‘But George died nineteen years ago!’ said Bob, aghast.
‘Aye, George is always the joker!’ William quipped, apparently ignoring, or indifferent to, Bob’s comment, and went on blathering of George in his excited, dead way, insensitive to truth, to reality, to propriety, to everything—insensitive too to the manifest distress of the living brother before him.
It was this which convinced me, above everything, that there was some ultimate and total loss of inner reality, of feeling and meaning, of soul, in William—and led me to ask the Sisters, as I had asked them of Jimmie G. ‘Do you think William has a soul? Or has he been pithed, scooped-out, de-souled, by disease?’
This time, however, they looked worried by my question, as if something of the sort were already in their minds: they could not say ‘Judge for yourself. See Willie in Chapel’, because his wisecracking, his confabulations continued even there. There is an utter pathos, a sad sense of lostness, with Jimmie G. which one does not feel, or feel directly, with the effervescent Mr Thompson.
Jimmie has moods, and a sort of brooding (or, at least, yearning) sadness, a depth, a soul, which does not seem to be present in Mr Thompson. Doubtless, as the Sisters said, he had a soul, an immortal soul, in the theological sense; could be seen, and loved, as an individual by the Almighty; but, they agreed, something very disquieting had happened to him, to his spirit, his character, in the ordinary, human sense.
It is because Jimmie is ‘lost’ that he can be redeemed or found, at least for a while, in the mode of a genuine emotional relation. Jimmie is in despair, a quiet despair (to use or adapt Kierkegaard’s term), and therefore he has the possibility of salvation, of touching base, the ground of reality, the feeling and meaning he has lost, but still recognises, still yearns for . . .
But for William—with his brilliant, brassy surface, the unending joke which he substitutes for the world (which if it covers over a desperation, is a desperation he does not feel); for William with his manifest indifference to relation and reality caught in an unending verbosity, there may be nothing ‘redeeming’ at all—his confabulations, his apparitions, his frantic search for meanings, being the ultimate barrier to any meaning.
Paradoxically, then, William’s great gift—for confabulation— which has been called out to leap continually over the ever-opening abyss of amnesia—William’s great gift is also his damnation. If only he could be quiet, one feels, for an instant; if only he could stop the ceaseless chatter and jabber; if only he could relinquish the deceiving surface of illusions—then (ah then!) reality might seep in; something genuine, something deep, something true, something felt, could enter his soul.
For it is not memory which is the final, ‘existential’ casualty here (although his memory is wholly devastated); it is not memory only which has been so altered in him, but some ultimate capacity for feeling which is gone; and this is the sense in which he is ‘de-souled’.
Luria speaks of such indifference as ‘equalisation’—and sometimes seems to see it as the ultimate pathology, the final destroyer of any world, any self. It exerted, I think, a horrified fascination on him, as well as constituting an ultimate therapeutic challenge. He was drawn back to this theme again and again—sometimes in relation to Korsakov’s and memory, as in The Neuropsychology of Memory, more often in relation to frontal-lobe syndromes, especially in Human Brain and Psychological Processes, which contains several full-length case-histories of such patients, fully comparable in their terrible coherence and impact to ‘the man with a shattered world’—comparable, and, in a way, more terrible still, because they depict patients who do not realise that anything has befallen them, patients who have lost their own reality, without knowing it, patients who may not suffer, but be the most God-forsaken of all. Zazetsky (in The Man with a Shattered World) is constantly described as a fighter, always (even passionately) conscious of his state, and always fighting ‘with the tenacity of the damned’ to recover the use of his damaged brain. But William (like Luria’s frontal-lobe patients—see next chapter) is so damned he does not know he is damned, for it is not just a faculty, or some faculties, which are damaged, but the very citadel, the self, the soul itself. William is ‘lost’, in this sense, far more than Jimmie—for all his brio; one never feels, or rarely feels, that there is a person remaining, whereas in Jimmie there is plainly a real, moral being, even if disconnected most of the time. In Jimmie, at least, re-connection is possible—the therapeutic challenge can be summed up as ‘Only connect’.
Our efforts to ‘re-connect’ William all fail—even increase his confabulatory pressure. But when we abdicate our efforts, and let him be, he sometimes wanders out into the quiet and undemanding garden which surrounds the Home, and there, in its quietness, he recovers his own quiet. The presence of others, other people, excite and rattle him, force him into an endless, frenzied, social chatter, a veritable delirium of identity-making and -seeking; the presence of plants, a quiet garden, the non-human order, making no social or human demands upon him, allow this identity-delirium to relax, to subside; and by their quiet, non-human self-sufficiency and completeness allow him a rare quietness and self-sufficiency of his own, by offering (beneath, or beyond, all merely human identities and relations) a deep wordless communion with Nature itself, and with this the restored sense of being in the world, being real.
13. Yes, Father-Sister
Mrs B., a former research chemist, had presented with a rapid personality change, becoming ‘funny’ (facetious, given to wisecracks and puns), impulsive—and ‘superficial’ (‘You feel she doesn’t care about you,’ one of her friends said. ‘She no longer seems to care about anything at all.’) At first it was thought that she might be hypomanic, but she turned out to have a cerebral tumour. At craniotomy there was found, not a meningioma as had been hoped, but a huge carcinoma involving the orbitofrontal aspects of both frontal lobes.
When I saw her, she seemed high-spirited, volatile—‘a riot’ (the nurses called her)—full of quips and cracks, often clever and funny.