Entering the Void

The fact is we are all given a death sentence. Once you're born you begin to die. But let’s say you get some very bad news, as some people do, and you’re told that you just have six months to live. You’re life is now finite. Something like this was what happened to the neurologist Oliver Sacks when he was informed that he was dying. Sacks had always been enormously productive in his work as a doctor and writer, the latter feeding off the former, but as odd as it sounds the news he received only motivated him more in both his work and his life. In an Op-Ed piece (“My Own Life,” NYT,  2/19/15), he quoted David Hume in describing his state of mind, “I now reckon upon a speedy dissolution. I have suffered very little pain from my disorder; and what is more strange, have, notwithstanding the great decline of my person, never suffered a moment’s abatement of my spirits. I possess the same ardour as ever in study and the same gaiety in company.” Some might take a different approach when given such a prognosis. They might slip into melancholy and self-pity or decide that since their days were numbered, they were simply going to gratify all their senses and do whatever they want. The might argue that they have spent their whole life working, being a parent or attending to their own parents in their years of convalescence and now it’s there time, meaning a license for self-indulgence. Sounds a little like the prisoner on death row, allowed whatever he wants for his last supper, no? This is precisely the plot of Kurosawa’s Ikiru which translates as “to live.” The central character, a civil servant named Watanabe, learns that he is going to die. At first he indulges in a Walpurgisnacht with a Mephisto like cohort, but the pleasures of wine, women and song pale against the void he's facing (Enter the Void is by the way the title of Gaspar Noe’s film about death which, like Ikiru, also has scene of Tokyo nightlife) and he finally finds solace in the notion of helping others and in particular by building a park for children. The last scene of the movie depicts him on one of the swings in the park he has built singing softly to himself and it’s one of the most touching and indelible images in the history of cinema.

Awakenings

Oliver Sacks the prominent neurologist who recently died (“Oliver Sacks, Neurologist Who Wrote About the Brain’s Quirks, Dies at 82," NYT, 8/30/15), wrote about his own prosopagnosia (“Face-Blind," The New Yorker, 8/30/10) which is the inability to recognize faces. But it was curious that he had an extraordinary ability to recognize and empathize with the conditions of his patients. This particular contrariety of his nature, in fact, epitomizes the way in which he regarded disabilities. It’s like the homily “one door closes and another opens.” He created a brilliant compromise formation from his condition--minds not faces, insight over sight-- which opened up a whole area of what might be called narrative neurology. His patients’ infirmities became the subject of great stories which humanized and helped understand anomalies of being. Thus he wrote about the The Man Who Mistook His Wife for A Hat: And Other Clinical Tales, SeeingVoices: A Journey Into the World of the Deaf, The Island of the Color Blind and a book which dealt with Temple Grandin, the autistic professor of animal science, An Anthropologist on Mars; Seven Paradoxical Tales. And speaking of narratives his l973 book about encephalitis, Awakenings, was made into the l990 film starring Robin Williams. Sacks died of cancer rather than prosopagnosia or any of the ailments he wrote about. However, once he received a terminal diagnosis he set about describing it and the way it affected his consciousness, as if he were one of his own patients--only in this case the exotic condition was death. In an Op-Ed piece, “My Periodic Table,” (NYT, 7/24/15) commenting on the comfort he had always found in the “physical sciences, he wrote, “I have tended since early boyhood to deal with loss—losing people dear to me—by turning to the nonhuman… And now, at this juncture when death is no longer an abstract concept, but a presence—I am again surrounding myself with metals and minerals little emblems of eternity.” In an earlier piece “My Own Life,” (NYT, 2/19/15), he quoted David Hume in prescribing a treatment for his end, “I now reckon upon a speedy dissolution. I have suffered very little pain from my disorder; and what is more strange, have, notwithstanding the great decline of my person, never suffered a moment’s abatement of my spirits. I possess the same ardour as ever in study and the same gaiety in company.” And later in the same piece he wrote somewhat more darkly, “When people die, they cannot be replaced. They leave holes that cannot be filled, for it is the fate—the genetic and neural fate—of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.” Sacks enjoyed an odd kind of defiance, something that was also shared by Tony Judt, the NYU historian whose dying became his own raison d’être and the catalyst for a number of essays that appeared in The New York Review of Books. The late Sherwin Nuland wrote a book called How We Die: Reflections on Life’s Final Chapter, but Sacks and Judt seem to have added a new stage or category to the death process and one that eschews the feelings of meaningless and nothingness that one might expect in a person who will soon no longer be able to enjoy the fruits of his or her labors. Sacks wrote, “I feel intensely alive, and I want and hope in the time that remains to deepen my friendships, to say farewell to those I love, to write more, to travel if I have the strength, to achieve new levels of understanding and insight.”

