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Hit on the head | page 1, 2
I then phoned United Airlines and got put on endless hold. Steam was rising from my head. But the sales rep, when she came back from quilting, or whatever occurs on the other end of the hold button, was quite nice, and told me she was having a bad day. The last customer had phoned and asked if she was Alaska Airlines. When she said no, he asked, "Why not?" And we laughed. Human beings are not capable of perfection. We not only have faults, but we parade them like virtues. We are infinitely irritating when we take ourselves seriously. Much about life is serious, but we are seldom up to the task. We are not consistent, informed, mature, cooperative. We are irascible, contrary, impudent, unmanageable, filled with false notions and grand ridiculousness. And we are hilarious. Consider life a 6 billion-ring circus, a huge zoo filled with funny animals, a giant non sequitur, institutionalized madness. Stand back and enjoy. The opposite of anger isn't calm, it's laughter. Anger means that you are taking yourself too seriously. I am all in favor of good psychotherapy, but be careful about believing in it. Therapy is also just another way of taking yourself seriously. Consider a paraphrase of Robert Frost's epitaph: God, if you forgive me my minor transgressions, I will forgive you for the great big joke you played on me. I have had a cognitive problem my entire life. Through years of reading, I have yet to find it listed anywhere. I have no conscious mind's eye. I cannot close my eyes and visualize anything. I don't recall or visualize phone numbers; yet I can dial them. I have to write down anything that I need to remember. Having stated that, I can recall what I was thinking about all the way back to an infant. I am now 59 years old. Are you aware of anybody else being like this? One of the most dramatic recognition defects in neurology is prosopagnosia -- the inability to recognize faces. The problem (lesion) is thought to be in the visual association areas of the occipital cortex -- the region that converts raw visual images into the final perception. (The primary cortex sees lines, angles, edges; the finished picture is processed in the association areas.) Ask Dr. Bob Dr. Robert Burton, who is a neurologist and novelist, answers health questions every Monday in Salon Health & Body. Please e-mail your queries to him at AskDrBob@ A brief example: a middle-aged man with primary degeneration of the visual association areas came into the consultation room with his wife, sat down next to her, across the table from me. He frequently deferred to her in presenting his history, turning to face her and ask her questions. I asked if he could point out his wife. He got up from his chair, walked around the room, inspected the wall hangings and my diplomas, then sat back down, turned to his wife and said, "She must be here somewhere." I asked how he knew, and he answered, "Because I know I came in with her." He then folded his hands in his lap and the two of us lapsed into the unbearable acknowledgment of his befuddlement. I asked him how he came into the room. He got up and walked around, looking for the door. He found it, opened and closed it, then turned and said, "I can't seem to find the door." This was despite his vision being 20/20. He could see, but he could not recognize and describe. Much of behavioral neurology is based on understanding various disconnection syndromes (one part of the cortex being disconnected from another): A man can read out loud, but he cannot understand what he has said, or he can write from dictation, but cannot read what he has written. Such patients often have marked self-image problems, but there is no consistent pattern, as the resulting behavioral disturbances are quite dependent upon the prior personality. This is the crossroads between neurology, biological psychiatry and pure metaphysics. Can you imagine how you would feel about yourself if you spent your entire day with a woman that you could not recognize as your wife. (Yes, perhaps with the exception of sex.) Alienation is at the heart of terror; it is no wonder that we neurologists tend not to emphasize such behavioral consequences. A young man (an accountant) underwent cardiac surgery, sustained a complication -- a cerebral embolism that destroyed much of his occipital cortex, but left him with residual pinpoint (tunnel) vision. He could see a small percentage of his former visual field, but could not keep his entire visual environment in mind despite continuously scanning it. All he could describe was what was directly in front of him. A neurologic example of "out of sight, out of mind." The most fascinating behavioral change? The man became profoundly paranoid. Because he could not envision the space around him, except by turning to look at it, he had no idea where he was in relationship to a door, window or passing traffic. Because he could not know what was behind him, he imagined all sorts of possibilities, including the most bizarre and threatening. He began to hug walls, his back pressed against an edge of his personal landscape. He used his back as a tactile defense against his fears, limiting himself to slinking around rooms. He became a tragic ongoing experiment in sensory isolation. His mind's eye had failed him. You say you've had your problem all your life. In all likelihood, this represents an isolated developmental disorder. I suspect that you are at one end of the spectrum of mind's-eye ability, the other being Michael Jordan, who can re-create an entire basketball court, or a master chess player who can play multiple games, keeping all the games in "mind." Recommended reading: Oliver Sacks' book "The Man Who Mistook His Wife For a Hat."
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