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Face to face with dying: I am not finished with living. Oliver Sacks

A MONTH ago, I felt that I was in good health, even robust health.

At 81, I still swim a mile a day. But my luck has run out — a few weeks ago I learned that I have multiple metastases in the liver.

Nine years ago it was discovered that I had a rare tumor of the eye, an ocular melanoma. The radiation and lasering to remove the tumor ultimately left me blind in that eye.

But though ocular melanomas metastasize in perhaps 50 percent of cases, given the particulars of my own case, the likelihood was much smaller. I am among the unlucky ones.

I feel grateful that I have been granted nine years of good health and productivity since the original diagnosis, but now I am face to face with dying. The cancer occupies a third of my liver, and though its advance may be slowed, this particular sort of cancer cannot be halted.

It is up to me now to choose how to live out the months that remain to me. I have to live in the richest, deepest, most productive way I can.

In this I am encouraged by the words of one of my favorite philosophers, David Hume, who, upon learning that he was mortally ill at age 65, wrote a short autobiography in a single day in April of 1776. He titled it “My Own Life.”

Maya Terro shared this link. August 30, 2015 ·

The New York Times

“There will be no one like us when we are gone, but then there is no one like anyone else, ever. When people die, they cannot be replaced. They leave holes that cannot be filled, for it is the fate — the genetic and neural fate — of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.

I cannot pretend I am without fear. But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers.

Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.”

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I am now face to face with dying. But I am not finished with living.
nytimes.com|By Oliver Sacks

Hume wrote: “I now reckon upon a speedy dissolution. I have suffered very little pain from my disorder; and what is more strange, have, notwithstanding the great decline of my person, never suffered a moment’s abatement of my spirits. I possess the same ardour as ever in study, and the same gaiety in company.”

I have been lucky enough to live past 80, and the 15 years allotted to me beyond Hume’s three score and five have been equally rich in work and love.

In that time, I have published five books and completed an autobiography (rather longer than Hume’s few pages) to be published this spring; I have several other books nearly finished.

Writing by Oliver Sacks in The Times

Hume continued, “I am … a man of mild dispositions, of command of temper, of an open, social, and cheerful humour, capable of attachment, but little susceptible of enmity, and of great moderation in all my passions.”

Here I depart from Hume. While I have enjoyed loving relationships and friendships and have no real enmities, I cannot say (nor would anyone who knows me say) that I am a man of mild dispositions. On the contrary, I am a man of vehement disposition, with violent enthusiasms, and extreme immoderation in all my passions.

Over the last few days, I have been able to see my life as from a great altitude, as a sort of landscape, and with a deepening sense of the connection of all its parts. This does not mean I am finished with life.

On the contrary, I feel intensely alive, and I want and hope in the time that remains to deepen my friendships, to say farewell to those I love, to write more, to travel if I have the strength, to achieve new levels of understanding and insight.

This will involve audacity, clarity and plain speaking; trying to straighten my accounts with the world. But there will be time, too, for some fun (and even some silliness, as well).

I feel a sudden clear focus and perspective. There is no time for anything inessential.

I must focus on myself, my work and my friends. I shall no longer look at “NewsHour” every night. I shall no longer pay any attention to politics or arguments about global warming.

This is not indifference but detachment — I still care deeply about the Middle East, about global warming, about growing inequality, but these are no longer my business; they belong to the future. I rejoice when I meet gifted young people — even the one who biopsied and diagnosed my metastases. I feel the future is in good hands.

I have been increasingly conscious, for the last 10 years or so, of deaths among my contemporaries.

My generation is on the way out, and each death I have felt as an abruption, a tearing away of part of myself. There will be no one like us when we are gone, but then there is no one like anyone else, ever. When people die, they cannot be replaced.

They leave holes that cannot be filled, for it is the fate — the genetic and neural fate — of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.

I cannot pretend I am without fear. But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers.

Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.

Correction: February 26, 2015
Because of an editing error, Oliver Sacks’s Op-Ed essay last Thursday misstated the proportion of cases in which the rare eye cancer he has — ocular melanoma — metastasizes. It is around 50 percent, not 2 percent, or “only in very rare cases.” When Dr. Sacks wrote, “I am among the unlucky 2 percent,” he was referring to the particulars of his case. (The likelihood of the cancer’s metastasizing is based on factors like the size and molecular features of the tumor, the patient’s age and the amount of time since the original diagnosis.)

The Psychology of What Makes a Great Story

“The great writer’s gift to a reader is to make him a better writer.”

The product of storytelling is wisdom

The Psychology of What Makes a Great Story

“Stories,” Neil Gaiman asserted in his wonderful lecture on what makes stories last, “are genuinely symbiotic organisms that we live with, that allow human beings to advance.”

But what is the natural selection of these organisms — what makes the ones that endure fit for survival? What makes a great story?

That’s what the great Harvard psychologist Jerome Bruner (October 1, 1915–June 6, 2016), who revolutionized cognitive psychology and pioneered the modern study of creativity in the 1960s, explores in his 1986 essay collection Actual Minds, Possible Worlds (public library).

