Into the Silent Land - Travels in Neuropsychology
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Transcript of Into the Silent Land - Travels in Neuropsychology
Into the Silent Land
Paul Broks trained as a clinical psycholog is t at Oxfo rd
Universi ty and went on to special ize in neuropsycho logy .
He has pursued a career combin ing both clinical pract ice
and fundamental brain research. He l ives in Cornwa l l and
is currently a Senior Clinical Lecturer in N e u r o p s y c h o l o g y
at P lymouth University. He wri tes a regular co lumn for
Prospect magaz ine and his w o r k has appeared in the Sunday
Times, Sunday Telegraph, Guardian, Daily Telegraph and
Granta. Into the Silent Land w a s shortl isted for the Gua rd i an
First B o o k Award 2003.
F r o m the reviews:
'Into the Silent Land is a smal l , s t range, beautiful g e m . . . B r o k s
is as much poet as s c i en t i s t . . . Indelible. ' Atul G a w a n d e ,
author of Complications
'Beautifully written and beautifully thought through. '
Professor Steven R o s e , author of The Making of Memory
'Into the Silent Land is as tonishing - a mix of real-life
neurological cases , science f ic t ion , r andom quips and deeply
personal r eve l a t i ons . . . T h e b o o k has no right to hang
together, but somehow it does , quite beautifully. '
S imon Hattenstone, Guardian
'R ive t ing . ' T o n y Gui ld , Independent
' I m p r e s s i v e . . . B r o k s ' s bes t s t o r i e s . . . p rove that all human
be ings are , as he puts it, ' s tory- tel l ing machines ' . Faced with
the material reality of the brain and the infinite configurations
of the mind, we realize that we are "at one level, no more
than meat ; and, on another, no more than f ic t ion". '
G a b y W o o d , Observer
'A debut of considerable quality. ' Rober t Macfar lane,
Sunday Times
' B r o k s has expressed what will surely be the twenty-first
cen tury ' s central angs t with sensitivity and e legance. '
Jeffrey Gray , TLS
'Into the Silent Land shows how people adapt to
ext raordinary c i r c u m s t a n c e s . . . Fasc inat ing . '
Ka th Murphy, Scotland on Sunday
' B r o k s enters the silent land with arc lights b l a z i n g . . .
Conf ron ted with bra ins and relationships that are fragile
and prov is iona l , B roks kindles compass ion and inspires. '
C l ive C o e n , Times Educational Supplement
'Into the Silent Land outlines what can happen after
severe brain-injury — and I am n o w increasingly fascinated
by what the brain i s capable of and w h y ' Sheena M c D o n a l d ,
Sunday Herald B o o k s of the Year
'A rare b o o k of s tagger ing bril l iance, l eav ing readers with
much to consider about their own l ives. ' Good Books Guide
'S tudded with dazzl ing insights and a great deal of food for
thought. ' T e s s Taylor , San Francisco Chronicle
'B roks is a gifted wr i t e r . . . H i s depict ions of patients is
heart-wrenching. ' Beth Greenbe rg , Boston Globe
'Writing beautifully about our mos t unbeautiful cogni t ive
apparatus , Broks descr ibes its rumpled surfaces , its ne twork
of neurons, its deep, secret spaces with such care that the act
itself powerfully i l luminates the bra in ' s creative capaci t ies . '
Lauren Slater, Elle
Into the Silent Land
Travels in Neuropsychology
PAUL B R O K S
Atlantic B o o k s
L o n d o n
First published in hardback in Great Britain in 2003
by Atlantic Books , an imprint of G r o v e Atlantic Ltd
Thi s paperback edition published by Atlantic Books in 2004
Copyr ight © Paul Broks 2003
T h e moral right of Paul Broks to be identified as the author of
this work has been asserted in accordance with the Copyright ,
D e s i g n s and Patents Act of 1988.
T h e author and publisher wish to thank the following for
permiss ion to quote from copyrighted material:
Dannie 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 (London: Hutchinson 1949).
All rights reserved. No part of this publication m a y be
reproduced, stored in a retrieval system, or transmitted in any
form or by any means , electronic, mechanical , photocopying,
recording or otherwise, without the prior permiss ion of both
the copyright owner and the above publisher of this book.
Earl ier drafts of a number of chapters have appeared in Prospect magazine.
' T h e Seahorse and the A l m o n d ' was published in earlier form in Granta magazine.
9 8 7 6 5 4 3 2 1
A C 1 P catalogue record for this b o o k is available from the British Library.
I S B N 184354 0 3 4 7
Printed in Great Britain by Mackays of Chatham pic, Chatham, Kent
Atlantic B o o k s
An imprint o f G r o v e Atlantic L t d
O r m o n d H o u s e
2 6 - 2 7 Boswell Street
L o n d o n
W C 1 N 3 J Z
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
Articles of Faith 123
Right This Way, Smiles a Mermaid 132
THREE No 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 R e a d i n g
Acknowledgemen t s
237
246
O N E
Swallowing the Dark
Different Lives
' W h y does raw meat g i v e me a h a r d - o n ? '
T h i s is Michael, chopping sirloin ready for the stir-fry. T y p i
cally, he is g o i n g to the trouble of p repar ing a g o o d lunch: bee f
in hoi-sin sauce . H e ' s bough t s o m e beer, too. W e ' r e dr inking
straight from the can. A m y , his girlfriend, sits at the kitchen
table reading a magaz ine .
'Michael, ' she says , without look ing up.
Michael sl ides the diced bee f into the w o k where it sizzles in
the hot oil .
'Easy , Amy. Only a twitch. ' He winks at m e , then d r o p s what
he is do ing and strides out of the r o o m . ' H a v e a listen to this, ' he
calls over his shoulder and soon the place is awash with cascades
of sound - brittle a rpegg io s , tumbl ing f ragments of melody. I t
is very loud.
Michael returns, f ingertips to temples, head tilted back .
'Koto , ' he says . ' J apanese . As ton ish ing . '
F r o m this angle the dent in his head , about three inches up
from the right eyebrow, is m o r e noticeable.
3
P A U L B R O K S
4
N e x t d a y I 'm over at S tuar t ' s . We sit in his stuffy front room.
An orna te b lack c lock (his early-retirement present) cl ings to
the wall like a huge fly. As I s t ruggle with milky tea, Stuart locks
me in his g a z e . He is about to say something , but doesn ' t . I t is a
l ong pause . Eventual ly he speaks .
' I don ' t love y o u any more , do I , l o v e ? '
T h e w o r d s are intended for his wife, Helen, who sits beside
him. ' N o , love , ' she replies. ' S o you say. '
T h e r e is silence aga in , except for the tick of the insectoid
c lock. T h e dent in S tuar t ' s head is above the left eyebrow.
Michael had c l imbed a tree to retrieve an entangled kite. He
needn ' t have bothered because the wind gus ted and the kite
drifted d o w n of its own accord , but he was high up by then. He
w a s cal l ing someth ing to A m y , but she couldn ' t make i t out.
Her d reams recall how abruptly his voice was stifled by the
creak and crack of a branch, and the wind-whipped silence of
the free fall as his b o d y cleared the b o u g h s . Concea led within
thick tufts of m e a d o w g r a s s w a s a spur of rock. A m y ' s dreams
a lso record the c rack of head hitting s tone. T h a t ' s what wakes
her.
T h e fall fractured Michael 's skull and released a flash flood of
b leeding into the right frontal lobe . ' I thought his number was
up, ' the su rgeon told m e , and had said as much to A m y as she
kept vigi l over Michael ' s coma tose body. ' N o point beat ing
about the bush , ' said the doctor . But , after three days and nights,
Michael c a m e b a c k to life — with a different number.
S tua r t ' s twist of fate w a s a m o t o r w a y pile-up. A bolt snapped
and blasted like a bullet from the vehicle in front. It came
I N T O T H E S I L E N T L A N D
through the windscreen, th rough his forehead and tore deep
into the left frontal lobe .
Desp i te the immedia te displacement of s o m e brain matter,
loss of consciousness w a s brief, as i s some t imes the case with
penetrating missi le wounds . He told the pa ramedics he w a s fine
and had better get h o m e now, but they saw the brain stuff
gell ing his hair and put him in the ambulance . S o o n the su rgeons
were working to extract the foreign b o d y from the interior
of Stuar t ' s head, a p rocess that a l so meant d i spos ing of s o m e
adjacent brain t issue. Part of Stuart went with it.
By these means , Prov idence has created mi r ro r - image
lesions of the brain. As a neuropsycholog is t , my role is to c o m
pare the consequences . Stuart now has t rouble get t ing started.
Helen encourages him out of bed in the morn ing , points him in
the direction of the ba th room, has his clothes ready, and ge ts
him breakfast before g o i n g to work . S h e leaves him lists of
things to do a round the house , and magaz ines and puzzle b o o k s
to fi l l the hours . But when she returns she often finds him where
she left him, sitting in si lence. She ' l l go over and h u g him and
he ' l l return the embrace , but i t ' s perfunctory.
He doesn ' t love her any more . I t ' s the plain truth and she
accepts it. Stuart is not to b lame . What he feels towards Helen is
what he feels towards all other peop le , including himself: indif
ference. T h i s absence of emot ion 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 and mot iva t ions , bu t lacks
the emotional charge of empathy. I ask what he feels about the
little girl who w a s abducted and murdered last year. He k n o w s i t
was a dreadful thing to happen. T h e y should h a n g the murderer
5
P A U L B R O K S
6
or chop his bal ls o f f but , no, i t doesn ' t make him feel anything
very much . T h e n , he s ays , i t ' s funny but he never used to
bel ieve in capital punishment .
Michael, on the other hand, has trouble s topping. A m y has to
rein him in. He ' l l talk to s t rangers in the street, he'll tell them
they ' re beautiful, or their children are , or their pets. He wants to
touch. He wants to celebrate . B e g g a r s b r ing a tear to his eye . He
once g a v e a m a n his coat and a £10 note. People take advantage.
Michael ' s empathic response is hair t r iggered, but more
complex social calculat ions befuddle him. When he f i rs t came
h o m e from the rehab centre his tastes were plain. A m y said he
l ived on fish f ingers and L e d Zeppelin. Michael said i t was like
g o i n g back in t ime. H e ' d a lways liked these things and now he
didn ' t feel he should pretend otherwise . F ine , said Amy. But she
wou ld not tolerate the po rn v ideos . L i k e Stuart , Michael no
longer feels the need to diss imulate .
' H o w do y o u feel in yourself , S tua r t ? ' I ask .
'All right. '
'Are y o u mise rab le? '
' N o . '
'Are you h a p p y ? '
' I don ' t think so . ' He turns to Helen. 'Am I h a p p y ? '
Helen looks at me . I l ook at Stuart . T h e quest ion g o e s round
in a circle.
Michael saw me off a t the front door . He w a s c lose to tears.
He pul led me to him and kissed me on the cheek. Fo r an instant
I thought he w a s g o i n g to say he loved me .
* * *
I N T O T H E S I L E N T L A N D
T h e bald head swivels . T h e vo ice honks like a k laxon ac ros s the
senior c o m m o n r o o m : ' I never m a k e mis takes . ' T h e r e is a
rustling of newspapers and clear ing of throats .
Martin has superior intelligence - my tests confirm it, and
he holds a master ' s degree in mechanical engineer ing — but he
happens to be autistic and has a p rob lem with v o l u m e control . Is
that a reason to bar him from the S C R ? N o . We ' l l enjoy our
coffee.
H e ' s been do ing one of his par ty pieces: calendar calculat ion.
Martin can g ive you the day of the week for any date y o u care to
mention, and h e ' s spot on every t ime, s e ldom taking m o r e than
a couple of seconds . H e ' s happy to ob l ige and s eems d i s a p
pointed when I soon run out of da tes I can vouch for.
' H o w do you do it, Martin? Y o u didn ' t even think about the
last one. '
T h e target date w a s 18 March 1988 (my son ' s b i r thday) .
'F r iday ' was the instant response .
' T h a t was easy, ' he says , ' I went to the dentist the d a y before . '
He grins with satisfaction.
I t ' s hard to tell his age . T h e face is lined but unweathered.
H e ' s wear ing a silver puffa jacket, s ta -pressed t rousers at half-
mast , and trainers. For ty-e ight g o i n g on fourteen. T h a t should
be 'trainer' in the singular. I t ' s on his right foot.
' I see you ' re wear ing odd shoes , ' I say.
'Yes , ' he replies. ' I t ' s Wednesday. ' I wait for further explana
tion, but none is for thcoming.
When I first saw Martin, for clinical assessments , he turned
up with his parents and they 'd put him in a suit. H i s shoes were
polished, and matched. He hardly said a word . Today , in his
7
P A U L B R O K S
8
casual attire, he is voluble . Before long , inevitably, he drops
into the g r o o v e of his special interests. T h e r e are several . One is
the Beat les . He k n o w s the record ing and release dates of every
record. Another is the ra i lways. He has memor ized the regional
t imetable, of cou r se , but what really fascinates him is the m o v e
ment of coal freight w a g o n s . T h e n there is astronomy, which,
currently, is his main preoccupat ion .
' D o you know how m a n y stars there are in the un iverse? ' he
asks . ' T e n to the power of twenty-two. '
I make a little b lowing sound and shake my head. He looks
p leased .
'Actually, ' I say, ' I read somewhere that if you think of each
star as a gra in of sand it wou ld take all the beaches and deserts
on the planet to match the number of s tars in the universe . '
I thought this wou ld impress him, but he ignores me . He
b e c o m e s agi ta ted, starts rocking back and forth on the edge of
his seat . W h e n he s tops he says , ' I don ' t think so . '
I a sk him if he thinks there is intelligent life out there a m o n g
all those gra ins of sand. He looks puzzled and I realize he ' s
taken the quest ion literally, so I clarify. A g a i n , the grin.
' Y e s , ' he s ays , ' there i s . ' T h e smile is sustained. I t is evidently
a conso l ing thought .
Beth jo ins us . S h e ' s one of our research assistants. I t ' s time to
go to the lab for the test ing sess ion. Mart in 's face lights up. He
has taken a shine to Beth.
'And what have you been up t o ? ' she asks him.
' I ' v e been masturba t ing quite a lot, ' he replies, as if through
a tannoy. I p ress mouth agains t knuckles to b lock the laughter.
I t ' s no g o o d . I snort and c o u g h .
I N T O T H E S I L E N T L A N D
' Excuse me , ' I say and c o u g h aga in for g o o d measu re . I t ' s
unprofessional , I know, but he cracks me up. I 'm only human.
I 'm not trying to make Martin look r idiculous. He is r idiculous.
L o o k at him in his daft clothes, b o o m i n g on about masturbat ion
and coal freight w a g o n s and the number of s tars in the un iverse .
I t ' s undeniable. A n d I reckon i t ' s a snub if you don't acknowl
edge his absurdity. I f you are to e n g a g e with Martin you must ,
to some extent, enter his wor ld .
'Martin, ' I say. ' T h i s is funny. Do you mind if I l a u g h ? '
' N o , ' he says . 'P lease l augh . '
But, given permiss ion , I f ind the humour soon d i sso lves , and
I 'm left sitting red-faced with tears on my cheeks and everyone
looking at me instead of him. I even f ind myse l f ponde r ing
Martin's confident assert ion of the existence of extraterrestrial
life. We are alone in the universe or we are not, I think. Either way,
how astonishing. We grin at each other.
His head is abnormal ly la rge , as is the brain that f i l ls it. My
col leagues and I have taken measurements . We are profil ing his
cognit ive strengths and l imitations and sett ing these agains t
detailed magnet ic resonance observa t ions of his brain. He is an
enthusiastic research participant and has c o m e to see h imsel f as
a neuro-engineer ing prob lem.
He has a theory. In his v iew aut ism is all about flow d y n a m
ics. Most of the t ime his thought p rocesses are stuck in the left
hemisphere of his brain. Consequent ly , his thinking is r igid,
categorical, and analytic. I f he could unblock the channel of
the corpus cal losum, which links the two s ides , then the s t reams
of the left and right brain wou ld m e r g e and he wou ld be
whole. Ordinary consc iousness wou ld f lour i sh . T h i s happens
9
P A U L B R O K S
10
somet imes , he bel ieves . Fo r br ief per iods the world takes on
a different appearance . He is m o r e relaxed and it is less of an
effort to connect with peop le . T h i s is where masturbation
c o m e s in: o r g a s m detonates a dam-bus t ing explosion in the
right hemisphere .
As Beth sees Martin to the door , I catch a fragment of their
conversat ion.
' B u t i f your boyfr iend leaves you . . . " he says .
'We ' l l s ee , ' s ays Beth.
Mart in 's gr in has an unworldly beauty.
* * *
It w a s her seventh birthday, E l l i e ' s father is telling me , a clear
m o r n i n g in Apri l . T h e y had s topped to chat to a neighbour.
Ell ie w a s los ing pat ience. She wanted to ride her new bicycle.
He can see i t now, blue and silver chrome, dazzl ing in the sun
light. A n d then, ' S h e w a s ly ing in the middle of the road , dead
still. It w a s like the wor ld had s topped, except for me . When I
go t c lose the rest caught up; the screech of tyres, the bicycle
sc rap ing ac ross the road . S o m e o n e sa id , " O h my g o o d L o r d ! ' "
His mind held a contradict ion as he looked down on his
daughter ' s b o d y : She's not badly injured and, at the same time,
She's dead. Nei ther w a s the case . N o t the latter because , of
cou r se , she is here , a y o u n g w o m a n now, squeezing his elbow;
and not the former. Her a r m s were g razed , nothing serious, and
her face w a s unblemished. But what her father could not see was
the fractured parietal bone and the s low seepage of b lood into
the right hemisphere of E l l i e ' s brain.
I N T O T H E S I L E N T L A N D
I t would be a week before she opened her eyes . But she w a s
not dead. A n d through the tunnel of intensive care — she in
coma , he consciousness flayed — E l l i e ' s father found the
strength not to pray. His prayer less vigi l w a s rewarded. El l ie
recovered and, months later, returned to school . He d r o p p e d
her off at the ga te and says he b lubbered so much on the dr ive to
work he had to stop the car. J o y can be so p rofound i t bo rde r s
on grief.
Ellie never regained the full s trength of her left a r m and leg ,
and she tired easily, but it d idn ' t s top her jo in ing in with the
other children. She s t ruggled to concentrate and keep p a c e in
some lessons , but that was to be expected. No one pushed her;
she pushed herself. She found a talent for l anguages and is now
prepar ing to go to university. So wha t ' s the p rob lem?
'Parallel parking, ' s ays El l ie , ' and over taking. '
She has difficulty j u d g i n g speeds and distances. S h e ' s twice
failed the dr iv ing test. Is i t anything to do with her bra in injury
and, if so , can I help?
I finish my assessments at the next appointment . El l ie has
worked hard at tests of spatial awareness , motor co-ordinat ion ,
concentration, and reaction t ime. T h e results show p rob lems
consistent with her brain injury. She senses this and, with a kind
of desperat ion, offers to take me for a dr ive . I accept .
' D o you want me to c o m e ? ' asks her father.
' N o , ' I tell him, ' g o and have a cup of tea. '
At f i rs t El l ie seems unsure where the car is parked. I t ' s an old
Citroen, the colour of tomato soup .
'Where shall I g o ? ' she says .
'Anywhere. Jus t dr ive a round. Go left here, then next right. '
11
P A U L B R O K S
A n d so we g o , me g iv ing directions. I have to admit she ' s
pret ty g o o d . Ten minutes into the dr ive nothing untoward has
happened and I 'm beg inn ing to quest ion the value of my tests.
T h e r e ' s no doubt she had p rob lems , but here we are in the real
wor ld and s h e ' s do ing fine.
El l ie has s teered the car into the middle of the road ready to
turn ac ross the o n c o m i n g traffic back into the hospital car park.
T h e indicator clicks as we wait. I t ' s a comfor t ing sound. Tick,
tick, tick. A l m o s t hypnot ic . T h e r e ' s a s teady flow of traffic, so
El l ie wai ts . Tick, tick, tick. T h e n a g a p ; nothing for fifty yards ,
space enough to get ac ross . But we don ' t move . Tick, tick, tick.
Another line of traffic d raws towards us , headed by a white
r emova l s van with Y O U R M O V E ! splashed across the front. Tick,
tick, tick, Y O U R M O V E !
T h e i m a g e of the van now filling my retina and flashing into
my brain takes the quick-and-dir ty route via the thalamus and
straight to the securi ty moni tors of the amygda la , deep in the
tempora l lobe . Action stations! No need to trouble the higher
cortical centres just yet, because someth ing has impelled Ellie to
turn ac ross the traffic and we are g o i n g to hit the van. Consc ious
del iberat ion wou ld be a hindrance. T h i s is bas ic survival . My
a r m s fly up and my head jerks s ideways . T h e amygda la screams
instructions to the brain s tem, s ignal l ing the release of chemi
cals into the b loods t ream and, th rough a clatter of synaptic
activity, ga lvan iz ing the au tonomic nervous sys tem. T h i s is red
alert!
T h e n I b e c o m e aware of the p i g squeal of tyres — the van ' s ,
not ours . My cortex is c o m i n g b a c k on-line; reflective con
sc iousness restores itself. We roll serenely on and I g lance back
12
I N T O T H E S I L E N T L A N D
to see the van pull ing away. Ellie remains unper turbed.
We are back in my office. 'It w a s a c lose call , ' I say.
' O h ? '
' I thought that van was g o i n g to hit u s . '
'What v a n ? '
I tell her that we could a r range for a m o r e advanced a s s e s s
ment of her dr iving skills, and that she is obl iged to inform the
dr iving licence authority of her condit ion.
' I a lready have , ' she says .
But I can't encourage her to drive. I see a d a m a g e d brain
encased in a tonne of metal cruising down the motorway, through
rush-hour traffic, through residential areas where children are
riding their birthday bicycles. T h e d a m a g e is beyond repair.
' I came to you for help, ' s ays El l ie . Her father g ives me an
empty ' T h a n k you ' as they leave.
A few months later I get a call from El l ie . She has taken her
dr iving test for a third t ime and pas sed . 'I thought y o u ' d like to
know,' she says .
I picture her father s tanding bes ide her. W h a t ' s that on his
face? Absolu t ion?
* * *
Mrs O ' G r a d y i s showing me pho tographs . T h e r e are three
a lbums opened out on the coffee table. T h e r e she is at K a t i e ' s
wedding; small , nervous , and neat in a pa le green suit. T w o
months on, there she is at S tephan ie ' s . B e i g e this t ime.
' I feel guilty, ' she confides. ' I still haven ' t told Steph. Do y o u
think I shou ld? '
13
P A U L B R O K S
14
' Y e s , ' I say. ' She ' l l unders tand. '
I decl ine a second cup of coffee and gather my stuff to leave,
but I 'm not g o i n g yet because Mrs O ' G r a d y has g rabbed my
a rm. She leads me to a corner of the r o o m and stands back with
an air of curiosity. She s tares , s teps forward, s tands back again .
She can ' t m a k e me out. T h e facial musculature shapes appre
hension, bu i ld ing to dread. T h e n she g o e s blank.
She walks to the other s ide of the r o o m , smacking her lips
and t u g g i n g her collar. I follow her to the kitchen where she
s tands by the s tove p icking her nose . T h e n she f i l ls the kettle, but
doesn ' t switch i t on. She fetches m u g s from the cupboard and
p laces them on a tray. F r o m time to t ime she seems to be aware
that there is s o m e o n e else in the r o o m . She looks at me , but I am
too much to fa thom. I feel semi-transparent . I speak, but there is
no response . Am I really here?
She f i l ls the m u g s with cold water f rom the kettle and carries
the t ray into the l iv ing r o o m . We sit in silence. I 'm thankful this
hasn ' t deve loped into a thrashing, foaming, full-blown fit . After
a while she reaches for the third a lbum.
' T h i s o n e ' s the hol idays , ' she says . 'Tener i fe . ' But she knows
someth ing is w r o n g when she sees plain water in the m u g s .
M r s O ' G r a d y takes br ief excurs ions from consciousness .
T h e s e are k n o w n as au tomat i sms , a feature of her epilepsy. T h e
consc ious mind switches off, but the bodi ly apparatus carries
on in a m o r e or less purposeful fashion: feeding the cat, walking
round the supermarket , boa rd ing a bus . H a d she reached for
the b read knife and p lunged it through my heart I doubt she
wou ld be convic ted of murder . T h e law makes provis ion for
au tomat i sms .
I N T O T H E S I L E N T L A N D
Watching Mrs O ' G r a d y ' s unoccupied b o d y scutt l ing about
I thought of her as a zombie . Students of consc iousness are fond
of zombies . N o t the Hait ian l iving dead or shambl ing ghou l s
of the Twilight Zone, but far s t ranger inhabitants of the wor ld of
philosophical conjecture. T h e s e creatures l ook and act like o rd i
nary people ; they walk , talk, s ing, l augh , and weep , have love
affairs, raise families, get drunk, a r g u e about poli t ics. T h e y are ,
in fact, like us in every w a y but one: they lack consc ious aware
ness. The i r brains regulate internal states of the b o d y and
control outward behaviour , but that 's all. Whi le the rest of us
move about in a bright pod of consc iousness , zombies just m o v e
about. The i r philosophical pu rpose is to crystall ize the mind-
b o d y problem. Is i t logical ly poss ib le to subtract mental life
from the work ing brain, in which case there wou ld be scope for
zombies (dual i sm)? Or are brain activity and consc iousness one
and the same thing (mater ia l i sm)? No doubt Mrs O ' G r a d y
would have someth ing to say on the matter.
T h e trouble is , not all of her excurs ions are so brief; hence
Mrs O ' G r a d y ' s guilt over S tephan ie ' s wedd ing . Her m e m o r y
holds no trace of the occas ion . Physica l ly she w a s there. Y o u
can see her in the photos . But she w a s not there mentally, at least
not in full. It was too protracted an ep i sode to fit the conven
tional scheme of an epileptic au tomat i sm. More likely her brain
had settled into a stable pattern of dysfunct ion with low-level
epileptic d ischarges j a m m i n g the t ransmiss ion of sensory infor
mation into memory . Her awareness wou ld have been a fragile
membrane of impress ions f loa t ing be tween ' now ' and ' then ' ,
but never quite connecting.
The re are other c i rcumstances in which human be ings appear
15
P A U L B R O K S
16
to act purposeful ly without the benefit of self-awareness. S l eep
walk ing is a g o o d example . I w a s in the C o m b i n e d Cade t Force
in my teens. O n e night, at camp, I somnambula ted through the
bar racks and mis took the N C O s ' quarters for the lavatory. I
shuffled in and urinated over one of the officers as he slept.
Unfortunately, the fol lowing m o r n i n g I w a s fully conscious .
H o w convenient i t would be somet imes to turn off con
sc iousness and carry on with ord inary behaviour. Imagine
flicking a switch on difficult days and flipping into oblivion,
k n o w i n g that your b o d y will continue g o i n g about its normal
bus iness . No one would notice. A p r e - p r o g r a m m e d wake-up
call would return you to sentience in t ime for a film or the
football . Cont ro l led au tomat ism might be preferable to per iods
of physical or emot ional d iscomfor t , or sheer bo redom. I f
everyone had a consc iousness switch then the world , most of
the t ime, wou ld be teeming with zombies . Perhaps i t a lready is.
Wha t t roubles Mrs O ' G r a d y is that she remembers one
w e d d i n g and not the other: K a t i e ' s , but not Steph 's . I t seems
unfair. In truth, she s ays , i t ' s not so much that she can' t r emem
ber as the feeling that she wasn ' t actually there. L ike she didn't
bother to turn up. I 'm not g o i n g to debate i t with her and, for
her own peace of mind, I think she should talk it through with
her daughters . Bu t if they couldn ' t tell, what difference does
it make?
Later , ly ing in bed , I confess to my wife that I am a zombie .
We had a malfunction with the transcranial magnet ic s t imula
tor. I t zapped my awareness modu le . I thought she should know,
but best not b reak it to the kids just yet. I say I hope it won' t
change the w a y she feels about m e . She is a l ready asleep.
The Space behind the Face
T h e illusion is irresistible. Behind every face there is a self. We
see the signal of consc iousness in a g l e a m i n g eye and imag ine
some ethereal space beneath the vault of the skull, lit by shifting
patterns of feeling and thought , charged with intention. An
essence. But what do we find in that space behind the face, when
we look?
T h e brute fact is there is nothing but material substance: f lesh
and b lood and bone and brain. I know, I 've seen. You l ook
down into an open head, watching the brain pulsa te , watching
the surgeon tug and p robe , and you unders tand with absolute
conviction that there is nothing m o r e to it. T h e r e ' s no one there.
I t ' s a kind of l iberation.
T h e illusion is irresistible, but not indissoluble . I t is m o r e
than twenty years since I b e g a n my clinical t raining at a rehabil
itation hospital for people with neurologica l d i sorders . I w a s a
student of clinical psychology , but w a s drawn mos t ly to neuro l
ogy. For as long as I could remember I had been interested in the
workings of the brain and, one w a y or another, as clinician or
17
P A U L B R O K S
18
scientist, I expected to make a career in neuropsychology, the
science of brain and mind. Neuro- rehab was a g o o d place to
start.
O n e of the patients w a s a seventeen-year-old b o y who had
s tepped into an empty lift shaft through which he fell three
f loors , a lmos t to his death. T h e su rgeons had done their best to
p iece him together aga in , but now the d o m e of his shaven head
w a s asymmetr ica l : convex on the r ight, concave on the left, with
a deep oval depress ion like the shell of a hard-boiled e g g
cracked with a spoon .
H i s face worked relentlessly, wri thing with anger and dread.
Most ly anger. He wou ld g rowl and grunt , and somet imes
howl, but , apar t f rom occasional vol leys of obscenity, he w a s
incapable of speech. T h i s i s not u n c o m m o n . People without
ord inary speech due to brain injury somet imes have the capa
city to s u m m o n up the vilest g o b s of abuse . I didn ' t know that at
the t ime. It came as a shock. Some t imes they can also s ing, but
this b o y never s ang . He sat contorted in his wheelchair, head
turned s ideways and b a c k at an uncomfortable angle , l imbs
buckled with spasticity, a s t ream of sal iva dribbling from the
corner o f his mouth .
T h e pr iap ism w a s a f inal , humil iat ing twist. D u e to a quirk of
the d a m a g e to his nervous sys tem he w a s continually troubled
by a painful erection. T h e y o u n g w o m e n tending him — nurses,
phys ios , and occupat ional therapists — pretended not to notice.
I felt pi ty for him, but a lso revuls ion. As a raw trainee not yet
accl imatized, I found him g ro te sque . What disturbed me most
w a s the f l ickering screen of his face: bleak images of a soul in
torment . Or so I imagined . T h e n I began to consider what
I N T O T H E S I L E N T L A N D
might remain of a ' sou l ' or a ' s e l f ' . I b e g a n to doubt there w a s
anything at all g o i n g on behind that face. He should be allowed to
die, I thought, and not just for his own sake. H o w did he l ook to
his mother? C o u l d she even bear to l ook?
T h e chaos of his face drained my sympathy. I t b roke the
rules. A face should al low public access to the pr ivate self. I t ' s an
ancient convention of the human race . T h e r e is a universal
system of s ignals . But this y o u n g man ' s facial d i sp lays worked
like a subterfuge, deny ing knowledge of what lay behind.
Perhaps nothing lay behind.
Then , one day, I happened to be a round when the b o y ' s
mother came to visit . I watched as she cradled his b roken head
in her a rms . Fo r the t ime that she w a s with him, but not much
longer, an extraordinary t ransformat ion came over his face. I t
became still. T h e rage subs ided . He seemed to regain his
humanity. Here were two selves , not just a mother and a b roken
shell of a son. T h e whole w a s grea ter than the s u m of its par ts .
Maybe it w a s a failure of imagina t ion that led me to sense a
seeping away of the b o y ' s self once his mother had g o n e , but the
capacity I d iscovered in myse l f to see a fellow human be ing as
less than a person w a s an appal l ing revelation. In such c i rcum
stances how are we to dis t inguish failure of empathy from val id
observat ion? Perhaps they amount to the s a m e thing.
N o w my own son has turned seventeen, the s a m e a g e as the
eggshell boy. He w a s in the vo id of pre-bir th when our friend
made his lonely descent through the lift shaft. To disturb s o m e
one from a state of non-exis tence is a terrible responsibili ty.
L o o k at what can happen.
I have a m e m o r y of be ing with my son when he w a s four
19
P A U L B R O K S
years o ld . I t is deep winter. We have to go out, so we leave the
w a r m t h of our house for the freezing night air. T h e r e are few
lights in the v i l lage and the sky is full of stars. We are hardly
beyond the front d o o r when he starts coughing .
'Are y o u all r igh t? '
' I t ' s okay, ' he s ays , ' I think I just swal lowed s o m e dark. '
He has the not ion that darkness is a substance. It will make
you choke if y o u swal low too much in one go . I could have put
him straight with s o m e prosa ic account of the cough ing reflex
be ing t r iggered by the shock of the cold air rather than a mouth
ful of da rkness , but I didn' t . I s tashed away the treasured image
and left him with the vers ion of reality fashioned by his infant
brain.
Real i ty is under constant review. Twenty- three centuries
ago , Aris to t le be l ieved that the heart must be the source of
mental life because of its dynamic action and its warmth . T h e
function of the bra in , he thought , w a s to cool the b lood . He
built his c o s m o l o g y on the bel ief that the Ear th stands mot ion
less at the centre of the universe , a fixed point about which the
sun and the m o o n and the stars revolve . Aris tot le w a s w r o n g on
every count , but his e r roneous beliefs - the product of intuition
and i l lusion — served him well enough . A n d though we now
k n o w immeasurab ly m o r e than Aris tot le about the workings
of the h u m a n b o d y and the structure of the c o s m o s , we should
not de lude ourse lves by thinking that we have arrived at some
pr iv i leged end-point of intellectual evolut ion.
We still live by intuitions and i l lusions, especially when our
thoughts turn inwards . T h e bright , intangible qualities of sub
ject ive experience have yet to be reconciled with the dark
20
I N T O T H E S I L E N T L A N D
substance of the brain, but that space behind the face is still lit
by the mind ' s eye . Irresistibly, we still see the v is ion of minds in
the light of other p e o p l e ' s eyes . C o s m o l o g i e s c o m e and g o , but
i f this illusion beg ins to fade then so d o e s the observer .
* * *
I 've been t rying to think of the eggshel l b o y ' s n a m e . I could
have g iven him a name . All the others have p s e u d o n y m s . It
wasn ' t deliberate. I didn ' t choose to deny him a n a m e . But when
the story was finished, I saw he didn' t have one . A n a m e wou ld
humanize him, ' s o m e o n e said . 'Ca l l him John or S teven or
R i c h a r d . . . '
On reflection, I thought it might do just the oppos i te .
21
The Seahorse and the Almond
Whisky on top of wine w a s a mistake. T h i s morn ing i t has left
me feeling fractionally too embod ied ; too aware of the weight
and m o v e m e n t o f my head, the bulk o f my tongue .
I w o k e late, b reak ing from a thick crust of sleep not much
before eight. H a l f an hour later, I 'm walk ing to work , without
hurry, but keep ing pace with the traffic. I t ' s a couple of miles. It
will do me g o o d . D o w n pas t the pa rade o f shops , past the odd
juxtaposi t ion of cas ino and funeral parlour , past the terraced
houses at the fringe of the park , and on up the other s ide of the
urban val ley towards the d rab monol i th on the b row of the hill.
T h e Dis t r ic t Genera l Hospi ta l i s visible from mos t of the city.
T o d a y i t is f ramed by a sky the co lour of cement.
N a o m i is deep ins ide . I t is her nineteenth birthday. She is on
a bed be ing pushed by a porter a l o n g shiny floors, into lifts and
out ac ross m o r e shiny f loors . She is tired, hav ing been awake
since the b reak of day, well before the neurophys io logy techni
cians c a m e to g lue e lectrodes to her scalp. T h e y left her with a
M e d u s a ' s head o f a n g r y serpents .
22
I N T O T H E S I L E N T L A N D
Arr iv ing at nine, I go straight to the ang iog raphy suite where
preparat ions are in hand for N a o m i ' s ordeal . T h e central cham
ber is small , about the size of a suburban l iv ing r o o m . It is
brightly lit and c r a m m e d with X - r a y equipment , moni tors , and
control panels . T h e centrepiece i s the na r row bed upon which
the patient, when she arrives, will be laid. T h e w a y i t tapers at
one end reminds me of an i roning boa rd . In the corner a quiet
man from Medical Il lustrations is set t ing up his v ideo camera
ready for the show. E E G technicians in white and rad iographers
in blue filter in and look busy.
We are g o i n g to interfere with the work ings of N a o m i ' s
brain, anaesthetizing each hemisphere in turn with injections
of Amyta l , a fast-act ing sedat ive. O u r a im is to isolate and inter
roga te one side of her head and then the other. Strictly,
'anaesthet ize ' is incorrect since the brain has no sensory recep
tors. It is a lways in a state of anaesthesia .
T h e radiologis t appears . ' D o we have a pa t ient? ' We do.
N a o m i is sitting up in her mobi le bed , which has been parked
just down the corridor, nowhere in particular. It has arr ived as
i f by t ime-lapse pho tog raphy m o v i n g from one indeterminate
station to the next, and now here she is . She looks lonely, so I go
and chat with her for a while. I wish her happy birthday.
I like N a o m i . I 've go t to k n o w her well these pas t few
months, watching her p rog re s s through an obstacle cour se of
investigations ( E E G , M R I , v ideo telemetry, n e u r o p s y c h o l o g y )
that will lead, she hopes , to the su rgeon ' s list, to the opera t ing
theatre and to the carv ing away of a small s treak of scarred
brain tissue - the source of her epilepsy.
Her faith in the doc tors and su rgeons is absolute . T h e f i ts will
23
P A U L B R O K S
24
cease . Al l will be well . A n d when she is seizure-free she will
go to university. Perhaps she will take a gap -yea r and travel to
Aust ra l ia . In t ime, she will apply for a driver 's licence. A n d so
on. She is incorrigibly optimist ic . It may be a feature of her
brain pa thology.
H e r boyfr iend, whose name I have forgotten, is less san
gu ine . Unl ike N a o m i , he can see the possibil i ty of failure. He
unders tands that the operat ion might not work . 'You ' re such a
pess imis t , ' N a o m i told him when I saw them both 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 voice
my concerns . It is a t ime for uncondit ional reassurance - not my
s t ronges t suit, but a necessary part of the repertoire, and well
pract ised .
Meanwhile , the radio logis t is sifting through his tray of para
phernal ia and realizes someth ing is miss ing . ' D o we have any
A m y t a l ? ' N o , not yet. O u r batch of the stuff looked suspi
c ious ly cloudy, poss ib ly contaminated. No problem. A call to
P h a r m a c y and we are assured that a supply of the d rug is
a l ready on its w a y from the Radcl iffe Infirmary. W h y i t has to
c o m e all the w a y from Oxfo rd I 've no idea. I don ' t enquire.
T h i s morn ing ' s p rocedure — a Wada test — is the final hurdle.
I f N a o m i pa s se s the test she advances to the surgeon ' s list. She is
p repared . Yes terday she rehearsed the protocol with one of my
co l leagues from the N e u r o p s y c h o l o g y Unit . She lay on her
back , raised both a r m s to the vertical, counted up to twenty,
imagined (at a round ten) that her left a rm had become limp and
I N T O T H E S I L E N T L A N D
let i t d rop to her s ide . T h i s is what happens when the d r u g hits
the right side of the brain. T h e n they went th rough the mot ions
o f testing. N a o m i per formed s o m e s imple act ions ( ' T o u c h
your nose . . . c lose your eyes . . . b low . . . ' ) ; recited the d a y s
of the week and counted backwards from ten. She descr ibed
a picture ( 'A man up a ladder, a b o y with a ball , a gir l , a kite,
a d o g and a cat, a pond , ducks . . . ' ) ; n amed objects; read sen
tences; did mental arithmetic. T h e instructions and ques t ions
were rapid-fire. Amyta l is fast act ing, but its effects are short
lived. In the test p roper the injected half-brain will s leep for just
two or three minutes — while we conduct our bus iness with its
wakeful twin.
My col league arrives carry ing a c l ipboard, a s topwatch, and
two black r ing-binders . On her w a y into the angio suite she
exchanges smiles and words with N a o m i , whose bed has n o w
moved closer to the main door . T h e r e ' s a smile for me too. She
already knows about the delay with the Amyta l . T i m e for a
coffee. We sit next to the machine that spills out the X - r a y n e g
atives and flip through N a o m i ' s case notes. He r his tory is
unremarkable. It all started with a fever when she w a s small .
S h e ' d been off colour for a couple of days , then seemed to p ick
up. Her mother wasn ' t sure , but in the end d ropped her off at
nursery school on the w a y to work .
Midway through the morn ing N a o m i fell asleep in the sand
pit, or so the teachers thought . When she couldn ' t be roused
they called an ambulance . She started shaking before she fell
asleep, the other children said . T h e doctor thought i t w a s p r o b
ably a febrile convuls ion: not to worry, a lot of k ids are p rone to
seizures i f their temperature c l imbs too high. T h e y mos t ly g r o w
25
P A U L B R O K S
26
out of it. A n d so , i t s eemed , she did. But the fits returned on the
first t ides of menstruat ion.
T h e y were shadowy figures with a pungent smell of electric
ity, a sensed presence , but no one there. O d d to identify the
smell of a seizure with electricity, which is odour less , but apt for
an electrical s to rm in the brain.
T h e ethereal v is i tors are part of the epileptic aura, a state of
altered awareness that serves to forewarn of an approaching
seizure. I t a lso has another, more visceral , feature. N a o m i says i t
feels like a spar row fluttering its w ings in the pit of her s tomach.
T h e bird ascends to her throat, b e c o m e s trapped, and s t ruggles
to e scape . Up to this point , under the gather ing g l o o m of the
b ra ins to rm, in the c o m p a n y of the empty shadows and the spar
row, she is fully consc ious and can articulate her experiences.
T h e n the s to rm breaks and she is swept beyond reflection. Her
eyes b e c o m e g lazed and empty. She tugs at her clothes, smacks
her l ips, and keeps wip ing her nose with the back of her hand.
I ' ve seen her in this state. She has gone with the wraiths. T h e y
have left an automaton, act ing out a purposeless , robotic routine.
