One tended to speak of him, instinctively, as a spiritual casualty—a ‘lost soul’: was it possible that he had really been ‘de-souled’ by a disease? ‘Do you think he has a soul?’ I once asked the Sisters. They were outraged by my question, but could see why I asked it. ‘Watch Jimmie in chapel,’ they said, ‘and judge for yourself.’
I did, and I was moved, profoundly moved and impressed, because I saw here an intensity and steadiness of attention and concentration that I had never seen before in him or conceived him capable of. I watched him kneel and take the Sacrament on his tongue, and could not doubt the fullness and totality of Communion, the perfect alignment of his spirit with the spirit of the Mass. Fully, intensely, quietly, in the quietude of absolute concentration and attention, he entered and partook of the Holy Communion. He was wholly held, absorbed, by a feeling. There was no forgetting, no Korsakov’s then, nor did it seem possible or imaginable that there should be; for he was no longer at the mercy of a faulty and fallible mechanism—that of meaningless sequences and memory traces—but was absorbed in an act, an act of his whole being, which carried feeling and meaning in an organic continuity and unity, a continuity and unity so seamless it could not permit any break.
Clearly Jimmie found himself, found continuity and reality, in the absoluteness of spiritual attention and act. The Sisters were right—he did find his soul here. And so was Luria, whose words now came back to me: ‘A man does not consist of memory alone. He has feeling, will, sensibility, moral being ... It is here . . . you may touch him, and see a profound change.’ Memory, mental activity, mind alone, could not hold him; but moral attention and action could hold him completely.
But perhaps ‘moral’ was too narrow a word—for the aesthetic and dramatic were equally involved. Seeing Jim in the chapel opened my eyes to other realms where the soul is called on, and held, and stilled, in attention and communion. The same depth of absorption and attention was to be seen in relation to music and art: he had no difficulty, I noticed, ‘following’ music or simple dramas, for every moment in music and art refers to, contains, other moments. He liked gardening, and had taken over some of the work in our garden. At first he greeted the garden each day as new, but for some reason this had become more familiar to him than the inside of the Home. He almost never got lost or disoriented in the garden now; he patterned it, I think, on loved and remembered gardens from his youth in Connecticut.
Jimmie, who was so lost in extensional ‘spatial’ time, was perfectly organised in Bergsonian ‘intentional’ time; what was fugitive, unsustainable, as formal structure, was perfectly stable, perfectly held, as art or will. Moreover, there was something that endured and survived. If Jimmie was briefly ‘held’ by a task or puzzle or game or calculation, held in the purely mental challenge of these, he would fall apart as soon as they were done, into the abyss of his nothingness, his amnesia. But if he was held in emotional and spiritual attention—in the contemplation of nature or art, in listening to music, in taking part in the Mass in chapel—the attention, its ‘mood’, its quietude, would persist for a while, and there would be in him a pensiveness and peace we rarely, if ever, saw during the rest of his life at the Home.
I have known Jimmie now for nine years—and neuropsychologically, he has not changed in the least. He still has the severest, most devastating Korsakov’s, cannot remember isolated items for more than a few seconds, and has a dense amnesia going back to 1945. But humanly, spiritually, he is at times a different man altogether—no longer fluttering, restless, bored, and lost, but deeply attentive to the beauty and soul of the world, rich in all the Kier-kegaardian categories—and aesthetic, the moral, the religious, the dramatic. I had wondered, when I first met him, if he was not condemned to a sort of ‘Humean’ froth, a meaningless fluttering on the surface of life, and whether there was any way of transcending the incoherence of his Humean disease. Empirical science told me there was not—but empirical science, empiricism, takes no account of the soul, no account of what constitutes and determines personal being. Perhaps there is a philosophical as well as a clinical lesson here: that in Korsakov’s, or dementia, or other such catastrophes, however great the organic damage and Humean dissolution, there remains the undiminished possibility of reintegration by art, by communion, by touching the human spirit: and this can be preserved in what seems at first a hopeless state of neurological devastation.
I know now that retrograde amnesia, to some degree, is very common, if not universal, in cases of Korsakov’s. The classical Korsakov’s syndrome—a profound and permanent, but ‘pure’, devastation of memory caused by alcoholic destruction of the mammillary bodies— is rare, even among very heavy drinkers. One may, of course, see Korsakov’s syndrome with other pathologies, as in Luria’s patients with tumours. A particularly fascinating case of an acute (and mercifully transient) Korsakov’s syndrome has been well described only very recently in the so-called Transient Global Amnesia (TGA) which may occur with migraines, head injuries or impaired blood supply to the brain. Here, for a few minutes or hours, a severe and singular amnesia may occur, even though the patient may continue to drive a car, or, perhaps, to carry on medical or editorial duties, in a mechanical way. But under this fluency lies a profound amnesia— every sentence uttered being forgotten as soon as it is said, everything forgotten within a few minutes of being seen, though long-established memories and routines may be perfectly preserved. (Some remarkable videotapes of patients during TGAs have recently [1986] been made by Dr John Hodges, of Oxford.)
Further, there may be a profound retrograde amnesia in such cases. My colleague Dr. Leon Protass tells me of a case seen by him recently, in which a highly intelligent man was unable for some hours to remember his wife or children, to remember that he had a wife or children. In effect, he lost thirty years of his life— though, fortunately, for only a few hours. Recovery from such attacks is prompt and complete—yet they are, in a sense, the most horrifying of ‘little strokes’ in their power absolutely to annul or obliterate decades of richly lived, richly achieving, richly memo-ried life. The horror, typically, is only felt by others—the patient, unaware, amnesiac for his amnesia, may continue what he is doing, quite unconcerned, and only discover later that he lost not only a day (as is common with ordinary alcoholic ‘blackouts’), but half a lifetime, and never knew it. The fact that one can lose the greater part of a lifetime has peculiar, uncanny horror.
In adulthood, life, higher life, may be brought to a premature end by strokes, senility, brain injuries, etc., but there usually remains the consciousness of life lived, of one’s past. This is usually felt as a sort of compensation: ‘At least I lived fully, tasting life to the full, before I was brain-injured, stricken, etc.’ This sense of ‘the life lived before’, which may be either a consolation or a torment, is precisely what is taken away in retrograde amnesia. The ‘final amnesia, the one that can erase an entire life’ that Bunuel speaks of may occur, perhaps, in a terminal dementia, but not, in my experience, suddenly, in consequence of a stroke. But there is a different, yet comparable, sort of amnesia, which can occur suddenly—different in that it is not ‘global’ but ‘modality-specific’.