Jerome Bruner

In an immensely insightful piece titled “Two Modes of Thought,” Bruner, turned 100 recently, writes:

There are two modes of cognitive functioning, two modes of thought, each providing distinctive ways of ordering experience, of constructing reality. The two (though complementary) are irreducible to one another. Efforts to reduce one mode to the other or to ignore one at the expense of the other inevitably fail to capture the rich diversity of thought.

Each of the ways of knowing, moreover, has operating principles of its own and its own criteria of well-formed (thought).

They differ radically in their procedures for verification. A good story and a well-formed argument are different natural kinds. Both can be used as means for convincing another. Yet what they convince of is fundamentally different: arguments convince one of their truth, stories of their lifelikeness.

The one verifies by eventual appeal to procedures for establishing formal and empirical proof. The other establishes Not truth but verisimilitude.

Maya Terro shared this link

A story (allegedly true or allegedly fictional) is judged for its goodness as a story by criteria that are of a different kind from those used to judge a logical argument as adequate or correct.

Art by Tove Jansson for a special edition of Alice’s Adventures in Wonderland

Bruner notes that the Western scientific and philosophical worldview has been largely concerned with the question of how to know truth, whereas storytellers are concerned with the question of how to endow experience with meaning — a dichotomy Hannah Arendt addressed brilliantly more than a decade earlier in her 1973 Gifford Lecture on thinking vs. knowing and the crucial difference between truth and meaning.

One could go even further and argue, after Walter Benjamin, that the product of the analytical mode is information, whereas the product of storytelling is wisdom.

Bruner calls these two contrasting modes the paradigmatic or logico-scientific, characterized by a mathematical framework of analysis and explanation, and the narrative. Each, he argues, is animated by a different kind of imagination:

The imaginative application of the paradigmatic mode leads to good theory, tight analysis, logical proof, sound argument, and empirical discovery guided by reasoned hypothesis.

But paradigmatic “imagination” (or intuition) is not the same as the imagination of the novelist or poet. Rather, it is the ability to see possible formal connections before one is able to prove them in any formal way.

The imaginative application of the narrative mode leads instead to good stories, gripping drama, believable (though not necessarily “true”) historical accounts.

It deals in human-like intention and action and the vicissitudes and consequences that mark their course. It strives to put its timeless miracles into the particulars of experience, and to locate the experience in time and place.

[…]

In contrast to our vast knowledge of how science and logical reasoning proceed, we know precious little in any formal sense about how to make good stories.

Perhaps one of the reasons for this is that story must construct two landscapes simultaneously. One is the landscape of action, where the constituents are the arguments of action: agent, intention or goal, situation, instrument, something corresponding to a “story grammar.”

The other landscape is the landscape of consciousness: what those involved in the action know, think, or feel, or do not know, think, or feel.

Illustration by Dasha Tolstikova from The Jacket by Kirsten Hall

Bruner considers the singular landscape of narrative:

Narrative deals with the vicissitudes of human intentions. And since there are myriad intentions and endless ways for them to run into trouble — or so it would seem — there should be endless kinds of stories. But, surprisingly, this seems not to be the case.

[…]

We would do well with as loose fitting a constraint as we can manage concerning what a story must “be” to be a story. And the one that strikes me as most serviceable is the one with which we began: narrative deals with the vicissitudes of intention.

But this matter of intention remains forever mediated by the reader’s interpretation.

What young Sylvia Plath observed of poetry — “Once a poem is made available to the public,” she told her mother, the right of interpretation belongs to the reader.” — is true of all art and storytelling, whatever the medium.

Bruner considers how the psychology of this interpretation factors into the question of what makes a great story:

It will always be a moot question whether and how well a reader’s interpretation “maps” on an actual story, does justice to the writer’s intention in telling the story, or conforms to the repertory of a culture.

But in any case, the author’s act of creating a narrative of a particular kind and in a particular form is not to evoke a standard reaction but to recruit whatever is most appropriate and emotionally lively in the reader’s repertory.

So “great” storytelling, inevitably, is about compelling human plights that are “accessible” to readers.

But at the same time, the plights must be set forth with sufficient subjunctivity to allow them to be rewritten by the reader, rewritten so as to allow play for the reader’s imagination.

One cannot hope to “explain” the processes involved in such rewriting in any but an interpretive way, surely no more precisely, say, than an anthropologist “explains” what the Balinese cockfight means to those who bet on it…

All that one can hope for is to interpret a reader’s interpretation in as detailed and rich a way as psychologically possible.

Art by Maurice Sendak for The Big Green Book by Robert Graves

This essential “subjunctivity” is the act of designating a mood for the story. “To be in the subjunctive mode,” Bruner explains, means “to be trafficking in human possibilities rather than in settled certainties.”

Out of this drive toward unsettled possibilities arises the ultimate question of “how a reader makes a strange text his own,” a question of “assimilating strange tales into the familiar dramas of our own lives, even more than transmuting our own dramas in the process” — something Bruner illustrates brilliantly with an exchange between Marco Polo and Kublai Khan from Italo Calvino’s masterwork Invisible Cities, which takes place after Marco Polo describes a bridge stone by stone:

“But which is the stone that supports the bridge?” Kublai Khan asks.

“The bridge is not supported by one stone or another,” Marco answers, “but by the line of the arch that they form.”

Kublai Khan remains silent, reflecting. Then he adds: “Why do you speak to me of the stones? It is only the arch that matters to me.”

