual state of m i n d or their true beliefs, there are often c o u n t e r - s i g n a l s that g i v e them away. T h i s a p p l i e s whether w e are l y i n g or, for the b e s t o f r e a s o n s , s i m p l y t r y i n g to g i v e a false i m p r e s s i o n to d i s g u i s e the true state of affairs. Paul E k m a n , a p i o n e e r in the s t u d y of e m o t i o n a l e x p r e s s i o n s ,

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lists s o m e o f these tell-tale s i g n s : ' a m o v e m e n t o f the b o d y , an inflection to the v o i c e , a s w a l l o w i n g in the throat, a d e e p or s h a l l o w b r e a t h , l o n g p a u s e s b e t w e e n w o r d s , a slip of the t o n g u e , a m i c r o f a c i a l e x p r e s s i o n , a gestural slip . . .' L i e s can be perf o r m e d beautifully, s a y s E k m a n , but u s u a l l y they are not. A n d then there a r e o c c a s i o n s w h e n w e b e h a v e with perfect control o f o u r a c t i o n s , but our b e h a v i o u r i s , a t s o m e level, not what w e w i s h o r intend. W e act a g a i n s t o u r better j u d g e m e n t ; w e yield t o temptation. W h e n I finished that last p a r a g r a p h I g o t up and went to the lavatory. I h a v e a b s o l u t e l y no idea h o w I did it. I b e c a m e aware o f a n ' u r g e ' t o g o , I s t o o d a n d found m y s e l f w a l k i n g t o the b a t h r o o m w h e r e , m a g i c a l l y , effortlessly, I h o s e d urine into the toilet b o w l . D o n ' t a s k me how. I take it for g r a n t e d that I can just 'think i t a n d d o i t ' . T h e c o - o r d i n a t e d neural, musculo-skeletal a n d u r o g e n i t a l activities i n v o l v e d in the enterprise of getting up a n d g o i n g to the l a v a t o r y are incredibly c o m p l e x . I just m a d e it happen.

I

have

phenomenal

control

over

neurobiological

p r o c e s s e s that no o n e in the w o r l d fully c o m p r e h e n d s , and I d o n ' t e v e n h a v e to think a b o u t it. I t r e m i n d e d m e t o m a k e the point that e v e n w h e n w e h a v e excellent control o v e r o u r v o l u n t a r y a c t i o n s , and at e v e r y level intend t o p e r f o r m t h e m , w e still d o n ' t u n d e r s t a n d precisely h o w an act of will g e t s translated into a c o m p l e x s e q u e n c e of b i o l o g ical activity ( o r v i c e v e r s a ) . S o , w e can s e e that the b o d y i s a n important feature o f the w a y we think a b o u t o u r s e l v e s - it s e e m s natural to believe that each o f u s o w n s a b o d y a n d that w e h a v e control over it. But w e c a n a l s o s e e that it is difficult to identify the ' s e l f with the ' b o d y '

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as a w h o l e ( b e c a u s e the b o u n d a r i e s are f u z z y ) , or with a n y particular part o f the b o d y . F u r t h e r m o r e , o u r control o v e r o u r b o d i e s , and our u n d e r s t a n d i n g o f the p r o c e s s e s i n v o l v e d , i s variable. P e r h a p s , as I say, i t ' s the idea of h a v i n g a b o d y that really matters. O n e m i g h t think that the face h a s s o m e special a l i g n m e n t with the self. N o other object p r o j e c t s s u c h a n a u r a o f vitality, and this vitality s e e m s t o c o m e from within. F a c e s are p o i n t s o f c o n v e r g e n c e b e t w e e n p e o p l e ; w h e r e w e s e e m t o l o c a t e the essence of another p e r s o n , a n d w h e r e we tend to l o c a t e ourselves: s o m e w h e r e b e h i n d the e y e s . In his n o v e l Immortality, Milan K u n d e r a writes: ' W i t h o u t the faith that o u r f a c e e x p r e s s e s our self, without that b a s i c illusion, that arch-illusion, we cannot live or at least we cannot take life seriously.' Imagine if someone you know were suddenly to undergo a radical transformation of his or her facial features. T h e y still h a v e a face, a regular o n e , b u t a different o n e . Is it p o s s i b l e to believe it's the s a m e p e r s o n ? W h a t i f they n o w l o o k just like s o m e o n e else y o u k n o w ? O r w h a t i f they r e s e m b l e y o u ? N o w i m a g i n e that p e r s o n with n o face a t all. C a n y o u e v e n think o f them as a person? W h a t is it y o u are thinking a b o u t ? We treat the face as an e m b l e m of the self. It g e n e r a t e s p o t e n t illusions. K u n d e r a m i g h t be right to s a y it w o u l d be hard to function as a h u m a n b e i n g without e m b r a c i n g the e m b l e m a n d s e e i n g the illusion. B u t it w o u l d be a m i s t a k e to identify f a c e s with selves. T h e face i s just another b o d y part. P e o p l e with h o r r e n d o u s facial disfigurements h a v e no less a s e n s e of s e l f than p e o p l e w h o h a v e lost an a r m or a l e g . In s o m e r e s p e c t s , p e r h a p s , their sense of s e l f is intensified.

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T h e face is just a fleshy structure animated by m u s c l e s attached to the b o n y structures of the skull. It contains i n f o r m a tion a b o u t o u r identity ( w h o w e a r e ) , our sex and our a g e (which are i m p o r t a n t facets o f the 'public s e l f ) , w h o and what w e are in t e r m s of the o b j e c t i v e , social facts of the matter. Y o u can think of these as 'static' features of the s e l f in so far as they are relatively f i x e d a n d e n d u r i n g . T h e n , t h r o u g h c h a n g e s i n patterns o f m u s c u l a r activity ( ' e x p r e s s i o n s ' , ' g a z e ' ) , the face transmits s i g n a l s a b o u t other, m o r e d y n a m i c , features s u c h a s o u r e m o t i o n a l state, our focus o f interest, a n d o u r i m m e d i a t e intentions. T h e s e h a v e a d o u b l e a s p e c t ; part p u b l i c , part p r i v a t e . Y o u can u s e facial information t o m a k e inferences a b o u t m y mental state a n d b e h a v i o u r a l d i s p o s i t i o n s . To that extent the i n f o r m a t i o n is ' p u b l i c ' b e c a u s e it is there for a n y o n e t o s e e . B u t y o u c a n ' t k n o w m y thoughts and feelings directly. Y o u c a n ' t e x p e r i e n c e them. W e s e e a n d hear a n d s p e a k t h r o u g h the face, creating the i m p r e s s i o n that c o n s c i o u s n e s s , 'the stuff of the s e l f ' , is c o n c e n trated there, e v e n t h o u g h there are no g r o u n d s for b e l i e v i n g it is really a n y m o r e ' t h e r e ' than in the right e l b o w or the small o f the b a c k . T h i s i s b e c a u s e there i s n o ' s e l f s t u f f ' t o b e located. T h e r e is n o t h i n g in, or b e h i n d , the face except for o r g a n i c matter, a n d n o t h i n g to s u g g e s t that the b i o l o g i c a l material of the h e a d , as o r g a n i c matter, h a s a g r e a t e r p r o p e n s i t y for 'selfh o o d ' than the material stuff o f other r e g i o n s o f the body. T h e r e just isn't. T r a v e l l i n g i n t h o u g h t f r o m the p o s i t i o n o f participanto b s e r v e r in the p h y s i c a l a n d social w o r l d ' t h r o u g h ' the face and into the m a c h i n e r y that lies b e h i n d we are transported, like

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A l i c e t h r o u g h the l o o k i n g g l a s s , to a v e r y different w o r l d . We g o from a b r i g h t p l a c e o f p e r s o n s , s e l v e s , a n d s u b j e c t i v e e x p e r i ence, to a d a r k , silent, e n c l o s e d , w o r l d of p h y s i c s , chemistry, and b i o l o g y . It is a m y s t e r i o u s j o u r n e y .

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Body Art

T h e r e ' s s o m e o n e here t o s e e m e . S h e ' s c o m e t o talk a b o u t her r e s e a r c h p r o j e c t . S h e ' s l o o k i n g for a P h D s u p e r v i s o r . ' H i , I ' m K a r a , ' s h e s a y s , drifting i n like scented s m o k e . ' I ' m m o r e o f a n e u r o m a n , ' I'd told her o v e r the p h o n e . ' I ' m not s u r e I c a n help.' I tried to put her off. I said I k n e w s o m e thing a b o u t b o d y - i m a g e c h a n g e s c a u s e d b y brain d a m a g e , and self-mutilation in the m e n t a l l y d i s t u r b e d , but n o t h i n g about the cult o f e x t r e m e b o d y modification. S h e w o u l d n ' t b e deterred, a n d h e r e s h e i s , o p e n i n g a folder to s h o w me s o m e s a m p l e s . T h e thing that first catches my e y e is a c l o s e - u p c o l o u r p h o t o g r a p h o f a m a n with his t o n g u e h a n g i n g out. T o n g u e s , a l m o s t . It is split f r o m the b a s e , g i v i n g it a w i c k e d , reptilian l o o k . Y o u can a l m o s t s e e it flicker. K a r a h a s a g l i s t e n i n g stud in the m i d d l e o f her o w n t o n g u e . I t ' s difficult t o i g n o r e o n c e y o u notice. T h e t o n e o f the I n f o r m a t i o n S h e e t i s r e a s s u r i n g . I t c o u l d b e f r o m a p r i v a t e hospital b r o c h u r e . I learn that The most popular method of tongue splitting is surgical. I m a g e s of D I Y enthusiasts with razor b l a d e s a n d s c i s s o r s r a p i d l y f a d e . N o t h i n g o f the sort.

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T h e operation is q u i c k and h i g h - t e c h , performed by an oralmaxiofacial ( s i c ) surgeon using an argon laser. T h e t o n g u e is slit in a single s w e e p , the laser cauterizing as it cuts. L o n g - t e r m s i d e effects are p l a y e d d o w n . T h e r e m a y b e m i n o r c h a n g e s i n s o m e speech s o u n d s , i t s a y s , a n d , p h y s i o l o g i c a l l y , the n u m b e r o f taste b u d s increases to c o v e r the extra s u r f a c e a r e a . E l s e w h e r e , a w o m a n reveals it t o o k a b o u t three w e e k s b e f o r e s h e c o u l d eat comfortably and control both tongues. No c l a i m s are m a d e for the g a s t r o n o m i c or s e x u a l a d v a n t a g e s of the split t o n g u e , b u t I b e g i n to w o n d e r . T h e r e are m a n y other i m a g e s . S o m e are relatively m u n d a n e (tattooed p e n i s e s , nipple p i e r c i n g s , scarification, b r a n d i n g ) a n d s o m e bizarre, like t r a n s d e r m a l implantation. K a r a s h o w s m e pictures of m e n with objects inserted into the forehead or scalp. T h e y l o o k like Star Wars characters. I cast my e y e o v e r a r e p o r t on non-psychotic self-cannibalism

(autophagy),

and

another

on

apotemnophilia, which, I learn, refers to a c r a v i n g for a m p u tation, s o m e t i m e s satisfied t h r o u g h the s e r v i c e s o f qualified surgeons. B o d y art has filtered into the m a i n s t r e a m . A l m o s t e v e r y b o d y has a tattoo or a p i e r c i n g these d a y s . T h e s a m e g o e s for b o d y modification: b r e a s t implants, n o s e j o b s , l i p o s u c t i o n , anorectic dieting, b o d y - b u i l d i n g . K a r a c o n d e m n s it all as a h o p e l e s s strivi n g for u n o b t a i n a b l e ideals o f conventional b e a u t y a n d eternal youth (the w o m e n in Vogue, the m e n on the c o v e r of Men's Health), culturally sanctioned a n d c o m m e r c i a l l y d r i v e n . S h e ' s right, o f c o u r s e . E x t r e m e b o d y modification, h o w e v e r , i s the antithesis. I t ' s a b o u t redefining the aesthetic, even the b o u n d aries, o f the b o d y .

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' A n d w h a t a b o u t c i r c u m c i s i o n ? ' s h e s a y s a s a n afterthought. K a r a , b y the w a y , i s distractingly beautiful. S e a r c h i n g for c o m m o n g r o u n d , w e s k i m a c r o s s b o d y - i m a g e d i s t o r t i o n s in n e u r o l o g i c a l d i s o r d e r s s u c h as e p i l e p s y and s t r o k e . W e d i s c u s s hysterical p a r a l y s i s , p h a n t o m l i m b s , and t r a n s s e x u a l i s m . I tell her a b o u t a n o s o g n o s i a , which m e a n s 'lack o f k n o w l e d g e o f i l l n e s s ' . P e o p l e with s e v e r e n e u r o l o g i c a l d i s abilities — q u a d r i p l e g i a , s a y — s o m e t i m e s s h o w a c o m p l e t e lack o f a w a r e n e s s o f their condition. ( I r e m e m b e r o n c e chatting with a m a n w h o w a s p a r a l y s e d from the neck d o w n . H e w a s telling me a b o u t his p l a n s to go r o c k c l i m b i n g at the w e e k e n d . ) I a g r e e that ' b o d y i m a g e ' is a fascinating area for research, but c a n ' t i m m e d i a t e l y s e e a point o f connection b e t w e e n K a r a ' s interests a n d my o w n . I tell her I'll think a b o u t it. A t h o m e , I stand n a k e d i n front o f the b a t h r o o m mirror. N o t e x a c t l y Men's Health, I think. W h a t m i g h t a little b o d y art do for m e ? I tell m y wife I ' m thinking o f h a v i n g m y penis tattooed. 'What do you have in m i n d ? ' 'Wolverhampton

Wanderers'

S h e l o o k s a t m e . ' O r m a y b e just Wolves'

116

The

Story of Einstein's Brain

Einstein: s h o c k - h a i r e d a n d s o c k l e s s g e n i u s , a v u n c u l a r s y m b o l of p u r e intellect, h e a d in a whirlwind of e q u a t i o n s a n d s p i r a l l i n g 2

g a l a x i e s , cultural icon. L o g o : E = m c . Scientist, s a g e , h u m a n i tarian, a m b i g u o u s pacifist, l o u s y h u s b a n d , n e g l i g e n t father, a n d now, w h a t ' s left of h i m , f r a g m e n t s of b r a i n in a jar. N o t l o n g after E i n s t e i n ' s death in 1955, R o l a n d B a r t h e s called his brain a mythical object, a p a r a d o x i c a l conflation of m a n , m a g i c , and m a c h i n e . N e a r l y fifty y e a r s o n , the m y t h r e m a i n s potent. To l o o k at a n y b r a i n is to confront a d e e p m y s t e r y . Y o u fall into the frame of an i m p o s s i b l e p i c t u r e , an E s c h e r stairway, a s c e n d i n g and d e s c e n d i n g a t the s a m e time. T h e b r a i n c a n ' t b e the theatre of c o n s c i o u s n e s s — i t ' s a solid o b j e c t — a n d yet it m u s t b e b e c a u s e y o u are c o n t e m p l a t i n g the s c e n e o n the f l o o d l i t s t a g e in your own head. But, looking at photographs of Einstein's brain - s n a p p e d

in the interlude b e t w e e n

extraction

from

the c r a n i u m and d e c i m a t i o n a t the h a n d s o f P r i n c e t o n H o s p i tal's d u t y p a t h o l o g i s t , T h o m a s H a r v e y — y o u feel the pull of myth as well as mystery. It is difficult n o t to s e e the o b j e c t

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as a s a c r e d relic. T h i s is the thing that bent the u n i v e r s e and humbled time. T h e r e w a s r u m o u r a n d s p e c u l a t i o n a b o u t the b r a i n from the start: it w a s h u g e a n d s t r a n g e , a n d then a g a i n it w a s m y s t e r i o u s l y tiny, the size of a walnut. In fact, it l o o k e d o r d i n a r y and w e i g h e d 2.7 p o u n d s . A b o u t a v e r a g e . I t w a s r e m o v e d within s e v e n h o u r s o f death, w e i g h e d fresh, then f i x e d i n formalin. After it h a d b e e n p h o t o g r a p h e d from all s i d e s , and m e a s u r e d with callipers, the cerebral h e m i s p h e r e s w e r e s e p a r a t e d and d i c e d into 240 b l o c k s . T h e n the b r a i n d i s a p p e a r e d . It followed H a r v e y into obscurity. S o o n after the a u t o p s y , H a r v e y h a d a n n o u n c e d that E i n stein's b r a i n w o u l d b e u s e d for scientific research and there w a s a tussle for p o s s e s s i o n b e t w e e n P r i n c e t o n and N e w Y o r k ' s Montefiore Medical Center. T h e y b o t h lost out. H a r v e y simply t o o k the p i e c e s h o m e with him a n d s t o r e d them i n c o o k i e j a r s . N e v e r m i n d his l a c k of qualifications for the j o b (he w a s a clinical p a t h o l o g i s t , n o t a n e u r o s c i e n t i s t ) , he w o u l d be the o n e to u n l o c k the secret o f E i n s t e i n ' s b r a i n . T h e p a t h o l o g i s t w a s a c c u s e d o f a s m a s h - a n d - g r a b exercise a n d , t h o u g h H a r v e y a l w a y s maintained h e had acted o n the authority

of

Einstein's

executor,

Otto

Nathan,

not

many

b e l i e v e d h i m . N a t h a n called him a thief a n d a liar and H a r v e y e v e n t u a l l y left P r i n c e t o n u n d e r a c l o u d , a l l e g e d l y fired for not r e l i n q u i s h i n g the b r a i n . He v a n i s h e d from the scene — but he h u n g o n t o his c o o k i e j a r s . I n 1978 H a r v e y w a s tracked d o w n b y S t e v e n L e v y , a j o u r n a l i s t w o r k i n g for the New Jersey Monthly. L e v y found h i m l i v i n g i n W i c h i t a , K a n s a s . T h e remnants o f E i n s t e i n ' s b r a i n w e r e in a b o x m a r k e d Costa Cider.

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T w o d e c a d e s later another j o u r n a l i s t t u r n e d u p : Michael Paterniti. T h e K e e p e r o f the B r a i n w a s then well into his e i g h t ies and l i v i n g in a b a s e m e n t b a c k in P r i n c e t o n . T o g e t h e r they set off for C a l i f o r n i a in a rented B u i c k S k y l a r k w i t h E i n s t e i n ' s brain stashed in the trunk, floating in a T u p p e r w a r e container. Paterniti w a n t e d to e x p l o r e r u m o u r s that it m i g h t be c l o n e d , or s o l d t o Michael J a c k s o n for m i l l i o n s o f d o l l a r s , b u t H a r v e y wasn't saying very much. T h e y ended u p a t the h o m e o f E i n s t e i n ' s g r a n d d a u g h t e r , E v e l y n , w h o s e e m e d less i n a w e o f the relic than a n y o n e e l s e . Paterniti's o w n reactions w e r e c o m p l e x . ' I n e v e r t h o u g h t that, h o l d i n g E i n s t e i n ' s b r a i n , I'd s o m e h o w i m a g i n e e a t i n g it,' h e s a i d at o n e point. T h e n , at a s e e d y motel on the w a y h o m e , he s l e p t with it: 'I go to b e d . I put E i n s t e i n ' s b r a i n on o n e p i l l o w a n d rest my o w n head on the other next to it, six inches a w a y ' W h a t a b o u t the science? W a s E i n s t e i n ' s b r a i n i n a n y w a y extraordinary? Despite H a r v e y ' s pledge, no study w a s conducted for three d e c a d e s after the c o n t e n t i o u s a u t o p s y . B y n o w h e had b e g u n t o mail bits o f b r a i n t o p r o m i n e n t n e u r o s c i e n t i s t s , p e o p l e better p l a c e d than he to e x a m i n e the material. Four sugar cube-sized pieces arrived at Marian D i a m o n d ' s Berkeley office in a m a y o n n a i s e jar. S h e e x a m i n e d the cellular structure o f the s p e c i m e n s m i c r o s c o p i c a l l y , finding a n u n u s u ally high ratio of glial cells to n e u r o n s in the inferior parietal l o b e , a n a r e a k n o w n t o b e a s s o c i a t e d with m a t h e m a t i c a l a n d spatial r e a s o n i n g . N e u r o n s are the b a s i c functional units o f the brain and the glia p r o v i d e the m e t a b o l i c a n d structural s u p p o r t required for them to do their w o r k . As for overall a n a t o m y , the first s t u d y a p p e a r e d in 1999.

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S a n d r a W i t e l s o n o f M c M a s t e r University, O n t a r i o , h a d r e c e i v e d , u n s o l i c i t e d , a p a c k a g e of b r a i n p i e c e s which she and her c o l l e a g u e s set a b o u t w e i g h i n g , m e a s u r i n g , a n d c o m p a r i n g with other b r a i n s . A g a i n , the inferior parietal l o b e s t o o d out as u n u s u a l , b e i n g 15 p e r cent larger than n o r m a l ; and the S y l v i a n fissure, which m a r k s the t e m p o r a l - p a r i e t a l b o u n d a r y , t o o k an o d d u p w a r d turn. S u c h o b s e r v a t i o n s h a v e b e e n d i s m i s s e d i n s o m e quarters a s little m o r e than primitive, b u m p - f o n d l i n g p h r e n o l o g y . Einstein, they say, w o u l d h a v e b e e n a p p a l l e d by the crudity of the science. I am not so s u r e . T h e r e is a picture of the G r e a t M a n u n d e r g o i n g E E G b r a i n w a v e r e c o r d i n g — his h e a d a n e x p l o s i o n o f wild hair a n d e l e c t r o d e l e a d s — while he is b e i n g a s k e d to 'think of relativi t y ' . H e w a s clearly g a m e for a l a u g h . A n d the b u m p a t least has a p l a u s i b l e location g i v e n E i n s t e i n ' s mathematical p r o w e s s and w h a t w e a l r e a d y k n o w a b o u t the o r g a n i z a t i o n o f brain functions. It is s o m e t h i n g . S o m e y e a r s a g o my y o u n g s o n a n d I w e r e in a s h o e s h o p in C a m b r i d g e w h e n in c a m e S t e p h e n H a w k i n g in his m o t o r i z e d wheelchair.

No

present-day

scientist

matches

Einstein's

celebrity, b u t H a w k i n g c o m e s c l o s e s t . L i k e Einstein h e s y m b o l izes p u r e intelligence. T h e shining m i n d i n the shrivelled b o d y h a s entered the p o p u l a r i m a g i n a t i o n . I ' v e yet to s e e his w a s t e d s h a p e on a T - s h i r t or his m u g on a m u g , but he h a s a p p e a r e d in e p i s o d e s of Star Trek ( r u b b i n g s h o u l d e r s with Einstein and N e w t o n ) a n d The Simpsons. As R o l a n d B a r t h e s remarks, b e i n g t u r n e d into a c a r t o o n is a s i g n that o n e h a s b e c o m e a legend. T h e r e w a s a w o m a n h e l p i n g h i m and they w e r e l o o k i n g at a r a c k o f c h e a p trainers. H a w k i n g d i d n ' t s e e m v e r y interested,

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t h o u g h i t w a s hard t o tell. M y s o n went c l o s e u p a n d s t a r e d a n d I expected him to s a y s o m e t h i n g indiscreet, b u t he lost interest. T h e trainers h e w a s e y e i n g w e r e a cut a b o v e H a w k i n g ' s . H e w a s not i m p r e s s e d , t h o u g h I felt p e c u l i a r l y t o u c h e d . T h i s w a s the m a n w h o visited b l a c k h o l e s from his wheelchair a n d surfed event horizons. A n d h e did s o i n T r u - F o r m trainers. B a r t h e s w o u l d h a v e liked that. It w o u l d h a v e signified s o m e t h i n g . A n d now Einstein's brain is back at Princeton Hospital. Actually, not as s u c h . It h a s a n e w o w n e r , o n e Elliot K r a u s s , p a t h o l o g i s t . He k e e p s it in a jar s o m e w h e r e secret.

They're perpetuating the

myth.

Harry? I didn't mean to startle you. But they are, don't you think? T h e p a r a d o x i c a l conflation o f m a n , m a g i c , a n d machine? Quite. N e u r o s c i e n c e thrives o n p a r a d o x i c a l conflations. Conflating m i n d and matter s e e m s p a r a d o x i c a l t o most people. Yes. It's hard to equate mental life with the sludgy stuff of the brain.

We should never lose sight of the

fact that the brain is a dollop of mush. I should know. O k a y - man, magic, machine, and mush.

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But trying to explain the genius of Einstein by measuring his bumps with callipers! It's phrenology. T h e r e ' s o n l y s o m u c h y o u can d o . H e ' s b e e n d e a d h a l f a century. H i s b r a i n is all in bits. I am thankful for small mercies.

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neuropsychology: noun [mass noun] the study of the relationship between behaviour, emotion, and cognition on the one hand, and brain function on the other. The New

Oxford Dictionary of English

A r t i c l e s o f faith: 1. T h e b r a i n is the o r g a n of the m i n d . 2. T h e mind is modular. 3 . T h e m o d u l a r i t y o f m i n d i s reflected i n the w o r k i n g s o f the brain.

The brain is the organ of the mind. No o n e d o u b t s that the b r a i n is the r o o t of all b e h a v i o u r and e x p e r i e n c e . If y o u b l o w out the contents of a p e r s o n ' s h e a d — as s c h o o l b o y s u s e d to b l o w o u t the contents of b i r d s ' e g g s — y o u a r e , likewise, left with an e m p t y shell. The mind is modular. Mental life is d i v e r s e a n d d i v i s i b l e . T h e mind is not a m o n o l i t h . We d i s t i n g u i s h the c o l o u r of an a p p l e

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f r o m its s h a p e , w e i g h t , and texture as we lift it from the fruit b o w l ; a n d a s w e take a bite w e s e p a r a t e the s n a p p i n g , crunching s o u n d f r o m the taste o f the j u i c e . T h e n , l o o k i n g b a c k o n the e x p e r i e n c e , w e s e g r e g a t e r a w sensation from the i m a g e s w e h o l d in m e m o r y . P e r c e p t i o n a n d m e m o r y are just t w o d o m a i n s . T h e mind i s a much broader confederation. T h e r e is also reason, emotion, l a n g u a g e , m o t i v a t i o n , a n d action. T h e s e facets o f mind function independently, at least to s o m e d e g r e e . It is p o s s i b l e to find malfunction in o n e d o m a i n a l o n g s i d e n o r m a l operation in o t h e r s . A n a m n e s i a c a p p r e c i a t e s all o f the s e n s o r y d i m e n s i o n s o f e a t i n g a n a p p l e , b u t h a s n o recollection o f the experience a n h o u r later. T h e n a g a i n , s o m e o n e with diminished s e n s e s but m e m o r y intact — a blind p e r s o n , s a y — h a s no difficulty r e m e m b e r i n g . N o n e o f this offends c o m m o n s e n s e . The modularity of mind is reflected in the workings of the brain. Mental functions a r e b i o l o g i c a l l y c o m p a r t m e n t a l i z e d . Different b r a i n s y s t e m s s u b s e r v e different p s y c h o l o g i c a l functions. It f o l l o w s that specified d a m a g e to the b r a i n h a s predictable functional c o n s e q u e n c e s .

* * *

mind: noun 1 the element of a person that enables them to be aware of the world and their experiences, to think, and to feel; the faculty of consciousness and t h o u g h t . . . brain: noun 1 an organ of soft nervous tissue contained in the skull of vertebrates, functioning as the coordinating centre of sensation and intellectual and nervous activity . . .

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self: noun (pl. selves) a person's essential being that distinguishes them from others, especially considered as the object of introspection . . . The New

Oxford Dictionary of English

A foreigner visiting Oxford or Cambridge for the first time is shown a number of colleges, libraries, playing fields, museums, scientific departments and administrative offices. He then asks 'But where is the University? I have seen where the members of the Colleges live, where the Registrar works, where the scientists experiment and the rest. But I have not yet seen the University in which reside and work the members of your University.' It has then to be explained to him that the University is not another collateral institution, some ulterior counterpart to the colleges, laboratories and offices which he has seen. The University is just the way in which all that he has already seen is organized. Gilbert Ryle, The Concept of Mind

T h e self has n o l o c a t i o n , h o w e v e r natural i t s e e m s for u s t o believe o t h e r w i s e . R y l e w a s r e c o n f i g u r i n g the ' m i n d - b o d y p r o b l e m ' , the ancient m y s t e r y : h o w d o mental e v e n t s a r i s e from physical s u b s t a n c e ? H i s s u g g e s t i o n w a s that, c o n t r a r y t o the assumptions of many philosophers and psychologists, it w a s a mistake to put m i n d a n d b o d y on the s a m e p l a n e of a n a l y s i s — a ' c a t e g o r y m i s t a k e ' . J u s t as the s t r a n g e r c o u l d not find 'the university' b e y o n d the l a b s , offices, and p l a y i n g fields, so we are hard put to d i s c o v e r a n y trace of a c o n s c i o u s m i n d , or self, in the

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b r a i n . T h e r e is no g h o s t in the m a c h i n e . M i n d s are the p r o d u c t o f b r a i n s , a n d s e l v e s d e p e n d u p o n m i n d s , but they require different f o r m s o f u n d e r s t a n d i n g . I am u s i n g a p e r s o n a l c o m p u t e r to t y p e these w o r d s . T h e y a p p e a r o n the s c r e e n b y virtue o f the w o r d p r o c e s s i n g software, essentially a set of instructions installed in the c o m p u t e r . T h e o p e r a t i o n s o f the s o f t w a r e are realized t h r o u g h the h a r d w a r e o f the c o m p u t e r ' s electronic microcircuitry. D e t a i l e d k n o w l e d g e of the h a r d w a r e is of little help in u n d e r s t a n d i n g the software, a n d v i c e v e r s a . B o t h h a r d w a r e and software are irrelevant to the content of the text. I h a p p e n to be writing a b o u t m i n d s , brains, a n d s e l v e s , b u t it c o u l d be a n y t h i n g — a g u i d e to sea fishing, a s u i c i d e n o t e or a J a p a n e s e haiku. T h i n k of the brain as the h a r d w a r e , the m i n d as the s o f t w a r e , a n d the s e l f as the text on the screen. In fact, w h y n o t a h a i k u ?

A true enigma: The self looks inward and finds Nothing hut neurons.

No m o r e haikus, I p r o m i s e .

* * * L i k e the s y m b o l on a d o l l a r bill, my e y e floats a b o v e a p y r a m i d . T h e four s i d e s o f the p y r a m i d represent the p e r s o n , the mind, the b r a i n , a n d the w o r l d . W h e n I ' m with a patient I ' m a w a r e , at different times, of each

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side of the p y r a m i d . Mostly, my attention is d r a w n to the person. It is a person who has come to see me or who is visited by me on a hospital w a r d . It is a p e r s o n w h o r e p o r t s a s y m p t o m of s o m e kind ( ' I ' m h a v i n g p r o b l e m s with m y m e m o r y ' ; ' I c a n ' t c o n c e n trate on anything'; 'I b r e a k d o w n in tears if s o m e o n e s a y s a kind w o r d ' ) . T h e r e is a l w a y s an 'I'. A n d e v e n w h e n — e s p e c i a l l y w h e n — the 'I' is d e f o r m e d by injury or d i s e a s e , w h e n it is s u b m e r g e d or d i s p e r s e d a n d h a s no v o i c e , I strive to m a k e it visible and coherent. T h i s is as m u c h for my benefit as theirs. A n d then I g l a n c e a c r o s s the p l a n e of the mind. ' Y o u ' r e h a v i n g p r o b l e m s with y o u r m e m o r y ? ' I say. ' T e l l m e , i n w h a t w a y d o e s y o u r m e m o r y let y o u d o w n ? ' I q u e s t i o n a n d p r o b e , seeking clues to the n a t u r e of the p r o b l e m . I k n o w that m e m o r y , and therefore m e m o r y d i s o r d e r , takes m a n y f o r m s . I c a n u s e special tests to help define and quantify the d i s o r d e r . It is a l s o important t o k n o w whether other c o m p o n e n t s o f the p a t i e n t ' s mental a p p a r a t u s are s h o w i n g s i g n s o f w e a r a n d tear. T h e confederation o f mental p r o c e s s e s w e call 'the m i n d ' c a n b r e a k d o w n i n w a y s not a l w a y s evident t o the p e r s o n w h o s e mind i t is. T h e y m i g h t c o m p l a i n o f m e m o r y i m p a i r m e n t , b u t u n k n o w n t o them there c o u l d b e other p r o b l e m s : subtle c h a n g e s in perception, say, or r e a s o n i n g or e m o t i o n . I take n o t e of their s y m p t o m s , but all the while I am l o o k i n g for other s i g n s . N e x t , m y g a z e shifts t o the third s u r f a c e o f the p y r a m i d . T h i s is w h e n I c o n s i d e r s i g n s a n d s y m p t o m s in relation to the w o r k ings of the brain. I m i g h t , for e x a m p l e , take certain failures of m e m o r y t o indicate a particular f o r m o f b r a i n d i s e a s e . O r , c o n versely, I m i g h t u s e k n o w l e d g e of a p a t i e n t ' s b r a i n d i s o r d e r to g u i d e m y u n d e r s t a n d i n g o f their p s y c h o l o g i c a l c o n d i t i o n . M y

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o b s e r v a t i o n s are set a l o n g s i d e other f o r m s o f e v i d e n c e , includi n g the p h y s i c a l i n v e s t i g a t i o n s o f n e u r o l o g i s t s and s u r g e o n s , a n d the i m a g e s m a d e a v a i l a b l e v i a b r a i n - s c a n n i n g m a c h i n e s . T h e fourth s i d e of the p y r a m i d represents the world. H e r e , I a m c o n c e r n e d with h o w the p e r s o n , g i v e n their brain d i s o r d e r a n d mental profile, can b e s t adjust to the w o r l d a r o u n d them. H o w will they g e t b y ? F o r the p e r s o n c o n c e r n e d this is, o f c o u r s e , the o n l y q u e s t i o n that matters.