After the tone p o e m of the aura — the unformed images , the
unnameab le scents — and after the rhythmic automat isms, there
somet imes fol lows a third, catastrophic, movement . Abou t one
in five of her attacks turns into a general ized seizure, what
wou ld once have been called a g rand mal . First , her muscles
contract and she falls to the g round , somet imes spurt ing b lood
as her jaw c lamps shut and her teeth sink into her tongue . She
s tops breathing and, unconsc ious , she urinates. T h e n come the
convuls ions — l imbs jerking mechanical ly for several minutes —
fol lowed by release into a deep sleep.
I N T O T H E S I L E N T L A N D
Despi te inventive cocktai ls of anti-epileptic medicat ion, with
dosages a lmost to toxic levels, the frequency of N a o m i ' s
seizures has steadily increased. N o w she ge t s them a lmos t every
day. She is desperate for a cure and wil l ing to take risks.
T h e planned operat ion has an ungain ly name : a m y g d a l o -
hippocampectomy, so called because i t involves removal of the
amygdala (from the Greek for ' a l m o n d ' ) and part of the ad ja
cent structure, the h ippocampus ( ' s e a h o r s e ' ) . Each half of the
brain contains an a lmond and a seahorse . T h e pu rpose of the
Wada test is to clear a w a y for the operat ion. We k n o w it is the
right side of N a o m i ' s brain that bea r s the scar t issue and dr ives
the seizures because w e ' v e seen the brain scans and w e ' v e
logged the clinical s igns . But we are a lso mak ing an assumpt ion ,
possibly unwarranted, that her left hemisphere , which looks
normal , is functioning normally. O u r test will help de termine
whether this is true. (It is 'Wada ' , by the way, not ' W A D A ' as
I 've just been reading in the case notes ; a c o m m o n error. T h e
procedure is named after Juhn Wada , the J a p a n e s e - C a n a d i a n
neurologist who f i rs t p roposed its u se . I t must be d i sappoin t ing
to be elevated to the status of an e p o n y m only to be mistaken for
an ac ronym.) We need to be as sure as poss ib le that there is no
'silent lesion' on that healthy side; in other words , a malfunction
that hasn' t shown up on the brain scans . Appea rances can be
deceptive. Brain t issue can look clean and p lump, but without
putt ing it to the test one can ' t be sure of its integrity.
O n e of the targets for surgery, the h ippocampus , is a vital
component of the bra in ' s m e m o r y circuitry, essential for l ay ing
down new traces. We need to know, above all, whether the left
hemisphere of N a o m i ' s brain i s up to the task of sus ta ining bas ic
27
P A U L B R O K S
m e m o r y functions. To the extent that each of us is the sum of
our memor ie s , the h ippocampus is the instrument by means
of which we assemble ourse lves . Every th ing accessible to
consc ious recall has been registered and recorded through its
channels.
What were y o u do ing ten minutes ago? W h o was the last
pe r son y o u spoke to? What did you have for breakfast? What
did you do yesterday, last weekend? When was the last t ime you
wept , and why? Conjure an i m a g e of your f i rs t school , the face
of your teacher, your best friend. R e m e m b e r your f i rs t kiss.
A n d then, stretching to the mental horizon, rising through the
squal ls and sunshine of personal experience, picture the tower
ing stacks of information in the public domain ; the raw
materials of culture. What d o e s the word ' en t ropy ' mean (or
' t h e ' o r ' w o r d ' o r ' m e a n ' ) ? H o w do you use a telephone? W h o
is the president of the Uni ted States? At what temperature does
water freeze? W h o wrote King Lear? Wha t is the function of the
l iver? All this information, personal and public , f inds its way
into m e m o r y by w a y of the h ippocampus .
As an aid to recall, medieval scholast ics developed elaborate,
architectural sys t ems of mental image ry — 'Thea t res of
M e m o r y ' or ' M e m o r y Pa laces ' - through which they would
take imag ina ry strolls, depos i t ing or retr ieving nuggets of
information at s t rategic locat ions. I like the idea that the Keeper
of the G a t e s is as fragile a creature as the seahorse . It doesn ' t
take much — a stroke of the su rgeon ' s knife — to finish it off and
c lose the entrance for g o o d . T h e f low of information s tops .
If, as p lanned, the su rgeon were to remove the right h ippo
campus , but i t turned out that N a o m i had no spare capacity in
28
I N T O T H E S I L E N T L A N D
the left, then the operat ion would , in a sense , cause N a o m i her
self to stop. She would form no new memor i e s of events or facts
beyond her present age of nineteen. I t would not prevent her
from g rowing old, but her age ing b o d y wou ld forever house the
mind of a nineteen-year-old girl .
Such things happened in the early days of epi lepsy surgery. A
handful of people , most famous ly a y o u n g mechanic known as
patient ' H M ' , ended up with dense and irreversible amnes ia ,
unable to retain new information for m o r e than a few minutes at
a t ime, and so unable to establish memor ies . You could visit HM
every day for a year and each t ime he wou ld greet you as a
stranger. L e a v e the r o o m for ten minutes and on your return he
would have no idea who you were .
Since then surgeons have restricted their interventions to just
one side of the brain, but even so there have been similar d i sa s
ters where it was not established prior to surgery that the other
side was in g o o d work ing order. T h a t ' s the reason w e ' r e here
today, I remind myself, g o i n g th rough these arcane rituals. We
want N a o m i to continue in mind as well as body.
I f the h ippocampus is the ga t eway to memory , one can p ic
ture the amygda la as hous ing the levers of emot ion . I t links the
informat ion-processing activities of the higher, cortical areas of
the brain — the machineries of l a n g u a g e , percept ion, and
rational thought — to deeper, older structures concerned with
the regulation of emot ion and mot ivat ion. In short , i t tells us
how to feel about what we are thinking and perceiv ing, and how
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 brain inhabit a wor ld devo id of emot ional
contour and colour. Dimin i shed insight into their own feelings
29
P A U L B R O K S
and behaviour is mir rored by a distorted perception of the e m o
tional l ives of others.
So the stakes are high for N a o m i : m e m o r y and emotion. We
need to ge t this right.
T h e Amyta l arr ives, del ivered by motorcycle courier. He
hands over a Jiffy b a g that a nurse opens to find two phials
containing a plain l iquid, the stuff that will shortly work its spell
on N a o m i ' s brain. O u r patient is now stretched out on the spe
cial bed , at the centre of things, wait ing. Her head rests on a
small square cushion. She is covered to the neck with a green
surgical sheet except for an exposed patch around her groin ,
where , hav ing adminis tered a local anaesthetic and m a d e a small
incision, the radio logis t is work ing to ga in access to the femoral
artery. N a o m i ' s face at the top of the sheet and this framed
expanse of pa le f lesh and pubic hair (and now b lood from the
cut) seem quite unrelated. Many people are surprised to learn
that the mos t feasible route to the brain for these purposes is by
w a y o f the gro in .
T h e catheter, a length of ultra-fine plast ic tubing, is inserted
and pushed , inch by inch, a long the femoral artery, up through
the a b d o m e n and into the chest . Its journey is visible, magnified
graini ly in spectral shades of grey, on the X - r a y monitors . I
watch as it finds its w a y to N a o m i ' s heart and from there to the
junction with the internal carot id . She , too, is watching. She can
see her insides on the moni tors suspended overhead which, with
exquisi te integrat ion of hand and eye , the radiologis t uses to
f ind his w a y from gro in to gu t to heart to brain. Nex t , a rad io-
o p a q u e dye is p u m p e d through the newly installed plastic piping
to f lood the b lood vesse ls of the brain.
30
I N T O T H E S I L E N T L A N D
T h e radiologis t takes a few X - r a y snaps to confirm that we
have reached our intended destination on the cerebrovascular
map. Stationed at N a o m i ' s midriff, he offers an occas ional word
of reassurance, and g lances now and then in her direction. He
means well , but the exchanges between them are perfunctory.
She, for her part , is be ing a g o o d patient. Her b o d y is pass ive ,
receptive. Her face shows bare ly a trace of emot ion , but when
the nurse brushes a strand of hair f rom her forehead, N a o m i ' s
eyes moisten.
We have here N a o m i the body, N a o m i the mind, and N a o m i
the person. T h e s e , at least , are the differences of emphas is
across the professional d ivis ions of labour. T h e rad io logis t
works in the realm of the flesh. He k n o w s the intricacies of
the vascular sys tem and is on g o o d terms with the ghos t s of his
X - r a y machine. I , the neuropsychologis t , will short ly s ignal a
pharmacologica l invasion and deconstruct ion o f N a o m i ' s mind.
T h e nurse, for now, is with N a o m i the pe r son .
We are all set to start. N a o m i has her a r m s raised and beg ins
to count. I l ook to my col league s tanding oppos i te with her
black folders, s topwatch, and c l ipboard, ready to assis t with test
materials and record responses . T h e neurophys io log i s t s are a
few feet back moni tor ing every squ igg le of b ra inwave activity
siphoned through the l ong bridal veil of mul t i -coloured leads
attached to N a o m i ' s head.
After a nod from m e , the radio logis t starts to inject the
Amyta l . It takes effect in a few seconds and I g r a b N a o m i ' s a rm
as i t swoons , gu id ing i t to rest at her s ide . At that momen t of col
lapse , the catching of the lifeless a rm, someth ing col lapses
inside me too and I catch myse l f thinking, What am I doing here f
31
P A U L B R O K S
32
I 'd rather be somewhere else, well away from this unwholesome
mind meddl ing . But here lies N a o m i . T h e r e is work to do and,
after all, better to be do ing this to a relative stranger than to
s o m e o n e y o u love . T h a t would be unbearable . She looks
remarkably calm and ordinary g iven that her right cerebral
hemisphere , half her brain, is now temporar i ly defunct. H o w
ordinary she looks .
I am clear about the pu rpose of the test, but curious to know
what is happening to ' N a o m i the pe r son ' , a question entirely
peripheral to the immedia te medical concerns . Our procedure is
pha rmaco log ica l , not surgical ; the altered state is transient. But
while the d r u g works its influence we have , effectively, ampu
tated one side of her brain. I wonder if, with half of the brain
c losed d o w n , we are e n g a g i n g with just one half of the person.
Psycho log i s t s used to be obsessed by the duality of the brain.
'Funct ional a s y m m e t r y ' w a s a hot topic when I w a s an under
g radua te in the 1970s. T h e bel ief was that the two halves of the
brain pe r fo rm distinct, though complementary, functions: left
hemisphere for l anguage , right for spatial awareness ; left for
rhythm, right for me lody ; rationality / intuition; analysis /
synthesis , and so on.
At the centre of attention at that t ime, scientifically and i m a g
inatively, were the so-cal led ' spl i t -brain ' studies. Split-brain
su rgery w a s a radical method of treating people who suffered
from severe and intractable epi lepsy — patients tormented by
frequent, debil i tat ing seizures that could not be controlled by
any other fo rm of treatment.
Epi lept ic seizures are caused by abnormal bursts of electrical
activity in the brain. T h e rat ionale for split-brain surgery -
I N T O T H E S I L E N T L A N D
commissuro tomy — w a s that cutting the co rpus ca l losum, the
main channel of communica t ion between the two hemispheres ,
would confine the abnormal electrical activity to one side of the
brain and so prevent the deve lopment of major seizures .
I was not much concerned with the clinical aspects of this
operation. I had no part icular interest in epilepsy. Wha t
intrigued me was that the spli t-brain patients were thought
experiments made flesh. T h e y fell into the ca tegory of phi lo
sophical conundrum that also includes the 'brain in the v a t ' , the
'brain t ransplant ' , and science f ict ion fantasies about te leporta-
tion and mind duplication.
T h o u g h t experiments are ' Imag ine i f . . . ' scenar ios des igned
to challenge our ordinary intuitions. In the seventeenth century
John L o c k e explored the concept of personal identity by i m a g
ining an exchange of brains between a prince and a cobbler. It is
psychological continuity that counts , he concluded. T h e prince
' goes with ' his brain and now f inds ' h i m s e l f in the b o d y of the
cobbler (and vice ve r sa ) . More recent var ia t ions on the theme,
some inspired directly by the split-brain cases , are less s t raight
forward.
What i f s o m e o n e ' s cerebral hemispheres are d iv ided and
transferred separately (memor ies , character traits and al l) to the
heads of two different people? What i f you swap a hemisphere
with your best friend, or your wors t enemy? Which of you is
which? T h e r e would be s o m e continuity in these cases , but
not unity. Convent ional notions of persona l identity wou ld be
seriously challenged.
But the split-brain cases were not flights of phi losophical
fancy. T h e y were real peop le with a real and irreversible su rg i -
33
P A U L B R O K S
34
cal divis ion of the brain. Inevitably they provoked as much
phi losophical interest as scientific. L ike many others, my own
imagina t ion w a s captured by the sugges t ion that, in dividing the
brain, the su rgeon ' s knife was also d iv id ing consciousness and
therefore d iv id ing the person . T h e very idea of bisecting the
l iv ing, consc ious brain clean down the middle was bizarre and
absurd . It had a touch of the macabre , a whiff of the chamber of
hor rors . T h e r e are many weird creatures in the menager ie
of neurologica l disorder , but the split-brain patients were of
the purest s t rangeness . I w a s drawn in.
' S t r ange ca se s ' , c lose ly observed , have an important place in
the neurologica l literature. Alexander Lur ia , a major figure in
the history of neuropsychology , w a s a master of case descrip
tion and a persuas ive advoca te of ' romant ic sc ience ' .
' W h e n done properly, ' he sa id , 'observat ion accomplishes
the classical a im of explaining facts, while not los ing sight of
the romant ic aim of preserv ing the manifold richness of the
subject . '
I don ' t hesitate to r ecommend the popular writ ings of Lur ia ,
Ol iver Sacks , and others to students as a w a y of introducing
them to the field, but I recognize that part of the appeal , part of
that 'manifold richness of the subjec t ' , has little to do with sci
ence or phi losophy. I t has more to do with the intrinsic
fascinat ion of the aberrant and the bizarre. Morbid fascination
would not be too wide o f the mark .
In this l ight, neurological case histories have a certain Gothic
appeal . Rep lace the dark forests, the c r a g g y mountains, the
ruined abbeys , and the elemental s to rms of the traditional
Goth ic tale with a desola te urban landscape . L e t a dilapidated
I N T O T H E S I L E N T L A N D
modern hospital stand for the c rumbl ing medieval cast le with its
labyrinthine pas sages , g l o o m y dungeons , and torture chambers .
T h e white-coated, mad scientist in his cobwebbed laboratory,
amid van de G r a a f genera tors , l ightning conductors , and the
paraphernal ia of alchemy, b e c o m e s the g r een -gowned su rgeon
in the sterile g leam of the opera t ing theatre, knife in hand, ready
to rework the bra in ' s s l imy fabric. At the centre of i t all is the
monster, wai t ing for the life force from the heavens to jolt its
dead l imbs, and the patient, brain exposed to the air, wai t ing for
the blade.
A n d here I am now, in the shadow of Dr Frankenstein,
having isolated one half of N a o m i ' s brain, about to e n g a g e in a
d ia logue w i t h . . . what? A person? A half -person? H a l f a bra in?
It doesn ' t feel as if I 'm deal ing with s o m e fragment of a mut i
lated self. N a o m i ' s spirits seem to lift. She answers my ques t ions
obl igingly and follows instructions with hardly a m o m e n t ' s
hesitation. T h o s e three short minutes f ly by. ' Y o u ' v e done ve ry
well, ' I tell her.
T h e d r u g wears off. T h e left a r m has returned to life and the
E E G trace i s back to normal . Her eyes are c losed and N a o m i
looks as i f she is asleep. We k n o w she isn' t from the rhythms of
the E E G - her brain is idl ing in a comfortable alpha rhythm,
indicating relaxed wakefulness. It is t ime for the next s t age of
the procedure , to see whether she r emembers anything from
the d rug phase . Fo r N a o m i , this element of the ritual is crucial .
Failure here would outweigh success at any other s t age . I f she is
to proceed to surgery she must pas s my m e m o r y tests.
S h e ' s not do ing so well. Come on, Naomi, come on, I 'm think
ing. ' T h e picture, N a o m i , what can you r e m e m b e r ? '
35
P A U L B R O K S
36
Perplexity, then a burs t of information: 'A man on a ladder,
a d o g chas ing a cat, a p o n d with s o m e ducks on it, a girl with a
kite, a b o y with a bal l . ' Al l , unfortunately, from the picture she
w a s shown at yes te rday ' s rehearsal .
Fo rma l test ing comple ted , I ask N a o m i how she found the
experience.
' N o p rob lem, ' she says . 'It w a s a breeze . '
T h e bra in ' s l anguage circuits are usual ly located on the left
s ide , so dis turbance or comple te loss of speech is the typical
r e sponse to injection of the left hemisphere . In other w a y s the
effects are less predictable. S o m e patients appear confused and
disor iented, s o m e b e c o m e agi ta ted, s o m e disinhibited. Others ,
like N a o m i , just look desola te .
H e r head is still, but her eyes flash left and right. She will not
respond to my s imple c o m m a n d s : 'Touch your nose , N a o m i ,
touch your nose . ' No th ing . When we get to D a y s o f the Week
she tries very hard, but all we get is 'Fa - fa - fa - fa - fa . . . ' On
C o u n t i n g B a c k from T e n she approximates the number words ,
but ge ts locked in a persevera t ive loop: 'Tern, nipe, ape , ape ,
ape , a p e . . . ' She looks a t the picture and has an u rge to point a t
things: ' D a , da . '
F o r a while she seems to be w a r m i n g to the task, appears
e n g a g e d , but her concentrat ion suddenly fades. At one point she
looks me in the eye and chuckles wickedly, then another wave of
emot ion sends her in a different direction. Her eyes dart left and
right again . She looks terrified; she looks feral.
' F ine , N a o m i , just f ine, ' I say as we complete the routine.
'Re l ax , w e ' r e nearly there now.' We retire to a side room
leav ing N a o m i to rest and recover from the d rug .
I N T O T H E S I L E N T L A N D
T h e speech dis turbance confirms for us that N a o m i ' s
l anguage control centres are located pr imari ly in the left hemi
sphere. T h i s is important for the su rgeon to know, g i v i n g him
greater licence for excurs ions into the right tempora l cortex if
necessary, with minimal risk of d isrupt ing l a n g u a g e functions.
And when i t comes to m e m o r y test ing there are no surpr ises .
Her failure to recall or recognize mos t of the test i tems confirms
that we were p lac ing unreasonable demands on the d a m a g e d
right h ippocampus: taunting the crippled seahorse .
T h e one exception is her accurate recall of the mental arith
metic task. Under the d r u g she had stared at the sum printed
on the test card and sa id , 'Sebber , seffen, f ife, f ife, five. ' N o w ,
correctly, she recalls, ' Fou r plus f ive equals nine. ' I ' ve seen this
before. Somehow, I think, numerical information must ga in
back-door access to the left hemisphere in a w a y that verbal
information cannot.
Recall of the experience of left hemisphere suppress ion is a lso
less predictable than for shutting down the right hemisphere.
S o m e patients have no recollection of events at all, at least noth
ing they can put into words . Others have at least partial insight
into the frustrations of their t emporary loss of speech. S o m e ,
like N a o m i , just tell tales. ' O h , i t w a s okay, ' she says . Well,
perhaps she did have some slight p rob lems with her speech at
first, but after that she was fine. Maybe it w a s a bit different to the
f irst time around, but not much, not really. Qui te enjoyable. T h i s
is the left hemisphere confabulat ing. It does this for all of us ,
every waking moment . I t edits our consc ious experiences, makes
them comprehensible and palatable. It is the brain 's spin-doctor .
* * *
37
P A U L B R O K S
T w o things disturb me dur ing the night. O n e is the hoarse , sotto
voce ba rk of an urban fox, receding in triplets down the street.
T h e other is a f ragment of d ream, sharp enough to wake me . I
s tagger , g i d d y from be ing spun in a la rge machine they called an
Accel lo t ron . It has m a d e me invisible, temporarily. I see my
daughter sitting in the ga rden and approach her. I speak. She
looks at m e , but her eyes cont inue searching. I have, truly,
b e c o m e invisible. T h e r e ' s no w a y I can reassure her. She is
terrified when I touch her hand. I 'm terrified.
N e x t day, f irst thing, I 'm sitting in my office watching the
v ideo of N a o m i ' s Wada test. I t ' s easy to miss important details
in the pat ient ' s responses so we a lways check the video. The re
w a s someth ing I failed to catch. T h e left hemisphere is sup
pressed and the or igin of N a o m i ' s f ragmented, mumbl ing
speech is uncertain. It could be the left hemisphere running on
empty or pe rhaps i t is c o m i n g from the other side of the brain.
Ei ther w a y i t ' s hard to make out what s h e ' s saying. For a
moment , her confusion s eems to subs ide and there is a look of
accusat ion in her eyes .
'Wata fam, ' she says , 'dooneer . '
I listen c losely a second and third time and realize i t ' s a
quest ion: 'Wha t the fuck am I d o i n g he re? '
38
The Sword of the Sun
I had never been much aware of my father's g lass eye, just as I
had never really noticed his foreign accent. We were sw imming
some distance from the shore. Fourteen years old, I w a s w a y
ahead. He called and I turned to find him treading water, right
hand covering the empty cave of his eye-socket , g o o d eye
exploring the g l immer ing depths. T h e fugitive eye stared up at
us from the seabed. I p lunged like a pearl diver, fol lowing its g a z e
all the w a y down, and snatched it up with a handful of sand.
Tha t evening, sk imming s tones into the sunset , I returned in
imaginat ion to the ocean floor. It w a s a cold and lonely p lace .
T h e n i t occurred to me that, depr ived of an obse rv ing eye , the
ocean was nothing. Such power! I c losed my eyes and i t w a s
gone .
Years later I read Italo Ca lv ino ' s Mr Palomar. It stirred m e m
ories. T h e e p o n y m o u s hero g o e s for an evening swim. As the
sun goes down i t sends a dazzl ing band of l ight ac ross the sea .
L o o k i n g back to the shore , Mr Pa lomar sees the sun ' s reflection
as a shining sword in the water. He swims towards it, but the
39
P A U L B R O K S
sword retreats with every s t roke and he is never able to overtake
it. Wherever he m o v e s he remains at the s w o r d ' s tip. It follows
him, 'poin t ing him out like the hand of a watch whose pivot is
the sun ' . He realizes that every bather experiences the same
effects of the light. Sa i lboards change their appearance as they
c ros s the reflection, co lours are muted , bodies silhouetted.
Wha t if all the swimmers and sa i lboarders return to the shore,
he wonder s , where wou ld the sword end?
Mr Pa lomar unders tands that nothing he sees exists in nature.
Na tu r e is a bundle of abstract ions — particles in fields of force.
T h e sun, the sea , the sword , and the sa i lboarders are inside his
head. H e f l o a t s a m o n g phantoms.
T h e sword of the sun c leaves the universe in two: there is
object ive reality — remote abstract ions without point of view —
and there is Pa lomar ' s pr ivate universe , the mi rage of human
percept ion. ' I am swimming in my mind; this sword of light
exists only there. ' But what kind of thing is Mr Palomar , the
Perceiver? No doubt he wou ld see himself, as I see myself, as a
s ingular , unified be ing , cont inuous with his child self as I am
cont inuous with the b o y d iv ing for his father's eye, m o v i n g
from fixed pas t to uncertain future. L ike the sun ' s reflection, this
is an i l lusion.
In the a n g i o g r a p h y suite, pe r forming a Wada test, I was the
il lusionist. O u r brain d r u g cleft the y o u n g w o m a n in two. T h e
left-brain vers ion of N a o m i w a s different from the right. Ms
Lef t -brain w a s talkative and cheerful. Ms Right-bra in was
unsett led, mute , m o r o s e . When the w o r d s f ina l ly broke
through, she hadn ' t a clue where she was . 'What the fuck am I
d o i n g he re? ' I ' ve never heard Ms Left-brain swear. Afterwards,
40
I N T O T H E S I L E N T L A N D
when the d r u g wore off, Ms Left-brain spoke for the whole
person. 'It was a breeze, ' she said . T h e r e w a s no recollection of
Ms Right -bra in ' s discomfort . I t had been edited out of the story.
O n e might think that the se l f is d iv ided in such c i rcum
stances, but this would be to swal low the il lusion of unity; to
imagine in the f irst place that there is s o m e 'whole thing ' to be
fractionated. T h e r e isn't . F r o m a neuroscience perspect ive we
are all divided and discont inuous. T h e mental p rocesses under
lying our sense of self — feelings, thoughts , memor i e s — are
scattered through different zones of the brain. T h e r e is no
special point o f convergence . No cockpit o f the soul . No sou l -
pilot. T h e y c o m e together in a work of f ict ion. A human be ing
is a story-tel l ing machine. T h e self is a story.
T h i s is not to say that our l ives are f ict ions. Unlike Rob inson
C r u s o e or E m m a B o v a r y we are embedded in a universe with
physical and moral d imens ions where every thought and action
splinters into a million consequences . R e a d e r s of F lauber t ' s
Madame Bovary will vary in their reactions to its heroine as she
makes her way through the novel , but her life and thoughts are
f ixed. She will a lways mar ry Char les , fall prey to the a b o m
inable Rodo lphe , and die her horrible death. I t ' s different for us
meat puppets . We don ' t know where our l ives are g o i n g . What
the fuck am I doing here? I often wonder .
W h o tells the s tory of the self? T h a t ' s like ask ing who thun
ders the thunder or rains the rain. It is not so much a quest ion of
us telling the s tory as the s tory telling us .
N o t so long a g o I asked my dad if he remembered the t ime I
rescued his eye from the bo t tom of the sea .
' N o , ' he said .
41
Soul in a Bucket
I once met a y o u n g m a n who w a s convinced his head was full of
water and contained a fish rather than a brain. It was quite a
l a rge fish, someth ing like a trout, and it unsettled him to think
of i t l iv ing in such c ramped condit ions. He no longer had need
of a brain since all his thoughts and behaviour were under the
control o f the C I A .
Mos t of us bel ieve that the head contains a person: a self.
H e r e ' s one , at the front of a lecture hall, spil l ing words that
seem to c o m e from nowhere . T h e r e , in the auditor ium, are 200
other se lves . R o w s of heads . Fo r each head to represent the
locat ion of a consc ious se l f requires a further, inferential, step, a
mental p roces s I am power less to resist.
T h e s a m e applies when we reflect on our own identity. We
create our selves by inference: automatical ly and irresistibly. In
d o i n g so we ride the rails of the deepes t human convention, but,
at root , it is just that: a convention. T h e self is not an intrinsic
feature of the brain and it is poss ib le to b e c o m e derailed —
th rough psychos i s , like the man with the fish in his head, or as
42
I N T O T H E S I L E N T L A N D
a result of brain d a m a g e . T h e degrada t ion of personal i ty is a
neurological commonplace .
Mary had suffered a brain haemor rhage ; to be prec ise , a
ruptured anterior communica t ing artery aneurysm. T h e arterial
wall had a lways been defective ( though she w a s not to k n o w )
and now, in her fiftieth year, the sac had burs t , pou r ing b lood
into the frontal lobes . T h e su rgeons opened up her head and
fixed a clip to stem the flow. She had been c lose to death. T h r e e
weeks later, sitting in my office, it w a s difficult to s tem the flow
o f words .
' I ' v e got a p o e m I wro te it yes terday well I haven ' t written it
down it just c a m e to me when I w a s sit t ing look ing out the
window at the lawn and these m a g p i e s c a m e v ic ious things you
wouldn ' t want to leave a baby outs ide they 'd peck its eyes out
like they do the sheep they attack in pa i rs they swoop d o w n and
confuse the sheep one then the other we had a kitten c l imbed an
apple tree i t did they flapped a round her p o o r thing w a s terrified
I threw a stone we shook the biscuit box to ge t her down . '
She paused . She had forgotten the p o e m .
'Where was I ? ' she said .
I didn' t say a word as I reached for the black case containing
my test equipment, and avoided eye contact . If I d idn ' t speak
and I didn't look , Mary would stay silent. Without the t r igger of
a word or a g lance she sat, if not exactly still ( she w a s a lways
fidgeting with the but tons on her b louse ) then at least quiet . But
to let slip a careless word or g lance w a s to open the s luice. I
quickly released the c lasps on the case and took s o m e clean his
tory sheets from a tray on my desk . Mary didn ' t m o v e a musc le .
She was not even fiddling with her but tons. I wondered how
43
P A U L B R O K S
l ong we could sit there like this, mot ionless and quiet. T h e
silence didn ' t t rouble her.
She seemed absorbed by a picture pos tcard pinned to the
boa rd behind my desk . It showed a Mediterranean scene, a sea
s ide town with a pine-fringed golden beach and blue sea , and a
seafront p r o m e n a d e with colourful shops and restaurants.
M A J O R C A b lazed diagonal ly, upper left, in curly yel low letters. It
had been there since the summer and now looked incongruous
beneath the seasonal tinsel and plastic holly my secretary had
s tuck about the p lace . A little Chr i s tmas tree sat on the filing
cabinet in a clutter of cards .
We b e g a n with quest ions about orientation. T i m e , place, and
person: the when, where , and who co-ordinates of personal
awareness . I t ' s important to exercise discretion. O n e doesn ' t
want to insult the patient by asking over ly simplistic questions.
But , with Mary, i t w a s appropr ia te to start with the basics .
Personal orientation w a s one of her p rob lems .
'Wha t day is i t ? '
' W e d n e s d a y '
' G o o d . A n d the da t e? '
' I s it the twenty-four th? '
'Actual ly i t ' s the sixteenth. What month is i t ? '
' J u l y '
'Wha t makes you think i t ' s J u l y ? '
' I t ' s w a r m in here. ' She undoes a button, then another.
' I should keep your b louse on, Mary, ' I tell her. We move on.
'Where are we n o w ? '
'At the hotel . '
'And what is the name of the town we are in? '
44
I N T O T H E S I L E N T L A N D
' I don ' t know,' she says . 'Majorca , somewhere . '
I ask her name. She g ives me a p i ty ing look .
'Me? I 'm Mary Magp ie . W h o did you think I w a s ? '
* * *
I 've been project ing images of the brain on to a la rge screen. At
f i rs t they were hyper-real 3 - D images , labelled and co lour -
coded to illustrate the anatomical landmarks . T h e cerebral
hemispheres looked like they were m a d e of shiny plast ic. But
now I am working on a m o r e schematic picture. A large b lock of
colour — hot mustard yel low — slides down behind m e , cas t ing a
trompe l 'oeil shadow against the pale screen. It bears the legend
C E R E B R A L C O R T E X and signifies the appara tus o f the consc ious
self.
T h e hall is full and the students are attentive. T h e y seem to
have enjoyed watching the shapes and w o r d s g l ide ac ross the
screen, falling into place with PowerPoint precis ion as the brain
assembles itself. I am pleased with my picture. It is like a w o r k of
art. T h e lecture hall as gallery.
In the shadows, on a table next to the i l luminated screen there
is another exhibit. It is hidden from view, but in a few minutes I
shall take it from its container and hold it aloft for the audience
to admire . Fo r now, we contemplate the d i a g r a m . It p rov ides a
standard representation of the major anatomical d ivis ions
(hindbrain, midbrain, forebrain) and s o m e of the componen t
structures (cerebel lum, thalamus, basal gang l i a , neocor tex) .
T h i s is an introductory lecture. I keep it s imple , but m o v e
swiftly through the lower structures like a child ascending a
45
P A U L B R O K S
c l imbing frame, eager to reach the top. I am most interested in
what g o e s on in the higher reaches, the zones containing the
interlinked sys tems of perception and thought, memory and
emot ion . Consequent ly , my account of the hindbrain and mid
brain structures is crisp. I encourage the students to imagine that
we are c rawl ing th rough the b a s e of a gargantuan skull and
c lamber ing up the bra ins tem. I t has the girth of an oak. We p ro
ceed under the shadow of the great lobes of the cerebral
hemispheres that l oom like thunderclouds. I t ' s the higher
branches we aspire to, w a y up in the g l o o m . I ask them what
they think they would see .
'No th ing , ' one of them answers correctly, ' i t ' s pitch black. '
'Sh ine a l ight, ' I say.
' H o w old are y o u , M a r y ? '
'Twenty-four . '
'And your children, how old are they? '
' E m m a ' s twenty-two, T o m ' s nineteen. '
I explained to Mary that we were in a hospital . D i d she know
why she w a s there? Yes , she told me . S h e ' d had an aneurysm,
but they 'd put i t right. She would be g o i n g home soon . In fact
she wou ld leave as soon as we had finished. I t w a s a pity her
sister had to s tay behind. He r sister? Yes , s h e ' d had an aneurysm
too, but she wasn ' t d o i n g so well . She would have to stay on the
ward a little longer.
Mary w a s b e c o m i n g agitated now. She s tood up and made for
the door .
' G o t to g o , ' she sa id . ' I left the b a b y '
'Wha t b a b y ? '
46
I N T O T H E S I L E N T L A N D
'My baby, ' she said. ' I left i t in the ga rden . T h o s e m a g p i e s will
have its eyes out. '
T h e baby w a s born last month. T h e y opened M a r y ' s head ,
and then they delivered her baby. It was a beautiful little gir l , but
there was a problem with her brain. It could be an aneurysm.
Perhaps they'll open her head as well.
Shine that light at the g l o s s y unders ide of the temporal lobe ,
directly above , and you will see that the outer surface is
wrapped in a sheet woven from an exquisi te material . N e x t
slide: T h i s is the ' g rey matter ' . I t covers all of the major lobes .
In reality the colour would be a dull, g r ey -b rown , but here we' l l
g ive it a silver sheen. D i s s o l v e into the fibres of this material .
Picture an exotic, i l luminated ga rden . See what makes i t gl isten.
T h e objects all a round ( 'neurons ' ) are certainly plant-like —
roughly spherical pods with slender, b ranching tendrils (the
'dendri tes ' ) and a longer p rocess (the ' a x o n ' ) extending from
one end. T h e axons, too, can be seen to branch into a number of
finer strands, each with a but ton-shaped endfoot that attaches to
a dendrite, or to the cell body, of another neuron.
It is a dense matrix of interconnection. A b o v e and below, near
and far, the neurons pulse and g low in a silent, iridescent fugue as
electrochemical signals traverse the long axons and influence the
target cell. Next slide: Here , for our benefit, packets of light shoot
along the axons and cause the cells to which they are linked to
g low either red or blue. R e d s ignals a state of excitement. T h e
target cell itself is now encouraged to fire pulses a long its own
axon to cells further a long in the network. Blue s ignals inhibition
and the target cell s tops firing. In effect, each neuron is either ' on '
47
P A U L B R O K S
48
or 'of f ' , generat ing pulses or ceasing to generate pulses. Neurons
are the bas ic functional units of the brain and that is their task: to
fire or not to fire. I t ' s all they do. Whichever region of the cortex
you plunge into, the scene is the same.
Where is the mind in this tangled w o o d of neurons and nerve
fibres? It isn ' t anywhere . A n d the self? What did you expect? A
genie in a bot t le?
Gottfr ied Leibniz , the eighteenth-century philosopher and
mathematician, per formed a similar thought experiment. He
imagined 'a machine whose construct ion would enable i t to
think, to sense , and to have percept ion ' and, further, that the
machine is ' enlarged while retaining the s a m e proport ions , so
that one could enter into it, just like into a windmil l ' . What does
he find in the interior of the mind-making machine? '. . . only
par ts push ing one another, and never anything by which to
explain a percept ion ' .
T h e en igma of personal identity may have a dark s ide. In his
e ssay 'Sor ry , but Your Soul Jus t D i e d ' T o m Wolfe imagines an
apocalypt ic near future where advanced methods of brain
i m a g i n g will strip away the i l lusion of self. People will realize
that all they are look ing at is a piece of machinery, devoid of
self, mind, or soul . At this point , he says , ' s o m e new Nie tzsche '
will step forward to announce the death of the soul and 'the
lurid carnival that will ensue m a y make the phrase "the total
ecl ipse of all va lues" seem tame. '
It is t rue. Neurosc ience is fast deve lop ing the technical and
conceptual wherewithal to reveal in fine, bare detail the neuro-
bio logica l substra tes of the mind. Perhaps it will despoil a
sacred myth — the myth of selfhood and souls . A n d , if so,
I N T O T H E S I L E N T L A N D
we may be wander ing innocently into the open ing phase of a
dangerous g a m e . O u r ethics and sys tems of just ice, our entire
moral order, are founded on the notion of society as a collective
of individual selves — au tonomous , introspect ive, accountable
agents. If this self-reflective, mora l agent is revealed to be
illusory, what then?
Values may have more to do with primit ive ideas about ghosts
in machines than we care to think, and perhaps by us ing the tools
of neuroscience to deconstruct the se l f we run the risk of split
ting a social a tom and releasing forces beyond our present
comprehension. Cou ld ' the century of neu rosc ience ' really
signify the death of the self and the col lapse of all va lues? I
think Wolfe honours neuroscience unduly. He is seduced by the
gadge t ry and the g a u d y images . You don ' t need futuristic new
technologies to expose the brute fact that there ' s nothing but
meat inside our heads. W e ' v e known this down the a g e s .
I t dawned on me s o m e t ime a g o that I w a s no longer e s p e
cially interested in the brain. Or rather, that my interest w a s
expanding outwards from the brain itself. It was as if I had been
in a congested city, g a w p i n g at the c rowds and the architecture
and the traffic from g r o u n d level. A n d now I was r is ing above
the bui ldings and the streets to take in a different perspect ive . I
could see suburbs and fields and rivers beyond and, in the d i s
tance, other towns and cities. Ci t ies don ' t float in a v a c u u m , and
neither do brains.
What became clear was that the brain could not be fully
unders tood if you treated it as an isolated object. I had underes
timated how tightly the bra in ' s functions are b o u n d to the rest of
the body and, at the same t ime, how deeply they are e m b e d d e d
49
P A U L B R O K S
50
in the wider physical and social landscape . No brain is an island.
W h e n M a r y ' s husband came to visit he had a ca lming effect.
T h e y seemed to function as a unit. M a r y ' s behaviour meshed
into the networks of partnership and so became more coherent
and consistent . In any relationship each person is partly defined
in te rms of the other. So , for Mary, her husband ' s presence was
a gu ide to self-definition. He prov ided a template. He drew
from her a behavioura l repertoire and a mental structure to
complement his own, and the centre of gravi ty lay between
them. T h e r e w a s stability, a kind of equil ibrium. T h i s effect was
not of his del iberate do ing . T h a t ' s just the w a y i t happens.
I f M a r y ' s heart or lungs or liver had been the pr imary site of
pa thology, rather than her brain, i t would be possible to describe
the d i sease in te rms of its effects on that particular o rgan system
in relation to the overall functioning of the rest of her body.
T h e function of the heart is to p u m p b lood , the liver secretes
bi le , the lungs enable the supply of oxygen to the b lood , and in
each case the frame of reference for a description of function is
the individual o rgan i sm. In defining brain function we have to
go beyond this, extending the frame of reference beyond the
sys tems of the body.
T h e brain evo lved as a means of orchestrat ing adaptive
interaction between the o rgan i sm and the world . To achieve this
i t mus t maintain both an inward and an outward orientation,
moni tor ing and regulat ing the state of var ious internal sys tems,
while at the s a m e t ime responding to the flow of events in the
external wor ld . In fact, as well as p lay ing its part in monitor ing
the b o d y ' s internal milieu, the brain must control interactions
with two kinds of external environment .
I N T O T H E S I L E N T L A N D
Accord ing to Western intellectual tradition, which dist in
guishes between Nature and Cul ture , we have a cur ious , duplex
kind of existence. We m o v e in a natural realm of t ime, space ,
and matter and, concurrently, through a socio-cul tural d imen
sion of people and ideas , a wor ld saturated with cus toms and
beliefs, rituals, traditions, laws, convent ions, fashions, lan
g u a g e , arts, and science. In the f i rs t wor ld we are subject ,
ultimately, to the laws of phys ics and, in the second , to the influ
ence of cus toms, beliefs, rituals, t radit ions, etc.
An emerg ing theme in neu ropsycho logy is that, just as i t has
functional sys tems devoted to percept ion of, and interaction
with, the physical environment , so the brain has evo lved s y s
tems dedicated to social cogni t ion and action. It constructs a
model of the o rgan i sm of which it is a part and, beyond this,
a representation of that o rgan i sm ' s p lace in relation to other,
similar, o rgan isms: people . As part of this p roces s i t a ssembles a
' se l f ' , which can be thought of as the device we humans employ
as a means of negotiat ing the social environment .
T ight ly bound to l anguage , these brain mechan isms are the
channels through which b i o l o g y finds express ion as culture, a
means of distributing mind beyond biological boundar ies . But i f
culture is in this w a y an extension of b io logy , an important
question arises: must we also accept that neurosc ience has
boundaries which deny full access to an unders tanding of brain
function? In other words , is neuroscience adequa te to its pr i
mary task — unders tanding the brain — or, to tackle the ' b i g '
questions (relating to self-awareness and persona l identi ty)
must we turn to other forms of science and scholarship?
To achieve s o m e unders tanding o f M a r y ' s condit ion we are
51
P A U L B R O K S
obl iged to skirt these fuzzy boundar ies of b i o l o g y and society.
B e y o n d account ing for her illness in te rms of physical pathol
o g y and apprecia t ing its consequences at the personal level, we
mus t try to unders tand what mechanisms might be opera t ing at
the intersection of the b iological (the bra in) and the social (the
s e l f ) . A major chal lenge for neuroscience in the twenty-first
century will be to try to figure out how brains and selves go
together.
We build a s tory of ourse lves from the raw materials of lan
g u a g e , memory , and experience. T h e idea o f the 'narrat ive s e l f
has a l ong history, with roots in Buddhis t teaching. Accord ing
to the doctr ine of Anattavada, the self is no more than the
a g g r e g a t e of an individual 's thoughts , feelings, percept ions and
actions. T h e r e is no central core or ' e g o ' . D a v i d H u m e , in the
eighteenth century, took a strikingly similar line. For him, the
extension of the se l f beyond such momen ta ry impress ions was
a fiction. Danie l Dennet t has offered a contemporary version,
emphas iz ing the power of l anguage in g iv ing coherence to our
exper ience over extended per iods . Acco rd ing to Dennet t , the
se l f is bes t under s tood as an abstract 'centre of narrative
g rav i ty ' .
Confabula t ion is the inadvertent construction of an er ro
neous self-story, s ignifying the neurological breakdown of the
storyteller. I t takes different forms, somet imes mundane , s o m e
t imes fantastic. As in M a r y ' s case , i t is typically associated with
d a m a g e to the frontal lobes and is p robably due to a combina
tion of things. M e m o r y disorder is one ingredient. In particular,
confabula tors have p rob lems with contextual memory . T h e y
m a y retain the kernel of s o m e autobiographical event or
52
I N T O T H E S I L E N T L A N D
episode , but fail to anchor it in a specific t ime or p lace . Memor ies
drift loose , images coll ide.
