Tuesday, April 7, 2009

On Part One: I am No One

On page 59 Mark has his first post-accident recognition of another patient’s sadness when he overhears someone sobbing in a room near his. This “feat of intellect” as Karin calls it seemed to be so much more to me at that moment. Every now and then while reading Powers’s novel I stop and have that moment of questioning: is he the echo-maker? Is he simply echoing what his interrupted mind grasps, words or actions that instigate a connection, a memory? It cannot be this simple. Mark recognizing sadness seemed pivotal to me in the unorganized, time-warped narrative. So much of him seems to still be present and what is missing is baffling because it seems to be so little he is not capable off. He shoots the shit with his two buddies and they recognize his progress but he gets overwhelmed. “When they’re near, he can’t hear himself think. Too much happening at once for him to see what’s wrong.” (67). He receives necessary, pseudo-romantic attention from Bonnie and then becomes captivated, infatuated by Barbara. He is able. He can walk and talk. Tracking his progress is confusing because of the parallel narrative of his sister, that at times overshadows his deficits and puts the reader’s focus on Karin. The self—our self, knowing who one is through memory and self-preservation—is not only taken from Mark but to an extent more so from Karin by her brother’s Capgras syndrome. “You think I’m just a symptom?” (92), she asks Daniel. Her sense of self, the idea of the life she has created and thought she knew and could hold on to, is taken away by the accident and Mark’s recovery and misidentification delusions send Karin deeper and deeper into the chase, the struggle. I cannot imagine what it must be like to be talking to your sibling, the closest genetic organism to you, knowing that they do not recognize who you are. I ask a completely unanswerable question: Why does Capgras manifest itself in this way? Why do patients not recognize loved ones especially? The mysterious note only adds to the delusion and shattering of the self. I am No One. To bring back someone else? Is Karin the one who needed bringing back? The obvious answer seems to me to be Mark but it is his challenge to bring back that other.
The pages are filled with cryptic lines about identity, life and death. Mark realizes on page 64 that he doesn’t even know where the dead are. For some reason this line and so many others seemed to make my mind pause and think and then blank. On the next page, he has another realization that seems so wise, so natural for someone who has had their world flipped inside out and upside down from one millisecond to the next. While asking his sister/actress to get him some sort of identification Mark seems to grasp something that at this very moment seems beyond me. They can operate on your brain without you even knowing it. In this thought Mark at once comes to terms with his accident and current situation and surrenders his body to the technology that, without his consent, has kept him alive.
I found myself struggling with the unannounced switch from Karin’s point of view to Mark’s. I definitely enjoyed reading the Mark sections more. Knowing his thoughts, the way they are presented and the way they expose his personality, made me understand the entire narrative better. “Nobody’s quite what they say they are, and he’s just supposed to laugh and play along.”

Capgras + Our Sense of Self

For me the most intriguing part of Capgras syndrome is the profound implications this disorder has with regard to how we define our sense of self. The Hirstein and Ramachandran article details the multiple brain functions that are involved in the process of recognizing a face. Part of our neurology allows us to consciously interpret what we see in front of us as another person, while another part is responsible for triggering the emotional arousal that results from our associations with a face that is familiar to us. The authors suggest that in the case of Capgras patients, the limbic section of the brain fails to enact this emotional response to the faces of loved ones, thus forcing the patient to conclude that the person they are encountering is not the really the relative they know and love, but an imposter.
In The Echo Maker, Richard Powers creates a vivid picture of the impact this kind of neurological disconnect can have on the lives and relationships of an affected person and his loved ones. Our sense of self is defined by our connection to others. The relationships we create anchor us in our surroundings and give meaning to our place in the world. In the novel, Mark’s conception of one of his most important relationships becomes wrapped in distrust and suspicion. Once he no longer has the grounding link to the person he loves most, his sense of self is profoundly shaken. The syndrome deeply impacts Karin as well, since much of her understanding of herself relies on the role she once inhabited in Mark’s life. She knows herself as his protector, his caretaker, his sister, and she has shaped a significant part of her identity around this version of herself. Mark’s accident changes all of this. His brain can process her face intellectually, but can no longer elicit the warm emotional reaction that would allow him to accept Karin as his sister. She is stripped of a role that she has long relied on to define herself.
In his interview with Terry Gross, Powers suggests that although Capgras is a rare phenomenon, the theme of the novel may resonate with readers because we may experience this “decoupling of intellectual recognition and emotional recognition” in small ways in our everyday lives. He gives the example of someone professing their love to another person, only to later admit that they no longer have those passionate feelings toward them. In that example, the person would recognize their lover as the same familiar face, but no longer feel the emotional arousal that their partner used to bring forth. In neuro-typical people, this decoupling would lead the person to conclude not that their lover is a fake, but that some change has taken place within themselves or the other that has caused the initial feelings to fade. Powers also emphasizes that the self is a kind of novelist, in that it has an amazing ability to revise its view of the world. Our environment, our relationships, our place in society – all these factors that make up our lives are constantly shifting, and as a result we must constantly reconstruct the narrative of our experience. Whether it’s a brain malfunction like Mark’s that interrupts our understanding of a relationship, or the more common reality of falling out of love, life demands that we are flexible in how we view ourselves and organize the world around us.