You sound like an expert. I am. So you didn't mean what you said before: that neuropsychology was what you felt most profoundly ignorant about. It was a rhetorical shimmy. N o t entirely. I t ' s e a s y e n o u g h t o clip definitions a n d b a s i c a s s u m p t i o n s together. L i k e I s a i d , I c o u l d ad lib a b o u t the structure and functions of the b r a i n - no p r o b l e m . A n d , true, t h o s e A r t i c l e s o f Faith g e t m e t h r o u g h the w o r k i n g day. But? T h e r e ' s s o m e t h i n g q u i r k y a t the philosophical centre o f n e u r o p s y c h o l o g y . A n i n c o m p l e t e n e s s . T h e A r t i c l e s o f F a i t h s u g g e s t a n integrity that, I fear, d o e s n ' t actually apply. No science is whole. Physics hasn't got a Theory of

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died intellectually frustrated.

If any science arrived at a state of completion, the scientists would lay down their tools. Job done. And there are definitely strange things at the philosophical heart of modern physics. Why should you wrestle with doubt? F o r all I k n o w , p h y s i c i s t s will o n e d a y f o r m u l a t e their T h e o r y o f E v e r y t h i n g . B u t I ' m inclined to think that o u r g o a l of d e s c r i b i n g mental life in t e r m s of b r a i n activity is not entirely feasible. I w o n d e r if the enterprise is q u i x o t i c . Why? B e c a u s e . . . O h , I d o n ' t k n o w . W h a t w a s that description o f D o n Q u i x o t e ? A m u d d l e - h e a d e d fool with frequent lucid intervals? G e t b a c k to m e when I ' m lucid. But does it stop you doing your job? No. Then why play The Knight of the Doleful Countenance? H a v e you read Cervantes? No. Me neither. Are you saying that the Articles of Faith are fine as far as they go—but they don't go far enough? Something is lacking? M y c o n c e r n i s that the A r t i c l e s o f F a i t h d i s r e g a r d s o m e i m p o r t a n t features o f mental life, w h i c h , if we are ever to a c h i e v e a coherent s c i e n c e of

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m i n d a n d b r a i n , will either h a v e t o b e b r o u g h t into the frame of n e u r o s c i e n c e — or thrown out. Such as? T h e things that matter m o s t t o u s : c o n s c i o u s e x p e r i e n c e a n d o u r s e n s e o f self. Is neuropsychology concerned with such things? O f c o u r s e . I ' v e m a d e a l i v i n g b y virtue o f the fact that the b r a i n is a v e r y flimsy construction. Its functions are easily w a r p e d by d i s e a s e and injury. T h e r e ' s n o s h o r t a g e o f tales t o tell o f fragile b r a i n s a n d shattered s e l v e s . Indeed. T h e q u e s t i o n is, h o w b e s t to tell them: as the science o f the b r a i n o r the art o f b e i n g h u m a n ? T h e h i d d e n c o n t r a p t i o n s o f the illusionist o r the illusion itself? Surely, for a clinical practitioner, both perspectives are necessary. Sometimes you are talking about the brain, and sometimes about the person, the self, consciousness and all. O n e h a s t o b e b i l i n g u a l , s w i t c h i n g from the l a n g u a g e o f n e u r o s c i e n c e t o the l a n g u a g e o f e x p e r i e n c e ; from talk o f ' b r a i n s y s t e m s ' and ' p a t h o l o g y ' t o talk o f ' h o p e ' , ' d r e a d ' , ' p a i n ' , ' j o y ' , ' l o v e ' , ' l o s s ' , a n d all the other a n i m a l s , fierce a n d t a m e , i n the z o o o f h u m a n consciousness. Then you seem to have tied the package: brain and person complete. centre?

Where's the strange philosophical

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I h a v e c o m e to realize h o w d e e p l y o d d it is to a s s u m e that b r a i n s a n d s e l v e s c o n v e r g e . You think they don't go together? I think they d o n ' t go together in w a y s that contemporary neuroscience would recognize. But they go together? W h a t d o y o u take m e for?

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M i d t o w n M a n h a t t a n . T h e p o w e r w a s out. I s t o o d a t the w i n d o w a s v e i n s o f l i g h t n i n g c r a c k l e d o v e r the G e n e r a l Electric b u i l d i n g a b l o c k a w a y . Its giant, g a l v a n i c t h r o e s w e r e startling. T h e thund e r r o l l e d t h r o u g h my g u t as it rattled the w i n d o w s and humbled the m o n u m e n t a l architecture. A n d then, a n o c e a n o f rain. N e w Y o r k w a s A t l a n t i s . I c o u l d s e e f i s h e s a n d w h a l e s and m e r m a i d s . W h e n the s t o r m d i e d the p o w e r w a s still out. I l a y on the b e d , drifted into a s l u m b e r and w o k e to find a girl s t a n d i n g at the w i n d o w , l o o k i n g o u t as I h a d l o o k e d out u p o n the storm. ' D o n ' t b e afraid,' she s a i d , still w a t c h i n g the rain, which w a s g e n t l e now. ' C o m e with m e . ' We left by a d o o r I h a d n ' t noticed b e f o r e . I followed her d o w n dim-lit c o r r i d o r s a n d v e r t i g i n o u s stairwells, then out into the s w i r l i n g street w h e r e a car w a s w a i t i n g . ' R i g h t this w a y , ' s h e s m i l e d . W e w e r e s o m e w h e r e o n the U p p e r E a s t S i d e . I r e c o g n i z e d

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her at o n c e , even in the g l o o m : C o l l i c u l a B r o d m a n n , P r e s i d e n t o f the A c a d e m y . ' N e u r o s c i e n c e is a b r o a d church,' she s a i d , ' b u t there is c o n cern that y o u m a y b e drifting t o w a r d s M y s t e r i a n i s m . ' O u t the w i n d o w a blue w h a l e d i p p e d majestically o v e r C e n t r a l P a r k . 'Oh?' ' T h e Disciplinary Council has received a complaint.' I t o o k the e n v e l o p e a n d read the letter. It a c c u s e d me of b r i n g i n g my p r o f e s s i o n and the broad church of neuroscience into disrepute (the s a m e p h r a s e ) o n a c c o u n t o f m y anti-scientific posture

and

espousal of Mysterian philosophy.

' D o e s this constitute a c h a r g e of s o m e k i n d ? ' I a s k e d . ' N o , ' s a i d C o l l i c u l a , 'but there are p r o c e d u r e s . ' ' A m I to be c h a r g e d ? ' ' T h a t ' s a matter for the I n v e s t i g a t o r y P a n e l . T h e y will first consider y o u r r e s p o n s e . ' T h r e e s o l e m n f i g u r e s entered the r o o m . 'Now?' I s a i d . ' Y e s , i f y o u are willing.' I t w a s hard t o tell w h o w a s s p e a k i n g . T h e three w e r e s e a t e d in s h a d o w s o m e distance away. T h e n the m a n on the left — N u m b e r 1 — d r e w a c a n d l e to h i m a n d started to r e a d f r o m a file. I r e c o g n i z e d my o w n w o r d s : My area of supposed expertise, neuropsychology, is the subject about which I feel the most profound ignorance. H e l o o k e d u p from the f i l e . ' I g n o r a n c e ? ' ' P r o f o u n d i g n o r a n c e , ' I confirmed. ' I f I w e r e a patient of y o u r s , w o u l d I be c o m f o r t e d to hear your proclamations of ignorance?'

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' P r o f e s s i o n a l s s h o u l d a c k n o w l e d g e their limitations,' I s a i d . T h e candle passed to N u m b e r 2, a w o m a n . She began reading f r o m her file. My w o r d s a g a i n : I find myself edging towards a doubt that it means anything at all to say that the brain generates consciousness. T h e r e w a s a l o n g p a u s e which, p e r h a p s , I w a s expected to fill. 'You are a professional neuropsychologist?' 'Yes.' ' H a v e y o u e v e r b e e n certified i n s a n e ? ' N u m b e r 3 w a s a m a n : Far from being the Holy Grail of neuroscience,

the search for consciousness within the circuitry of an

individual brain can lead only to fool's gold. H e w a s direct. ' Y o u b e l i e v e that the relationship between m i n d a n d matter is u n f a t h o m a b l e . In other w o r d s , y o u are a Mysterian.' ' N o . I wouldn't be so bold.' ' A n d yet y o u find c o m f o r t in M y s t e r i a n i s m . ' 'I am a clinician. I h a v e it i n g r a i n e d in me that s o m e p r o b l e m s h a v e no s o l u t i o n a n d that there are times w h e n it is w i s e to a c c e p t the fact. A s W i t t g e n s t e i n s a i d , the p h i l o s o p h e r ' s treatm e n t of a q u e s t i o n is like the treatment of an illness. But if the d i s e a s e is i n c u r a b l e , then so be it. I ' m c o m f o r t a b l e with the idea of not h a v i n g s o l u t i o n s to e v e r y p r o b l e m . I g u e s s t h e r e ' s a l s o a part o f m e that likes m y s t e r y for m y s t e r y ' s s a k e . O m n i s c i e n c e w o u l d b e insufferably t e d i o u s . ' ' A n d as far as c o n s c i o u s n e s s is c o n c e r n e d , the d i s e a s e is incurable?' ' C o u l d b e . I d o n ' t k n o w . I ' m indifferent to the m i n d - b o d y p r o b l e m . ' T h i s w a s n o t true; o r rather i t w a s not the w h o l e truth.

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' B u t d o y o u , o r d o n ' t y o u , b e l i e v e that n e u r o s c i e n c e can find the s o l u t i o n ? ' ' I ' m not s u r e n e u r o s c i e n c e h a s e v e n found the p r o b l e m , ' I s a i d . ' T h e fly is still stuck in the b o t t l e . ' C o l l i c u l a offered m e a g l a s s o f w i n e . ' W h a t d o y o u b e l i e v e ? ' she asked. ' N o t h i n g , ' I replied. ' S o m e t i m e s I w o n d e r " H o w d o e s m e a t b e c o m e m i n d ? " and i t s e e m s a b s u r d . ' 'Indeed.' ' T h e n , other times, I s e e it as a p s e u d o - p r o b l e m , a screen of c o n f u s i o n . . . ' — I realized we w e r e sitting at a table, e a t i n g dinner. I had food in my m o u t h . I c h e w e d and s w a l l o w e d b e f o r e finishi n g the sentence — ' . . . behind which there i s a n e m p t y s p a c e . ' T h e food w a s g o o d . T h e w i n e w a s g o o d . C o l l i c u l a , I n o w noticed, w a s n a k e d . S o w a s I a n d , b e f o r e l o n g , w e w e r e m a k i n g love; she writhed w a r m l y b e n e a t h m e o n the g l a s s y f l o o r . T h e r e w a s a n a q u a r i u m b e l o w with s h a r k s g l i d i n g and s m a l l e r f i s h e s darting. How do I know this isn't a dream? I w o n d e r e d . N o w I w a s s t a n d i n g , n a k e d , b e f o r e the three s o l e m n figures. I s e e m e d to be g i v i n g a presentation. I l o o k e d at N u m b e r 1 a n d said: ' S o m e p e o p l e b e l i e v e that the u n i v e r s e and e v e r y t h i n g in it, including h u m a n m i n d s , i s m a d e o f physical stuff.' 'Materialism,' he s a i d . I turned to N u m b e r 2: ' T h e o p p o s i t e v i e w is that reality is non-material; physical objects a n d events are m a n i f e s t a t i o n s o f mental a c t i v i t y ' ' I d e a l i s m , ' she s a i d . ' T h e y b e l i e v e the physical w o r l d is a figment. T h e u n i v e r s e exists entirely on a mental or spiritual p l a n e . '

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'Hmm.' ' S o m e v e r s i o n s o f i d e a l i s m d o n ' t d e n y the physical w o r l d , b u t s a y w e c a n ' t h a v e direct k n o w l e d g e o f it. O b j e c t s and events a r e mental c o n s t r u c t i o n s b e c a u s e they c o m e to life o n l y in the a r e n a o f the m i n d . ' ' T h e u n o b s e r v e d tree falling i n the forest m a k e s n o s o u n d ? ' ' Y e s . A n d there are n o g r e e n l e a v e s o n the b r a n c h e s o r d a p p l e d s u n l i g h t o n the forest f l o o r . T h e c r e a k i n g , c r a s h i n g s o u n d s o f a falling tree, the i m a g e o f l e a v e s a n d g r e e n n e s s , a n d notions o f s u n l i g h t a n d d a p p l i n g are all c o n s t r u c t i o n s o f the m i n d . ' N u m b e r 3 w a s a b o u t to s p e a k , but I cut h i m short. I h a d to p r e s s o n : ' T h e third o p t i o n i s d u a l i s m . D u a l i s t s b e l i e v e that the w o r l d i s c o m p o s e d o f b o t h p h y s i c a l a n d mental stuff.' ' D u a l i s m is d e a d in the water,' s a i d N u m b e r 1. ' M o d e r n s c i e n c e h a s n o p l a c e for d u a l i s m . ' ' B u t intuitively it feels right,' I a d d e d . ' E v e n to materialists a n d i d e a l i s t s w h o reject the i d e a intellectually. E v e n t o y o u , perhaps.' He did not dissent. ' E v e r y normal person believes they h a v e a b o d y a n d m o s t tend to think there is m o r e to them than that. T h e y feel they h a v e mental qualities distinct from their

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p r o b a b l y m o s t — b e l i e v e they h a v e s o u l s that will s u r v i v e the d e a t h o f the b o d y . ' 'I h o p e y o u are n o t g o i n g to defend a b e l i e f in s o u l s and spirits,' s a i d N u m b e r 2 . ' C e r t a i n l y not.' Number 1 Mysterian?' 'No.'

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' T h e n y o u accept that science will s o l v e the p u z z l e o f c o n s c i o u s n e s s ; it is m e r e l y a matter of t i m e ? ' 'And research funding,' interjected N u m b e r 3, to the a m u s e ment of the others. ' N o , ' I said. N u m b e r 2 told me I w a s c o n f u s e d . N u m b e r 1 w o n d e r e d whether I had m i s h e a r d his q u e s t i o n s . I told h i m I ' d h e a r d him perfectly well but that, with respect, his q u e s t i o n s w e r e s i m plistic. I k n e w what I w a n t e d to say. I w a n t e d to s a y s o m e t h i n g a b o u t the p r o b l e m o f c o n s c i o u s n e s s b e i n g built into s c i e n c e itself, b u t I hadn't thought i t t h r o u g h a n d , s u d d e n l y a w a r e o f m y n a k e d ness, w a s l o s i n g the thread o f m y a r g u m e n t . ' L e t ' s go back to Descartes,' I said, as much to myself as to the others. I w a s l o o k i n g for a w a y t h r o u g h . 'Must w e ? ' T h i s w a s N u m b e r 2. ' Y e s we m u s t , ' I s a i d . ' W e m u s t . ' I s t r o d e o v e r to w h e r e the three w e r e s e a t e d , leaned f o r w a r d , and rested my e l b o w s on the table directly in front of N u m b e r 2. ' H e has a lot to a n s w e r for.' S h e s m i l e d , rather sweetly I t h o u g h t . I reminded them that the m i n d - b o d y p r o b l e m , the b e a s t we g r a p p l e with today, is a l e g a c y of the dualist i d e a s f o r m u l a t e d b y R e n e D e s c a r t e s i n the seventeenth century. H e w a s not the first p h i l o s o p h e r to d i s t i n g u i s h b e t w e e n m i n d a n d b o d y , b u t he crystallized that distinction and so set the t e r m s of all s u b s e quent d e b a t e a b o u t their relationship. In the p r o c e s s he r e l e a s e d a p a c k o f t r o u b l e s o m e d i c h o t o m i e s into the W e s t e r n w a y o f thinking: m i n d v e r s u s matter; subjective v e r s u s o b j e c t i v e ; observer versus observed.

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' Y o u c a n ' t b l a m e it all on D e s c a r t e s , ' said N u m b e r 3. ' O f c o u r s e not,' I s a i d . ' D u a l i s t i c thinking runs t h r o u g h e v e r y m a j o r r e l i g i o n - they all p r o m o t e the fallacious idea that b o d y a n d s o u l are s e p a r a t e entities.' N u m b e r 1 p o i n t e d o u t , correctly, that the i d e a a l m o s t certainly p r e d a t e s o r g a n i z e d r e l i g i o n b y m a n y t h o u s a n d s o f y e a r s . He s a i d it w e n t b a c k to the d a w n of h u m a n history. I a g r e e d . In fact, I b e l i e v e d it w a s p a r t of o u r b i o l o g i c a l m a k e - u p . I said that, quite p r o b a b l y , w e w e r e innately p r e d i s p o s e d t o think i n t e r m s o f the s e p a r a t i o n o f m i n d s a n d b o d i e s . T h e idea w a s built into the h a r d w a r e o f the h u m a n central n e r v o u s s y s t e m . E v o l u t i o n h a s e n d o w e d u s with b r a i n s that are naturally inclined t o certain w a y s o f thinking a b o u t p e o p l e , especially w h e n it c o m e s to interpreting their mental states. It w a s a c o n s e q u e n c e o f l i v i n g i n c o m p l e x social g r o u p s , a n d a b y - p r o d u c t o f the e v o l u t i o n o f l a n g u a g e . W e continually, a n d effortlessly, p i c ture e a c h o t h e r ' s t h o u g h t s a n d intentions. W e f o r m a s s e s s m e n t s of w h a t p e o p l e ' h a v e in m i n d ' - p r e s u p p o s i n g that there are s u c h t h i n g s a s m i n d s . W e are all m i n d - r e a d e r s . A n d the s a m e mental m a c h i n e r y e n a b l e s u s t o f o r m a n i d e a o f o u r s e l v e s a s unified a n d c o n t i n u o u s b e i n g s - to m a k e s e n s e of what is g o i n g o n with r e g a r d t o o u r o w n mental states. P e o p l e with i m p o v e r i s h e d m i n d - r e a d i n g skills ( s u c h as autistic p e o p l e ) , or with rich b u t unreliable interpretations o f their o w n a n d o t h e r s ' mental activities (like s c h i z o p h r e n i c s ) are s e v e r e l y d i s a d v a n t a g e d . W h a t D e s c a r t e s d i d , in effect, w a s to take this primordial intuition — the s e p a r a t e n e s s of b o d y a n d m i n d — and b u i l d a s y s t e m o f p h i l o s o p h y a r o u n d it. A n d the i d e a s h e formulated h a v e b e c o m e i n g r a i n e d i n o u r w a y o f thinking. H i s d i v i s i o n o f

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mind and matter, and the d e m a r c a t i o n of s u b j e c t i v e a n d o b j e c tive r e a l m s o f k n o w l e d g e , laid the f o u n d a t i o n s o f the m o d e r n scientific a g e . T h e m i n d - b o d y p r o b l e m and science itself s t e m f r o m the s a m e split in the fabric of reality. T h i s creates fundamental p r o b l e m s for a science of c o n s c i o u s n e s s . S c i e n c e p r o c e e d s by systematic o b s e r v a t i o n a n d e x p e r i m e n t a t i o n . T h e w h o l e p o i n t is to p r o v i d e factual, p u b l i c , k n o w l e d g e a b o u t the w o r l d as it is, independent o f p e r s o n a l feelings and o p i n i o n s , s t r i p p e d o f s u b jectivity — in other w o r d s , to p r o v i d e objective knowledge. B u t c o n s c i o u s n e s s , in e s s e n c e , is s u b j e c t i v e a n d p r i v a t e . I can i m a g ine y o u r experiences, b u t I d o n ' t h a v e t h e m , a n d y o u c a n n e v e r have mine. E x p e r i e n c e is a first-person b u s i n e s s . S c i e n c e o p e r ates in the third p e r s o n . ' S o , ' I s a i d , ' c o n s c i o u s n e s s p o s e s a f o r b i d d i n g c h a l l e n g e for science. W h a t m a k e s science s t r o n g a s a m e a n s o f u n d e r s t a n d ing the outer, material w o r l d — o b j e c t i v e , t h i r d - p e r s o n o b s e r vation — is precisely w h a t m a k e s it ineffectual w h e n it c o m e s to u n d e r s t a n d i n g the "inner w o r l d " o f c o n s c i o u s n e s s . ' ' W e can s t u d y b r a i n states a n d functions,' said N u m b e r 3. ' S i m p l y r e c o g n i z e that brain activity a n d c o n s c i o u s n e s s a r e o n e and the s a m e thing and the p r o b l e m g o e s a w a y . ' ' S o m e t i m e s I s e e it that w a y , a n d s o m e t i m e s I d o n ' t . ' 'Because you can't make up your m i n d ? ' ' N o , b e c a u s e t h e r e ' s m o r e than o n e w a y o f s e e i n g . I a g r e e that every c o n s c i o u s mental event, each and e v e r y t h o u g h t a n d e m o tion, is g r o u n d e d in s o m e physical state of the brain. B u t there are objective, third-person descriptions of the b r a i n a n d its functions; and then there are subjective, first-person e x p e r i e n c e s . '

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' A n d n e v e r the twain shall m e e t ? I s that w h a t y o u ' r e s a y i n g ? ' ' W h a t I think I ' m s a y i n g is that p h e n o m e n a l c o n s c i o u s n e s s the r a w feel of e x p e r i e n c e — is invisible to conventional scientific scrutiny a n d will forever r e m a i n s o . It is, by definition, s u b jective — w h e r e a s s c i e n c e , by definition, a d o p t s an objective s t a n c e . Y o u c a n ' t b e i n t w o p l a c e s a t o n c e . Y o u either experience c o n s c i o u s n e s s " f r o m the i n s i d e " ( a p a n g o f hunger, the blueness of the sky, the chill of an a u t u m n b r e e z e , sunlight d a p p l i n g the forest floor) or y o u v i e w it " f r o m the o u t s i d e " ( v a r i o u s configur a t i o n s o f neural activity a n d p a t t e r n s o f b e h a v i o u r associated with different b o d i l y states a n d c o n d i t i o n s in the external envir o n m e n t ) . S c i e n c e c a n s t u d y the neural activity, the b o d i l y states, the e n v i r o n m e n t a l c o n d i t i o n s , and the o u t w a r d b e h a v i o u r s — i n c l u d i n g v e r b a l b e h a v i o u r s that stand for different states o f a w a r e n e s s ( " T h a t h u r t s " ; " T h i s tastes like c h o c o l a t e " ; " M y heart l e a p s up w h e n I b e h o l d / A r a i n b o w in the s k y . . . " ) , b u t the quality — the feel — of o u r e x p e r i e n c e s remains forever p r i v a t e a n d therefore o u t of b o u n d s to scientific a n a l y s i s . I can't s e e a w a y r o u n d this. P r i v a t e n e s s is a fundamental constituent of consciousness.' N u m b e r 2 s i g h e d wearily. S u d d e n l y , and uncharacteristically, I felt a s u r g e of anger. ' A n d d o n ' t try to define it a w a y ! ' I s h o u t e d . ' D o n ' t tell me c o n s c i o u s n e s s s i m p l y d o e s n ' t exist in the material u n i v e r s e — that there is just the b r a i n a n d its functions — b e c a u s e , from w h e r e I stand, it fucking d o e s ! A n d , u n l e s s y o u ' r e a z o m b i e or a r o o t v e g e t a b l e , it d o e s for y o u , t o o . ' I instantly r e g r e t t e d m y o u t b u r s t . A w a r e a g a i n o f m y n a k e d n e s s , I felt r i d i c u l o u s . ( N e v e r g e t a n g r y with y o u r clothes off.)

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B u t , I thought, that's p r e c i s e l y the point. From where I stand. Only I occupy my position. Only you occupy yours. ' M i g h t there be a c o n v e r g e n c e of the s u b j e c t i v e a n d the objective if we had a detailed k n o w l e d g e of o u r b r a i n states, plus a m o r e refined technical v o c a b u l a r y to d e s c r i b e t h e m ? ' It was Collicula speaking. ' N o , ' I s a i d . ' W o r d s w o r t h c o u l d recast the d e s c r i p t i o n of his heart l e a p i n g up at the sight of a r a i n b o w in t e r m s of p h o t o n s of refracted sunlight s t i m u l a t i n g the cells of his retina, in turn g e n e r a t i n g specific patterns o f electrochemical activity t h r o u g h his brain, in turn l e a d i n g to stimulation of the adrenal g l a n d , in turn c a u s i n g a fluctuation in the rhythm of his heart. I am not convinced this takes us a n y further. It is still " h i s " e y e , " h i s " brain, and " h i s " heart that are the f o c u s o f interest, n o t t h o s e o f K e a t s o r C o l e r i d g e . I t i s the v i e w from w h e r e h e s t a n d s . H e i s , essentially, irreducibly, d e s c r i b i n g a p e r s o n a l point of view, n o t a pattern of neural s i g n a l s . ' 'I fail to s e e the r e l e v a n c e of poetry,' s a i d N u m b e r 2. So I q u o t e d another poet. ' R o b e r t F r o s t said that " P o e t r y is w h a t is lost in translation. It is also what is lost in interpretation." L i k e w i s e , c o n s c i o u s n e s s is lost in translating from first-person e x p e r i e n c e to t h i r d - p e r s o n description of brain states. O n e can a c c e p t , as I d o , that all p s y c h o l o g i c a l activity d e p e n d s o n n e u r o n a l activity, a n d o n e can chart the neural s u b s t r a t e s of this or that p s y c h o l o g i c a l p r o c e s s , but the p o e t r y of c o n s c i o u s n e s s h a s b e e n lost in the interpretation.' ' B r a i n activity and c o n s c i o u s n e s s are o n e a n d the s a m e thing,' said N u m b e r 3.

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' Y e s , t h e r e ' s truth in that statement.' ' T h e r e f o r e , since n e u r o s c i e n c e is b e s t p l a c e d to describe the w o r k i n g s of the b r a i n , it is clearly b e s t p l a c e d to g i v e an a c c o u n t of consciousness?' ' N o . I t d o e s n ' t follow.' 'I d e s p a i r , ' s a i d N u m b e r 2 u n d e r her breath. ' S o m e p e o p l e h a v e a r g u e d that c o n s c i o u s n e s s i s d o u b l e a s p e c t , ' I s a i d . 'It h a s an o b j e c t i v e a n d a subjective s i d e . It is u n i q u e in that r e s p e c t a n d so can't be treated in quite the s a m e w a y a s other natural p h e n o m e n a like c l o u d s o r flowers o r p e b b l e s , w h i c h c a n be u n d e r s t o o d from a p u r e l y objective s t a n d p o i n t . T h e r e is n o t h i n g mystical a b o u t subjective reality; it is j u s t different f r o m the o b j e c t i v e , science-friendly variety. It is just as real, j u s t as material, a n d h a s n o t h i n g to do with the kind of i m m a t e r i a l mental stuff that D e s c a r t e s b e l i e v e d in. Mental e v e n t s a r e b a s e d in p h y s i c a l events — the t w o coincide perfectly. T h e s u b j e c t i v e a n d the o b j e c t i v e are different takes o n the s a m e u n d e r l y i n g reality. B u t the subjective realm is out of b o u n d s to science.' ' A r e these y o u r b e l i e f s ? ' N u m b e r 1 a s k e d . C o m e to think of it, I really w a s n ' t s u r e , and the w o r d s spilled o u t in the thinking: ' I ' m really not s u r e . ' ' S o , w h a t d o y o u b e l i e v e ? ' C o l l i c u l a d e m a n d e d for a s e c o n d time. I w a s a b o u t to r e p e a t ' N o t h i n g ' , w h i c h w a s , in fact, as c l o s e to the truth as a n y t h i n g else I m i g h t h a v e s a i d , but I d i d n ' t want t h e m to think I w a s b e i n g p e r v e r s e ; a n d I d i d n ' t w a n t to be there all night. So I t o o k the e a s y o p t i o n . I p l a y e d it straight d o w n the line.

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'I am a materialist,' I s a i d . 'I b e l i e v e that the w o r l d a n d e v e r y thing in it is m a d e of p h y s i c a l stuff a n d , w h a t e v e r the o r i g i n s of the u n i v e r s e , we are a natural p r o d u c t of its material e v o l u t i o n : sentience, intellect, e m o t i o n s , m o r a l c o d e s a n d all. A l l b e h a v iour and e x p e r i e n c e , all k n o w l e d g e a n d u n d e r s t a n d i n g o f the w o r l d and o u r s e l v e s , d e p e n d u p o n the w o r k i n g s o f a p h y s i c a l d e v i c e : the b r a i n . ' There was a murmur of approval. ' G o o d . P e r h a p s , after all, y o u are not a M y s t e r i a n . ' T h i s w a s a non sequitur. M y s t e r i a n i s m and m a t e r i a l i s m a r e not mutually e x c l u s i v e . B u t I let it p a s s . P e r h a p s I w a s , p e r h a p s I w a s n ' t . W h o c a r e s ? At a n y r a t e , the three figures s e e m e d h a p p y with m y p r o n o u n c e m e n t . T h e y g a t h e r e d their p a p e r s a n d w e r e g o n e ; oddly, t h o u g h , I d i d n ' t s e e them l e a v e . T h a t c o u l d h a v e b e e n that; except n o w I found C o l l i c u l a sitting astride m e , her face lit b y the j a d e w a t e r s o f the a q u a r i u m below. ' W h a t d o y o u really b e l i e v e ? ' s h e a s k e d . 'I m e a n t w h a t I said a b o u t m a t e r i a l i s m , a n d I m e a n t w h a t I said a b o u t subjective e x p e r i e n c e b e i n g b e y o n d the reach of science. B u t , in truth, I really d o n ' t h a v e firm beliefs on the matter. I l o o k at the m i n d - b o d y p r o b l e m o n e w a y a n d it s e e m s to e v a p o r a t e . I l o o k at it another a n d I ' m tantalized.' ' P e r h a p s t h e r e ' s m o r e than o n e p r o b l e m , ' s h e s a i d . ' O r p e r h a p s y o u are m o r e than o n e p e r s o n . ' I w a s d e e p inside her n o w and c o u l d n ' t c a r e l e s s .

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No Water, No Moon

The Ghost Tree ( l )

I drive a c r o s s t o w n to the infirmary. J a k e is on o n e of the o r t h o p a e d i c w a r d s . T h e b e d s are p a c k e d i n r o w s a l o n g the w a l l s . W h e n I arrive his wife is at his b e d s i d e . S h e l o o k s a b o u t s e v e n teen, a year or t w o y o u n g e r than J a k e . T h e r e is no talk b e t w e e n them - a b u b b l e of silence. I get the i m p r e s s i o n there h a s b e e n no conversation for s o m e time. H e i s the i m a g e o f C h r i s t o n the C r o s s . M a t t e d curls o f b l a c k hair d r o p over sunken c h e e k s . H i s forehead is b r u i s e d and s c a b b e d w h e r e a c r o w n of t h o r n s m i g h t h a v e b e e n a n d a b e d sheet, c r u m p l e d at his h o l l o w midriff, s e r v e s as a loincloth. H i s lean, p a l e , u p p e r b o d y b e a r s other s c a r s o f the s m a s h : b r o a d purple g r a z e s and y e l l o w i n g c o n t u s i o n s . B u t a t the b o t t o m o f the b e d there i s n o t h i n g . T h e i m p l o d i n g metal o f the car s e v e r e d o n e l e g a t the m o m e n t o f collision. T h e other, m a n g l e d b e y o n d redemption, w a s s u r g i c a l l y r e m o v e d in the h o u r s that f o l l o w e d . If he is a car thief, then J a k e h a s p a i d a h i g h p r i c e for his m i s d e m e a n o u r s . O n l y now, a s the b a n d a g e d s t u m p a p p e a r s from under the sheet, do I notice that his right h a n d is a l s o m i s s i n g .

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He g i v e s a h a n d l e s s w a v e to an old m a n in a wheelchair. W h e n I p i c k up the m e d i c a l file from the n u r s i n g station the c h a r g e n u r s e tells m e o f J a k e ' s disturbed b e h a v i o u r . Yesterday he w a s incontinent a n d s m e a r e d his faeces into his w o u n d s . I am n o t l o o k i n g f o r w a r d to this. I feel cowardly. I want to turn and g o . B u t w h e n w e s p e a k h e i s perfectly pleasant. H e s e e m s c o m p o s e d , e v e n tranquil. H e puts m e a t m y e a s e . T h e pain i s tolerable now, he tells m e . Y e s t e r d a y it d r o v e him m a d . ' W h e r e d o e s it h u r t ? ' I a s k . ' L e f t foot,' h e s a y s . I run t h r o u g h s o m e routine q u e s t i o n s a b o u t levels of c o n s c i o u s n e s s a n d recall o f e v e n t s i n the h o u r s immediately f o l l o w i n g the accident. J a k e can't r e m e m b e r . ' H e was c o n s c i o u s , ' s a y s the child b r i d e . ' H o w can y o u be so s u r e ? ' I ask. S h e k n o w s b e c a u s e J a k e h a d activated the d i a l - h o m e function on his m o b i l e p h o n e , p e r h a p s adventitiously as a result of the i m p a c t o r i n a m o m e n t o f lucidity. T h e r e w a s n o o n e h o m e when the p h o n e r a n g . T h e a n s w e r i n g m a c h i n e t o o k the m e s s a g e and s t o r e d it until s h e returned next m o r n i n g from her night shift at the filling station. J a k e w a s calling for her, w a i l i n g like a baby. I do my stuff a n d l e a v e . I ' v e h a d e n o u g h . It is only four in the afternoon a n d I ' m d u e to attend a m e e t i n g later o n , but I p h o n e in with an e x c u s e a n d h e a d for h o m e . It is a s u m m e r ' s e v e n i n g , g r e y and o v e r c a s t , perfectly still e x c e p t for a tiny p l a n e d r o n i n g t h r o u g h l o w c l o u d , in and out of visibility. There are people in there, I think, b u t o n l y with an effort o f i m a g i n a t i o n . F r o m this d i s t a n c e , w h o w o u l d care i f i t fell f r o m the s k y ?

