OLIVER SACKS no trouble solving complex problems in tests, but was disturbed by what seemed like major changes in the world around him. He could not deny that the man in the mirror was in his late 40s, but was not able to explain it. Sacks wrote in his notes that his patient was “without a past (or future), stuck in a constantly changing, meaningless moment.” He diagnosed the condition as Korsakov’s syndrome, damage to the mamillary bodies in the brain caused by alcohol. This affects memory, although the rest of the brain experiences no change. Sacks located Jimmie’s brother, who noted that Jimmy had left the navy in 1965 and without the structure it provided began drinking heavily. For some reason he had experienced retrograde amnesia, going back to 1945. Sacks asked Jimmie to keep a diary so that he knew what he had done the day before, but this did nothing to give him a sense of continuity as it was as if the events he read about had happened to someone else. Jimmie seemed to have been “de-souled,” something was missing in terms of a self. Sacks asked the religious Sisters in the old people’s home whether they thought Jimmie had indeed lost his “soul.” Somewhat affronted, they responded by telling him to watch Jimmie when he was in chapel. When Sacks went to observe him there, it was a different Jimmie. He seemed lost in the act of worship and the ritual of the mass, somehow more “together” than before. The level of spiritual meaning was obviously enough to overcome his normal mental chaos. Sacks writes: “Memory, mental activity, mind alone, could not hold him; but moral attention and action could hold him completely.” The same was true if Jimmie was in the garden or looking at art or listening to music. Thus, although Jimmie was dead to the normal experience of memory that we feel gives us a sense of self, at other times he was evidently a fully alive person, gaining meaning from experience. Through a careful regimen of like activity he was able to maintain a sense of calm; there was still some part of him, whether a “soul” or a “self,” that had found a way to exist despite the disease.
The self vs Tourette’s Part Two of The Man Who Mistook His Wife for a Hat is titled “Excesses.” The cases looked at involve not a loss but a superabundance of certain functions: flights of fancy, exaggerated perception, irrational exuberance, manias. These “hyper-states” actually give the people involved a heightened sense of life that normality does not. While they are technically ill, such conditions give subjects a feeling of great wellbeing and zest for life (although in the back of their mind there is the feeling that it cannot last). The functions meld with the person’s identity, so that some may not want to be cured. One example of neurological excess is a syndrome first described in 1885. Gilles de la Tourette was a pupil of the pioneering neurologist Charcot (as was 244