‘What could we do? What should we do? There are no prescriptions,’ Luria wrote, ‘in a case like this. Do whatever your ingenuity and your heart suggest. There is little or no hope of any recovery in his memory. But a man does not consist of memory alone. He has feeling, will, sensibilities, moral being—matters of which neuropsychology cannot speak. And it is here, beyond the realm of an impersonal psychology, that you may find ways to touch him, and change him. And the circumstances of your work especially allow this, for you work in a Home, which is like a little world, quite different from the clinics and institutions where I work. Neuropsychological, there is little or nothing you can do; but in the realm of the Individual, there may be much you can do.’
Luria mentioned his patient Kur as manifesting a rare self-awareness, in which hopelessness was mixed with an odd equanimity. ‘I have no memory of the present,’ Kur would say. ‘I do not know what I have just done or from where I have just come ... I can recall my past very well, but I have no memory of my present.’ When asked whether he had ever seen the person testing him, he said, ‘I cannot say yes or no, I can neither affirm nor deny that I have seen you.’ This was sometimes the case with Jimmie; and, like Kur, who stayed many months in the same hospital, Jimmie began to form ‘a sense of familiarity’; he slowly learned his way around the home—the whereabouts of the dining room, his own room, the elevators, the stairs, and in some sense recognised some of the staff, although he confused them, and perhaps had to do so, with people from the past. He soon became fond of the nursing sister in the Home; he recognised her voice, her footfalls, immediately, but would always say that she had been a fellow pupil at his high school, and was greatly surprised when I addressed her as ‘Sister’.
‘Gee!’ he exclaimed, ‘the damnedest things happen. I’d never have guessed you’d become a religious, Sister!’
Since he’s been at our Home—that is, since early 1975—Jimmie has never been able to identify anyone in it consistently. The only person he truly recognises is his brother, whenever he visits from Oregon. These meetings are deeply emotional and moving to observe—the only truly emotional meetings Jimmie has. He loves his brother, he recognises him, but he cannot understand why he looks so old: ‘Guess some people age fast,’ he says. Actually his brother looks much younger than his age, and has the sort of face and build that change little with the years. These are true meetings, Jimmie’s only connection of past and present, yet they do nothing to provide any sense of history or continuity. If anything they emphasise—at least to his brother, and to others who see them together—that Jimmie still lives, is fossilised, in the past.
All of us, at first, had high hopes of helping Jimmie—he was so personable, so likable, so quick and intelligent, it was difficult to believe that he might be beyond help. But none of us had ever encountered, even imagined, such a power of amnesia, the possibility of a pit into which everything, every experience, every event, would fathomlessly drop, a bottomless memory-hole that would engulf the whole world.
I suggested, when I first saw him, that he should keep a diary, and be encouraged to keep notes every day of his experiences, his feelings, thoughts, memories, reflections. These attempts were foiled, at first, by his continually losing the diary: it had to be attached to him—somehow. But this too failed to work: he dutifully kept a brief daily notebook but could not recognise his earlier entries in it. He does recognise his own writing, and style, and is always astounded to find that he wrote something the day before.
Astounded—and indifferent—for he was a man who, in effect, had no ‘day before’. His entries remained unconnected and un-connecting and had no power to provide any sense of time or continuity. Moreover, they were trivial—‘Eggs for breakfast’, Watched ballgame on TV—and never touched the depths. But were there depths in this unmemoried man, depths of an abiding feeling and thinking, or had he been reduced to a sort of Humean drivel, a mere succession of unrelated impressions and events?
Jimmie both was and wasn’t aware of this deep, tragic loss in himself, loss of himself. (If a man has lost a leg or an eye, he knows he has lost a leg or an eye; but if he has lost a self— himself—he cannot know it, because he is no longer there to know it.) Therefore I could not question him intellectually about such matters.
He had originally professed bewilderment at finding himself amid patients, when, as he said, he himself didn’t feel ill. But what, we wondered, did he feel? He was strongly built and fit, he had a sort of animal strength and energy, but also a strange inertia, passivity, and (as everyone remarked) ‘unconcern’; he gave all of us an overwhelming sense of ‘something missing,’ although this, if he realised it, was itself accepted with an odd ‘unconcern.’ One day I asked him not about his memory, or past, but about the simplest and most elemental feelings of alclass="underline"
‘How do you feel?’
‘How do I feel,’ he repeated, and scratched his head. ‘I cannot say I feel ill. But I cannot say I feel well. I cannot say I feel anything at all.’
‘Are you miserable?’ I continued.
‘Can’t say I am.’
‘Do you enjoy life?’
‘I can’t say I do ...’
I hesitated, fearing that I was going too far, that I might be stripping a man down to some hidden, unacknowledgeable, unbearable despair.
‘You don’t enjoy life,’ I repeated, hesitating somewhat. ‘How then do you feel about life?’
‘I can’t say that I feel anything at all.’
‘You feel alive though?’
‘Feel alive? Not really. I haven’t felt alive for a very long time.’
His face wore a look of infinite sadness and resignation.
Later, having noted his aptitude for, and pleasure in, quick games and puzzles, and their power to ‘hold’ him, at least while they lasted, and to allow, for a while, a sense of companionship and competition—he had not complained of loneliness, but he looked so alone; he never expressed sadness, but he looked so sad— I suggested he be brought into our recreation programs at the Home. This worked better—better than the diary. He would become keenly and briefly involved in games, but soon they ceased to offer any challenge: he solved all the puzzles, and could solve them easily; and he was far better and sharper than anyone else at games. And as he found this out, he grew fretful and restless again, and wandered the corridors, uneasy and bored and with a sense of indignity—games and puzzles were for children, a diversion. Clearly, passionately, he wanted something to do: he wanted to do, to be, to feel—and could not; he wanted sense, he wanted purpose—in Freud’s words, ‘Work and Love’.
Could he do ‘ordinary’ work? He had ‘gone to pieces’, his brother said, when he ceased to work in 1965. He had two striking skills— Morse code and touch-typing. We could not use Morse, unless we invented a use; but good typing we could use, if he could recover his old skills—and this would be real work, not just a game. Jimmie soon did recover his old skill and came to type very quickly—he could not do it slowly—and found in this some of the challenge and satisfaction of a job. But still this was superficial tapping and typing; it was trivial, it did not reach to the depths. And what he typed, he typed mechanically—he could not hold the thought—the short sentences following one another in a meaningless order.