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I am sitting out in the g a r d e n a n d I m u s t h a v e d o z e d o f f b e c a u s e the student dissertation I w a s r e a d i n g h a s fallen to the g r o u n d , face d o w n . M y coffee i s s t o n e c o l d . E v i d e n t l y , I ' v e b e e n asleep for s o m e time. I pick up the dissertation, which o p e n s at a p a g e c o n t a i n i n g i m a g e s of a series of b r a i n s c a n s . I k n o w the p e r s o n w h o s e b r a i n this is. MJ17 says the c a p t i o n , p r e s e r v i n g a n o n y m i t y , b u t I k n o w her as M a g g i e . S h e is o n e of my research patients. I recall the last time I s a w her. It m u s t be a c o u p l e of m o n t h s a g o . S h e g r e e t e d m e , a s usual, like a n o l d friend, t a k i n g b o t h o f m y h a n d s i n h e r s and g r i p p i n g them w a r m l y for a g o o d m i n u t e . S h e t o o k m y a r m a s w e walked d o w n the h a l l w a y a n d into her l i v i n g r o o m . T h e n , while I ' m e x c h a n g i n g pleasantries with her h u s b a n d , D o n , M a g g i e touches m y cheek. S h e really h a s n o i d e a w h o I a m . H e r m e m o r y is a v o i d . T h i s , and the lack of inhibition, is a result of the disfigurement of her b r a i n . T h e r e are b l a d e s o f g r a s s o n the p a g e f r o m the freshly m o w n lawn and the pictures of the b r a i n h a v e a kind of v e g e t a b l e quality. Figure 1, I read, Coronal T1-weighted magnetic resonance images through

the

amygdaloid complex and hippocampal regions.

I a m l o o k i n g inside M a g g i e ' s h e a d . S h e w a s p r o b a b l y h u m m i n g a tune to herself as these pictures w e r e b e i n g taken. W h e n s h e is not talking she i s h u m m i n g o r s i n g i n g . D o n d o e s n ' t c o m p l a i n . T h e pictures are m o s t l y grey. D e n s e material, like b o n e , s h o w s u p white. D a r k e r r e g i o n s signify l o w e r d e n s i t y : the b l a c k butterfly of the lateral ventricles, filled with fluid rather than brain tissue; the s h a d o w y r e c e s s e s o f the outer c o n v o l u t i o n s . L i k e a cauliflower. L a r g e a r e a s of the anterior t e m p o r a l l o b e s have b e e n eaten a w a y b y the v i r u s . T h e s e , too, s h o w a s b l a c k .

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M a g g i e w a s unlucky. T h e b u g — h e r p e s simplex — is v e r y like the c o m m o n c o l d s o r e v i r u s , but it found a w a y into her brain. T h e n a g a i n , s h e ' s lucky, t o o . L u c k y t o h a v e s u r v i v e d . D o n thinks so. W h o am I to say she isn't? Little white a r r o w s h a v e b e e n s u p e r i m p o s e d o n either side o f each picture t o identify the r e g i o n s o f d a r k s p a c e n o r m a l l y o c c u p i e d b y the a m y g d a l a a n d the h i p p o c a m p u s : the a l m o n d a n d the s e a h o r s e , vital c o m p o n e n t s o f the machineries o f m e m o r y a n d e m o t i o n . T h e i r l o s s i s w h a t m a k e s M a g g i e intere s t i n g for s c i e n c e . As a clinician I h a v e a d u t y to be scientifically informed and inquisitive. S o m e o n e sits b e f o r e me in the clinic. T h e y h a v e a fault with their neural m a c h i n e r y a n d I n e e d to appreciate its characteristics. T h e y s p e a k of s y m p t o m s , I listen and l o o k for s i g n s . I h y p o t h e s i z e . I test a n d d e d u c e . I refer, as n e e d s b e , to the scientific literature. B u t I fail if, as part of this p r o c e s s , I do not a l s o e n g a g e with the patient in an ordinary, h u m a n way. O n e has t o a b s o r b s o m e o n e ' s p e r s o n a l c o n c e r n s t o understand their p r e d i c a m e n t . It is, after all, the person w h o is ill, not the neural machine. T h i s a f t e r n o o n , with J a k e , I h a d found it difficult to maintain the n e c e s s a r y b a l a n c e b e t w e e n d e t a c h m e n t and a b s o r p t i o n . D i s p a s s i o n a t e a n a l y s i s h a d g i v e n w a y t o e m o t i o n a l synthesis. T h e mutilated y o u n g m a n with the p h a n t o m limb, his calm civility, the d e v o t i o n o f his y o u n g w i f e , the cutting d e s p e r a t i o n o f the m e s s a g e on the a n s w e r i n g m a c h i n e : it w a s t o o potent a mix and I w a s caught off-guard. A n d n o w I s e e k s a n c t u a r y in the s o l i t u d e of my g a r d e n and a retreat into sleep, s c i e n c e , a n d abstraction — the dissertation: the

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s o o t h i n g i c o n s of a b u g - e a t e n b r a i n . I t ' s an effective r e m e d y . H o w c o m f o r t i n g t o l o s e sight o f M a g g i e a n d c o n t e m p l a t e instead M J 1 7 . It is g e t t i n g d a r k now. T h e c l o u d s h a v e thinned a n d a c r e s c e n t m o o n i s visible. A t the b o t t o m o f the g a r d e n there i s a n a p p l e tree. It l o o k s tired a n d forlorn. T h i s , instantly, is h o w I s e e it. It is an old tree, b e a r i n g fruit for the last t i m e . I s e e n o t just the f a d i n g s h a p e of the trunk, the t w i s t i n g b r a n c h e s , the l e a v e s d a r k e n i n g in the g l o o m and the p a l e , h a l f - g r o w n a p p l e s ; I s e e the a g e of the tree a n d its w e a r i n e s s . I h a v e in m i n d the s h a r p taste o f the fruit. T h i s i s h o w i t a p p e a r s t o m e . A n d h o w d o I k n o w it is b e a r i n g fruit for the last time? B e c a u s e I realize it is not there at all. My b r a i n h a s c o n s p i r e d with the failing light to conjure a fleeting illusion of the tree f r o m m e m o r i e s of similar g r e y e v e n i n g s a y e a r a g o , b e f o r e it w a s felled by a F e b r u a r y g a l e . It is a g h o s t tree, r o o t e d o n l y in t h o u g h t .

* * * I am in a church. It w a s o n c e a church, a n y w a y . N o w i t ' s a u n i versity b u i l d i n g . I ' m here for a s y m p o s i u m a n d p e o p l e are milling a r o u n d drinking coffee b e f o r e the final m o r n i n g s e s s i o n . I keep an eye on the time b e c a u s e I ' m p r e s e n t i n g a p a p e r . T h e p r o g r a m m e h a s reunited m e with t w o c o l l e a g u e s from my p o s t g r a d u a t e d a y s . I h a v e n ' t s e e n t h e m for twenty y e a r s . We stand in a triangle. M u n d a n e facts of b i o g r a p h y s l o t t o g e t h e r as p l a n k s in the c o n v e r s a t i o n a l p l a t f o r m . We all h a v e w i v e s , a n d children, a n d d o g s . R i c k affects e m b a r r a s s m e n t . So b o u r g e o i s . W h y h a v e n ' t w e h a d m o r e interesting l i v e s ?

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' Y o u d o n ' t like c o m m i t m e n t , y o u g e t m a r r i e d . Y o u d o n ' t w a n t k i d s , they take o v e r y o u r life. Y o u g e t a d o g , y o u ' r e forever s c o o p i n g shit into plastic b a g s . ' S t e v e a n d I concur, but we d o n ' t m e a n it either. S t e v e h a s b e e n in the U n i t e d S t a t e s for ten y e a r s and his voice f o l l o w s m i d - A t l a n t i c c o n t o u r s . ' I g u e s s the m y t h o f romantic l o v e is w h e r e the rot sets in,' he s a y s , ' i f y o u let it.' L i f e and relat i o n s h i p s are m o r e r a n d o m than we think but, in the end, m o s t of us fall into a pattern. With w h o m , it d o e s n ' t m u c h matter. I t ' s the pattern that c o u n t s . ' I f y o u d o n ' t relinquish the myth, y o u ' r e b o u n d to be d i s a p p o i n t e d . B u t if y o u d o n ' t b e l i e v e it in the first place...' I c l i m b the spiral s t a i r w a y to the u p p e r lecture theatre. T h e sun-filled, s t a i n e d - g l a s s w i n d o w s e n d s c u r v e s o f p u r p l e , yellow, a n d red a l o n g the steel handrails. T h e hall itself is c o o l and d a r k . I t f i l l s the h i g h e r r e a c h e s o f the n a v e . M y audience trickles in. T h e r e aren't m a n y a n d they scatter a b o u t the p l a c e like a congregation. With a click of the m o u s e , a q u o t a t i o n rolls a c r o s s the screen b e h i n d m e : We should take care not to make the intellect our god. It has, of course, powerful muscles, hut no personality. T h a t w a s E i n s t e i n . It sets the tone of my talk, which is a b o u t h o w the b r a i n g e n e r a t e s e m o t i o n s a n d h o w e m o t i o n s regulate social behaviour. T h e r e are structures for a n a l y s i n g the g e o m e t r y o f the face, a n d o t h e r s for interpreting the m e a n i n g o f e x p r e s s i o n s . T h e s e feed into s y s t e m s for d e c o d i n g p e o p l e ' s intentions and d i s p o s i tions, c a l c u l a t i n g their d e s i r e s a n d beliefs. T h e n there are m e c h a n i s m s for s e l e c t i n g p r o g r a m s o f action, for shifting g e a r

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and m a n o e u v r i n g the v e h i c l e o f the ' s e l f ' t h r o u g h the s o c i a l landscape. T h e a m y g d a l a is a crucial c o m p o n e n t of the s o c i a l b r a i n . It acts as a control centre linking h i g h e r cortical p r o c e s s e s , i n c l u d i n g rational t h o u g h t , to the m o r e ancient e m o t i o n a l m a c h i n e r i e s lower d o w n . In particular, it is b e l i e v e d to be i n v o l v e d in the p r o d u c t i o n o f fear and anger. O n the screen n o w i s a l a r g e , m o v i n g , t a l k i n g , g e s t u r i n g i m a g e o f M a g g i e ( a k a M J 1 7 ) . S h e i s h a v i n g a g o o d l a u g h with a research assistant. T w o g i r l s together. I t ' s M a g g i e b a c k i n her twenties telling r i s q u e stories a b o u t her b o s s . He w a s a one. S o m e w h e r e , o f f - c a m e r a , D o n ' s g e n t l e v o i c e c o a x e s her b a c k o n t o safer g r o u n d . H e d o e s n ' t w a n t t o c a u s e e m b a r r a s s m e n t . I ' v e set the v i d e o in the w r o n g p l a c e . I intended to s h o w M a g g i e a n d D o n talking a b o u t their S p a n i s h holiday. B u t a t least the a u d i ence can see she is not a c a b b a g e . S h e is u p b e a t a n d a n i m a t e d , e a g e r for c o m p a n y . I'll h a v e to tell the s t o r y m y s e l f . T h e y ' d b e e n o u t for a m e a l . T h e t w o b o y s l e a p t f r o m nowhere. T h e r e was shouting and pushing. T h e y g r a b b e d Maggie. D o n w a s thrown back against a wall. O n e hand gripped his throat, the other t o o k his wallet. B u t D o n i s a b i g m a n . H e fought b a c k . H e g a v e the b o y a p o u n d i n g . A n d all the t i m e , with D o n ' s a m y g d a l a e trilling like fire b e l l s , j o l t i n g his b o d y f r o m visceral fear to t h r a s h i n g , m e c h a n i c a l a n g e r , p u p i l s d i l a t e d , c a r d i o v a s c u l a r s y s t e m i n o v e r d r i v e , b l o o d d r a i n i n g from g u t t o straining m u s c l e s , fists like h a m m e r s - all the t i m e M a g g i e smiles benignly. T h e fluid-filled s p a c e s i n her h e a d w h e r e the a m y g d a l a e u s e d t o nestle are p o o l s o f tranquillity. B a c k a t the hotel, D o n w a s still s h a k i n g . M a g g i e c o u l d n ' t

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f a t h o m it. S h e t h o u g h t the b o y s w e r e just larking a r o u n d .

S o far, s o g o o d . N o a m y g d a l a , n o fear. I t ' s a nice a n e c d o t e t o c o l o u r the s t a n d a r d e x p l a n a t i o n o f fear p r o d u c t i o n : the cortex p e r c e i v e s , the a m y g d a l a interprets a n d t r i g g e r s a r e s p o n s e . But then, b a c k h o m e , M a g g i e sits w a t c h i n g T V . I t ' s a s o a p o p e r a . T h e r e ' s a s p a r k o f a g g r e s s i o n b e t w e e n t w o female characters, n o t h i n g e x t r e m e or o u t of the ordinary. It g e t s to her, t h o u g h , e n o u g h to s w i p e her b r e a t h , a n d start her heart t h u m p i n g . ' N o , d o n ' t , ' s h e s a y s . ' P l e a s e , no!' F e a r rises until the flesh of her face is pulled taut in a rictus of terror. T h e a n e c d o t e n o w b e c o m e s a w i n d o w o f insight into the true functions o f the a m y g d a l a . A t a n y rate, that's the w a y I p r e s e n t it. E v i d e n t l y , fear can be t r i g g e r e d without involvement o f the a m y g d a l a . Its function i s t o p e r f o r m a p p r a i s a l s o f danger. M a g g i e , m i n u s a m y g d a l a , is o b l i v i o u s to the real threat of the m u g g i n g , but s h o w s e x c e s s i v e fear i n r e s p o n s e t o a n i n n o c u o u s T V programme. ' I n t e r e s t i n g , ' s o m e o n e s a y s , 'but o n l y a n e c d o t a l . ' I h a v e to a g r e e . B u t I ' m all for a n e c d o t e s . In his presentation S t e v e talks about his d o g . He g r a n t s the animal a r u d i m e n t a r y s e n s o r y a w a r e n e s s , but nothing like human c o n s c i o u s n e s s . H i s wife and kids d i s a g r e e . T h e y value emotion o v e r intellect. T h e y are convinced the d o g h a s feelings — primitive and unarticulated but, at root, like o u r s . W h a t perplexes S t e v e is that he can't help b e h a v i n g as if he believes this too. ' I g u e s s i t ' s m y social b r a i n , ' h e s a y s . ' I t ' s a s i g n that y o u ' r e h u m a n , ' I tell h i m .

* * *

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M a g g i e ' s story a p p e a r e d in an article I w r o t e for a m a g a z i n e . T h e m u g g i n g a n e c d o t e can a l s o b e found i n the d i s c u s s i o n s e c tion of a scientific p a p e r I c o - a u t h o r e d a few y e a r s a g o , w h e r e M a g g i e is referred to as ' Y W ' . A l t h o u g h I think it g i v e s an insight into the functions of the a m y g d a l a , as my critic in the audience s a i d , the e v i d e n c e is o n l y a n e c d o t a l . B u t e v i d e n c e like this w o u l d be hard to c o m e by experimentally, for practical a n d ethical r e a s o n s . Clinical a n e c d o t e s are n o t o n l y an i n v a l u a b l e s o u r c e o f inspiration for m o r e s y s t e m a t i c theoretical a n d e x p e r i mental studies, they are s o m e t i m e s i m p o r t a n t in their o w n right. Shortly after the s t o r y a p p e a r e d in the m a g a z i n e I r e c e i v e d a letter from a reader w h o , like M a g g i e , h a d quite recently suffered herpes s i m p l e x encephalitis. I'll call h i m A n t h o n y . It w a s a remarkable letter. With A n t h o n y ' s p e r m i s s i o n , here are s o m e extracts:

I continue to experience the two effects that you write about. I have both the reduced sense of personal danger, and the physical reaction to argument or conflict. On the one hand I have become a risk-taker, e.g. dangerous jay-walking (and I had a period of shoplifting), while on the other hand, I have to leave a room (escape) if anyone raises their voice, even mildly. I no longer watch TV because I cannot stand the 'tension' that stories create . . .

Anthony's combination of 'fearlessness' (or 'recklessness') on the o n e h a n d , and o v e r - s e n s i t i v i t y to m i l d conflict a n d d r a matic tension o n the other clearly r e s e m b l e s s o m e features o f M a g g i e ' s b e h a v i o u r . Q u i t e likely there is a d e g r e e of o v e r l a p in

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their patterns of brain pathology. This would not be surprising since herpes simplex has a predilection for certain areas of the brain (the temporal and orbitofrontal regions in particular). But what distinguishes Anthony's account is how insightful and articulate it is. Maggie would have had difficulty expressing her thoughts in this way. Then he went on to describe somewhat different symptoms of a kind I hadn't come across before.

Thankfully, some earlier symptoms that directly linked words and emotions have subsided. I used to 'feel' words. Whenever I heard or spoke a word or phrase indicating a physical state, I would automatically feel the state as well. So I know exactly what is meant by 'gut-wrenching' or 'toe-curling'. It was very disconcerting whenever people asked me whether I ever felt sad or hurt or afraid. Not only had I felt these things - who wouldn't when a virus starts invading your brain! — but I felt them equally strongly every time I was asked.

A third set of symptoms concerned Anthony's ability to communicate in face-to-face interactions with others. These symptoms are reminiscent of those reported by people with Asperger's syndrome or high-functioning autism. They are intriguing in the light of current theories about the brain disorder that may underlie autism. A number of influential scientists have implicated the amygdala.

I can no longer 'read between the lines' either, and I take people's language literally - I get little clue from their

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expressions. This can be hilarious, but is also very frustrating. Luckily, I am currently living with Australian friends, who value straight talking, so I have less trouble 'reading' them than I do the typical contorted English relation between words and feelings.

He elaborated on this in a subsequent communication:

Nowadays, finding it hard to distinguish levels of meaning in people's words, I am very concerned that everything be straight and true and meaningful - otherwise I do not understand. Linked to this, I will tell anybody anything - what my parents don't know about my previous sex life isn't worth knowing! . . . The virus ate my shame.

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C h a r l e s c o u l d hear the s u r g e o n s talking. O n e o f them w a s a n g r y . T h e y w e r e g o i n g t o start cutting. T h e r e w e r e fingers a t his a b d o m e n . N e x t , there w o u l d b e a knife. T h i s c o u l d n ' t b e . H e m u s t tell them: Don't cut! I'm still awake! Please, not yet! T h e w o r d s f o r m e d i n his b r a i n , b u t their p a s s a g e t o the v o c a l a p p a r a t u s w a s b l o c k e d . H e lay m o t i o n l e s s a n d m u t e a s the b l a d e sliced his f l e s h . T h e pain f l u n g him from his b o d y . L o o k i n g d o w n on the s c e n e from the ceiling, he s a w that the a n g r y s u r g e o n w a s still c o m p l a i n i n g a b o u t s o m e t h i n g . C h a r l e s felt p r o f o u n d u n e a s e , not tranquillity o r indifference, a s s o m e h a v e described. H o w w a s he to get back? T h e e x p e r i e n c e left him with a p o s t - t r a u m a t i c stress d i s o r d e r — flashbacks, n i g h t m a r e s , p a n i c attacks. N o w he w a s s e e k i n g c o m p e n s a t i o n . I n t r a - o p e r a t i v e a w a r e n e s s is an a c k n o w l e d g e d p r o b l e m . Effective a n a e s t h e s i a r e q u i r e s the j u d i c i o u s m i x i n g a n d m a t c h i n g of d r u g s to patients a n d c o n d i t i o n s . It is not all or n o t h i n g , like flicking a light switch. Different o p e r a t i v e p r o c e d u r e s d e m a n d different d e p t h s o f a n a e s t h e s i a , and patients

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v a r y i n t e r m s o f their r e s p o n s e . Currently, there i s n o w h o l l y reliable m e t h o d o f d e t e c t i n g a w a r e n e s s . T h e r e are b o u n d t o b e mistakes. P e r h a p s o n e o r t w o patients p e r t h o u s a n d o p e r a t i o n s are able t o recall events o c c u r r i n g d u r i n g s u r g e r y . T h e figures a r e h i g h e r for obstetric and c a r d i a c p r o c e d u r e s , w h i c h r e q u i r e lighter anaesthesia. ( T h i s d o e s not include t h o s e w h o m a y b e a w a r e a t the time, but w h o s u b s e q u e n t l y fail to recall.) B u t while intraoperative a w a r e n e s s is a r e c o g n i z e d c o m p l i c a t i o n of s u r g e r y , the o u t - o f - b o d y e x p e r i e n c e ( O O B E ) i s not. I didn't think it w o u l d help C h a r l e s ' s c a s e . H e ' d be labelled a fantasist, which w o u l d b e unfair b e c a u s e O O B E s , too, are relatively c o m m o n — a r o u n d fifteen p e r cent of the g e n e r a l p o p u lation admit to h a v i n g e x p e r i e n c e d o n e . I d i d n ' t think that C h a r l e s ' s soul left his b o d y — b e c a u s e I d o n ' t b e l i e v e in d e t a c h able s o u l s — but I c o u l d fully accept that he h a d e x p e r i e n c e d a frightening hallucination. T h e r e are m a n y f o r m s o f intermittent p s y c h o s i s . I spent my first t e r m at u n i v e r s i t y l o d g i n g w i t h a rather d o u r w o r k i n g - c l a s s family on the outskirts of Sheffield. I'll call them the F a n c y s , t h o u g h their real n a m e w a s less p l a u s i b l e . M r s F a n c y fed m e p o r r i d g e for b r e a k f a s t . S o m e t i m e s I ' d g e t b a c k late, the w o r s e for wear, a n d s o m e t i m e s I d i d n ' t c o m e b a c k at all. I think she found m e difficult. B r e a k f a s t s w e r e b l e a k . W e d i d n ' t h a v e m u c h to talk a b o u t . T h e n o n e m o r n i n g s h e started telling m e a b o u t A u n t J u d i t h , h o w she w a s a l w a y s w e l c o m e t o d r o p in, o f c o u r s e , b u t , d e a r o h dear, h o w she picked her times. S h e h a d t u r n e d up in the m i d d l e o f the night a g a i n . T h r e e i n the m o r n i n g . T h i r d time this w e e k .

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It w a s tiring, e s p e c i a l l y for Mr F a n c y w h o w a s on the early shift. A u n t J u d i t h w a s lonely. S h e w o u l d chat for a n h o u r o r s o , and then s h e w o u l d go h o m e . I s a i d I h a d n ' t b e e n d i s t u r b e d , which w a s true. I h a d n ' t h e a r d the d o o r b e l l — or p e r h a p s she had her o w n k e y ? A u n t J u d i t h h a d n o need o f d o o r b e l l o r k e y I w a s told. S h e h a d a gift. S h e c o u l d p r o j e c t her spirit. A n d three times that w e e k s h e h a d p r o j e c t e d h e r s e l f t h r o u g h the night air to the foot o f M r a n d M r s F a n c y ' s b e d . S h e lived i n S c o t l a n d . A d a y or t w o later Mr F a n c y raised the matter a g a i n . (I w o u l d n ' t h a v e d a r e d . ) He k n e w I w a s in on the story. ' Y o u ' v e h e a r d all a b o u t o u r J u d i t h , I gather. I t ' s a bit of a n u i s a n c e , ' he s a i d , a n d then carried on a s s e m b l i n g his s o n ' s train set on the flowery c a r p e t in front of the g a s fire. T h e four-yearold lay supine. N o t h i n g m o r e w a s said. J u s t b e f o r e I left the F a n c y s I h a d an unsettling experience. I w o k e i n the early h o u r s , a w a r e o f s o m e t h i n g g l o w i n g faintly i n the c o r n e r o f the r o o m . M y heart t h u m p e d a n offbeat. W h e n I t u r n e d to l o o k , it w a s n ' t A u n t J u d i t h I s a w but a C h r i s t m a s tree. I ' d g o t b a c k late, let m y s e l f in, helped m y s e l f to a s n a c k , then g o n e s t r a i g h t to b e d . I h a d n ' t noticed a tree. H o w c o u l d I not h a v e n o t i c e d ? I g o t up for a c l o s e r l o o k . I b r u s h e d a b r a n c h a n d c a u g h t the scent o f the p i n e n e e d l e s . R e t u r n i n g t o b e d I w a s s o o n a s l e e p , but s o m e t h i n g else d i s turbed m e . P e r h a p s it w a s v o i c e s in the street. I can't remember. B u t I do r e m e m b e r g e t t i n g up to shut the w i n d o w and noticing that the tree h a d g o n e . It a p p e a r e d from n o w h e r e , then, silently, it d i s a p p e a r e d . It w a s there. I t o u c h e d it. I c o u l d smell it. I slept in. W i n t e r s u n s h i n e filled the r o o m . T h e C h r i s t m a s tree l o o k e d s p l e n d i d , red b a u b l e s and silver tinsel splintering

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the light. So there was a tree. I tried to g e t u p , b u t found I w a s p a r a l y s e d . I l o o k e d at my right a r m a n d willed it to m o v e . I c o m m a n d e d it to m o v e . It s t a y e d put. W h e n I tried to sit up or roll over nothing h a p p e n e d . I p a n i c k e d . On the i n s i d e I w a s a twisti n g fury, but the shell o f m y b o d y r e m a i n e d m o t i o n l e s s . I g a v e up the s t r u g g l e , o v e r w h e l m e d by an intuition that if I tried a n y harder I w o u l d b r e a k t h r o u g h the shell a n d float away. I c l o s e d m y e y e s . T h e r o o m w a s still a b l o c k o f s u n l i g h t w h e n I o p e n e d them a g a i n , but there w a s no tree. I n o w r e c o g n i z e this as a lucid d r e a m , an h a l l u c i n a t o r y state in the hinterlands of s l u m b e r w h e r e the m i n d is alert, b u t the b o d y remains b o u n d by the p a r a l y s i s of s l e e p — the intersection o f d r e a m life a n d reality. P e r h a p s i n t r a - o p e r a t i v e a w a r e n e s s i s like this. I t ' s h a p p e n e d s e v e r a l t i m e s s i n c e , a n d e a c h time I found m y s e l f restrained b y the s a m e f o r c e f u l intuition. N e x t time I'll grit my teeth a n d let g o .

* * *

N o t l o n g a g o I w a s renting a c o t t a g e o n the e d g e o f D a r t m o o r . It w a s a S u n d a y afternoon a n d I'd b e e n w o r k i n g at a g l a s s t o p p e d table by the w i n d o w . I w a s tired. I h a d n ' t slept well the p r e v i o u s night. N o w I s t o p p e d , transfixed b y m u s i c . I often w o r k to m u s i c — u s u a l l y B a c h or M o z a r t . T h i s w a s B a c h ; a partita for s o l o flute, e n d l e s s l y circling a n d c l i m b i n g , falling and rising, b r i g h t lines of s o u n d filling the air. G r e a t m u s i c cancels the distinction b e t w e e n the external w o r l d a n d o u r inner life. I w a s a b s o r b e d , but, a l s o , it w a s me w h o w a s

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a b s o r b i n g . I w a s at the centre of a m a c h i n e of s o u n d , but the m a c h i n e w a s a l s o within m e . I first s a w the g e e s e in reflection, t h r o u g h the s m o k e d g l a s s s u r f a c e o f the table, s w i m m i n g i n a b r o n z e p o o l o f sky. T h e r e w e r e three. I l o o k e d up at the w i n d o w to w a t c h them s p e e d i n g s o u t h - w e s t u n d e r c l o u d s that n o w l o o k e d unnaturally white and p a t c h e s of s k y u n n a t u r a l l y b l u e . I felt d i s e m b o d i e d . It w a s as if I w e r e i n s i d e the c o t t a g e , sitting at the table by the w i n d o w a n d , a t the s a m e t i m e , f l y i n g with the g e e s e , h i g h o v e r the D e v o n shire w o o d s a n d fields. I w a s d i s l o c a t e d and distributed, just as the g e e s e w e r e s i m u l t a n e o u s l y i n o n e p l a c e a n d another: out there, a n d h e r e in the w o r l d b e n e a t h the g l a s s - t o p p e d table. T h i s w a s not a n o u t - o f - b o d y e x p e r i e n c e . I t w a s not u n p l e a s ant o r d i s t u r b i n g i n a n y w a y . S u b d u e d b y f a t i g u e , introverted b y s o l i t u d e , e l e v a t e d b y the e x t r e m e b e a u t y o f the m u s i c , m y perc e p t i o n s a n d s e n s e o f s e l f h a d b e e n m o m e n t a r i l y reconfigured. O u r b o d y schema is surprisingly malleable. V. S. Ramachand r a n a n d his c o l l e a g u e s h a v e d e v i s e d s o m e s i m p l e exercises t o illustrate this fact. I s o m e t i m e s u s e them to enliven dull lectures. Here's an example. F i r s t , put on a blindfold a n d h a v e s o m e o n e sit in front of y o u , f a c i n g in the s a m e direction. T h e n let another p e r s o n take y o u r right h a n d a n d start t a p p i n g a n d s t r o k i n g the n o s e o f the p e r s o n in front of y o u with y o u r index finger, while at the s a m e time u s i n g their o w n left h a n d t o tap and s t r o k e y o u r n o s e . I t ' s best i f the t a p p i n g a n d s t r o k i n g alternate i n r a n d o m s e q u e n c e s , and they m u s t be s y n c h r o n o u s — that is, a t a p / s t r o k e on the other person's nose must be matched by a t a p / s t r o k e on your own n o s e . A f t e r a while, thirty s e c o n d s or s o , y o u m a y b e g i n to feel

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that y o u are t a p p i n g y o u r o w n n o s e at a r m ' s length, as if, like P i n o c c h i o ' s , it has g r o w n e n o r m o u s or is floating o u t there in front o f y o u . I t ' s even p o s s i b l e to project s e n s a t i o n s on to i n a n i m a t e objects. T r y this. Y o u n e e d a table and a friend. Sit with a h a n d under the table, hidden from view, while y o u r friend t a p s / strokes the surface of the table a n d s i m u l t a n e o u s l y t a p s / s t r o k e s y o u r hidden hand. I t ' s crucially i m p o r t a n t that y o u d o n ' t s e e w h a t ' s g o i n g on u n d e r the table — that w o u l d ruin the effect, b u t a s y o u watch y o u r friend's other h a n d y o u s h o u l d g r a d u a l l y feel the t a p p i n g and s t r o k i n g s e n s a t i o n s a r i s i n g from the table itself. W h e n it w o r k s (which isn't a l w a y s ) , the effect is c o m p e l l i n g . Y o u k n o w at a rational level that the s u r f a c e of the table is b e y o n d the b o u n d a r i e s o f y o u r b o d y , but t h a t ' s n o t the w a y i t feels. T h e p h e n o m e n a l experience o v e r r i d e s the rational a n a l y sis. T h e table h a s b e e n t e m p o r a r i l y i n c o r p o r a t e d into y o u r b o d y s c h e m a . I t h a s b e c o m e part o f ' y o u ' . S o , even on as fundamental a matter as w h e r e ' y o u ' are in relation to y o u r b o d y , the c o n s c i o u s , reflective s e l f is e a s i l y deceived.

I liked the story of the Christmas tree, s h e s a i d . Thanks. Why do you call it a lucid dream? Perhaps it was some other kind of vision. ' W h a t other k i n d ? ' Hypnagogic

imagery.

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Oh. Or do I mean hypnopompic? T h e y ' r e both forms of dream-like imagery at the e d g e s o f s l e e p , w h e n y o u ' r e d r o p p i n g o f f o r waking up. H y p n a g o g i c is when you're dropping off. B u t , a n y w a y , no, it w a s n ' t either of those. Don't most people fall asleep with random thoughts and pictures floating through their mind? I s u p p o s e they do So what's special? H y p n a g o g i c i m a g e s are m o r e v i v i d . T h e r e ' s m o r e clarity and detail. T h e y s e e m m o r e a u t o n o m o u s as well. T h e y h a v e a life of their o w n . I u s e d to g e t beautiful, w e i r d s c e n e s g o i n g t h r o u g h my s l e e p y h e a d as a child — later, too, on into my teens and early twenties. It rarely h a p p e n s now. I t ' s a pity. I m i s s them. What did you see? I t u s u a l l y started with faces. T h e y l o o m e d u p f r o m n o w h e r e . T h e first o n e a l w a y s t o o k m e b y s u r p r i s e . T h e y w e r e quite ordinary, a n o n y m o u s f a c e s mostly, b u t s o m e t i m e s they w o u l d m o r p h into g a r g o y l e s o r g o b l i n s . T h e y s e e m e d real. A s b r i g h t a s television. Just

faces?

N o . Sometimes it w a s m o r e elaborate — parades of little p e o p l e , all b r i g h t c o l o u r s like a m e d i e v a l p a g e a n t . T h e y s e e m e d to h a v e a life of their o w n . I t w a s fascinating, a n d totally b e y o n d m y c o n t r o l . I u s e d to w a t c h the little p e o p l e strolling

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by. T h e y a l w a y s s e e m e d t o b e g o i n g s o m e w h e r e . S o m e o f them w o u l d b e c a r r y i n g p a c k s o r p u s h i n g carts. I w a s a spectator, on the sidelines, w a t c h i n g from a d i s t a n c e . I k n e w they w o u l d n ' t bother m e . I w a s n ' t really part of it. I c o u l d n ' t enter the s c e n e . A l t h o u g h s o m e t i m e s it d i d s e e m like t h e y ' d s e n s e d m y p r e s e n c e . O n e o r t w o w o u l d step o u t s i d e the f l o w , c o m e c l o s e a n d l o o k directly t o w a r d s m e . B u t their e y e s w e r e u n s e e i n g , like I w a s b e h i n d a o n e - w a y s c r e e n . I c o u l d see t h e m , b u t they c o u l d n ' t s e e m e . Yet for a m o m e n t they s e n s e d I w a s there. I h a d no influence o v e r the b e h a v i o u r a n d a p p e a r a n c e o f these creatures, o r the w o r l d they inhabited. Where did they come from? M y brain, o f c o u r s e . S o m e h i d d e n c o r n e r o f m y mind. Ah,

hut which undiscovered territory?