T h e n there is disinhibition of associa t ions . Words , thoughts ,
and memor ies reach consc iousness through a p roces s of natural
selection. Fo r every item of awareness there is a mult i tude of
suppressed alternatives reverberat ing through the neural nets.
T h e confabulator 's theatre of consc iousness i s c rowded with
gatecrashers ( imaginary babies , magp ies , the number twenty-
four) . T h e reduplication of relatives or the creation of
imaginary children is a c o m m o n theme.
Finally, there is a dis turbance of the neuropsycholog ica l
mechanisms responsible for maintaining a distinction between
the external world and internally generated thoughts and
actions (falling into the frame of a seas ide pos tcard , you are
transported to the island of Majorca) .
I reach into the shadows behind the screen and retrieve a smal l ,
semi-transparent plastic bucket. I dip into the bucket and fish
out a human brain. I have no idea to w h o m the brain be longed .
I can't tell if i t ' s male or female, black or white, or, with any reli
ability, its a g e . I may even have passed this person on the street.
In its natural state, encased within the skull, brain matter is
gelat inous. T h i s brain, fixed in formalin, has a sol id , rubbery
feel and would carve like a very tender tuna steak.
It looks small and lacklustre after the br ight pictures on the
screen, but i t holds the interest of my audience. T h e end-of-
lecture rustling of papers s tops . All eyes turn towards the g r e y -
brown object as I point out the major landmarks . In te rms of
impart ing factual knowledge about the structure and functions
53
P A U L B R O K S
of the brain, the main pu rpose of my lecture, this little coda
adds nothing. Yet the students leave with something they
wouldn ' t o therwise have had: a clearer sense of the brain as a
b io logica l object; a physical m a s s as well as a textbook concoc
tion of co lours and neat abstract ions. I t will help them
appreciate the distinction between the brain and the self.
W h e n the A p o l l o as t ronauts went to the m o o n and brought
b a c k pictures of our planet of oceans and c louds hanging over a
g r e y m o o n s c a p e in the middle of a b lack nowhere, i t changed
the w a y we saw ourse lves . We knew already that we inhabited
the surface of a smal l , spinning sphere that rolled around an
ord inary star, a t the e d g e of an unremarkable galaxy, just one of
indeterminate bil l ions in a vast , indifferent co smos . But now,
occupy ing a few degrees of retinal space , comfortably absorbed
in the folds of the visual cortex, a mere port ion of the visual
f ie ld, we saw our h o m e in its true co lours . I t w a s precious and
vulnerable , a small fragile object , a thing we should take care of.
I t w a s , indeed, our h o m e . We might have extrapolated these
sentiments from the knowledge we already posses sed , but the
images set off an interplay of intellect and imaginat ion that
m a d e the new perspect ive irresistible.
Some th ing similar happens when y o u see a brain. Imag ina
tion infiltrates intellect. You get a sense of location and
vulnerabili ty. O u r home .
T h e hall empties , but a few students stay behind for a closer
look . T h e y want to touch it. A y o u n g w o m a n asks i f she might
hold the brain . She dons rubber g l o v e s and takes the specimen in
her cupped hands. T h e r e is wonder and apprehension on her
face . Y o u see this look on the faces of small children holding
54
I N T O T H E S I L E N T L A N D
caterpillars. A y o u n g man turns the brain over to examine its
unders ide. He picks at the s tump of a severed artery. Another
tests the weight , feeling the d rop of the object first in the left
hand then the right. He says i t ' s odd , but your head doesn ' t feel
this heavy.
Six months later Mary c a m e to the outpatients ' clinic. I t w a s
a routine follow-up. She did not remember me but , a l though her
m e m o r y was still poor , she had m a d e g o o d p r o g r e s s in other
areas. The re w a s no longer the prol ixi ty of speech or the f rag
mented attention that had characterized her behaviour before .
In particular, over a per iod of two hours of interviewing and
neuropsychological testing, I detected no s igns of confabula
tion. T h e n , work done , idly chatting as we wai ted for her
husband to collect her, I asked what p lans she had for the week
end.
' O h , ' she said. ' I ' d like to watch the b a d g e r s aga in . '
'Rea l l y? '
'Yes , in the f ield over the back wall . Y o u can see them from
the garden shed. ' She w a s look ing a t my name- t ag . ' B r o c k the
badger , ' she said .
Mary ' s husband arrived and they left together. I never saw
them again and I didn ' t ask him about the b a d g e r s at the bo t tom
of the garden.
Like the surface of the Ear th , the brain is pret ty much
mapped . T h e r e are no secret compar tments inaccessible to the
surgeon ' s knife or the magnet ic gaze of the brain scanner; no
mysterious humours pe rvad ing the cerebral ventricles, no soul
in the pineal g land, no vital spark , no spirits in the tangled
55
P A U L B R O K S
56
w o o d . T h e r e i s nothing you can' t touch or squeeze , weigh and
measu re , as we might the physical propert ies of other objects.
So y o u will search in vain for any semblance of a self within the
structures of the brain: there is no ghos t in the machine. It is
t ime to g r o w up and accept this fact. But , somehow, we are the
p roduc t of the operat ion of this machinery and its p rogress
th rough the physical and social wor ld .
Minds emerge from p rocess and interaction, not substance.
In a sense , we inhabit the spaces between things. We subsist in
empt iness . A beautiful, l iberating, thought and nothing to be
afraid of. T h e notion of a tethered soul is crude by compar ison.
Shine a l ight, i t ' s obv ious .
In the Theatre
In the days before brain scans i t w a s imposs ib le to locate
tumours beneath the surface of the brain with any precis ion.
Surgeons blindly poked a round in the soft t issues, caus ing
untold d a m a g e in the p rocess .
T h e poet-physician Dann ie A b s e wro te a p o e m , ' In the
T h e a t r e ' , in which he recounts a ha r rowing experience
described by his father, Dr Wilfred A b s e . I first read this p o e m
when I was a student and it raised the hairs on the back of my
neck. It concerns an ep isode that occurred in 1918 while A b s e
senior was assis t ing at a brain operat ion.
His voice introduces the p o e m . T h e patient, he tells us , i s
fully awake throughout the operat ion under a local anaesthetic,
while the fingers of L a m b e r t R o g e r s , the su rgeon - ' r ash as a
blind man ' s ' — crudely search for the tumour in the brain t issues
- 'all somewhat hit and mi s s ' . T h i s , s ays Dr A b s e , is one ope ra
tion he will never forget. T h e p o e m , and the operat ion, opens
with reassuring words for the patient:
57
P A U L B R O K S
58
Sister saying — 'Soon you' 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, fingering still;
his dresser thinking, '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.
I N T O T H E S I L E N T L A N D
T h e poem no longer chills me . W h y ? Perhaps I am a m o r e
sophisticated reader of poet ry n o w and see too clearly the
boards and backdrop of a me lod rama . But I don ' t think so. It is
obviously meant to be theatrical and , to my mind, conveys
authentic d rama . It is a fine p o e m . It still packs a punch. But it
doesn ' t unsettle me as i t once did.
Perhaps my experiences as a clinician over the years have left
me desensitized to human suffering or lacking appeti te for the
bizarre and extraordinary. I hope not, and don ' t think so.
Inevitably, one deve lops s t ra tegies for self-preservat ion.
Anyone who has worked with patients on acute hospital w a r d s
will tell you that you cannot resonate with every t remor of feel
ing, and that somet imes there are v is ions of horror and raw fear
that can only be observed obliquely.
Perfect, constant empathy in such c i rcumstances wou ld be
suicidal. But i t is less a p rocess of desensit izat ion than one of
becoming acclimatized. T h e r e is a difference. T h e former s u g
gests an atrophy of feeling, the latter is merely to b e c o m e
accustomed to different condit ions. W h e n the profess ional
facade slips in the presence of persona l suffering, as i t d o e s from
time to t ime, the pain still penetrates. A n d as for indifference to
the bizarre and extraordinary, the ve ry oppos i te is t rue. F r o m
where I stand, in early middle a g e , the universe l ooks as
myster ious and absurd as ever - human be ings especially. T h e
older I get the more astonished I am by the plain fact of my own
existence and consc iousness , let a lone s t range and dis turbing
neurological cases .
T h e reason the p o e m has lost its power to g i v e me g o o s e p i m
ples comes down, I think, to that word ' sou l ' . Fo r full effect it
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60
requires an acceptance, at s o m e level, that souls exist. Cons ider
the pivotal moment when, defenceless against the surgeon ' s
frantic fingers, the dy ing brain asserts itself: Leave my soul alone,
leave my soul alone. T h i s feels like the intrusion of a supernatu
ral force. Someth ing other than the brain, and something other
than the patient even, seems to have entered the scene. It is hard
to identify the vo ice with the soft mass of the inert brain, and it
is dis tanced from the patient, whose b o d y now becomes a ven
tr i loquis t ' s dummy, mouth ing w o r d s as if to the sound of a
cracked record. T h e y are w o r d s of despair. T h e eerie intruder
w a s reluctant to manifest itself, one feels, but had no choice.
N o w , i f you had asked me twenty-odd years ago whether I
thought there were such things as souls I would have said that of
course there were not. U n d e r g o i n g training in clinical and sci
entific disciplines, I wou ld have considered such talk to be
pr imit ive and pre-scientific. ' S o u l ' implied a spiritual substance
of s o m e kind, a mental essence or ego acting behind the material
scenes of brain structure and function, gu id ing and controll ing
and, i f you chose to bel ieve it, su rv iv ing the death of the body.
I t carried connotat ions of the supernatural , representing ideas
that I found at best misgu ided or intellectually inelegant, at
wors t sinister and re t rogress ive .
I t ook the v iew that the mind w a s the product of the brain in
its interactions with the physical and social world . I still hold
that view. T h e difference in my emotional response to the poem
then and now requires a more subtle explanation.
I think it has to do with a change in background intuitions, as
o p p o s e d to foreground beliefs. When I first encountered the
p o e m I explicitly denied the existence of souls , but there was a
I N T O T H E S I L E N T L A N D
part of me still begui led by the imaginat ive power of the term.
It feels natural to bel ieve that someth ing like a soul exists. It m a y
indeed be natural in the sense that evolut ion has shaped our c o g
nitive architecture in w a y s that p red i spose us to bel ieve in the
separation of mind and brain.
We live in a social as well as a physical wor ld , and negotiat ion
of our complex social environment requires the attribution of
mental states (feelings, beliefs, des i res , intentions) to ourse lves
and others, perhaps inevitably inclining us to bel ieve that the
world contains two sorts of stuff, material and immater ia l .
Dua l i sm m a y have deep evolut ionary roots . We all feel that, as
well as a brain, someth ing else occupies the interior of our head
and the heads of other peop le — an irreducible mental co re , the
origin of thoughts and actions. It is a primit ive belief, but it is
compell ing.
It may follow that a bel ief in souls (or implicit bel ief or half-
belief or quas i -be l ief ) is a necessary condit ion for o rd inary
human interaction. We v iew ourse lves as integrated mental
entities with an agenda of intentions and actions, authors of our
own destiny. In a mora l universe , pe rhaps that is the only con
ceivable w a y to v iew other people too.
All I can say is that now, when the b r a i n / s o u l / p a t i e n t p leads
Leave my soul alone, it s eems to me less like the intrusion of a
supernatural force. N o t h i n g has entered the scene. T h e r e is still
a desperat ion for survival , but this, I n o w see , emanates from a
stark no man ' s land between the muti lated t issues of the bra in ,
the sound waves of 'that voice so arct ic ' , and the horrified
response of the onlookers . T h e r e is horror still, but not super
natural horror.
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Perhaps , over the years , my immers ion in the rationalism of
clinical science has rusted those machineries of imagination
that genera te bel ief in supernatural souls — or half-belief or
quasi-belief . Perhaps this should wor ry me; I may have lost
someth ing . But I prefer to think that the screen between the two
doma ins — scientific unders tanding and primitive imaginat ion —
has b e c o m e m o r e transparent, a l lowing a clearer v iew in both
direct ions.
Certainly, I feel better able to cope with ambiguity. The re is
scientific rationality and there is imaginat ion. Somet imes they
coincide, and all peop le have elements of both. T h e poem
bet rays an ambigui ty about the reality of souls . T h e fearful
w o r d s crank out through the antique g r a m o p h o n e of the vocal
appara tus , blurr ing and s l o w i n g , ' . . . leave . . . my . . . soul. . .
alone...' - an i m a g e of a soul less mechanism - but they are said
to cease at last only 'when something other died'.
S o , it doesn ' t chill me as it used to, but I feel another response.
Behind the horror I see m o r e clearly now there is also pity. T h e
brain thinks i t ' s a soul . T h e r e is real pa thos in that.
I m a y not bel ieve in souls , but I still find brain surgery discon
certing, and this is partly why A b s e ' s p o e m retains some of its
original power . T h e experience of witnessing an operation on
the brain is, in certain respects, quite different from other kinds
of surgery. Al l surgical procedures are invasive, but neuro
surgery s eems like the ult imate intrusion. In abdominal and
cardiothoracic operat ions you see the surgeon bur row into the
pat ient ' s body, expos ing the inner work ings - the pumps , the fil
ters, the p ipes , the va lves . I t can be shocking, but we have this
w a y of separa t ing ideas of 'the pe r son ' from what i s happening
62
I N T O T H E S I L E N T L A N D
to 'the person ' s b o d y ' . T h e person , one tends to imag ine , i s
elsewhere dur ing the invasion of her innards; she has with
drawn to a safe , anaesthetized place ( somewhere in the head,
our intuitions tell u s ) .
It is a different matter when the contents of the skull are open
for inspection and prey to the su rgeon ' s knife. T h e r e can be no
question of any ' re locat ion ' to another part of the body. I t
would be absurd to think of the ghost ly se l f retreating to s o m e
other o rgan or l imb. At the same instant one unders tands that
there is, of course , no ghos t ly self in the first p lace . W h e n we
see the brain we realize that we are , at one level, no m o r e than
meat; and, on another, no m o r e than fiction.
T h e same insight — at once mundane and myster ious — is a
potent element of the f amous Zapruder footage of the Kennedy
assassination. Recall the images and you will k n o w what I mean .
Jackie Kennedy in the Da l l a s sunshine, in her pretty pink, pil l
box hat, scrambl ing to retrieve the debris of her husband ' s
shattered head from the back of the l imousine . She finds a piece
of something and tries to replace it. Or so i t appears . Wha t g r im
desperat ion; what appal l ing intimacy.
T h o s e g l impses o f naked brain are an epiphany. T h e Mos t
Powerful Man in the World , smil ing immorta l ly and w a v i n g to
the c rowds just now, has had the top of his head b lown away. I t
is not just that he, like all of us , is vulnerable , or that his phys i -
cality is so brittle. N o r is i t even the suddenness of his transition
from human be ing to inert substance. Wha t locks these i m a g e s
into place is the exposure of the g rey-p ink brain. If that is what
T h e Most Powerful Man in the World can be reduced to, i f that
is what he is, then there is no hope for the rest of u s . We knew it
63
P A U L B R O K S
64
anyway, but our awareness of the fact is intensified by the drama
and the mythic status of the actors . T h a t is the horror of the
f i lm. A n d when you watch, do you not sense a f l icker of self-
pi ty? Desp i t e myself , I fear for my soul .
A-Z
A former neurosurgeon co l league , recall ing his training days ,
has a s tory about walk ing through the streets of L o n d o n with a
fellow student of surgery. His friend s topped , mid -conve r sa
tion, evidently troubled. T h e y had reached a small s ide street.
T h e man was b e c o m i n g agi tated and kept look ing up a t the
street name.
' T h i s street, ' he sa id , ' is not in the A - Z . '
A n d i t wasn ' t . T h e y checked. T h e wou ld -be su rgeon had a
remarkable visual memory . For no part icular reason he had set
himself the task, successfully accompl i shed , of memor iz ing the
entire A - Z street m a p o f L o n d o n . A n d now he had s tumbled
upon a mismatch. T h e m a p of his imagina t ion wou ld have to be
amended in one small detail, enough to make it superior to the
published vers ion.
His problem though (and ult imately what barred his w a y to a
career in neurosurgery) w a s that his exceptional power s of v i s
ual imagery were exceptional only in two d imensions . A m o n g
other attributes of intellect and temperament , the pract ice of
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P A U L B R O K S
66
neurosurgery demands an ability to think in three dimensions.
T h i s man w a s like Mr Squa re , the lowly, two-dimensional
character in Edwin A b b o t ' s nineteenth-century satirical tale
Flatland: A Romance of Many Dimensions. Mr Square has no
inkling of a geome t ry beyond the plane of Flat land until, one
night, he is visi ted by L o r d Sphere , a be ing from the land
of three d imens ions (appear ing to him as a circle, magical ly
chang ing shape ) . Fa i l ing to convince by explanation, L o r d
Sphere peels his humble acquaintance from Flatland and f l ings
him into Space land , p rov ing that there is, indeed, a world of
three-dimensional objects . It is a revelatory, l ife-transforming
experience. But , of course , on his return, he fails miserably to
pe r suade his fellow Fla t landers of the existence of this other
wor ld and the H i g h Priests (who are circular) condemn him as a
d a n g e r o u s heretic.
T h e trainee su rgeon ' s A—Z of the brain lacked the necessary
third d imension . He wasn ' t able to inhabit the metropol is of the
brain in the w a y a neurosurgeon must .
N e u r o p s y c h o l o g y requires four d imensions . At least.
The Mirror
Judy gets home from work . She pou r s herself a mart ini , pu ts a
record on the hi-fi and d rops into a soft leather chair. God s h e ' s
t i r e d . . . She s leeps. A n d y can read the bed t ime stories . T h e little
girl kisses her s leeping mother and, reluctantly, g o e s to bed .
When J u d y wakes , the r o o m is semi-dark . She sits bol t
upright and flinches from the pain in her head. T h e r e is no
music . She tries to fix her posi t ion. I m a g e s of the dai ly routine
tumble together: get up, go to work , c o m e home . A cat stretches
on the back of a chair by the window. T h e r e is enough of the
fading light to br ing its g inger fur to life. But J u d y ' s cat is a
tabby.
An unfamiliar man enters the r o o m : late midd le -aged , g r ey
hair. He gl ides by, g lanc ing briefly in her direction, and switches
on a lamp in the corner. It casts a cone of light upwards to the
ceiling.
' D i d you say something , J u d e ? '
N o w that the light is on she sees that the r o o m is a lso
unfamiliar.
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P A U L B R O K S
68
Where am I? Who is this?
J u d y has a habit of twist ing and pull ing at her wedd ing ring
when s h e ' s s t ressed. T h e r ing has g o n e .
' J u d e , ' the m a n says , ' I don ' t k n o w what you ' re on about . '
She is ask ing for her daughter and husband. T h e man leaves and
a w o m a n enters. She kneels by the s ide of the chair and takes
J u d y ' s hand. I t ' s a gent le interrogat ion.
' I ' m J u d y Jenkins . I 'm thirty-nine — and I don ' t know where
the b l o o d y hell I am! '
But she k n o w s the year: 1976.
T h e Pr ime Minister? ' H a r o l d Wilson . '
T h e man ' s vo ice breaks in, but J u d y cuts him short.
' D o n ' t tell me I 'm get t ing mixed up! ' she snaps . ' I know what
year it i s . '
N o w h e ' s in front of her ho ld ing up a newspaper , pointing to
the date at the top of the p a g e : Saturday, 10 April 1999. A shaft
of log ic breaks the frame.
'Fetch me a mirror . '
* * *
1999 'And then I sa id , "Fetch me a mirror ." I said I 'd be an old w o m a n
in 1 9 9 9 . . . ' S h e ' s tell ing me the s tory again . I t must be the fourth
or fifth t ime. I 'm not really l istening. I don ' t need to. I t ' s the
s a m e story.
T h e neuroscient is t Michael Gazzan iga quotes John Updike
and Ra lph Waldo E m e r s o n : 'A thread runs through all things:
all wor lds are s t rung on it, as beads : and men, and events, and
life c o m e to us , only because of that thread. ' In other words
I N T O T H E S I L E N T L A N D
( says Updike) our subjectivity domina tes outer reality, ' and the
universe has a personal structure ' .
Accord ing to Gazzan iga , the brain has a dedicated sys tem for
binding the s trands of a mult i tude of special ized brain modu le s
into a single thread of personal experience. He calls it ' the Inter
preter' and locates it in the left cerebral hemisphere . T h e
Interpreter identifies patterns of connect ion between disparate
brain sys tems and correlates these with events in the external
world. T h i s g ives unity and continuity and enables each of us to
create a personal life story.
J u d y ' s mirror arr ives. She sees that her face is wrinkled and
gaunt , her hair short and grey. It must be a dream, she thinks. I t ' s
too much to take in all at once . She panics and tries to s tand, but
her left leg is para lysed by the s troke. She loses consc iousness .
When she wakes there is a man leaning over her, p ress ing a
mask to her face; a soldier perhaps , though his uniform is too
gaudy for the military. She senses movement and vibrat ion and
recognizes the sounds of an engine g o i n g through the gea r s . She
is in some kind of vehicle.
'Take i t easy, Judy, ' says the man in uniform, ' you ' re g o i n g to
be just fine. '
The re are red and g rey blankets and cylinders , tubes and
leads, plastic boxes , instruments with dials , and other i tems of
equipment. A n d there, sitting oppos i te , is the grey-ha i red man .
He leans in closer to her. ' W h a t ' s that? ' he asks .
' H a s anyone told A n d y ? ' she mumbles .
T h e erasure of twenty-three years i s remarkable enough .
J u d y ' s personal life over that per iod is a comple te blank. She can
only comprehend the bit terness of her d ivorce from A n d y in the
abstract, and the grey-ha i red man, with w h o m she has been
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P A U L B R O K S
70
l iv ing for the pas t eighteen years , is a stranger. T h e same goes
for public events. ( 'Margare t T h a t c h e r ? ' ) But equally striking is
the w o r k of J u d y ' s Interpreter, her teller of tales. Its s t ruggle for
continuity is heroic . With nothing else to hand, i t reaches back
m o r e than two decades to find material for a story. It br idges
the twenty-three years as if they were twenty-three minutes.
* * *
2002
'And then I sa id , "Fetch me a mir ror" . . . '
Beaten into submiss ion by the logic of an unknown present,
p lus the irrefutable evidence in the mirror, J u d y ' s Interpreter
has reset the c lock and set about the bus iness of regulat ing a
different life. Very little m e m o r y has returned, but things are
g o i n g fine with the grey-ha i red man, and J u d y is a grandmother
now.
T h i s kind of amnes ia is extremely rare. I have come across
only one other case that bears compar i son to J u d y ' s . Tha t
patient, too, m a d e an astonishingly smooth adjustment to her
new ci rcumstances . H o w resilient peop le are. I f one day you
woke up to find that y o u had been t ransformed into a gigant ic
insect, the chances are you wou ld just get up and carry on with
your new life.
* * *
2003
'And then I sa id , "Fetch me a mir ror" . . . '
The Visible Man
As J a m e s M o o n awoke one m o r n i n g after dis turbing d reams , he
found himself t ransformed into an anatomical i l lustration. He
rose from his bed thinking all w a s as i t should be and headed for
the ba throom, the first routine act of another routine day. But ,
looking in the mirror, he noticed that the d o m e of his head had
become transparent.
The re , bathed in a g l o s s y light, w a s his brain, look ing like a
vivid picture from the p a g e s of a tex tbook or a h igh-resolut ion
computer graphic . T h e outer surfaces , the grea t convoluted
lobes of the cerebral hemispheres , were rendered in pastel
shades with sculptural clarity: compac t , rounded , so l id , with
sharp contours defining the major anatomical d ivis ions .
T h e frontal lobes (pa le m a u v e ) were packed just behind the
forehead. T h e temporal lobes (powder blue) we re to either s ide
at the level of the ears . A b o v e and somewhat behind these were
the parietal lobes ( champagne ) and, at the back , the occipital
lobes ( j ade) . T h e n , as you wou ld expect , there were cu taway
views from the s ide , from above , and face-on, reveal ing s t ruc-
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P A U L B R O K S
tures deep beneath the surface. T h e s e were coded with bolder
co lours : cobalt b lue , lemon, cherry red, o range , purple .
T h e closer he looked, the more J a m e s saw. N o t just the bulb
ous , fruit-like forms of the putamen and the g lobus pall idus, and
the flat-topped oval of the thalamus at the centre, or the
sweep ing , overarch ing curves of the fornix and the caudate. But
there, like bright clusters of je l lybeans, were the s u b c o m p o
nents of these structures: the pulvinar, the lateral geniculate
body, the dorsomedia l nucleus. He did not yet know the names
of these things, but he would .
Of course, it's a dream, he thought , I'm still asleep. But the
mundane objects of the ba th room s tood in their usual places
and on the sill w a s a copy of yes te rday ' s newspaper , just as he
had left it, a picture of a w o m a n smil ing on the front page . Wind
and rain beat agains t the w indow pane . He would seek advice
without delay.
S o , lit tering c rumbs of breakfas t toast as he went, J a m e s
g r a b b e d his hat (a g reen canvas one like anglers wea r ) , s lammed
the front door behind him, and set off for the medical centre.
O n e corner of the wai t ing r o o m w a s partit ioned as a chil
dren ' s p lay area. I t w a s strewn with soft toys and plastic bricks in
p r imary colours . A small child sat in the middle , t ugg ing a string
from the back of a p ink doll .
' I ' m so happy, ' said the doll . T h e child chuckled as the string
slid b a c k inside.
All the while G r e g knew that, beneath the hat, his head was
still g l o w i n g like the aurora boreal is . And wouldn't that amuse the
child, he thought . He resisted the temptation, however, and was
soon called through.
72 •
I N T O T H E S I L E N T L A N D
73
' H o w can I he lp? ' said Dr Vesal ius .
J a m e s removed his hat. 'Wel l? ' he asked. ' H a v e you ever seen
anything like i t? '
T h e mult icoloured radiance seemed brighter than before . I t
shone like a halo. If Dr Vesal ius w a s shocked he didn ' t show it.
A true profess ional , he just leaned forward, p ress ing together
the tips of his fingers.
'Yesterday all was well , ' J a m e s explained. ' T h e n this m o r n
ing I wake up to find my head transparent and my brain a
f i r e w o r k d i s p l a y '
' I see , ' said Dr Vesalius. He said he would make a r r ange
ments for J a m e s to meet a specialist .
On the w a y out there was another child p lay ing with the dol l .
She pulled gr imly a t the str ing. ' I ' m so happy. I 'm so h a p p y . . . '
the doll kept saying , though the child w a s not amused . J a m e s
lifted his hat briefly, but it m a d e no difference.
* * *
What had caused those nightmares? T h e prev ious evening,
J a m e s had eaten a light supper and drunk no more than a finger
of whisky. Bored with T V , he had searched for something to read
and found an old illustrated encyclopaedia , which he took to bed .
Idly turning the pages , he came ac ross a picture of a rock
pool . He remembered i t well from his chi ldhood. T h e water w a s
clear as g lass . B lue-grey rocks thrust up th rough a bed of
smooth pebbles and sand towards a summer sky. A b o v e the
water-line there were barnacles bak ing in the sunshine, a few
limpets and whelks — snail-like things with curly shells.
P A U L B R O K S
74
Musse ls clustered and tumbled through the f i lmy surface of
the water and into the psychedel ic world below, which was
b r i m m i n g with all kinds of life: crabs and shrimps, s lugs and
starfish, sea anemones , spindly prawns , and gr im-faced little
f ishes dar t ing th rough the b ladderwrack and brown seaweed. I t
still fascinated him, still d rew him into the scene, but not quite
th rough the p a g e and into the water as before .
L o o k i n g at the picture now, through adult eyes, was oddly
dis i l lusioning. He had often walked a long the beach at low tide
and had yet to find a rock pool so stuffed with life and colour.
But i t wasn ' t just disi l lusionment. T h e r e was something else
equal ly unsett l ing. He closed the b o o k and w a s soon asleep.
In one d ream he found h imsel f tightly bound , head to toe,
scarcely able to breathe. Aware of a sl ight swaying motion, he
had the sense that he w a s l odged high in the branches of a tree or
suspended in a net of s o m e kind. T h e r e w a s a nauseat ing jolt,
and another, as if he were be ing d r a g g e d a long like coal in a
sack . O n e part icularly violent jerk pulled the binding from his
eyes and what he saw wrenched his gut .
Wha t had appeared to be the shadow of a black awning
turned out to be the bel ly of a mons t rous spider. He tried to
b reak free, but i t w a s use less and he w a s soon embraced by the
beas t ' s s laver ing maw. T h e r e w a s no pain, just warmth and
mois ture . As the b o n d s b roke he saw his own disintegrating
b o d y : his segmented b rown belly, his six trembling legs , the
m e m b r a n e s of his buckled wings . He called out, but his voice
w a s a twittering squeak .
A n d now this. J a m e s stared, without expression, a t the
mirror , then sank into an armchair . He felt inordinately weary.
* * *
I N T O T H E S I L E N T L A N D
It was dark when the doorbel l rang . A pastel g l o w fol lowed
J a m e s down the d ingy hallway, reminding him of the state of
his skull. He took the f isherman's hat f rom the coa t -hook and
placed i t on his head before opening the door . T h e r e s tood
Millie, in a swirl of rain and autumn leaves .
She had brought with her two b a g s full of b o o k s , which she
was now stacking up on the kitchen table.
' T h e s e are from the library, ' she sa id , ' a s reques ted . ' A m o n g
others, there w a s a medical textbook, an atlas of neuroanatomy,
and a mass ive tome called Elements of Cognitive Neuroscience.
'And this one I bought . ' She handed over a s l im paperback :
Neuroscience for the Brainless.
T h e y sat a t oppos i te ends of the so fa , Millie with a r m s
folded, J a m e s g r ipp ing the br im of his hat. She w a s look ing
away as she spoke: ' A l l right, keep i t on . ' Her cheeks were red.
After unpacking the b o o k s she had chased J a m e s a round the flat,
snatching at his hat. It was a g a m e at first, she thought , but then
he shouted at her to leave him a lone . T h e y sat in si lence.
'Okay , ' he sa id , ' I ' l l take it off.'
T h e delicate spray of light danced about his head and he
wondered why he should have been so coy with Millie. W h y
should she not see this mos t enchanted part of h im, this magica l
wellspring - the source of his thoughts , his hopes and beliefs,
and of his love for her?
'Well, ' she sa id , 'what w a s all the fuss a b o u t ? '
He might have been compar ing fossil spec imens or s emi
precious stones. ' T h e co lours are different, ' he noted, 'but the
shapes are the s a m e . '
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P A U L B R O K S
76
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 shim
mering 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 hind-
brain. 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-RYE-
etul), 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).
I N T O T H E S I L E N T L A N D
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 was plain to see that his brain w a s a physical mass ,
like a hand or a foot, J a m e s found the compar i son of brain and
fist mildly disconcert ing and soon returned to obse rv ing the real
thing.
I t was Mil l ie 's idea to go to the Chinese restaurant. J a m e s
wore a baseball cap.
'You need to get yourse l f out of yourself , ' she sa id .
T h e y drank white wine and J a m e s b e g a n to unwind. He even
squeezed her knee under the table.
' I t ' s go ing to be all r ight, ' he said on the w a y home . 'You ' l l
see . '
T h i s be ing a Friday, Millie s tayed the night, but w a s too tired
to make love .
* * *
T h e dawn light seemed to g r o w in s teps as i f the Ear th ' s rotat ion
had developed a fault. J a m e s lay l istening to the rain, d ipp ing in
and out of sleep. Millie lay bes ide him. He watched her d r e a m
ing through the blind saccades of her l idded eyes . H e r brain w a s
in darkness , but the d reams , no doubt , were as br ight as day.
He must have drifted off again because , next, he w a s aware
of the smell of fresh coffee. Millie had been out for cro issants
and newspapers . J a m e s didn ' t think his brain w a s a sight for
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P A U L B R O K S
78
the breakfas t table and remembered to put on his hat before
g o i n g th rough to the kitchen, but Millie, through a mouthful of
croissant , told him instantly to take it off.
She returned to her newspaper . He picked up the medical
textbook, scanning the list of contents as if reading from a
menu: Dementia; Cerebrovascular Disease; Hydrocephalus;
Epilepsy; Extrapyramidal Disease; Cerebral Tumours; Demyeli-
nating Diseases; Diseases of the Spinal Cord; Motor Neurone
Disease. T h a t ' s just Neu ro logy . N o t even half of Neuro logy .
T h e n there ' s Cardiovascular Disease; Endocrine Disease; Haema-
tological Disease; Gastrointestinal Disease; and Cancer.
He w a s impressed by the myr iad forms o f demise . G o d was
an inventive des t royer as well as an artful creator. It had never
occurred to J a m e s that the work ings of the b o d y could break
down in so m a n y w a y s . But his condit ion was nameless .
He had two mir rors now, us ing them in combinat ion for the
difficult s ide and rear v iews , and was t rying to match the text
b o o k d i a g r a m s with the polychromat ic contours of the object
filling his head.
' I t ' s a beautiful machine, ' he said a loud , though there was no
one else a round. Millie had left him to it. ' O r is it a p lace? '
T h e b o o k s differed in emphasis . S o m e were concerned with
sys t ems and functions, others , especial ly the atlas of neuro
anatomy, concentrated m o r e on the bra in ' s geography,
conjur ing s t range undula t ing landscapes . C o m b i n i n g the differ
ent images , J a m e s pictured a metropol is , at once futuristic (full
of mys te r ious machines) and ancient (the Greek and Lat in
names evoked classical t imes) . Seen this way, his brain became a
labyrinthine structure with vaults and chambers , floors and
I N T O T H E S I L E N T L A N D
screens, columns, pa thways , b r idges , canals and aqueducts , with
streams of information flowing in every direction. Am I in there
or out here? he wondered .
'Am I out here or in there? '
First the thought, then the words . T h o u g h t . Speech .
Though t . Speech. Al ternat ing be tween the two, eyes fixed on
the image in the mirror, he noticed a pattern, an ebb ing and
f lowing of activity on the outer surface of the left frontal lobe .
As he spoke, the soft m a u v e luminescence seemed to harden
momentari ly into a brighter g laze that d i sso lved as the ut terance
s topped. L o o k i n g closer, he saw s t rands of light cas t ing back
and forth between the frontal area and the blue recesses of the
temporal lobe. A n d w a s that a fainter pu lse , deep down? Prob
ably the thalamus, he thought, consul t ing 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 more perplexed he became . He began to feel
detached from his brain — a remote observer . It acquired the
aura of something alien, an object quite separa te from him. He
would concentrate on a patch of colour or listen to a sound
or perform an action or think a thought — Elephants are large
mammals. Six sevens are forty-two. Democracy is a good thing. I
love Millie — and there, plain to see , were the correlated brain
patterns.
But the activity associated with thoughts and act ions w a s not
the same as his consc ious awareness of those thoughts and
events. H o w could i t be? He w a s look ing in from the outs ide ,
like watching goldfish in a bowl . Goldfish and o n e ' s percept ion
of them are not the s a m e thing. T h e m o r e he gazed upon it, the
more J a m e s felt that he w a s someth ing other than his brain.
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P A U L B R O K S
80
A n d where do thoughts and feelings c o m e from? Not me, he
thought , because he saw that every fluctuation in the f low of
experience, every intention and action, w a s anticipated by d is
tinct t remors of activity ac ross the bra in ' s surface. It was not a
case of thinking or do ing someth ing and watching the brain
follow step or dance in synchrony. His brain was ahead of him.
Ideas were bubbl ing up in the neuronal cauldron a g o o d half-
second before they appeared in consc iousness , even thoughts
about thinking thoughts , and thoughts about thoughts about
thinking thoughts . So who w a s stirring the mental broth? A n d i f
he were a mere spectator, what exactly was his vantage point?
But then, just as a d rawing of a cube seems to change per
spect ive , continually j umping inwards and outwards , he would
switch to a different view. T h e object in his head would absorb
and begui le him, and he wou ld identify more closely than ever
with its work ings . That's it, he thought. That's what I amount to.
This is my sum total. There is no one stirring the broth. The func
tions of the brain have a life and logic of their own. Thoughts,
feelings, and intentions produce me, not the other way around.
He c a m e to the conclus ion that he was neither in there nor out
here. Bo th perspect ives were false. He wasn ' t anywhere.
In the evening J a m e s and Millie went to the cinema. J a m e s
kept his hat pul led firmly down. It w a s hardly the place to have
o n e ' s head blaz ing like a beacon .
* * *
A v a g u e curiosi ty d rew him back to the encyclopaedia . There
w a s someth ing w r o n g with the rock poo l , he was sure . T h e
I N T O T H E S I L E N T L A N D
plants, pebbles , and fishes were d isplayed as t reasured objects in
a g lass case , the exhibits separa ted evenly one from another in a
perfectly il luminated three-dimensional space . T h e artistry w a s
calculated. T h o s e beautiful things were intended to be m e m o
rable. He knew he would have no difficulty recogniz ing a rock
goby if ever he saw one, or a cushion starlet or a chameleon shrimp.
Yet, a l though the picture w a s c r a m m e d with information,
he could appreciate what w a s lacking. T h e r e w a s no sense of
process or behaviour , nothing of the s t ruggle for existence in the
world-between-t ides. O n e did not see the mons t rous d o g whelk
devour ing the barnacles or bo r ing into the shell of a mussel to
suck out its innards, or the invisible a lchemy of the seaweeds ,
absorbing sunshine, synthesizing foods from water and carbon
dioxide, releasing l ife-sustaining oxygen into the water.
T h e scene w a s altogether too benign . A rock pool is , in
reality, a precar ious place . To survive is to mesh with complex
networks of behaviour and intricate pat terns of phys ics and
chemistry, all shaped minutely by the ebb and flow of the tides
and the rotation of the Ear th . T h e life of the rock poo l is a
fragile product of the microscopica l ly small and the as t ronomi
cally large.
But that was not it. I l lustrations only ever g i v e a snapshot .
He reached for one of the shiny new textbooks and set i t
a longside the encyclopaedia . T h e brain pictures were bright ly
coloured like the rock pool and, in the s a m e way, were con
cerned with categorical clarity: this little fishy is the hippo
campus, this the medulla, this the cerebellum. T h e creatures
f loated in suspension beneath the rippling surface of the cortex.
T h e f low of time had s topped. T h e r e w a s no hint o f dynamics
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P A U L B R O K S
82
at the mic roscop ic level or of forces in the world beyond
the b o u n d a r y of the skull, both of which shaped the activity of
the brain, just as the life of the rock pool was shaped by photo
synthesis and the gravi tat ional influence of the moon .
I t w a s then that an uns teadying thought s w u n g into J a m e s ' s
head . He watched i t d rop from the frontal cortex and circle the
l imbic lobe . A brain, like a rock poo l , he realized, is a lso a most
precar ious habitat. T h e life of the se l f depends absolutely on
the integrity of brain function.
A n d then he saw what i t w a s about the rock pool that really
t roubled him. T h e r e w a s a creature he hadn' t noticed before, a
squat , sp idery thing, du l l -grey and ug ly compared to the rest.
It lay beneath a brittle star, part hidden by a curtain of brown-
weed and the c laws of a shore crab. T h i s little fellow didn' t figure
in the key. It d idn ' t have a number. Perhaps it had crawled
from behind a rock. Perhaps the picture had other dimensions
after all.
He looked at the mirror, into his brain. A n d there i t was , the
sp idery thing.
* * *
Dr S t roop ' s office on the fourteenth f loor of the Distr ict G e n
eral w a s a shambles . T h e r e were box f i les , case notes, books
piled all over the p lace , and cardboard boxes full of other stuff.
On top of the f i l ing cabinet, caught in a shaft of late afternoon
sunlight , w a s a plast ic mode l of the brain, somewhat larger than
l ife-size. Its co lours s eemed to f i l l the r o o m and J a m e s felt
uneasy sit t ing near to it.
I N T O T H E S I L E N T L A N D
' I f ind that mos t people try to ignore it,' he sa id , rol l ing his
eyes upwards , 'but i t must be of s o m e profess ional interest to
you . '
' O h , what ' s that? ' asked Dr S t roop .
' T h e colour cod ing i s much the s a m e as yours . Do you
mind? ' J a m e s lifted the plastic brain from its stand and ran his
f ingers over the surface. ' T h e frontal lobes are quite similar, and
the parietal, but my temporal lobes are blue and these occipital
lobes are a darker shade of green . '
He leaned forward for Dr S t roop to get a better view, but the
doctor didn' t seem very interested. Ra i s i ng his eyes , J a m e s
caught him looking at his watch. He wou ld have asked him
about the spidery thing — perhaps he wou ld be able to identify it
— but could see that he was well behind with his clinic and didn ' t
want to cause further delay. Br ing ing the consultat ion to a c lose ,
Dr S t roop muttered someth ing about 'd iagnos t ic inves t iga
tions ' and said that a r rangements would be m a d e for a brain
scan. Hardly necessary in my case, thought J a m e s .
T h e next t ime they met, Dr S t roop had a s o m b r e look , but he
spoke kindly.
' D o you have anyone with y o u ? '
' N o , ' said J a m e s . T h e doctor asked him to sit down .
'We have your pictures, ' he said with an uncertain smile . He
slid a large square film under the clip of a wal l -mounted light
box and flicked the switch. T h e i m a g e of J a m e s ' s brain w a s
monochrome and murky, except for one feature. C o u l d that be
the spider, sitting p lump and bright in the middle? If so , i t had
been busy. Skeins of cobweb spread like the w ings of an angel ,
one into the right hemisphere , and one into the left.
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P A U L B R O K S
'Wha t i s i t ? ' sa id J a m e s .
'A butterfly g l i oma . '
T h a t sounded rather beautiful.
'A tumour. '
T h a t evening as he splashed water on his face, J a m e s noticed
someth ing in the pa lm of his cupped hand, or rather something
about it. It w a s the left hand. T h e skin w a s paler, like g reasep roo f
paper . T h e r e were shapes beneath: t racings of tendons, bones ,
and b lood vesse ls . He inspected the rest of his body. His a rms
and l egs looked f ine , as did his chest and abdomen. He turned
his penis left and right and lifted it to see the unders ide . He care
fully checked the soles of his feet. Every th ing seemed normal .