Polo answers: “Without stones there is no arch.”

Bruner extracts from this an allegory of the key to great storytelling:

But still, it is not quite the arch. It is, rather, what arches are for in all the senses in which an arch is for something — for their beautiful form, for the chasms they safely bridge, for coming out on the other side of crossings, for a chance to see oneself reflected upside down yet right side up.

So a reader goes from stones to arches to the significance of arches is some broader reality — goes back and forth between them in attempting finally to construct a sense of the story, its form, its meaning.

As our readers read, as they begin to construct a virtual text of their own, it is as if they were embarking on a journey without maps — and yet, they possess a stock of maps that might give hints, and besides, they know a lot about journeys and about mapmaking.

First impressions of the new terrain are, of course, based on older journeys already taken. In time, the new journey becomes a thing in itself, however much its initial shape was borrowed from the past. The virtual text becomes a story of its own, its very strangeness only a contrast with the reader’s sense of the ordinary.

The fictional landscape, finally, must be given a “reality” of its own — the ontological step. It is then that the reader asks that crucial interpretive question, “What’s it all about?” But what “it” is, of course, is not the actual text — however great its literary power — but the text that the reader has constructed under its sway. And that is why the actual text needs the subjunctivity that makes it possible for a reader to create a world of his own.

Bruner concurs with Barthes’s conviction that the writer’s greatest gift to the reader is to help her become a writer, then revises it to clarify and amplify its ambition:

The great writer’s gift to a reader is to make him a better writer.

Actual Minds, Possible Worlds is a remarkable read in its totality, exploring the psychological realities of language, thought and emotion, and the self.

Complement this particular portion with Susan Sontag on the task of storytelling, Oliver Sacks on its curious psychology, and Martha Nussbaum on how it remaps our interior lives, then revisit Bruner on creative wholeness, art as a mode of knowing, and the six essential conditions for creativity.

What hallucination reveals about our minds

Neurologist and author Oliver Sacks brings our attention to Charles Bonnet syndrome — when visually impaired people experience lucid hallucinations. He describes the experiences of his patients in heart warming detail and walks us through the biology of this under-reported phenomenon.

Oliver Sacks. Neurological anthropologist

Since “Awakenings” stormed the bestseller lists (and the silver screen), Oliver Sacks has become an unlikely household name, single-handedly inventing the genre of neurological anthropology. Full bio

We see with the eyes, but we see with the brain as well. And seeing with the brain is often called imagination.

And we are familiar with the landscapes of our own imagination, our inscapes. We’ve lived with them all our lives. But there are also hallucinations as well, and hallucinations are completely different. They don’t seem to be of our creation. They don’t seem to be under our control. They seem to come from the outside, and to mimic perception.

0:46 So I am going to be talking about hallucinations, and a particular sort of visual hallucination which I see among my patients.

A few months ago, I got a phone call from a nursing home where I work. They told me that one of their residents, an old lady in her 90s, was seeing things, and they wondered if she’d gone bonkers or, because she was an old lady, whether she’d had a stroke, or whether she had Alzheimer’s.

they asked me if I would come and see Rosalie, the old lady. I went in to see her. It was evident straight away that she was perfectly sane and lucid and of good intelligence, but she’d been very startled and very bewildered, because she’d been seeing things. And she told me — the nurses hadn’t mentioned this — that she was blind, that she had been completely blind from macular degeneration for five years. But now, for the last few days, she’d been seeing things.

 I said, “What sort of things?” And she said, “People in Eastern dress, in drapes, walking up and down stairs. A man who turns towards me and smiles. But he has huge teeth on one side of his mouth. Animals too. I see a white building. It’s snowing, a soft snow. I see this horse with a harness, dragging the snow away. Then, one night, the scene changes. I see cats and dogs walking towards me. They come to a certain point and then stop. Then it changes again. I see a lot of children. They are walking up and down stairs. They wear bright colors, rose and blue, like Eastern dress.”

TED
ted.com|By Oliver Sacks

Sometimes, she said, before the people come on, she may hallucinate pink and blue squares on the floor, which seem to go up to the ceiling. I said, “Is this like a dream?” And she said, “No, it’s not like a dream. It’s like a movie.”

She said, “It’s got color. It’s got motion. But it’s completely silent, like a silent movie.” (You never hear sounds in dreams too) And she said that it’s a rather boring movie. She said, “All these people with Eastern dress, walking up and down, very repetitive, very limited.” (Laughter)

And she has a sense of humor. She knew it was a hallucination. But she was frightened.

She’d lived 95 years and she’d never had a hallucination before. She said that the hallucinations were unrelated to anything she was thinking or feeling or doing, that they seemed to come on by themselves, or disappear. She had no control over them.

She said she didn’t recognize any of the people or places in the hallucinations. And none of the people or the animals, well, they all seemed oblivious of her. And she didn’t know what was going on. She wondered if she was going mad or losing her mind.

I examined her carefully. She was a bright old lady, perfectly sane. She had no medical problems. She wasn’t on any medications which could produce hallucinations. But she was blind.