T h e fascination for me w a s — still is — that this s t r a n g e , nocturnal w o r l d w a s the p r o d u c t o f m y brain a n d yet I h a d no c o n s c i o u s control o v e r the s h a p e it t o o k . I r e m e m b e r o n c e l o o k i n g c l o s e l y at a b a n n e r s o m e of the little fellows w e r e c a r r y i n g . It w a s beautifully e m b r o i d e r e d , fantastic c o l o u r s — m o s t l y reds and g o l d s . A n d I t h o u g h t I c o u l d n ' t p o s s i b l y create s o m e t h i n g s o beautiful. I w a s s o m e t i m e s a m a z e d by w h a t I saw. It c o n v i n c e d me that I w a s just o n e p r o d u c t of my b r a i n ' s activity — a w a v e of c o n s c i o u s , s e l f - a w a r e n e s s o n the s u r f a c e o f a n o c e a n . You needed convincing? I thought you were a psychologist.

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Well, o b v i o u s l y , I k n e w that a lot of mental life g o e s o n b e l o w the level o f a w a r e n e s s . T h a t ' s o r t h o d o x c o g n i t i v e p s y c h o l o g y . A n d I k n o w the F r e u d i a n stuff, a n d J u n g . B u t these pictures put abstract t h e o r y in the s h a d e . I s p r a n g from the s a m e s o u r c e a s the g a r g o y l e s , the g o b l i n s and the colourful p a g e a n t s — the s a m e brain — but I felt no c o n n e c t i o n with them. Do you think their little lives went on when you weren't

looking?

N o w , that w o u l d be eerie. I'd prefer to think they d i d n ' t . I ' m sure they n e e d e d an o b s e r v e r to b r i n g them to life. Perhaps we all do. My b r a i n conjured them up, and they required a solitary s p e c t a t o r — me — but o n c e the s p o o l s w e r e rolling I p l a y e d no part. R o b e r t L o u i s S t e v e n s o n h a d similar experiences. H e put them to g o o d u s e . A lot of his stories w e r e b a s e d on dreams or hypnagogic imagery. Which? J e k y l l a n d H y d e , for o n e . No,

which: dreams or hypnagogic imagery?

S o m e t i m e s h e s e e m s t o b e talking a b o u t o n e , a n d s o m e t i m e s the other. F r o m what h e s a y s about Jekyll and H y d e it was probably based on a true n i g h t m a r e . B u t at other times he s e e m s t o b e d e s c r i b i n g h y p n a g o g i c stuff. H e had this technique for g e t t i n g into h y p n a g o g i c states. S o m e t i m e s he w o u l d lie in b e d resting his e l b o w s on the sheets with his a r m s p o i n t i n g u p w a r d s ,

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p o i s e d t o d r o p i f h e n o d d e d off. T h a t w a y he c o u l d drift into the h y p n a g o g i c w o r l d a n d stay alert e n o u g h to w a t c h the s h o w without d r o p p i n g o f f completely. He talks a lot a b o u t little p e o p l e , t o o - the little p e o p l e w h o run the d r e a m theatre. Did they wear medieval clothes? N o , their c o s t u m e s w e r e G e o r g i a n . And all this is different from lucid dreams? I can't s p e a k for others, but in my e x p e r i e n c e lucid d r e a m s and h y p n a g o g i c i m a g e r y a r e v e r y different. H y p n a g o g i c i m a g e s are realistic in the w a y that v i d e o i m a g e s a r e realistic. Y o u can o b s e r v e them minutely, like w h e n I l o o k e d c l o s e up at the banner. T h e c o l o u r s w e r e v i v i d . I c o u l d see the thread. B u t also, like a v i d e o , y o u realize y o u ' r e not part o f it. And in a lucid dream you are? F o r m e , lucid d r e a m s s e e m a b s o l u t e l y real. Y o u ' r e right there in the thick of it, a n d even t h o u g h y o u t w i g a t s o m e s t a g e a n d start t o a p p r e c i a t e that i t ' s a d r e a m or hallucination, and y o u b e g i n to think it t h r o u g h rationally even s o , it still s e e m s real. T h a t C h r i s t m a s tree w a s there i n the c o r n e r o f the r o o m a s far a s I c o u l d tell. I went up c l o s e and t o u c h e d it.

Had you been overdoing the jazz cigarettes or anything? N o . Or anything. Were you scared?

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M o r e p e r p l e x e d than s c a r e d . E x c e p t for the feeling o f p a r a l y s i s a t the end. T h a t w a s frightening. Y o u ' r e stuck there p o w e r l e s s and y o u start t o think a n y t h i n g c o u l d h a p p e n . T h e n t h e r e ' s the feeling that y o u m i g h t just p o p out of y o u r skin a n d fly o u t the window. I ' v e talked t o p e o p l e w h o ' v e h a d full-blown o u t - o f - b o d y e x p e r i e n c e s a n d s o m e o f them d e s c r i b e a w h o o s h i n g , v i b r a t i n g sensation just at the point o f d e p a r t u r e . I ' v e h a d the s a m e , but that's where I s t r u g g l e h a r d to s t a y put. I t ' s a l o n g time since I h a d o n e of t h o s e d r e a m s , but next time I really m i g h t try to let g o . I d o u b t it, t h o u g h . I ' m a c o w a r d . I ' m a l w a y s t o o terrified b y the thought o f n o t g e t t i n g b a c k . D i s c r e t i o n i s the better part of valour. But you don't really think it's possible? I f y o u m e a n s o m e t h i n g s u p e r n a t u r a l like m y soul s l i p p i n g o u t o f m y skin a n d flying a r o u n d , n o , I d o n ' t think i t ' s p o s s i b l e . B u t the thought is still terrifying. I d o n ' t b e l i e v e in g h o s t s , but, on b a l a n c e , I ' d rather pitch my tent on a c a m p s i t e than in a g r a v e y a r d . So you think it's possible in a different sense? I think o u t - o f - b o d y e x p e r i e n c e s are real e x p e r i e n c e s , just like the p h a n t o m C h r i s t m a s tree w a s real to m e . A lot of p e o p l e s a y they have t h e m . B u t t h e r e ' s a natural explanation, like there is for other illusions a n d hallucinations. What is it? I don't know.

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Where would you start to look for an explanation? Y o u c o u l d start with the p h y s i o l o g y . T h e r e ' s a pattern. It s e e m s to h a p p e n either in states of l o w a r o u s a l o r v e r y h i g h a r o u s a l . I t can h a p p e n — p r o b a b l y m o s t often d o e s h a p p e n — just l y i n g in b e d . B u t it can a l s o h a p p e n w h e n the p e r s o n is in mortal d a n g e r — h a n g i n g o v e r a p r e c i p i c e , say. B u t , for m e , the first p l a c e to start l o o k i n g for e x p l a n a t i o n s w o u l d b e a t the n e u r o p s y c h o l o g i c a l level — a n a l y s e which b r a i n s y s t e m s m i g h t be involved. So, what do you think? I think it's s o m e t h i n g to do with d i s t o r t i o n s of b o d y schema. You mean body image? N o t quite. B o d y i m a g e i s h o w y o u a s a p e r s o n s e e yourself. I t ' s like a mental picture y o u h a v e of y o u r o w n b o d y a n d i t ' s tied u p t o y o u r f e e l i n g s a b o u t it; y o u r attitude t o w a r d s it. B o d y s c h e m a is m o r e like the b r a i n ' s w o r k i n g m o d e l o f the b o d y . And this can go wrong? I t can g o w r o n g i n all sorts o f w a y s . O b v i o u s l y , t h e r e ' s n o r m a l l y a tight relationship b e t w e e n the b o d y a n d the self. Y o u d o n ' t g e t o n e w i t h o u t the other. B u t in s o m e w a y s the relationship is l o o s e r than we tend to think. I t ' s quite s u b t l e . It i s n ' t that difficult to trick y o u r b r a i n a n d twist its b o d y s c h e m a out o f s h a p e . So when someone is having an out-of-body experience the conscious, thinking part of them is somehow dislocated from their body schema.

The

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different brain systems have got temporarily decoupled. S o m e t h i n g like that. T h e b o d y s c h e m a and the c o n s c i o u s s e l f are u s u a l l y in s y n c h . B u t at the b r a i n s y s t e m s level they can b e s e p a r a t e d t o s o m e degree. T h e y ' r e dissociable. It's plausible,

I suppose. But a little prosaic,

don't

you think? Much more exciting to imagine disembodied sprits

whizzing

off to adventures on

the astral plane. E x c i t i n g , but b a r m y .

By the w a y , I s a i d , w h o are y o u ?

B u t s h e w a s a l r e a d y f a d i n g b a c k into the lush d a r k n e s s behind my eyelids.

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The past is all of one texture - whether feigned or suffered whether acted out in three dimensions, or only witnessed in that small theatre of the brain which we keep brightly lighted all night long, after the jets are down, and darkness and sleep reign undisturbed in the remainder of the body. Robert Louis Stevenson, 'A Chapter on Dreams' I stood already committed to a profound duplicity of life . . . both sides of me were in dead earnest. . . Dr

Jekyll

The Strange Case of Dr Jekyll and Mr Hyde ( 1 8 8 6 ) , the classic tale of a d i v i d e d self, reflects s o m e of the m o r a l a n d intellectual p r e o c c u p a t i o n s o f the V i c t o r i a n e r a : g o o d v e r s u s evil; r e a s o n v e r s u s p a s s i o n ; religion v e r s u s s c i e n c e ; civilization v e r s u s s a v a g e r y ; o r d e r v e r s u s c h a o s — b u t w a s a l s o b o r n o f the d o u b l e ness within its author, R o b e r t L o u i s S t e v e n s o n . A w o r l d traveller a n d adventurer, S t e v e n s o n w r o t e the s t o r y i n the s e d a t e E n g l i s h s e a s i d e t o w n o f B o u r n e m o u t h . T o all

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a p p e a r a n c e s h e w a s l e a d i n g the s o r t o f life h e w o u l d p r e v i o u s l y have despised:

'Respectability, dullness, a n d similar villas

e n c o m p a s s e d h i m for miles in e v e r y direction,' w r o t e his s t e p s o n . B u t the o u t w a r d i m a g e o f b l a n d respectability m a s k e d the s u b v e r s i v e m a c h i n a t i o n s of his inner w o r l d ; and here we have a template

for Jekyll and Hyde.

T h e s t o r y i s prefigured i n S t e v e n s o n ' s earlier life and w o r k . A s a child h e h a d b e e n fascinated b y the s t o r y o f D e a c o n B r o d i e . W i l l i a m B r o d i e ( a c c o r d e d the title ' D e a c o n ' a s head o f a g u i l d ) w a s a r e s p e c t a b l e E d i n b u r g h cabinet-maker by day, but b y night w a s the l e a d e r o f a g a n g o f thieves. H e w a s h a n g e d for his c r i m e s i n 1788. T h e s t o r y s o intrigued y o u n g L o u i s that, a t the a g e of fourteen, he drafted a p l a y a b o u t B r o d i e . A later vers i o n , Deacon Brodie, or the double life, w a s published in 1879, and p e r f o r m e d in B r a d f o r d three y e a r s later. Its themes w e r e d a y a n d night, g o o d a n d evil, a n d the duality o f h u m a n personality: e x p o s i n g the d e p r a v i t y that m i g h t lurk beneath a veneer of civility. B o l t i n g the d o o r a n d d i s c a r d i n g his d a y t i m e g a r b , B r o d i e d e c l a r e s : ' . . . b y night w e are our naked s e l v e s . . . the d a y for t h e m , the night for m e . ' A s a y o u n g m a n e a g e r t o slip the g r i p o f C a l v i n i s t i c c o n v e n tion in b o u r g e o i s E d i n b u r g h , S t e v e n s o n cultivated his own, m o r e b e n i g n , duality o f character. H e and his friend, C h a r l e s B a x t e r , ' a s s u m e d the liberating r o l e s o f J o h n s o n and T h o m s o n , heavy-drinking, convivial, blasphemous iconoclasts, whose s e n s e of h u m o u r w o u l d h a v e b e e n a little t o o s t r o n g for the S t e v e n s o n s ' H e r i o t R o w d r a w i n g - r o o m ' ; i n which g u i s e , 'they c o u l d f u l l - b l o o d e d l y enjoy t h o s e p l e a s u r e s denied to S t e v e n s o n a n d B a x t e r , a n d t o D r J e k y l l ' . ( I q u o t e from E m m a L e t l e y ' s

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introduction to the O x f o r d W o r l d ' s C l a s s i c s edition of Dr Jekyll and Mr Hyde.) B u t there w a s a d e e p e r d i v i s i o n in S t e v e n s o n ' s p s y c h e than is revealed b y g l i m p s e s o f his c h i l d h o o d o b s e s s i o n s , the student r o l e - p l a y i n g , and the s u b v e r s i v e i m a g i n a t i o n . It t o o k the f o r m of a dissociation. D i s s o c i a t i o n is a psychiatric t e r m that refers to the splitting o f mental p r o c e s s e s from m a i n s t r e a m c o n s c i o u s ness. T h e s e p a r a t e d part o f the m i n d s e e m s t o maintain a life o f its o w n . In S t e v e n s o n ' s c a s e the d i s s o c i a t i o n w a s e v i d e n t in his d r e a m life, and in the i m p o r t a n t part that d r e a m s p l a y e d in the creative p r o c e s s . H e g i v e s a v i v i d a c c o u n t o f this i n the e s s a y ' A C h a p t e r on D r e a m s ' , in which he writes a b o u t h i m s e l f in the third p e r s o n . In c h i l d h o o d he h a d b e e n ' a n ardent a n d u n c o m fortable dreamer. W h e n he h a d a t o u c h of fever at night, a n d the r o o m swelled and s h r a n k , and his clothes, h a n g i n g on a nail, n o w l o o m e d u p instant t o the b i g n e s s o f a church, a n d n o w d r e w a w a y into a h o r r o r of infinite d i s t a n c e a n d infinite littleness, the p o o r soul w a s v e r y well a w a r e o f w h a t m u s t f o l l o w . . . s o o n e r o r later the n i g h t - h a g w o u l d h a v e h i m by the throat, a n d p l u c k him, s t r a n g l i n g and s c r e a m i n g , f r o m his s l e e p . ' T h e swelling a n d shrinking, l o o m i n g and r e c e d i n g , a r e examples of micropsia and macropsia, pathological distortions i n the perception o f the size o r s h a p e o f objects w h i c h c o m e under the g e n e r i c h e a d i n g o f ' m e t a m o r p h o p s i a s ' . M i c r o p s i a refers to an illusory reduction in an o b j e c t ' s size, m a c r o p s i a to the o p p o s i t e . Illusions of this sort are often r e p o r t e d in temporal l o b e epilepsy, b u t m a y b e e x p e r i e n c e d i n other n e u r o l o g i c a l conditions, i n c l u d i n g m i g r a i n e . T h e y can a l s o b e c a u s e d b y fever, a s S t e v e n s o n ' s a c c o u n t s u g g e s t s , a n d m a y

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be quite c o m m o n in c h i l d h o o d in the a b s e n c e of illness. I certainly r e m e m b e r h a v i n g s u c h e p i s o d e s a s a y o u n g child. T h e d e s c r i p t i o n o f things l o o m i n g u p 'to the b i g n e s s o f a church' a n d then d r a w i n g a w a y 'into a h o r r o r of infinite distance and infinite littleness' c a p t u r e s the feeling quite brilliantly. M a n y o f S t e v e n s o n ' s c h i l d h o o d d r e a m s w e r e far from fearful o r d i s t u r b i n g . ' H e w o u l d take l o n g , uneventful j o u r n e y s and see s t r a n g e t o w n s a n d beautiful p l a c e s as he lay in b e d . ' T h e dreamer (that is, S t e v e n s o n ) h a d 'an o d d t a s t e ' for the G e o r g i a n period — consistent with his interest in D e a c o n B r o d i e — and this ' b e g a n to rule the features o f his d r e a m s . . . ' T h e n , a s a student, h e b e g a n to d r e a m in s e q u e n c e , ' a n d thus to lead a d o u b l e life — o n e of the day, o n e of the night—one that he h a d e v e r y reason to believe w a s the true o n e , another that h e had n o m e a n s o f p r o v i n g false.' O n e e x h a u s t i n g s e q u e n c e o f recurrent d r e a m s w a s ' e n o u g h to s e n d h i m , t r e m b l i n g for his r e a s o n , to the d o o r s of a certain d o c t o r ' . T h e d r e a m h a d him in a s u r g i c a l theatre, 'his heart in his m o u t h , his teeth o n e d g e , s e e i n g m o n s t r o u s m a l f o r m a t i o n s and the a b h o r r e d dexterity o f s u r g e o n s ' . T h e n h e w o u l d return t o his l o d g i n g s at the top of a tall b u i l d i n g on the H i g h Street. At least, he tried to return. I n s t e a d he found h i m s e l f endlessly c l i m b i n g stairs to reach the top floor, his clothes wet, all manner o f p e o p l e b r u s h i n g p a s t him o n their w a y d o w n : ' b e g g a r l y w o m e n o f the street, g r e a t , w e a r y , m u d d y l a b o u r e r s , p o o r scarecrows of men, pale parodies of women . . . ' When, finally, h e s a w the light o f d a w n b r e a k i n g t h r o u g h the w i n d o w s h e w o u l d g i v e u p the ascent, turn, a n d g o b a c k d o w n t o the street 'in his w e t c l o t h e s , in the w e t , h a g g a r d d a w n , t r u d g i n g to another day of monstrosities and operations'.

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A n d then there c a m e a t u r n i n g point. He ' h a d l o n g b e e n in the c u s t o m o f setting h i m s e l f t o s l e e p with t a l e s ' , b u t , h e s a y s , these w e r e ' i r r e s p o n s i b l e i n v e n t i o n s ' ; tales told for the teller's p l e a s u r e that w o u l d not s t a n d the scrutiny of a critical reader. T h e y lacked all the i m p o r t a n t e l e m e n t s o f g o o d s t o r y t e l l i n g , such as plausible characters, a consistent s t r u c t u r e , a n d a c o m pelling plot. H i s d r e a m s , like m o s t p e o p l e ' s , w e r e 'tales w h e r e a thread m i g h t b e d r o p p e d , o r o n e a d v e n t u r e quitted for another, o n f a n c y ' s least s u g g e s t i o n . S o that the little p e o p l e w h o m a n a g e m a n ' s internal theatre h a d not as yet r e c e i v e d a v e r y r i g o r o u s t r a i n i n g . . . ' T h i s i s his first m e n t i o n o f 'the little p e o p l e ' . S t e v e n s o n ' s d r e a m s m a d e w o n d e r f u l r a w material for his narratives and c a m e to p l a y an i n c r e a s i n g l y i m p o r t a n t r o l e in his creative life. T h e tales b e g a n t o sell a n d , ' H e r e w a s h e , a n d here w e r e the little p e o p l e w h o did that p a r t of his b u s i n e s s , in quite n e w c o n d i t i o n s . ' A g r e a t e r discipline w a s r e q u i r e d . ' T h e stories m u s t n o w b e t r i m m e d a n d p a r e d a n d set u p o n a l l - f o u r s , they m u s t run from a b e g i n n i n g to an end a n d fit (after a m a n n e r ) with the l a w s o f l i f e . . . ' Storytelling h a d b e c o m e a b u s i n e s s , n o t o n l y for S t e v e n s o n , but a l s o for the little p e o p l e w h o r a n the d r e a m theatre. B u t , he s a y s , they u n d e r s t o o d the c h a n g e a s well a s he. ' W h e n h e l a y d o w n t o p r e p a r e h i m s e l f for s l e e p , h e n o l o n g e r s o u g h t a m u s e ment, but printable and profitable tales; a n d after he h a d d o z e d off in his b o x - s e a t , his little p e o p l e c o n t i n u e d their e v o l u t i o n s with the s a m e mercantile d e s i g n s . ' O n e such d r e a m s t o r y is d e s c r i b e d at l e n g t h . It is w o r t h r e c o u n t i n g i n detail b e f o r e h e a r i n g S t e v e n s o n ' s a p p r a i s a l . H e

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tells it ' e x a c t l y as it c a m e to h i m ' . T h e d r e a m casts him as 'the s o n of a v e r y rich a n d w i c k e d m a n ' , a l a n d o w n e r , w h o m he has a v o i d e d b y l i v i n g a b r o a d m u c h o f the time. O n his return t o E n g l a n d he finds that his father h a s taken a y o u n g wife, w h o is treated cruelly. F o r r e a s o n s not entirely clear to the dreamer, father a n d s o n a g r e e that they s h o u l d meet, but, t h r o u g h pride a n d a n g e r , neither will c o n d e s c e n d to visit the other; so they m e e t o n neutral g r o u n d , ' a d e s o l a t e , s a n d y country b y the s e a ' . T h e y quarrel a n d , ' s t u n g b y s o m e intolerable insult', the y o u n g e r m a n strikes the other d e a d . A b o v e s u s p i c i o n for the m u r d e r , he inherits his father's estates a n d finds h i m s e l f installed under the s a m e r o o f as the w i d o w . T h e t w o o f them ' l i v e d v e r y m u c h a l o n e , a s p e o p l e m a y after a b e r e a v e m e n t ' , b u t s h a r e d m e a l s , spent e v e n i n g s together, a n d g r a d u a l l y d e v e l o p e d a friendship. T h e n the a t m o s p h e r e c h a n g e s . T h e d r e a m e r s e n s e s that the w o m a n h a r b o u r s s u s p i c i o n s a b o u t his guilt. H e d r a w s b a c k from her c o m p a n y ' a s m e n d r a w b a c k f r o m a p r e c i p i c e s u d d e n l y d i s c o v e r e d ' . But the attraction w a s n o w s o s t r o n g that 'he w o u l d drift a g a i n and a g a i n into the old intimacy, a n d a g a i n and a g a i n be startled b a c k b y s o m e s u g g e s t i v e q u e s t i o n o r s o m e inexplicable m e a n i n g i n her e y e . So they lived at c r o s s p u r p o s e s , a life full of broken dialogue, challenging glances, and suppressed passion.' T h e n o n e day, h e s e e s the w o m a n s l i p p i n g out o f the h o u s e . He p u r s u e s her to the station a n d on to the train, which takes t h e m to the s e a s i d e , w h e r e he f o l l o w s her out over the sandhills, t o the v e r y site o f the m u r d e r . ' T h e r e s h e b e g a n t o g r o p e a m o n g the bents, h e w a t c h i n g her, flat u p o n his f a c e ; a n d p r e s e n t l y s h e had s o m e t h i n g in her hand

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— I cannot r e m e m b e r w h a t it w a s , b u t it w a s d e a d l y e v i d e n c e a g a i n s t the d r e a m e r — and as she held it up to l o o k at it, p e r h a p s from the s h o c k o f the d i s c o v e r y , her foot s l i p p e d , a n d s h e h u n g a t s o m e peril o n the brink o f the tall s a n d - w r e a t h s . H e h a d n o thought but t o s p r i n g u p a n d r e s c u e her; a n d there they s t o o d face to face, she with that d e a d l y matter o p e n l y in her h a n d — his v e r y p r e s e n c e o n the s p o t another link o f p r o o f . ' T h e y return to the train a r m in a r m , j o u r n e y h o m e a n d settle to an o r d i n a r y e v e n i n g . C o n v e r s a t i o n h a s b e e n kept to the trivial. A l t h o u g h the w o m a n w a s a b o u t to s a y s o m e t h i n g after her rescue, he had cut her short. N o w , e x p e c t i n g her to d e n o u n c e him at any m o m e n t ,

' s u s p e n s e and fear d r u m m e d in the

d r e a m e r ' s b o s o m ' . B u t she d o e s not d e n o u n c e h i m . N o r d o e s s h e in the d a y s to follow. In fact, her d i s p o s i t i o n g r o w s m o r e kindly. In contrast, the dreamer, b u r d e n e d with s u s p e n s e , ' w a s t e d a w a y like a m a n with a d i s e a s e ' . U n a b l e to b e a r it a n y l o n g e r he ransacks the w o m a n ' s r o o m while she i s out. H e d i s c o v e r s the d a m n i n g e v i d e n c e a m o n g her jewels. A n d , a s h e s t a n d s h o l d i n g the object ('which w a s his l i f e ' ) in the p a l m of his h a n d , t r y i n g to fathom w h y she s h o u l d h a v e s o u g h t it, kept it, b u t n e v e r u s e d it, the d o o r o p e n s and the w o m a n enters the r o o m . ' S o , o n c e m o r e , they s t o o d , e y e t o e y e , with the e v i d e n c e between them; and o n c e m o r e s h e raised to him a f a c e b r i m m i n g with s o m e c o m m u n i c a t i o n ; a n d o n c e m o r e h e shied a w a y f r o m speech and cut her off. But b e f o r e he left the r o o m , w h i c h he h a d turned u p s i d e d o w n , h e laid b a c k his d e a t h - w a r r a n t w h e r e h e had found it; and at that, her face lighted u p . T h e next thing he heard, she w a s e x p l a i n i n g t o her m a i d , with s o m e i n g e n i o u s f a l s e h o o d , the d i s o r d e r of her things.'

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T h e d r e a m s t o r y r e a c h e s its c l i m a x the f o l l o w i n g m o r n i n g a t b r e a k f a s t . T h r o u g h o u t the m e a l s h e h a d 'tortured him with sly a l l u s i o n s ' b u t now, with the s e r v a n t s g o n e , he b u r s t s from his r e s e r v e a n d confronts her. W h y w a s s h e treating him s o ? S h e k n e w e v e r y t h i n g . W h y d i d s h e not s i m p l y d e n o u n c e h i m ? W h y m u s t s h e torture h i m ? H e a s k s o v e r a n d over. S h e , too, has s p r u n g to her feet, p a l e f a c e d . ' A n d w h e n h e h a d d o n e , s h e fell u p o n her k n e e s , and with o u t s t r e t c h e d h a n d s : " D o y o u not u n d e r s t a n d ? " she cried. " I l o v e y o u ! ' " A t this point, 'with a p a n g o f w o n d e r and mercantile d e l i g h t , the d r e a m e r a w o k e ' . T h e story, h e s u b s e q u e n t l y reali z e d , h a d ' u n m a r k e t a b l e e l e m e n t s ' , w h i c h is w h y he presents it to us in this b r i e f f o r m a n d d i d n ' t m a k e m o r e of it. B u t it s e r v e s to illustrate his point that the little p e o p l e are 'substantive inventors and performers'. ' T o the end they h a d kept their secret. [ T h e d r e a m e r ] h a d n o g u e s s w h a t e v e r at the m o t i v e of the w o m a n — the hinge of the w h o l e w e l l - i n v e n t e d p l o t — until the instant of that highly d r a m a t i c d e c l a r a t i o n . It w a s not his tale; it w a s the little p e o p l e ' s ! A n d o b s e r v e : not o n l y w a s the secret kept, the story w a s told w i t h really guileful craftsmanship. T h e c o n d u c t o f both actors i s (in the cant p h r a s e ) p s y c h o l o g i c a l l y correct, and the e m o t i o n a p t l y g r a d u a t e d up to the s u r p r i s i n g c l i m a x . I am a w a k e now, a n d I k n o w this t r a d e ; a n d yet I c a n n o t better it. I am a w a k e , and I live by this b u s i n e s s ; a n d yet I c o u l d not o u t d o — c o u l d not perh a p s e q u a l — that crafty artifice . . . b y w h i c h the s a m e situation is twice p r e s e n t e d a n d the t w o a c t o r s twice b r o u g h t face to face o v e r the e v i d e n c e , o n l y o n c e it is in her h a n d , o n c e in his - and t h e s e in their d u e order, the least d r a m a t i c first. T h e m o r e I think

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of it, the m o r e I am m o v e d to p r e s s u p o n the w o r l d my question: W h o are the Little People? T h e y are near connections of the d r e a m e r ' s , b e y o n d d o u b t ; they . . . s h a r e plainly in his training; they h a v e plainly learned like h i m to b u i l d the s c h e m e of a c o n siderate story and t o a r r a n g e e m o t i o n i n p r o g r e s s i v e o r d e r ; o n l y I think they h a v e m o r e talent; a n d o n e t h i n g is b e y o n d d o u b t , they can tell him a s t o r y p i e c e by p i e c e , like a serial, a n d k e e p him all the while in i g n o r a n c e of w h e r e they a i m . ' S t e v e n s o n c o n c e d e s that the Little P e o p l e ( o r ' m y B r o w n i e s ' ) d o half his w o r k for him while h e s l e e p s . H e a l s o s p e c u l a t e s that they m i g h t well do the rest for h i m as w e l l , w h e n he is w i d e a w a k e . T h i s is a c u r i o u s l y m o d e r n insight, in line w i t h current v i e w s o n the i m p o r t a n c e o f u n c o n s c i o u s p r o c e s s e s i n cognition. ' F o r m y s e l f — what I call I, my c o n s c i o u s e g o , the d e n i z e n of the pineal g l a n d u n l e s s he h a s c h a n g e d his r e s i d e n c e since D e s c a r t e s , the m a n with the c o n s c i e n c e a n d the v a r i a b l e b a n k account, the m a n with the hat a n d the b o o t s , a n d the p r i v i l e g e of v o t i n g and not c a r r y i n g his c a n d i d a t e at the g e n e r a l e l e c t i o n s — I am s o m e t i m e s t e m p t e d to s u p p o s e he is no story-teller at all, but a creature as matter of fact as a n y c h e e s e m o n g e r or a n y cheese, and a realist b e m i r e d up to the e a r s in actuality; so that, by that account, the w h o l e of my p u b l i s h e d fiction s h o u l d be the single-handed product of s o m e Brownie, s o m e Familiar, s o m e unseen c o l l a b o r a t o r . . . ' S t e v e n s o n w o n d e r s whether his r o l e m i g h t b e s t b e u n d e r s t o o d as an a d v i s e r a n d enabler; he edits the s t o r i e s ; he d r e s s e s them in his finest p r o s e ; he p e r f o r m s the l a b o r i o u s task of sitting at the table and writing the w o r d s d o w n ; a n d he p r e p a r e s a n d

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d e l i v e r s the m a n u s c r i p t . B u t can h e , he w o n d e r s , actually claim to be the a u t h o r of the s t o r i e s ? T h e s t o r y of J e k y l l and H y d e a l s o h a s its o r i g i n s in a d r e a m . S t e v e n s o n h a d for s o m e time b e e n t r y i n g to find a vehicle to e x p l o r e 'that s t r o n g s e n s e o f m a n ' s d o u b l e b e i n g ' . A s well a s the p l a y a b o u t D e a c o n B r o d i e , he h a d a l r e a d y written a s t o r y with that

theme,

The

Travelling

Companion,

but

this

had

been

r e t u r n e d by an editor on the a m b i g u o u s g r o u n d s that it w a s a ' w o r k o f g e n i u s a n d i n d e c e n t ' . S t e v e n s o n w a s not h a p p y with i t either — he d i s a g r e e d that it w a s a w o r k of g e n i u s — and d e s t r o y e d the m a n u s c r i p t . T h e n , he s a y s , he hit certain 'financial fluctuations', which for t w o d a y s forced h i m to rack his b r a i n s 'for a plot of a n y s o r t ' for a s a l e a b l e story. A n d then, on the s e c o n d night, he h a d a nightm a r e , s c r e a m i n g s o l o u d l y his wife felt she h a d t o w a k e him. H e w a s not b e s t p l e a s e d . 'I w a s d r e a m i n g a fine b o g e y tale,' he told her. N e v e r t h e l e s s , h e h a d m a n a g e d t o s e c u r e s o m e key elements of the s t o r y : 'I d r e a m e d the s c e n e at the w i n d o w , and a scene afterward split in two, in which H y d e , p u r s u e d for s o m e crime, t o o k the p o w d e r a n d u n d e r w e n t the c h a n g e in the p r e s e n c e of his p u r s u e r s . ' T h e rest o f the story, h e s a y s , ' w a s m a d e awake, a n d c o n s c i o u s l y , a l t h o u g h I think I can trace in m u c h of it the m a n n e r of my B r o w n i e s ' , a d d i n g that they ' h a v e not a rudiment of w h a t we call a c o n s c i e n c e ' . C o n s c i e n c e m a k e s c o w a r d s o f u s all.