T u r n i n g a w a y from the mirror, he looked across his shoulder
and saw that his lower back w a s translucent. Spinal column,
pelvic bones , and ribs were clear to see . A n d parts of the inter
nal o rgans : s tomach , liver, intestines.
He w a s s truck by h o w densely packed they were , not f loa t ing
l oose like odd - shaped ba l loons as they somet imes appear in
tex tbooks . But the colours! T h a t couldn ' t be right: ice-blue
s tomach , c r imson liver, o range intestines, and the bones were
white as a ghost - t ra in skeleton 's .
I t d idn ' t s top there. T h e fol lowing m o r n i n g he sat once more
with his mi r rors and b o o k s . I t w a s odd that he hadn ' t noticed the
butterfly w i n g s before , but hav ing seen them on the brain scan
picture and k n o w i n g exactly where to look , he could now trace
their outl ine.
Butterfly glioma c a m e under Cerebral Tumours in the medical
tex tbook. T h e p r o g n o s i s w a s poor , but how fortunate he was
84
I N T O T H E S I L E N T L A N D
to have been spared the psychiatr ic s y m p t o m s that, accord ing
to the book , were often associated with such growths . Hi s
thoughts turned to Millie. An image of her face shone as br ight
as stained g lass in his m ind ' s eye . Where w a s that, exact ly?
Neither in there nor out here. A n d where exactly w a s Millie? Was
it days or weeks since he had seen her?
'Millie, where are y o u ? ' he called out.
' I 'm right here, J a m e s , ' came the familiar vo ice . He could see
her now, in the mirror. ' L o o k , ' she said . He saw beneath her
naked breast a beat ing heart, all bright co lours .
Millie faded. His reflection w a s all that remained. S ta r ing
hard into the mirror, his face somet imes a s sumed a sinister
aspect. With no discernible change in express ion, i t suddenly
f i l led with menace and contempt. He wou ld cover his eyes and
shake his head to break the spell. But this t ime he w a s s low to
react. T h e malice surged from the mirror and poured th rough
his helpless eyes. It breached the wall of the retina and hurtled
down the visual pa thways deep into his brain. He felt it. He
watched it all the way.
T o o late. He was gone . N o w there was no face in the mirror ,
or rather there were remnants of a face. T h e r e w a s nerve and
muscle , bone and cart i lage, l idless eyes and skinless l ips.
Abstract shapes . L igh t and shade .
He had searched in vain for a scintillating rock poo l . T h e
ones he found were bleak puddles compared to the picture in the
encyclopaedia. N o w J a m e s s tood naked a t the e d g e of the sea ,
the bones of his skeletal toes submerged in d a m p sand , his skele
tal hand outstretched against white waves and g rey c loud , salt
spray fresh in his transparent nostrils. T h e chill of the water
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P A U L B R O K S
l app ing at his ankles shot neuronal needles to his testicles, half
p leasure , hal f pain. He spread his fingers for inspection — white
b o n e , skin, musc le , veins — then bunched them into fists.
' I am J a m e s M o o n , the Visible Man! ' he said in a half-shout
that w a s swept away by the ocean wind the moment the breath
left his t ransparent l ips. ' T h i s is what I am! '
H i s thoughts leapt and curled within the folds of his brain.
Sharp as lasers , they were cas t ing shadows across the sky.
86
TWO
The Spark in the Stone
I Think Therefore I Am Dead
I am sitting alone in the small seminar r o o m on the tenth floor.
Th i s is known as ' H a r r y ' s r o o m ' . I am at the head of a l ong oak
table, working at a laptop computer . T h e d o o r is at my back and
the single window at the other end of the r o o m sheds a thin,
early evening light. T h e r e are glass-f ronted oak cabinets a long
the walls , left and right. On the shelves are rows of d isplay jars
containing specimens of human brain, each suspended in a
liquid the colour of watery p iss . T h i s i s H a r r y ' s collection. T h e
specimens are ar ranged accord ing to pa tho logy : tumours , ce re
brovascular d isease , degenera t ive d isorders , and so on. T h e r e
are whole brains, hal f brains, and parts of brain, sl iced and s e g
mented. C l o s e to my right shoulder, there swims a cerebel lum.
T h e r o o m is ineffably still. A m o n g the relics of natural
disease and degenerat ion sit three vic t ims of unnatural v i o
lence. Thei r stories intertwine. T h e f i rs t bra in w a s caught with
the second bra in ' s wife and was dispatched with a pistol shot to
the back of the head. After put t ing an end to its wife, the second
brain f inal ly dispatched itself. T h e w o m a n ' s brain, third in line,
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P A U L B R O K S
90
comple tes the set. He r s is perfectly intact. She go t it in the heart,
accord ing to Harry. I once told him I thought she might have
been better p laced between the other two, to keep the rivals
apart .
' E v e n in death, ' I sa id , ' you can sense their contempt for one
another. '
I t didn ' t seem to wor ry him. A n d , anyway, I wondered, what
w a s she do ing here? Her brain didn ' t illustrate a pa thology of
any kind. H a r r y ' s response w a s that she exemplified the normal ,
intact brain. He wouldn ' t concede that in displaying the speci
mens in this w a y he had also created a tableau, showcas ing the
fickle heart as much as the fragile brain. Al l the same , it was a
tale he seemed fond of telling.
T h e material substance of the brain was bread and butter to
Harry, a neuropathologis t , but not to me . I remember the
ambiva lence I felt when I first held a human brain in the palm of
my hand, the fascination but a lso the distaste. I was surprised,
and m o v e d , by how heavy i t was . Perhaps a part of me had
expected it to be weight less , like a mental image or a train of
thought . I w a s eager to confirm for myse l f that the internal
s tructures matched the familiar textbook pictures but, s o m e
how, felt disinclined to start cutting. I imagined the wor lds it had
created: sky, c louds , peop le , p leasure , and pain. Everyth ing. I t ' s
all in there.
'I could be bounded in a nutshell and count myse l f a king of
infinite space , ' said Hamle t , 'were it not that I have bad dreams. '
T h e infinite space w a s within the shell of his head. A n d so,
inescapably, were the d reams . But looking around now at these
dead still, g r ey -be ige objects i t is hard to see them as erstwhile
I N T O T H E S I L E N T L A N D
progeni tors of infinite space . T h e y each represent the oppos i te :
a singularity. A point at which the universe has co l lapsed . I love
the stillness of this p lace and the hum of the void — the sense of
worlds dissolved and diss ipated pass ions . I t f i l ls me with a sense
of being. I am not yet pickled meat .
T h e light is fading and the pale amber sky at the hor izon
almost matches the colour of the l iquid in the jars . T h e r e is a
s ingle, bright star.
My area of supposed expert ise, neuropsychology , i s the s u b
ject about which I feel the mos t p rofound ignorance . I am
ignorant of many things. Fo r instance, I k n o w nothing of the
Russian l anguage . Q u a n t u m phys ics i s beyond me . Keynes ian
economics? T h e work ings of the internal combus t ion engine?
Irish political history? My knowledge consis ts of v a g u e not ions
poor ly unders tood , loose ly g ra sped general principles, and co l
lections of disjointed facts. But I could take lessons in Russ i an
and m u g up on Irish history and the other things. I will never
master the mathematics required for a p roper unders tand ing of
quantum mechanics, but I can appreciate someth ing of the
f lavour of the subject from the popular wri t ings of exper ts in the
field, and take comfort from the fact that, fundamentally, it
seems to be beyond them, too. But when i t c o m e s to under
standing the relationship between the brain and the consc ious
mind, my ignorance is deep and there is nowhere to turn.
An ocean of incomprehension heaves beneath the tex tbook-
confident surface of plain facts and technicalities that I present
to my col leagues and patients. I have a clear picture of the m a t e
rial components of the brain and am prepared to ad lib at length
about features of its functional architecture — the interlocking
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P A U L B R O K S
sys tems and subsys tems of percept ion, memory , and action. But
quite h o w our brains create that private sense of self-awareness
we all float a round in is a mystery. I have no idea how the trick is
achieved.
Wouldn ' t i t be absurd for an airline pilot to deny knowledge
of the principles of flight, or for a physician to claim ignorance
of the bas ics of human phys io logy and ana tomy? Yet I , a neuro
psycholog is t , can g ive no sat isfactory account of how the brain
genera tes consc ious awareness . W o r s e still, I f ind myse l f edg ing
towards a doubt that it means anything at all to say that the brain
genera tes consc iousness .
Hard ly anyone visits H a r r y ' s r o o m these days . The re are
small commit tee meet ings once a month and an occasional jour
nal club. Otherwise , it is used as I am us ing it now, as a quiet
space for catching up with d ischarge letters and clinical reports.
I t w a s never u sed much for seminars and Harry, of course ,
doesn ' t c o m e here any more .
I ' ve been t ry ing to finish a report . T h e patient, Jeanie , has a
dement ing illness and seems to be rapidly fading away. She is
only f i f ty- three. I t ' s not Alzhe imer ' s , I 'm pretty sure of that, but
we have yet to c o m e up with a firm d iagnos is . I saw her this
m o r n i n g in a s ide r o o m . She had been shar ing a bay with five
other beds on the main neu ro logy ward until a couple of nights
a g o when she b e c a m e agi tated and began to develop delusional
ideas about the other patients. A nurse found her at three in the
m o r n i n g pack ing a case and prepar ing to leave.
' I don ' t want to cause trouble, ' Jeanie had said in a whisper,
'but I 'm not like the rest of them. I shouldn ' t be here. T h e y ' r e all
lesbians . '
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I N T O T H E S I L E N T L A N D
T h i s morn ing she w a s cheerful. An order ly had just b r o u g h t
her a cup of tea. Her daughter , L i s a , w a s feeding her baby on the
other side of the bed . L i s a visi ted every day. We sat and chatted
with sunshine s t reaming through the uncurtained window.
Jeanie was happy, though increasingly preoccupied with
thoughts of death.
' I ' ve often wondered , ' she sa id , 'what happens , medica l ly
speaking, when you die . ' She wanted to k n o w the p rocedure
when a patient died on the ward . H o w could the doc to r s be sure
someone was dead? Where did the b o d y g o ? W h o took it?
'We have work to do, ' I sa id , 'shall we press o n ? '
First , I checked her orientation for t ime, p lace , and pe rson .
Fine . She knew who I was , where we were , the d a y of the week ,
and the month. She w a s quick to supply au tobiographica l infor
mation and seemed fully aware of her current c i rcumstances .
Next , I began to p robe different aspects of mental function with
some standard beds ide tests. O n e of these w a s a verbal fluency
task in which she had to generate w o r d s with a des igna ted initial
letter. T h e first letter w a s 'F'.
'F i re , flag, funeral, ' she said. 'Will that d o ? '
'Tell me s o m e more — as m a n y as you can, ' I u rged her, bu t
the allotted sixty seconds ran d ry with nothing m o r e to show.
She managed just one word for 'A' and another three for ' S ' .
F r o m letter fluency, we moved on to categories .
' L e t ' s see how many different kinds of four - legged animal
you can think of,' I said, and Jeanie pinched the b r idge of her
nose . Ha l f a minute went by with no response . T h e baby, now
asleep in her carrycot , began to stir, then settled. I reminded
Jeanie of her task.
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P A U L B R O K S
' Y o u know, ' she told m e , ' I seem to be hav ing problems with
this one . Fou r - l egged animals? For s o m e reason I can only think
of three- legged animals . ' I noticed the trace of a smile on L i sa ' s
l ips, but her eyes were as dull as lead.
I realize that it might seem mad to quest ion the role of the
brain in consc iousness . T h e r e can be no doubt that brains and
sel f -awareness are in c lose al ignment. My brain and I are never
far apart , and I accept that I am sitting here, in Ha r ry ' s room,
with my l iving brain, consc ious and self-aware, whereas those
lifeless spec imens in the oak cabinets are not. I am thinking
thoughts , l istening, and looking . I can hear occasional sounds of
traffic from the street far be low and, unexpectedly, faint ripples
of harps ichord mus ic from somewhere a long the corridor. T h e
taste of coffee is still in my mouth and I feel the contact between
e lbow and table, knuckles and chin, as I lean forward to read the
text on the computer screen.
With consc ious deliberation I have been str inging words
together on the screen in front of me through the play of f ingers
on keyboard , intermittently catching and turning over unso
licited, idle thoughts and images . (At one point , I f ind mysel f
h u m m i n g a B o b Marley tune. It drifts in from nowhere.) And
there, through the window, I see a star, a hundred million miles
away, but s imul taneously a lso in my head. Its image enters my
eye and f low-char ts through the visual sys tems of my brain,
f inds a link with m e m o r y and l anguage and, from outer space ,
ga ins a n a m e and a location in semantic space : 'Venus ' .
S o , d o e s consc ious awareness have a physical location: mine,
here and now, in H a r r y ' s r o o m , precisely somewhere between
my ears? Self-evidently, i t seems . But then, go into the skull;
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I N T O T H E S I L E N T L A N D
visit the bra in ' s interior work ings and you will find that there is
nothing much to see . N o t a spark of colour or whisper of sound
and no s igns of intelligent life. As you wander th rough this
silent land you can descr ibe its g e o g r a p h y adequate ly enough in
the third person , but, quite obviously , not the first.
F r o m this van tage point i t s eems self-evidently true that con
sciousness does not have a part icular locat ion. It is no m o r e to be
found in the hills and dales of the frontal lobes or on the s lopes
of the Rolandic f issure than in the chair you are sit t ing on . T h e
more you search the terrain, the c loser your analys is of sub
stance and structure, the faster the wi l l -o ' - the-wisp recedes . We
are embodied , but nowhere traceable within the physical s t ruc
tures of the body. I don ' t be l ieve in immaterial mind stuff or
souls detachable from bod ies , and I 'm not say ing that the brain
isn't necessary for consc iousness . Whether it is sufficient is
another matter.
Jeanie g rew tired of my tests. She w a s los ing concentrat ion.
In the middle of s o m e mental arithmetic, she s lowed to a s top
and I let her sit and stare for a while. L i s a w a s sitting back in her
chair, head resting agains t the wall , eyes c losed . T h e baby w a s
fast asleep. Hospi ta ls are never quiet, but you f ind pockets of
resignation and weariness where t ime itself s eems beca lmed .
T h e sounds of the outs ide wor ld are distant and abstract . We
each withdrew into our private wor lds . Jean ie , I a l lowed myse l f
to imagine , was roaming s o m e high plateau of bewi lderment in
pursuit of three- legged animals ; the baby w a s drifting content
edly on a pond of mother ' s milk. But I did not p re sume to
imagine what L i s a w a s thinking.
Consc iousness is a puzzle . F r o m one perspect ive i t s eems that
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96
i t must have a physical location ( p e o p l e ' s pains and pleasures go
where peop le g o ) , yet, from another, the s a m e sugges t ion seems
faintly absurd . O n c e inside the head i t becomes clear that con
sc iousness is not a ' thing' to be located. A n d even if we think of
it as a ' function' or a ' p roces s ' rather than a ' thing' , what sense
d o e s it make to say that the crucial elements reside in this or that
region of the bra in? N o r d o e s consc iousness depend in some
mys te r ious w a y on the integrated functioning of the whole
brain . I have seen many patients who, as a result of surgery,
injury, or d i sease have had much less than whole brains and they
seemed perfectly consc ious as far as I could tell. I 'm sure they 'd
tell you they were .
Fo r Wittgenstein, phi losophy w a s not so much about finding
solut ions to puzzles as about correct ing fundamental misunder
s tandings . T h e phi losopher ' s treatment of a quest ion, he said, is
like the treatment of an il lness. O u r minds are knotted with mis
concept ions about the wor ld and the job of phi losophy is to
unravel the knot , or, as he sa id , to show the fly the way out of
the fly-bottle.
T h e r e w a s a t ime — before the b rash intrusion of cognit ive
science - when the 'm ind-body p rob lem ' lived quietly in the
clois ters of academic phi losophy, no trouble to anyone. T h e s e
days , the redefined f ield of ' consc iousness s tudies ' is a garden of
del ights , s w a r m i n g with phi losophers and scientists of every
str ipe. D e b a t e is lively, somet imes strident, and with the neuro-
scientists shout ing loudest of all above their noisy brain
scanners , mos t do not notice the f ly buzzing frantically to escape
the fly-bott le. T h e y are engrossed . H o w does the mental arise
from the material? H o w can subjective experience be reconciled
I N T O T H E S I L E N T L A N D
with that s o g g y m a s s occupy ing the skull? T h e y are full of con
f idence, too. Mos t of them expect a solut ion. T h e chimera of
consciousness rises like a vapou r and entices them to bel ieve
that it really is just a matter of t ime before a w a y is found of
accounting for subject ive, f irst-person phenomena in object ive,
third-person terms. Desp i t e the p rod ig ious amoun t of intellec
tual energy that has been driven into this enterprise in recent
years , philosophical and scientific, i t s eems to me that the fly is
still stuck in the bott le.
Eventually, Jeanie sa id , 'Am I d e a d ? '
I didn' t respond immediately. L i s a ' s eyes remained c losed
and I let the silence flow. Jeanie smi led . Her face w a s lit with a
benign perplexity.
' I 'm just wonder ing , ' she said . ' H a v e I d i e d ? ' T h e r e w a s a
smear of toothpaste a round the corner of her mouth . She didn ' t
seem to notice the droplets of tea spill ing on to her d ress ing-
gown. But there w a s a glint in her eye. She w a s deve lop ing her
theme. 'In the middle of the night I w a s convinced, ' she sa id . ' I
thought they would come to take me away. N o , I wasn ' t afraid.
I waited to see what would happen. A n d then s o m e o n e did
come . It was a tall man. He just watched, and I tried to s ay s o m e
thing, but my lips wouldn ' t m o v e . T h e n the tall man left. He
didn' t say a word either.'
L i s a spoke. ' W e ' v e been through this before , M u m . You ge t
confused somet imes . You ' r e not g o i n g to d ie . N o t for a l ong
time. '
G iven the uncertainty of her mother ' s d iagnos i s this w a s , of
course , not necessari ly the case . Jean ie g a v e no indication that
she was listening.
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' I can ' t say for sure that I am dead, ' she continued, 'but things
are not the s ame . I don ' t feel real. It seems to me I might be dead. '
Her express ion d immed . ' H o w would I know if I was d e a d ? '
Jean ie w a s well oriented for t ime, p lace , and person. She
knew the day and the month, the n a m e of the town we were in
and the hospital , and she w a s clear about her name , age , and
address . As for be ing dead or al ive, she w a s all at sea. I wrote on
my notepad: Cotard's?
I once saw an old w o m a n who w a s profoundly depressed.
' B u r y m e , ' she said . 'You might as well , I 've been dead for
s o m e t ime. '
She bel ieved her insides had rotted away. I tried to reason
with her, bu t i t w a s useless . ' L o o k , ' I said, 'you ' re here talking to
m e . H o w can you b e d e a d ? '
' Jus t w o r d s , ' she replied. A wor ld of shadows f l ickered
a round her, human figures came and went, the curtains bil
lowed , nights fell, d a y s b roke . But she felt no connection with
any of this. T i m e hol lowed her carcass and words fell dead at
her feet. J u s t words . T h a t w a s the f i rs t t ime I 'd come across
C o t a r d ' s s y n d r o m e , which is usual ly associated with severe
depress ion , but is somet imes seen in cases of neurological dis
ease . T h e pe r son sinks into a nihilistic delusional state, often, as
in this case , to the extent that they bel ieve they no longer exist.
T h e condit ion takes its name from the French psychiatrist
Ju l e s C o t a r d who, in 1882, published a series of case studies
of peop le suffering what he referred to as le delire de negation.
T h e clinical presentat ion differed somewhat from patient to
patient, but de lus ions o f self-negat ion were c o m m o n . T h e s e
ranged from the bel ief that parts of the b o d y were miss ing or
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I N T O T H E S I L E N T L A N D
had putrefied, to the comple te denial of bodi ly existence. T h e
expressed belief that one is dead is not a defining feature of the
syndrome. In fact, of the eight ' p u r e ' cases repor ted by C o t a r d
(excluding a further three with concomitant persecutory de lu
sions or other debilitating i l lness) only one embraced death as
an explanation of her condit ion. Others s l ipped into non-exis t
ence, or skirted the abyss , s o m e h o w defying the convent ional
understanding that ceas ing to exist mus t be tantamount to
death. T h e r e were even s o m e patients locked in the paradoxica l
state of denying their bodi ly existence yet at the s a m e t ime
bel ieving themselves to be immorta l .
What drives such s t range de lus ions? D e p r e s s i o n is usual ly a
factor, but is not a lways present . Jean ie , peer ing quizzically into
the void , is not depressed . Her case , at least , calls for a neu ro -
biological explanation. O n e possibil i ty is that the exper iences
arise from a disturbance of brain mechanisms which ordinari ly
bind sensation and thought to the neural sys tems under ly ing
emotion. T h i s ancient duty is per formed by the l imbic sys tem,
deep inside the cerebral hemispheres . A pr ime function of this
sys tem, an evolut ionary raison d'etre, is to create states of readi
ness for action. I t d o e s this through the implementat ion of
so-cal led 'affect p r o g r a m s ' .
If your sensory sys tems inform you that there is a c razed-
looking man fast approach ing with an axe , your b o d y will enlist
the affect p r o g r a m identified with fear. Before you have t ime
even to experience terror, before the eye-bu lg ing , vo l tage su rge
of awareness, var ious physio logica l sys tems will have reconfig
ured themselves in preparat ion for a response . Y o u will turn and
run. T h e thought ' I am terrified' will follow hot on your heels ,
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P A U L B R O K S
though , mos t likely, will have entered the past tense by the time
it catches up. 'I w a s terrified,' you will later recall.
But what is this 'I ' that c la ims the terror, and what is the 'you '
that reflects upon the experience? It is not a s ingle thing, or a
thing at all. It is , in its mos t primit ive form, a principle of b io
logical organizat ion. T h e affect p r o g r a m s , so this story goes ,
not only gu ide adapt ive interaction with the external world but,
as a by-produc t of this p rocess , they also form the biological
point of or igin of the self. By imbuing perceptions, thoughts,
and act ions with an emot ional hue (however pale) they g ive
cohes ion to experience.
Fee l ings are generated which form the bas is of our sense of
identity, creat ing the condit ions for ownership of thoughts and
for agency in the control of actions. T h e s e perceptions,
thoughts , wishes , beliefs, ut terances, and act ions are mine. I feel
it. The i r c o m m o n cause is centred upon my needs and mot iva
tions, m a d e manifest through the affect p r o g r a m s of my limbic
brain. I feel I think, therefore I am. N o t e that this is merely a
functional descr ipt ion of the b iological roots of the self. D o n ' t
a sk where the feeling of the feeling c o m e s from; or the feeling of
the feeling of the feeling. Such quest ions tighten the knot.
B e y o n d this unelaborated , b iological core there are , of
cou r se , d imens ions of the se l f with a pas t and a future as well as
a raw present: in narrat ive te rms, the autobiographical self. In
C o t a r d ' s s y n d r o m e , however , the core has d isso lved . Cogni t ion
is decoup led from feeling and, consequently, thoughts and
act ions have no f ixed moor ings . T h e r e is no ' I ' left to claim own
ership. It d is integrates ; the f ragments drift apart . O n e patient
bel ieved she had b e c o m e little more than fresh air: ' Jus t a voice ,
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and if that goes , I won ' t be anything. ' If the vo ice went she
would be lost and wouldn ' t know where she had g o n e , she said .
Jeanie became fascinated with her teacup.
' L o o k at this, ' she said . ' I s i t real? H o w can I tell? It doesn ' t
look real. ' She contemplated the object as if i t had just mater ia l
ized out of thin air, then her gaze turned to me . 'And what about
y o u ? ' she said. 'Are you rea l? '
I had s topped taking notes and sat , hands c lasped over my
head, ponder ing the innocent quest ion. 'Be l ieve me , ' I sa id , ' I ' m
real and so are you . Take my word for it.'
' I think I can trust you , ' she sa id , but she wasn ' t sure .
S o m e phi losophers (d ismissed by others as 'Myster ians ' )
a rgue that the 'problem of consc iousness ' exceeds human mental
capacity in the way that differential calculus or the concept of
democracy are beyond the intellectual s cope of a rabbit or a
pigeon. I find this v iew curiously comfort ing, but then I 'm m o r e
of a clinician than a scientist. In my trade, unlike science, incor
rigible optimism can be counter-product ive. S o m e prob lems
have no solution. But if there is a w a y to untie this knot of knots
perhaps the f irst m o v e is to acknowledge that we are not only
physically embodied, but also embedded in the wor ld about us .
T h e mind may be local to the b o d y and the brain, but i t is also, in
different ways , distributed beyond biological boundar ies .
T h e notion of 'the extended m i n d ' has been ga in ing currency
in cognit ive science, but similar ideas were deve loped m o r e than
f i f ty years a g o by the Russ ian neuropsycholog is t A lexande r
Lur ia . For Lur ia , psychologica l phenomena were part o f the
natural world and so subject to the laws of nature, but he a lso
recognized that the structure of the mind has social d imens ions .
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102
He thought that scientific p s y c h o l o g y should be al igned with the
b io logica l sciences, but bel ieved that one could never fully
unders tand the relationship between the brain and the mind by
treat ing the brain as a c losed biological sys tem. T h e working
brain has to be unders tood not only as part of a larger biological
sys tem (the rest of the b o d y ) , but a lso as a component of the
wider social sys tem. What we refer to as the ' se l f ' is a product of
b io logica l and social forces ar is ing from the interaction of indi
vidual , isolated, brains . T h e r e is no spark in a s ingle stone but,
s t ruck together, two s tones can start a blaze.
T h e chal lenge for neuroscience will be to fit the brain (a b io
logical object) and the self (a social construct) within a c o m m o n
f ramework of unders tanding. T h e brain sciences m a y have to
open up to a ' socia l p a r a d i g m ' . Far from be ing the Ho ly Grai l of
neurosc ience , the search for consc iousness within the circuitry
of an individual brain can lead only to fool 's go ld . Sant iago
R a m o n y Cajal (joint winner of the 1906 Nobe l Prize for his
w o r k on the structure of the neuron and one of the founding
fathers of m o d e r n neurosc ience) once said: 'As long as our
brain is a mystery, the universe , the reflection of the structure of
the brain, will a lso be a m y s t e r y ' We and the world are tightly
intertwined. T h o u g h we m a y not have a special place in the uni
ve r se , the universe , as far as we can ever understand it, has a
special p lace in u s .
'I think I can trust you . I think. I think . . .' J e an i e ' s words
were s t rugg l ing for life. Her gaze drifted over the pale-blue
paint on the wall . 'I think I can. ' M o v i n g with a mother ' s g race ,
L i s a lifted the s leeping baby from the cot and placed the bundle
of blankets and pink f lesh in J e a n i e ' s a rms . Jean ie kissed her
I N T O T H E S I L E N T L A N D
granddaughter and began to weep . I t w a s t ime for me to go .
'Mum' s more herself after a g o o d cry,' sa id L i s a .
' T h a t makes sense , ' I told her.
Ju les Co ta rd died a t the a g e of forty-nine. He succumbed to
diphtheria after nurs ing one of his children to recovery. I recall
this fossilized fact of b iog raphy as I s tack my case notes . T h e
g low of the computer screen is now brighter than the sky and,
when the machine shuts down , H a r r y ' s r o o m is a lmost dark .
Paradoxically, as the g l o o m descends , the jars a long the wal ls
gain a kind of luminescence, as i f they have absorbed s o m e of
the receding light. My report is finished. T h e laptop lid c loses
with a satisfying click and I go ac ross to take a c loser l ook at one
of the brain specimens. I lean c lose to read the printed label:
Subarachnoid haemorrhage.
' H o w ' s it go ing , H a r r y ? ' I say.
How's it going, Paul?
Me?
There's no one else.
I was lost in thought.
What were you thinking about?
Noth ing much.
The immensity of the universe, the mystery of
consciousness, and the finality of death, no doubt.
Yes.
Fetch me a Gauloise!
103
I t wou ld be g o o d to cause a stink.
I'd love a cigarette.
I t mus t be torture.
Tell me more about the woman who thought she was
dead.
I ' ve nothing to add .
There's plenty more you could say.
But I 'm not g o i n g to.
Why not?
L e t the s tory stand. I t ' s truer to life. I don ' t
a lways k n o w the final ou tcome — and that applies
to Jean ie .
The diagnosis, at least. The prognosis.
H a s h i m o t o ' s d i sease . Uncertain .
So there was hope?
I t ' s an inflammation of the brain.
Vodka and Saliva
T h i s afternoon I d rove to the beach. T h e r e were no takers so I
went alone, or rather, i t w a s me and the d o g . A d o g is c o m p a n y
if you don ' t think about it too hard, which mos t ly I don ' t .
I t had blown up chilly by the time we go t there, but I s tr ipped
to my shorts and went in, caut iously at first. T h e water w a s
aggress ively cold. T h e only w a y to p roceed w a s not to think but
to act, so I instructed my b o d y to trot forward and dive into the
next wave . Dutifully, it d id , a l though I watched the approach ing
wave with trepidation. Under the water there is actually a
dull ing of sensation, as i f consc iousness i tself is momentar i ly
submerged in the thrum of the ocean, then it returns with full
force. I surfaced and rolled on to my back , g a s p i n g with the
cold, a rms and l egs dr iv ing the water, intensely aware of every
startled neuron. I w a s enveloped by sea and sky, but n o w felt
detached from both. T h e d o g paddled bes ide me showing no
signs of discomfort .
Descar tes bel ieved that d o g s , indeed all animals , are uncon
scious automata . An animal sc reaming in pain is like the ch iming
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of a c lock. My faithful friend is a machine. Its fidelity is merely
reflexive. It doesn ' t feel the cold . Intr iguing, then, to learn that
the grea t m a n himsel f kept a pet d o g , Mister Scratch, of which
he w a s very fond.
'I k n o w that I exist , ' said Desca r t e s , ' the quest ion is, what is
this " I " that I k n o w ? ' He w a s quite sure the ' I ' that he knew was
not his body. ' I am not this a s semblage of l imbs, ' he said, but of
course he knew he was . Jus t as , a t one level, he must have
bel ieved that Mister Scratch had s o m e degree of conscious
awareness . He w a s far too clever to feel affection for an au toma
ton, surely.
I might not be as clever as Descar tes , but I trust my intuitions,
and i t s eems to me that my b o d y is an important part of the ' I '
that I know. It is the physical appara tus over which I have direct
control , the thing I u r g e to dive into icy waters , the thing that
g o e s to w o r k and sees patients and g ives lectures. I never leave
h o m e without it.
My b o d y has certain boundar ies ( roughly defined by my
skin) , which g ive it a characteristic shape ; and as I steer it from
one p lace to another my thoughts and experiences go with it. I f
y o u are hav ing a bad t ime for s o m e reason and I say 'My
thoughts are with you , ' don ' t bel ieve me . My thoughts are very
much with me. A l w a y s . Bel iev ing that thoughts are displaced
from your b o d y or that other p e o p l e ' s thoughts can be inserted
into your head, is a s ign of mental illness.
My b o d y is, without doubt , a part of what I think of as my
' s e l f . I t ' s the part of my se l f that can be weighed and measured;
it casts shadows , and it has proper t ies in c o m m o n with other
physical objects like trees and fi l ing cabinets, cars , and planets.
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' B o d y is a port ion of the soul d i scern 'd by the f ive senses , ' sa id
Will iam Blake.
I have a s t rong sense that I am located in my body. I dr ive my
car to the beach and I dr ive my b o d y into the cold shock of the
waves . On the w a y to the beach I see h e d g e r o w s and trees f lash
by through the windscreen of the car and , trott ing into the
water, I see the waves and the sky as if f rom behind the wind
screen of my eyes. I feel located in my b o d y and I identify with
it in other ways , too. Fo r example , if I see it a m o n g other bod ie s
pictured in a pho tograph I might say someth ing like ' T h a t ' s m e '
or ' T h e r e I am. ' I 'd say someth ing similar even about an old
photograph showing me as a baby, despi te the fact that the b o d y
bears no resemblance to the one I currently have .
I f someone passes my b o d y in the street they might , i f they
recognize it, offer a greet ing, us ing my n a m e . A n a m e is another
way we have of thinking about our se lves - a label to identify
our bodies and mark their act ions. ' T h a t ' s Paul over there, run
ning into the sea . ' O n e can change o n e ' s n a m e , but not o n e ' s
body.
So , I feel I occupy my b o d y (there is no s t ronger intuition)
and, with that, comes a sense of ownership and agency. I t ' s
my b o d y and I control it. I make it do things. My b o d y a lso
contributes to my sense of continuity — the feeling that I am the
same person from one day to the next. W h e n I l ook in the mirror
each day I expect to see the s a m e thing, m o r e or less . I 'd be
surprised if one day I looked in the mirror and saw N e l s o n
Mandela or a w o m a n or a giant moth . I 'd be rattled.
Identifying the se l f with the b o d y seems reasonable enough ,
but there are s o m e prob lems . For example , the boundar ies of
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P A U L B R O K S
the b o d y are not so easy to define. H o w much a part of us are our
hair or our f ingernai ls? What about bod i ly f lu ids? What about
food? I pick a s t rawberry from a basket , I swal low it and
i t b e c o m e s incorpora ted into my body. At what point does i t
b e c o m e a par t of my b o d y and so a part of me?
As a student I had tutorials with the famous psychiatrist
An thony Storr . He w a s a relaxed teacher, very charming, and
I 'm sure I learned someth ing about psychotherapy. But all I can
recall is one of his thought experiments .
He asked us to cons ider how often we swal low our own
sa l iva . We do i t all the t ime, of course , without thinking. T h e n
he invited us to imag ine that, instead of swal lowing, we spat
into a tumbler. H o w wou ld we n o w feel about s ipping from a
tumbler full of our own spit? I t ' s the s a m e stuff, but no thanks!
N o t even with ice , l emon , and a la rge dash of vodka . W h a t ' s
the difference? A b o u n d a r y has been c rossed . As the ph i loso
pher Dan ie l Denne t t puts it, once someth ing is outs ide our
b o d i e s i t b e c o m e s alien and susp ic ious , not quite part of us ,
some th ing to be rejected. T h e spit in the tumbler has
' r enounced its ci t izenship ' . Boundar ies and border controls are
important .
Dennet t a lso reminds us that the society of the human b o d y
has m a n y interlopers — bacteria , v i ruses , microscopic mites —
not all ' enemies within ' or even tolerated parasi tes . S o m e , like
the bacter ia in our gu t , are vital to survival . I identify with my
body, but not with any of these b u g s , or i tems of food pass ing
th rough my digest ive sys tem or, indeed, with any particular part
of my b o d y on a larger scale — my knees , my knuckles , the b lood
cours ing th rough my veins. I could lose an a rm or a leg or a pint
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of b lood and I would still be me . Perhaps i t ' s the idea of hav ing
a body that really matters .
I may feel that I inhabit and control a b o d y and that such feel
ings are fundamental to my sense of self, but there are m a n y
features of my b o d y over which I have no direct control . I can ' t
s top the age ing p rocess . I can ' t s top it deve lop ing a tumour or a
degenerat ive brain d i sease , i f that 's what the genes dictate. A n d
there are mill ions of phys io logica l p rocesses g o i n g on inside me
that I scarcely know about , let a lone control .
A l though I can claim a better than ave rage k n o w l e d g e of
human biology, I have only a general notion of what my inter
nal components are. Many intelligent peop le with a perfectly
functional sense of se l f haven' t a clue about what g o e s on inside
them. It is largely irrelevant to the everyday bus iness of be ing a
person. Jus t as when you drive a car you don ' t really need to
know how the engine works .
Even when you consider those things that we directly take
charge of, the activities of the b o d y through which we exercise
our free will (voluntary movements of the l imbs, f ingers, head ,
vocal apparatus , e tc . ) , even here, the degree of control i s s o m e
times so poor that we achieve effects in the wor ld quite oppos i te
to those we intend. T h e practice of decept ion is a case in point .
When people display express ions for emot ions they are not feel
ing, or say things inconsistent with their actual state of mind
or their true beliefs, there are often counter -s ignals that g i v e
them away. T h i s applies whether we are ly ing or, for the best of
reasons, s imply t rying to g i v e a false impress ion to d i sgu i se the
true state of affairs.
Paul Ekman , a pioneer in the s tudy of emot ional express ions ,
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P A U L B R O K S
lists s o m e of these tell-tale s igns : ' a movement of the body,
an inflection to the vo ice , a swal lowing in the throat, a deep or
shal low breath, l ong pauses between words , a slip of the tongue,
a microfacial express ion, a gestural slip . . .' L i e s can be per
fo rmed beautifully, says E k m a n , but usual ly they are not. A n d
then there are occas ions when we behave with perfect control of
our act ions, but our behaviour is , a t s o m e level, not what we
wish or intend. We act agains t our better judgement ; we yield to
temptat ion.
W h e n I finished that last pa rag raph I got up and went to the
lavatory. I have absolute ly no idea h o w I did it. I became aware
of an ' u r g e ' to g o , I s tood and found myse l f walking to the bath
r o o m where , magical ly , effortlessly, I hosed urine into the toilet
bowl . D o n ' t ask me how. I take it for granted that I can just
' think i t and do i t ' . T h e co-ordinated neural , musculo-skeletal
and urogeni ta l activities involved in the enterprise of gett ing up
and g o i n g to the lava tory are incredibly complex. I just made it
happen. I have phenomenal control over neurobiological
p rocesses that no one in the world fully comprehends , and I
don ' t even have to think about it.
I t reminded me to make the point that even when we have
excellent control over our voluntary act ions, and at every level
intend to per form them, we still don ' t unders tand precisely how
an act of will ge ts translated into a complex sequence of b io log
ical activity (or vice v e r s a ) .
S o , we can see that the b o d y is an important feature of the
w a y we think about ourse lves - i t s eems natural to believe that
each of us owns a b o d y and that we have control over it. But we
can a l so see that i t is difficult to identify the ' s e l f with the ' b o d y '
110
I N T O T H E S I L E N T L A N D
as a whole (because the boundar ies are fuzzy) , or with any
particular part of the body. Fur the rmore , our control over our
bodies , and our unders tanding of the p rocesses involved, is
variable. Perhaps, as I say, i t ' s the idea of hav ing a b o d y that
really matters .
One might think that the face has s o m e special a l ignment
with the self. No other object projects such an aura of vitality,
and this vitality seems to come from within. F a c e s are points of
convergence between people ; where we seem to locate the
essence of another person , and where we tend to locate our
selves: somewhere behind the eyes. In his novel Immortality,
Milan Kundera writes: 'Without the faith that our face expresses
our self, without that bas ic i l lusion, that arch-i l lusion, we
cannot live or at least we cannot take life seriously. '
Imagine i f someone you k n o w were suddenly to unde rgo a
radical t ransformation of his or her facial features. T h e y still
have a face, a regular one , but a different one . Is it poss ib le to
believe i t ' s the s a m e person? What i f they now look just like
someone else you know? Or what i f they resemble y o u ? N o w
imagine that person with no face at all. C a n you even think of
them as a person? Wha t is it you are thinking about?
We treat the face as an emblem of the self. It generates potent
illusions. Kundera might be r ight to say i t wou ld be hard to
function as a human be ing without embrac ing the emblem and
seeing the illusion. But it wou ld be a mistake to identify faces
with selves. T h e face is just another b o d y part . People with hor
rendous facial disfigurements have no less a sense of se l f than
people who have lost an a rm or a leg . In s o m e respects , perhaps ,
their sense of self is intensified.
111
P A U L B R O K S
112
T h e face is just a f leshy structure animated by muscles
attached to the bony structures of the skull. I t contains informa
tion about our identity (who we a re ) , our sex and our age (which
are important facets of the 'public s e l f ) , who and what we are
in te rms of the object ive, social facts of the matter. You can
think of these as 's tat ic ' features of the self in so far as they are
relatively f ixed and enduring.
T h e n , th rough changes in patterns of muscular activity
( ' express ions ' , ' g a z e ' ) , the face transmits s ignals about other,
m o r e dynamic , features such as our emotional state, our focus of
interest, and our immedia te intentions. T h e s e have a double
aspect ; part public , part pr ivate . You can use facial information
to make inferences about my mental state and behavioural dis
posi t ions . To that extent the information is 'public ' because it is
there for anyone to see . But you can ' t know my thoughts and
feelings directly. You can ' t experience them.
We see and hear and speak through the face, creating the
impress ion that consc iousness , ' the stuff of the se l f ' , is concen
trated there, even though there are no g rounds for bel ieving it
is really any m o r e ' t he re ' than in the right e lbow or the small
of the back . T h i s i s because there i s no ' se l f s t u f f ' to be located.
T h e r e is nothing in, or behind, the face except for organic
matter, and nothing to sugges t that the b iological material of the
head, as o rgan ic matter, has a greater propensi ty for 'self
h o o d ' than the material stuff of other regions of the body.
T h e r e just isn't.
Trave l l ing in thought from the posi t ion of participant-
observer in the physical and social wor ld ' through ' the face and
into the machinery that lies behind we are transported, like
I N T O T H E S I L E N T L A N D
113
Alice through the looking g l a s s , to a very different wor ld . We
go from a bright place of pe r sons , se lves , and subject ive exper i
ence, to a dark, silent, enclosed, wor ld of phys ics , chemistry,
and bio logy. It is a myster ious journey.
Body Art
T h e r e ' s s o m e o n e here to see me . S h e ' s c o m e to talk about her
research project . S h e ' s looking for a P h D supervisor .
'H i , I 'm K a r a , ' she s a y s , drifting in like scented smoke.
' I ' m m o r e of a neuro man , ' I 'd told her over the phone. ' I 'm
not sure I can help. ' I tried to put her off. I said I knew s o m e
thing about b o d y - i m a g e changes caused by brain d a m a g e , and
self-mutilat ion in the mental ly disturbed, but nothing about the
cult of extreme b o d y modification. She wouldn ' t be deterred,
and here she is , open ing a folder to show me s o m e samples .
T h e thing that f irst catches my eye is a c lose-up colour photo
g r a p h of a man with his t ongue hang ing out. T o n g u e s , a lmost .
It is split f rom the b a s e , g iv ing it a wicked, reptilian look. You
can a lmos t see it flicker. K a r a has a gl is tening stud in the middle
of her own tongue . I t ' s difficult to ignore once you notice.
T h e tone of the Informat ion Sheet is reassur ing. I t could be
from a pr ivate hospital b rochure . 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 lades and sc issors rapidly fade. No th ing of the sort.