And I then said to her, “I think I know what you have.” I said, “There is a special form of visual hallucination which may go with deteriorating vision or blindness. This was originally described right back in the 18th century, by a man called Charles Bonnet. And you have Charles Bonnet syndrome. There is nothing wrong with your brain. There is nothing wrong with your mind. You have Charles Bonnet syndrome.”

she was very relieved at this, that there was nothing seriously the matter, and also rather curious. She said, “Who is this Charles Bonnet?” She said, “Did he have them himself?” And she said, “Tell all the nurses that I have Charles Bonnet syndrome.” (Laughter) “I’m not crazy. I’m not demented. I have Charles Bonnet syndrome.” Well, so I did tell the nurses.

for me, this is a common situation. I work in old-age homes, largely. I see a lot of elderly people who are hearing impaired or visually impaired. About 10 percent of the hearing impaired people get musical hallucinations. And about 10 percent of the visually impaired people get visual hallucinations. You don’t have to be completely blind, only sufficiently impaired.

with the original description in the 18th century, Charles Bonnet did not have them. His grandfather had these hallucinations. His grandfather was a magistrate, an elderly man. He’d had cataract surgery. His vision was pretty poor. And in 1759, he described to his grandson various things he was seeing.

The first thing he said was he saw a handkerchief in midair. It was a large blue handkerchief with four orange circles. And he knew it was a hallucination. You don’t have handkerchiefs in midair. And then he saw a big wheel in midair. But sometimes he wasn’t sure whether he was hallucinating or not, because the hallucinations would fit in the context of the visions.

So on one occasion, when his granddaughters were visiting them, he said, “And who are these handsome young men with you?” And they said, “Alas, Grandpapa, there are no handsome young men.” And then the handsome young men disappeared. It’s typical of these hallucinations that they may come in a flash and disappear in a flash. They don’t usually fade in and out. They are rather sudden, and they change suddenly.

Charles Lullin, the grandfather, saw hundreds of different figures, different landscapes of all sorts. On one occasion, he saw a man in a bathrobe smoking a pipe, and realized it was himself. That was the only figure he recognized.

On one occasion when he was walking in the streets of Paris, he saw — this was real — a scaffolding. But when he got back home, he saw a miniature of the scaffolding six inches high, on his study table. This repetition of perception is sometimes called palinopsia.

With him and with Rosalie, what seems to be going on — and Rosalie said, “What’s going on?” — and I said that as you lose vision, as the visual parts of the brain are no longer getting any input, they become hyperactive and excitable, and they start to fire spontaneously. And you start to see things.

The things you see can be very complicated indeed.

With another patient of mine, who, also had some vision, the vision she had could be disturbing. On one occasion, she said she saw a man in a striped shirt in a restaurant. And he turned around. And then he divided into six figures in striped shirts, who started walking towards her. And then the six figures came together again, like a concertina. Once, when she was driving, or rather, her husband was driving, the road divided into four and she felt herself going simultaneously up four roads.

She had very mobile hallucinations as well. A lot of them had to do with a car. Sometimes she would see a teenage boy sitting on the hood of the car. He was very tenacious and he moved rather gracefully when the car turned. And then when they came to a stop, the boy would do a sudden vertical takeoff, 100 foot in the air, and then disappear.

9:01 Another patient of mine had a different sort of hallucination. This was a woman who didn’t have trouble with her eyes, but the visual parts of her brain, a little tumor in the occipital cortex. And, above all, she would see cartoons.

These cartoons would be transparent and would cover half the visual field, like a screen. And especially she saw cartoons of Kermit the Frog. (Laughter) Now, I don’t watch Sesame Street, but she made a point of saying, “Why Kermit?” she said, “Kermit the Frog means nothing to me. You know, I was wondering about Freudian determinants. Why Kermit? Kermit the Frog means nothing to me.”

She didn’t mind the cartoons too much. But what did disturb her was she got very persistent images or hallucinations of faces and as with Rosalie, the faces were often deformed, with very large teeth or very large eyes. And these frightened her.

Well, what is going on with these people? As a physician, I have to try and define what’s going on, and to reassure people, especially to reassure them that they’re not going insane.

Something like 10 percent of visually impaired people get these. But no more than one percent of the people acknowledge them, because they are afraid they will be seen as insane or something. And if they do mention them to their own doctors they may be misdiagnosed.

In particular, the notion is that if you see things or hear things, you’re going mad, but the psychotic hallucinations are quite different. Psychotic hallucinations, unlike Charles Bonnet hallucinations, whether they are visual or vocal, they address you. They accuse you. They seduce you. They humiliate you. They jeer at you.

You interact with them. There is none of this quality of being addressed with these Charles Bonnet hallucinations. There is a film. You’re seeing a film which has nothing to do with you, or that’s how people think about it.

There is also a rare thing called temporal lobe epilepsy, and sometimes, if one has this, one may feel oneself transported back to a time and place in the past. You’re at a particular road junction. You smell chestnuts roasting. You hear the traffic. All the senses are involved. And you’re waiting for your girl. And it’s that Tuesday evening back in 1982.