180

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Child (Slight Return)

T e n minutes to g o . I ' m g o i n g to r o u n d o f f my lecture with a story. I scan the a u d i t o r i u m . T h e s t u d e n t s a r e still attentive, p e n s and n o t e p a d s at the ready. A p a l e girl in the front r o w h a s a small tape r e c o r d e r a n d r e a c h e s into her b a g for a r e p l a c e m e n t cassette. A p i g e o n settles on the sill o u t s i d e o n e of the h i g h w i n d o w s a n d , w a t c h i n g it, I forget m o m e n t a r i l y w h a t I w a s about t o say. T h e n i t c o m e s b a c k t o m e : R o b e r t ' s story. O n e day, i n the foothills o f m i d d l e a g e , R o b e r t t o o k a l o n g l o o k at h i m s e l f in the mirror. T h e reflection sent an u n e q u i v o c a l message. Life was running out and he w a s g o i n g nowhere. He w a s stale: b o r e d with his j o b , o u t o f l o v e with his w i f e , stifled b y his family, disenchanted with himself. B u t w h a t s t r u c k h i m m u c h harder, g r i p p e d him and s h o o k him t o the c o r e o f his b e i n g , w a s the t h o u g h t that a t the end o f this d r e a r y line o f d a y s , there w a s o b l i v i o n . It w a s time for a c h a n g e . T h a t d a y o n his w a y t o w o r k h e s t o p p e d a t the n e w s a g e n t s , a s u s u a l , to b u y a n e w s p a p e r . He p a i d for it b u t , on the w a y out,

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w h e n the s h o p k e e p e r w a s n ' t l o o k i n g , R o b e r t t o o k a chocolate b a r f r o m a s h e l f a n d s l i p p e d it into his p o c k e t . T h i s little act of theft w a s c u r i o u s l y e n e r g i z i n g . H i s s e n s e s felt stripped and raw a n d he ran b a c k to his car in a whorl of elation. He d r o v e faster than h e s h o u l d , but, instead o f g o i n g t o w o r k , h e travelled 320 m i l e s f r o m Y o r k s h i r e t o C o r n w a l l . B y early e v e n i n g , h e found h i m s e l f sitting on a b e a c h , in the face of a w a r m sea breeze. R o b e r t w a s p r o f o u n d l y happy. T h e sun set, it g r e w d a r k and chilly, but he s t a y e d there all night, c o n c e d i n g to sleep o n l y as the sun r o s e in another part of the sky. C o u l d h e b e s u r e i t w a s the s a m e sun? h e w o n d e r e d . H e r e t u r n e d h o m e late in the d a y with no explanation except the truth a n d spent another s l e e p l e s s night p l a c a t i n g his distressed w i f e . S h e d e m a n d e d a m o r e p l a u s i b l e v e r s i o n o f events. 'Robert, w h a t w e r e y o u thinking o f ? ' she s a i d . He s a i d h e ' d b e e n thinking a b o u t e v e r y t h i n g and had put a few t h i n g s straight in his m i n d . L i f e reverted to routine for a c o u p l e of w e e k s . T h e n , d r i v i n g h o m e f r o m w o r k o n e F r i d a y e v e n i n g , R o b e r t switches o n the car r a d i o a n d h e a r s an interview with J u l i a n B r e a m , the classical guitarist. A t o n e point the interviewer a s k s B r e a m what h e thinks o f 'electrically amplified g u i t a r s ' . ' T h e electric b a s s i s fine,' h e s a y s , b u t o t h e r w i s e h e ' s not i m p r e s s e d . W h a t d o e s h e think of J i m i H e n d r i x as a p l a y e r ? R o b e r t detects a note of c o n d e s c e n s i o n in the interviewer's v o i c e at the m e n t i o n of H e n d r i x , b u t thinks i t ' s a g o o d q u e s t i o n , o n e he h i m s e l f w o u l d h a v e w a n t e d to put. He w a i t s for the reply. Don't let me down, Julian, h e thinks. T h e r e i s n o l e t - d o w n . ' H e w a s brilliant,' s a y s B r e a m , l e a v i n g the interviewer m o m e n t a r i l y f l u m m o x e d . R o b e r t gets

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another b u r s t of e n e r g y like the o n e he h a d w h e n he stole the chocolate bar. H e turns r o u n d the car, h e a d s b a c k into t o w n a t s p e e d a n d pulls up on the p a v e m e n t o u t s i d e a m u s i c a l i n s t r u m e n t s s t o r e . T h e s h o p is set to c l o s e in five m i n u t e s a n d the s a l e s staff are c a s h i n g up. He tells them he m u s t h a v e a F e n d e r S t r a t o c a s t e r , the guitar H e n d r i x p l a y e d . T h e y o b l i g e . R o b e r t b u y s a n a m p l i fier

to

go

with

it

and

a

book

containing

note-by-note

transcriptions o f H e n d r i x s o n g s . T h i s c o m e s t o n e a r l y a t h o u sand p o u n d s . ' B u t R o b e r t , ' s a y s his w i f e w h e n h e g e t s h o m e , ' y o u c a n ' t even p l a y the guitar.' He tells her he is g o i n g to learn. But that night all elation h a s d r a i n e d away. He lies a w a k e until the early h o u r s in a state of a g i t a t i o n , t o r m e n t e d by thoughts o f f a d i n g into n o t h i n g n e s s , a c c o m p a n i e d b y g u t c h u r n i n g feelings of the p r o x i m i t y of d e a t h . Tonight, tomorrow, just around the corner. It's coming, it's coming. He is c l o s e to p a n i c . It's coming,

it's coming. T h e next day, o u t of n o w h e r e , he

a n n o u n c e s to his wife that their m a r r i a g e is o v e r a n d he l e a v e s her, the h o u s e , the children, a n d his n e w guitar, n e v e r to return. R o b e r t g o e s b a c k to C o r n w a l l , w h e r e he finds a b a r j o b , g r o w s his hair, cultivates a tanned a n d w e a t h e r e d l o o k a n d b e c o m e s , in effect, s o m e o n e e l s e . T w o y e a r s later, l i v i n g a l o n e in a t h r e a d b a r e b e d - s i t in the s u b u r b s of a northern city, R o b e r t can s c a r c e l y recollect the C o r n i s h interlude. T h e r e are f r a g m e n t s , i m a g e s f r o m s o m e o n e e l s e ' s m e m o r y , b u t they d o n ' t c o h e r e — a b l u e l a m p s h a d e , a rainy night, the shiny, stainless-steel s u r f a c e s of a hotel kitchen,

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a w o m a n ( J a c k i e ? J e n n y ? ) , a fistfight, the s e a . It is hard to pull t o g e t h e r t h o u g h t s from o n e m i n u t e to the next. H e feels n a u s e o u s . S o m e t h i n g rises s q u i r m i n g from the pit o f his s t o m a c h to his gullet. In the b a t h r o o m mirror, his reflected f a c e s e e m s d r a i n e d o f a n y m e a n i n g , a l m o s t the a b s e n c e o f a reflection. He s t a n d s s t a r i n g for a while, then turns on the w a s h b a s i n tap, turns it off, turns it on a g a i n , off, o n , before c r a s h i n g to the floor. H i s l i m b s stiffen, then jerk fiercely for several m i n u t e s , as a s p r e a d i n g p a t c h of urine d a r k e n s his trouser l e g . He sleeps. T h i s i s R o b e r t ' s third o r fourth seizure this w e e k . T h e next h a p p e n s in the m i d d l e of a s u p e r m a r k e t a n d , afterwards, h e ' s taken t o hospital. T h e d o c t o r s are c o n c e r n e d that, despite r e c o v e r i n g f r o m the fit, he h a s r e m a i n e d inert and disoriented. T h e y i n v e s t i g a t e with h e a d s c a n s a n d find a l a r g e m a s s in the orbitofrontal r e g i o n of the b r a i n . It turns out to be a mening i o m a . T h i s is a t u m o u r , intrinsically b e n i g n , which has i n v a d e d the outer c o v e r i n g s of the b r a i n . It h a s b e e n g r o w i n g for several y e a r s . B y d i s t o r t i n g the frontal l o b e s o f R o b e r t ' s brain, i t w a s r e s h a p i n g the v e r y p e r s o n h e felt h i m s e l f t o b e . T h e y o p e r a t e . T u m o u r e x c i s e d , R o b e r t e n q u i r e s o f his n u r s e s m o s t d a y s : ' W h e n are m y children c o m i n g ? ' a n d ' C a n I g o h o m e n o w ? ' T h e lecture s e e m s t o h a v e g o n e well e n o u g h . T h e s e n e u r o g o t h i c tales g e n e r a l l y d o . I tell them ' R o b e r t ' s s t o r y ' is a s o m e w h a t e m b e l l i s h e d a c c o u n t of a real c a s e . I ' v e tinkered with s o m e o f the b i o g r a p h i c a l i n f o r m a t i o n a n d , o f c o u r s e , the p a t i e n t ' s n a m e w a s not really R o b e r t , but the clinical details a r e , in e s s e n c e , faithful. T h i s m a n really did l e a v e his family on an impulse

184

following several

episodes

o f uncharacteristically

INTO

T H E

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L A N D

eccentric b e h a v i o u r , i n c l u d i n g acts o f petty theft a n d s p o n t a n e o u s trips t o s e a s i d e t o w n s a n d other p l a c e s . H e really d i d spend s u m s o f m o n e y h e c o u l d ill afford o n l u x u r y g o o d s like musical instruments (which h e c o u l d not p l a y ) a n d e x p e n s i v e clothes (which h e m i g h t , o r m i g h t not, w e a r ) . H e w a s a J i m i H e n d r i x fan, t o o . A l a r g e , i c o n i c i m a g e o f the g r e a t m a n stared from his b e d r o o m wall at the rehab unit. H e n drix, at least, r e m a i n e d c o n s t a n t in his life. W h e t h e r or n o t he s t o o d in conference with the m i r r o r in the w a y I d e s c r i b e at the b e g i n n i n g a n d the end, I ' v e no i d e a . I threw that in. P e r h a p s , s o m e w h e r e , I h a d in m i n d the i m a g e of J e k y l l s t a n d i n g b e f o r e the m i r r o r a s h e w a t c h e s his t r a n s f o r m a t i o n into H y d e , a n d then, a t the end, p e r h a p s i t w a s D r a c u l a , bereft o f s o u l , bereft o f reflection. I d o n ' t k n o w . I t ' s o n l y just o c c u r r e d to m e . After the operation h e really did expect t o return t o the b o s o m o f his family, u n a w a r e that they h a d l o n g since m o v e d o n . W h e n did the s l o w t u m o u r take r o o t ? H o w l o n g h a d i t b e e n g r o w i n g and h e a v i n g its b u l k into his frontal l o b e s , i n s i d i o u s l y recalibrating his p e r s o n a l i t y ? A m e n i n g i o m a like R o b e r t ' s c a n take y e a r s to d e v e l o p , eventually b e c o m i n g a stable feature of the intracranial l a n d s c a p e . T h e b r a i n c a n , u p t o a point, a c c o m m o d a t e a s l o w - g r o w i n g m a s s w i t h o u t b e t r a y i n g m a j o r clinical s i g n s o r s y m p t o m s . I t d e p e n d s o n the rate o f g r o w t h a n d w h e r e i t ' s l o c a t e d . S o m e p e o p l e g r o w old and d i e n e v e r k n o w i n g that for h a l f their life or m o r e they w e r e h a r b o u r i n g a b e n i g n b r a i n tumour. P e r h a p s they n e v e r k n o w w h o they m i g h t h a v e b e e n . I o n c e s a w a m a n in his s e v e n t i e s a d m i t t e d to hospital for investigation of a s t r o k e . He t u r n e d o u t to h a v e a t u m o u r the size o f a n o r a n g e nestling i n the parietal l o b e o f his b r a i n . I t h a d

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n o t h i n g to do with the s t r o k e , h a d p r o b a b l y been there for d e c a d e s a n d w a s n ' t , apparently, g i v i n g him a n y trouble. It had b e c o m e a part of him. Perhaps

Robert would

h a v e left his wife

and

children

a n y w a y . P e r h a p s he w a s restless and b o r e d , or d e p r e s s e d . A m i d - l i f e crisis. It c o u l d be that the t u m o u r just hastened the p r o c e s s or even h a d n o t h i n g at all to do with his i m p u l s i v e d e c i s i o n to p a c k his b a g s a n d g o . We can't rule this out entirely, but I think not. I m p a i r m e n t s of social j u d g e m e n t , i m p u l s i v e b e h a v iour, a n d all the rest that e m e r g e d t h r o u g h R o b e r t ' s personality c h a n g e are a c o m m o n c o n s e q u e n c e of d a m a g e to the frontal lobes. U n l i k e the m a n with the s t r o k e , R o b e r t ' s t u m o u r was c a u s i n g him t r o u b l e . H e d e v e l o p e d epilepsy. B u t s u p p o s e h e hadn't. S u p p o s e there h a d b e e n n o o b v i o u s m e d i c a l c o m p l i c a t i o n s , that the t u m o u r w a s just there, n u d g i n g a n d n i g g l i n g , resetting the d i a l s o f R o b e r t ' s personality. W o u l d there h a v e b e e n g r o u n d s for s a y i n g that his b e h a v i o u r w a s p a t h o l o g i c a l ? N o . Y o u w o u l d s a y it w a s a mid-life crisis. D e s p i t e my u n d i s g u i s e d haste to d r a w the p r o c e e d i n g s to a c l o s e (I h a v e a train to catch) there a r e several q u e s t i o n s . S o m e a r e technical, but they a r e m o s t l y a b o u t the story, as a story. Fair enough. ' H a v e y o u e v e r c o n s i d e r e d all this from a Christian p e r s p e c t i v e ? ' a s k s the p a l e girl at the front a s , finally, I gather my notes. ' N o , not really,' I s a y rather briskly. ' P e r h a p s we can d i s c u s s it next w e e k ? ' ' B u t w h a t h a p p e n e d t o R o b e r t i n the e n d ? ' ' H e became profoundly depressed.'

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I s p a r e her the i n f o r m a t i o n that after b e i n g d i s c h a r g e d f r o m his rehab hospital, there w e r e t w o b o t c h e d s u i c i d e a t t e m p t s before he finally s u c c e e d e d in killing himself. T h i r d t i m e lucky. I h a v e this u n n e c e s s a r y i m a g e of R o b e r t h a n g i n g h i m s e l f with H e n d r i x s i n g i n g ' V o o d o o C h i l d ' in the b a c k g r o u n d : And if I don't meet you no more in this world / I'll meet you in the next one. /And don't he late . . . It didn't h a p p e n that w a y . My train is m o r e than h a l f an h o u r late a n d I kill time in a b o o k s h o p . I n o w regret not a l l o w i n g the p a l e girl m o r e t i m e . S h e s e e m e d g e n u i n e l y d i s t r e s s e d . I r e s o l v e to s e e k her o u t after the next lecture and m a k e a m e n d s . B u t n o w I ' m on the train. I h a v e a beer in o n e hand a n d , in the other, the p a p e r b a c k I ' v e just bought. It's about c o s m o l o g y and I'm trying to get s o m e i m a g inative p u r c h a s e on the i m m e n s i t y of it all. I t ' s the kind of t h i n g I s o m e t i m e s read a s a w a y o f w i n d i n g d o w n . T h e g r a n d i l o q u e n t p r o s e (velvet mantle of the night... cosmic symphony of the heavens), and the b i g , r o u n d n u m b e r s (four hundred billion galaxies) h a v e a s o o t h i n g effect. Cosmology

and

neuropsychology

have

absurdity

in

c o m m o n . T h e r a w facts are s t r a n g e b e y o n d i m a g i n a t i o n . It sets me thinking a b o u t h o w the p h y s i c a l forces that twist the g a l a x i e s and roll the train a l o n g the t r a c k c o n n e c t with the social and p s y c h o l o g i c a l forces that a n i m a t e the p a s s e n g e r s . T h a t recalcitrant child a n d his w e a r y m o t h e r , the old c o u p l e sitting i n silence, the w o m a n o p p o s i t e w h o catches m y e y e , d i s p l a y s a m i c r o m o m e n t a r y flicker of an e y e b r o w a n d s m i l e s as the y o u n g m a n with a n o b s c e n e m e s s a g e printed o n his T - s h i r t takes the seat b e s i d e her. Fleetingly, she a n d I w e r e complicit. I entered her mind and s h e entered m i n e . W e can p l o t the m o t i o n s o f the

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p l a n e t s , but h o w d o y o u m e a s u r e the force o f a g l a n c e , o r the w e i g h t of a s m i l e ? T h i n k i n g these t h o u g h t s a n d l o o k i n g a t the p e o p l e a r o u n d me I entertain m y s e l f by s e e i n g them for what, at o n e level of d e s c r i p t i o n , they certainly a r e : c o m p l e x b i o l o g i c a l machines. P h y s i c a l o b j e c t s . I take a little t h o u g h t j o u r n e y behind their e y e s a n d all I s e e is d a r k n e s s ; then, l o o k i n g to the w i n d o w , a g a i n s t the d a r k , I s e e m y s e l f l o o k i n g b a c k at m e , lost in a confusion of first a n d third p e r s o n . T h e i m a g e in the w i n d o w r e s e m b l e s a machine like the o t h e r s on the train, but with an involuntary flip from third p e r s o n t o f i r s t , I ' m b a c k n o w o n this s i d e o f the reflection, sitting in my o w n clear c a p s u l e of c o n s c i o u s n e s s . I b u y the illus i o n that other p e o p l e inhabit similar c a p s u l e s , but o b v i o u s l y they d o n ' t . A n d f r o m their p e r s p e c t i v e neither d o I . I g e t a n o t h e r beer. I l o o k a g a i n at my reflection. It chuckles. W h e n finally I g e t h o m e , I feel p r o f o u n d l y content, i m m e r s e d in m y family.

S e c u r e , i m m u t a b l e , invulnerable, i m m o r t a l . A s

R o b e r t o n c e felt, p e r h a p s .

*** T h e p a l e girl i s not here today. N o t i n the front row, a n y w a y . I ' m e a r l y and I w a t c h the students as they file in. T h e r o w s fill up, but s h e i s not here. S o m e l a t e c o m e r s arrive f i v e , ten minutes into m y lecture, but she is not a m o n g them. I p i c k up w h e r e we left o f f last w e e k , p o i n t i n g out that illness o f v a r i o u s k i n d s m a y indirectly affect the w a y w e s e e o u r s e l v e s , b u t that n e u r o l o g i c a l d i s e a s e s o m e t i m e s g o e s straight t o the c o r e a n d d i s t o r t s the p e r s o n i n e s s e n c e . L i k e parasitic w a s p larvae

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d e v o u r i n g a living caterpillar from the i n s i d e , a d i s e a s e can penetrate the s u b s t r u c t u r e s of the s e l f — the neural s y s t e m s c o n trolling l o n g - t e r m m e m o r y o r t h o s e that r e g u l a t e e m o t i o n o r the hatching of intentions or the s h a p i n g of beliefs. I r e m i n d them o f R o b e r t ' s s l o w - g r o w i n g t u m o u r a n d h o w h e c a m e t o s e e the w o r l d in a different way. He t h o u g h t differently, b e h a v e d differently, felt differently a b o u t the p e o p l e a r o u n d him. W a s the R o b e r t w h o i m p u l s i v e l y b o u g h t e x p e n s i v e c l o t h e s a n d e l e c tric g u i t a r s , w h o stole c h o c o l a t e b a r s , m a d e i m p r o m p t u trips t o s e a s i d e t o w n s , and finally w a l k e d out on his wife a n d children — w a s h e the s a m e R o b e r t w h o , p r e v i o u s l y , h a d b e e n s o d e v o t e d t o his family, w o r k e d hard to p a y the bills, w h o w o u l d n e v e r h a v e d r e a m t o f stealing anything, a n d d i d n ' t take risks o r g e t into fights? If not, w h e n did J e k y l l b e c o m e H y d e ? W a s there a s i n g l e incident or a s i n g l e d a y that m i g h t be s a i d to m a r k the t r a n s i tion? Is it p o s s i b l e to pin it d o w n to a s i n g l e m o m e n t ? D o n ' t we all d o rash a n d stupid things from time t o time? H o w m a n y a d d up to a p e r s o n a l i t y c h a n g e ? T h e n the return journey. R o b e r t ' s t u m o u r w a s r e m o v e d a n d he w a s b a c k to s o m e t h i n g like his f o r m e r self. Something like. H e y e a r n e d for his wife a n d k i d s . H e w a n t e d them b a c k . B u t i n other w a y s he w a s irretrievably different, intellectually a n d emotionally. H i s mental p o w e r s w e r e d i m i n i s h e d . H e b e c a m e forgetful a n d c o u l d n ' t c o n c e n t r a t e . H e c o u l d n ' t p l a n t h i n g s from o n e d a y t o the next; his v i e w o f the future w a s f o r e s h o r t ened. H i s face w a s p r e s s e d a g a i n s t the wall o f the p r e s e n t , b u t the past w a s at his shoulder. It w a s w h e r e he felt he b e l o n g e d ; in the g o l d e n valley of the time b e f o r e the t u m o u r . M o r e than that, it w a s where he often b e l i e v e d h i m s e l f to b e .

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T h i s w a s n o t a wistful d w e l l i n g on the past. S o m e t i m e s he w a s c o n f u s e d to the extent that he b e l i e v e d nothing had c h a n g e d . H i s w i f e w o u l d c o m e t o collect him. S h e would. S h e ' d b e here s o o n . T h e y w o u l d p i c k u p the children from school together. T h e y w o u l d g o h o m e . T h e p a s t w a s like a radio jingle; not m u c h tone or m e l o d y , b u t it w a s in his h e a d and w o u l d not l e a v e h i m a l o n e . T h e n there w a s the d e p r e s s i o n - and in o n e of these b l a c k t r o u g h s h e t o o k his o w n life. W h a t relationship did p o s t - o p e r a t i v e R o b e r t h a v e t o his f o r m e r s e l v e s ? W h a t w a s his ' r e a l ' s e l f ? W h a t w a s his identity? I realize I ' m waffling. S o m e of the students are shuffling in their s e a t s . T h e y h a v e c o m e t o d e p e n d o n lectures structured like s e l f - a s s e m b l y furniture m a n u a l s , with h a n d o u t s and w e b p a g e s full of d i a g r a m s and flow charts, bullet points and refere n c e s . Y o u g i v e t h e m L e g o bricks o f fact and o p i n i o n and y o u tell t h e m p r e c i s e l y h o w they fit together. I ' m thinking a l o u d . It disturbs them. ' D o n ' t w o r r y a b o u t the p r e c i s e m e a n i n g s o f t e r m s like self a n d personal identity,' I say. O r d i n a r y l a n g u a g e notions will do for now. A c t u a l l y , I ' m inclined to think that o r d i n a r y l a n g u a g e n o t i o n s are a b o u t as g o o d as it g e t s when it c o m e s to talking a b o u t ' p e r s o n a l identity' a n d the ' s e l f ' , but I d o n ' t mention this. ' T h i n k of your self. Y o u k n o w , that which y o u think r o u g h l y defines you, the c o n s c i o u s b e i n g sitting here in this lecture theatre; that which d i s t i n g u i s h e s y o u from the p e r s o n sitting next t o y o u o r s o m e o n e s o m e w h e r e else d o i n g s o m e t h i n g different. Or a c o r p s e . ' A c o r p s e ? W h e r e d i d that c o m e f r o m ? B u t then an i m a g e of last n i g h t ' s s t r a n g e d r e a m f l o a t s b e f o r e m e . Matilda, o n e o f the

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junior d o c t o r s , w a s there. W e h a d the top h a l f o f a m a n ' s b o d y ready for dissection. N e x t thing I k n o w , the h e a d is s e p a r a t e d from the torso. T h e r e ' s Mattie, m e , a n d s o m e other m a l e , I d o n ' t k n o w who. I feel s q u e a m i s h , b u t try n o t to let it show. R e l u c tantly, but deftly, Mattie g e t s started with a cranial saw. At s o m e level I k n e w it w a s a d r e a m b e c a u s e s a w i n g t h r o u g h the skull of a c a d a v e r invariably r e l e a s e s the smell of b u r n i n g b o n e - think of that acrid smell of the d e n t i s t ' s drill b o r i n g into y o u r teeth. B u t t h e r e ' s n o o d o u r . N o s o u n d e v e n . S o o n the top of the skull is r e m o v e d a n d we are l o o k i n g inside at the remnants of the brain, except it l o o k s m o r e like a m a s s of m e l t e d candle w a x than a brain. I c a n s e n s e M a t t i e ' s d i s g u s t . She's going to be sick, I think. A n d s h e is - just a little, in the efficient, m e a s ured w a y that cats are sick — straight into the o p e n e d h e a d a n d over the w a x y brain. T h i s j o b i s g e t t i n g t o m e . P e r h a p s t h e r e ' s a part o f m e t r y i n g t o tell m e s o m e t h i n g . A s i f r e p u l s e d b y m y p r i v a t e t h o u g h t s ( a r e they h o v e r i n g like a p o l l u t e d mist a b o v e my h e a d ? ) , a w o m a n at the b a c k of the hall stands up and m a k e s her w a y to the exit. T h e d r e a m r e p l a y s itself like a s c e n e f r o m a film. I m e r e l y o b s e r v e . T h e m a c a b r e narrative h a s n o t h i n g t o d o with m e . I didn't plan or construct it. It a p p e a r e d fully f o r m e d in my d r e a m . If s o m e o n e had told me this s t o r y y e s t e r d a y , as a d r e a m vignette o f their o w n , I w o u l d not h a v e c l a i m e d rights o f o w n ership. It w o u l d h a v e s e e m e d novel a n d unfamiliar. If o v e r breakfast this m o r n i n g I h a d b e e n a s k e d a b o u t my d r e a m last night, I m i g h t well h a v e b e e n u n a b l e to r e m e m b e r . I u s u a l l y can't. T h e scene u n f o l d e d while the c o n s c i o u s , reflecting, d e l i b e r -

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a t i n g 'I' was d o r m a n t a n d , by the time 'I' returned to wakefuln e s s , i t h a d retreated into s o m e secret c o m p a r t m e n t o f m y brain, like a hermit c r a b f o l d i n g b a c k into its shell. S y n a p t i c a l l y e n c r y p t e d to s u r v i v e the transition b e t w e e n sleep and w a k e fulness, the virtual shell then travels with me to the university. I b r i n g it to the lecture. A n d then at s o m e u n c o n s c i o u s signal, or p e r h a p s for no r e a s o n at all, the c r a b e m e r g e s and the d r e a m s t o r y u n r a v e l s in the m i d d l e of my talk. It h a s nothing to do with m e . T h e a u d i e n c e settles d o w n w h e n I s h o w them d i a g r a m s o f the b r a i n a n d tabulate s o m e o f the clinical s y n d r o m e s associated with d a m a g e to the frontal l o b e s : 1. Dysexecutive type ( d o r s o l a t e r a l d a m a g e ) ; impaired j u d g e m e n t a n d difficulties with p l a n n i n g a n d p r o b l e m - s o l v i n g . L a c k p e r s i s t e n c e or, the o p p o s i t e , persist in p e r f o r m i n g an action well b e y o n d the point o f usefulness o r a p p r o p r i a t e ness ('perseveration'). 2. Disinhibited type (orbitofrontal d a m a g e ) ; b e h a v i o u r is s t i m ulus-driven.

The

balance

between

internally

generated

a c t i o n s a n d t h o s e t r i g g e r e d by external objects and events is lost. T e n d t o b e distractible. S h o w i m p o v e r i s h e d social insight. 3. Apathetic type ( m e d i o f r o n t a l d a m a g e ) ; a p a t h y and indiffere n c e , l o s s o f initiative, lack o f spontaneity; i m p o v e r i s h m e n t o f s p e e c h and t h o u g h t ; r e d u c e d b e h a v i o u r a l output. I a s k them whether R o b e r t ' s b e h a v i o u r fits any of these schemes, w h i l e reflecting, privately, that my t e a c h i n g style t o d a y has per-

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h a p s d i s p l a y e d elements o f the first a n d s e c o n d s y n d r o m e , i f n o t the third. In c o n c l u s i o n , I q u i c k l y r e v i e w the m a i n t h e m e s of the l e c ture and we finish ten m i n u t e s early. T h e r e are no q u e s t i o n s . T h e p a l e girl is not here to a s k whether I h a v e c o n s i d e r e d it all from a Christian p e r s p e c t i v e . I w i s h s h e w e r e . T h i s train's o n time, m o r e o r l e s s . I t ' s s e v e n o ' c l o c k and darker than it s h o u l d be for the time of year. S u d d e n l y I feel tired. P e r h a p s I ' m b r e w i n g a c o l d . O n e of the s t u d e n t s p r e s s e d a b o o k a b o u t B u d d h i s m into m y h a n d s a s I w a s l e a v i n g the lecture hall. T h e r e ' s s o m e stuff a b o u t suffering a n d d e a t h setting the c o - o r d i n a t e s for life. I ' m not in the m o o d . I m u s t h a v e b e e n twenty minutes o n the s a m e p a g e . At the station, as p e o p l e are b o a r d i n g the train, I w a t c h a m a n and a w o m a n on the p l a t f o r m . T h e y a r e e m b r a c i n g p a s s i o n a t e l y , s a y i n g their g o o d b y e s . I ' m r e m i n d e d o f w h a t s o m e o n e o n c e said a b o u t p a r t i n g s : h o w the instant t h e y ' r e g o n e the p e r s o n y o u w e r e with s e e m s m o r e powerfully p r e s e n t than e v e r b e f o r e . A b s e n c e i s tangible. T h e m a n g e t s o n the train, the w o m a n r e m a i n s on the p l a t f o r m . He l o o k s red e y e d a n d quite shaken. I watch the face o f his g i r l f r i e n d / w i f e / m i s t r e s s a s w e pull a w a y . It has a chilling c o m p o s u r e . It is a b l o c k i n g f a c e , d e n y i n g entry and exit. H e w o n ' t see her a g a i n . He sits just a c r o s s the aisle from me a n d I feel an irrational u r g e to g i v e him the b o o k a b o u t B u d d h i s m . I p u t it a s i d e a n d turn to the b u n d l e of p a p e r s I p i c k e d up at the university. I still h a v e a p i g e o n h o l e , e v e n t h o u g h it's a y e a r since I left. T h e D e p a r t m e n t a l C o m m i t t e e m i n u t e s are a t the t o p o f the pile but, beneath this, s o m e t h i n g catches my e y e : a n o t e a b o u t the

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s u i c i d e of an u n d e r g r a d u a t e . A w o m a n , a final-year student. It is n o t a n a m e I r e c o g n i z e . T h e train clatters a c r o s s s o m e points, c l a c k e t y - c l a c k , a n d m y s t o m a c h turns. ' T h a t girl w h o killed herself. W h a t did she l o o k l i k e ? ' I ' m h o m e . A t last I ' v e found m y old a d d r e s s b o o k and I ' m p h o n i n g a f o r m e r c o l l e a g u e at the university, the o n e w h o pers u a d e d me to do the lectures. He is s l u g g i s h . It is well past midnight. ' I ' m s o r r y , ' I say. ' I t ' s l a t e . ' ' N o , it's o k a y . ' ' W h a t d i d she l o o k l i k e ? ' 'I don't know. I've no idea.' I t takes p r e s e n c e o f m i n d t o put a n end t o o n e ' s o w n life. S u i c i d e m a y be the bitter fruit of h o p e l e s s n e s s a n d despair, but it i s a l s o the e n d point o f a d e c i s i o n - m a k i n g p r o c e s s . T h e r e s e e m s to be a 'letting g o ' , an a c c e p t a n c e of the idea of death that i n d u c e s clarity o f t h o u g h t and p e a c e o f m i n d . T h o s e c l o s e t o a s u i c i d e often r e p o r t that the p e r s o n s e e m e d h a p p i e r o r m o r e tranquil than u s u a l in their final h o u r s . T h e r e ' s s o m e t h i n g I read s o m e w h e r e — I c a n ' t p l a c e it — a b o u t the c a u s e s of suicide and h o w they are n o t a l w a y s o b v i o u s o r predictable and how, i f s o m e o n e is in a particular frame of m i n d , it d o e s n ' t take m u c h to tip t h e m o v e r — an innocent r e m a r k misinterpreted; a g e s t u r e misperceived. I ' v e t h o u g h t a b o u t the p a l e girl a lot this p a s t w e e k , but h a v e n ' t f o l l o w e d it u p . I d o n ' t w a n t to a p p e a r m o r b i d or o b s e s s i v e . I c o u l d h a v e m a d e discreet enquiries, found s o m e pretext. It w o u l d h a v e b e e n a n o r m a l thing to do. B u t I didn't, for my o w n s a k e . I d i d not w a n t to s e e myself b e h a v i n g in that way,

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b e t r a y i n g s i g n s o f culpability. I ' m not c u l p a b l e . Yet m o r e than o n c e I have pictured a counter-factual w o r l d w h e r e I ' m the p e r fect, patient teacher. ' H a v e y o u e v e r c o n s i d e r e d all this f r o m a Christian p e r s p e c t i v e ? ' s h e a s k s , and I s a y : ' T e l l m e w h a t y o u m e a n , e x a c t l y ' T h e n we h a v e a c o n v e r s a t i o n for five, ten, twenty minutes; h o w e v e r l o n g it takes for me to listen to her c o n c e r n s and put m y o w n point o f v i e w g e n t l y and c o n s i d e r ately, without c r u s h i n g her. A n d then I w o u l d h a v e c a u g h t my train, b e c a u s e it w a s h a l f an h o u r late a n y w a y a n d in my wry, atheistic w a y I w o u l d h a v e c o n s t r u e d this as a beneficent n o d from the C r e a t o r , a little t h a n k s - f o r - t a k i n g - t h e - t r o u b l e g e s t u r e . I think a b o u t her n o w as I rush to my lecture. T h e train w a s late. T h e hall i s full. T h e y ' r e w a i t i n g . S h e ' s w a i t i n g . T h e r e s h e is in the front r o w with her mini cassette recorder. W h e r e h a v e y o u been? I w a n t to a s k her. W h e r e were y o u ?

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I t ' s C l a r a , m y trainee, o n the p h o n e , a s k i n g m e t o c o m e and see Mr B a r r i n g t o n . I ' m f o r m i n g a picture as I m a k e my w a y d o w n the c o r r i d o r to the outpatient clinic. Mid-fifties, light g r e y suit, w e t , b l u e e y e s , s a n d y hair, m o i s t h a n d s h a k e , the hint of a s t a m mer. I s a w h i m a c o u p l e of w e e k s a g o . T h e r e before me as I enter the r o o m is a m i d d l e - a g e d m a n , the s a m e suit, the s a m e e y e s . But this m a n is c o m p l e t e l y b a l d . H i s h e a d glistens u n d e r the strip l i g h t i n g . T h e r e are tears filling his e y e s and he is s w e a t i n g profusely. He l o o k s g l o b u l a r , d r i p p i n g w e t to his b o n e s . I t ' s a feature o f his m e d i c a l condition. T h e y h a d started their a s s e s s m e n t s , C l a r a explains, but M r B a r r i n g t o n q u i c k l y b e c a m e d i s t r e s s e d and felt u n a b l e to c o n tinue. S h e tells me this in just t h o s e t e r m s , as if r e a d i n g from a set of n o t e s . I m a k e a pretence of j o t t i n g d o w n s o m e notes of my o w n , but w h a t I h a v e written, a n d am n o w tilting t o w a r d s C l a r a is: What happened to his hair? Mr Barrington is ahead of me. 'You're probably wondering w h a t h a p p e n e d t o m y hair.'