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I N T O T H E S I L E N T L A N D
T h e operation is quick and high-tech, performed by an oral-
maxiofacial (s ic) surgeon using an argon laser. T h e tongue is slit
in a single sweep, the laser cauterizing as it cuts. L o n g - t e r m side
effects are played down. T h e r e m a y be minor changes in s o m e
speech sounds , i t s ays , and, physiological ly , the number of taste
buds increases to cover the extra surface area. E l sewhere , a
woman reveals i t took about three weeks before she could eat
comfortably and control both tongues. No cla ims are m a d e for
the gas t ronomic or sexual advan tages of the split t ongue , but I
begin to wonder.
The re are many other images . S o m e are relatively mundane
(tattooed penises , nipple pierc ings , scarification, b rand ing) and
some bizarre, like t ransdermal implantat ion. K a r a shows me
pictures of men with objects inserted into the forehead or scalp.
T h e y look like Star Wars characters . I cast my eye over a report
on non-psychotic self-cannibalism (autophagy), and another on
apotemnophilia, which, I learn, refers to a c rav ing for a m p u
tation, somet imes satisfied through the services of qualified
surgeons .
B o d y art has filtered into the mains t ream. A l m o s t e v e r y b o d y
has a tattoo or a piercing these days . T h e s a m e g o e s for b o d y
modification: breast implants , nose jobs , l iposuct ion, anorectic
dieting, body-bui ld ing . K a r a condemns it all as a hopeless str iv
ing for unobtainable ideals of conventional beauty and eternal
youth (the women in Vogue, the men on the cover of Men's
Health), culturally sanctioned and commercia l ly dr iven. S h e ' s
right, of course . Ex t reme b o d y modification, however , is the
antithesis. I t ' s about redefining the aesthetic, even the b o u n d
aries, of the body.
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P A U L B R O K S
'And what about c i rcumcis ion? ' she s ays as an afterthought.
K a r a , by the way, is distract ingly beautiful.
Search ing for c o m m o n g round , we skim across b o d y - i m a g e
dis tor t ions in neurologica l d i sorders such as epi lepsy and
s t roke. We discuss hysterical para lys is , phantom l imbs, and
t ranssexual ism. I tell her about anosognos i a , which means ' lack
of knowledge of i l lness ' . People with severe neurological d is
abilities — quadr ip legia , say — somet imes show a complete lack
of awareness of their condit ion. ( I remember once chatting
with a m a n who w a s para lysed from the neck down. He was
tell ing me about his p lans to go rock c l imbing at the weekend.) I
ag ree that ' b o d y i m a g e ' is a fascinating area for research, but
can ' t immedia te ly see a point of connection between Kara ' s
interests and my own. I tell her I'll think about it.
At h o m e , I s tand naked in front of the ba th room mirror. N o t
exact ly Men's Health, I think. What might a little b o d y art do for
me? I tell my wife I 'm thinking of hav ing my penis tattooed.
'Wha t do you have in m i n d ? '
'Wolverhampton Wanderers'
She looks at me . ' O r m a y b e just Wolves'
116
The Story of Einstein's Brain
Einstein: shock-haired and sockless genius , avuncular symbo l
of pure intellect, head in a whirlwind of equat ions and spiral l ing
galaxies , cultural icon. L o g o : E = m c 2 . Scientist , s a g e , humani
tarian, ambiguous pacifist, lousy husband, negl igent father, and
now, what ' s left of him, f ragments of brain in a jar.
N o t long after Einste in 's death in 1955, Ro land Bar thes called
his brain a mythical object , a paradoxica l conflation of man ,
magic , and machine. Nea r ly fifty years on, the myth remains
potent. To look at any brain is to confront a deep mystery. Y o u
fall into the frame of an imposs ib le picture, an Escher stairway,
ascending and descending a t the s a m e t ime. T h e brain can ' t be
the theatre of consc iousness — i t ' s a solid object — and yet it mus t
be because you are contemplat ing the scene on the f loodl i t s tage
in your own head. But , looking at pho tog raphs of Eins te in ' s
brain - snapped in the interlude between extract ion from
the cranium and decimation at the hands of Princeton H o s p i
tal 's duty pathologis t , T h o m a s Harvey — you feel the pull of
myth as well as mystery. It is difficult not to see the object
117
P A U L B R O K S
as a sacred relic. T h i s is the thing that bent the universe and
humbled t ime.
T h e r e w a s rumour and speculat ion about the brain from the
start: i t w a s huge and s t range , and then again i t was myster i
ous ly tiny, the size of a walnut. In fact, it looked ordinary and
we ighed 2.7 pounds . A b o u t ave rage . I t w a s removed within
seven hours of death, we ighed fresh, then f ixed in formalin.
After i t had been pho tog raphed from all s ides, and measured
with call ipers, the cerebral hemispheres were separated and
diced into 240 blocks . T h e n the brain d isappeared . I t followed
H a r v e y into obscurity.
S o o n after the autopsy, H a r v e y had announced that E in
stein 's bra in would be used for scientific research and there was
a tussle for posses s ion between Princeton and N e w York ' s
Montefiore Medical Center . T h e y both lost out. Harvey simply
t o o k the pieces h o m e with him and s tored them in cookie jars .
N e v e r mind his lack of qualifications for the job (he was a clini
cal pa thologis t , not a neuroscient is t ) , he would be the one to
unlock the secret of Einste in 's brain.
T h e pa thologis t w a s accused of a smash -and-g rab exercise
and, though H a r v e y a lways maintained he had acted on the
authori ty of Einste in 's executor, Ot to Nathan , not many
be l ieved him. Na than called him a thief and a liar and Harvey
eventually left Pr inceton under a c loud, al legedly fired for not
rel inquishing the brain. He vanished from the scene — but he
h u n g on to his cookie ja rs . In 1978 Harvey w a s tracked down by
Steven L e v y , a journal is t work ing for the New Jersey Monthly.
L e v y found h im l iv ing in Wichita , K a n s a s . T h e remnants o f
Eins te in ' s bra in were in a box marked Costa Cider.
118
I N T O T H E S I L E N T L A N D
T w o decades later another journal is t turned up : Michael
Paterniti. T h e Keeper of the Brain w a s then well into his eight
ies and l iving in a basement back in Princeton. Toge the r they set
off for Cal ifornia in a rented Buick Skylark with Eins te in ' s
brain stashed in the trunk, floating in a Tuppe rware container.
Paterniti wanted to explore rumours that i t might be c loned, or
sold to Michael J ackson for mil l ions of dol lars , but H a r v e y
wasn ' t say ing very much.
T h e y ended up a t the h o m e of Eins te in ' s g randdaughter ,
Evelyn , who seemed less in awe of the relic than anyone else .
Paterniti 's own reactions were complex . ' I never thought that,
holding Einstein 's brain, I 'd s o m e h o w imagine eat ing it,' he said
at one point. T h e n , at a seedy motel on the w a y h o m e , he slept
with it: ' I go to bed . I put Einste in 's bra in on one pi l low and rest
my own head on the other next to it, six inches a w a y '
What about the science? Was Einste in 's bra in in any w a y
extraordinary? Desp i t e H a r v e y ' s p l edge , no s tudy w a s con
ducted for three decades after the contentious autopsy. By now
he had begun to mail bits of brain to prominent neuroscient is ts ,
people better placed than he to examine the material .
Four sugar cube-sized pieces arr ived at Marian D i a m o n d ' s
Berkeley office in a mayonnaise jar. She examined the cellular
structure of the specimens microscopical ly , finding an unusu
ally high ratio of glial cells to neurons in the inferior parietal
lobe, an area known to be associated with mathematical and
spatial reasoning. N e u r o n s are the bas ic functional units of the
brain and the glia p rov ide the metabol ic and structural suppor t
required for them to do their work .
As for overall anatomy, the first s tudy appeared in 1999.
119
P A U L B R O K S
120
Sandra Wite lson of McMaster Universi ty, Ontario, had re
ce ived, unsol ici ted, a p a c k a g e of brain pieces which she and her
co l l eagues set about we igh ing , measur ing , and compar ing with
other brains . A g a i n , the inferior parietal lobe s tood out as
unusual , be ing 15 per cent larger than normal ; and the Sylvian
f issure, which marks the temporal-parietal boundary, took an
o d d upward turn.
Such observat ions have been d ismissed in some quarters as
little m o r e than primit ive, bump-fondl ing phrenology. Einstein,
they say, would have been appalled by the crudity of the science.
I am not so sure . T h e r e is a picture of the Grea t Man undergoing
E E G bra inwave recording — his head an explosion of wild hair
and electrode leads — while he is be ing asked to 'think of relativ
i ty ' . He w a s clearly g a m e for a laugh. A n d the b u m p at least has
a plausible location g iven Einstein 's mathematical p rowess and
what we a l ready k n o w about the organizat ion of brain func
tions. It is something.
S o m e years a g o my y o u n g son and I were in a shoe shop in
C a m b r i d g e when in c a m e Stephen H a w k i n g in his motorized
wheelchair. No present -day scientist matches Einstein 's
celebrity, but H a w k i n g c o m e s closest . L ike Einstein he symbo l
izes pure intell igence. T h e shining mind in the shrivelled b o d y
has entered the popula r imaginat ion . I 've yet to see his wasted
shape on a T-shi r t or his m u g on a m u g , but he has appeared in
ep i sodes of Star Trek ( rubb ing shoulders with Einstein and
N e w t o n ) and The Simpsons. As Ro land Barthes remarks, be ing
turned into a car toon is a s ign that one has b e c o m e a legend.
T h e r e w a s a w o m a n helping him and they were looking at a
rack of cheap trainers. H a w k i n g didn ' t seem very interested,
I N T O T H E S I L E N T L A N D
though i t was hard to tell. My son went c lose up and stared and
I expected him to say someth ing indiscreet, but he lost interest.
T h e trainers he was eyeing were a cut above Hawking ' s . He w a s
not impressed , though I felt peculiar ly touched. T h i s w a s the
man who visited black holes from his wheelchair and surfed
event horizons. A n d he did so in T r u - F o r m trainers. Bar thes
would have liked that. I t would have signified someth ing .
A n d now Einstein 's brain is back at Pr inceton Hospi ta l .
Actually, not as such. It has a new owner, one Ell iot K r a u s s ,
pathologist . He keeps it in a jar somewhere secret .
They're perpetuating the myth.
Har ry?
I didn't mean to startle you. But they are, don't you
think?
T h e paradoxical conflation o f man , m a g i c , and
machine?
Quite.
Neurosc ience thrives on paradoxical conflations.
Conflat ing mind and matter seems paradoxica l to
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, m a g i c , machine, and mush .
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P A U L B R O K S
But trying to explain the genius of Einstein by
measuring his bumps with callipers! It's phrenology.
T h e r e ' s only so much you can do. H e ' s been
dead half a century. His brain is all in bits.
I am thankful for small mercies.
122
Articles of Faith
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
Articles of faith:
1. T h e brain is the o rgan of the mind.
2 . T h e mind is modular .
3 . T h e modular i ty of mind is reflected in the work ings of
the brain.
The brain is the organ of the mind. No one doubts that the brain
is the root of all behaviour and experience. If you b low out the
contents of a pe r son ' s head — as schoo lboys used to b low out the
contents of b i rds ' e g g s — you are , l ikewise, left with an empty
shell.
The mind is modular. Mental life is d iverse and divis ible . T h e
mind is not a monoli th . We dist inguish the colour of an apple
123
P A U L B R O K S
124
from its shape , weight , and texture as we lift it from the fruit
bowl ; and as we take a bite we separa te the snapping , crunching
sound from the taste of the juice . T h e n , looking back on the
exper ience , we seg rega te raw sensation from the images we
hold in memory .
Percept ion and m e m o r y are just two domains . T h e mind is a
much b roader confederat ion. T h e r e is also reason, emotion,
l a n g u a g e , mot iva t ion , and action. T h e s e facets of mind func
tion independently, at least to s o m e degree . It is possible to find
malfunction in one doma in a longs ide normal operat ion in
others. An amnes iac appreciates all of the sensory dimensions
of eat ing an apple , but has no recollection of the experience an
hour later. T h e n aga in , s o m e o n e with diminished senses but
m e m o r y intact — a blind person , say — has no difficulty remem
ber ing . N o n e o f this offends c o m m o n sense .
The modularity of mind is reflected in the workings of the brain.
Mental functions are b io logica l ly compartmental ized. Different
brain sys tems subserve different psychologica l functions. I t
fol lows that specified d a m a g e to the brain has predictable func
tional consequences .
* * *
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 though 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 . . .
I N T O T H E S I L E N T L A N D
125
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 scien
tists experiment and the rest. But I have not yet seen the
University in which reside and work the members of your Uni
versity.' 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 no locat ion, however natural i t s eems for us to
believe otherwise. Ry le w a s reconfiguring the ' m i n d - b o d y
problem' , the ancient mystery: how do mental events arise from
physical substance? His sugges t ion w a s that, contrary to the
assumptions of many phi losophers and psycholog is t s , i t w a s a
mistake to put mind and b o d y on the s a m e plane of analys is — a
'ca tegory mis take ' . Jus t as the s tranger could not find ' the
universi ty ' beyond the labs , offices, and p lay ing fields, so we are
hard put to discover any trace of a consc ious mind, or self, in the
P A U L B R O K S
126
brain. T h e r e is no ghos t in the machine. Minds are the product
of bra ins , and se lves depend upon minds , but they require dif
ferent fo rms of unders tanding.
I am us ing a personal computer to type these words . T h e y
appear on the screen by virtue of the word process ing software,
essential ly a set of instructions installed in the computer. T h e
opera t ions of the software are realized through the hardware of
the compute r ' s electronic microcircuitry. Deta i led knowledge
of the hardware is of little help in unders tanding the software,
and vice versa . Both hardware and software are irrelevant to the
content of the text. I happen to be writ ing about minds , brains,
and se lves , but it could be anything — a gu ide to sea fishing, a
suicide note or a J a p a n e s e haiku. T h i n k of the brain as the hard
ware , the mind as the software, and the self as the text on the
screen.
In fact, why not a haiku?
A true enigma:
The self looks inward and finds
Nothing hut neurons.
No m o r e haikus, I p romi se .
* * *
Like the symbol on a dol lar bill, my eye floats above a pyramid.
T h e four s ides of the pyramid represent the person, the mind,
the bra in , and the wor ld .
W h e n I 'm with a patient I 'm aware , at different t imes, of each
I N T O T H E S I L E N T L A N D
side of the pyramid . Mostly, my attention is d rawn to the person.
I t is a person who has come to see me or who is visi ted by me on
a hospital ward. It is a person who reports a s y m p t o m of s o m e
kind ( ' I 'm having problems with my m e m o r y ' ; ' I can ' t concen
trate on anything' ; ' I b reak down in tears if s o m e o n e says a kind
w o r d ' ) . The re is a lways an ' I ' . A n d even when — especial ly
when — the 'I ' is de formed by injury or d i sease , when it is s u b
merged or dispersed and has no voice , I strive to make it visible
and coherent. T h i s is as much for my benefit as theirs.
A n d then I g lance across the plane of the mind. 'You ' r e
having problems with your m e m o r y ? ' I say. 'Tel l m e , in what
way does your m e m o r y let you d o w n ? ' I ques t ion and p r o b e ,
seeking clues to the nature of the p rob lem. I k n o w that memory ,
and therefore m e m o r y disorder , takes m a n y forms . I can use
special tests to help define and quantify the disorder . It is a lso
important to know whether other components of the pat ient ' s
mental appara tus are showing s igns of wear and tear.
T h e confederation of mental p rocesses we call ' the m i n d ' can
break down in w a y s not a lways evident to the pe r son whose
mind i t is. T h e y might complain of m e m o r y impai rment , but
unknown to them there could be other p rob lems : subtle changes
in perception, say, or reasoning or emot ion. I take note of their
symptoms , but all the while I am looking for other s igns .
Next , my gaze shifts to the third surface of the py ramid . T h i s
is when I consider s igns and s y m p t o m s in relation to the w o r k
ings of the brain. I might , for example , take certain failures of
memory to indicate a particular form of brain d i sease . Or , con
versely, I might u se knowledge of a pat ient ' s bra in d isorder to
guide my unders tanding of their psychologica l condit ion. My
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P A U L B R O K S
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 easy enough to clip definitions
and bas ic assumpt ions together. L ike I said, I
could ad lib about the structure and functions of
the brain - no prob lem. A n d , true, those Art icles
of Faith get me th rough the work ing day.
But?
T h e r e ' s someth ing quirky at the philosophical
centre o f neuropsychology . An incompleteness.
T h e Art ic les of Fai th sugges t an integrity that,
I fear, doesn ' t actually apply.
No science is whole. Physics hasn't got a Theory of
128
observa t ions are set a longs ide other forms of evidence, includ
ing the physical invest igat ions of neurologis ts and surgeons ,
and the images m a d e avai lable via bra in-scanning machines.
T h e fourth s ide of the pyramid represents the world. Here , I
am concerned with how the person , g iven their brain disorder
and mental profile, can best adjust to the world around them.
H o w will they get by? For the person concerned this is, of
course , the only quest ion that matters .
Everything. Einstein 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?
For all I know, physicis ts will one day formulate
their T h e o r y of Every th ing . But I 'm inclined
to think that our goal of descr ib ing mental life
in terms of brain activity is not entirely feasible.
I wonder if the enterprise is quixotic .
Why?
Because . . . O h , I don ' t know. Wha t w a s that
description of D o n Quixote? A muddle -headed
fool with frequent lucid intervals? G e t b a c k to
me when I 'm lucid.
But does it stop you doing your job?
N o .
Then why play The Knight of the Doleful
Countenance?
Have you read Cervan tes?
No.
Me neither.
I N T O T H E S I L E N T L A N D
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?
My concern is that the Art ic les of Fai th d i s regard
some important features of mental life, which,
if we are ever to achieve a coherent science of
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P A U L B R O K S
mind and brain, will either have to be brought
into the frame of neuroscience — or thrown out.
Such as?
T h e things that matter mos t to us : consc ious
experience and our sense of self.
Is neuropsychology concerned with such things?
Of course . I 've m a d e a l iv ing by virtue of the
fact that the brain is a very flimsy construction.
Its functions are easi ly warped by disease and
injury. T h e r e ' s no shor tage of tales to tell of
fragile brains and shattered selves .
Indeed.
T h e quest ion is, how best to tell them: as the
science of the brain or the art of be ing human?
T h e hidden contrapt ions of the illusionist or the
il lusion 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 has to be bi l ingual , switching from the
l anguage of neuroscience to the l anguage of
experience; from talk of 'brain sys tems ' and
' p a t h o l o g y ' to talk o f ' h o p e ' , ' d r ead ' , ' pa in ' ,
' j o y ' , ' l o v e ' , ' l o s s ' , and all the other animals ,
fierce and tame, in the zoo of human
consc iousness .
Then you seem to have tied the package: brain and
person complete. Where's the strange philosophical
centre?
I N T O T H E S I L E N T L A N D
I have come to realize how deeply o d d it is to
assume that brains and selves converge .
You think they don't go together?
I think they don ' t go together in w a y s that
contemporary neuroscience would recognize .
But they go together?
What do you take me for?
131
Right This Way, Smiles a
Mermaid
Midtown Manhattan. T h e power w a s out. I s tood at the window
as veins of l ightning crackled over the Genera l Electric bui lding
a b lock away. Its giant , ga lvan ic throes were startling. T h e thun
der rol led th rough my gu t as i t rattled the windows and humbled
the monumenta l architecture. A n d then, an ocean of rain. N e w
Y o r k w a s Atlantis . I could see f ishes and whales and mermaids .
W h e n the s to rm died the power w a s still out.
I lay on the bed , drifted into a s lumber and woke to find a girl
s tanding at the window, look ing out as I had looked out upon the
s to rm.
' D o n ' t be afraid, ' she sa id , still watching the rain, which was
gent le now. ' C o m e with m e . '
We left by a d o o r I hadn' t noticed before. I followed her
down dim-li t corr idors and ver t ig inous stairwells, then out into
the swir l ing street where a car w a s wait ing.
'R igh t this way, ' she smiled.
We were somewhere on the U p p e r Eas t S ide . I recognized
132
I N T O T H E S I L E N T L A N D
her at once, even in the g l o o m : Col l icula B r o d m a n n , President
of the Academy.
'Neurosc ience is a b road church, ' she sa id , 'but there is con
cern that you may be drifting towards Myster ianism. ' O u t the
window a blue whale d ipped majestically over Central Park .
' O h ? '
' T h e Discipl inary Counci l has received a complaint . '
I took the envelope and read the letter. I t accused me of
br inging my profess ion and the broad church of neuroscience into
disrepute (the s a m e phrase) on account of my anti-scientific
posture and espousal of Mysterian philosophy.
' D o e s this constitute a charge of s o m e k ind? ' I asked.
' N o , ' said Col l icula , 'but there are procedures . '
'Am I to be c h a r g e d ? '
' T h a t ' s a matter for the Invest igatory Panel . T h e y will first
consider your response . '
Th ree solemn f igures entered the r o o m .
'Now?' I sa id .
'Yes , i f you are wil l ing. '
I t was hard to tell who was speaking . T h e three were seated
in shadow s o m e distance away. T h e n the man on the left —
Number 1 — drew a candle to him and started to read from a file.
I recognized my own words : My area of supposed expertise,
neuropsychology, is the subject about which I feel the most profound
ignorance.
He looked up from the f i le . ' I g n o r a n c e ? '
'P rofound ignorance , ' I confirmed.
' I f I were a patient of yours , wou ld I be comfor ted to hear
your proclamat ions o f i gno rance? '
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P A U L B R O K S
' P ro fess iona l s should acknowledge their limitations, ' I said.
T h e candle pa s sed to N u m b e r 2 , a w o m a n . She began reading
from her file. My w o r d s again: 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 ong pause which, perhaps , I was expected to f i l l .
' Y o u are a profess ional neuropsycho log i s t ? '
' Y e s . '
' H a v e you ever been certified insane? '
N u m b e r 3 w a s a man: Far from being the Holy Grail of neuro
science, the search for consciousness within the circuitry of an
individual brain can lead only to fool's gold.
He w a s direct. ' Y o u bel ieve that the relationship between
mind and matter is unfa thomable . In other words , you are a
Myster ian. '
' N o . I wouldn ' t be so bo ld . '
'And yet you find comfort in Myster ianism. '
'I am a clinician. I have it ingrained in me that some problems
have no solut ion and that there are t imes when it is wise to
accept the fact. As Wittgenstein said, the phi losopher 's treat
ment of a quest ion is like the treatment of an illness. But if the
d i sease is incurable, then so be it. I 'm comfortable with the idea
of not hav ing solut ions to every prob lem. I guess there 's a lso a
part of me that likes mys te ry for mys te ry ' s sake. Omniscience
wou ld be insufferably tedious . '
'And as far as consc iousness is concerned, the disease is
incurab le? '
' C o u l d b e . I don ' t know. I 'm indifferent to the mind-body
p rob lem. ' T h i s w a s not true; or rather i t w a s not the whole truth.
134
I N T O T H E S I L E N T L A N D
'Bu t do you, or don ' t you , bel ieve that neuroscience can find
the solut ion? '
' I 'm not sure neuroscience has even found the p rob lem, ' I
said. ' T h e fly is still s tuck in the bot t le . '
Coll icula offered me a g l a s s of wine. 'Wha t do you be l i eve? '
she asked.
'Noth ing , ' I replied. ' Some t imes I wonder " H o w d o e s meat
become m i n d ? " and i t s eems absurd . '
' Indeed. '
'Then , other t imes, I see it as a pseudo-prob lem, a screen of
confusion. . . '—I realized we were sitting at a table, eat ing dinner.
I had food in my mouth. I chewed and swal lowed before finish
ing the sentence — ' . . . behind which there is an empty space . '
T h e food was g o o d . T h e wine w a s g o o d . Col l icu la , I now
noticed, was naked. So was I and, before long , we were mak ing
love; she writhed warmly beneath me on the g l a s sy f loor . T h e r e
was an aquar ium be low with sharks g l id ing and smaller f ishes
darting. How do I know this isn't a dream? I wondered .
N o w I was standing, naked, before the three so lemn figures.
I seemed to be g iv ing a presentation. I looked at N u m b e r 1 and
said: ' S o m e people bel ieve that the universe and every th ing in it,
including human minds , is m a d e of physical stuff.'
'Material ism, ' he said .
I turned to N u m b e r 2: ' T h e oppos i te v iew is that reality is
non-material; physical objects and events are manifestat ions of
mental ac t iv i ty '
' Ideal ism, ' she said .
' T h e y bel ieve the physical world is a f igment. T h e universe
exists entirely on a mental or spiritual p lane . '
135
P A U L B R O K S
136
' H m m . '
' S o m e vers ions of ideal ism don ' t deny the physical world,
bu t s ay we can ' t have direct knowledge of it. Objects and events
are mental construct ions because they come to life only in the
arena of the mind. '
' T h e unobse rved tree fall ing in the forest makes no s o u n d ? '
' Y e s . A n d there are no green leaves on the branches or dap
pled sunlight on the forest f loor . T h e creaking, crashing sounds
of a fall ing tree, the image of leaves and greenness , and notions
of sunl ight and dapp l ing are all construct ions of the mind. '
N u m b e r 3 w a s about to speak , but I cut him short. I had to
p ress on: ' T h e third opt ion is dua l i sm. Dua l i s t s bel ieve that the
wor ld is c o m p o s e d of bo th physical and mental stuff.'
' D u a l i s m is dead in the water, ' said N u m b e r 1. 'Modern
science has no place for dual i sm. '
' B u t intuitively it feels right, ' I added . ' E v e n to materialists
and idealists who reject the idea intellectually. Even to you ,
perhaps . ' He did not dissent . ' E v e r y normal person believes
they have a b o d y and mos t tend to think there is more to them
than that. T h e y feel they have mental qualit ies distinct from
their flesh-and-blood physical appara tus . Many people -
p robab ly mos t — bel ieve they have souls that will survive the
death of the body. '
' I h o p e you are not g o i n g to defend a bel ief in souls and
spiri ts , ' said N u m b e r 2 .
'Cer ta in ly not. '
N u m b e r 1 returned to his earlier quest ion: 'Are you a
Mys te r i an? '
' N o . '
I N T O T H E S I L E N T L A N D
' Then you accept that science will so lve the puzzle of con
sciousness; it is merely a matter of t ime? '
'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 confused. N u m b e r 1 wondered
whether I had misheard his quest ions . I told him I 'd heard
him perfectly well but that, with respect, his ques t ions were s im
plistic.
I knew what I wanted to say. I wanted to say someth ing about
the problem of consc iousness be ing built into science itself, but
I hadn't thought i t through and, suddenly aware of my naked
ness, was los ing the thread of my argument .
' L e t ' s go back to Descar tes , ' I sa id , as much to myse l f as to
the others. I was looking for a w a y through.
'Must w e ? ' T h i s w a s N u m b e r 2 .
'Yes we must , ' I said. 'We must . '
I s trode over to where the three were seated, leaned forward,
and rested my e lbows on the table directly in front of N u m b e r 2.
' H e has a lot to answer for.' She smiled, rather sweetly I thought .
I reminded them that the mind -body prob lem, the beas t we
grapple with today, is a l egacy of the dualist ideas formulated
by Rene Descar tes in the seventeenth century. He w a s not the
first phi losopher to dist inguish between mind and body, but he
crystallized that distinction and so set the te rms of all s u b s e
quent debate about their relationship. In the p roces s he released
a pack of t roublesome dichotomies into the Western w a y of
thinking: mind versus matter; subjective ve r sus object ive;
observer versus observed.
137
P A U L B R O K S
138
' Y o u can ' t b lame i t all on Desca r t e s , ' said N u m b e r 3.
' O f cour se not, ' I said. 'Dual i s t ic thinking runs through
every major rel igion - they all p romote the fallacious idea that
b o d y and soul are separa te entities. '
N u m b e r 1 pointed out , correctly, that the idea a lmost cer
tainly predates o rgan ized rel igion by many thousands of years .
He said i t went back to the dawn of human history. I agreed . In
fact, I bel ieved it w a s part of our b io logica l make-up. I said that,
quite probably , we were innately pred isposed to think in terms
of the separa t ion of minds and bod ies . T h e idea was built into
the hardware of the human central nervous sys tem.
Evo lu t ion has endowed us with brains that are naturally
inclined to certain w a y s of thinking about people , especially
when it c o m e s to interpreting their mental states. It was a conse
quence of l iv ing in complex social g r o u p s , and a by-product of
the evolut ion of l anguage . We continually, and effortlessly, p ic
ture each other 's thoughts and intentions. We form assessments
of what peop le 'have in m i n d ' - p resuppos ing that there are
such things as minds . We are all mind-readers . A n d the same
mental machinery enables us to form an idea of ourse lves as
unified and cont inuous be ings - to make sense of what is go ing
on with regard to our own mental states. People with impover
ished mind- read ing skills (such as autistic peop le ) , or with rich
but unreliable interpretations of their own and others ' mental
activities (like schizophrenics) are severely d isadvantaged.
Wha t Desca r t e s did , in effect, was to take this primordial
intuition — the separa teness of b o d y and mind — and build a
sys tem of ph i losophy a round it. A n d the ideas he formulated
have b e c o m e ingra ined in our w a y of thinking. His division of
I N T O T H E S I L E N T L A N D
mind and matter, and the demarcat ion of subject ive and ob jec
tive realms of knowledge , laid the foundat ions of the m o d e r n
scientific age .
T h e mind-body problem and science itself s tem from the
same split in the fabric of reality. T h i s creates fundamental
problems for a science of consc iousness . Science p roceeds by
systematic observat ion and experimentat ion. T h e whole point
is to provide factual, public , knowledge about the wor ld as it is,
independent of personal feelings and opinions , s tr ipped of s u b
jectivity — in other words , to p rov ide objective knowledge. But
consciousness , in essence , is subject ive and pr ivate . I can i m a g
ine your experiences, but I don ' t have them, and y o u can never
have mine. Exper ience is a first-person bus iness . Science oper
ates in the third person.
' S o , ' I sa id , ' consc iousness poses a forbidding chal lenge for
science. What makes science s t rong as a means of unders tand
ing the outer, material world — object ive, third-person obser
vation — is precisely what makes it ineffectual when it c o m e s to
understanding the "inner wor ld" of consc iousness . '
'We can s tudy brain states and functions, ' said N u m b e r 3.
'S imply recognize that brain activity and consc iousness are one
and the same thing and the p rob lem g o e s away. '
' Somet imes I see it that way, and somet imes I don ' t . '
'Because you can ' t make up your m i n d ? '
' N o , because there 's more than one w a y of seeing. I agree that
every conscious mental event, each and every thought and e m o
tion, is g rounded in s o m e physical state of the brain. But there
are objective, third-person descript ions of the brain and its func
tions; and then there are subjective, first-person experiences. '
139
P A U L B R O K S
140
'And never the twain shall meet? Is that what you ' re s a y i n g ? '
'Wha t I think I 'm say ing is that phenomenal consciousness -
the raw feel of experience — is invisible to conventional scientific
scrutiny and will forever remain so. I t is , by definition, sub
jective — whereas science, by definition, adopts an objective
s tance. Y o u can ' t be in two places at once . You either experience
consc iousness " f rom the ins ide" (a p a n g of hunger, the blueness
of the sky, the chill of an autumn breeze , sunlight dappl ing the
forest f loor) or you v iew i t " f rom the ou t s ide" (var ious configu
rat ions of neural activity and pat terns of behaviour associated
with different bodi ly states and condit ions in the external envi
ronment ) . Science can s tudy the neural activity, the bodi ly
states, the environmental condit ions, and the outward behav
iours — including verbal behaviours that stand for different
states of awareness ( " T h a t hurts"; " T h i s tastes like chocolate" ;
" M y heart leaps up when I behold / A ra inbow in the s k y . . . " ) ,
but the quali ty — the feel — of our experiences remains forever
pr ivate and therefore out of bounds to scientific analysis . I can't
see a w a y round this. Pr ivateness is a fundamental constituent of
consc iousness . '
N u m b e r 2 s ighed wearily. Suddenly, and uncharacteristically,
I felt a su rge of anger.
'And don ' t try to define it away! ' I shouted. ' D o n ' t tell me
consc iousness s imply doesn ' t exist in the material universe —
that there is just the brain and its functions — because , from
where I stand, it fucking does! A n d , unless you ' re a zombie or a
roo t vegetable , i t d o e s for you , too. '
I instantly regret ted my outburst . Aware again of my naked
ness , I felt r idiculous. ( N e v e r ge t angry with your clothes off .)
I N T O T H E S I L E N T L A N D
But, I thought, that 's precisely the point. From where I stand.
Only I occupy my posi t ion. O n l y you occupy yours .
'Might there be a convergence of the subject ive and the
objective if we had a detailed knowledge of our brain states,
plus a more refined technical vocabu la ry to descr ibe t hem? ' It
was Coll icula speaking.
' N o , ' I said. 'Wordswor th could recast the descript ion of his
heart leaping up at the sight of a ra inbow in te rms of photons of
refracted sunlight s t imulat ing the cells of his retina, in turn
generat ing specific patterns of electrochemical activity th rough
his brain, in turn leading to st imulation of the adrenal g land , in
turn caus ing a fluctuation in the rhythm of his heart. I am not
convinced this takes us any further. It is still "h i s " eye , "h i s "
brain, and "h i s" heart that are the focus of interest, not those of
Keats or Co le r idge . I t is the v iew from where he s tands . He is ,
essentially, irreducibly, descr ib ing a personal point of view, not
a pattern of neural s igna ls . '
' I fail to see the relevance of poetry, ' said N u m b e r 2. So I
quoted another poet .
'Rober t Fros t said that "Poet ry is what is lost in translat ion. It
is also what is lost in interpretation." L ikewise , consc iousness is
lost in translating from first-person experience to thi rd-person
description of brain states. O n e can accept , as I do , that all
psychological activity depends on neuronal activity, and one
can chart the neural substrates of this or that psycholog ica l
process , but the poet ry of consc iousness has been lost in the
interpretation. '
'Brain activity and consc iousness are one and the s a m e
thing, ' said N u m b e r 3.
141
P A U L B R O K S
142
' Y e s , there ' s truth in that statement. '
'The re fo re , s ince neuroscience is best placed to describe the
work ings of the brain, i t is clearly best placed to g ive an account
o f consc iousnes s? '
' N o . I t doesn ' t follow.'
' I despair , ' said N u m b e r 2 under her breath.
' S o m e people have a rgued that consc iousness i s double
aspect , ' I sa id . 'It has an objective and a subjective s ide. It is
un ique in that respect and so can' t be treated in quite the same
w a y as other natural phenomena like c louds or flowers or
pebbles , which can be unders tood from a purely objective
s tandpoint . T h e r e is nothing mystical about subjective reality; i t
is just different f rom the object ive, science-friendly variety. It is
just as real, just as material , and has nothing to do with the kind
of immaterial mental stuff that Desca r t e s bel ieved in. Mental
events are based in physical events — the two coincide perfectly.
T h e subject ive and the object ive are different takes on the same
under ly ing reality. But the subjective realm is out of bounds to
science. '
'Are these your be l ie fs? ' N u m b e r 1 asked.
C o m e to think of it, I really wasn ' t sure , and the words
spilled out in the thinking: ' I ' m really not sure . '
' S o , what do y o u be l i eve? ' Col l icula demanded for a second
t ime.
I w a s about to repeat 'No th ing ' , which w a s , in fact, as c lose to
the truth as anything else I might have said, but I didn' t want
them to think I w a s be ing perverse ; and I didn ' t want to be there
all night. So I t o o k the easy opt ion. I p layed it straight down the
line.
I N T O T H E S I L E N T L A N D
' I am a materialist , ' I said. 'I bel ieve that the wor ld and every
thing in i t is made of physical stuff and, whatever the or ig ins of
the universe, we are a natural p roduc t of its material evolut ion:
sentience, intellect, emot ions , mora l codes and all. All behav
iour and experience, all knowledge and unders tanding of the
world and ourselves , depend upon the work ings of a physical
device: the brain. '
The re was a murmur of approva l .
' G o o d . Perhaps, after all, you are not a Myster ian. '
T h i s was a non sequitur. Myster ianism and mater ia l ism are
not mutually exclusive. But I let it pass . Perhaps I w a s , pe rhaps
I wasn ' t . W h o cares? At any rate, the three figures seemed
happy with my pronouncement . T h e y gathered their pape r s and
were gone ; oddly, though, I didn ' t see them leave.
Tha t could have been that; except now I found Col l icu la sit
ting astride me , her face lit by the jade waters of the aquar ium
below.
'What do you really be l i eve? ' she asked.
'I meant what I said about mater ial ism, and I meant what
I said about subjective experience be ing beyond the reach of
science. But , in truth, I really don ' t have firm beliefs on the
matter. I look at the mind-body p rob lem one w a y and it s eems
to evaporate . I l ook at it another and I 'm tantalized. '
'Perhaps there 's m o r e than one p rob lem, ' she said . ' O r per
haps you are more than one person . '
I was deep inside her now and couldn ' t care less .
143
T H R E E
No Water, No Moon
The Ghost Tree ( l )
I drive across town to the infirmary. J a k e is on one of the
orthopaedic wards . T h e beds are packed in rows a long the wal ls .
When I arrive his wife is at his beds ide . She looks about seven
teen, a year or two younger than J a k e . T h e r e is no talk be tween
them - a bubble of silence. I get the impress ion there has been
no conversation for some t ime.
He is the image of Chris t on the C r o s s . Matted curls of b lack
hair drop over sunken cheeks. His forehead is b ru ised and
scabbed where a crown of thorns might have been and a bed
sheet, crumpled at his hol low midriff, serves as a loincloth. Hi s
lean, pale, upper b o d y bears other scars of the smash : b r o a d
purple grazes and yel lowing contusions . But a t the bo t tom of
the bed there is nothing. T h e implod ing metal of the car severed
one leg a t the moment of coll ision. T h e other, mang led beyond
redemption, was surgical ly r emoved in the hours that fol lowed.
If he is a car thief, then J a k e has paid a high price for his mi s
demeanours . Only now, as the bandaged s tump appears from
under the sheet, do I notice that his right hand is a lso miss ing .
147
P A U L B R O K S
148
He g ives a handless w a v e to an old man in a wheelchair.
W h e n I p ick up the medical file from the nurs ing station the
charge nurse tells me of J a k e ' s disturbed behaviour. Yesterday
he w a s incontinent and smeared his faeces into his wounds . I am
not l ook ing forward to this. I feel cowardly. I want to turn and
go . But when we speak he i s perfectly pleasant. He seems com
p o s e d , even tranquil . He puts me a t my ease . T h e pain i s
tolerable now, he tells me . Yesterday i t d rove him mad .
' W h e r e d o e s it hur t? ' I ask.
'Lef t foot , ' he says .
I run th rough s o m e routine quest ions about levels of con
sc iousness and recall of events in the hours immediately
fol lowing the accident. J a k e can' t remember.
' H e was consc ious , ' s ays the child br ide .
' H o w can y o u be so s u r e ? ' I ask.
She knows because J a k e had activated the d ia l -home function
on his mobi le phone , perhaps adventi t iously as a result of the
impact or in a moment of lucidity. T h e r e was no one home when
the phone rang . T h e answer ing machine took the message and
s tored it until she returned next morn ing from her night shift at
the filling station. J a k e w a s call ing for her, wail ing like a baby.
I do my stuff and leave. I 've had enough . It is only four in the
afternoon and I 'm due to attend a meet ing later on, but I phone
in with an excuse and head for home .
It is a s u m m e r ' s evening, g r ey and overcast , perfectly still
except for a tiny plane d ron ing through low c loud , in and out of
visibility. There are people in there, I think, but only with an effort
of imagina t ion . F r o m this dis tance, who would care i f i t fell
f rom the sky?
I N T O T H E S I L E N T L A N D
I am sitting out in the garden and I mus t have dozed of f
because the student dissertation I w a s reading has fallen to the
g round , face down. My coffee is s tone cold . Evidently, I 've been
asleep for s o m e t ime.
I pick up the dissertat ion, which opens at a p a g e containing
images of a series of brain scans. I k n o w the pe r son whose bra in
this is. MJ17 says the capt ion, p rese rv ing anonymity, but I k n o w
her as M a g g i e . She is one of my research patients. I recall the last
t ime I saw her. It must be a couple of months ago . She greeted
me , as usual , like an old friend, taking both of my hands in hers
and gr ipping them w a r m l y for a g o o d minute. She took my a rm
as we walked down the hal lway and into her l iv ing r o o m . T h e n ,
while I 'm exchanging pleasantries with her husband , D o n ,
Magg ie touches my cheek. She really has no idea who I am. H e r
memory is a void . T h i s , and the lack of inhibition, is a result of
the disfigurement of her brain.
The re are blades of g r a s s on the p a g e from the freshly m o w n
lawn and the pictures of the brain have a kind of vegetable
quality. Figure 1, I read, Coronal T1-weighted magnetic resonance
images through the amygdaloid complex and hippocampal regions.
I am looking inside M a g g i e ' s head. She was p robab ly h u m m i n g
a tune to herself as these pictures were be ing taken. When she is
not talking she is h u m m i n g or s ing ing . D o n doesn ' t compla in .
T h e pictures are mos t ly grey. D e n s e material , like bone ,
shows up white. Darke r regions signify lower densi ty: the black
butterfly of the lateral ventricles, filled with fluid rather than
brain t issue; the shadowy recesses of the outer convolut ions .
L ike a cauliflower. L a r g e areas of the anterior temporal lobes
have been eaten away by the virus . T h e s e , too, show as black.
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P A U L B R O K S
M a g g i e w a s unlucky. T h e b u g — herpes simplex — is very like the
c o m m o n cold sore v i rus , but i t found a w a y into her brain. Then
aga in , s h e ' s lucky, too. L u c k y to have survived . D o n thinks so.
W h o am I to s ay she isn ' t?
Lit t le white a r rows have been super imposed on either side of
each picture to identify the reg ions of dark space normally
occupied by the a m y g d a l a and the h ippocampus : the almond
and the seahorse , vital components of the machineries of
m e m o r y and emot ion . The i r loss i s what makes M a g g i e inter
es t ing for sc ience.
As a clinician I have a duty to be scientifically informed and
inquisi t ive. S o m e o n e sits before me in the clinic. T h e y have a
fault with their neural machinery and I need to appreciate its
characterist ics. T h e y speak of s y m p t o m s , I listen and look for
s igns . I hypothesize . I test and deduce . I refer, as needs be , to the
scientific literature. But I fail if, as part of this p rocess , I do not
a l so e n g a g e with the patient in an ordinary, human way. O n e has
to absorb s o m e o n e ' s personal concerns to understand their
predicament . It is , after all, the person who is ill, not the neural
machine .