And the temporal lobe hallucinations are all-sense hallucinations, full of feeling, full of familiarity, located in space and time, coherent, dramatic. The Charles Bonnet ones are quite different. (I wouldn’t mind lovely temporal lobe hallucinations)

 So in the Charles Bonnet hallucinations, you have all sorts of levels, from the geometrical hallucinations — the pink and blue squares the woman had — up to quite elaborate hallucinations with figures and especially faces. Faces, and sometimes deformed faces, are the single commonest thing in these hallucinations. And one of the second commonest is cartoons.

what is going on? Fascinatingly, in the last few years, it’s been possible to do functional brain imagery, to do fMRI on people as they are hallucinating. And in fact, to find that different parts of the visual brain are activated as they are hallucinating.

When people have these simple geometrical hallucinations, the primary visual cortex is activated. This is the part of the brain which perceives edges and patterns. You don’t form images with your primary visual cortex.

When images are formed, a higher part of the visual cortex is involved in the temporal lobe. And in particular, one area of the temporal lobe is called the fusiform gyrus. And it’s known that if people have damage in the fusiform gyrus, they maybe lose the ability to recognize faces.

But if there is an abnormal activity in the fusiform gyrus, they may hallucinate faces, and this is exactly what you find in some of these people. There is an area in the anterior part of this gyrus where teeth and eyes are represented, and that part of the gyrus is activated when people get the deformed hallucinations.

There is another part of the brain which is especially activated when one sees cartoons. It’s activated when one recognizes cartoons, when one draws cartoons, and when one hallucinates them. It’s very interesting that that should be specific.

There are other parts of the brain which are specifically involved with the recognition and hallucination of buildings and landscapes.

14:09 Around 1970, it was found that there were not only parts of the brain, but particular cells. Face cells” were discovered around 1970. And now we know that there are hundreds of other sorts of cells, which can be very, very specific. So you may not only have “car” cells, you may have “Aston Martin” cells. (Laughter) I saw an Aston Martin this morning. I had to bring it in. And now it’s in there somewhere. (Laughter)

 at this level, in what’s called the infero-temporal cortex, there are only visual images, or figments or fragments. It’s only at higher levels that the other senses join in and there are connections with memory and emotion.

And in the Charles Bonnet syndrome, you don’t go to those higher levels. You’re in these levels of inferior visual cortex where you have thousands and tens of thousands and millions of images, or figments, or fragmentary figments, all neurally encoded in particular cells or small clusters of cells.

15:22 Normally these are all part of the integrated stream of perception, or imagination, and one is not conscious of them. It is only if one is visually impaired or blind that the process is interrupted.

And instead of getting normal perception, you’re getting an anarchic, convulsive stimulation, or release, of all of these visual cells in the inferotemporal cortex. So, suddenly you see a face. Suddenly you see a car. Suddenly this, and suddenly that. The mind does its best to organize and to give some sort of coherence to this, but not terribly successfully.

 When these were first described, it was thought that they could be interpreted like dreams. But in fact people say, “I don’t recognize the people. I can’t form any associations.” “Kermit means nothing to me.” You don’t get anywhere thinking of them as dreams.

I’ve more or less said what I wanted. I think I just want to recapitulate and say this is common.

Think of the number of blind people. There must be hundreds of thousands of blind people who have these hallucinations, but are too scared to mention them.

So this sort of thing needs to be brought into notice, for patients, for doctors, for the public. Finally, I think they are infinitely interesting and valuable, for giving one some insight as to how the brain works.

16:58 Charles Bonnet said, 250 years ago — he wondered how, thinking these hallucinations, how, as he put it, the theater of the mind could be generated by the machinery of the brain.

Now, 250 years later, I think we’re beginning to glimpse how this is done. Thanks very much.

17:22 Chris Anderson: That was superb. Thank you so much. You speak about these things with so much insight and empathy for your patients. Have you yourself experienced any of the syndromes you write about?

Oliver Sacks: I was afraid you’d ask that. (Laughter) Well, yeah, a lot of them. And actually I’m a little visually impaired myself. I’m blind in one eye, and not terribly good in the other. And I see the geometrical hallucinations. But they stop there.

CA: And they don’t disturb you? Because you understand what’s doing it, it doesn’t make you worried?

 OS: Well they don’t disturb me any more than my tinnitus, which I ignore. They occasionally interest me, and I have many pictures of them in my notebooks. I’ve gone and had an fMRI myself, to see how my visual cortex is taking over. And when I see all these hexagons and complex things, which I also have, in visual migraine, I wonder whether everyone sees things like this, and whether things like cave art or ornamental art may have been derived from them a bit.

 

 

Learning He Has Terminal Cancer: Oliver Sacks

A Month ago, I felt that I was in good health, even robust health.

At 81, I still swim a mile a day. But my luck has run out — a few weeks ago I learned that I have multiple metastases in the liver.

Nine years ago it was discovered that I had a rare tumor of the eye, an ocular melanoma. Although the radiation and lasering to remove the tumor ultimately left me blind in that eye, only in very rare cases do such tumors metastasize. I am among the unlucky 2 percent.

My Own Life

I feel grateful that I have been granted 9 years of good health and productivity since the original diagnosis, but now I am face to face with dying.

The cancer occupies a third of my liver, and though its advance may be slowed, this particular sort of cancer cannot be halted.

It is up to me now to choose how to live out the months that remain to me.

I have to live in the richest, deepest, most productive way I can.

