The man who mistook his wife for a hat (24 page)

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Authors: Oliver Sacks,Оливер Сакс

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   But what of the status of the first lost, then recovered, memory? Why the amnesia-and the explosive return? Why the total blackout and then the lurid flashbacks? What actually happened in this strange, half-neurological drama? All these questions remain a mystery to this day.
   
20
   
The Visions of Hildegard
   'Vision of the Heavenly City'. From a manuscript of Hildegard's
Scivias,
written at Bingen about 1180. This figure is a reconstruction from several visions of migrainous origin.
   The religious literature of all ages is replete with descriptions of 'visions', in which sublime and ineffable feelings have been accompanied by the experience of radiant luminosity (William James
   Figure A
   Figure B
   Figure C
   Figure D
   Varieties of migraine hallucination represented in the visions of Hilde-gard.
   In Figure A, the background is formed of shimmering stars set upon wavering concentric lines. In Figure B, a shower of brilliant stars (phos-phenes) is extinguished after its passage-the succession of positive and negative scotomas. In Figures C and D, Hildegard depicts typically migrainous fortification figures radiating from a central point, which, in the original, is brilliantly luminous and colored.
   speaks of 'photism' in this context). It is impossible to ascertain, in the vast majority of cases, whether the experience represents a hysterica] or psychotic ecstasy, the effects of intoxication, or an epileptic or migrainous manifestation. A unique exception is provided in the case of Hildegard of Bingen (1098-1180), a nun and mystic of exceptional intellectual and literary powers, who experienced countless 'visions' from earliest childhood to the close of her life, and has left exquisite accounts and figures of these in the two manuscript codices which have come down to us-
Scivias
and
Liber divinorum operum
('Book of divine works').
   A careful consideration of these accounts and figures leaves no room for doubt concerning their nature: they were indisputably migrainous, and they illustrate, indeed, many of the varieties of visual aura earlier discussed. Singer (1958), in the course of an extensive essay on Hildegard's visions, selects the following phenomena as most characteristic of them:
   In all a prominent feature is a point or a group of points of light, which shimmer and move, usually in a wave-like manner, and are most often interpreted as stars or flaming eyes [Figure B]. In quite a number of cases one light, larger than the rest, exhibits a series of concentric circular figures of wavering form [Figure A]; and often definite fortification-figures are described, radiating in some cases from a coloured area [Figures C and D]. Often the lights gave that impression of
working,
boiling or fermenting, described by so many visionaries . . .
   Hildegard writes:
   The visions which I saw I beheld neither in sleep, nor in dreams, nor in madness, nor with my carnal eyes, nor with the ears of the flesh, nor in hidden places; but wakeful, alert, and with the eyes of the spirit and the inward ears, I perceive them in open view and according to the will of God.
   One such vision, illustrated by a figure of stars falling and being quenched in the ocean (Figure B), signifies for her 'The Fall of the Angels':
   I saw a great star most splendid and beautiful, and with it an exceeding multitude of falling stars which with the star followed southwards . . . And suddenly they were all annihilated, being turned into black coals . . . and cast into the abyss so that I could see them no more.
   Such is Hildegard's allegorical interpretation. Our literal interpretation would be that she experienced a shower of phosphenes in transit across the visual field, their passage being succeeded by a negative scotoma. Visions with fortification-figures are represented in her
Zelus Dei
(Figure C) and
Sedens Lucidus
(Figure D), the fortifications radiating from a brilliantly luminous and (in the original) shimmering and coloured point. These two visions are combined in a composite vision (first picture), and in this she interprets the fortifications as the
aedificium
of the city of God.
   Great rapturous intensity invests the experience of these auras, especially on the rare occasions when a second scotoma follows in the wake of the original scintillation:
   The light which I see is not located, but yet is more brilliant than the sun, nor can I examine its height, length or breadth, and I name it 'the cloud of the living light'. And as sun, moon, and stars are reflected in water, so the writings, sayings, virtues and works of men shine in it before me . . .
   Sometimes I behold within this light another light which I name 'the Living Light itself . . . And when I look upon it every sadness and pain vanishes from my memory, so that I am again as a simple maid and not as an old woman.
   Invested with this sense of ecstasy, burning with profound theo-phorous and philosophical significance, Hildegard's visions were instrumental in directing her towards a life of holiness and mysticism. They provide a unique example of the manner in which a physiological event, banal, hateful or meaningless to the vast majority of people, can become, in a privileged consciousness, the substrate of a supreme ecstatic inspiration. One must go to Dostoievsky who experienced on occasion ecstatic epileptic auras to which he attached momentous significance, to find an adequate historical parallel.
   There are moments, and it is only a matter of five or six seconds, when you feel the presence of the eternal harmony … a terrible thing is the frightful clearness with which it manifests itself and the rapture with which it fills you. If this state were to last more than five seconds, the soul could not endure it and would have to disappear. During these five seconds I live a whole human existence, and for that I would give my whole life and not think that I was paying too dearly . . .
   