T h i s af ternoon, with J a k e , I had found it difficult to maintain
the necessary ba lance be tween detachment and absorpt ion. D i s
pass iona te analys is had g iven w a y to emotional synthesis. T h e
mutilated y o u n g man with the phantom limb, his calm civility,
the devot ion of his y o u n g wife, the cutting desperat ion of the
m e s s a g e on the answer ing machine: i t w a s too potent a mix and
I w a s caught of f -guard .
A n d now I seek sanctuary in the sol i tude of my garden and a
retreat into sleep, science, and abstract ion — the dissertation: the
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I N T O T H E S I L E N T L A N D
soothing icons of a bug-ea ten brain. I t ' s an effective remedy.
H o w comfort ing to lose sight o f M a g g i e and contempla te
instead MJ17 .
It is get t ing dark now. T h e c louds have thinned and a crescent
m o o n is visible. At the bo t tom of the ga rden there is an apple
tree. It looks tired and forlorn. T h i s , instantly, is h o w I see it. It
is an old tree, bear ing fruit for the last t ime. I see not just the
fading shape of the trunk, the twist ing branches , the leaves
darkening in the g l o o m and the pa le , ha l f -grown apples ; I see
the age of the tree and its wear iness . I have in mind the sharp
taste of the fruit. T h i s is how i t appears to m e . A n d h o w do I
know it is bear ing fruit for the last t ime? Because I realize it is
not there at all. My brain has conspired with the fail ing light to
conjure a f leeting illusion of the tree from memor i e s of similar
grey evenings a year ago , before it w a s felled by a Feb rua ry ga le .
It is a ghos t tree, rooted only in thought .
* * *
I am in a church. It w a s once a church, anyway. N o w i t ' s a uni
versity bui lding. I 'm here for a s y m p o s i u m and peop le are
milling around drinking coffee before the final m o r n i n g sess ion.
I keep an eye on the time because I 'm present ing a paper .
T h e p r o g r a m m e has reunited me with two co l leagues from
my pos tgraduate days . I haven ' t seen them for twenty years . We
stand in a triangle. Mundane facts of b iog raphy slot together as
planks in the conversat ional p la t form. We all have wives , and
children, and d o g s . Rick affects embarrassment . So bou rgeo i s .
W h y haven ' t we had m o r e interesting l ives?
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P A U L B R O K S
152
' Y o u don ' t like commitment , you get marr ied. You don ' t
want kids, they take over your life. You get a d o g , you ' re forever
s c o o p i n g shit into plast ic b a g s . '
S teve and I concur, but we don ' t mean it either.
S teve has been in the Uni ted States for ten years and his voice
fol lows mid-Atlant ic contours . ' I g u e s s the myth of romantic
love is where the rot sets in, ' he s ays , ' i f you let it.' L i fe and rela
t ionships are m o r e r andom than we think but, in the end, most
of us fall into a pattern. With w h o m , i t doesn ' t much matter. I t ' s
the pattern that counts . ' I f you don ' t relinquish the myth, you ' re
b o u n d to be d isappointed . But if you don ' t bel ieve i t in the f irst
p l a c e . . . '
I c l imb the spiral s ta i rway to the upper lecture theatre. T h e
sun-filled, s ta ined-g lass window sends curves of purple, yellow,
and red a long the steel handrails . T h e hall itself is cool and
dark . I t f i l ls the higher reaches of the nave . My audience trickles
in. T h e r e aren' t m a n y and they scatter about the place like a
congrega t ion .
With a click of the m o u s e , a quotat ion rolls across the screen
behind me : We should take care not to make the intellect our god.
It has, of course, powerful muscles, hut no personality. Tha t was
Einstein. I t sets the tone of my talk, which is about how the
brain genera tes emot ions and how emot ions regulate social
behaviour .
T h e r e are structures for ana lys ing the geomet ry of the face,
and others for interpreting the mean ing of express ions . T h e s e
feed into sys t ems for decod ing p e o p l e ' s intentions and disposi
t ions, calculat ing their desi res and beliefs. T h e n there are
mechan i sms for select ing p r o g r a m s of action, for shifting gear
I N T O T H E S I L E N T L A N D
and manoeuvr ing the vehicle of the ' s e l f ' th rough the social
landscape.
T h e amygda la is a crucial component of the social brain. I t
acts as a control centre l inking higher cortical p rocesses , includ
ing rational thought, to the m o r e ancient emot ional machiner ies
lower down. In particular, it is bel ieved to be involved in the
product ion of fear and anger.
On the screen now is a l a rge , m o v i n g , talking, ges tur ing
image of M a g g i e (aka M J 1 7 ) . She is hav ing a g o o d laugh with a
research assistant. T w o gir ls together. I t ' s M a g g i e back in her
twenties telling r isque stories about her b o s s . He w a s a one.
Somewhere , off-camera, D o n ' s gent le voice coaxes her back on
to safer g round . He doesn ' t want to cause embarrassment . I ' ve
set the v ideo in the w r o n g p lace . I intended to show M a g g i e and
D o n talking about their Spanish holiday. But at least the audi
ence can see she is not a cabbage . She is upbeat and animated,
eager for company. I'll have to tell the s tory myself .
T h e y ' d been out for a meal . T h e two b o y s leapt f rom
nowhere. T h e r e was shout ing and push ing . T h e y g r a b b e d
Magg ie . D o n w a s thrown back agains t a wall . O n e hand g r ipped
his throat, the other took his wallet. But D o n is a b i g man . He
fought back. He g a v e the boy a pound ing . A n d all the t ime, with
D o n ' s amygda lae trilling like fire bel ls , jol t ing his b o d y from
visceral fear to thrashing, mechanical anger, pupi ls di lated, car
diovascular sys tem in overdr ive , b lood dra ining from gut to
straining muscles , fists like hammers - all the t ime M a g g i e
smiles benignly. T h e fluid-filled spaces in her head where the
amygda lae used to nestle are poo l s of tranquillity.
Back a t the hotel, D o n w a s still shaking. M a g g i e couldn ' t
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P A U L B R O K S
154
fa thom it. She thought the b o y s were just larking around.
So far, so g o o d . No amygda la , no fear. I t ' s a nice anecdote to
co lour the s tandard explanat ion of fear product ion: the cortex
perce ives , the a m y g d a l a interprets and t r iggers a response. But
then, b a c k h o m e , M a g g i e sits watching T V . I t ' s a soap opera .
T h e r e ' s a spark of aggress ion between two female characters,
nothing extreme or out of the ordinary. I t gets to her, though,
enough to swipe her breath, and start her heart thumping.
' N o , don ' t , ' she says . ' P l ease , no!'
Fear rises until the flesh of her face is pulled taut in a rictus of
terror. T h e anecdote now becomes a window of insight into the
true functions of the amygda l a . At any rate, that 's the way I
present it. Evidently, fear can be t r iggered without involvement
of the amygda l a . Its function is to perform appraisals of danger.
M a g g i e , minus a m y g d a l a , is obl iv ious to the real threat of the
m u g g i n g , but shows excess ive fear in response to an innocuous
T V p r o g r a m m e .
' Interest ing, ' s o m e o n e says , 'but only anecdotal . '
I have to agree . But I 'm all for anecdotes .
In his presentation Steve talks about his d o g . He grants the
animal a rudimentary sensory awareness, but nothing like human
consciousness . His wife and kids disagree. T h e y value emotion
over intellect. T h e y are convinced the d o g has feelings — primi
tive and unarticulated but, at root, like ours . What perplexes
Steve is that he can't help behaving as if he believes this too.
' I g u e s s i t ' s my social brain, ' he says .
' I t ' s a s ign that you ' re human, ' I tell him.
* * *
I N T O T H E S I L E N T L A N D
155
M a g g i e ' s story appeared in an article I wro te for a magaz ine .
T h e m u g g i n g anecdote can also be found in the d iscuss ion sec
tion of a scientific paper I co-authored a few years ago , where
Maggie is referred to as ' Y W ' . A l though I think it g ives an
insight into the functions of the amygda la , as my critic in the
audience said, the evidence is only anecdotal . But evidence like
this would be hard to c o m e by experimentally, for practical and
ethical reasons. Clinical anecdotes are not only an invaluable
source of inspiration for m o r e systematic theoretical and exper i
mental studies, they are somet imes important in their own right.
Shortly after the s tory appeared in the magaz ine I received a
letter from a reader who, like M a g g i e , had quite recently suf
fered herpes simplex encephalitis. I'll call him Anthony. It w a s a
remarkable letter. With An thony ' s pe rmiss ion , 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 . . .
An thony ' s combinat ion of ' fear lessness ' (or ' r eck lessness ' )
on the one hand, and over-sensi t ivi ty to mild conflict and d ra
matic tension on the other clearly resembles s o m e features of
M a g g i e ' s behaviour . Qui te likely there is a degree of over lap in
P A U L B R O K S
156
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 discon
certing 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 disor
der 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
I N T O T H E S I L E N T L A N D
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 under
stand. 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.
157
The Ghost Tree (2)
Char les could hear the su rgeons talking. O n e of them was
angry. T h e y were g o i n g to start cutting. T h e r e were fingers a t
his abdomen . Nex t , there would be a knife. T h i s couldn ' t be . He
mus t tell them: Don't cut! I'm still awake! Please, not yet!
T h e w o r d s fo rmed in his brain, but their p a s s a g e to the vocal
appara tus w a s b locked. He lay mot ionless and mute as the blade
sliced his f lesh. T h e pain f lung him from his body. L o o k i n g
d o w n on the scene from the ceil ing, he saw that the angry
su rgeon w a s still compla in ing about something. Char les felt
p rofound unease , not tranquillity or indifference, as some have
descr ibed . H o w w a s he to get back?
T h e experience left him with a post- t raumatic stress disorder
— flashbacks, n ightmares , panic attacks. N o w he was seeking
compensa t ion . Int ra-operat ive awareness is an acknowledged
p rob lem. Effective anaesthesia requires the judicious mixing
and matching of d r u g s to patients and condit ions. I t is not all
or nothing, like flicking a light switch. Different operat ive p ro
cedures demand different depths of anaesthesia, and patients
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I N T O T H E S I L E N T L A N D
vary in terms of their response . Currently, there is no whol ly
reliable method of detect ing awareness . T h e r e are bound to be
mistakes.
Perhaps one or two patients per thousand opera t ions are able
to recall events occurr ing dur ing surgery. T h e figures are higher
for obstetric and cardiac procedures , which require l ighter
anaesthesia. ( T h i s d o e s not include those who m a y be aware a t
the t ime, but who subsequent ly fail to recall .) But while intra
operative awareness is a recognized complicat ion of surgery,
the out -of -body experience ( O O B E ) is not.
I didn't think it would help Char les ' s case . H e ' d be labelled
a fantasist, which would be unfair because O O B E s , too, are
relatively c o m m o n — around fifteen per cent of the general p o p u
lation admit to hav ing experienced one . I d idn ' t think that
Char les ' s soul left his b o d y — because I don ' t be l ieve in detach
able souls — but I could fully accept that he had experienced a
frightening hallucination. T h e r e are many fo rms of intermit
tent psychosis .
I spent my first term at universi ty l o d g i n g with a rather dour
working-class family on the outskirts of Sheffield. I'll call them
the Fancys , though their real name was less plausible . Mrs Fancy
fed me porr idge for breakfast . Somet imes I 'd ge t back late, the
worse for wear, and somet imes I didn ' t c o m e back at all. I think
she found me difficult. Breakfas ts were bleak. We didn ' t have
much to talk about .
Then one morn ing she started telling me about Aunt Judi th ,
how she was a lways we lcome to d rop in, of cou r se , but , dear oh
dear, how she picked her t imes. She had turned up in the middle
of the night again . T h r e e in the morn ing . Th i rd t ime this week .
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P A U L B R O K S
160
It w a s tiring, especial ly for Mr Fancy who was on the early shift.
Aun t Judi th w a s lonely. She would chat for an hour or so, and
then she wou ld go home . I said I hadn' t been disturbed, which
w a s true. I hadn ' t heard the doorbel l — or perhaps she had her
own key? Aunt Judi th had no need of doorbel l or key I was told.
She had a gift. She could project her spirit. A n d three times that
w e e k she had projected herself through the night air to the foot
of Mr and Mrs F a n c y ' s bed . She lived in Scot land.
A day or two later Mr Fancy raised the matter again . (I
wouldn ' t have dared . ) He knew I was in on the story.
' Y o u ' v e heard all about our Judi th , I gather. I t ' s a bit of a
nuisance, ' he said, and then carried on assembl ing his son ' s train
set on the f lowery carpet in front of the g a s fire. T h e four-year-
old lay supine . N o t h i n g m o r e w a s said .
Jus t before I left the Fancys I had an unsettl ing experience. I
w o k e in the early hours , aware of someth ing g lowing faintly in
the corner of the r o o m . My heart thumped an offbeat. When
I turned to look , it wasn ' t Aunt Judi th I saw but a Chr is tmas
tree. I 'd go t back late, let myse l f in, helped myse l f to a snack,
then g o n e straight to bed . I hadn ' t noticed a tree. H o w could I
not have not iced? I go t up for a c loser look . I brushed a branch
and caught the scent of the pine needles.
Re tu rn ing to bed I w a s soon asleep, but someth ing else d is
turbed m e . Perhaps it w a s vo ices in the street. I can' t remember.
But I do remember get t ing up to shut the window and noticing
that the tree had g o n e . It appeared from nowhere, then, silently,
it d i sappeared . It w a s there. I touched it. I could smell it.
I slept in. Winter sunshine filled the r o o m . T h e Chris tmas
tree looked splendid, red baubles and silver tinsel splintering
I N T O T H E S I L E N T L A N D
the light. So there was a tree. I tried to get up, but found I w a s
paralysed. I looked at my right a r m and willed it to m o v e . I c o m
manded it to m o v e . It s tayed put. When I tried to sit up or roll
over nothing happened. I panicked. On the inside I w a s a twist
ing fury, but the shell of my b o d y remained mot ionless . I g a v e
up the s t ruggle , overwhelmed by an intuition that if I tried any
harder I would break through the shell and float away.
I c losed my eyes. T h e r o o m was still a b lock of sunlight when
I opened them again , but there was no tree.
I now recognize this as a lucid d ream, an hal lucinatory state
in the hinterlands of s lumber where the mind is alert, but the
body remains bound by the para lys is of s leep — the intersection
of dream life and reality. Perhaps intra-operat ive awareness is
like this. I t ' s happened several t imes since, and each t ime I found
mysel f restrained by the s a m e forceful intuition. N e x t t ime I'll
grit my teeth and let go .
* * *
N o t long a g o I was renting a cot tage on the e d g e of D a r t m o o r .
It was a Sunday afternoon and I 'd been work ing at a g l a s s -
topped table by the window. I w a s tired. I hadn ' t slept well the
previous night. N o w I s topped, transfixed by mus ic .
I often work to mus ic — usually Bach or Mozart . T h i s w a s
Bach; a partita for so lo flute, endlessly circl ing and c l imbing,
falling and rising, br ight lines of sound fi l l ing the air. Grea t
music cancels the distinction between the external wor ld and
our inner life. I was absorbed , but, also, i t w a s me who was
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P A U L B R O K S
162
absorb ing . I w a s at the centre of a machine of sound , but the
machine w a s a lso within m e .
I first saw the ge e se in reflection, through the smoked g lass
surface of the table, s w i m m i n g in a bronze pool of sky. The re
were three. I looked up at the w indow to watch them speeding
south-west under c louds that now looked unnaturally white and
patches of sky unnatural ly b lue . I felt d i sembodied . It was as if
I were inside the co t tage , si t t ing at the table by the window and,
at the s a m e t ime, f lying with the geese , high over the D e v o n
shire w o o d s and fields. I w a s dis located and distributed, just as
the gee se were s imul taneously in one place and another: out
there, and here in the wor ld beneath the g lass - topped table.
T h i s w a s not an ou t -o f -body experience. I t was not unpleas
ant or d is turbing in any way. Subdued by fat igue, introverted by
sol i tude , e levated by the ext reme beauty of the music , my per
cept ions and sense of se l f had been momentar i ly reconfigured.
O u r b o d y schema is surpr is ingly malleable . V. S . Ramachan -
dran and his co l leagues have devised s o m e simple exercises to
illustrate this fact. I somet imes use them to enliven dull lectures.
H e r e ' s an example .
Fi rs t , put on a blindfold and have s o m e o n e sit in front of you,
facing in the s a m e direction. T h e n let another person take your
right hand and start t app ing and s t roking the nose of the person
in front of you with your index finger, while at the same time
us ing their own left hand to tap and stroke your nose . I t ' s best i f
the tapp ing and s t roking alternate in r andom sequences, and
they mus t be synchronous — that is, a t a p / s t r o k e on the other
pe r son ' s nose must be matched by a t a p / s t r o k e on your own
nose . After a while, thirty seconds or so , you may begin to feel
I N T O T H E S I L E N T L A N D
that you are tapping your own nose at a r m ' s length, as if, like
Pinocchio 's , i t has g r o w n e n o r m o u s or is floating out there in
front of you.
I t ' s even possible to project sensat ions on to inanimate
objects. T r y this. You need a table and a friend. Sit with a hand
under the table, hidden from view, while your friend t a p s /
strokes the surface of the table and s imul taneously t a p s / s t r o k e s
your hidden hand. I t ' s crucially important that y o u don ' t see
what ' s go ing on under the table — that wou ld ruin the effect, but
as you watch your fr iend's other hand you should g radua l ly feel
the tapping and s t roking sensat ions ar is ing from the table itself.
When it works (which isn' t a lways ) , the effect is compel l ing .
You know at a rational level that the surface of the table is
beyond the boundar ies of your body, but that ' s not the w a y i t
feels. T h e phenomenal experience overr ides the rational ana ly
sis. T h e table has been temporar i ly incorpora ted into your b o d y
schema. I t has b e c o m e part of ' you ' .
So , even on as fundamental a matter as where ' y o u ' are in
relation to your body, the consc ious , reflective se l f is easi ly
deceived.
I liked the story of the Christmas tree, she said.
Thanks .
Why do you call it a lucid dream? Perhaps it was
some other kind of vision.
'What other k ind? '
Hypnagogic imagery.
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P A U L B R O K S
O h .
Or do I mean hypnopompic?
T h e y ' r e both fo rms of dream-like imagery a t
the edges of s leep, when you ' re d ropp ing off or
wak ing up. H y p n a g o g i c i s when you ' re d ropp ing
off. But , anyway, no, i t wasn ' t either of those.
Don't most people fall asleep with random thoughts
and pictures floating through their mind?
I suppose they do
So what's special?
H y p n a g o g i c images are m o r e v iv id . T h e r e ' s
more clarity and detail. T h e y seem more
a u t o n o m o u s as well. T h e y have a life of their
own. I used to ge t beautiful, weird scenes go ing
through my sleepy head as a child — later, too,
on into my teens and early twenties. It rarely
happens now. I t ' s a pity. I miss them.
What did you see?
I t usual ly started with faces. T h e y loomed up
from nowhere . T h e first one a lways took me by
surpr ise . T h e y were quite ordinary, anonymous
faces mostly, but somet imes they would morph
into ga rgoy l e s or gobl ins . T h e y seemed real.
As bright a s television.
Just faces?
N o . Some t imes i t w a s m o r e elaborate — parades
of little peop le , all br ight co lours like a medieval
pageant . T h e y seemed to have a life of their
own. I t w a s fascinating, and totally beyond my
control . I used to watch the little people stroll ing
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I N T O T H E S I L E N T L A N D
by. T h e y a lways seemed to be g o i n g somewhere .
S o m e of them would be car ry ing packs o r
pushing carts. I w a s a spectator, on the sidelines,
watching from a dis tance. I knew they wouldn ' t
bother me . I wasn ' t really part of it. I couldn ' t
enter the scene. A l though somet imes i t did seem
like they 'd sensed my presence. O n e or two
would step outs ide the f low, c o m e c lose and
look directly towards me . But their eyes were
unseeing, like I w a s behind a one -way screen.
I could see them, but they couldn ' t see me . Yet
for a moment they sensed I w a s there. I had no
influence over the behaviour and appearance
of these creatures, or the wor ld they inhabited.
Where did they come from?
My brain, o f course . S o m e hidden corner o f
my mind.
Ah, hut which undiscovered territory?
T h e fascination for me w a s — still is — that this
s t range, nocturnal wor ld w a s the produc t o f my
brain and yet I had no consc ious control over the
shape it took. I remember once looking c losely at
a banner s o m e of the little fellows were car ry ing.
I t was beautifully embroidered , fantastic co lours
— most ly reds and go lds . A n d I thought I
couldn' t poss ib ly create someth ing so beautiful.
I was somet imes amazed by what I saw.
It convinced me that I w a s just one p roduc t
of my brain 's activity — a w a v e of consc ious ,
self-awareness on the surface of an ocean .
You needed convincing? I thought you were a
psychologist.
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P A U L B R O K S
Well, obviously , I knew that a lot of mental life
g o e s on be low the level o f awareness . T h a t ' s
or thodox cogni t ive psychology. A n d I know the
Freudian stuff, and J u n g . But these pictures put
abstract theory in the shade . I sp rang from the
s a m e source as the ga rgoy le s , the gobl ins and the
colourful pageants — the same brain — but I felt
no connect ion with them.
Do you think their little lives went on when you
weren't looking?
N o w , that wou ld be eerie. I 'd prefer to think
they didn ' t . I 'm sure they needed an observer
to b r ing them to life.
Perhaps we all do.
My brain conjured them up, and they required
a sol i tary spectator — me — but once the spoo l s
were rol l ing I p layed no part . Rober t L o u i s
S tevenson had similar experiences. He put them
to g o o d use . A lot of his stories were based on
d r e a m s or hypnagog ic imagery.
Which?
Jekyl l and H y d e , for one.
No, which: dreams or hypnagogic imagery?
Some t imes he seems to be talking about one,
and somet imes the other. F r o m what he says
about Jekyl l and H y d e i t was probably based
on a true nightmare . But at other t imes he seems
to be descr ib ing hypnagog ic stuff. He had this
technique for get t ing into hypnagog ic states.
S o m e t i m e s he would lie in bed resting his e lbows
on the sheets with his a rms point ing upwards ,
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I N T O T H E S I L E N T L A N D
poised to d rop i f he nodded off. T h a t w a y
he could drift into the h y p n a g o g i c wor ld and
stay alert enough to watch the show without
d ropp ing off completely. He talks a lot abou t
little people , too - the little peop le who run
the d ream theatre.
Did they wear medieval clothes?
N o , their cos tumes were G e o r g i a n .
And all this is different from lucid dreams?
I can't speak for others, but in my experience
lucid d reams and hypnagog ic image ry are very
different. H y p n a g o g i c images are realistic in the
w a y that v ideo images are realistic. Y o u can
observe them minutely, like when I looked c lo se -
up at the banner. T h e co lours were v iv id . I could
see the thread. But also, like a v ideo , y o u realize
you ' re not part of it.
And in a lucid dream you are?
For m e , lucid d reams seem absolutely real.
You ' re right there in the thick of it, and even
though you twig at s o m e s tage and start to
appreciate that i t ' s a d ream or hallucination,
and you beg in to think it th rough rationally -
even so , i t still s eems real. T h a t Chr i s tmas tree
was there in the corner of the r o o m as far as
I could tell. I went up c lose and touched it.
Had you been overdoing the jazz cigarettes or
anything?
N o . Or anything.
Were you scared?
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P A U L B R O K S
More perplexed than scared. Excep t for the
feeling of para lys is a t the end. T h a t w a s
frightening. You ' r e s tuck there power less and
you start to think anything could happen. T h e n
there ' s the feeling that you might just pop out
of your skin and fly out the window. I 've talked
to peop le w h o ' v e had full-blown out -of -body
experiences and s o m e of them descr ibe a
whoosh ing , v ibra t ing sensation just at the point
of depar ture . I ' ve had the s ame , but that 's where
I s t rugg le hard to s tay put. I t ' s a long t ime since
I had one of those d reams , but next t ime I really
might try to let go . I doubt it, though. I 'm a
coward . I 'm a lways too terrified by the thought
of not get t ing back . Discre t ion is the better part
o f valour .
But you don't really think it's possible?
I f you mean someth ing supernatural like my
soul s l ipping out of my skin and flying around,
no, I don ' t think i t ' s poss ib le . But the thought is
still terrifying. I don ' t bel ieve in ghos t s , but, on
ba lance , I 'd rather pitch my tent on a campsi te
than in a g raveya rd .
So you think it's possible in a different sense?
I think ou t -o f -body experiences are real
experiences, just like the phantom Chr is tmas tree
w a s real to m e . A lot of people say they have
them. But there ' s a natural explanation, like
there is for other i l lusions and hallucinations.
What is it?
I don ' t know.
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I N T O T H E S I L E N T L A N D
Where would you start to look for an explanation?
You could start with the phys io logy . T h e r e ' s
a pattern. It s eems to happen either in states of
low arousal or very high arousa l . I t can happen
— probably mos t often d o e s happen — just ly ing
in bed . But i t can also happen when the pe r son is
in mortal danger — hang ing over a precipice , say.
But , for me , the first p lace to start looking for
explanations wou ld be at the neuropsycholog ica l
level — analyse which brain sys t ems might be
involved.
So, what do you think?
I think i t ' s someth ing to do with distort ions
o f b o d y schema.
You mean body image?
N o t quite. B o d y i m a g e is how you as a pe r son see
yourself . I t ' s like a mental picture y o u have of
your own b o d y and i t ' s tied up to your feel ings
about it; your attitude towards it. B o d y schema is
more like the bra in ' s work ing model of the body.
And this can go wrong?
I t can go w r o n g in all sorts of w a y s . Obvious ly ,
there 's normal ly a tight relationship be tween the
b o d y and the self. You don ' t get one without the
other. But in s o m e w a y s the relationship is looser
than we tend to think. I t ' s quite subtle. I t isn ' t
that difficult to trick your brain and twist its b o d y
schema out of shape .
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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P A U L B R O K S
different brain systems have got temporarily
decoupled.
Someth ing like that. T h e b o d y schema and the
consc ious self are usual ly in synch. But at the
brain sys t ems level they can be separated to some
deg ree . T h e y ' r e d issociable .
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.
Exci t ing , but barmy.
By the way, I sa id , who are you?
But she w a s a l ready fading back into the lush darkness behind
my eyel ids.
170
The Dreams of
Robert Louis Stevenson
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 (1886) , the classic
tale of a divided self, reflects s o m e of the mora l and intellectual
preoccupat ions of the Victorian era: g o o d versus evil; reason
versus pass ion; rel igion ve r sus science; civilization ve r sus
savagery ; order versus chaos — but w a s a lso bo rn of the doub le -
ness within its author, Rober t L o u i s S tevenson.
A world traveller and adventurer, S tevenson wro te the s tory
in the sedate Engl ish seas ide town of Bournemou th . To all
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P A U L B R O K S
appearances he w a s leading the sort of life he would previously
have despised: 'Respectabil i ty, dullness, and similar villas
encompassed him for miles in every direction, ' wro te his s tep
son . But the outward i m a g e of bland respectability masked the
subvers ive machinat ions of his inner wor ld ; and here we have a
template for Jekyll and Hyde.
T h e s tory is prefigured in S tevenson ' s earlier life and work.
As a child he had been fascinated by the s tory of D e a c o n
B r o d i e . Wil l iam Brod i e (accorded the title ' D e a c o n ' as head of
a gu i ld ) w a s a respectable Ed inburgh cabinet-maker by day, but
by night w a s the leader of a g a n g of thieves. He was hanged for
his c r imes in 1788. T h e s tory so intr igued y o u n g L o u i s that, a t
the a g e of fourteen, he drafted a p lay about Brod ie . A later ver
s ion, Deacon Brodie, or the double life, was published in 1879, and
per fo rmed in Bradford three years later. Its themes were day
and night, g o o d and evil, and the duali ty of human personali ty:
expos ing the depravi ty that might lurk beneath a veneer of
civility. Bol t ing the d o o r and d iscard ing his dayt ime garb,
B rod i e d e c l a r e s : ' . . . by night we are our naked s e l v e s . . . the day
for them, the night for me . '
As a y o u n g man eager to slip the gr ip of Calvinist ic conven
tion in b o u r g e o i s Ed inburgh , S tevenson cultivated his own,
m o r e ben ign , duali ty of character. He and his friend, Charles
Baxter , ' a s sumed the l iberating roles of Johnson and T h o m s o n ,
heavy-dr inking , convivial , b l a sphemous iconoclasts , whose
sense of humour wou ld have been a little too s t rong for the
S tevensons ' Her io t R o w d rawing - room ' ; in which gu ise , ' they
could ful l -bloodedly enjoy those pleasures denied to Stevenson
and Baxter , and to Dr Jeky l l ' . ( I quote from E m m a Le t ley ' s
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I N T O T H E S I L E N T L A N D
introduction to the Oxford Wor ld ' s C lass i c s edition of Dr Jekyll
and Mr Hyde.)
But there was a deeper divis ion in S tevenson ' s psyche than is
revealed by g l impses of his chi ldhood obsess ions , the student
role-playing, and the subvers ive imaginat ion . I t t ook the fo rm
of a dissociation. Dissoc ia t ion is a psychiatr ic term that refers to
the splitting of mental p rocesses from mains t ream consc ious
ness. T h e separated part of the mind seems to maintain a life of
its own. In S tevenson ' s case the dissociat ion w a s evident in his
dream life, and in the important part that d reams p layed in the
creative process . He g ives a vivid account of this in the essay 'A
Chapter on D r e a m s ' , in which he writes about h imse l f in the
third person. In chi ldhood he had been 'an ardent and u n c o m
fortable dreamer. When he had a touch of fever at night, and the
room swelled and shrank, and his clothes, hang ing on a nail,
now loomed up instant to the b igness of a church, and now drew
away into a horror of infinite distance and infinite littleness, the
poor soul was very well aware of what must f o l l o w . . . sooner or
later the n ight-hag would have him by the throat, and pluck
him, s t rangl ing and sc reaming , f rom his s leep. '
T h e swell ing and shrinking, l o o m i n g and receding, are
examples of micropsia and macrops ia , pathological dis tor t ions
in the perception of the size or shape of objects which c o m e
under the generic head ing of 'me tamorphops i a s ' . Microps ia
refers to an i l lusory reduction in an objec t ' s s ize, mac rops i a
to the opposi te . I l lusions of this sort are often repor ted in
temporal lobe epilepsy, but m a y be exper ienced in other
neurological condit ions, including migra ine . T h e y can a lso be
caused by fever, as S tevenson ' s account sugges t s , and m a y
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P A U L B R O K S
174
be quite c o m m o n in chi ldhood in the absence of illness. I cer
tainly remember hav ing such ep isodes as a y o u n g child. T h e
descript ion of things l o o m i n g up ' to the b igness of a church'
and then d rawing away ' into a horror of infinite distance and
infinite l i t t leness' captures the feeling quite brilliantly.
Many of S tevenson ' s chi ldhood dreams were far from fearful
or dis turbing. ' H e would take long, uneventful journeys and see
s t range towns and beautiful places as he lay in bed. ' T h e dreamer
(that is, S tevenson) had 'an odd t as te ' for the Georg ian period —
consistent with his interest in D e a c o n Brod ie — and this 'began to
rule the features of his d r e a m s . . . ' T h e n , as a student, he began
to dream in sequence , 'and thus to lead a double life — one of the
day, one of the night—one that he had every reason to believe was
the true one , another that he had no means of p rov ing false. '
O n e exhaust ing sequence o f recurrent d reams was ' enough
to send him, t rembling for his reason, to the d o o r s of a certain
doc tor ' . T h e d ream had him in a surgical theatre, 'his heart in his
mouth , his teeth on edge , see ing mons t rous malformat ions and
the abhorred dexterity of su rgeons ' . T h e n he would return to
his l o d g i n g s at the top of a tall bui ld ing on the H igh Street. At
least , he tried to return. Instead he found himself endlessly
c l imbing stairs to reach the top floor, his clothes wet, all manner
of peop le brush ing past him on their w a y down: ' beggar ly
w o m e n of the street, great , weary, m u d d y labourers , poor
sca recrows o f men , pa le pa rod ies o f w o m e n . . . ' When , f i n a l l y ,
he saw the light of dawn breaking through the windows he
would g i v e up the ascent, turn, and go back down to the street
' in his wet clothes, in the wet , h a g g a r d dawn, t rudging to
another day of monstros i t ies and opera t ions ' .
I N T O T H E S I L E N T L A N D
A n d then there came a turning point. He 'had l ong been in
the cus tom of setting h imsel f to s leep with ta les ' , but , he says ,
these were ' i rresponsible inventions ' ; tales told for the teller 's
pleasure that would not stand the scrutiny of a critical reader.
T h e y lacked all the important elements of g o o d storytel l ing,
such as plausible characters, a consistent structure, and a c o m
pelling plot.
His dreams, like mos t p e o p l e ' s , were ' tales where a thread
might be d ropped , or one adventure quitted for another, on
fancy 's least sugges t ion . So that the little peop le who m a n a g e
man ' s internal theatre had not as yet received a ve ry r igorous
t r a i n i n g . . . ' T h i s is his first mention of 'the little p e o p l e ' .
S tevenson 's d reams m a d e wonderful raw material for his
narratives and came to play an increasingly important role in his
creative life. T h e tales began to sell and, ' H e r e w a s he, and here
were the little people who did that part of his bus iness , in quite
new condit ions. ' A greater discipline w a s required. ' T h e stories
must now be t r immed and pared and set upon al l-fours, they
must run from a beg inning to an end and fit (after a manner )
with the laws of l i f e . . . '
Storytel l ing had b e c o m e a bus iness , not only for S tevenson ,
but also for the little people who ran the d ream theatre. But , he
says , they unders tood the change as well as he. 'When he lay
down to prepare himself for s leep, he no longer sough t a m u s e
ment, but printable and profitable tales; and after he had dozed
off in his box-sea t , his little people continued their evolut ions
with the s a m e mercantile des igns . '
O n e such dream story is descr ibed at length. I t is wor th
recounting in detail before hear ing S tevenson ' s appraisa l . He
175
P A U L B R O K S
176
tells i t 'exact ly as i t came to h im' . T h e dream casts him as 'the
son of a very rich and wicked m a n ' , a landowner, whom he has
avo ided by l iv ing abroad much of the t ime. On his return to
E n g l a n d he finds that his father has taken a y o u n g wife, who is
treated cruelly. F o r reasons not entirely clear to the dreamer,
father and son agree that they should meet, but, through pride
and anger, neither will condescend to visit the other; so they
meet on neutral g r o u n d , 'a desola te , sandy country by the sea ' .
T h e y quarrel and, ' s tung by s o m e intolerable insult ' , the
younger man strikes the other dead .
A b o v e suspicion for the murder, he inherits his father's
estates and finds himself installed under the same roo f as the
widow. T h e two of them ' l ived very much a lone, as people may
after a be reavemen t ' , but shared meals , spent evenings together,
and g radua l ly deve loped a friendship. T h e n the atmosphere
changes . T h e dreamer senses that the w o m a n harbours suspi
cions about his guilt . He d raws back from her company 'as
men d raw back from a precipice suddenly d i scovered ' . But the
attraction w a s now so s t rong that 'he would drift again and
again into the old intimacy, and again and again be startled back
by s o m e sugges t ive quest ion or s o m e inexplicable meaning in
her eye . So they l ived at c ross purposes , a life full of broken
d ia logue , chal lenging g lances , and suppressed pass ion . '
T h e n one day, he sees the w o m a n sl ipping out of the house.
He pursues her to the station and on to the train, which takes
them to the seas ide , where he fol lows her out over the sandhills,
to the ve ry site of the murder .
' T h e r e she b e g a n to g r o p e a m o n g the bents, he watching her,
f lat upon his face; and presently she had someth ing in her hand
I N T O T H E S I L E N T L A N D
— I cannot remember what it was , but it w a s deadly evidence
against the dreamer — and as she held it up to look at it, pe rhaps
from the shock of the discovery, her foot s l ipped, and she hung
at some peril on the brink of the tall sand-wreaths . He had no
thought but to spr ing up and rescue her; and there they s tood
face to face, she with that deadly matter openly in her hand — his
very presence on the spot another link of proof . '
T h e y return to the train a rm in a rm, journey h o m e and settle
to an ordinary evening. Conversa t ion has been kept to the triv
ial. Al though the w o m a n was about to say someth ing after her
rescue, he had cut her short. N o w , expect ing her to denounce
him at any moment , ' suspense and fear d r u m m e d in the
dreamer 's b o s o m ' . But she does not denounce him. N o r does she
in the days to follow. In fact, her disposi t ion g r o w s more kindly.
In contrast, the dreamer, burdened with suspense , 'was ted away
like a man with a d i s e a s e ' . Unable to bear it any longer he
ransacks the w o m a n ' s r o o m while she is out. He d iscovers the
damning evidence a m o n g her jewels. A n d , as he stands hold ing
the object ( 'which was his l i fe ' ) in the palm of his hand, t ry ing to
fathom why she should have sought it, kept it, but never used it,
the door opens and the w o m a n enters the room.
' S o , once more , they s tood, eye to eye , with the evidence
between them; and once more she raised to him a face b r imming
with some communicat ion; and once m o r e he shied away from
speech and cut her off. But before he left the r o o m , which he had
turned upside down, he laid back his death-warrant where he
had found it; and at that, her face l ighted up. T h e next thing he
heard, she w a s explaining to her maid , with s o m e ingenious
falsehood, the disorder of her things. '
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P A U L B R O K S
178
T h e d ream story reaches its cl imax the fol lowing morning at
breakfas t . T h r o u g h o u t the meal she had ' tortured him with sly
a l lus ions ' but now, with the servants gone , he bursts from his
reserve and confronts her. W h y w a s she treating him so? She
knew everything. W h y did she not s imply denounce him? W h y
mus t she torture h im? He asks over and over. She , too, has
s p r u n g to her feet, pa le faced.
'And when he had done , she fell upon her knees , and with
outstretched hands: " D o you not under s t and?" she cried. " I
love you ! ' " At this point , 'with a p a n g of wonder and mercantile
del ight , the d reamer a w o k e ' . T h e story, he subsequently real
ized, had 'unmarketable e lements ' , which is why he presents it to
us in this br ief form and didn ' t make more of it. But i t serves to
illustrate his point that the little people are 'substantive inven
tors and per formers ' .
' T o the end they had kept their secret. [The dreamer] had no
g u e s s whatever at the mot ive of the w o m a n — the hinge of the
whole well- invented plot — until the instant of that highly dra
mat ic declarat ion. It w a s not his tale; i t was the little people ' s !
A n d observe : not only w a s the secret kept, the story was told
with really guileful craftsmanship. T h e conduct of both actors is
(in the cant phrase ) psychologica l ly correct, and the emotion
apt ly g radua ted up to the surpr is ing cl imax. I am awake now,
and I k n o w this t rade; and yet I cannot better it. I am awake, and
I l ive by this bus iness ; and yet I could not ou tdo — could not per
haps equal — that crafty artifice . . . by which the same situation
is twice presented and the two actors twice b rought face to face
over the evidence , only once it is in her hand, once in his - and
these in their due order, the least dramatic first. T h e more I think
I N T O T H E S I L E N T L A N D
of it, the more I am moved to press upon the world my question:
Who are the Little People? T h e y are near connections of the
dreamer 's , beyond doubt; they . . . share plainly in his training;
they have plainly learned like him to build the scheme of a con
siderate story and to ar range emot ion in p rog re s s ive order ; only
I think they have more talent; and one thing is beyond doubt ,
they can tell him a s tory piece by piece , like a serial , and keep
him all the while in ignorance of where they a im. '
Stevenson concedes that the Litt le People (or ' m y Brownie s ' )
do half his work for him while he s leeps . He a lso speculates
that they might well do the rest for him as well , when he is
wide awake. T h i s is a cur iously m o d e r n insight, in line with
current views on the importance of unconsc ious p rocesses in
cognition.
'For myse l f — what I call I , my consc ious ego, the denizen of
the pineal g land unless he has changed his residence since
Descar tes , the man with the conscience and the var iable bank-
account, the man with the hat and the boo t s , and the pr iv i lege of
vot ing and not car ry ing his candidate at the general elect ions —
I am somet imes tempted to suppose he is no story-teller at all,
but a creature as matter of fact as any cheesemonger or any
cheese, and a realist bemired up to the ears in actuality; so that,
by that account, the whole of my published fiction should be the
single-handed product o f s o m e Brownie , s o m e Famil iar , s o m e
unseen c o l l a b o r a t o r . . . '
S tevenson wonders whether his role might best be under
stood as an adviser and enabler; he edits the s tories; he dresses
them in his finest p rose ; he per forms the labor ious task of sit t ing
at the table and writ ing the words down; and he prepares and
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P A U L B R O K S
180
delivers the manuscript . But can he, he wonders , actually claim
to be the author of the stories?
T h e s tory of Jekyl l and H y d e a lso has its or igins in a dream.
S tevenson had for s o m e t ime been t rying to find a vehicle to
explore 'that s t rong sense of m a n ' s double be ing ' . As well as the
p lay about D e a c o n Brod ie , he had already written a s tory with
that theme, The Travelling Companion, but this had been
returned by an editor on the a m b i g u o u s g rounds that it was a
'work of genius and indecent ' . S tevenson was not happy with i t
either — he d i sagreed that it w a s a work of genius — and
des t royed the manuscript .
T h e n , he s ays , he hit certain 'financial fluctuations' , which for
two d a y s forced him to rack his brains 'for a plot of any sor t ' for
a saleable story. A n d then, on the second night, he had a night
mare , sc reaming so loudly his wife felt she had to wake him. He
w a s not best p leased. ' I was d reaming a f ine b o g e y tale, ' he told
her. Never the less , he had m a n a g e d to secure s o m e key elements
of the s tory: 'I d reamed the scene at the window, and a scene
afterward split in two, in which H y d e , pursued for some crime,
took the powder and underwent the change in the presence of
his pursuers . ' T h e rest of the story, he says , 'was m a d e awake,
and consciously, a l though I think I can trace in much of it the
manner of my Brownies ' , add ing that they 'have not a rudiment
of what we call a consc ience ' .
Consc i ence makes cowards o f us all.