In this I am encouraged by the words of one of my favorite philosophers, David Hume, who, upon learning that he was mortally ill at age 65, wrote a short autobiography in a single day in April of 1776.

He titled it “My Own Life.”

I now reckon upon a speedy dissolution,” he wrote. “I have suffered very little pain from my disorder; and what is more strange, have, notwithstanding the great decline of my person, never suffered a moment’s abatement of my spirits. I possess the same ardour as ever in study, and the same gaiety in company.”

I have been lucky enough to live past 80, and the 15 years allotted to me beyond Hume’s three score and five have been equally rich in work and love.

In that time, I have published 5 books and completed an autobiography (rather longer than Hume’s few pages) to be published this spring; I have several other books nearly finished.

Hume continued,

“I am … a man of mild dispositions, of command of temper, of an open, social, and cheerful humour, capable of attachment, but little susceptible of enmity, and of great moderation in all my passions.”

Here I depart from Hume.

While I have enjoyed loving relationships and friendships and have no real enmities, I cannot say (nor would anyone who knows me say) that I am a man of mild dispositions. On the contrary, I am a man of vehement disposition, with violent enthusiasms, and extreme immoderation in all my passions.

And yet, one line from Hume’s essay strikes me as especially true: “It is difficult,” he wrote, “to be more detached from life than I am at present.”

Over the last few days, I have been able to see my life as from a great altitude, as a sort of landscape, and with a deepening sense of the connection of all its parts. This does not mean I am finished with life.

On the contrary, I feel intensely alive, and I want and hope in the time that remains to deepen my friendships, to say farewell to those I love, to write more, to travel if I have the strength, to achieve new levels of understanding and insight.

This will involve audacity, clarity and plain speaking; trying to straighten my accounts with the world. But there will be time, too, for some fun (and even some silliness, as well).

I feel a sudden clear focus and perspective.

There is no time for anything inessential. I must focus on myself, my work and my friends. I shall no longer look at “NewsHour” every night.

I shall no longer pay any attention to politics or arguments about global warming.

This is not indifference but detachment

I still care deeply about the Middle East, about global warming, about growing inequality, but these are no longer my business; they belong to the future. I rejoice when I meet gifted young people — even the one who biopsied and diagnosed my metastases. I feel the future is in good hands.

I have been increasingly conscious, for the last 10 years or so, of deaths among my contemporaries.

My generation is on the way out, and each death I have felt as an abruption, a tearing away of part of myself.

There will be no one like us when we are gone, but then there is no one like anyone else, ever. When people die, they cannot be replaced. They leave holes that cannot be filled, for it is the fate — the genetic and neural fate — of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.

I cannot pretend I am without fear.

But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers.

Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.

“Self Illusion”: Bruce Hood and Virginia Woolf?

At a phase in her writing career, and after writing two novels with a conventional Victorian narrator (of viewing everything from above), Virginia Woolf announced in her diary in 1920: “I have finally arrived at some idea of a new form for a new novel. Only thoughts and feelings, and no cups and tables.” The new form would trace the flow of our consciousness, the “flight of the mind” as it unfolds in time.

As Woolf shifted her attention to her inner feelings she realized that her consciousness never stood still: Her thoughts flowed erratically, and every moment ushered in a new wave of sensation.  Woolf’s mind was neither solid nor certain: “It was very undependable—now to be found in a dusty road, now in a scrap of newspaper in the street, now in a daffodil in the sun.”

At any given moment, Woolf seemed to be scattered in a million little pieces. Her brain was barely bound together. And yet, it was bound together. Her mind was made of fragments, but it never came undone. She knew that something kept us from disintegrating, at least most of the time. Woolf wrote in her diary: “I press to my centre and there is something there.”

Woolf’s art was a search for whatever held us together. What she found was the self, “the essential thing.” Although the brain is just a complex network of electric neurons and contradictory impulses, Woolf realized that the self makes us whole. It is the fragile source of our identity, the author of our consciousness. If the self didn’t exist, then we wouldn’t exist.

Woolf projected the feeling of simultaneously affirm our existence and expose our ineffability, to show us that we are “like a butterfly’s wing…clamped together with bolts of iron.”

Bruce Hood, a psychologist at the University of Bristol, picks up where Woolf and the modernists left off. In his excellent new book, The Self Illusion, he seeks to understand how the singularity of the self emerges from the cacophony of mind and the mess of social life.

Jonah Lehrer interviewed Bruce Hood and posted on May 25, 2012 under “The Self Illusion: An Interview With Bruce Hood” (with slight editing):

“Dr. Hood was kind enough to answer a few of my questions below:

LEHRER: The title of The Self Illusion is literal. You argue that the self – this entity at the center of our personal universe – is actually just a story, a “constructed narrative.” Could you explain what you mean?

HOOD: The best stories make sense. They follow a logical path where one thing leads to another and provide the most relevant details and signposts along the way so that you get a sense of continuity and cohesion. This is what writers refer to as the narrative arc – a beginning, middle and an end. If a sequence of events does not follow a narrative, then it is incoherent and fragmented so does not have meaning.

Our brains think in stories. The same is true for the self and I use a distinction that William James drew between the self as “I” and “me.” Our consciousness of the self in the here and now is the “I” and most of the time, we experience this as being an integrated and coherent individual – a bit like the character in the story.