Awakenings

Starting with an early book on Parkinsonism, Awakenings (which was later made into a movie starring Robert De Niro and Robin Williams), Oliver Sacks has written about neurological conditions with the drama of a fiction writer. Recently, he wrote a piece in The New Yorker about his own battle with prosopagnosia. Prosopagnosia is the inability to recognize faces. Another condition, agnosia, is the inability to recognize objects—the syndrome that the subject of Dr. Sacks’s 1985 tome, The Man Who Mistook His Wife for a Hat, suffered from. A complementary disorder is Capgras syndrome, in which the subject recognizes a face, but sees it as a mask occupied by an imposter. Richard Powers, a novelist and MacArthur fellow who has devoted his career to writing fiction about ailments of the mind, documents this condition in The Echo Maker. So we have novelists like Powers and Larry Shainberg (who wrote Memories of Amnesia, about a brain surgeon suffering from the aforementioned disorder) writing fiction about neurology and neuroscience, and neurologists and neuroscientists like Sacks and V.S. Ramachandran writing novelistically about the conditions they encounter in their work. Since the early ‘70s, when Sacks started to write poetically about neurological anomalies, the vocabulary of neurology and neuroscience has been coming into common parlance, much the way Freud’s discoveries of neurosis and hysteria did in early part of the last century. Today, parietal lobes, the amygdala, the hippocampus and the prefrontal cortex are talked about the way the libido, the id and the superego were discussed when psychoanalysis first came under the scrutiny of the educated reader. This evolution in the way the functions and dysfunctions of the mind are described is significant in and of itself as a cultural phenomenon—whether looked at from the left or right side of the brain.

The Prisoner

Locked-in Syndrome is the subject of the Julien Schnabel film, The Diving Bell and the Butterfly, based on the book of the same name by French journalist and author, Jean-Dominique Bauby. In the current New York Review of Books, the brilliant NYU political philosopher Tony Judt reveals his struggle with a form of ALS, or Lou Gehrig’s disease. Judt describes becoming a prisoner of his own body, to the extent that he is no longer able to attend to any of his own needs. Pleasure becomes secondary when a minor itch can be a source of torment. Nighttime and sleep can feel like abandonment, the anxiety only assuaged by the presence of the baby monitor. The miracle, and the nightmare, is the brain’s ability to function even when it is the very element that has caused the body to stop functioning. This dualism is only part of the incongruity described in the horror story that Bauby and Judt tell with disconcerting vividness.

   

How can prose soar when the body is tethered to the ball and chain of neuro-muscular collapse? Compensation is certainly part of the story. Oliver Sacks has spent a good deal of his career detailing how the loss of one or another faculty can result in the creation of new talents and capacities. V.S. Ramachandran’s phantom limb hypothesis also comes to mind. The mind’s ability to project an alternate reality as a means of coping with trauma is bewildering.  The massive neurological failure described by Judt goes beyond the loss of hearing or sight.  Helen Keller was at least able to get up and walk. She could swallow, feel, and scratch that itch. For Judt, the very act of writing the article is a testament to the richness of his inner life, and a challenge to the descriptive power of predictable words like aspiration and hope. Why live when there is nothing to live for? Judt does not undergo a transcendent, white light experience, but neither does he appear to be the victim of what we would normally define as despair. For starters, he is graced with the will to dictate his thoughts.

Life is Elsewhere

Life is Elsewhere is the title of a novel by the Czech writer Milan Kundera. It is a phrase that was graffitied on Paris walls by student revolutionaries during the riots of ’68. George Carlin famously quipped, “I’m into a lifestyle that doesn’t require my presence.” In Samuel Beckett’s Endgame, Clov asks Hamm, “Do you believe in the life to come.” His response: “Mine was always that.”

Oliver Sacks’s recent essay on asylums in The New York Review of Books is a reminder that not all mental institutions are snake pits, and that in the 19th century, some asylums offered the possibility of companionship and community for those who had inadvertently opted out of so-called normalcy. In The Divided Self, another ‘60s artifact, R.D. Laing argues for schizophrenia as a viable form of existence characterized by forms of expression that have value in and of themselves, and that are not only significant as manifestations of mental illness.

When the stock market moves from inflated values to values more commensurate to the equities they reflect, financial analysts call it an adjustment . Whether for reasons financial, political, or geological, the earth seems to be in the throes of something more drastic than an adjustment. It is wobbling on its axis, both metaphorically and literally. Tectonic and climatic shifts have caused massive upheavals, taking the forms of tsunamis in Southeast Asia, flooding in the Southwest United States, drought in Africa, and the melting of polar ice caps. It was recently reported that in the next 10-15 years, shipping companies may no longer have to use the Panana Canal, as they can make their way through the North Pole, thus shaving thousands of miles off their trips. But this savings has been achieved at a cost, and not only in environmental terms. Technological advancement has been met with the equal and opposing rise of fundamentalism, with triumphs of reason overshadowed by desperate millenarian passions.

Every age has its upheavals, its plagues, its inquisitions. In the twelfth century, the Arab world, now so fraught with the ravages of war and religious strife, was the seat of advanced science, with polymathss like Averroes making historic contributions. Today, globalism has compounded the effects of local upheaval. Modern transportation exports viruses and violence with equal efficiency. A once economically viable society like Iceland finds its whole financial system in danger of collapse due to the alacrity with which it leveraged its investments abroad.

Can we still refer to Imperial America when talking about a country whose deficit exceeds the trillion-dollar mark? And when and how do changes in the bulwarks of a society filter down to the foot soldiers of the everyday life? Astronomers believe that a meteor hitting the earth may have caused the ice age, eradicating a huge reptilian population. Which economic or meteorological scourge will hasten the onset of the newest stage of evolution, and where will it lead? Will life still be here—or elsewhere?