Voodoo Child (Slight Return)
Ten minutes to go. I 'm g o i n g to round off my lecture with a
story. I scan the audi tor ium. T h e students are still attentive,
pens and notepads at the ready. A pale girl in the front row has
a small tape recorder and reaches into her b a g for a replacement
cassette. A p igeon settles on the sill outs ide one of the high
windows and, watching it, I forget momentar i ly what I w a s
about to say. T h e n i t c o m e s back to me : R o b e r t ' s story.
O n e day, in the foothills of middle age , Rober t took a l ong
look at himself in the mirror. T h e reflection sent an unequivocal
message . Li fe was running out and he w a s g o i n g nowhere . He
was stale: bored with his job, out of love with his wife , stifled by
his family, disenchanted with himself. But what s t ruck him
much harder, gr ipped him and shook him to the core of his
being, was the thought that at the end of this d reary line of days ,
there was oblivion. It was time for a change.
Tha t day on his way to work he s topped at the newsagents , as
usual , to buy a newspaper . He paid for i t but , on the w a y out,
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P A U L B R O K S
when the shopkeeper wasn ' t looking , Rober t took a chocolate
bar f rom a shelf and sl ipped it into his pocket . T h i s little act of
theft w a s cur iously energizing. H i s senses felt stripped and raw
and he ran back to his car in a whorl of elation. He drove faster
than he should , but, instead of g o i n g to work , he travelled 320
miles from Yorkshire to Cornwal l . By early evening, he found
h imsel f sitting on a beach , in the face of a w a r m sea breeze.
Rober t w a s profoundly happy.
T h e sun set, i t g r e w dark and chilly, but he stayed there all
night, conceding to sleep only as the sun rose in another part of
the sky. C o u l d he be sure i t w a s the same sun? he wondered . He
returned h o m e late in the day with no explanation except the
truth and spent another s leepless night placat ing his distressed
wife . She demanded a more plausible vers ion of events.
'Robert, what were you thinking o f ? ' she said .
He said h e ' d been thinking about everything and had put a
few things straight in his mind.
L i fe reverted to routine for a couple of weeks. T h e n , dr iving
h o m e from w o r k one Fr iday evening, Rober t switches on the
car radio and hears an interview with Jul ian Bream, the classical
guitarist . At one point the interviewer asks Bream what he
thinks of 'electrically amplified gui ta rs ' . ' T h e electric bass is
fine,' he s ays , but otherwise h e ' s not impressed. What does he
think of J i m i Hendr ix as a player? Rober t detects a note of con
descens ion in the interviewer 's voice at the mention of Hendrix,
bu t thinks i t ' s a g o o d quest ion, one he himself would have
wanted to put . He waits for the reply. Don't let me down, Julian,
he thinks. T h e r e i s no le t-down. ' H e w a s brilliant, ' says Bream,
leav ing the interviewer momentar i ly f lummoxed. Rober t gets
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I N T O T H E S I L E N T L A N D
another burst of energy like the one he had when he stole the
chocolate bar.
He turns round the car, heads back into town at speed and
pulls up on the pavement outs ide a musical instruments s tore .
T h e shop is set to c lose in five minutes and the sales staff are
cashing up. He tells them he mus t have a Fender Stratocaster ,
the guitar Hendrix played. T h e y obl ige . Rober t b u y s an ampl i
fier to go with it and a b o o k containing note-by-note
transcriptions of Hendr ix s o n g s . T h i s c o m e s to nearly a thou
sand pounds .
'But Rober t , ' s ays his wife when he ge ts h o m e , ' you can ' t
even play the guitar. '
He tells her he is g o i n g to learn.
But that night all elation has drained away. He lies awake
until the early hours in a state of agi ta t ion, to rmented by
thoughts of fading into nothingness , accompanied by gu t -
churning feelings of the proximity of death. Tonight, tomorrow,
just around the corner. It's coming, it's coming. He is c lose to panic .
It's coming, it's coming. T h e next day, out of nowhere , he
announces to his wife that their mar r i age is over and he leaves
her, the house , the children, and his new guitar , never to return.
Robert g o e s back to Cornwal l , where he f inds a bar job ,
g r o w s his hair, cultivates a tanned and weathered look and
becomes , in effect, s o m e o n e else .
T w o years later, l iv ing a lone in a threadbare bed-s i t in the
suburbs of a northern city, Rober t can scarcely recollect the
Corn i sh interlude. T h e r e are f ragments , images f rom s o m e o n e
e l se ' s memory , but they don ' t cohere — a blue l ampshade , a
rainy night, the shiny, stainless-steel surfaces of a hotel kitchen,
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P A U L B R O K S
184
a w o m a n ( Jack ie? J e n n y ? ) , a fistfight, the sea . It is hard to pull
together thoughts from one minute to the next.
He feels nauseous . Someth ing rises squ i rming from the pit of
his s tomach to his gullet . In the ba th room mirror, his reflected
face s eems drained of any meaning , a lmost the absence of a
reflection. He s tands s tar ing for a while, then turns on the wash
bas in tap, turns it off, turns it on aga in , off, on, before crashing
to the floor. H i s l imbs stiffen, then jerk fiercely for several
minutes , as a sp read ing patch of urine darkens his trouser leg .
H e s leeps .
T h i s is R o b e r t ' s third or fourth seizure this week. T h e next
happens in the middle of a supermarket and, afterwards, he ' s
taken to hospital . T h e doc tors are concerned that, despite
recover ing from the fit, he has remained inert and disoriented.
T h e y invest igate with head scans and find a large mass in the
orbitofrontal region of the brain. It turns out to be a menin
g i o m a . T h i s is a tumour, intrinsically benign , which has invaded
the outer cover ings of the brain. I t has been g r o w i n g for several
years . By dis tor t ing the frontal lobes of Robe r t ' s brain, i t was
reshaping the very pe r son he felt h imself to be . T h e y operate.
T u m o u r excised, Rober t enquires of his nurses most days :
' W h e n are my children c o m i n g ? ' and ' C a n I go home n o w ? '
T h e lecture seems to have g o n e well enough . T h e s e neuro-
gothic tales general ly do. I tell them ' R o b e r t ' s s to ry ' is a
somewha t embell ished account of a real case . I 've tinkered with
s o m e of the b iographica l information and, of course , the
pat ient ' s n a m e w a s not really Rober t , but the clinical details are,
in essence , faithful. T h i s man really did leave his family on an
impulse fol lowing several ep isodes of uncharacteristically
I N T O T H E S I L E N T L A N D
185
eccentric behaviour, including acts of petty theft and spon ta
neous trips to seas ide towns and other p laces . He really did
spend sums of money he could ill afford on luxury g o o d s like
musical instruments (which he could not p l a y ) and expensive
clothes (which he might , or might not, wea r ) .
He was a J imi Hendr ix fan, too. A la rge , iconic i m a g e of the
great man stared from his b e d r o o m wall at the rehab unit. H e n
drix, at least, remained constant in his life. Whether or not he
s tood in conference with the mirror in the w a y I descr ibe at the
beginning and the end, I 've no idea. I threw that in. Perhaps ,
somewhere , I had in mind the i m a g e of Jekyl l s tanding before
the mirror as he watches his t ransformation into H y d e , and
then, at the end, perhaps i t w a s D r a c u l a , bereft of soul , bereft of
reflection. I don ' t know. I t ' s only just occurred to me . After the
operation he really did expect to return to the b o s o m of his
family, unaware that they had long since m o v e d on.
When did the s low tumour take root? H o w long had i t been
g rowing and heaving its bulk into his frontal lobes , ins idiously
recalibrating his personal i ty? A men ing ioma like R o b e r t ' s can
take years to develop, eventually b e c o m i n g a stable feature of
the intracranial landscape . T h e brain can, up to a point , a c c o m
modate a s low-g rowing m a s s without be t ray ing major clinical
s igns or symptoms . I t depends on the rate of g rowth and where
i t ' s located. S o m e people g r o w old and die never k n o w i n g that
for half their life or m o r e they were harbour ing a ben ign brain
tumour. Perhaps they never k n o w who they might have been.
I once saw a man in his seventies admit ted to hospital for
investigation of a stroke. He turned out to have a tumour the
size of an o range nestl ing in the parietal lobe of his brain. I t had
P A U L B R O K S
186
nothing to do with the s t roke, had probably been there for
decades and wasn ' t , apparently, g iv ing him any trouble. I t had
b e c o m e a part of him.
Perhaps Rober t wou ld have left his wife and children
anyway. Perhaps he was restless and bored , or depressed. A
mid-l ife crisis. It could be that the tumour just hastened the
p rocess or even had nothing at all to do with his impulsive deci
s ion to pack his b a g s and go . We can' t rule this out entirely, but
I think not. Impai rments of social judgement , impulsive behav
iour, and all the rest that emerged through Rober t ' s personali ty
change are a c o m m o n consequence of d a m a g e to the frontal
lobes .
Unl ike the man with the s t roke, Robe r t ' s tumour was causing
him trouble . He deve loped epilepsy. But suppose he hadn't .
S u p p o s e there had been no obv ious medical complicat ions, that
the tumour w a s just there, nudg ing and n iggl ing , resetting the
dials of R o b e r t ' s personali ty. Would there have been g rounds
for s ay ing that his behaviour was pathological? N o . You would
say it was a mid-l ife crisis .
Desp i t e my undisguised haste to d raw the proceedings to a
c lose (I have a train to catch) there are several quest ions. S o m e
are technical, but they are most ly about the story, as a story. Fair
enough .
' H a v e y o u ever cons idered all this from a Christ ian perspec
t ive? ' asks the pale girl at the front as , finally, I gather my notes.
' N o , not really, ' I say rather briskly. 'Perhaps we can discuss
i t next w e e k ? '
' B u t what happened to Rober t in the e n d ? '
' H e b e c a m e profoundly depressed . '
I N T O T H E S I L E N T L A N D
I spare her the information that after be ing d i scharged from
his rehab hospital , there were two botched suicide at tempts
before he finally succeeded in kill ing himself. T h i r d t ime lucky.
I have this unnecessary image of Rober t hang ing h imse l f with
Hendrix s inging ' V o o d o o C h i l d ' in the background : 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 happen that way.
My train is more than half an hour late and I kill t ime in a
bookshop . I now regret not a l lowing the pale girl m o r e t ime. She
seemed genuinely dis t ressed. I resolve to seek her out after the
next lecture and make amends . But now I 'm on the train. I have
a beer in one hand and, in the other, the paperback I ' ve just
bought . I t ' s about c o s m o l o g y and I 'm t rying to get s o m e i m a g
inative purchase on the immensi ty of i t all. I t ' s the kind of thing
I somet imes read as a w a y of winding down . T h e grandi loquent
p rose (velvet mantle of the night... cosmic symphony of the heav
ens), and the b ig , round numbers (four hundred billion galaxies)
have a sooth ing effect.
C o s m o l o g y and neuropsycho logy have absurdi ty in
common . T h e raw facts are s t range beyond imaginat ion .
I t sets me thinking about how the physical forces that twist
the galaxies and roll the train a long the track connect with the
social and psychologica l forces that animate the passenger s .
Tha t recalcitrant child and his wea ry mother, the old couple
sitting in silence, the w o m a n oppos i te who catches my eye , d i s
plays a mic romomenta ry f l icker of an eyebrow and smiles as the
young man with an obscene m e s s a g e printed on his T-shi r t takes
the seat beside her. Fleetingly, she and I were complicit. I entered
her mind and she entered mine. We can plot the mot ions of the
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188
planets , but how do you measure the force of a g lance , or the
weight of a smile?
Th ink ing these thoughts and looking at the people around
me I entertain myse l f by see ing them for what, at one level of
descript ion, they certainly are: complex biological machines.
Physical objects . I take a little thought journey behind their eyes
and all I see is darkness ; then, looking to the window, against the
dark , I see myse l f looking back at m e , lost in a confusion of first
and third pe r son . T h e image in the window resembles a machine
like the others on the train, but with an involuntary flip from
third pe r son to f irs t , I 'm back now on this s ide of the reflection,
sitting in my own clear capsule of consc iousness . I buy the illu
s ion that other peop le inhabit similar capsules , but obvious ly
they don ' t . A n d from their perspect ive neither do I .
I ge t another beer. I l ook aga in at my reflection. It chuckles.
W h e n finally I get h o m e , I feel profoundly content, immersed in
my family. Secure , immutable , invulnerable, immortal . As
Rober t once felt, perhaps .
* * *
T h e pale girl is not here today. N o t in the front row, anyway. I 'm
early and I watch the students as they file in. T h e rows fil l up, but
she is not here. S o m e la tecomers arrive f ive, ten minutes into my
lecture, but she is not a m o n g them.
I p ick up where we left off last week, point ing out that illness
of va r ious kinds m a y indirectly affect the w a y we see ourselves ,
bu t that neurologica l d i sease somet imes g o e s straight to the core
and distorts the pe r son in essence . L ike parasit ic wasp larvae
I N T O T H E S I L E N T L A N D
devour ing a l iving caterpillar from the inside, a d i sease can
penetrate the substructures of the self — the neural sys t ems con
trolling long- term m e m o r y or those that regulate emot ion or
the hatching of intentions or the shap ing of beliefs. I remind
them of Rober t ' s s l ow-g rowing tumour and how he c a m e to see
the world in a different way. He thought differently, behaved
differently, felt differently about the peop le a round him. Was
the Robert who impulsively bough t expensive clothes and e lec
tric gui tars , who stole chocolate bars , m a d e impromptu trips to
seaside towns, and finally walked out on his wife and children —
was he the same Rober t who, previously, had been so devo ted to
his family, worked hard to pay the bills, who would never have
dreamt of stealing anything, and didn ' t take risks or get into
f ights? If not, when did Jekyll b e c o m e H y d e ? Was there a s ingle
incident or a s ingle day that might be said to mark the transi
tion? Is it possible to pin it down to a s ingle moment? D o n ' t we
all do rash and stupid things from time to t ime? H o w many add
up to a personali ty change?
Then the return journey. Robe r t ' s tumour w a s r emoved and
he was back to someth ing like his former self. Something l ike.
He yearned for his wife and kids. He wanted them back . But in
other w a y s he was irretrievably different, intellectually and
emotionally. His mental powers were diminished. He b e c a m e
forgetful and couldn' t concentrate. He couldn ' t p lan things
from one day to the next; his v iew of the future w a s foreshort
ened. His face was pressed agains t the wall of the present , but
the past was at his shoulder. It was where he felt he be longed ; in
the golden valley of the t ime before the tumour. More than that,
i t was where he often bel ieved himself to be .
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T h i s w a s not a wistful dwel l ing on the past . Somet imes he
w a s confused to the extent that he bel ieved nothing had
changed . His wife wou ld c o m e to collect him. She would. S h e ' d
be here soon . T h e y would pick up the children from school
together. T h e y wou ld go home . T h e pas t was like a radio jingle;
not much tone or melody, but i t w a s in his head and would not
leave him a lone . T h e n there w a s the depress ion - and in one of
these black t roughs he took his own life. What relationship did
pos t -opera t ive Rober t have to his former selves? What was his
' real ' se lf? What w a s his identity?
I realize I 'm waffling. S o m e of the students are shuffling in
their seats . T h e y have c o m e to depend on lectures structured
like se l f -assembly furniture manuals , with handouts and web
p a g e s full of d i a g r a m s and f low charts, bullet points and refer
ences. Y o u g i v e them L e g o bricks of fact and opinion and you
tell them precisely how they fit together. I 'm thinking aloud. It
d is turbs them.
' D o n ' t wor ry about the precise meanings of terms like self
and personal identity,' I say. Ord ina ry l anguage notions will do
for now. Actually, I 'm inclined to think that ordinary l anguage
not ions are about as g o o d as i t ge ts when i t comes to talking
about 'personal identi ty ' and the ' s e l f ' , but I don ' t mention this.
' T h i n k of your self. Y o u know, that which you think roughly
defines you, the consc ious be ing sitting here in this lecture
theatre; that which dis t inguishes you from the person sitting
next to y o u or s o m e o n e somewhere else do ing someth ing differ
ent. Or a co rpse . '
A co rpse? Where did that come from? But then an image of
last n igh t ' s s t range d ream f loats before me . Matilda, one of the
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I N T O T H E S I L E N T L A N D
junior doctors , was there. We had the top half of a m a n ' s b o d y
ready for dissection. N e x t thing I know, the head is separa ted
from the torso. T h e r e ' s Mattie, m e , and s o m e other ma le , I don ' t
know who. I feel squeamish , but try not to let it show. R e l u c
tantly, but deftly, Mattie ge ts started with a cranial saw.
At some level I knew it was a d ream because sawing th rough
the skull of a cadaver invariably releases the smell of bu rn ing
bone - think of that acrid smell of the dent is t ' s drill bo r ing
into your teeth. But there ' s no odour . No sound even. S o o n
the top of the skull is r emoved and we are look ing inside at the
remnants of the brain, except i t looks more like a m a s s of mel ted
candle wax than a brain. I can sense Mat t ie ' s d i sgus t . She's going
to be sick, I think. A n d she is - just a little, in the efficient, m e a s
ured way that cats are sick — straight into the opened head and
over the waxy brain.
T h i s job is get t ing to me . Perhaps there ' s a part of me t rying
to tell me something. As i f repulsed by my pr ivate thoughts (are
they hovering like a pol luted mist above my h e a d ? ) , a w o m a n at
the back of the hall s tands up and makes her w a y to the exit.
T h e dream replays itself like a scene from a film. I mere ly
observe. T h e macabre narrat ive has nothing to do with me .
I didn't plan or construct it. It appeared fully fo rmed in my
dream. If someone had told me this s tory yesterday, as a d ream
vignette of their own, I would not have c la imed rights of o w n
ership. I t would have seemed novel and unfamiliar. If over
breakfast this morn ing I had been asked about my d ream last
night, I might well have been unable to remember . I usual ly
can't .
T h e scene unfolded while the consc ious , reflecting, del iber-
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P A U L B R O K S
192
at ing 'I ' was do rman t and, by the t ime 'I ' returned to wakeful
ness , i t had retreated into s o m e secret compar tment of my brain,
like a hermit crab folding back into its shell. Synaptical ly
encrypted to surv ive the transition between sleep and wake
fulness, the virtual shell then travels with me to the university. I
b r ing i t to the lecture. A n d then at s o m e unconsc ious signal , or
pe rhaps for no reason at all, the crab emerges and the dream
s tory unravels in the middle of my talk. I t has nothing to do
with m e .
T h e audience settles down when I show them d iag rams of
the brain and tabulate s o m e of the clinical syndromes associated
with d a m a g e to the frontal lobes :
1. Dysexecutive type (dorsolateral d a m a g e ) ; impaired j u d g e
ment and difficulties with p lanning and problem-solv ing .
L a c k pers is tence or, the oppos i te , persist in per forming an
action well beyond the point of usefulness or appropr ia te
ness ( ' pe r severa t ion ' ) .
2. Disinhibited type (orbitofrontal d a m a g e ) ; behaviour is s t im
ulus-dr iven. T h e balance between internally generated
act ions and those t r iggered by external objects and events is
lost . T e n d to be distractible. S h o w impoverished social
insight .
3. Apathetic type (mediofrontal d a m a g e ) ; apathy and indiffer
ence , loss of initiative, lack of spontaneity; impoverishment
of speech and thought; reduced behavioural output.
I ask them whether Rober t ' s behaviour fits any of these schemes,
while reflecting, privately, that my teaching style today has per-
I N T O T H E S I L E N T L A N D
haps displayed elements of the first and second s y n d r o m e , i f not
the third.
In conclusion, I quickly review the main themes of the lec
ture and we finish ten minutes early. T h e r e are no quest ions .
T h e pale girl is not here to ask whether I have considered it all
from a Christ ian perspect ive . I wish she were .
T h i s train's on t ime, m o r e or less . I t ' s seven o ' c lock and
darker than it should be for the t ime of year. Sudden ly I feel
tired. Perhaps I 'm b rewing a cold. O n e of the students pressed a
b o o k about Buddh i sm into my hands as I w a s leav ing the lecture
hall. T h e r e ' s s o m e stuff about suffering and death set t ing the
co-ordinates for life. I 'm not in the m o o d . I mus t have been
twenty minutes on the s a m e p a g e .
At the station, as peop le are boa rd ing the train, I watch a m a n
and a w o m a n on the platform. T h e y are embrac ing passionately ,
say ing their goodbyes . I 'm reminded of what s o m e o n e once
said about par t ings: how the instant they ' re g o n e the pe r son y o u
were with seems m o r e powerfully present than ever before .
Absence is tangible. T h e man gets on the train, the w o m a n
remains on the platform. He looks red eyed and quite shaken. I
watch the face of his g i r l f r i end /wi fe /mi s t r e s s as we pull away.
It has a chilling composure . It is a b locking face, deny ing entry
and exit. He won ' t see her again .
He sits just ac ross the aisle from me and I feel an irrational
u rge to g ive him the b o o k about Buddh i sm. I put i t as ide and
turn to the bundle of papers I picked up at the university. I still
have a p igeonhole , even though i t 's a year since I left. T h e
Departmental Commi t t ee minutes are at the top of the pile
but, beneath this, someth ing catches my eye: a note about the
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194
suicide of an undergradua te . A w o m a n , a final-year student. It
is not a n a m e I recognize . T h e train clatters across some points,
c lackety-clack, and my s tomach turns.
' T h a t girl who killed herself. Wha t did she look l ike? '
I 'm home . At last I 've found my old address b o o k and I 'm
phon ing a former co l league at the university, the one who per
suaded me to do the lectures. He is s luggish . I t is well past
midnight .
' I ' m sorry, ' I say. ' I t ' s late . '
' N o , i t ' s okay. '
'Wha t did she look l ike? '
' I don ' t know. I ' ve no idea. '
I t takes presence of mind to put an end to o n e ' s own life.
Suic ide m a y be the bitter fruit of hopelessness and despair, but i t
is a lso the end point of a dec i s ion-making process . T h e r e seems
to be a ' let t ing g o ' , an acceptance of the idea of death that
induces clarity of thought and peace of mind. T h o s e c lose to a
suicide often report that the pe r son seemed happier or more
tranquil than usual in their final hours . T h e r e ' s something I read
somewhere — I can ' t p lace it — about the causes of suicide and
h o w they are not a lways obv ious or predictable and how, i f
s o m e o n e is in a particular frame of mind, it doesn ' t take much to
tip them over — an innocent remark misinterpreted; a gesture
misperce ived .
I 've thought about the pale girl a lot this past week, but
haven ' t fol lowed it up. I don ' t want to appear morbid or obses
s ive . I could have m a d e discreet enquiries, found s o m e pretext.
It wou ld have been a normal thing to do. But I didn' t , for my
own sake . I did not want to see myself behaving in that way,
I N T O T H E S I L E N T L A N D
betraying s igns of culpability. I 'm not culpable. Yet m o r e than
once I have pictured a counter-factual wor ld where I 'm the per
fect, patient teacher. ' H a v e you ever cons idered all this f rom a
Christian perspec t ive? ' she asks , and I say : 'Tel l me what you
mean, exac t ly ' T h e n we have a conversat ion for five, ten,
twenty minutes; however long it takes for me to listen to her
concerns and put my own point of v iew gently and consider
ately, without crushing her. A n d then I wou ld have caught my
train, because i t was half an hour late anyway and in my wry,
atheistic way I would have const rued this as a beneficent nod
from the Creator , a little thanks-for- taking-the-trouble ges ture .
I think about her now 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 wai t ing. S h e ' s wai t ing. T h e r e she
is in the front row with her mini cassette recorder. Where have
you been? I want to ask her. Where were you?
195
Mr Barrington's Quandary
I t ' s C l a r a , my trainee, on the phone , asking me to come and see
Mr Barr ington . I 'm forming a picture as I make my way down
the corr idor to the outpatient clinic. Mid-fifties, light g rey suit,
wet , b lue eyes , sandy hair, mois t handshake, the hint of a s tam
mer. I saw him a couple of weeks ago . T h e r e before me as I enter
the r o o m is a midd le -aged man, the s a m e suit, the same eyes. But
this man is complete ly bald . Hi s head glistens under the strip
l ighting. T h e r e are tears f i l l ing his eyes and he is sweating
profusely. He looks globular , dr ipping wet to his bones . I t ' s a
feature of his medical condit ion.
T h e y had started their assessments , C la ra explains, but Mr
Bar r ing ton quickly b e c a m e distressed and felt unable to con
tinue. She tells me this in just those te rms, as if reading from a
set of notes . I make a pretence of jot t ing down some notes of
my own, but what I have written, and am now tilting towards
C l a r a is: What happened to his hair?
Mr Barr ington i s ahead of me . 'You ' r e probably wonder ing
what happened to my hair. '
196
I N T O T H E S I L E N T L A N D
Apparent ly it fell out at the weekend, mos t ly dur ing Sa tu rday
night while he lay in bed t rying to sleep. It c a m e out in c lumps as
his head tossed and turned on the pillow, cover ing the sheets and
sticking to his perspi r ing skin. He tried to b rush it away, but the
sheets were damp and he w a s afraid of wak ing his wife. Severa l
times he went to the ba th room to d i spose of the hair he had
gathered, each time noticing in the mirror, without part icular
dismay, the virgin patches of skin advanc ing ac ross his head.
'You weren ' t conce rned? ' I ask .
' N o . I t ' s the least o f my worr ies . '
Anyway, he had lost a few c lumps over the week , so i t wasn ' t
that much of a shock when the whole lot fell out. H e ' s been
under a terrible strain, he explains, and things seem to have
come to a head. I note the unintended pun. L a n g u a g e has a life
of its own. H e ' s had these things p lay ing on his mind, he s ays ,
this thing in particular.
'Would you like to talk about i t ? ' I ask . 'Are y o u able t o ? '
Mr Barr ington d rops his face in his hands and sobs . Be tween
bubbl ing sniffs and quiver ing exhalat ions he asks pe rmiss ion to
remove his jacket. He also removes his tie. H i s c ream shirt is
marked with a bib of sweat down to the fourth but ton and there
are large ovals of dampness under the armpits . He regains his
composure and is s teel ing h imsel f to say someth ing , but is not
quite ready.
'Why don ' t you take a break , ' I say, 'ge t a breath of fresh air.
Then , i f you like, you can c o m e back and we'll chat. We'll leave
the tests for now.'
Mr Barr ington just stares at the floor between us . N o , he s a y s ,
he must talk. I t ' s dr iv ing him m a d . But he remains hesitant. H i s
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P A U L B R O K S
g a z e retreats to his feet. T h e n , looking in C la ra ' s direction, he
s ays i f we don ' t mind he thinks h e ' d find i t easier i f . . .
C l a r a unders tands . 'I ' l l see you later,' she says , and leaves.
Mr Barr ington g a z e s out of the window across the suburbs
towards the distant hills, his wet, b lue eyes unblinking. He isn't
admir ing the view. He is adrift somewhere in a vast , inner space ,
the exhausted prey of a relentless emotional predator: guilt . I
shake his s o g g y hand at the end of the sess ion. He is very gra te
ful. I l istened. I advised . Ou t s ide it has started to rain.
Clinical supervis ion . While C la ra fills the kettle, I think back
to Mr Barr ington . I see his a r m s swing down at his sides, his
head roll back . I hear the sustained, oscil lat ing g roan like a child
exhausted by a bout of c ry ing . T h e n the confession: a single,
w e e d y act of marital infidelity, a l ong time ago. His wife never
knew. H e ' d a lmost forgotten.
'Bu t now i t 's p l ay ing on your consc ience? ' I 'd said, which
w a s feeble in the c i rcumstances . T h i s was not a wasp at a picnic.
It w a s a skewer ing torment .
H i s hair had fallen out. T h e s to rm t roopers of the super-ego
were d o i n g their wors t , c o m m a n d i n g him to put the record
s traight with his wife. But i t would break her heart, wouldn ' t it?
W h a t w a s he to d o ?
'Tel l me what to do , ' he said . ' P l ease . '
I wonder if we can disentangle the d i lemma from the disease .
T h e provis ional d i agnos i s is mul t isys tem atrophy, a degenera
tive condit ion. I t carr ies a p o o r p rognos i s . Perhaps he ' s clearing
the decks . But the d isease is affecting his brain, so the urge to
c o m e clean, and the inability to decide what to do about i t might
a lso be unders tood in neurologica l te rms.
198
I N T O T H E S I L E N T L A N D
I once m a d e a h o m e visit to see a head-injured patient. S o m e
one had swung a basebal l bat through the front of his skull . A
year on and he w a s do ing as well as could be expected. He c a m e
to greet me at the front door , but as he put his hand forward he
noticed a milk bottle on the doors tep . Before his hand connected
with mine he was bending to pick up the bott le. He had a lmos t
reached i t when he began to straighten aga in and turn towards
me , only to change tack and bend to the doors tep . He s t ra ight
ened again . He bent. He straightened. He bent. He shifted his
weight and shuffled, s t rugg l ing to execute one or other of the
action plans hopeless ly misfiring in the mutilated circuitry of his
frontal lobes: motor dysexecutive syndrome. Finally, I picked up
the bottle and gave i t to him. We wou ld have been there all d a y
otherwise. Perhaps Mr Bar r ing ton ' s quandary is a case of mora l
dysexecutive syndrome .
Cla ra returns with m u g s of tea. I feel inclined to keep Mr
Barr ington 's secret. He w a s naked enough . I won ' t tell her, not
yet anyway. Perhaps not at all, perhaps I'll take charge of the
case , and then she need never know.
199
Out of Darkness Cometh Light
Molineux. T h e h o m e of Wolverhampton Wanderers . I t ' s a long
w a y to c o m e for a football match. T w o hundred miles and more
f rom h o m e . I still can ' t get used to the new s tadium, all pale
br ick and mus ta rd-co loured steel. When we arrive I feel I
should be somewhere else. T h e Molineux of old was j agged and
dark — a place of wrough t iron, rough concrete, and foul smells.
N o w even the lavator ies are spruce and well lit. A fan stands at
the urinal with a pie in his free hand.
I r emember the club mot to —Out of darkness cometh light—as
my sons and I ascend the s teps to the Stan Cul l is stand, formerly
the Nor th Bank . By the s tandards of Anfie ld 's Spion Kop or the
Hol te E n d a t Villa Park , the Nor th Bank w a s small . F r o m other
par ts of the g r o u n d i t looked hunched and hooded , especially on
floodlit, rainy nights . But the acoust ics were demonic . T h e
noise of the c rowd w a s a beast . I t su rged up to the rafters and
bel ted the r o o f like Beelzebub. At such t imes the Nor th Bank
w a s a s ingle vocal appara tus , the crowd a s teaming tongue in a
b lack throat.
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I N T O T H E S I L E N T L A N D
But the terraces are gone . T h e swir l ing m a s s of f lesh i s no
more . S ing ing and chanting are m o r e sporad ic and usual ly fizzle
out. N o w we sit on plastic seats , listen to anodyne p o p over the
PA, watch men dressed as car toon animals wander ing the
touchline, careful not to s t ray into opposi t ion territory for fear
of inciting the crowd. ( T h e r e is hostility enough in the vo ices
around us — this is Wolves v. West B r o m w i c h Alb ion ; an acrid
domest ic squabble . ) A n d then J e f f Beck c o m e s over the P A :
' H i - H o Silver L in ing ' . T h e c rowd ga lvan izes . I t ' s an anthem. I
find mysel f s inging a long to the chorus: ' . . . and i t ' s H i - H o
W O L V E R H A M P T O N ! ' My sons look a t me uncomfortably. I
s ing the next chorus, but with less gus to . T h i r d t ime round I 'm
silent. I look about me and am visi ted by doubt . Is this
Molineux? Is it me?
T h e other day I showed my students a video. T h e scene is a
clinic room. A y o u n g man and an old man sit facing each other.
T h e y o u n g man is taking a history, put t ing quest ions , carefully
probing the old man ' s observat ions and recollections. T h e old
man concentrates, g iv ing each quest ion careful thought , but i t is
clear from his responses that, despi te appearances (he smiles
readily, seems fully engaged and has put on a suit for the occa
s ion) , there are great vo ids between the sparse constel lat ions of
recollection.
He has a brain d isease and can hardly carry memor i e s from
one day to the next. I m a d e the v ideo m o r e than twelve years
ago. T h e old man and my younger se l f are pe r fo rming a famil
iar routine. He is dead n o w and i t occurs to me that every
molecule of my younger se l f has been replaced with the p a s s a g e
of t ime. In a sense , neither of those bod ies has surv ived .
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P A U L B R O K S
202
Similarly, nothing remains of the b o y who s tood on the terraces.
S o , what surv ives? What makes us the same person from one
year to the next, one week, one day, one minute to the next?
S o m e phi losophers have emphas ized conscious recollection.
Cont inui ty of the pe r son is down to continuity of memory. If I
can reclaim the thoughts and experiences of the young clinician
in the v ideo or, further back , the b o y on the terraces, then we are
the s a m e person . T h a t ' s not difficult. I have clear memor ies of
m a k i n g the film and can picture the pat ient ' s wife off-camera.
My impress ions of the old s tadium also remain vivid . I see
myse l f ar r iv ing, as usual , an hour before k ick-off and taking my
place halfway up the terraces or, when I was small , at the trench
wall right behind the goa l . I recall the o range gravel surround
ing the pitch and the lurid green of the g r a s s , the smells of
cigaret te smoke and O x o . I have a mental image of the a s y m
metric outline of the s tands, so clear I could d raw you a picture.
A n d , a l though much is a blur, I can conjure snapshots of certain
g a m e s and goa l s . I saw these things from a particular perspec
tive. Mine. I w a s there. It w a s me .
But there ' s a p rob lem with this line of reasoning: amnesia.
What if I couldn't r emember these things? Would disruption of
m e m o r y decouple me from the child I once w a s ? Suppose I
retained a m e m o r y link with the y o u n g clinician and that he, in
turn, could recall the b o y (whereas I can ' t ) . It would lead to the
conclus ion that the younger man and myse l f were the same
pe r son , that he and the b o y were the s ame , but that the b o y and
I were not.
A n d then there ' s my patient. H i s p rob lem was with recent
memory , not remote . In all l ikelihood he forgot the v ideo after a
I N T O T H E S I L E N T L A N D
few days , but would have had no trouble reminisc ing about his
childhood. Was the old man fused with his child-self, but d i s lo
cated from the person he had been a week a g o ?
Another v iew is that we should abandon the idea of a pers is t
ing ego. A person is more like a club — a football club, s ay -
existing by consensus , capable of dissolut ion and reconsti tu-
tion. Wolverhampton Wanderers twice went into l iquidation in
the 1980s; the current p layers weren ' t even bo rn when I started
coming to matches; the s tadium was demol i shed and rebuilt.
Noth ing tangible survives , yet here we are still — me and the
Wolves.
T h e image of my ten-year-old se l f b r ings a churning to my
chest. I feel an urge to h u g my sons , but resist. T h e y ' r e too
b ig and wouldn ' t thank me . We settle in to the match. We lose
one-nil. T h e exit from Wolverhampton is d reary and slow, but
spirits are lifting by the time we reach the motorway. We m a d e
the trip for the s a m e fixture last season . T h e match v ideo is
advertised for sale on the club websi te . I ' ve decided to b u y it.
We' l l look for ourse lves behind the goa l , halfway up in the Stan
Cull is stand. I 'm g o i n g to watch me and my kids not get t ing any
older in a universe where the score will a lways be Wolves 3,
Alb ion 1. I t ' s a restricted universe , but reliable.
203
To Be Two or Not to Be
He had a wild l ook about him. Cof fee stained the front of his
white lab coat , though now he w a s sw igg ing water from a milk
bot t le .
'Ca l l me D e r e k , ' he said .
T h i s w a s , I reckoned, the thirteenth t ime I 'd been here. He
never r emembered me .
D e r e k w a s from long ago. He appeared to function now as a
technician, but in the old days he w a s a philosopher, hauled in to
adv i se on the metaphys ics and mora l s of the new technology.
He g a v e up phi losophy, hav ing solved all the problems that
interested him, and now enjoyed push ing buttons for a living.
As i t turned out, the metaphysical implicat ions of teleportation
seemed to be no m o r e profound than the metaphysical implica
tions of T V . In any event, peop le soon go t used to the idea. You
s tepped into the boo th , you s tepped out somewhere else: across
the street or ac ross the solar sys tem.
Telepor ta t ion is speed-of- l ight swift. T h e journey to Mars,
which once took several weeks by conventional spacecraft, can
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I N T O T H E S I L E N T L A N D
now be accomplished in a matter of minutes . You enter the
booth and, before you k n o w it, the d o o r sl ides open and y o u ' v e
arrived; delivered, br isk as a b lade of l ight, to the Mart ian
plains. Subjectively, i t ' s instantaneous. But , even now, m a n y
people misunders tand the bas ic principles. I t ' s a lways been the
way. H o w many unders tood the phys ics o f T V ? I t ' s the m e s
sage that matters, not the med ium. S o , too, with teleportat ion.
I t does not, as s o m e still imagine , involve breaking down the
b o d y to its constituent a toms and whizzing them of f for
reassembly at the destination point. Wha t travels be tween the
transceivers is not a s t ream of a toms but a s t ream of data . D e r e k
pushes the green button and the scanners plot the exact co -o rd i
nates of every a tom in your body. ( T h e r e are rough ly ten bill ion
billion billion of them; the devil is in the detail .) T h e informa
tion is encoded and transmitted from this end and received and
decoded at the other, where the p rocess of reconstruct ion takes
place us ing locally available material . An a tom is an a tom is an
a tom, after all. T h e r e ' s nothing special about my a toms or
yours . T h e y don ' t carry ID labels.
O n e other detail: once the a tomic co-ordinates have been
plotted, the b o d y is annihilated. It is instant and painless; a fo rm
of vaporizat ion - or 'd i scorpora t ion ' , as they call it. T h i s hap
pens precisely at the point of t ransmiss ion. I t must . T h e event
and its t iming are determined by decree of the Subcommi t t ee on
Personal Identity.
W h y ? W h y dest roy the b o d y while the information is in
transit, before the replica has been constructed? Surely, i t wou ld
be better to wait those few minutes to make sure that the
reassembly instructions arrive in g o o d shape? You might think
205
P A U L B R O K S
so , and the Subcommi t tee considered the matter carefully
before ar r iv ing at a different view.
After much debate i t was decided that even br ief per iods of
' a synchronous parallel ex i s tence ' were unacceptable . In law,
b io logica l pe r sons take precedence over their digital form.
Des t ruc t ion of a l iv ing b o d y is deemed acceptable only if the
digital copy represents the ' latest ve r s ion ' . If a person continued
in b io logica l form until his or her copy arrived on Mars (or
wherever ) then the replica would be 'existentially asymmetr ic '
with the or iginal . As the data s t ream traversed the inter
planetary vo id , the psychologica l life of the original would have
continued to evolve . T h e replica would , therefore, not strictly
be a replica. It would be a c lose match, but not exact.
To cut a l ong s tory short , i t w a s decreed that destruction of
the original in such ci rcumstances would be tantamount to
murder . T h e pe r son copied must be precisely the person who
arr ives, down to the last a tom of the last molecule of every
musc le and membrane , and every last nuance of the neural nets.
My thirteenth trip. S tepp ing into the cubicle still g ave me a
tickle of excitement. I w a s , after all, about to be obliterated. T h e
suspens ion of existence is brief. But i t ' s real. For the duration of
the t ransmiss ion I wou ld be dead , nothing and nowhere, every
a tom of my b o d y returned to chaos . My heart quickened a t the
thought . To step into the boo th w a s to make a leap of faith that
the technology wou ld hold g o o d , that I would be resurrected at
the other end.
S o m e t ime a g o D e r e k placed a s ign above the entrance, a
f ragment of an old p o e m : Do not go gentle into that good night.
I noticed it as I s tepped ac ross the threshold.
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I N T O T H E S I L E N T L A N D
D e r e k ' s smil ing face appeared on a screen. ' R e a d y ? '
I was ready. I took a deep breath. You sense a feeble, m y o
clonic jolt, like s tumbling on the br ink of s leep, and there ' s a
momentary blackness . A n d that 's it. J o u r n e y ' s end. But this
time, when the door slid open, I realized I hadn ' t m o v e d a mil
limetre.
'P rob lems , D e r e k ? ' I said.
He wasn ' t smil ing now. 'Shit , shit, shit, ' he mumbled .
It was some kind of malfunction. At least I'm still here in one
piece, I thought to myself. My atoms haven't been scattered to the
ether. Apparently, though, it w a s a c lose call (the back-up copy
process had also fai led) , and I had to admit that I w a s shaken.
Tempora ry oblivion was fine, but I wasn ' t p repared for the per
manent option. T h e y took me to the on-si te medical facility
where I strolled through a b o d y scanner and go t an unsmi l ing
thumbs-up from the operat ive who then sent me on to Psycho l
ogy. Psych? T h e operat ive sh rugged : search me . Routine, I
thought.
I read the mental hygiene pos te rs as I sat wai t ing for the
psychologis t . She had appeared briefly to int roduce herself,
then left. She seemed f lus tered. T h e r e were raised voices s o m e
where. O n e of them w a s D e r e k ' s . I couldn ' t catch mos t of what
they were saying , but the female vo ice , the p sycho log i s t ' s
I assumed, said someth ing about this or that be ing a matter for
the Subcommit tee . D e r e k said someth ing indecipherable to
which a third, mascul ine, voice responded: ' O u t of the q u e s
tion!' What followed sounded like a scuffle. Nex t , the d o o r burs t
open and there was D e r e k .
'Someth ing extraordinary has happened, ' he said . ' I think
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P A U L B R O K S
you ' r e entitled to k n o w - ' but that w a s all he had time to say. He
w a s set u p o n by three security g u a r d s and d r a g g e d away.
I don ' t trust psychologis t s . You get the hmms and the uh-huhs,
the nods , the d o g g y - f a c e express ions of concern, the uncondi
tional posi t ive regard , the whole profess ional s imulacrum of
empathy, and then your hour ' s up and they ' re on to the next
client. It mus t take a certain thickness of skin or thinness of soul
to do that kind of stuff day in, day out. But this psychologis t was
flustered, which put me at my ease immediately. She didn't
k n o w quite how to play it, so I helped her out.
"What you ' r e telling m e , ' I sa id , ' is that I w a s scanned and d is
patched but — obviously , s ince I 'm here talking to you — not
vapor ized at the point of depar ture . ' She nodded . 'And at the
other end, meanwhile , my replica was assembled and is now
fulfilling my duties on M a r s ? '
' T h a t is correct . '
'Well , ' I sa id . 'Well , fuck me . What went w r o n g ? '
Actual ly, I w a s less taken aback than you might imagine.