The self which we tell others about, is autobiographical or the “me”, which again is a coherent account of who we think we are based on past experiences, current events and aspirations for the future.

The neuroscience supports the claim that self is constructed. For example, Michael Gazzaniga demonstrated that spilt-brain patients presented with inconsistent visual information, would readily confabulate an explanation to reconcile information unconsciously processed with information that was conscious. Spilt-brain patients would make up a story.

Oliver Sacks reported various patients who could confabulate accounts to make sense of their impairments. Ramachandran describes patients who are paralyzed but deny they have a problem.

These are all extreme clinical cases but the same is true of normal people. We can easily spot the inconsistencies in other people’s accounts of their self but we are less able to spot our own, and when those inconsistencies are made apparent by the consequences of our actions, we make the excuse, “I wasn’t myself last night” or “It was the wine talking!” Well, wine doesn’t talk and if you were not your self, then who were you and who was being you?

LEHRER: The fragmented nature of the self is very much a theme of modernist literature. Nietzsche said it first: “My hypothesis is the subject as multiplicity” and Virginia Woolf echoed Nietzsche, writing in her diary that we are “splinters and mosaics; not, as they used to hold, immaculate, monolithic, consistent wholes.”

In your book, you argue that modern neuroscience has confirmed the “bundle theory” of the self proposed by Hume. Do you think they have also confirmed these artistic intuitions about the self? If so, how has science demonstrated this? Are we really just a collection of “splinters and mosaics”?

HOOD: Yes, absolutely. When I was first asked to write this book, I really could not see what the revelation was all about. We had to be a multitude – a complex system of evolved functions. Neuroscientists spend their time trying to reverse engineer the brain by trying to figure out the different functions we evolved through natural selection.

So far, we have found that the brain is clearly a complex of interacting systems all the way up from the senses to the conceptual machinery of the mind – the output of the brain. From the very moment that input from the environment triggers a sensory receptor to set off a nerve impulse that becomes a chain reaction, we are nothing more that an extremely complicated processing system that has evolved to create rich re-presentations of the world around us.

We have no direct contact with reality because everything we experience is an abstracted version of reality that has been through the processing machinery of our brains to produce experience.

I think Nietzsche’s nihilism and Woolf’s depression could have been reflections of their intuitive understanding that the richness of experience must be made up of a multitude of hidden processes and that the core self must be an illusion – and maybe that upset them.

But I don’t think appreciating the self as an illusion is a bad thing. In fact, I think it is inescapable. My critics often dismiss my position as too reductionist or too materialist. Well, if the human condition is not materialist, then an alternative good explanation must be non-materialist.

Show me good evidence for souls and spirits and then I will be forced to change my view. But so far, there has been no reliable evidence for souls, ghosts or supernatural entities that inhabit bodies. They are conspicuous by their absence.

In contrast, we know that if you alter the physical state of the brain through a head injury, dementia or drugs, each of these changes our self. Whether it is through damage, disease or debauchery, we know that the self must be the output of the material brain.

LEHRER: If the self is an illusion, then why does it exist? Why do we bother telling a story about ourselves?

HOOD: For the same reason that our brains create a highly abstracted version of the world around us. It is bad enough that our brain is metabolically hogging most of our energy requirements, but it does this to reduce the workload to act. That’s the original reason why the brain evolved in the first place – to plan and control movements and keep track of the environment.

It’s why living creatures that do not act or navigate around their environments do not have brains. So the brain generates maps and models on which to base current and future behaviors. Now the value of a map or a model is the extent to which it provides the most relevant useful information without overburdening you with too much detail.

The same can be said for the self. Whether it is the “I” of consciousness or the “me” of personal identity, both are summaries of the complex information that feeds into our consciousness. The self is an efficient way of having experience and interacting with the world.

For example, imagine you ask me whether I would prefer vanilla or chocolate ice cream? I know I would like chocolate ice cream. Don’t ask me why, I just know. When I answer with chocolate, I have the seemingly obvious experience that my self made the decision. However, when you think about it, my decision covers a vast multitude of hidden processes, past experiences and cultural influences that would take too long to consider individually. Each one of them fed into that decision.

LEHRER: Let’s say the self is just a narrative. Who, then, is the narrator? Which part of me is writing the story that becomes me?

HOOD: This is the most interesting question and also the most difficult to answer because we are entering into the realms of consciousness. For example, only this morning as I was waking up, I was aware that I was gathering my thoughts together and I suddenly became fixated by this phrase, “gathering my thoughts.” I felt I could focus on my thoughts, turn them over in my mind and consider how I was able to do this. Who was doing the gathering and who was focusing? This was a compelling experience of the conscious self.

I would argue that while I had the very strong impression that I was gathering my thoughts together, you do have to question how did the thought to start this investigation begin? Certainly, most of us never bother to think about this, so I must have had an unconscious agenda that this would be an interesting exercise.

Maybe it was your question that I read a few days ago or maybe this is a problem that has been ticking over in my brain for some time. It seemed like a story that I was playing out in my head to try and answer a question about how I was thinking. But unless you believe in a ghost in the machine, it is impossible to interrogate your own mind independently. In other words, the narrator and the audience are one and the same.