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A p p a r e n t l y it fell o u t at the w e e k e n d , m o s t l y d u r i n g S a t u r d a y night while he lay in b e d t r y i n g to sleep. It c a m e o u t in c l u m p s as his h e a d t o s s e d a n d turned on the pillow, c o v e r i n g the sheets a n d sticking to his p e r s p i r i n g skin. He tried to b r u s h it a w a y , b u t the sheets w e r e d a m p a n d h e w a s afraid o f w a k i n g his w i f e . S e v e r a l times h e went t o the b a t h r o o m t o d i s p o s e o f the hair h e h a d g a t h e r e d , each time n o t i c i n g in the mirror, w i t h o u t p a r t i c u l a r d i s m a y , the v i r g i n p a t c h e s o f skin a d v a n c i n g a c r o s s his h e a d . 'You weren't concerned?' I ask. ' N o . I t ' s the least o f m y w o r r i e s . ' A n y w a y , he h a d lost a few c l u m p s o v e r the w e e k , so it w a s n ' t that m u c h of a s h o c k w h e n the w h o l e lot fell out. H e ' s b e e n u n d e r a terrible strain, he e x p l a i n s , a n d t h i n g s s e e m to h a v e c o m e to a h e a d . I note the u n i n t e n d e d p u n . L a n g u a g e h a s a life o f its o w n . H e ' s h a d these things p l a y i n g o n his m i n d , h e s a y s , this thing in particular. ' W o u l d y o u like t o talk a b o u t i t ? ' I a s k . ' A r e y o u able t o ? ' M r B a r r i n g t o n d r o p s his f a c e i n his h a n d s a n d s o b s . B e t w e e n b u b b l i n g sniffs a n d q u i v e r i n g e x h a l a t i o n s he a s k s p e r m i s s i o n to r e m o v e his jacket. H e a l s o r e m o v e s his tie. H i s c r e a m shirt i s m a r k e d with a bib of s w e a t d o w n to the fourth b u t t o n a n d there are l a r g e o v a l s o f d a m p n e s s u n d e r the a r m p i t s . H e r e g a i n s his c o m p o s u r e and i s s t e e l i n g h i m s e l f t o s a y s o m e t h i n g , b u t i s not quite ready. ' W h y d o n ' t y o u take a b r e a k , ' I say, ' g e t a b r e a t h of fresh air. T h e n , i f y o u like, y o u c a n c o m e b a c k a n d we'll chat. We'll l e a v e the tests for now.' M r B a r r i n g t o n just stares a t the floor b e t w e e n u s . N o , h e s a y s , h e m u s t talk. I t ' s d r i v i n g him m a d . B u t h e r e m a i n s hesitant. H i s

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g a z e retreats to his feet. T h e n , l o o k i n g in C l a r a ' s direction, he s a y s i f w e d o n ' t m i n d h e thinks h e ' d find i t easier i f . . . C l a r a u n d e r s t a n d s . 'I'll s e e y o u later,' she s a y s , a n d leaves. M r B a r r i n g t o n g a z e s o u t o f the w i n d o w a c r o s s the s u b u r b s t o w a r d s the distant hills, his wet, b l u e e y e s unblinking. He isn't a d m i r i n g the view. He is adrift s o m e w h e r e in a v a s t , inner s p a c e , the e x h a u s t e d p r e y of a relentless e m o t i o n a l p r e d a t o r : guilt. I s h a k e his s o g g y h a n d a t the end o f the s e s s i o n . H e i s v e r y g r a t e ful. I listened. I a d v i s e d . O u t s i d e it h a s started to rain. Clinical s u p e r v i s i o n . W h i l e C l a r a fills the kettle, I think b a c k to Mr B a r r i n g t o n . I s e e his a r m s s w i n g d o w n at his sides, his h e a d roll b a c k . I hear the s u s t a i n e d , oscillating g r o a n like a child e x h a u s t e d by a b o u t of c r y i n g . T h e n the c o n f e s s i o n : a single, w e e d y act of marital infidelity, a l o n g time a g o . H i s wife never knew. H e ' d a l m o s t forgotten. ' B u t n o w i t ' s p l a y i n g o n y o u r c o n s c i e n c e ? ' I'd s a i d , which w a s feeble in the c i r c u m s t a n c e s . T h i s w a s not a w a s p at a picnic. It w a s a s k e w e r i n g t o r m e n t . H i s hair h a d fallen out. T h e s t o r m t r o o p e r s o f the s u p e r - e g o w e r e d o i n g their w o r s t , c o m m a n d i n g him t o put the record s t r a i g h t with his w i f e . B u t it w o u l d b r e a k her heart, w o u l d n ' t it? What was he to do? 'Tell me what to do,' he said. 'Please.' I w o n d e r if we can d i s e n t a n g l e the d i l e m m a from the d i s e a s e . T h e p r o v i s i o n a l d i a g n o s i s i s m u l t i s y s t e m atrophy, a d e g e n e r a tive c o n d i t i o n . It c a r r i e s a p o o r p r o g n o s i s . P e r h a p s h e ' s clearing the d e c k s . B u t the d i s e a s e is affecting his b r a i n , so the u r g e to c o m e c l e a n , a n d the inability to d e c i d e what to do a b o u t it might also be understood in neurological terms.

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I o n c e m a d e a h o m e visit to s e e a h e a d - i n j u r e d patient. S o m e o n e h a d s w u n g a b a s e b a l l b a t t h r o u g h the front of his skull. A year o n a n d h e w a s d o i n g a s well a s c o u l d b e e x p e c t e d . H e c a m e to g r e e t me at the front d o o r , b u t as he put his h a n d f o r w a r d he noticed a milk bottle on the d o o r s t e p . B e f o r e his h a n d c o n n e c t e d with mine h e w a s b e n d i n g t o p i c k u p the bottle. H e h a d a l m o s t reached it when he b e g a n to straighten a g a i n a n d turn t o w a r d s m e , only t o c h a n g e tack and b e n d t o the d o o r s t e p . H e s t r a i g h t ened a g a i n . H e bent. H e s t r a i g h t e n e d . H e bent. H e shifted his weight and shuffled, s t r u g g l i n g t o e x e c u t e o n e o r other o f the action p l a n s h o p e l e s s l y misfiring in the mutilated circuitry of his frontal l o b e s : motor dysexecutive syndrome. Finally, I p i c k e d up the bottle and g a v e it to him. We w o u l d h a v e b e e n there all d a y otherwise. P e r h a p s M r B a r r i n g t o n ' s q u a n d a r y i s a c a s e o f m o r a l dysexecutive syndrome. C l a r a returns with m u g s of tea. I feel inclined to k e e p Mr B a r r i n g t o n ' s secret. He w a s n a k e d e n o u g h . I w o n ' t tell her, not yet anyway. P e r h a p s not at all, p e r h a p s I'll take c h a r g e of the c a s e , and then s h e n e e d never know.

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Molineux. T h e h o m e of Wolverhampton Wanderers. It's a long w a y t o c o m e for a football m a t c h . T w o h u n d r e d miles and m o r e f r o m h o m e . I still c a n ' t g e t u s e d to the n e w s t a d i u m , all pale b r i c k a n d m u s t a r d - c o l o u r e d steel. W h e n we arrive I feel I s h o u l d b e s o m e w h e r e else. T h e Molineux o f old w a s j a g g e d and d a r k — a p l a c e of w r o u g h t iron, r o u g h c o n c r e t e , and foul smells. N o w e v e n the l a v a t o r i e s a r e s p r u c e a n d well lit. A fan stands at the urinal with a pie in his free hand. I r e m e m b e r the club m o t t o —Out of darkness cometh light—as my s o n s a n d I a s c e n d the s t e p s to the S t a n C u l l i s stand, formerly the N o r t h B a n k . B y the s t a n d a r d s o f A n f i e l d ' s S p i o n K o p o r the H o l t e E n d a t Villa P a r k , the N o r t h B a n k w a s small. F r o m other p a r t s o f the g r o u n d i t l o o k e d h u n c h e d a n d h o o d e d , especially o n floodlit, rainy n i g h t s . B u t the a c o u s t i c s w e r e d e m o n i c . T h e n o i s e of the c r o w d w a s a b e a s t . It s u r g e d up to the rafters and b e l t e d the r o o f like B e e l z e b u b . A t such times the N o r t h B a n k w a s a s i n g l e v o c a l a p p a r a t u s , the c r o w d a s t e a m i n g t o n g u e in a b l a c k throat.

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B u t the terraces are g o n e . T h e s w i r l i n g m a s s o f f l e s h i s n o m o r e . S i n g i n g and chanting are m o r e s p o r a d i c a n d u s u a l l y fizzle out. N o w w e sit o n plastic s e a t s , listen t o a n o d y n e p o p o v e r the P A , watch m e n d r e s s e d a s c a r t o o n a n i m a l s w a n d e r i n g the touchline, careful not to s t r a y into o p p o s i t i o n territory for fear of inciting the c r o w d . ( T h e r e is hostility e n o u g h in the v o i c e s a r o u n d us — this is W o l v e s v. West B r o m w i c h A l b i o n ; an acrid d o m e s t i c s q u a b b l e . ) A n d then J e f f B e c k c o m e s o v e r the P A : ' H i - H o Silver L i n i n g ' . T h e c r o w d g a l v a n i z e s . I t ' s a n a n t h e m . I find m y s e l f s i n g i n g a l o n g to the c h o r u s : ' . . . a n d i t ' s H i - H o W O L V E R H A M P T O N ! ' My sons look at me uncomfortably. I s i n g the next c h o r u s , but with less g u s t o . T h i r d t i m e r o u n d I ' m silent. I l o o k a b o u t me a n d am visited by d o u b t . Is this Molineux? Is it m e ? T h e other d a y I s h o w e d my students a v i d e o . T h e s c e n e is a clinic r o o m . A y o u n g m a n a n d an old m a n sit f a c i n g each other. T h e y o u n g m a n is taking a history, p u t t i n g q u e s t i o n s , carefully p r o b i n g the old m a n ' s o b s e r v a t i o n s and recollections. T h e old m a n concentrates, g i v i n g each q u e s t i o n careful t h o u g h t , b u t it is clear from his r e s p o n s e s that, d e s p i t e a p p e a r a n c e s ( h e s m i l e s readily, s e e m s fully e n g a g e d a n d h a s put on a suit for the o c c a s i o n ) , there are g r e a t v o i d s b e t w e e n the s p a r s e c o n s t e l l a t i o n s o f recollection. He has a brain disease and can hardly carry memories from o n e d a y to the next. I m a d e the v i d e o m o r e than t w e l v e y e a r s a g o . T h e old m a n and m y y o u n g e r s e l f are p e r f o r m i n g a f a m i l iar routine. H e i s d e a d n o w a n d i t o c c u r s t o m e that e v e r y m o l e c u l e o f m y y o u n g e r s e l f h a s b e e n r e p l a c e d with the p a s s a g e o f time. I n a s e n s e , neither o f t h o s e b o d i e s h a s s u r v i v e d .

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Similarly, n o t h i n g r e m a i n s o f the b o y w h o s t o o d o n the terraces. S o , w h a t s u r v i v e s ? W h a t m a k e s u s the s a m e p e r s o n from o n e y e a r to the next, o n e w e e k , o n e day, o n e minute to the next? S o m e p h i l o s o p h e r s h a v e e m p h a s i z e d c o n s c i o u s recollection. C o n t i n u i t y of the p e r s o n is d o w n to continuity of m e m o r y . If I c a n r e c l a i m the t h o u g h t s and e x p e r i e n c e s o f the y o u n g clinician in the v i d e o or, further b a c k , the b o y on the terraces, then we are the s a m e p e r s o n . T h a t ' s not difficult. I h a v e clear m e m o r i e s o f m a k i n g the film a n d c a n picture the p a t i e n t ' s wife o f f - c a m e r a . My i m p r e s s i o n s of the old s t a d i u m a l s o r e m a i n v i v i d . I see m y s e l f a r r i v i n g , a s u s u a l , a n h o u r b e f o r e k i c k - o f f and taking m y p l a c e halfway up the t e r r a c e s or, w h e n I w a s s m a l l , at the trench wall right b e h i n d the g o a l . I recall the o r a n g e g r a v e l s u r r o u n d i n g the pitch a n d the lurid g r e e n o f the g r a s s , the smells o f c i g a r e t t e s m o k e a n d O x o . I h a v e a mental i m a g e of the a s y m m e t r i c outline of the s t a n d s , so clear I c o u l d d r a w y o u a picture. A n d , a l t h o u g h m u c h is a blur, I can conjure s n a p s h o t s of certain g a m e s a n d g o a l s . I s a w these things from a particular p e r s p e c tive. Mine. I w a s there. It w a s m e . B u t t h e r e ' s a p r o b l e m with this line of r e a s o n i n g : a m n e s i a . W h a t if I couldn't r e m e m b e r these t h i n g s ? W o u l d disruption of m e m o r y d e c o u p l e me from the child I o n c e w a s ? S u p p o s e I retained a m e m o r y link with the y o u n g clinician and that he, in turn, c o u l d recall the b o y ( w h e r e a s I c a n ' t ) . It w o u l d lead to the c o n c l u s i o n that the y o u n g e r m a n a n d m y s e l f w e r e the s a m e p e r s o n , that h e a n d the b o y w e r e the s a m e , b u t that the b o y and I w e r e not. A n d then t h e r e ' s m y patient. H i s p r o b l e m w a s with recent m e m o r y , n o t r e m o t e . In all likelihood he f o r g o t the v i d e o after a

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few d a y s , but w o u l d h a v e h a d n o t r o u b l e r e m i n i s c i n g a b o u t his childhood. W a s the old m a n fused with his child-self, b u t d i s l o cated from the p e r s o n he h a d b e e n a w e e k a g o ? A n o t h e r v i e w is that we s h o u l d a b a n d o n the i d e a of a p e r s i s t i n g e g o . A p e r s o n is m o r e like a club — a football club, s a y existing b y c o n s e n s u s , c a p a b l e o f d i s s o l u t i o n a n d r e c o n s t i t u tion. W o l v e r h a m p t o n W a n d e r e r s twice w e n t into liquidation in the 1980s; the current p l a y e r s w e r e n ' t e v e n b o r n w h e n I started c o m i n g t o matches; the s t a d i u m w a s d e m o l i s h e d a n d rebuilt. N o t h i n g tangible s u r v i v e s , yet here we a r e still — me a n d the Wolves. T h e image of my ten-year-old self brings a churning to my chest. I feel an u r g e to h u g my s o n s , b u t resist. T h e y ' r e t o o b i g and w o u l d n ' t thank m e . W e settle i n t o the m a t c h . W e l o s e one-nil. T h e exit from W o l v e r h a m p t o n i s d r e a r y a n d slow, b u t spirits are lifting by the time we reach the m o t o r w a y . We m a d e the trip for the s a m e fixture last s e a s o n . T h e m a t c h v i d e o is advertised for sale on the club w e b s i t e . I ' v e d e c i d e d to b u y it. W e ' l l l o o k for o u r s e l v e s b e h i n d the g o a l , halfway up in the S t a n Cullis stand. I ' m g o i n g t o w a t c h m e a n d m y k i d s not g e t t i n g a n y older in a u n i v e r s e w h e r e the s c o r e will a l w a y s be W o l v e s 3, A l b i o n 1. I t ' s a restricted u n i v e r s e , b u t reliable.

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He h a d a w i l d l o o k a b o u t h i m . C o f f e e stained the front of his white lab c o a t , t h o u g h n o w h e w a s s w i g g i n g w a t e r from a milk bottle. 'Call me Derek,' he said. T h i s w a s , I r e c k o n e d , the thirteenth time I'd b e e n here. He never remembered me. D e r e k w a s from l o n g a g o . H e a p p e a r e d t o function n o w a s a technician, b u t in the o l d d a y s he w a s a p h i l o s o p h e r , hauled in to a d v i s e o n the m e t a p h y s i c s a n d m o r a l s o f the n e w technology. H e g a v e u p p h i l o s o p h y , h a v i n g s o l v e d all the p r o b l e m s that interested h i m , a n d n o w e n j o y e d p u s h i n g b u t t o n s for a living. A s i t t u r n e d out, the m e t a p h y s i c a l i m p l i c a t i o n s o f teleportation s e e m e d t o b e n o m o r e p r o f o u n d than the m e t a p h y s i c a l implications o f T V . I n a n y event, p e o p l e s o o n g o t u s e d t o the idea. Y o u s t e p p e d into the b o o t h , y o u s t e p p e d o u t s o m e w h e r e else: a c r o s s the street o r a c r o s s the s o l a r s y s t e m . T e l e p o r t a t i o n i s s p e e d - o f - l i g h t swift. T h e j o u r n e y t o M a r s , w h i c h o n c e t o o k s e v e r a l w e e k s b y c o n v e n t i o n a l spacecraft, can

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n o w be a c c o m p l i s h e d in a matter of m i n u t e s . Y o u enter the b o o t h a n d , b e f o r e y o u k n o w it, the d o o r s l i d e s o p e n a n d y o u ' v e arrived; d e l i v e r e d , b r i s k as a b l a d e of light, to the M a r t i a n plains. Subjectively, i t ' s i n s t a n t a n e o u s . B u t , e v e n now, m a n y p e o p l e m i s u n d e r s t a n d the b a s i c principles. I t ' s a l w a y s b e e n the way. H o w m a n y u n d e r s t o o d the p h y s i c s o f T V ? I t ' s the m e s s a g e that matters, not the m e d i u m . S o , too, w i t h t e l e p o r t a t i o n . I t d o e s not, a s s o m e still i m a g i n e , i n v o l v e b r e a k i n g d o w n the b o d y t o its constituent a t o m s a n d w h i z z i n g t h e m o f f for r e a s s e m b l y at the destination point. W h a t travels b e t w e e n the transceivers is not a s t r e a m of a t o m s but a s t r e a m of d a t a . D e r e k p u s h e s the g r e e n button a n d the s c a n n e r s p l o t the exact c o - o r d i nates o f e v e r y a t o m i n y o u r b o d y . ( T h e r e are r o u g h l y ten billion billion billion of them; the devil is in the detail.) T h e i n f o r m a tion is e n c o d e d and transmitted from this end a n d r e c e i v e d a n d d e c o d e d a t the other, w h e r e the p r o c e s s o f r e c o n s t r u c t i o n takes p l a c e u s i n g locally a v a i l a b l e material. A n a t o m i s a n a t o m i s a n a t o m , after all. T h e r e ' s n o t h i n g special a b o u t m y a t o m s o r y o u r s . T h e y d o n ' t c a r r y I D labels. O n e other detail: o n c e the a t o m i c c o - o r d i n a t e s h a v e b e e n plotted, the b o d y is annihilated. It is instant a n d p a i n l e s s ; a f o r m of v a p o r i z a t i o n - or ' d i s c o r p o r a t i o n ' , as they call it. T h i s h a p p e n s precisely a t the point o f t r a n s m i s s i o n . I t m u s t . T h e event and its t i m i n g are d e t e r m i n e d b y d e c r e e o f the S u b c o m m i t t e e o n Personal Identity. W h y ? W h y d e s t r o y the b o d y while the i n f o r m a t i o n i s i n transit, before the replica h a s b e e n c o n s t r u c t e d ? S u r e l y , it w o u l d be better to wait t h o s e few m i n u t e s to m a k e s u r e that the r e a s s e m b l y instructions arrive i n g o o d s h a p e ? Y o u m i g h t think

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s o , a n d the S u b c o m m i t t e e c o n s i d e r e d the matter carefully b e f o r e a r r i v i n g at a different view. After m u c h d e b a t e i t w a s d e c i d e d that even b r i e f p e r i o d s o f ' a s y n c h r o n o u s parallel e x i s t e n c e ' w e r e u n a c c e p t a b l e . I n law, b i o l o g i c a l p e r s o n s take p r e c e d e n c e o v e r their digital f o r m . D e s t r u c t i o n of a l i v i n g b o d y is d e e m e d acceptable only if the digital c o p y r e p r e s e n t s the 'latest v e r s i o n ' . If a p e r s o n continued in b i o l o g i c a l f o r m until his or her c o p y arrived on M a r s (or w h e r e v e r ) then the replica w o u l d be 'existentially a s y m m e t r i c ' with the o r i g i n a l . As the d a t a s t r e a m traversed the interp l a n e t a r y v o i d , the p s y c h o l o g i c a l life o f the original w o u l d have c o n t i n u e d t o e v o l v e . T h e replica w o u l d , therefore, not strictly be a replica. It w o u l d be a c l o s e m a t c h , but not exact. To cut a l o n g s t o r y short, it w a s d e c r e e d that destruction of the o r i g i n a l in s u c h c i r c u m s t a n c e s w o u l d be tantamount to m u r d e r . T h e p e r s o n c o p i e d m u s t b e precisely the p e r s o n w h o a r r i v e s , d o w n t o the last a t o m o f the last m o l e c u l e o f every m u s c l e a n d m e m b r a n e , a n d e v e r y last n u a n c e o f the neural nets. My thirteenth trip. S t e p p i n g into the cubicle still g a v e me a tickle of excitement. I w a s , after all, a b o u t to be obliterated. T h e s u s p e n s i o n o f existence i s brief. B u t i t ' s real. F o r the duration o f the t r a n s m i s s i o n I w o u l d be d e a d , n o t h i n g and n o w h e r e , every a t o m o f m y b o d y returned t o c h a o s . M y heart quickened a t the t h o u g h t . To s t e p into the b o o t h w a s to m a k e a leap of faith that the t e c h n o l o g y w o u l d h o l d g o o d , that I w o u l d be resurrected at the o t h e r e n d . S o m e time a g o D e r e k p l a c e d a s i g n a b o v e the entrance, a f r a g m e n t of an old p o e m : Do not go gentle into that good night. I n o t i c e d it as I s t e p p e d a c r o s s the threshold.

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D e r e k ' s s m i l i n g face a p p e a r e d o n a screen. ' R e a d y ? ' I w a s ready. I t o o k a d e e p breath. Y o u s e n s e a feeble, m y o clonic jolt, like s t u m b l i n g on the b r i n k of sleep, a n d t h e r e ' s a m o m e n t a r y b l a c k n e s s . A n d that's it. J o u r n e y ' s end. B u t this time, when the d o o r slid o p e n , I realized I h a d n ' t m o v e d a m i l limetre. 'Problems, D e r e k ? ' I said. He w a s n ' t s m i l i n g now. 'Shit, shit, shit,' he m u m b l e d . It w a s s o m e kind of malfunction. At least I'm still here in one piece, I t h o u g h t to myself. My atoms haven't been scattered to the ether. Apparently, t h o u g h , it w a s a c l o s e call (the b a c k - u p c o p y p r o c e s s had a l s o f a i l e d ) , and I h a d to a d m i t that I w a s s h a k e n . T e m p o r a r y oblivion w a s fine, but I w a s n ' t p r e p a r e d for the p e r manent option. T h e y t o o k m e t o the on-site m e d i c a l facility where I strolled t h r o u g h a b o d y scanner a n d g o t an u n s m i l i n g t h u m b s - u p from the o p e r a t i v e w h o then sent m e o n t o P s y c h o l o g y . Psych? T h e o p e r a t i v e s h r u g g e d : s e a r c h m e . Routine, I thought. I read the mental h y g i e n e p o s t e r s as I sat w a i t i n g for the p s y c h o l o g i s t . S h e h a d a p p e a r e d briefly to i n t r o d u c e herself, then left. S h e s e e m e d f l u s t e r e d . T h e r e w e r e r a i s e d v o i c e s s o m e where. O n e o f them w a s D e r e k ' s . I c o u l d n ' t catch m o s t o f w h a t they w e r e s a y i n g , b u t the female v o i c e , the p s y c h o l o g i s t ' s I a s s u m e d , said s o m e t h i n g a b o u t this or that b e i n g a matter for the S u b c o m m i t t e e . D e r e k s a i d s o m e t h i n g i n d e c i p h e r a b l e t o which a third, m a s c u l i n e , v o i c e r e s p o n d e d : ' O u t of the q u e s tion!' W h a t followed s o u n d e d like a scuffle. N e x t , the d o o r b u r s t open and there w a s D e r e k . ' S o m e t h i n g e x t r a o r d i n a r y h a s h a p p e n e d , ' h e s a i d . ' I think

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y o u ' r e entitled t o k n o w - ' but that w a s all h e h a d time t o say. H e w a s set u p o n b y three security g u a r d s and d r a g g e d away. I d o n ' t trust p s y c h o l o g i s t s . Y o u get the hmms and the uh-huhs, the n o d s , the d o g g y - f a c e e x p r e s s i o n s o f c o n c e r n , the u n c o n d i tional p o s i t i v e r e g a r d , the w h o l e p r o f e s s i o n a l s i m u l a c r u m o f e m p a t h y , a n d then y o u r h o u r ' s up a n d t h e y ' r e on to the next client. It m u s t take a certain thickness of skin or thinness of soul t o d o that kind o f stuff d a y in, d a y out. B u t this p s y c h o l o g i s t w a s flustered, which put m e a t m y e a s e immediately. S h e didn't k n o w quite h o w to p l a y it, so I helped her out. "What y o u ' r e telling m e , ' I s a i d , 'is that I w a s s c a n n e d and d i s p a t c h e d but — o b v i o u s l y , since I ' m here talking to y o u — not v a p o r i z e d at the point of d e p a r t u r e . ' S h e n o d d e d . ' A n d at the other e n d , m e a n w h i l e , m y replica w a s a s s e m b l e d and i s n o w fulfilling m y duties o n M a r s ? ' ' T h a t is correct.' ' W e l l , ' I s a i d . 'Well, fuck m e . W h a t went w r o n g ? ' A c t u a l l y , I w a s less taken a b a c k than y o u m i g h t i m a g i n e . H u m a n e v o l u t i o n h a s e q u i p p e d the b r a i n with a n i m p r e s s i v e r a n g e o f a d a p t i v e r e s p o n s e s for c o p i n g with all sorts o f situations. It g e a r s up the b o d y for fight or flight in the face of p h y s i c a l threat, to recoil from c o n t a m i n a t i o n , to affiliate with its f e l l o w s , t o m a t e a n d r e p r o d u c e , a n d t o c o m e t o t e r m s with loss. B u t s e l f - d u p l i c a t i o n w a s not a feature o f H o m o s a p i e n s ' environment

of

evolutionary

adaptedness

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on

the

s a v a n n a h . It takes a while to f o r m u l a t e a r e s p o n s e . I s o o n b e g a n to r e g a r d my replica as a kind of rival and w o n d e r e d w h a t i t w a s g e t t i n g u p t o o n m y behalf. I n h u m a n relations similarity is often the fulcrum a b o u t which p o i n t s of difference

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w o r k the g r e a t e s t l e v e r a g e . I t ' s w h a t g i v e s a p e r s o n a l r i v a l r y its edge in many cases. A n d what w a s m y r e p l i c a ' s v i e w o f events, I w a n t e d t o k n o w . H a d it e x p r e s s e d an o p i n i o n ? At this, the p s y c h o l o g i s t ' s face b e c a m e g r a v e . H e r m o d e switched from e m p a t h i c therapist t o p u r v e y o r - o f - t h e - p a r t y - l i n e . T h i s w a s a n e x c e p t i o n a l event, s h e said. T h e S u b c o m m i t t e e o n P e r s o n a l Identity w a s m e e t i n g i n e m e r g e n c y s e s s i o n at that v e r y m o m e n t to d e c i d e the i s s u e . W h a t had h a p p e n e d w a s i n c o n t r a v e n t i o n o f the P r o l i f e r a t i o n of P e r s o n s A c t . It w a s a s e r i o u s matter. S h e w a s at liberty o n l y to present me with the b a r e facts a n d regretted that s h e c o u l d not enter into speculation a b o u t future d e v e l o p m e n t s . N o , I w o u l d not at this s t a g e be p e r m i t t e d to contact my wife or a n y other m e m b e r s o f m y family, o r friends, o r c o l l e a g u e s . O r a n y o n e . T h e S u b c o m m i t t e e w a s e x p e c t e d to deliver a s t a t e m e n t within a d a y or two and until then I w o u l d be their g u e s t . W h a t e x a c t l y w a s the issue that the S u b c o m m i t t e e w a s in s e s s i o n to d e c i d e ? S h e w a s not at liberty to say. T h e y t o o k me to a s m a l l r o o m that l o o k e d o u t u p o n a q u a d r a n g l e . A solitary c o p p e r b e e c h o c c u p i e d the centre of the lawn, its p u r p l i s h - b r o w n leaves s h i m m e r i n g in the e v e n i n g s u n s h i n e . I lay on my b u n k and stared at the ceiling. It g r e w d a r k . I l o n g e d to s p e a k to my wife and children, b u t c o m m u n i c a t i o n with the outside w o r l d w a s forbidden. I w a n t e d to r e a s s u r e t h e m that I w a s okay. I w o u l d h a v e called them by n o w in o r d i n a r y c i r c u m stances. T h e y ' d b e w o r r i e d sick. W h a t h a d they b e e n t o l d ? A n d then, d r o p p i n g like a f o r g e h a m m e r from my h e a d to my g u t , this thought: The call has already been made. In time, miraculously, I slept. It w a s a heavy, d r e a m l e s s sleep,

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as if I ' d b e e n d r u g g e d . P e r h a p s I h a d . B u t in the m i d d l e of the night I w o k e to find a tall figure s t a n d i n g at the foot of the bed. It r e m a i n e d m o t i o n l e s s , its f a c e in s h a d o w . I w o u l d have been first to s p e a k , h a d the w o r d s not lost their tired w a y t h r o u g h the s o m n o l e n t circuitry o f m y b r a i n . ' L i s t e n , ' s a i d the figure. ' L i s t e n . I think y o u are entitled to know.' I t w a s D e r e k . H e e x p l a i n e d , without preliminary. T h e S u b c o m m i t t e e ' s q u a n d a r y — my mortal p r o b l e m — w a s this: given the u n f o r t u n a t e turn o f e v e n t s , they w e r e n o w d e b a t i n g whether to a l l o w me a n d my replica to continue to exist in parallel, and thereby c o n t r a v e n e the P r o l i f e r a t i o n o f P e r s o n s A c t , o r t o h a v e o n e o f u s , e v e n a t this late s t a g e , v a p o r i z e d . T o b e two, o r not t o b e . It w a s a hard o n e to call, he s a i d . In law, the creation of surp l u s i n d i v i d u a l s w a s a s e r i o u s c r i m e ; the m i r r o r i m a g e o f m u r d e r . T o D e r e k ' s k n o w l e d g e , m y replica h a d not i m m e d i ately b e e n i n f o r m e d o f the c i r c u m s t a n c e s , s o had carried o n a s i f n o t h i n g u n t o w a r d h a d h a p p e n e d . H e c o u l d not s a y for sure that it h a d b e e n i n f o r m e d e v e n now. T h i s c o u l d be an influential factor i f the S u b c o m m i t t e e d e c i d e d that o n e o f u s h a d t o g o . If the r e p l i c a ' s relationship with my wife h a d e v o l v e d even to the m e r e s t extent of a b r i e f televisual c o m m u n i c a t i o n then that c o u l d w e i g h t the d e c i s i o n in f a v o u r of a l l o w i n g the replica to s u r v i v e rather than m e . D i s c o r p o r a t i o n w a s not m y preferred o p t i o n . B u t surely, I t h o u g h t , the p r o p o s a l w o u l d not be carried a n y w a y . T h e y couldn't. I t w a s p r e p o s t e r o u s . H a v i n g presented itself, the d r e a d p r o p o s i t i o n h a d to c r a n k t h r o u g h the archaic, c l o c k w o r k l o g i c of the c o m m i t t e e p r o c e s s , b u t then, surely, it w o u l d b e t h r o w n out.

