This is a guest post by Jonathan Taylor.
In 1922, Sigmund Freud famously claimed that ‘Anatomy is destiny.’ It’s a startling thing for a psychologist to say: to suggest that, in the end, psychology is trumped by anatomy, biology, physiology.
And maybe this isn’t only the case on an individual basis: maybe it’s also (consciously or unconsciously) a more general prediction for future sciences of the mind.
The destiny of Freudian psychology lies in a more materialistic, anatomical science—that of neurology.
In the later twentieth century, psychology is complicated, if not superseded, by modern neurological explanations of human behaviour. The end result of this is a kind of neurological materialism, which subsumes all individual psychology under the banner of what Francis Crick calls ‘The Astonishing Hypothesis.’ This is the notion ‘that “You,” your joys and your sorrows, your memories and your ambitions, your sense of personal identity and free will, are in fact no more than the behaviours of a vast assembly of nerve cells and their associated molecules …. “You’re nothing but a pack of neurons.”’
You don’t have to agree entirely with Crick’s Astonishing Hypothesis to appreciate that modern neuroscience radically complicates traditional notions of psychology, identity and free will.
As a reader and writer who is drawn both to Freudian psychology (for all its problems) and modern neuroscience, I think the ways in which writers have negotiated this ambivalent relationship over the last hundred years is endlessly fascinating.
In this article, I’m going to talk about five books on neuroscience which I’d recommend as starting-points on the subject, and which conceive the relationship between individual psychology and contemporary neurology in very different ways. I’m also going to talk about ways their ideas affected and shaped my own writing—that is, how the language of neurology infected my own non-fiction, fiction and poetry.
This article originated as a talk I gave at Lowdham Book Festival in 2018. I was invited to give the talk because of an interview by neurologist Prof. Andrew Lees on a website called Five Books. In the interview, he named my memoir Take Me Home: Parkinson’s, My Father, Myself, which came out from Granta in 2007, as one of his five favourite books on neuroscience. In providing my own recommendations in return, I’m not—unlike Lees—speaking as an expert, by any means, in the subject. I come at the subject not as a neurologist or neuroscientist, but rather as an amateur, an enthusiast, a reader and creative writer.
As an amateur enthusiast, the first of my recommended books on neuroscience is a simple one: it’s a cartoon book called Introducing Mind and Brain by Angus Gellatly and Oscar Zarate. It’s beautifully done and represents the best introduction to the subject I’ve come across.
It tackles the most challenging philosophical questions and concepts in an approachable way, capturing the defamiliarised mirror-world of neurology: its strange symptoms, illnesses, tics and disorientating perspectives. This is what reading about neurology does: it defamiliarises the everyday, brings into question things many people think of as natural, such as facial recognition, and turns them into something bizarre, and terribly fragile.
I can’t think of a book which so well marries detailed information with the perceptual disturbances of neurological conditions. It does this through cartoon, which seems strangely apt, given the (horrifically, grotesquely, sometimes beautifully) cartoonish nature of some of the brain’s malfunctions.
My own memoir Take Me Home isn’t primarily about neuroscience, as such—it’s about my father’s Parkinson’s disease, dementia, peculiar brain syndromes, and my role as part-time carer for him. No doubt my experience of my father’s neurological illnesses, as I was growing up, lies behind my fascination with neuroscience.
But the memoir is primarily a subjective, personal account of illness—not, by any means, a medical treatise. Whilst I was writing it, I was reading around the subject of Parkinson’s and related neurological disorders, and came across the late great Oliver Sacks’s book, Awakenings (1973)—one of the books, I suppose, which has meant most to me in my life.
Awakenings, as you may know either from the book or the later film (starring Robin Williams and Robert De Niro), tells the stories of Sacks’s patients in the 1960s. It’s a kind of weird composite novel in non-fiction form—a novel told in stories, but these stories are also ‘true’ case studies.
Sacks’s patients had been immobile and unresponsive—near-comatose—since the Sleeping Sickness epidemic of the 1920s. Sacks gave them the then-new Parkinsonian drug, L-Dopa, and observed their sudden moments of physical and psychological awakenings, as a result of the treatment. There were a wide variety of responses to the drug—beautiful, touching, strange, disturbing, tragic—which Sacks describes in his book, sensitively and empathetically.