H u m a n evolut ion has equipped the brain with an impressive
r ange of adapt ive responses for cop ing with all sorts of situa
tions. It g e a r s up the b o d y for fight or flight in the face of
physical threat, to recoil from contaminat ion, to affiliate with its
fel lows, to mate and reproduce , and to come to terms with loss.
But self-duplicat ion was not a feature of H o m o sapiens ' envi
ronment of evolu t ionary adaptedness out there on the
savannah . It takes a while to formulate a response .
I soon b e g a n to regard my replica as a kind of rival and won
dered what i t w a s get t ing up to on my behalf. In human relations
similarity is often the fulcrum about which points of difference
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I N T O T H E S I L E N T L A N D
work the greatest leverage . I t ' s what g ives a personal r ivalry its
edge in many cases .
A n d what was my replica 's v iew of events, I wanted to know.
Had i t expressed an opinion? At this, the p sycho log i s t ' s face
became g rave . Her m o d e switched from empathic therapist to
purveyor-of- the-party-l ine. T h i s w a s an except ional event, she
said. T h e Subcommit tee on Personal Identity w a s meet ing in
emergency sess ion at that ve ry momen t to decide the i s sue .
What had happened was in contravention of the Prol iferat ion
of Persons Ac t . I t was a ser ious matter. She w a s at l iberty only
to present me with the bare facts and regretted that she could not
enter into speculation about future deve lopments . N o , I wou ld
not at this s tage be permit ted to contact my wife or any other
members of my family, or friends, or co l leagues . Or anyone .
T h e Subcommit tee was expected to deliver a s tatement within a
day or two and until then I wou ld be their gues t . Wha t exact ly
was the issue that the Subcommit tee w a s in sess ion to decide?
She was not at liberty to say.
T h e y took me to a small r o o m that looked out upon a q u a d
rangle. A soli tary copper beech occupied the centre of the lawn,
its purpl ish-brown leaves sh immer ing in the evening sunshine. I
lay on my bunk and stared at the ceil ing. It g r e w dark. I longed
to speak to my wife and children, but communica t ion with the
outside world w a s forbidden. I wanted to reassure them that I
was okay. I would have called them by now in ord inary c i rcum
stances. T h e y ' d be worr ied sick. Wha t had they been told? A n d
then, d ropp ing like a forge hammer from my head to my gut ,
this thought: The call has already been made.
In t ime, miraculously, I slept. It w a s a heavy, d reamless sleep,
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as if I 'd been d r u g g e d . Perhaps I had. But in the middle of the
night I woke to find a tall figure s tanding at the foot of the bed.
It remained mot ionless , its face in shadow. I would have been
first to speak , had the w o r d s not lost their tired way through the
somnolen t circuitry o f my brain.
'L i s t en , ' said the figure. 'L is ten . I think you are entitled to
know. '
I t w a s D e r e k . He explained, without preliminary. T h e Sub
commi t t ee ' s quandary — my mortal p roblem — was this: given
the unfortunate turn of events , they were now debat ing whether
to al low me and my replica to continue to exist in parallel, and
thereby contravene the Prol iferat ion of Persons Ac t , or to have
one of u s , even at this late s t age , vapor ized . To be two, or not to
b e . It w a s a hard one to call, he said. In law, the creation of sur
p lus individuals w a s a ser ious cr ime; the mirror image of
murder . To D e r e k ' s knowledge , my replica had not immedi
ately been informed of the c i rcumstances , so had carried on as i f
noth ing untoward had happened. He could not say for sure that
i t had been informed even now. T h i s could be an influential
factor i f the Subcommi t t ee decided that one of us had to go.
If the repl ica 's relationship with my wife had evolved even to
the merest extent of a br ief televisual communicat ion then that
could weight the decis ion in favour of a l lowing the replica to
surv ive rather than m e . Discorpora t ion w a s not my preferred
opt ion. Bu t surely, I thought , the proposa l would not be carried
anyway. T h e y couldn't. I t w a s prepos te rous . H a v i n g presented
itself, the dread propos i t ion had to crank through the archaic,
c lockwork logic of the commit tee p rocess , but then, surely, i t
wou ld be thrown out.
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I N T O T H E S I L E N T L A N D
' I don ' t want to die , ' I told D e r e k .
' I t wouldn ' t be the end of the wor ld , ' he replied, which s truck
me as an odd thing to say.
Derek sat in the easy chair at the far end of the r o o m , still in
shadow. 'What ' s the difference? ' he said . ' S u p p o s e i t had g o n e
according to plan. You would have s tepped into the boo th , the
scanners would have done their stuff, your b o d y wou ld have
been zapped to zero, and your replica wou ld have appeared on
Mars, walking your walk and talking your talk. A n d that is what
has happened — that is what a lways happens — except this t ime
the zapping may have been a little de layed . '
T h e difference, D e r e k , I might have sa id , is that I 'm still
here, now, and, having had t ime to reflect, I don ' t think I want
to be zapped to zero, even though, twelve t imes before , this is
precisely what has happened.
Nevertheless , D e r e k had a point. E a c h of the p rev ious t imes
I 'd been teleported to Mars the experience w a s the s a m e . I
walked out of the booth with perfect recollection of the d a y ' s
events up to the point of s tanding in the transceiver on Ear th
and experiencing that familiar little jolt and the br ief b lackness ,
and then there I was taking in the Martian landscape . T h e r e w a s
perfect continuity. T h e twelfth t ime I r emembered the eleventh,
the eleventh time the tenth, and so on. A n d each t ime I could
reflect back not just on that d a y ' s events, but on events of the
previous day, too, the prev ious weeks and months and all the
years of my sentient, se l f -conscious life.
On arrival, I a lways called my wife, told her I w a s okay, that
I missed her already, and checked on the kids. T h e n I went about
my business . A n d when I slept I knew my d reams had m a d e
211
P A U L B R O K S
212
their digital w a y ac ross the void with the rest of me . T h e y had
their familiar fabric, the usual blend of the mundane and the
myster ious . I dreamt of h o m e , of work , of ordinary things.
A n d then it w a s no surprise to meet the lost and the dead and run
unfettered by log ic and t ime through the streets of my child
h o o d or take w ing over oceans and s t range cities; I dreamt secret
d reams . T h i s i s what had a lways impressed me most about tele
portat ion. N o t only w a s the b o d y reconstructed in perfect
replica, and the consc ious mind, but the unconscious mind, too:
those things hidden from the obse rv ing ' I ' .
N o w my replica was d reaming those dreams, and before i t
slept it had called my wife, told her it missed her already, checked
on the kids, and gone about its business . It had done those things,
not I. We were not the s ame . I was flowing in a different stream
of consciousness . But i f the replica wasn ' t me now, how could i t
have been me on the previous twelve occasions? What did the
experience of perfect continuity amount to? Was i t no more than
the illusion of life d isguis ing a dozen deaths?
I t w a s just three weeks since I 'd last m a d e the trip. D i d that
mean that, as a sentient, se l f -conscious be ing , I was less than a
month old, exquisi tely configured from the chaos of a billion
bil l ion bill ion a toms and artificially equipped with the memory
banks and disposi t ions of a midd le -aged man? If so, my identity
w a s a fiction.
' T h e p rob lem, ' said D e r e k , ' is that mos t of us have false
beliefs about our own nature. People expect determinate
answers to ques t ions about personal identity: " Y e s , i t is the same
p e r s o n " or " N o , i t i sn ' t ." T h a t ' s one great misconcept ion. T h e
other is that personal identity matters in the first p lace. '
I N T O T H E S I L E N T L A N D
I experienced a s low infusion of anger, r is ing in my chest ,
diffusing to my face and fists.
' I t ' s fine for you , De rek , ' I sa id , ' to deny the impor tance of
personal identity and pontificate on the conceptual confusion of
anyone else on the planet who happens to bel ieve otherwise . Bu t
put yourse l f in my posi t ion. T h e r e ' s a distinct possibi l i ty that
I 'm about to be snuffed out. R igh t now my concerns about
whether I shall still be here by the weekend — or "zapped to
ze ro" as you indelicately put i t - seem real enough . A n d if I am
to be vapor ized, I 'm sure you ' l l have no difficulty g i v i n g a deter
minate answer to the quest ion of whether I exist or not . '
'Well, ' he said, ' that 's not quite the point . '
I 'd been sitting on the edge of the bunk, but s tood now and
moved towards him. Both of my fists, I not iced, were t ightly
clenched.
'Derek , ' I sa id , ' y o u ' d better go , ' at which he raised a p laca
tory pa lm, acknowledged my dis tress , and said he w a s here to
help. In fact, h e ' d been through someth ing similar in the early
days , since when he had achieved a kind of insight. H i s travels
in phi losophy and daily exposure to the plain facts of te leporta
tion had brought him to a vis ion of the self, which, once
absorbed, began a t once to d raw the st ing of death. T h i s mos t
natural of fears was revealed as synthetic. I t could be d i sman
tled. Intellectually.
He had once watched h imsel f die , he told me . I t w a s one of
the first interplanetary teleportations. Hi s first, and only, visi t to
Mars . He entered the booth and fol lowed the usual p rocedures
and, sure enough, s tepped out into the reception zone at the
Martian base as i f he were s tepping out of his front door . I t w a s
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P A U L B R O K S
a b i g event in those days . T h e y were ready with champagne and
s m o k e d sa lmon to celebrate. At first no one in the reception
par ty w a s aware of the malfunction back on Earth. But then the
m e s s a g e c a m e through. Scanning and t ransmission had worked
a treat — of cour se they had, there he was , soak ing his reconsti
tuted flesh in c h a m p a g n e — but the vaporizat ion phase had failed
to kick in.
D e r e k had arrived but , at the s a m e t ime, he hadn' t left. A n d
w a s i t for better or w o r s e that the Ear thbound version of Derek
had suffered fatal injuries in the p rocess? T h e discorporat ion
mechanism had stuttered and s topped. His whole b o d y blinked
on the brink of extinction, fading then regaining its shape, but
only at the cost of significant d a m a g e to the cardiovascular
sys tem. He wou ld be dead within a week.
D e r e k 2 had returned at once , not knowing what to expect.
'I tried to console him, ' he said, 'I told him I loved his wife;
I wou ld care for his children; I would finish the book he was
wri t ing. A n d , of course , from my perspect ive, nothing had
changed: they were my wife and children, i t w a s my b o o k and
it w a s my intention that I should finish it. So , I told him:
" D o n ' t despai r ; nothing will really change . " But he wept. He
said that no doubt I wou ld do all those things as well as he could,
and i t w a s s o m e consolat ion that his family would not suffer
the pain of bereavement , but the fact remained that within a
few d a y s he wou ld lose consc iousness for ever. T h i s would be
a terrible loss .
' H e had been thinking of a h o m e mov ie , the one where his
smi l ing daughter — my smil ing daughter — is s tanding in the
kitchen with a basket of s trawberries . S h e ' s about three years
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I N T O T H E S I L E N T L A N D
old. T h e r e is sunlight s t reaming th rough the w indow on to her
face. A n d she takes the fattest s t rawberry in the basket and
crams i t into her mouth; i t ' s so b i g she has to push i t in with the
palm of her hand. Her cheeks are bu lg ing as she s t rugg les to
chew. Her eyes are c losed . She is utterly absorbed , over
whelmed, by the experience of the fruit. She even sways a little
from side to s ide , as v i r tuoso violinists do. " T h a t ' s what i t ' s all
about ," he said. " C o n s c i o u s experience. A n d that is what I shall
lose; that beautiful smile , the taste of s t rawberr ies , fond m e m o
r ies ." A n d to that extent, he w a s r ight , ' said D e r e k . ' H i s
consciousness would fade , beyond darkness and silence to
oblivion. He would b e c o m e nothing.
' I was with him when he died. T h e r e w a s no one else a round .
We had agreed that i t would be in the best interests of the family
that they should never know of our duplicat ion. W h y should
they be t roubled? T h e r e w a s no need. Le t life go on as normal .
I admired his resolve at the end. I t m a d e me feel p roud . He so
wanted to see his loved ones for one last t ime, but under s tood
the distress and confusion i t would cause . So i t w a s just me
and him. I held his hand. A n d then life did go on as normal . I
went h o m e and h u g g e d my wife and children, and eventual ly
I finished my b o o k . '
' T h e n i t can ' t be denied that personal identity really d o e s
matter, ' I sa id . 'Your former se l f died a lonely death. His con
sciousness switched off like a light. He lost everything:
beautiful memor ies , the love of his family, hopes and plans for a
future that he would never reach; life itself. T h o s e things m a d e
up his identity. No th ing m o r e mattered, and nothing mattered
more . '
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P A U L B R O K S
216
D e r e k leaned forward, e lbows on knees , thumbs to cheek
bones , f ingers to forehead. 'Yes and no, ' he said.
We talked for hours , until the light of a g rey dawn conjured
shapes in the cour tyard as i f from imaginat ion. T h e copper
beech seemed reluctant to appear . Was this to be my last day?
D e r e k did mos t of the talking. He mus t have thought these
things th rough a thousand t imes before , but still there was a note
of u rgency in his vo ice , as if he were on the brink of a revela
tion. I am not a phi losopher , and at t imes I found him hard to
follow, but I go t the gis t .
He explained that there were two w a y s of looking at a person
or, rather, two theories about what persons are , and what is
involved in their continued existence over t ime. T h e f irs t theory
he called E g o Theory . T h i s i s the intuitive, common-sense view,
but one that w a s held, a lso, by s o m e of the greatest phi loso
phers , mos t f amous ly Rene Desca r t e s . I t m a d e sense to me , too:
I wake up in the morn ing ; I go to work ; I feel happy when things
go well and I feel frustrated when they don ' t ; I hold certain
beliefs about the wor ld and express var ious opinions and prefer
ences: I used to like Beethoven, but n o w I prefer Mozart; I like
chocola te better than cheesecake; I enjoy walks in the country
s ide ; I take the v iew that peop le should be kind to one another,
and I feel bad if I do the w r o n g thing. I act, I feel, I think, I
be l ieve , I g r o w older, and I change in other ways . But 'I ' am
a lways there at the centre of things as t ime g o e s by.
Wha t i s this ' I ' ? We ordinari ly claim ownership of our
act ions and thoughts and experiences: I did it; that 's my idea; I
feel hungry ; I intend to b u y a bir thday present for my daughter
I N T O T H E S I L E N T L A N D
. . . So the 'I ' is the experiencer of experiences, the thinker of
thoughts, and the doer of deeds . E a c h day is a blizzard of s ens
ations and thought pat terns, but I g i v e them coherence and link
them to my memor ies and my p lans for the future.
I t ' s natural to think in this way. We are the p rogen i to r s of
thoughts and actions and they are ours in the thinking and do ing .
Accord ing to E g o Theory , i t is this 'I ' that consti tutes the
essence of the person and which pers is ts over t ime. But , aga in ,
what is it? Descar tes bel ieved that the e g o w a s a purely mental
thing, a soul or spiritual substance, but y o u don ' t have to go
a long with that to accept the idea of the self, the ego , as a kind of
hub about which the wheel of experience revolves .
In this non-spiri tual sense the e g o is merely the subject of
experience, it is that which unifies s o m e o n e ' s consc iousness at
any given moment . I watch the sky l ighten, I see the leaves of
the copper beech gain colour, and I hear birds s ing ing . Wha t
g ives this scene its unity? Wha t pulls these disparate threads of
experience together? I do. T h e y are experiences had by m e , this
person, at this t ime. A n d the wheel rolls on through the years ,
account ing for the unity of my life.
T h e s e thoughts were running through my mind as D e r e k
spoke. I was thinking them. ' I can see ing nothing to d i sagree
with there, ' I told him.
D e r e k s topped talking and, for a moment , there w a s only
b i rdsong; then he turned to Bundle Theory . He said that like
many styles in art — such as Goth ic , b a r o q u e , and rococo —
Bundle T h e o r y owed its n a m e to its critics. But the n a m e w a s
g o o d enough. T h i s theory rejects the idea that act ions and e x p e
riences are owned by s o m e inner essence , e g o or ' I ' . T h e r e are
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P A U L B R O K S
just sequences of act ions and experiences. No th ing more . Each
life is a l ong series — or bundle — of mental states and events,
bound together by var ious kinds of causal relation, such as
those linking the percept ion of a f ierce-looking d o g with the
emot ion of fear and the disposi t ion to run away, or the different
causal relations that hold between ep isodes of experience and
ep i sodes of memory . A n d that ' s all. T h e idea of a central ego, or
pe r son , contr ibutes nothing to our unders tanding of the unity
of consc iousness at any g iven t ime, nor d o e s i t pull the golden
thread of experience th rough a lifetime.
' S o , ' said D e r e k , ' f rom this perspect ive the ego is a hollow
fabrication, and y o u could even say that Bundle Theor i s t s deny
the existence of peop le . '
'Bu t that ' s absurd . '
' Y e s , ' he sa id , ' and you are not the f i rs t to say so. T h e
eighteenth-century phi losopher, T h o m a s Reid [he came to be
k n o w n as 'the c o m m o n - s e n s e phi losopher ' ] m a d e a similar
object ion. "I am not thought ," said Re id , "I am not action, I am
not feeling; I am someth ing which thinks and acts and feels."
Y e s , of course , that ' s what i t s eems like for all of us, and it 's
certainly the w a y we are used to talking about ourselves and
others — as if there really were s o m e central nucleus of a self, a
ghos t ly pilot set t ing the course and handling the controls.
" D o n ' t call me a sequence of events ," you say, "I am a person, a
person, a P E R S O N ! ' " D e r e k beat his fists on the a rms o f the chair
for emphas i s .
' F ine , ' he sa id . 'Bund le Theor i s t s accept this as a fact. But
they accept i t only as a fact of g rammar . People and subjects-of-
exper ience exist as a feature of the w a y we use our l anguage , but
218
I N T O T H E S I L E N T L A N D
in no other way. If you say there is m o r e to i t than this, if you say
there is someth ing behind the chains of interacting mental
events and brain functions, someth ing above and beyond ,
observ ing and control l ing, bundl ing it all together, ho ld ing its
shape from one day to the next, then the Bundle Theor i s t wou ld
say that you were profoundly mistaken. '
' I think you ' re beg inning to lose me now, ' I admit ted, ' I can
accept that there are many p rocesses g o i n g on in my brain of
which I am unaware , all sor ts of hidden machiner ies p r o d u c i n g
thoughts and percept ions, shaping speech-pat terns , influenc
ing decisions and actions in w a y s too rapid or subtle to be picked
out by the spotl ight of consc iousness . But , once such things
are in the spotl ight , who or what is hav ing the experiences, if
not I ? '
T h e sense that I was author of my own thoughts and act ions
felt like more than a 'fact of g r a m m a r ' to me . D e r e k mere ly
replied that yes , i t was indeed difficult to accept the truth of the
matter. He said there w a s a conflict between scientific under
standing and p e o p l e ' s ord inary intuitions about what they
believe themselves to be , because there is nothing in the brain
sciences to support E g o Theory .
Few, if any, neuroscientists bel ieve that there is anything cor
responding to a se l f or ego distinct from a multiplicity of mental
states and their associated pat terns of brain activity. F r o m the
perspect ive of neuroscience, Bundle T h e o r y i s obv ious ly true.
But E g o T h e o r y won ' t go away. We can ' t shake i t off. T h e
beliefs that most of us hold about our cont inued existence over
time are built upon assumpt ions that E g o T h e o r y , or someth ing
very like it, is true.
219
P A U L B R O K S
220
' T h a t ' s what I meant , ' said D e r e k , 'when I said that most
peop le hold false beliefs about themselves . '
Bund le T h e o r y was not a new idea, he explained, just a diffi
cult one to c o m e to te rms with. Its roots reached down to the
sixth century BC and the teachings of Siddhartha G o t a m a , the
Buddha , ' the enlightened o n e ' . Anattavada, the Buddhist d o c
trine of 'no sou l ' or 'no se l f ' , ho lds that people and selves have
only nominal existence (as opposed to actual exis tence) , mean
ing they are just combinat ions of other elements. T h e self i s no
m o r e than a bundle of fleeting impress ions .
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, O Mara? You are
misled by a false conception. 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 , ' he continued, 'when teleportation came a long many
people had g r a v e misg iv ings . T h e y saw i t not as the fastest
means of t ransport , but as a sure means of dy ing . T rue , i f you
submit to the p rocess , your replica turns out perfect in every
way, with an identical b o d y and brain and identical patterns of
mental activity, including m e m o r y sys tems replete to the last
a tom and iota of information. " B u t , " they said, "don't be fooled.
T h o u g h it might resemble you in every way, the replica will not
in fact be you . It will be s o m e o n e else. It can' t poss ibly be you
because your b o d y and brain have been des t royed . ' "
'And they were right, ' I sa id . 'My present predicament
p roves it.'
'Pe rhaps , ' said D e r e k . ' In a way. But not in any way that
I N T O T H E S I L E N T L A N D
really matters in ordinary life. N o t i f Bund le T h e o r y is true, as
I bel ieve i t to b e . T h e fact is that teleportat ion b e c a m e c o m m o n
place. I t became a tried and trusted m o d e of t ransport and no
one had any complaints . People went into the boo th and they
came out at the other end, intact in b o d y and mind. L i f e went on
as usual . Y o u ' v e done i t numerous t imes yourse l f and i t ' s never
been a problem, at least not until now. A n d I want to pe r suade
you that, even now, even if the Subcommi t tee c o m e s to the con
clusion that you are to be vapor ized , i t isn ' t really as much of a
problem as you fear.
'Le t me put i t this way. E v e n though i t involves dest ruct ion of
the body and reconstruction us ing entirely new mater ials , we
should think of travelling by teleportation as no m o r e threaten
ing or problematic than travell ing on l i fe ' s j ou rney from one
day to the next. What matters in both cases , in te rms of what is
preserved, is precisely the s ame : psychologica l continuity. We
are the same from one day to the next only in so far as the bundle
of mental states, actual and potential , that our brain takes with it
to sleep at night resembles the bundle that it wakes up with in
the morning . You survive from one day to the next because the
psychological links have been maintained.
' O n Tuesday you have a certain set of memor ie s and plans ,
aptitudes and disposi t ions. T h e s e flow from the ones you had on
Monday and are , in turn, causal ly linked to the ones you will
have on Wednesday, Thur sday , and Friday. A n d if, on Saturday,
you are teleported to Mars , your replica emerges with the very
same pattern of mental states, which will be carried forward to
the next day and the next and the next th rough the usual causal
links. The re is no break in the continuity of mental life. You and
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P A U L B R O K S
your replica are psychologica l ly cont inuous at the deepest level.
A n d you mus t realize that the mechanisms of mental survival
over t ime in ord inary life really are no different, and that there
is no other kind of continuity that really matters. The re is no
point peer ing into the bundle , hop ing to catch a g l impse of some
elusive, obse rv ing ego. T h e r e isn' t one . T h e bundle i s all. '
I w a s beg inn ing to unders tand, but it didn' t help my case . I
might still have to face the prospect of an untimely death. I said
that Bundle T h e o r y might very well be true, as D e r e k believed,
and my mind would live on in replicated form — and, yes, there
w a s s o m e consola t ion in that. T h e replica moves forward in
t ime with my s tock of memor ie s and disposi t ions. I t can go on
to fulfil my plans and obl igat ions . Perhaps it really was the case
that, by any meaningful analysis of the nature of mental life, I
s tood in relation to my replica as I s tood in relation to the person
I w a s yes terday and the pe r son I might be tomorrow. But, at the
s a m e t ime, it w a s a lso clear that a branching had taken place.
Whi le the repl ica 's mind had rolled out with perfect continu
ity from the mind I embodied at the point when D e r e k pushed
the green but ton to initiate the scanning p rocess , our minds had,
since then, b e g u n to d iverge as , minute by minute, we absorbed
different experiences. We did not know whether the replica had
even been informed of the teleportation malfunction. I f not,
then it wou ld be car ry ing on as normal — as me — happily un
aware that a vers ion of its former self was languishing
miserab ly on a truncated branch line.
Would it care? I wondered . I liked to think that I (and there
fore it) would feel compass ion . But really who knows how one
might react i f s o m e bizarre alternative vers ion of o n e ' s self
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I N T O T H E S I L E N T L A N D
showed up like the spectre at the feast, threatening to warp the
status quo? It could p rove a dreadful encumbrance .
I put it to D e r e k that my replica and I m a y once have been
identical, but we were g r o w i n g apart . We were deve lop ing
alternative points of view. We had b e c o m e different peop le i f
only in the restricted, l anguage-dependent sense that Bund le
Theor is t s al lowed talk o f people . A n d I , f rom my perspec t ive ,
did not relish the prospect of a premature death, notwithstand
ing the considerable difficulties that future life with a dupl icate
would inevitably entail. ( A s the night w o r e on I had been think
ing more and more about my wife and what her s t ra tegy migh t
be for coping with a duplicated husband. )
' I can understand, ' D e r e k said, 'that y o u don ' t want to d ie .
Even Bundle Theor i s t s don ' t want to d ie . Fo r mos t peop le the
truth of Bundle T h e o r y does not dispel the i l lusion of the ego .
T h e y cling to their false beliefs. ' But he also said that acceptance
of that truth could have a l iberating effect. A m o n g other things,
it opened the possibil i ty of looking at death in a different way.
He personal ly had found this to be the case . I t w a s l iberat ing
and consol ing. Before he had fully absorbed the truth of Bund le
T h e o r y he said that he had felt imprisoned in himself. H i s life
seemed like a g lass tunnel through which he w a s m o v i n g
faster and faster every year and, at the end of which, there w a s
nothing but darkness .
' N o w my view has changed. T h e wal ls o f the g l a s s tunnel
have dissolved. I live in the open air.' It had b rough t him closer
to people . He was less concerned about his own life and more
concerned with the lives of others. He cared less about his own
inevitable death. Mental events and experiences wou ld continue
223
P A U L B R O K S
to be a feature of the wor ld after his death, he said, and it was
true that none of these wou ld be linked to his present mental life
by the sort of direct exper ience-memory or intention-action
connect ions that shaped the exist ing bundle of experiences.
T h e r e wou ld be s o m e indirect connections, however — m e m o
ries of h im, thoughts influenced by his thinking, advice
fol lowed.
'We all make a mark , ' he said . ' T h e s imple facts of death are
this: that it will b reak the more direct relations between my
present mental events and mental events ar is ing in the future,
and that certain other relations will not be broken. Once the ego
is r emoved from the scene, that is all there is to it.'
I found this m o r e depress ing than uplifting. I told him that his
redescript ion of death seemed to me to reflect an impoverished
v iew of life. Perhaps it w a s better to anticipate los ing the self in
death than to deny it in life, a denial that, surely, amounted to a
form of nihilism. A n d , anyway, even i f Bundle T h e o r y was true
I could not bel ieve it. Intellectually, I could follow his a rgu
ments and accept the facts of neuroscience but , psychologically,
it w a s imposs ib le to identify with his theory. It ran counter to
o n e ' s experience of the wor ld .
D e r e k ' s response , aga in , was that i t was difficult to g rasp
the truth, and if he w a s be ing charged with nihilism then he
wou ld accept that in so far as it applied to his v iew of the self.
T h e term, he reminded m e , is from the Lat in nihil, meaning
'nothing ' . 'It is perfectly true to say that the self is No Th ing . '
Otherwise , he rejected the charge . He said that in accepting the
truth of Bund le T h e o r y his appreciat ion of the value of life had
only been enriched.
224
I N T O T H E S I L E N T L A N D
Apparently, in f inding Bundle T h e o r y depres s ing and
unpalatable I was in g o o d company. D e r e k sa id that the ph i lo so
pher D a v i d H u m e , who had formulated an influential vers ion of
the theory in the eighteenth century, reflected on his own a r g u
ments and was pitched into a deep depress ion , the cure for
which was to get out m o r e - dining and p lay ing b a c k g a m m o n
with friends. A n d in the twentieth century, T h o m a s N a g e l also
came to the conclusion that, whatever the truth of the theory, it
was impossible for the human psyche to digest .
'De rek , ' I said, 'perhaps you should ge t out m o r e , too. R e d i s
cover your self. ' He rose from his seat , g r inn ing broadly , and
came across and s lapped me on the back .
'Maybe , ' he said. ' M a y b e not. ' T h e n he wished me luck and
was gone .
I dozed off and dreamt I was in the beautiful city of Venice,
in the Piazza San Marco. Bel ls were r inging and p igeons circled
and swooped . T h e r e were no peop le . T h e n , ac ross the square
from the direction of the Basi l ica , there appeared 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 vers ion , perhaps as she wou ld have been
when we first visited the city. T h e m a n had no face, just a
smooth plane of skin where the usual contours and orifices
should have been. T h e r e w a s no greet ing.
I woke to find that a white envelope had been pushed under
the door . It contained an invitation to appear before the S u b
committee on Personal Identity at eleven o ' c lock that morn ing .
I t was now ten. I showered , breakfas ted on bread , cheese , and
coffee, and prepared to meet my fate.
225
Gulls
' I ' v e go t a lump, ' my wife says . 'Fee l . '
I 'm watching the S unda y afternoon football and still have an
eye on the g a m e as she directs my hand to the outer curve of her
left breast . It is the s ixty-seventh minute. T h e r e is a lump.
'Wha t d o e s i t feel l ike? ' We are in the b e d r o o m now. She has
str ipped to the waist . I palpate the breast as if I 'm an expert.
'Wha t do you th ink? ' she says .
' T h e r e ' s a bump. More of a b u m p than a lump. '
T h e GP is reassur ing a t first, but deve lops doubts , and organ
izes a referral to the breast clinic. Ka te returns tearful. We both
need cheer ing up, so we head for the coast , half-an-hour 's drive,
s topp ing to b u y sandwiches on the way. I t ' s a fine day, as bright
as the cal l ing gul ls . T h e tide is low and the sea is a hard blue. It
feels g o o d to be al ive. But later, in the pub, i t ' s my turn to be
tearful. T h e second beer helps.
T h u r s d a y week , the day of the appointment . We sit in the
g rey -b lue wai t ing r o o m at the breast clinic. T h e r e is a TV in the
226
I N T O T H E S I L E N T L A N D
227
corner with the sound muted. S o m e TV chef i s bak ing a bir th
day cake. No one is interested.
O u r turn. T h r o u g h to the examinat ion r o o m , my semi-naked
wife looking fragile as the surgeon p rods and palpates and ge ts
to work with his blue marker pen. He doesn ' t say much . T h e
nurse does most of the talking. S h e ' s lovely.
Our turn again . Yes , there i s someth ing suspic ious on the X-
ray, the surgeon says . H e ' s g o i n g to do a core biopsy. Seven
s lamming shots of the silver gun , and each t ime he holds up the
phial to inspect the m a g g o t y p lugs of f lesh . H e ' s not quite ge t
ting what he wants . We ' l l have the results in a few days .
'But you don ' t like the look of i t ? ' I ask .
' N o . '
'You think i t ' s cancer. '
'Yes . '
T h e nurse specialist has joined us : bad news personified. T h e
surgeon leaves and i t 's the three of us in the examinat ion r o o m ,
K a t e ' s tears hot on my shoulder. T h e nurse sits quietly. I have
my back to her, which feels like a discourtesy.
I t ' s a nasty, sticky word , 'mas t ec tomy ' . I don ' t like the sound
of i t coming from the su rgeon ' s mouth . We are back in the
consult ing room. H e ' s plott ing the likely course : surgery,
chemotherapy, and radiotherapy, not necessar i ly in that order.
We don ' t go straight home . We stop by the r iverside and walk in
the woods . I can' t remember the last t ime I wept .
A week on. T h e y ' r e setting it up as a B a d N e w s Consul ta t ion .
T h e y have grave- jo l ly faces — profess ional wistfulness. But we
know already. The re isn't much by w a y of preliminary. T h e
surgeon squints over his spectacles .
P A U L B R O K S
228
' I t ' s a mal ignant , invas ive , ductal carc inoma, ' he says , with a
trace of apo logy . I s there anything else we want to know? H e ' s
not g o i n g to tell us unless we ask .
'Wha t about the h i s to logy? A r e the cells well , or poorly,
differentiated? '
'Poorly, ' he s ays , ' G r a d e 3. '
I t ' s a bad one . He replays the likely treatment scenario: four
cycles of neoadjuvant chemotherapy over three months; m a s
tectomy, fol lowed by radiotherapy. T h e plan is provisional ,
because if the chemo fails to shrink the tumour they'll br ing the
su rgery forward. Ar rangemen t s will be m a d e for bone and liver
scans . We can do b loods and a chest X - r a y straight away. I keep
s ay ing ' w e ' .
H o w o d d this is. T h e wors t news , but a sense of relief. I
have already pictured the su rgeon slicing off my wi fe ' s breast .
I have imagined it be ing thrown to was te . I have seen it rising
in s m o k e through the incinerator chimney. Yet there is comfort
in the thought of get t ing on with treatment. Whatever i t takes.
I t a lmos t feels re laxing to walk out ac ross the main concourse
of the hospital — like a depar ture lounge with its cafe and shops
- this p lace I know in a parallel professional life, out into the
sunlight.
T h i s t ime we don ' t weep by the r iverside or walk in the
w o o d s . We head for the supermarket . A famil iar- looking man in
shorts and T-shi r t is load ing his shopping into the back of a
Volvo. I t ' s a f a m o u s TV newsreader . I want to tell him our
news. B a c k h o m e we drink beer and eat curry and watch
football .
We are handed over to another su rgeon , a specialist in breast
I N T O T H E S I L E N T L A N D
reconstruction. Kate sits on the e d g e of the bed . T h e su rgeon
stands s t roking his chin, obse rv ing her bus t with the eye of a
sculptor. He s toops , presses and p robes the d iseased breas t , then
stands back for a fresh view. He takes out a little ruler and starts
measur ing. H e ' s we igh ing things up ; thinking on his feet. Yes ,
he says , we could go for a wide local excision instead of mas t ec
tomy. A n d now, despite myself , I find I 'm p lay ing D e v i l ' s
Advoca te . I 've read the latest New England Journal of Medicine
and understand that, all things be ing equal , less radical inter
ventions are just as effective. But I need to hear it f rom the m a n
in the dark suit.
F ive months on, pos t -chemo, Ka te lies on a hospital bed ,
draped in drips and drains, recover ing from her second ope ra
tion in a month. T h e f irs t was to r emove the lump. T h i s one has
restored the breast to its original shape , though we have yet to
see the sculptor 's handiwork. She is swaddled in a 'bear hugger '
blanket, f i l led with w a r m air to aid the perfusion of b lood . With
her hair just starting to g r o w back she looks like the D a l a i L a m a ,
but much prettier.
* * *
T h e year before last. E v e n i n g on the terrace of a French seas ide
hotel, late summer , the sea as smoo th as mercury, the sky not yet
drained of its blue. T h e r e would be s tars , but t ime had s lowed.
Even the gul ls seemed suspended on the cool ing air, and m a d e
hardly a sound. T h e y are more sof t-spoken here. Ka te and I
were drinking cold beer, recover ing from the heat of the day,
our skin feeling full of the sun, our l imbs aching from a l ong
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P A U L B R O K S
230
swim. We said little, but sat content watching the darkness
gather. T h e candle on the table remained unlit.
I b e c a m e aware of the man and w o m a n two tables a long . She
had said someth ing inaudible, to which he had replied 'Non,
merci,' bu t nothing else w a s said .
T h e man , about forty, sat hunched with a rms folded, as i f
constra ined by a straitjacket. H i s face had a drawn, intent look.
He could have been concentrat ing hard. F r o m time to t ime, his
lips pur sed and his right shoulder seemed to jerk forward a little.
I watched , discreetly. I noticed, too, the squ i rming movement of
his right hand. Pressed between forearm and b iceps of the left
l imb, i t w a s t ry ing to escape .
A waiter appeared from nowhere offering something, but
the w o m a n waved him away. Ka te had her back to all this and
couldn ' t see what w a s g o i n g on.
Somehow, the man and w o m a n on the terrace brought to
mind a scene from a novel I had been reading: Kundera ' s Immor
tality. O n e of the characters , A g n e s , is lying in bed next to her
husband , Paul . Both have difficulty s leeping and A g n e s drifts
into a familiar fantasy about a kindly visitor from another
planet. T h e s t ranger tells her that in the next life she will not be
returning to Ear th .
A n d P a u l ? ' she enquires . N o , she i s told, Paul won ' t be s tay
ing either. Wha t the s tranger needs to know is, do they want to
s tay together in the life to c o m e or never meet again? In Paul ' s
presence , A g n e s a lways knew she would be incapable o f say ing
that she no longer wanted to be with him. H o w could she?
Wouldn ' t that amoun t to s ay ing that there had never been any
love between them, that their life had been based on the illusion
I N T O T H E S I L E N T L A N D
231
of love? A n d for this reason she wou ld a lways capitulate.
Aga ins t her wishes she wou ld tell the s t ranger that of cour se
they wanted to remain together in the next life.
I put the s a m e quest ion to my wife. ' Imag ine , ' I sa id , 'a v i s i
tor from outer space joins us now at this table. He makes his
offer of another life beyond death, and g ives y o u a choice . Y o u
can make ar rangements for me to join you or you can decide
that, at the end of this life, we should part c o m p a n y never to
meet aga in . '
T h e hand escapes . I t wri thes from under the left forearm and
pushes forward, pa lm facing outward to the sea . T h e m a n ' s
expression d o e s not change, he looks straight ahead, but I see
that his knees are now pressed tight together and are e d g i n g to
the left as his upper b o d y twists to the right. T h e w o m a n takes
the errant hand and puts i t between her pa lms . She g u i d e s i t back
towards the man ' s chest. She holds it fast with her left hand and,
at the same t ime, reaches for his left with her right. Still he looks
straight ahead, does not speak . I watch as she refolds the a rms ,
pull ing them tight like a knot . T h e man g ives no a c k n o w l e d g e
ment. She returns to her seat.
Ka te was still thinking about the quest ion. T o o long , I
thought. I wouldn ' t bel ieve her now. T h e n , straight out , she
said: ' I ' d go i t a lone. Wouldn ' t y o u ? ' She said that one lifetime
was enough, however much you loved s o m e o n e .
T w o more couples c a m e to sit a t the table be tween us and the
French couple . I 'd seen them from a dis tance at the beach that
afternoon. At first I 'd a s sumed they were French, but there w a s
a self-deprecating jokiness about one of the w o m e n as she
s t ruggled, inelegantly, to ge t into a wetsuit . I thought it be t rayed
P A U L B R O K S
232
her as Eng l i sh . I w a s right. T h e y ordered a round of drinks,
then another, and another. The i r candle w a s lit, and it lit the red
dening faces a round the table and gut tered in the g lass of the
accumula t ing bott les .
T h e French couple were away in the shadows. You could
hardly see them now. But a second and third time I noticed the
m a n ' s hand escape and, each t ime, saw the w o m a n retrieve it. He
jerked and writhed as she tied the a rms together, before settling
back into a bunched repose , set to unravel again at any moment .
It's Huntington's disease, I thought . St Vitus's dance. Poor man.
Poor woman.
T h e involuntary, chorei form movements are only the half of
it. T h e r e ' s the dement ia , too, and perhaps psychos is . T h e d is
ease is relentless and he will dance like a puppet to his death. His
fate w a s fixed at concept ion. A r o g u e gene , dormant for
decades , had struck, and his brain w a s crumbl ing at its core,
deep beneath the wrinkled mantle of the cortex, down in the
dark interiors of the basa l gang l ia , where actions are deciphered
from the codes of intention. A n d now all is confusion. The re are
act ions and intentions, but they don ' t necessari ly coincide.
Meanwhile , they will do their best , this couple , to deny the
terror and defy the puppeteer . T h e y will enjoy a summer ' s
even ing together out on the terrace.
I absorbed my w i f e ' s answer - I'd go it alone. Wouldn't you?-
and took another sip of beer.
'Would y o u ? ' I asked. S o m e o n e in the Engl i sh g r o u p
knocked an empty bott le o f f the table. It shattered on the
g r o u n d , burs t ing shards in every direction. I noticed that the
French couple were g o n e .
I N T O T H E S I L E N T L A N D
' S o , ' I said, ' i t ' s just the one l i fet ime? '
'Afraid so , ' she said . 'Bet ter make the mos t of it.'
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'
F U R T H E R R E A D I N G
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, neuro
psychology, 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 pop
ular 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 neuro
logical thinker and, among many other topics, this stimulating book
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P A U L B R O K S
238
has some interesting things to say about phantom limbs and the neuro-
biological bases of the body schema, complementing the impression
istic 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 case-
study 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 Neuro
science: 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 neuro
psychology. One approach emphasizes functional anatomy and is con
cerned 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
I N T O T H E S I L E N T L A N D
239
to explore patterns of activity in the normal, intact brain. The above-
cited 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 dam
aged brain as a way of testing and refining theories of normal cognitive
function. They start with a theory of cognition — some model of short-
term 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 Explo
rations 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 second
ary to their main enterprise, the fruits of the cognitive neuro
psychologists' labours are directly relevant to an understanding of the
structure and functions of the brain. In order to know how psycholog
ical 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, Neuro
psychology: 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
P A U L B R O K S
240
more than a dictionary, this is an excellent reference work containing
substantial entries on most aspects of clinical and experimental neuro
psychology. The list of contributors is impressive.
For those specifically interested in psychiatric aspects of neurologi
cal disorder the classic text is W. A. Lishman's Organic Psychiatry,
Third Edition (Blackwell Science, 1997). Although geared for a spe
cialist readership, it is sufficiently lucid and digestible to be of interest
to the motivated lay reader.
The emerging discipline of cognitive neuropsychiatry puts the prin
ciples 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,
I N T O T H E S I L E N T L A N D
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 'intel
lectual 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 prob
lem of consciousness. In 'Right this way, Smiles a Mermaid' the narra
tor 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 con
sciousness, 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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242
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 con
scious 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 philoso
pher, 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
I N T O T H E S I L E N T L A N D
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 Mind-
blindness (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 dis
turbing 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 enter
taining account of his quest for the great man's grey matter and subse
quent 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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P A U L B R O K S
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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 collab
orators — as well as a comprehensive survey of existing knowledge of
the classical domains of interest: the brain bases of perception, lan
guage, 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 con
sider 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 neuro
psychology concerns individual human beings — patients — struggling
to make their way in a world rendered difficult and sometimes dis
turbingly 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
I N T O T H E S I L E N T L A N D
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 under
standing.
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 commemo
rative 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 noth
ing 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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A C K N O W L E D G E M E N T S
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, previ
ously, 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 Good-
hart 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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