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'I d o n ' t want to d i e , ' I told D e r e k . ' I t w o u l d n ' t b e the end o f the w o r l d , ' h e r e p l i e d , w h i c h s t r u c k me as an o d d thing to say. D e r e k sat in the e a s y chair at the far end of the r o o m , still in shadow. ' W h a t ' s the d i f f e r e n c e ? ' h e s a i d . ' S u p p o s e i t h a d g o n e a c c o r d i n g t o plan. Y o u w o u l d h a v e s t e p p e d into the b o o t h , the scanners w o u l d h a v e d o n e their stuff, y o u r b o d y w o u l d h a v e been z a p p e d t o zero, and y o u r replica w o u l d h a v e a p p e a r e d o n M a r s , w a l k i n g y o u r w a l k a n d talking y o u r talk. A n d that i s w h a t has h a p p e n e d — that is w h a t a l w a y s h a p p e n s — e x c e p t this time the z a p p i n g m a y h a v e b e e n a little d e l a y e d . ' T h e difference, D e r e k , I m i g h t h a v e s a i d , is that I ' m still here, now, and, h a v i n g h a d time to reflect, I d o n ' t think I w a n t to be z a p p e d to zero, e v e n t h o u g h , t w e l v e t i m e s b e f o r e , this is precisely what has h a p p e n e d . N e v e r t h e l e s s , D e r e k h a d a point. E a c h o f the p r e v i o u s t i m e s I'd b e e n teleported to M a r s the e x p e r i e n c e w a s the s a m e . I walked out o f the b o o t h with perfect recollection o f the d a y ' s events up to the point of s t a n d i n g in the t r a n s c e i v e r on E a r t h and experiencing that familiar little jolt a n d the b r i e f b l a c k n e s s , and then there I w a s t a k i n g in the Martian l a n d s c a p e . T h e r e w a s perfect continuity. T h e twelfth time I r e m e m b e r e d the eleventh, the eleventh time the tenth, a n d so o n . A n d each time I c o u l d reflect b a c k not just o n that d a y ' s events, but o n e v e n t s o f the p r e v i o u s day, too, the p r e v i o u s w e e k s a n d m o n t h s a n d all the y e a r s o f m y sentient, s e l f - c o n s c i o u s life. On arrival, I a l w a y s called my w i f e , told her I w a s o k a y , that I m i s s e d her already, and c h e c k e d on the k i d s . T h e n I w e n t a b o u t m y b u s i n e s s . A n d w h e n I slept I k n e w m y d r e a m s h a d m a d e

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their digital w a y a c r o s s the v o i d with the rest o f m e . T h e y had their familiar fabric, the u s u a l b l e n d of the m u n d a n e and the m y s t e r i o u s . I d r e a m t o f h o m e , o f w o r k , o f o r d i n a r y things. A n d then it w a s no s u r p r i s e to m e e t the lost and the d e a d and run unfettered b y l o g i c a n d time t h r o u g h the streets o f m y childh o o d or take w i n g o v e r o c e a n s a n d s t r a n g e cities; I d r e a m t secret d r e a m s . T h i s i s w h a t h a d a l w a y s i m p r e s s e d m e m o s t a b o u t telep o r t a t i o n . N o t o n l y w a s the b o d y reconstructed i n perfect replica, a n d the c o n s c i o u s m i n d , but the u n c o n s c i o u s m i n d , too: t h o s e t h i n g s h i d d e n from the o b s e r v i n g ' I ' . N o w m y replica w a s d r e a m i n g those d r e a m s , and before i t slept it h a d called my wife, told her it m i s s e d her already, checked on the kids, a n d g o n e a b o u t its b u s i n e s s . It had d o n e those things, not I. We w e r e not the s a m e . I w a s flowing in a different stream o f c o n s c i o u s n e s s . B u t i f the replica w a s n ' t m e now, h o w could i t h a v e b e e n m e o n the p r e v i o u s twelve o c c a s i o n s ? W h a t did the e x p e r i e n c e of perfect continuity a m o u n t to? W a s it no m o r e than the illusion of life d i s g u i s i n g a d o z e n deaths? It w a s just three w e e k s since I ' d last m a d e the trip. D i d that m e a n that, as a sentient, s e l f - c o n s c i o u s b e i n g , I w a s less than a m o n t h o l d , e x q u i s i t e l y c o n f i g u r e d from the c h a o s of a billion billion billion a t o m s a n d artificially e q u i p p e d with the m e m o r y b a n k s a n d d i s p o s i t i o n s o f a m i d d l e - a g e d m a n ? I f s o , m y identity w a s a fiction. ' T h e problem,' beliefs

about

our

s a i d D e r e k , 'is that m o s t o f u s h a v e false own

nature.

People

expect determinate

a n s w e r s to q u e s t i o n s a b o u t p e r s o n a l identity: " Y e s , it is the s a m e p e r s o n " or " N o , it isn't." T h a t ' s one great misconception. T h e other is that p e r s o n a l identity m a t t e r s in the first p l a c e . '

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I experienced a s l o w infusion of a n g e r , r i s i n g in my chest, diffusing to my face and fists. ' I t ' s fine for y o u , D e r e k , ' I s a i d , 'to d e n y the i m p o r t a n c e of p e r s o n a l identity and pontificate o n the c o n c e p t u a l c o n f u s i o n o f a n y o n e else o n the planet w h o h a p p e n s t o b e l i e v e o t h e r w i s e . B u t put y o u r s e l f in my p o s i t i o n . T h e r e ' s a distinct p o s s i b i l i t y that I ' m a b o u t t o b e snuffed out. R i g h t n o w m y c o n c e r n s a b o u t whether I shall still be here by the w e e k e n d — or " z a p p e d to z e r o " as y o u indelicately put it - s e e m real e n o u g h . A n d if I am to be v a p o r i z e d , I ' m s u r e y o u ' l l h a v e no difficulty g i v i n g a d e t e r minate answer to the q u e s t i o n of whether I exist or n o t . ' 'Well,' he s a i d , ' t h a t ' s not quite the p o i n t . ' I'd b e e n sitting o n the e d g e o f the b u n k , b u t s t o o d n o w a n d m o v e d t o w a r d s h i m . B o t h o f m y fists, I n o t i c e d , w e r e tightly clenched. ' D e r e k , ' I s a i d , ' y o u ' d better g o , ' at w h i c h he r a i s e d a p l a c a tory p a l m , a c k n o w l e d g e d m y d i s t r e s s , a n d said h e w a s here t o help. In fact, h e ' d b e e n t h r o u g h s o m e t h i n g similar in the e a r l y d a y s , since w h e n he h a d a c h i e v e d a kind of insight. H i s travels in p h i l o s o p h y and daily e x p o s u r e to the plain facts of t e l e p o r t a tion had b r o u g h t him to a v i s i o n of the self, w h i c h , o n c e a b s o r b e d , b e g a n a t o n c e t o d r a w the s t i n g o f death. T h i s m o s t natural o f fears w a s r e v e a l e d a s synthetic. I t c o u l d b e d i s m a n tled. Intellectually. H e had o n c e w a t c h e d h i m s e l f d i e , h e told m e . I t w a s o n e o f the first interplanetary teleportations. H i s first, a n d only, visit to M a r s . H e entered the b o o t h and f o l l o w e d the u s u a l p r o c e d u r e s and, s u r e e n o u g h , s t e p p e d o u t into the reception z o n e at the Martian b a s e a s i f h e w e r e s t e p p i n g o u t o f his front d o o r . I t w a s

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a b i g e v e n t i n t h o s e d a y s . T h e y w e r e r e a d y with c h a m p a g n e and s m o k e d s a l m o n to c e l e b r a t e . At first no o n e in the reception p a r t y w a s a w a r e o f the malfunction b a c k o n Earth. B u t then the m e s s a g e c a m e t h r o u g h . S c a n n i n g a n d t r a n s m i s s i o n had w o r k e d a treat — of c o u r s e they h a d , there he w a s , s o a k i n g his reconstituted flesh in c h a m p a g n e — b u t the v a p o r i z a t i o n p h a s e had failed to kick in. D e r e k h a d arrived but, a t the s a m e time, h e h a d n ' t left. A n d w a s it for better or w o r s e that the E a r t h b o u n d v e r s i o n of D e r e k h a d suffered fatal injuries in the p r o c e s s ? T h e d i s c o r p o r a t i o n m e c h a n i s m h a d stuttered and s t o p p e d . H i s w h o l e b o d y blinked on the brink of extinction, f a d i n g then r e g a i n i n g its s h a p e , but o n l y at the c o s t of significant d a m a g e to the c a r d i o v a s c u l a r s y s t e m . H e w o u l d b e d e a d within a w e e k . D e r e k 2 h a d returned at o n c e , not k n o w i n g what to expect. 'I tried to c o n s o l e h i m , ' he s a i d , 'I told him I l o v e d his wife; I w o u l d care for his children; I w o u l d finish the b o o k he w a s w r i t i n g . A n d , o f c o u r s e , from m y p e r s p e c t i v e , nothing had c h a n g e d : they w e r e m y wife a n d children, i t w a s m y b o o k and it w a s my intention that I s h o u l d finish it. S o , I told him: " D o n ' t d e s p a i r ; n o t h i n g will really c h a n g e . " B u t h e wept. H e s a i d that no d o u b t I w o u l d do all those things as well as he c o u l d , a n d it w a s s o m e c o n s o l a t i o n that his family w o u l d not suffer the pain of b e r e a v e m e n t , b u t the fact r e m a i n e d that within a few d a y s h e w o u l d l o s e c o n s c i o u s n e s s for ever. T h i s w o u l d b e a terrible l o s s . ' H e h a d b e e n thinking o f a h o m e m o v i e , the o n e where his s m i l i n g d a u g h t e r — my s m i l i n g d a u g h t e r — is s t a n d i n g in the kitchen with a b a s k e t of s t r a w b e r r i e s . S h e ' s a b o u t three y e a r s

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o l d . T h e r e i s sunlight s t r e a m i n g t h r o u g h the w i n d o w o n t o her face. A n d she takes the fattest s t r a w b e r r y in the b a s k e t a n d c r a m s it into her m o u t h ; i t ' s so b i g s h e h a s to p u s h it in w i t h the p a l m o f her h a n d . H e r c h e e k s are b u l g i n g a s s h e s t r u g g l e s t o chew. H e r e y e s are c l o s e d . S h e i s utterly a b s o r b e d , o v e r w h e l m e d , by the e x p e r i e n c e of the fruit. S h e e v e n s w a y s a little from s i d e t o s i d e , a s v i r t u o s o violinists d o . " T h a t ' s w h a t i t ' s all a b o u t , " he s a i d . " C o n s c i o u s e x p e r i e n c e . A n d that is w h a t I shall l o s e ; that beautiful s m i l e , the taste o f s t r a w b e r r i e s , fond m e m o r i e s . " A n d t o that extent, h e w a s r i g h t , ' s a i d D e r e k . ' H i s c o n s c i o u s n e s s w o u l d f a d e , b e y o n d d a r k n e s s a n d silence t o oblivion. He would b e c o m e nothing. ' I w a s with him w h e n h e d i e d . T h e r e w a s n o o n e else a r o u n d . We had a g r e e d that it w o u l d be in the b e s t interests of the f a m i l y that they s h o u l d n e v e r k n o w o f o u r d u p l i c a t i o n . W h y s h o u l d they b e t r o u b l e d ? T h e r e w a s n o n e e d . L e t life g o o n a s n o r m a l . I a d m i r e d his r e s o l v e at the e n d . It m a d e me feel p r o u d . He so w a n t e d t o s e e his l o v e d o n e s for o n e last t i m e , b u t u n d e r s t o o d the distress and confusion i t w o u l d c a u s e . S o i t w a s j u s t m e and h i m . I held his h a n d . A n d then life d i d go on as n o r m a l . I went h o m e a n d h u g g e d m y wife a n d children, a n d e v e n t u a l l y I finished my b o o k . ' ' T h e n i t c a n ' t b e d e n i e d that p e r s o n a l identity really d o e s matter,' I s a i d . ' Y o u r f o r m e r s e l f d i e d a l o n e l y death. H i s c o n s c i o u s n e s s switched

o f f like a light.

He lost e v e r y t h i n g :

beautiful m e m o r i e s , the l o v e of his family, h o p e s a n d p l a n s for a future that he w o u l d n e v e r reach; life itself. T h o s e t h i n g s m a d e u p his identity. N o t h i n g m o r e m a t t e r e d , a n d n o t h i n g m a t t e r e d more.'

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D e r e k l e a n e d f o r w a r d , e l b o w s o n k n e e s , t h u m b s t o cheekb o n e s , f i n g e r s t o f o r e h e a d . ' Y e s a n d no,' h e s a i d .

We talked for h o u r s , until the light of a g r e y d a w n conjured s h a p e s i n the c o u r t y a r d a s i f from i m a g i n a t i o n . T h e c o p p e r b e e c h s e e m e d reluctant t o a p p e a r . W a s this t o b e m y last d a y ? D e r e k d i d m o s t o f the talking. H e m u s t h a v e t h o u g h t these t h i n g s t h r o u g h a t h o u s a n d t i m e s b e f o r e , b u t still there w a s a note of u r g e n c y in his v o i c e , as if he w e r e on the brink of a revelation. I am not a p h i l o s o p h e r , a n d at times I found him hard to follow, b u t I g o t the g i s t . He e x p l a i n e d that there w e r e t w o w a y s of l o o k i n g at a p e r s o n or, rather, t w o theories a b o u t w h a t p e r s o n s a r e , and what is i n v o l v e d i n their c o n t i n u e d existence o v e r time. T h e f i r s t theory h e called E g o T h e o r y . T h i s i s the intuitive, c o m m o n - s e n s e view, b u t o n e that w a s held, a l s o , b y s o m e o f the g r e a t e s t p h i l o s o phers, m o s t famously R e n e Descartes. It m a d e sense to me, too: I w a k e up in the m o r n i n g ; I go to w o r k ; I feel h a p p y w h e n things go well a n d I feel frustrated w h e n they d o n ' t ; I hold certain beliefs a b o u t the w o r l d a n d e x p r e s s v a r i o u s o p i n i o n s and prefere n c e s : I u s e d to like B e e t h o v e n , but n o w I prefer Mozart; I like c h o c o l a t e better than c h e e s e c a k e ; I enjoy w a l k s in the c o u n t r y s i d e ; I take the v i e w that p e o p l e s h o u l d be kind to o n e another, a n d I feel b a d if I do the w r o n g thing. I act, I feel, I think, I b e l i e v e , I g r o w older, a n d I c h a n g e in other w a y s . B u t 'I' am a l w a y s there a t the centre o f t h i n g s a s time g o e s by. W h a t i s this ' I ' ? W e o r d i n a r i l y c l a i m o w n e r s h i p o f our a c t i o n s a n d t h o u g h t s a n d e x p e r i e n c e s : I d i d it; that's my idea; I feel h u n g r y ; I intend to b u y a b i r t h d a y present for my d a u g h t e r

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. . . So the 'I' is the experiencer of e x p e r i e n c e s , the thinker of thoughts, and the d o e r o f d e e d s . E a c h d a y i s a blizzard o f s e n s ations and t h o u g h t p a t t e r n s , but I g i v e t h e m c o h e r e n c e a n d link them to my m e m o r i e s a n d my p l a n s for the future. I t ' s natural to think in this way. We a r e the p r o g e n i t o r s of thoughts and actions and they a r e ours in the thinking a n d d o i n g . A c c o r d i n g to E g o T h e o r y , it is this 'I' that constitutes the e s s e n c e o f the p e r s o n and which p e r s i s t s o v e r t i m e . B u t , a g a i n , what is it? D e s c a r t e s b e l i e v e d that the e g o w a s a p u r e l y mental thing, a soul or spiritual s u b s t a n c e , but y o u d o n ' t h a v e to go a l o n g with that to a c c e p t the i d e a of the self, the e g o , as a kind of hub a b o u t which the wheel of e x p e r i e n c e r e v o l v e s . In this non-spiritual s e n s e the e g o is m e r e l y the subject of experience, it is that which unifies s o m e o n e ' s c o n s c i o u s n e s s at any g i v e n m o m e n t . I w a t c h the s k y lighten, I s e e the l e a v e s of the c o p p e r b e e c h g a i n c o l o u r , a n d I hear b i r d s s i n g i n g . W h a t g i v e s this scene its unity? W h a t p u l l s these d i s p a r a t e t h r e a d s o f experience together? I do. T h e y are e x p e r i e n c e s h a d by m e , this p e r s o n , at this time. A n d the wheel rolls on t h r o u g h the y e a r s , a c c o u n t i n g for the unity o f m y life. T h e s e thoughts were running through my mind as D e r e k s p o k e . I w a s thinking them. ' I can s e e i n g n o t h i n g t o d i s a g r e e with there,' I told him. D e r e k s t o p p e d talking a n d , for a m o m e n t , there w a s o n l y b i r d s o n g ; then he t u r n e d to B u n d l e T h e o r y . He s a i d that like m a n y styles in art — s u c h as G o t h i c , b a r o q u e , a n d r o c o c o — B u n d l e T h e o r y o w e d its n a m e t o its critics. B u t the n a m e w a s g o o d e n o u g h . T h i s t h e o r y rejects the i d e a that a c t i o n s a n d e x p e riences are o w n e d b y s o m e inner e s s e n c e , e g o o r ' I ' . T h e r e are

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just s e q u e n c e s o f a c t i o n s and experiences. N o t h i n g m o r e . E a c h life is a l o n g series — or b u n d l e — of mental states and events, b o u n d t o g e t h e r b y v a r i o u s kinds o f causal relation, such a s t h o s e linking the p e r c e p t i o n of a fierce-looking d o g with the e m o t i o n of fear a n d the d i s p o s i t i o n to run away, or the different c a u s a l relations that h o l d b e t w e e n e p i s o d e s o f experience and e p i s o d e s o f m e m o r y . A n d t h a t ' s all. T h e idea o f a central e g o , o r p e r s o n , contributes n o t h i n g t o o u r u n d e r s t a n d i n g o f the unity of c o n s c i o u s n e s s at a n y g i v e n time, nor d o e s it pull the g o l d e n thread of e x p e r i e n c e t h r o u g h a lifetime. ' S o , ' s a i d D e r e k , ' f r o m this p e r s p e c t i v e the e g o is a hollow fabrication, a n d y o u c o u l d even s a y that B u n d l e T h e o r i s t s d e n y the existence o f p e o p l e . ' 'But that's absurd.' ' Y e s , ' h e s a i d , ' a n d y o u are not the f i r s t t o s a y so. T h e e i g h t e e n t h - c e n t u r y p h i l o s o p h e r , T h o m a s R e i d [he c a m e t o b e k n o w n as 'the c o m m o n - s e n s e p h i l o s o p h e r ' ] m a d e a similar o b j e c t i o n . "I am n o t t h o u g h t , " s a i d R e i d , "I am not action, I am n o t feeling; I am s o m e t h i n g which thinks and acts and feels." Y e s , of c o u r s e , t h a t ' s w h a t it s e e m s like for all of us, and it's certainly the w a y w e are u s e d t o talking a b o u t o u r s e l v e s and o t h e r s — as if there really w e r e s o m e central nucleus of a self, a g h o s t l y pilot setting the c o u r s e and h a n d l i n g the controls. " D o n ' t call me a s e q u e n c e of e v e n t s , " y o u say, "I am a p e r s o n , a person, a

P E R S O N ! ' "

D e r e k b e a t his fists o n the a r m s o f the chair

for e m p h a s i s . ' F i n e , ' he s a i d . ' B u n d l e T h e o r i s t s a c c e p t this as a fact. But they a c c e p t it o n l y as a fact of g r a m m a r . P e o p l e and subjects-ofe x p e r i e n c e exist a s a feature o f the w a y w e u s e o u r l a n g u a g e , but

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in no other way. If y o u s a y there is m o r e to it than this, if y o u s a y there is s o m e t h i n g behind the chains of interacting mental events and brain functions, s o m e t h i n g a b o v e a n d b e y o n d , o b s e r v i n g and c o n t r o l l i n g , b u n d l i n g it all together, h o l d i n g its s h a p e from o n e d a y to the next, then the B u n d l e T h e o r i s t w o u l d s a y that y o u w e r e p r o f o u n d l y m i s t a k e n . ' 'I think y o u ' r e b e g i n n i n g to l o s e me n o w , ' I a d m i t t e d , 'I can accept that there are m a n y p r o c e s s e s g o i n g o n i n m y b r a i n o f which I am u n a w a r e , all s o r t s of h i d d e n m a c h i n e r i e s p r o d u c i n g t h o u g h t s and p e r c e p t i o n s , s h a p i n g s p e e c h - p a t t e r n s , influenci n g d e c i s i o n s and actions i n w a y s t o o r a p i d o r subtle t o b e p i c k e d out b y the spotlight o f c o n s c i o u s n e s s . B u t , o n c e s u c h t h i n g s are in the spotlight, w h o or what is h a v i n g the e x p e r i e n c e s , if not I ? ' T h e s e n s e that I w a s a u t h o r o f m y o w n t h o u g h t s a n d a c t i o n s felt like m o r e than a 'fact of g r a m m a r ' to m e . D e r e k m e r e l y replied that y e s , it w a s i n d e e d difficult to a c c e p t the truth of the matter. He said there w a s a conflict b e t w e e n scientific u n d e r s t a n d i n g and p e o p l e ' s o r d i n a r y intuitions a b o u t w h a t they believe t h e m s e l v e s to b e , b e c a u s e there is n o t h i n g in the b r a i n sciences t o s u p p o r t E g o T h e o r y . Few, if any, neuroscientists b e l i e v e that there is a n y t h i n g c o r r e s p o n d i n g to a s e l f or e g o distinct from a multiplicity of mental states and their a s s o c i a t e d p a t t e r n s o f b r a i n activity. F r o m the p e r s p e c t i v e o f n e u r o s c i e n c e , B u n d l e T h e o r y i s o b v i o u s l y true. But E g o T h e o r y w o n ' t g o away. W e c a n ' t s h a k e i t off. T h e beliefs that m o s t o f u s hold a b o u t o u r c o n t i n u e d e x i s t e n c e o v e r time are built u p o n a s s u m p t i o n s that E g o T h e o r y , o r s o m e t h i n g v e r y like it, is true.

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' T h a t ' s w h a t I m e a n t , ' s a i d D e r e k , ' w h e n I said that m o s t p e o p l e h o l d false beliefs a b o u t t h e m s e l v e s . ' B u n d l e T h e o r y w a s n o t a n e w i d e a , he e x p l a i n e d , just a difficult o n e to c o m e to t e r m s with. Its r o o t s reached d o w n to the sixth century B C a n d the t e a c h i n g s o f S i d d h a r t h a G o t a m a , the B u d d h a , 'the enlightened o n e ' . Anattavada, the B u d d h i s t d o c trine o f ' n o s o u l ' o r ' n o s e l f ' , h o l d s that p e o p l e and selves have o n l y n o m i n a l existence ( a s o p p o s e d t o actual e x i s t e n c e ) , m e a n i n g they a r e just c o m b i n a t i o n s o f other elements. T h e s e l f i s n o m o r e than a b u n d l e of fleeting i m p r e s s i o n s . D e r e k quoted from m e m o r y a segment of s o m e Buddhist text: 'A sentient being does exist, you think, misled by a false conception.

O Mara? You are

This bundle of elements is void of

Self. In it there is no sentient being. Just as a set of wooden parts receives the name of carriage, so do we give to elements the name of fancied

being.'

' N o w , ' h e c o n t i n u e d , ' w h e n teleportation c a m e a l o n g m a n y p e o p l e h a d g r a v e m i s g i v i n g s . T h e y s a w i t not a s the fastest means of transport, but as a sure means of dying. True, if you s u b m i t to the p r o c e s s , y o u r replica turns o u t perfect in every w a y , with a n identical b o d y a n d b r a i n and identical patterns o f mental activity, i n c l u d i n g m e m o r y s y s t e m s replete to the last a t o m a n d iota of i n f o r m a t i o n . " B u t , " they s a i d , "don't be fooled. T h o u g h it m i g h t r e s e m b l e y o u in e v e r y way, the replica will not in fact be y o u . It will be s o m e o n e else. It can't p o s s i b l y be y o u because your b o d y and brain have been destroyed.'" ' A n d they w e r e right,' I s a i d . ' M y present p r e d i c a m e n t p r o v e s it.' ' P e r h a p s , ' s a i d D e r e k . ' I n a w a y . B u t not in a n y w a y that

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really matters i n o r d i n a r y life. N o t i f B u n d l e T h e o r y i s true, a s I b e l i e v e it to b e . T h e fact is that teleportation b e c a m e c o m m o n p l a c e . It b e c a m e a tried and trusted m o d e of t r a n s p o r t a n d no o n e had a n y c o m p l a i n t s . P e o p l e w e n t into the b o o t h a n d they c a m e out at the other e n d , intact in b o d y a n d m i n d . L i f e w e n t on as usual. Y o u ' v e done it numerous times yourself and it's never been a p r o b l e m , at least not until now. A n d I w a n t to p e r s u a d e y o u that, e v e n now, e v e n if the S u b c o m m i t t e e c o m e s to the c o n clusion that y o u are to be v a p o r i z e d , it i s n ' t really as m u c h of a p r o b l e m as y o u fear. ' L e t m e put i t this w a y . E v e n t h o u g h i t i n v o l v e s d e s t r u c t i o n o f the b o d y a n d reconstruction u s i n g entirely n e w m a t e r i a l s , w e should think o f travelling b y teleportation a s n o m o r e threatening o r p r o b l e m a t i c than travelling o n l i f e ' s j o u r n e y f r o m o n e d a y to the next. W h a t m a t t e r s in b o t h c a s e s , in t e r m s of w h a t is p r e s e r v e d , is precisely the s a m e : p s y c h o l o g i c a l continuity. We are the s a m e from o n e d a y to the next o n l y in so far as the b u n d l e of mental states, actual and potential, that o u r b r a i n takes with it to sleep at night r e s e m b l e s the b u n d l e that it w a k e s up with in the m o r n i n g . Y o u s u r v i v e from o n e d a y to the next b e c a u s e the p s y c h o l o g i c a l links h a v e b e e n m a i n t a i n e d . ' O n T u e s d a y y o u h a v e a certain set o f m e m o r i e s a n d p l a n s , aptitudes and d i s p o s i t i o n s . T h e s e flow from the o n e s y o u h a d o n M o n d a y a n d a r e , in turn, c a u s a l l y linked to the o n e s y o u will h a v e o n W e d n e s d a y , T h u r s d a y , and Friday. A n d if, o n S a t u r d a y , y o u are teleported t o M a r s , y o u r replica e m e r g e s with the v e r y s a m e pattern o f mental states, which will b e carried f o r w a r d t o the next d a y and the next a n d the next t h r o u g h the u s u a l c a u s a l links. T h e r e is no b r e a k in the continuity of mental life. Y o u a n d

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y o u r replica a r e p s y c h o l o g i c a l l y c o n t i n u o u s at the d e e p e s t level. A n d y o u m u s t realize that the m e c h a n i s m s o f mental survival o v e r t i m e in o r d i n a r y life really are no different, and that there is no other kind of continuity that really matters. T h e r e is no point p e e r i n g into the b u n d l e , h o p i n g to catch a g l i m p s e of s o m e e l u s i v e , o b s e r v i n g e g o . T h e r e isn't o n e . T h e b u n d l e i s all.' I w a s b e g i n n i n g to u n d e r s t a n d , but it didn't help my c a s e . I m i g h t still h a v e to f a c e the p r o s p e c t of an untimely death. I said that B u n d l e T h e o r y m i g h t v e r y well b e true, a s D e r e k believed, a n d my m i n d w o u l d live on in replicated f o r m — a n d , y e s , there w a s s o m e c o n s o l a t i o n i n that. T h e replica m o v e s forward i n time with m y s t o c k o f m e m o r i e s a n d d i s p o s i t i o n s . I t can g o o n to fulfil my p l a n s and o b l i g a t i o n s . P e r h a p s it really w a s the case that, by a n y m e a n i n g f u l a n a l y s i s of the n a t u r e of mental life, I s t o o d in relation to my replica as I s t o o d in relation to the p e r s o n I w a s y e s t e r d a y a n d the p e r s o n I m i g h t be t o m o r r o w . But, at the s a m e t i m e , it w a s a l s o clear that a b r a n c h i n g h a d taken p l a c e . W h i l e the r e p l i c a ' s m i n d h a d rolled out with perfect continuity f r o m the m i n d I e m b o d i e d at the point w h e n D e r e k pushed the g r e e n b u t t o n to initiate the s c a n n i n g p r o c e s s , our m i n d s had, since then, b e g u n t o d i v e r g e a s , minute b y minute, w e a b s o r b e d different e x p e r i e n c e s . We did not k n o w whether the replica had e v e n b e e n i n f o r m e d o f the teleportation malfunction. I f not, then it w o u l d be c a r r y i n g on as n o r m a l — as me — happily una w a r e that a v e r s i o n of its f o r m e r s e l f w a s l a n g u i s h i n g m i s e r a b l y on a truncated b r a n c h line. Would it care? I w o n d e r e d . I liked to think that I (and therefore it) w o u l d feel c o m p a s s i o n . B u t really w h o k n o w s h o w o n e m i g h t react i f s o m e b i z a r r e alternative v e r s i o n o f o n e ' s self

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s h o w e d up like the s p e c t r e at the feast, t h r e a t e n i n g to w a r p the status q u o ? It c o u l d p r o v e a dreadful e n c u m b r a n c e . I put it to D e r e k that my replica a n d I m a y o n c e h a v e b e e n identical, but w e w e r e g r o w i n g apart. W e w e r e d e v e l o p i n g alternative p o i n t s o f view. W e h a d b e c o m e different p e o p l e i f only in the restricted, l a n g u a g e - d e p e n d e n t s e n s e that B u n d l e T h e o r i s t s a l l o w e d talk o f p e o p l e . A n d I , f r o m m y p e r s p e c t i v e , did not relish the p r o s p e c t of a p r e m a t u r e d e a t h , n o t w i t h s t a n d i n g the c o n s i d e r a b l e difficulties that future life with a d u p l i c a t e w o u l d inevitably entail. ( A s the night w o r e on I h a d b e e n thinki n g m o r e and m o r e a b o u t m y wife and w h a t her s t r a t e g y m i g h t be for c o p i n g with a d u p l i c a t e d h u s b a n d . ) ' I can u n d e r s t a n d , ' D e r e k s a i d , 'that y o u d o n ' t w a n t t o d i e . E v e n B u n d l e T h e o r i s t s d o n ' t w a n t t o d i e . F o r m o s t p e o p l e the truth o f B u n d l e T h e o r y d o e s not dispel the illusion o f the e g o . T h e y cling to their false beliefs.' B u t he a l s o s a i d that a c c e p t a n c e of that truth c o u l d h a v e a liberating effect. A m o n g other t h i n g s , it o p e n e d the p o s s i b i l i t y of l o o k i n g at d e a t h in a different w a y . H e p e r s o n a l l y h a d found this t o b e the c a s e . I t w a s l i b e r a t i n g and c o n s o l i n g . B e f o r e h e h a d fully a b s o r b e d the truth o f B u n d l e T h e o r y he said that he h a d felt i m p r i s o n e d in himself. H i s life s e e m e d like a g l a s s tunnel t h r o u g h w h i c h he w a s m o v i n g faster and faster e v e r y y e a r a n d , at the end of w h i c h , there w a s nothing but d a r k n e s s . ' N o w m y v i e w h a s c h a n g e d . T h e w a l l s o f the g l a s s tunnel have d i s s o l v e d . I live in the o p e n air.' It h a d b r o u g h t h i m c l o s e r t o p e o p l e . H e w a s l e s s c o n c e r n e d a b o u t his o w n life a n d m o r e c o n c e r n e d with the lives o f others. H e c a r e d less a b o u t his o w n inevitable death. Mental events and e x p e r i e n c e s w o u l d c o n t i n u e

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to be a feature of the w o r l d after his death, he s a i d , and it w a s true that n o n e of these w o u l d be linked to his present mental life b y the sort o f direct e x p e r i e n c e - m e m o r y o r intention-action c o n n e c t i o n s that s h a p e d the e x i s t i n g b u n d l e o f experiences. T h e r e w o u l d b e s o m e indirect c o n n e c t i o n s , h o w e v e r — m e m o ries

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followed. ' W e all m a k e a m a r k , ' he s a i d . ' T h e s i m p l e facts of death are this: that it will b r e a k the m o r e direct relations b e t w e e n my p r e s e n t mental events and mental events a r i s i n g in the future, a n d that certain other relations will not be b r o k e n . O n c e the e g o is r e m o v e d from the s c e n e , that is all there is to it.' I found this m o r e d e p r e s s i n g than uplifting. I told him that his r e d e s c r i p t i o n of death s e e m e d to me to reflect an i m p o v e r i s h e d v i e w of life. P e r h a p s it w a s better to anticipate l o s i n g the self in d e a t h than to d e n y it in life, a denial that, surely, a m o u n t e d to a f o r m o f nihilism. A n d , a n y w a y , e v e n i f B u n d l e T h e o r y w a s true I c o u l d not b e l i e v e it. Intellectually, I c o u l d follow his a r g u m e n t s a n d a c c e p t the facts o f n e u r o s c i e n c e but, psychologically, it w a s i m p o s s i b l e to identify with his theory. It ran counter to o n e ' s e x p e r i e n c e o f the w o r l d . D e r e k ' s r e s p o n s e , a g a i n , w a s that it w a s difficult to g r a s p the truth, a n d if he w a s b e i n g c h a r g e d with nihilism then he w o u l d accept that in so far as it a p p l i e d to his v i e w of the self. T h e t e r m , he r e m i n d e d m e , is from the L a t i n nihil, m e a n i n g ' n o t h i n g ' . 'It i s perfectly true t o s a y that the s e l f i s N o T h i n g . ' O t h e r w i s e , he rejected the c h a r g e . He said that in a c c e p t i n g the truth o f B u n d l e T h e o r y his a p p r e c i a t i o n o f the v a l u e o f life had o n l y b e e n enriched.

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unpalatable I w a s i n g o o d c o m p a n y . D e r e k s a i d that the p h i l o s o pher D a v i d H u m e , w h o h a d f o r m u l a t e d a n influential v e r s i o n o f the theory in the eighteenth century, reflected on his o w n a r g u ments and w a s pitched into a d e e p d e p r e s s i o n , the c u r e for which w a s to g e t out m o r e - d i n i n g a n d p l a y i n g b a c k g a m m o n with friends. A n d i n the twentieth century, T h o m a s N a g e l a l s o c a m e to the c o n c l u s i o n that, w h a t e v e r the truth of the theory, it w a s i m p o s s i b l e for the h u m a n p s y c h e t o d i g e s t . ' D e r e k , ' I s a i d , ' p e r h a p s y o u s h o u l d g e t o u t m o r e , too. R e d i s c o v e r y o u r self.' H e r o s e f r o m his seat, g r i n n i n g b r o a d l y , a n d c a m e a c r o s s and s l a p p e d m e o n the b a c k . ' M a y b e , ' h e s a i d . ' M a y b e not.' T h e n h e w i s h e d m e luck a n d was gone. I d o z e d off and d r e a m t I w a s in the beautiful city of V e n i c e , i n the P i a z z a S a n M a r c o . B e l l s w e r e r i n g i n g a n d p i g e o n s circled and s w o o p e d . T h e r e w e r e n o p e o p l e . T h e n , a c r o s s the s q u a r e from the direction of the B a s i l i c a , there a p p e a r e d a y o u n g couple. T h e y walked towards me. T h e w o m a n I recognized as my wife, a younger version, perhaps as she w o u l d have been when we first visited the city. T h e m a n h a d no f a c e , just a s m o o t h p l a n e o f skin w h e r e the u s u a l c o n t o u r s a n d orifices should have been. T h e r e w a s no greeting. I w o k e to find that a white e n v e l o p e h a d b e e n p u s h e d u n d e r the d o o r . It contained an invitation to a p p e a r b e f o r e the S u b c o m m i t t e e o n P e r s o n a l Identity a t eleven o ' c l o c k that m o r n i n g . It w a s n o w ten. I s h o w e r e d , b r e a k f a s t e d on b r e a d , c h e e s e , a n d coffee, and p r e p a r e d t o m e e t m y fate.