As the philosopher Gilbert Ryle pointed out, when it comes to the mind you cannot be both the hunter and the hunted. I think that he is saying that the brain creates both the mind and the experience of mind. So you can become aware of a thought, but you are not independent to that thought. Now that is a very unsatisfactory answer for most people because it simply does not accord with mental experience.

We entertain thoughts. We consider options. We gather our thoughts together. We play out scenarios in our mind. However, unquestionable as that mental experience might seem to all of us, there can be no one inside our head considering the options. Otherwise, you would then have the problem of an infinite regress – who is inside their head, and so on, and so on.

LEHRER: I get the sense that not all of your colleagues agree with your deconstruction of the self. Some argue, in fact, that the self is a bit like a wristwatch. Just because a watch is a bundle of different parts doesn’t mean it is an illusion. How do you respond to these critiques?

HOOD: For me, an illusion is not what it seems and for most of us, we consider our self as some essential core of who we are. Most of us feel our self is at the center of our existence responding to everything around us – that notion of an integrated entity is what I am challenging, not the experience of self.

Most of us, including myself have that experience but that does not make it real. For example, most us think that we see the world continuously throughout the waking day when in fact we only see a fraction of the world in front of us, and because the brain blanks out our visual experience every time we move our eyes in a process called saccadic suppression, we are effectively blind for at least 2 hrs of the day. This is why you cannot see your own eyes moving when you look in a mirror! So conscious experience is not a guarantee of what’s really true.

As for the comparison with a wristwatch…Clearly, it is composed of many parts and the sum of the parts is the wristwatch. However, a wristwatch is only a wristwatch by convention. An alien or a Neanderthal would just consider it to be some form of complex composite object. You could even use the wristwatch as a weapon to kill small animals. It’s a bizarre use of this object I grant you, but there is nothing inherent or essential to the watch that defines what it is.

A microbe living on the watch face may not consider it an object. So a wristwatch is a wristwatch because of a recognized function and to some extent, a convention – both of which do not confer an independent reality to the mind that is considering it. It depends on how you look at it.

When people talk about the reality of the self as the culmination of its constituent parts, I think that they are falling for the trap of thinking that the self exists independently to its parts, which it doesn’t.

In the book, I argue that because we have evolved as social animals, those around us construct a large part of our mental life that we experience as our self. We can see the influence of others but often fail to recognize how we too are shaped.

I am not denying the role of genes and temperaments that we inherit from our biology. After all, children raised in the same environment can end up very different, but even these intrinsic properties of who we are, play out in a social world which defines us. If you think about it, many of the ways we describe each other, such as helpful, kind, generous, mean, rude or selfish can only make sense in the context of others.

So those around us largely define who we are. I hope this book will remind us of this obvious point that we so easily forget…” End of interview

Do you think there is similarity between Hood’s views and this post? https://adonis49.wordpress.com/2012/05/11/genes-are-transformed-by-nurturing-genes-functioning-as-default-program/

Fragile is normal;

Being normal is pretty fragile. Maybe if you read “The man who substituted his wife for her hat” by the physician Oliver Sacks you might realize how barely tenable the concept of normalcy is. In general, scientists (including psychologists) consider what is normal the sample of items or group of people, within a restricted community, who share a particular attribute or characteristic 68% of the total studied, which means one standard deviation from the means (which has no meaning whatsoever, except that it is amenable to mathematical manipulations of other mathematical derivatives).

Now if we want to study the same group who share two characteristics then the percentage deteriorates rapidly.  If you need to investigate people who share three characteristics then you might as well not to resume your investigation: your project would lead nowhere.  When we walk the street we are amazed to discover that there are more “normal” people than we imagined. There are mainly two reasons for our imagination:

First, the “abnormal” people (for example, the Mongolians, the smart idiots, the clinically found psychologically disturbed) are sheltered off the street, voluntarily or involuntarily.  Most of them are secluded in rooms at homes, or in the basement, or in the attic.

Second, the majority of “abnormal” people that look normal on the street are labeled normal in contrast to our perceived over valuation to our personality.  They are normal with a bad connotation; they are not as good as us in many ways.  There are a few instances when we observe people of being in a category of “better than normal” but we never declare ourselves defeated.  In the depth of our psychic we know that if we get to “know” them deeper than the superficial aspects, let’s say sort of skin deep, then these super normal must have vices and diseases that instantly drag them way below “normalcy”.

You have got people who lost the functions of language, memory or part of it, identity recognition, time, and space.  You have got people who lost the feeling of their body, of imagination, of who consider one of their limbs are stranger to their bodies, people stuck in one moment in their life, people who cannot see what is on one side (right or left), super talented people in one restricted domain of music, numbers, chess, poetry, or drawing.

You have people who would describe a glove in much detail (not recognizing what they are describing) until they wear it and then would exclaim “My God! This is a glove!” People who would describe a rose in detail and after smelling it shout “But this is a rose!”

We are subjected at any instant to flipping from normal to the other side of the category and we will have no idea that we have flipped; even psychiatrists will never tell us how we have been categorized: we are no longer normal people to communicate intelligibly with; as if our folks or relatives should fair better than us to be told the whole truth.

Today is much better than tomorrow. Extend a soft hand to your “normal” neighbor today.


adonis49

adonis49

adonis49

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