PART FOUR
   
THE WORLD OF THE SIMPLE
   
Introduction
   When I started working with retardates several years ago, I thought it would be dismal, and wrote this to Luria. To my surprise, he replied in the most positive terms, and said that there were no patients, in general, more 'dear' to him, and that he counted his hours and years at the Institute of Defectology among the most moving and interesting of his entire professional life. He expresses a similar sentiment in the preface to the first of his clinical biographies
(Speech and the Development of Mental Processes in the Child,
Eng. tr. 1959): 'If an author has the right to express feelings about his own work, I must note the warm sense with which I always turn to the material published in this small book.'
   What is this 'warm sense' of which Luria speaks? It is clearly the expression of something emotional and personal-which would not be possible if the defectives did not 'respond', did not themselves possess very real sensibilities, emotional and personal potentials, whatever their (intellectual) defects. But it is more. It is an expression of scientific interest-of something that Luria considered of quite peculiar scientific interest. What could this be? Something other than 'defects' and 'defectology', surely, which are of rather limited interest in themselves. What is it, then, that is especially interesting in the simple?
   It has to do with qualities of mind which are preserved, even enhanced, so that, though 'mentally defective' in some ways, they may be mentally interesting, even mentally complete, in others. Qualities of mind other than the conceptual-this is what we may explore with peculiar clarity in the simple mind (as we may also
   in the minds of children and 'savages'-though, as Clifford Geertz repeatedly emphasises, these categories must never be equated: savages are neither simple nor children; children have no savage culture; and the simple are neither savages nor children). Yet there are important kinships-and all that Piaget has opened out for us in the minds of children, and Levi-Strauss in the 'savage mind', awaits us, in a different form, in the mind and world of the simple.*
   What awaits our study is equally pleasing to the heart and mind, and, as such, especially incites the impulse to Luria's 'romantic science'.
   What is this quality of mind, this disposition, which characterises the simple, and gives them their poignant innocence, transparency, completeness and dignity-a quality so distinctive we must speak of the 'world' of the simple (as we speak of the 'world' of the child or the savage)?
   If we are to use a single word here, it would have to be 'con-creteness'-their world is vivid, intense, detailed, yet simple, precisely because it
is
concrete: neither complicated, diluted, nor unified, by abstraction.
   By a sort of inversion, or subversion, of the natural order of things, concreteness is often seen by neurologists as a wretched thing, beneath consideration, incoherent, regressed. Thus for Kurt Goldstein, the greatest systematiser of his generation, the mind, man's glory, lies wholly in the abstract and categorical, and the effect of brain damage, any and all brain damage, is to cast him out from this high realm into the almost subhuman swamplands of the concrete. If a man loses the 'abstract-categorical attitude' (Goldstein), or 'prepositional thought' (Hughlings Jackson), what remains is subhuman, of no moment or interest.

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