In Awakenings, Sacks writes of the need for a subjective (as well as medically objective) view of illness: that is, the need to understand illness from the perspective of the patient and, indeed, the carer.
He says: ‘We must come down from our position as “objective observers,” and meet our patients face-to-face; we must meet them in a sympathetic and imaginative encounter …. They can tell us, and show us, what it is like being Parkinsonian—they can tell us, but nobody else can …. The on-going nature of neurotic illness and its treatment cannot be displayed except by biography.’
This is what I tried to do in my own memoir: it’s not a pathological account, but a subjective biography (a biography of an illness, of my father, of my relationship with him, of what it’s like to be a carer, and so on), which attempts to understand the experience of illness from within.At one point, early on in the memoir, I address Sacks’s work directly:
In terms of Parkinson’s, many of the neurological symptoms are based on automatic repetition. They have beautiful sounding names: palilalia is the repetition of words; palipraxia is the repetition of actions; echopraxia is the repetition of other people’s actions; and the most magical sounding of all, echolalia, is my father automatically repeating “Let go let go let go” after we’ve said it to him a dozen times. It was only recently, by reading Oliver Sacks’s book Awakenings, that I myself found out that these are recognised, neurological symptoms. Back in 1995, I just thought my father was suffering from a well-known symptom called “paininthearse-alia.” Since finding out the official names of his symptoms, though, I’ve started seeing palilalia, palipraxia, echopraxia and echolalia everywhere, in infirmaries, on phones, in parks, symphonies, novels …. Looking back to 1995, these compulsive repetitions certainly echoed from patient to carers (and back again): lift him up, sit him down, lift him up, sit him down, untwist his emaciated legs, relax his shaking arms, untwist his legs, relax his arms, make him drink some pop, make him eat some food, make him drink some pop, teeth in, teeth out, teeth in, sit him down, lift him up … and so on and on, as if the carers reflect the patient in a hall of echolalias and echopraxias.
I think this is what memoir can do better than almost any other form of writing: capture the rhythms, circularities, narratives of illness and ageing.
Memoirs aren’t tied, like novels sometimes are, to the grinding logic of plot, to beginnings, middles and endings, to linear models of causality and chronology: they can do strange things with form and time, which mirror the experience of illness. One memoir which I learnt a lot from in this respect was Linda Grant’s Remind Me Who I Am Again? (1998).
Grant’s memoir is a detailed and poignant account of the author’s experience of her mother’s encroaching dementia.
Some of the most memorable passages involve shopping trips, in which Grant captures her mother’s increasing forgetfulness, and her own frustration with it, in moments of wonderfully-handled dialogue.
She’s incredibly good at capturing the circularity and repetitive rhythms of talking to someone with dementia—dialogue which is ‘Like Alice in the garden,’ Grant remarks, ‘on the path that, whatever she does, always leads straight back to where she started …. And you thought Groundhog Day was just a movie.’
At moments like these, the broken structures and peculiar rhythms of impaired speech and its symptoms come very close to poetry, even music.
Poetry, I’ve found over the years, is a form of writing particularly suited to exploring neurological subject matter—in its musicality, its rhythms, its repetitions, its distortions or heightening of everyday language, it can come closer than, say, conventional prose to echoing the tics, compulsions and contortions of neurological illness.
In my latest poetry collection, Cassandra Complex (Shoestring, 2018), there are various poems on neurological themes, including two short poems which relate directly to Sacks’s work.
The poem ‘A Chaos Theory of Parkinson’s’ arises both from my own experience of my father’s illness, and also from an extended analogy Sacks draws, in Awakenings, between chaos theory and the butterfly effect, on the one hand, and neurological illness, on the other:
A Chaos Theory of Parkinson’s
After Oliver Sacks, Awakenings
A butterfly flutter in one finger
might spiral into a storm of tremors.
L-Dopa minutely under the ideal dose
might cause a lightning-strike fall.
And you never know such a fall
might unlock a long-caged memory
like a rainbow of butterflies
released into sky.
This poem is immediately followed by an even shorter poem, which is called simply ‘Awakenings.’ Here, I try and capture in poetry the effect of L-Dopa on the patients Sacks treated:
After Oliver Sacks
For nurses the postencephalitics seemed petrified
their personalities paralytically im-prism-ed.