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' I ' v e g o t a l u m p , ' m y wife s a y s . ' F e e l . ' I ' m w a t c h i n g the S u n d a y a f t e r n o o n football and still h a v e an e y e o n the g a m e a s s h e directs m y hand t o the outer c u r v e o f her left b r e a s t . It is the s i x t y - s e v e n t h m i n u t e . T h e r e is a l u m p . ' W h a t d o e s it feel l i k e ? ' We are in the b e d r o o m now. S h e has s t r i p p e d to the w a i s t . I p a l p a t e the b r e a s t as if I ' m an expert. 'What do you think?' she says. ' T h e r e ' s a b u m p . M o r e of a b u m p than a l u m p . ' T h e G P i s r e a s s u r i n g a t first, b u t d e v e l o p s d o u b t s , and o r g a n izes a referral to the b r e a s t clinic. K a t e returns tearful. We both n e e d c h e e r i n g up, s o w e h e a d for the c o a s t , half-an-hour's drive, s t o p p i n g to b u y s a n d w i c h e s on the w a y . I t ' s a fine day, as bright as the c a l l i n g g u l l s . T h e tide is l o w and the s e a is a hard blue. It feels g o o d t o b e a l i v e . B u t later, i n the p u b , i t ' s m y turn t o b e tearful. T h e s e c o n d b e e r helps. T h u r s d a y w e e k , the d a y o f the a p p o i n t m e n t . W e sit i n the g r e y - b l u e w a i t i n g r o o m at the b r e a s t clinic. T h e r e is a TV in the

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corner with the s o u n d m u t e d . S o m e T V c h e f i s b a k i n g a birthd a y cake. N o o n e i s interested. O u r turn. T h r o u g h t o the e x a m i n a t i o n r o o m , m y s e m i - n a k e d wife l o o k i n g fragile a s the s u r g e o n p r o d s a n d p a l p a t e s a n d g e t s t o w o r k with his blue m a r k e r p e n . H e d o e s n ' t s a y m u c h . T h e nurse d o e s m o s t o f the talking. S h e ' s lovely. O u r turn a g a i n . Y e s , there i s s o m e t h i n g s u s p i c i o u s o n the X ray, the s u r g e o n s a y s . H e ' s g o i n g t o d o a c o r e b i o p s y . S e v e n s l a m m i n g s h o t s o f the silver g u n , and each time h e h o l d s u p the phial t o inspect the m a g g o t y p l u g s o f f l e s h . H e ' s not quite g e t ting what he w a n t s . W e ' l l h a v e the results in a few d a y s . ' B u t y o u d o n ' t like the l o o k of i t ? ' I a s k . 'No.' ' Y o u think i t ' s cancer.' 'Yes.' T h e n u r s e specialist h a s j o i n e d u s : b a d n e w s personified. T h e s u r g e o n leaves and it's the three o f u s i n the e x a m i n a t i o n r o o m , K a t e ' s tears hot o n m y shoulder. T h e n u r s e sits quietly. I h a v e my b a c k to her, which feels like a d i s c o u r t e s y . I t ' s a nasty, sticky w o r d , ' m a s t e c t o m y ' . I d o n ' t like the s o u n d of it c o m i n g from the s u r g e o n ' s m o u t h . We are b a c k in the consulting r o o m . H e ' s plotting the likely c o u r s e : s u r g e r y , chemotherapy, and radiotherapy, not n e c e s s a r i l y in that order. W e d o n ' t g o straight h o m e . W e stop b y the r i v e r s i d e a n d w a l k i n the w o o d s . I can't r e m e m b e r the last time I w e p t . A w e e k o n . T h e y ' r e setting it up as a B a d N e w s C o n s u l t a t i o n . T h e y h a v e g r a v e - j o l l y faces — p r o f e s s i o n a l wistfulness. B u t w e k n o w already. T h e r e isn't m u c h b y w a y o f preliminary. T h e s u r g e o n squints o v e r his s p e c t a c l e s .

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' I t ' s a m a l i g n a n t , i n v a s i v e , ductal c a r c i n o m a , ' he s a y s , with a t r a c e o f a p o l o g y . I s there a n y t h i n g else w e w a n t t o k n o w ? H e ' s n o t g o i n g t o tell u s u n l e s s w e a s k . ' W h a t a b o u t the h i s t o l o g y ? A r e the cells well, o r poorly, differentiated?' ' P o o r l y , ' h e s a y s , ' G r a d e 3.' I t ' s a b a d o n e . He r e p l a y s the likely treatment s c e n a r i o : four c y c l e s o f n e o a d j u v a n t c h e m o t h e r a p y o v e r three m o n t h s ; m a s tectomy, f o l l o w e d b y radiotherapy. T h e plan i s p r o v i s i o n a l , b e c a u s e if the c h e m o fails to shrink the t u m o u r they'll b r i n g the s u r g e r y f o r w a r d . A r r a n g e m e n t s will b e m a d e for b o n e and liver s c a n s . We c a n do b l o o d s and a chest X - r a y straight away. I keep saying 'we'. H o w o d d this is. T h e w o r s t n e w s , b u t a s e n s e of relief. I h a v e a l r e a d y pictured the s u r g e o n slicing o f f m y w i f e ' s breast. I h a v e i m a g i n e d it b e i n g t h r o w n to w a s t e . I h a v e seen it rising in s m o k e t h r o u g h the incinerator chimney. Yet there is comfort in the t h o u g h t of g e t t i n g on with treatment. W h a t e v e r it takes. It a l m o s t feels r e l a x i n g to w a l k o u t a c r o s s the m a i n c o n c o u r s e of the hospital — like a d e p a r t u r e l o u n g e with its cafe and s h o p s - this p l a c e I k n o w in a parallel p r o f e s s i o n a l life, out into the sunlight. T h i s time w e d o n ' t w e e p b y the riverside o r w a l k i n the w o o d s . We h e a d for the s u p e r m a r k e t . A f a m i l i a r - l o o k i n g m a n in s h o r t s a n d T - s h i r t is l o a d i n g his s h o p p i n g into the b a c k of a V o l v o . I t ' s a f a m o u s TV n e w s r e a d e r . I w a n t to tell him o u r n e w s . B a c k h o m e w e drink b e e r a n d eat curry and watch football. We are h a n d e d o v e r to another s u r g e o n , a specialist in breast

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reconstruction. K a t e sits o n the e d g e o f the b e d . T h e s u r g e o n stands s t r o k i n g his chin, o b s e r v i n g her b u s t with the e y e of a sculptor. H e s t o o p s , p r e s s e s a n d p r o b e s the d i s e a s e d b r e a s t , then stands b a c k for a fresh view. He takes o u t a little ruler a n d starts m e a s u r i n g . H e ' s w e i g h i n g t h i n g s u p ; thinking o n his feet. Y e s , h e s a y s , w e c o u l d g o for a w i d e local e x c i s i o n instead o f m a s t e c tomy. A n d now, d e s p i t e myself, I find I ' m p l a y i n g D e v i l ' s A d v o c a t e . I ' v e read the latest New England Journal of Medicine and understand that, all things b e i n g e q u a l , less radical interventions are just as effective. B u t I n e e d to hear it f r o m the m a n in the dark suit. F i v e m o n t h s o n , p o s t - c h e m o , K a t e lies on a hospital b e d , d r a p e d in drips and d r a i n s , r e c o v e r i n g from her s e c o n d o p e r a tion i n a m o n t h . T h e f i r s t w a s t o r e m o v e the l u m p . T h i s o n e h a s restored the b r e a s t to its o r i g i n a l s h a p e , t h o u g h we h a v e yet to see the s c u l p t o r ' s h a n d i w o r k . S h e is s w a d d l e d in a ' b e a r h u g g e r ' blanket, filled with w a r m air to aid the p e r f u s i o n of b l o o d . W i t h her hair just starting t o g r o w b a c k she l o o k s like the D a l a i L a m a , but m u c h prettier.

* * * T h e year before last. E v e n i n g o n the terrace o f a F r e n c h s e a s i d e hotel, late s u m m e r , the s e a as s m o o t h as m e r c u r y , the s k y n o t yet drained o f its blue. T h e r e w o u l d b e s t a r s , b u t t i m e h a d s l o w e d . E v e n the g u l l s s e e m e d s u s p e n d e d o n the c o o l i n g air, a n d m a d e hardly a s o u n d . T h e y are m o r e s o f t - s p o k e n here. K a t e a n d I w e r e drinking cold beer, r e c o v e r i n g f r o m the heat o f the day, our skin feeling full of the s u n , o u r l i m b s a c h i n g f r o m a l o n g

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s w i m . We s a i d little, but sat content w a t c h i n g the d a r k n e s s gather. T h e c a n d l e o n the table r e m a i n e d unlit. I b e c a m e a w a r e o f the m a n and w o m a n t w o tables a l o n g . S h e h a d s a i d s o m e t h i n g i n a u d i b l e , to which he h a d replied 'Non, merci,' b u t n o t h i n g else w a s s a i d . T h e m a n , a b o u t forty, sat h u n c h e d with a r m s folded, a s i f c o n s t r a i n e d by a straitjacket. H i s face h a d a d r a w n , intent l o o k . H e c o u l d h a v e b e e n c o n c e n t r a t i n g h a r d . F r o m time t o time, his lips p u r s e d a n d his right s h o u l d e r s e e m e d to jerk forward a little. I w a t c h e d , discreetly. I noticed, t o o , the s q u i r m i n g m o v e m e n t of his right h a n d . P r e s s e d b e t w e e n f o r e a r m and b i c e p s of the left limb, it w a s t r y i n g to e s c a p e . A w a i t e r a p p e a r e d f r o m n o w h e r e offering s o m e t h i n g , but the w o m a n w a v e d him away. K a t e had her b a c k to all this and couldn't see what w a s g o i n g on. S o m e h o w , the m a n a n d w o m a n o n the terrace b r o u g h t t o m i n d a s c e n e f r o m a novel I h a d b e e n r e a d i n g : K u n d e r a ' s Immortality. O n e of the c h a r a c t e r s , A g n e s , is l y i n g in b e d next to her h u s b a n d , P a u l . B o t h h a v e difficulty s l e e p i n g and A g n e s drifts into a familiar fantasy a b o u t a kindly visitor from another planet. T h e s t r a n g e r tells her that in the next life she will not be r e t u r n i n g to E a r t h . A n d P a u l ? ' s h e e n q u i r e s . N o , s h e i s told, Paul w o n ' t b e s t a y i n g either. W h a t the s t r a n g e r n e e d s t o k n o w is, d o they want t o s t a y t o g e t h e r in the life to c o m e or never m e e t a g a i n ? In P a u l ' s p r e s e n c e , A g n e s a l w a y s k n e w she w o u l d b e i n c a p a b l e o f s a y i n g that s h e n o l o n g e r w a n t e d t o b e with him. H o w could she? W o u l d n ' t that a m o u n t to s a y i n g that there h a d never b e e n any l o v e b e t w e e n them, that their life h a d b e e n b a s e d on the illusion

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o f l o v e ? A n d for this r e a s o n s h e w o u l d a l w a y s capitulate. A g a i n s t her w i s h e s s h e w o u l d tell the s t r a n g e r that o f c o u r s e they w a n t e d to r e m a i n together in the next life. I put the s a m e q u e s t i o n to my w i f e . ' I m a g i n e , ' I s a i d , 'a v i s i tor from outer s p a c e j o i n s u s n o w a t this table. H e m a k e s his offer o f another life b e y o n d d e a t h , a n d g i v e s y o u a c h o i c e . Y o u can m a k e a r r a n g e m e n t s for m e t o join y o u o r y o u can d e c i d e that, at the end of this life, we s h o u l d part c o m p a n y n e v e r to meet again.' T h e hand e s c a p e s . I t writhes f r o m u n d e r the left f o r e a r m a n d p u s h e s f o r w a r d , p a l m f a c i n g o u t w a r d t o the s e a . T h e m a n ' s e x p r e s s i o n d o e s not c h a n g e , he l o o k s straight a h e a d , b u t I s e e that his k n e e s are n o w p r e s s e d tight t o g e t h e r a n d are e d g i n g t o the left a s his u p p e r b o d y twists t o the right. T h e w o m a n takes the errant hand and p u t s it b e t w e e n her p a l m s . S h e g u i d e s it b a c k t o w a r d s the m a n ' s chest. S h e h o l d s it fast with her left h a n d a n d , at the s a m e time, reaches for his left with her right. Still he l o o k s straight a h e a d , d o e s not s p e a k . I w a t c h as s h e refolds the a r m s , pulling them tight like a k n o t . T h e m a n g i v e s n o a c k n o w l e d g e ment. S h e returns to her seat. K a t e w a s still thinking a b o u t the q u e s t i o n . T o o l o n g , I thought. I w o u l d n ' t b e l i e v e her now. T h e n , straight out, s h e said: ' I ' d g o i t a l o n e . W o u l d n ' t y o u ? ' S h e s a i d that o n e lifetime was enough, however much you loved someone. T w o m o r e c o u p l e s c a m e t o sit a t the table b e t w e e n u s a n d the French c o u p l e . I'd seen t h e m f r o m a d i s t a n c e at the b e a c h that afternoon. A t first I ' d a s s u m e d they w e r e F r e n c h , b u t there w a s a s e l f - d e p r e c a t i n g j o k i n e s s a b o u t o n e o f the w o m e n a s s h e s t r u g g l e d , inelegantly, to g e t into a wetsuit. I t h o u g h t it b e t r a y e d

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her as E n g l i s h . I w a s right. T h e y o r d e r e d a r o u n d of drinks, then another, a n d another. T h e i r c a n d l e w a s lit, and it lit the redd e n i n g f a c e s a r o u n d the table a n d g u t t e r e d in the g l a s s of the accumulating bottles. T h e F r e n c h c o u p l e w e r e a w a y i n the s h a d o w s . Y o u could h a r d l y s e e t h e m now. B u t a s e c o n d a n d third time I noticed the m a n ' s h a n d e s c a p e a n d , each t i m e , s a w the w o m a n retrieve it. H e jerked a n d w r i t h e d as she tied the a r m s together, b e f o r e settling b a c k into a b u n c h e d r e p o s e , set to unravel a g a i n at any m o m e n t . It's Huntington's disease, I t h o u g h t . St Vitus's dance. Poor man. Poor woman. T h e involuntary, c h o r e i f o r m m o v e m e n t s are only the h a l f o f it. T h e r e ' s the d e m e n t i a , t o o , a n d p e r h a p s p s y c h o s i s . T h e d i s e a s e is relentless a n d he will d a n c e like a p u p p e t to his death. H i s fate w a s fixed at c o n c e p t i o n . A r o g u e g e n e , d o r m a n t for d e c a d e s , h a d s t r u c k , a n d his b r a i n w a s c r u m b l i n g a t its c o r e , d e e p b e n e a t h the w r i n k l e d m a n t l e of the cortex, d o w n in the d a r k interiors o f the b a s a l g a n g l i a , w h e r e actions are deciphered f r o m the c o d e s o f intention. A n d n o w all i s confusion. T h e r e are a c t i o n s a n d intentions, b u t they d o n ' t necessarily coincide. M e a n w h i l e , they will do their b e s t , this c o u p l e , to d e n y the terror a n d defy the p u p p e t e e r . T h e y will enjoy a s u m m e r ' s e v e n i n g t o g e t h e r o u t o n the t e r r a c e . I a b s o r b e d my w i f e ' s a n s w e r - I'd go it alone. Wouldn't you?a n d t o o k a n o t h e r sip o f beer. ' W o u l d y o u ? ' I a s k e d . S o m e o n e i n the E n g l i s h g r o u p k n o c k e d an e m p t y b o t t l e o f f the table. It shattered on the g r o u n d , b u r s t i n g s h a r d s in e v e r y direction. I noticed that the French couple were gone.

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' S o , ' I s a i d , ' i t ' s just the o n e l i f e t i m e ? ' 'Afraid s o , ' she s a i d . ' B e t t e r m a k e the m o s t o f it.'

L A N D

Remember me when I am gone away, Gone far away into the silent land; When you can no more hold me by the hand, Nor I half turn

to go yet turning stay.

Christina Rossetti, 'Remember'

FURTHER

READING

Some of the following readings relate to particular chapters in this book, others will illuminate its general themes. Still others are recommended simply as sound introductions to neuroscience, neuropsychology, and philosophy of mind for those sufficiently motivated to go beyond my case stories and other meanderings. Recent years have seen the publication of several fine works of popular science devoted to neuropsychology, neuroscience, and related topics. There are also some outstanding new textbooks. I can't think of a better general introduction to brain science than Ian Glynn's An Anatomy of Thought: the Origin and Machinery of the Mind (Weiden-

feld & Nicolson, 1999). Susan Greenfield's The Human Brain: A Guided Tour (Phoenix, 1998) provides a useful brief survey; and for those who prefer to be spoon-fed, Mind and Brain for Beginners by

Angus Gellatly and Oscar Zarate (Icon Books, 1998) is an entertaining and informative cartoon book. Bruno Aldaris's Neuroscience for the Brainless (Figment Books, 1994) which I quote in 'The Visible Man' is, sadly, virtually unobtainable these days. Also recommended is Phantoms in the Brain: Human Nature and the

Architecture of the Mind. (Fourth Estate, 1998) by V. S. Ramachandran and Sandra Blakeslee. Ramachandran is a remarkably inventive neurological thinker and, among many other topics, this stimulating book

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has some interesting things to say about phantom limbs and the neurobiological bases of the body schema, complementing the impressionistic treatment I accord these topics in 'The Ghost Tree' chapters. Todd E. Feinberg's Altered Egos: How the Brain Creates the Self

(Oxford University Press, 2001) is another excellent collection of casestudy vignettes and theoretical speculations. Among other fascinating material, it contains a chapter on the important (but in research terms relatively neglected) phenomenon of confabulation, which topic forms one of the strands of 'Soul in a Bucket'. I was amused to discover that we both appreciate the utility of the eye and pyramid symbol, though use it to quite different ends. As for basic textbooks, I list my recommendations below. There may be other books of equal merit, but these are the ones with which I am familiar and they are very good indeed: Gazzaniga, M. S., Ivry, R. B. and Mangun, G. R., Cognitive Neuroscience: The Biology of the Mind, Second Edition (Norton & Co.,

2002). Kolb, B. and Whishaw, I.

Q., An Introduction to Brain and Behavior

(Worth Publishers, 2001). Rosenzweig, M. R., Breedlove, S. M. and Leiman, A. L., Biological Psychology:

An

Introduction

to

Behavioral,

Cognitive,

and

Clinical

Neuroscience, Third Edition (Sinauer Associates, Inc., 2002). It is important to note that there are different varieties of neuropsychology. One approach emphasizes functional anatomy and is concerned with studying the neural bases of psychological functions. Scientists working in this field are like mapmakers. Their mission is to explore the neurobiological landscape, charting the relationship between mental events and the structures and processes of the brain. Localization and distribution of functions is the central concern. This approach includes the classical method of examining the psychological consequences of 'focal' (localized) brain damage as well as the newer methods of cognitive neuroscience that use brain-scanning machines

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to explore patterns of activity in the normal, intact brain. The abovecited general texts are representative of this approach. Other investigators—so-called cognitive neuropsychologists — have relatively little interest in the details of brain function. They assume, of course, that brain systems and mental life are intertwined, but their primary concern is the structure of the mind, not the brain. Cognitive neuropsychologists study the performance of the damaged brain as a way of testing and refining theories of normal cognitive function. They start with a theory of cognition — some model of shortterm memory, say, or of language production — and form hypotheses as to how memory or speech might be affected by brain disorder. The model gains support to the extent that patients' behaviour fits with predictions. Alternatively, their test performance may challenge the original model, leading to its modification or abandonment. What matters is the robustness (or otherwise) of the theoretical models rather than the precise nature of the underlying neurological disorder. The best introduction to cognitive neuropsychology is Human Cognitive

Neuropsychology:

A

Textbook

with

Readings

(Psychology

Press, 1996) by Andy Ellis and Andy Young. Alan Parkin's Explorations in Cognitive Neuropsychology (Blackwell, 1996) is also excellent, and The Handbook of Cognitive Neuropsychology (Psychology Press,

2000), edited by Brenda Rapp, is a useful source book. The biological and psychological approaches are complementary. Although considerations of anatomy and physiology may be secondary to their main enterprise, the fruits of the cognitive neuropsychologists' labours are directly relevant to an understanding of the structure and functions of the brain. In order to know how psychological functions are represented in neural systems the functions themselves must be clearly delineated. Modern clinical neuropsychology draws on both traditions, a fact nicely illustrated in David Andrewes's comprehensive survey, Neuropsychology: From Theory to Practice (Psychology Press, 2001). I also recommend

The Blackwell Dictionary of Neuropsychology (Blackwell,

1996), edited by J. G. Beaumont, P. M. Kenealy and J. C. Rogers. Much

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more than a dictionary, this is an excellent reference work containing substantial entries on most aspects of clinical and experimental neuropsychology. The list of contributors is impressive. For those specifically interested in psychiatric aspects of neurological disorder the classic text is W. A. Lishman's Organic Psychiatry, Third Edition (Blackwell Science, 1997). Although geared for a specialist readership, it is sufficiently lucid and digestible to be of interest to the motivated lay reader. The emerging discipline of cognitive neuropsychiatry puts the principles and methods of cognitive neuropsychology to work in the field of psychiatric research. Peter Halligan and John Marshall's Method in Madness: Case Studies in Cognitive Neuropsychiatry (Psychology Press,

1996) provides a stimulating introduction. It includes a fine chapter on Cotard's syndrome by Andy Young and Kate Leafhead ('Betwixt Life and Death: Case Studies of the Cotard Delusion'), which helped shape my thinking as I came to write 'I Think Therefore I Am Dead'. Themes of consciousness, self, and personal identity thread right through this book. I hope that professional philosophers will not find my excursions into their territory too naive or superficial. If that is the case I blame the following: David Chalmers, The Conscious Mind: In Search of a Fundamental Theory (Oxford University Press, 1996); Francis Crick, The Astonishing Hypothesis (Simon and Schuster, 1994); Daniel

Dennett,

Consciousness Explained (Penguin

Books,

1993);

Owen Flanagan, The Problem of the Soul: Two Visions of the Mind and

How to Reconcile Them (Basic Books, 2002); Gerald Edelman and Giulio

Tonini,

Consciousness:

How

Matter

Becomes

Imagination

(Penguin, 2001); Nicholas Humphrey, A History of the Mind (Chatto and Windus, 1992); Colin McGinn, The Mysterious Flame: Conscious Minds in a Material World (Basic Books, 1999); Thomas Nagel, The View from Nowhere (Oxford University Press, 1986); John Searle, The Mystery of Consciousness (Granta Books, 1997); and Max Velmans, Understanding Consciousness (Routledge, 2000).

It would take another long chapter to summarize the range of ideas represented in these works (materialism, dualism, neural Darwinism,

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Mysterianism, and so on), and I have resisted the temptation to offer such a summary — for one thing I don't feel qualified to undertake the task. Searle's highly readable book summarizes the thinking of some of the key figures in the current debate, as well as presenting the author's own views. If nothing else, it is worth reading for the testy exchange between Searle and Dennett in which each accuses the other of 'intellectual pathology'. It took me straight back to the school playground {Fight!

Fight!

Fight!).

I find Searle's 'biological naturalism' hard to fathom, but generally have difficulties fixing my own co-ordinates when it comes to the problem of consciousness. In 'Right this way, Smiles a Mermaid' the narrator stands accused of being a 'Mysterian'. Owen Flanagan, I believe, originally coined the term in honour (not quite the right word) of Colin McGinn for propounding the view that the mind-body problem is insoluble, or at least that we feeble-minded humans are incapable of solving it. I am much drawn to McGinn's deeply subversive position, but also find Dennett persuasive (as should be apparent throughout the book). That's my problem. For an incisive analysis of the neuropsychological bases of consciousness, see Larry Weiskrantz's Consciousness Lost and Found: A

Neuropsychological Exploration (Oxford University Press, 1997). The work of the neurologist Antonio Damasio has also been influential in shaping my thoughts on consciousness, self, and related matters. See, in particular, Descartes' Error: Emotion,

Reason and the Human Brain

(Picador, 1995), and The Feeling of What Happens: Body, Emotion and

the Making of Consciousness (Heinemann, 1999). Joseph LeDoux's Synaptic Self: How Our Brains Become Who We Are (Macmillan, 2002)

also makes an important contribution to our understanding of the neurobiological underpinnings of the self. Again, for those who prefer cartoon books, David Papineau and Howard Selina's Introducing Consciousness (Icon Books, 2000) is a sparky introduction to the field of consciousness studies. In a recent collection of essays, Consciousness and the Novel (Seeker and Warburg, 2002), the novelist and critic David Lodge offers some

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valuable insights concerning the representation of consciousness in literature. Works of literature — in contradistinction to science describe 'the dense specificity of personal experience'. Science, from its objective, third-person perspective, tries to formulate universally applicable, general explanations. The subjective and the unique are anathema to science. Lodge suggests that 'Lyric poetry is arguably man's most successful effort to describe qualia' (the 'raw feels' of conscious awareness). 'The novel is arguably man's most successful effort to describe the experience of individual human beings moving through space and time.' 'To Be Two or Not to Be' draws heavily on the ideas of the philosopher, Derek Parfit, and I took the liberty of using the name 'Derek' for one of the central characters. Although most of what the fictional Derek has to say is, I believe, representative of the real Derek Parfit's ideas, there may be instances where the views of the two Dereks diverge in more or less subtle ways. The best way to become acquainted with Mr Parfit's thoughts on personal identity is to consult his masterwork, Reasons and Persons (Oxford University Press, 1984). Don't expect to read it in one sitting, however. A digestible account of some of Parfit's ideas — and much else besides - can be found in Jonathan Glover's I:

The Philosophy and Psychology of Personal Identity

(Penguin Books, 1991). I saw Parfit lecture on personal identity, around the time that Reasons and Persons was published, in the Department of Physiology at Oxford during a series of seminars on the science and philosophy of mind. I thought at the time that he was saying something that was either quite trivial (if entertaining) or extremely profound and not a little disturbing. With the passage of the years I can see it was the latter. I have to say that, like his fictional counterpart, he did have a slightly wild look about him, and he was swigging water from a milk bottle throughout his presentation. The scientific paper to which I refer in 'The Ghost Tree (1)' was co-authored with Andy Young and others and published in the journal Neuropsychologia (P. Broks, A. W. Young, et al., 'Face processing

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impairments after encephalitis: amygdala damage and the recognition of fear', Neuropsychologia 36, pp.59-70, 1998). In 'The Ghost Tree (2)' I refer to the concept 'the social brain' — the notion that the brain has evolved systems dedicated to social perception and understanding. A good general introduction to this way of thinking is Fridays Footprint: How Society Shapes the Human Brain (Oxford University Press, 1997)

by Leslie Brothers. Simon Baron-Cohen makes a strong case for the relevance of the social brain to an understanding of autism in Mindblindness (MIT Press, 1995). 'The Sword of the Sun' was inspired by a story of the same name in Italo Calvino's Mr Palomar (Vintage, 1999), translated from the Italian by William Feaver . In 'Vodka and Saliva' I quote from Paul Ekman's Telling Lies:

Clues to Deceit in the Marketplace,

Politics and Marriage

(Norton, 2001). 'The Dreams of Robert Louis Stevenson' was inspired by 'A Chapter on Dreams', which can be found as an appendix to The Strange Case of Dr Jekyll and Mr Hyde and Weir of Hermiston (Oxford

World's Classics, 1998). The introduction by Emma Letley was very helpful, as was Robert Mighall's introduction to the Penguin Classics edition of Jekyll and Hyde (Penguin, 2002). 'The Visible Man', of course, pays homage to Kafka's classic allegorical tale 'Metamorphosis', available in The Complete Short Stories of Fran\ Kafka (Vintage Clas-

sics, 1999). 'In the Theatre' takes as its focal point Dannie Abse's disturbing poem, 'In the Theatre (A True Incident)', from his Collected Poems, 1948- 76 (Hutchinson, 1977). I had already drafted 'The Story of Einstein's Brain' when I came upon Driving Mr Albert: A Trip Across America with Einstein's Brain (Abacus, 2002), Michael Paterniti's entertaining account of his quest for the great man's grey matter and subsequent journey through America with it stashed in the trunk of his Buick. In 'Gulls' I refer to Milan Kundera's Immortality (Faber and Faber, 1991), translated from the Czech by Peter Kussi. In 'Soul in a Bucket' I mention Tom Wolfe's essay, 'Sorry, but Your Soul Just Died', which appears in Hooking Up (Jonathan Cape, 2000). The Working Brain by Alexander Romanovich Luria (Penguin, 1973) is out of date, hard to obtain, and difficult to read — at least I

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found it so when I first came across it in my undergraduate days. I can't, for these reasons, recommend the book as an introductory text, but I cite it because its author has been a significant influence on my own approach to clinical practice. Luria, to whom I refer more than once in these pages, is one of the undisputed giants of neuropsychology, and The Working Brain (published four years before he died) summarizes his life's work. It presents a general theory of the organization of brain function — the distillation of forty years' work by Luria and his collaborators — as well as a comprehensive survey of existing knowledge of the classical domains of interest: the brain bases of perception, language, memory, thought, and action. Anyone developing a serious interest in the subject should at some stage track down, read, and appreciate Luria for the breadth of his vision of brain science, his recognition that the study of brain function is a multidisciplinary enterprise, and his insight that, ultimately, it becomes necessary to consider the brain in relation to other brains if one is to comprehend its workings: neuropsychology has social dimensions as well as biological and psychological. 'The eye of science,' he wrote, 'does not probe a "thing", an event isolated from other things or events. Its real object is to see and understand the way a thing or event relates to other things or events.' Luria should be read not least for his understanding that neuropsychology concerns individual human beings — patients — struggling to make their way in a world rendered difficult and sometimes disturbingly strange by their brain damage. As far as neuropsychology is concerned, he was an advocate of 'romantic science' — recognizing the importance of combining close observation of individual patients (and understanding them as people) with a more systematic, 'classical' understanding of the facts of neurological disorder derived through conventional scientific method. This should be the aim of all clinicians — not to lose sight of the unique in the context of the universal, and vice versa. Luria's

scientific biography,

The

Making of Mind:

A Personal

Account of Soviet Psychology (Harvard University Press, 1986), edited

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by Michael and Shelia Cole, is a fascinating fusion of the personal, the political, and the scientific. But he is best known as a master of the extended case history, classic examples of which are The Man with a Shattered World (Penguin, 1975) and The Mind of a Mnemonist

(Harvard University Press, 1986). Another master of that genre is, of course, Oliver Sacks, whose works I have studiously avoided while writing this book. His influence was strong enough. I especially recommend The Man Who Mistook his Wife for a Hat (Picador, 1986) and An Anthropologist on Mars (Picador,

1995). These collections of neurological case histories, full of warmth and insight, embody the spirit of Alexander Luria, whom Sacks acknowledges as an important influence. Like Luria, he appreciates the complementarity of 'classical' and 'romantic' modes of understanding. In the mid-1980s I was, for reasons not worth going into, somewhat disillusioned with clinical psychology. I thought about an academic career as a possible alternative, but did not relish the uncertain prospect of drifting on to the trail of short-term, post-doctoral research appointments with no guarantee of a proper job at the end. I might easily have given up neuropsychology altogether at that point. I might have been happy enough doing other things. Then I got a call from Merck Sharp and Dohme, the drug firm ( 'America's Most Admired Company' according to Fortune Magazine — I still have the commemorative mug). The unexpected call came from Susan Iversen, at that time Director of Behavioural Pharmacology at the MSD Neuroscience Research Centre. They were setting up a clinical research unit, she said, and would I be interested in joining them? I told her I knew nothing about psychopharmacology. 'Don't worry, love,' she said, 'you'll soon pick it up.' The advice was sound, and it is my advice to anyone interested in finding out more about neuropsychology, but wary of what might appear to be a rather daunting academic discipline: Don't worry, love, you '11 soon pick it up.

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Thanks to the patients whose stories lie at the heart of this book and from whom I have had the privilege of learning about the human dimension of neuropsychology, as opposed to what the textbooks teach. I hope I have given something in return. It is a plain fact that this book would not have been written without the vision of my editor and publisher, Toby Mundy. The project was Toby's idea in the first place and he has seen it through with great elan. Apart from anything else, I thank him for his patience. It has also been a pleasure working with the impressive Bonnie Chiang, and, previously, Alice Hunt at Atlantic Books. I am grateful to Ian Pindar who read the penultimate draft in full and made numerous fine adjustments. Warm thanks also to my friends at Prospect, in particular David Goodhart and Alex Linklater, for the opportunity to write a monthly column for a very fine magazine. From the bottom of my heart, I thank my entire family for their unfailing support down the years, but most of all my wife, Sonja, and sons Daniel and Jonathan, to whom I dedicate this book. You are more precious to me than ever.

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