L-Dopa was a beam of light shot through them
refracted, split, rainbowed, bent, shattered.
Like poetry, music also has a close relationship with aspects of neurology and neurological illness.
Sacks understands this: Awakenings features some beautiful passages, where music plays a major part in the action—for example, where waltz music helps the Parkinsonian patients coordinate their movements. Later in his career, he collected all of his case studies and thoughts on music and neurology in a startling book called Musicophilia (2007).
Music’s importance to neurologists like Sacks is profound: it can operate on a deeper level than language, like a powerful neurological drug. He writes: ‘The perception of music and the emotions it can stir is not solely dependent on memory, and music does not have to be familiar to exert its emotional power. I have seen deeply demented patients weep or shiver as they listen to music they have never heard before, and I think that they can experience the entire range of feelings the rest of us can …. Once one has seen such responses, one knows that there is still a self to be called upon, even if music, and only music, can do the calling.’
Musicophilia is a unique book about the close relationship between musical experience and neurology: about earworms—i.e. catchy tunes which won’t leave your head, and which are often related to forms of OCD; musical prodigies; musicolepsy, which is a condition where certain kinds of music can cause seizures; and auditory hallucinations.
The idea of auditory hallucinations came to shape my second novel, Melissa (Salt, 2015), which is structured around a collective musical hallucination. The novel opens on a June afternoon in 1999, on a small street in Stoke-on-Trent, at the moment a young girl, Melissa Comb, dies of Leukaemia. Almost simultaneously, everyone on the street is struck by the same musical hallucination: everyone hears, that is, orchestral music in their heads.
The story draws on images from Sacks’s Musicophilia, and includes a fictional neurologist in the narrative. His name is Prof. Christopher Sollertinsky, and he’s come to haunt other stories I’ve written since—sometimes turning up in narratives when I least expect him. I’ve written more about Melissa and neurology here: http://www.litro.co.uk/2016/09/neurology-grief-melissa.
The Doctor’s Perspective
Of course, in the end what Sacks and my own fictional neurologist demonstrate is that the doctor is a storyteller him or herself: illnesses are narratives, stories, and the doctor is often the storyteller. Perhaps this idea is deep-rooted in our culture: in the distant past, village storytellers were also sometimes ‘doctors’ (in the widest sense).
One contemporary British doctor, who was also a friend of Sacks, and who tells a very good story is Andrew Lees. Just as he recommended my memoir, I want to recommend his remarkable and genre-bending book, Mentored by a Madman: The William Burroughs Experiment (2016). This is an autobiography, a medical memoir, a work of literary criticism, and also an essay about the state of medicine. The latter aspect of the book is disturbing—it does not make for comfortable reading, and brings into question many of our deepest assumptions, and capitalism’s attitude towards medical research.
Above all, though, the book is a subjective account of a neurologist’s experiences in the ward and laboratory. Like Sacks’s work, it is compelling, sensitive, and compassionate. Lees talks about his medical and research work, and tries to understand and contextualise that work in relation to literary texts by William Burroughs, Arthur Conan Doyle and others. He emphasises the human (and humanist) side of his work as a neurologist; talking of his early apprenticeship, he writes: ‘Neurology had, and still has, more than its fair share of devastating, incurable maladies, and from time to time my teachers would curb my fondness for new discovery by reminding me of the importance of the laying on of hands and kind words …. I did learn to tell the painful truth without frightening people.’
Perhaps, in the end, this is what lies behind the best books on neurological illness: telling the truth of pain with a concomitant sensitivity. All of these books—by Sacks, Grant, Lees, Gellatly and Zarate—attempt to capture both the horror of ‘devastating … maladies’ alongside unexpected moments of strange beauty.
About the author
Jonathan Taylor is an author, editor, lecturer and critic. His books include the novel Melissa (Salt, 2015), the poetry collections Cassandra Complex (Shoestring, 2018) and Musicolepsy (Shoestring, 2013), and the memoir Take Me Home (Granta, 2007). He directs the MA in Creative Writing at the University of Leicester. Originally from Stoke-on-Trent, he now lives in Leicestershire with his wife, the poet Maria Taylor, and their twin daughters, Miranda and Rosalind. His website is www.jonathanptaylor.co.uk.