To Take Away What Is Unnecessary, You Must First Define What is Necessary

Through the fictional autistic narrator, Christopher, author Mark Haddon introduces a vital theme, not only apparent throughout The Curious Incident of the Dog in Night-time, but also evident in the non-fictional accounts of autism provided by Oliver Sacks (throughout his Anthropologist on Mars). The theme is that of Occam’s razor, which (in Christopher’s translation from latin) states, “no more things should be presumed to exist than are absolutely necessary” (Haddon 90).
There is certainly evidence enough to argue that Christopher’s mental state is an illustration of this tenet. For one, he (like other autistic individuals) considers the non-goal-oriented chit-chat that so greatly comprises human interaction as unnecessary: “I didn’t reply to this either because Mrs. Alexander was doing what it called chatting, where people say things to each other which aren’t questions and answers and aren’t connected” (Haddon 40). [As Feinberg describes this phenomenon, albeit rather bluntly: individuals with Asperger’s (the less-severe and more functional form of autism), “…cannot see the point in social chit-chat. They do not ming having a discussion…on a particular issue in order to establish the truth of the matter…But just a casual, superficial chat? Why bother? And what on earth about? How?...it is both too hard and pointless” (Feinberg 172). Perhaps a more neutral and reflective tone is found in Oliver Sacks’ description of the same sentiments (or lack there of) in Temple Grandlin: “By professional standards, she is extraordinarily successful, but other human interactions—social, sexual—she cannot ‘get’” (Sacks 260). Indeed, the emotional understanding and communication that serves as the basis for such social interactions (be it chit-chat or deep empathic exchange) rests on an individual’s ability to share the emotions of the other person, an ability that is also lacking in Sacks’ other true-life character, Stephen: “He seemed not to understand different emotions and would laugh if one of the children had a temper tantrum or screamed” (201).
In turn, Christopher’s direct, simplistic thinking is another example of the reductionist motif. He does not waste time in mincing words or thoughts, but states and attends to things without the presumed prefrontal cortical inhibition that causes otherwise neuro-normative individuals to hold their tongues: i.e. when Christopher explains to Mrs. Alexander why he does not feel sad about his mother’s (supposed) death: “I don’t feel sad…because mother is dead. And because Mr. Shears isn’t around anymore. So I would be feeling sad about something that isn’t real and doesn’t ecist. And that would be stupid” (Haddon 75). Or, when Christopher shows up at his mother’s house and genuinely asserts to Mr. Shears that “I’m going to live with you because Father killed Wellington with a garden fork and I’m frightened of him” (192). Likewise, Oliver Sacks’ depiction of Temple’s lack of “…diffidence or embarrassment (emotions unknown to her)” (Sacks 262) while displaying her bedroom and squeeze-machine “…with a complete absence of inhibition or hesitation” (265). Thus the regular tentativeness, humbleness, or self-consciousness that might be expected of a non-autistic individual is not apparent. Such is the case, as well, with Steven Wiltshire who “…seemed to have no sense of either vanity or modesty, but showed [Oliver Sacks] his drawings, commented on them, in an ingenuous way and with total absence of self-consciousness” (Sacks 205).
A further embodiment of the theme present in Occam’s razor is the presumed “hypertrophy of a single mental faculty” (Sacks 193) to the exclusion of all others that characterize savant talents. Inherent in this distinction is a cleavage of all (or most) other mental faculties that unrelated (and thus unnecessary to) the hypertrophized faculty—i.e. verbal/communicative skills, emotional competence, etc. Christopher compares this to the otherwise normative state of mind, wherein “most people are almost blind and they don’t see most things and there is lots of spare capacity in their heads and it is filled with things which aren’t connected and are silly, like ‘I’m worried that I might have left the gas cooker on” (Haddon 144). Thus, at least to Christopher, such non-autistic minds to not cleave the unnecessary or surperfluous.
It is crucial to note, however, that to define “necessary” or its counterpart, “superfluous” is entirely subjective. Indeed, Christopher sees what others may deem necessary as silly, or stupid (in his words); while most non-autistic individuals would deem his retention of every detail when looking at a farm field, for instance, as equally unnecessary—disadvantageous, in fact. Thus it can be argued that perspective is inherently correct.
This, of course, leads into the discrepancy over whether savantism is a deficit or a gift. Most would see it as a disadvantage, if it is to be accompanied by social deficits and interpersonal dysfunctional; however, as Temple asserts, “If I could snap my fingers and be nonautistic, I would not…Autism is par of who I am” (Sacks 291); “It is possible that persons with bits of these [autistic] traits are more creative, or possible even geniuses…If science eliminated these genes, maybe the whole world would be taken over by accountants” (292).
In summation, then, one individual’s take on Occam’s razor may be entirely different than another’s: unnecessary and necessary (and the removal of and/or implementation of each) are highly dependant upon perspective—which, itself, is colored by an individual’s predisposition, emotional interior, exterior, and cognitive capacities. The very insistence that deficits such as autism are unnecessary can even be lumped into this discrepancy.

Monday, April 6, 2009

I'm glad I don't have Capgras.

In Kim Ferguson’s Intro to Cognitive Science class last semester, we watched a documentary about a man suffering from accidental Capgras, that is, arising from physical injury to the brain. I believe it was a car accident, making his case very similar to Mark’s. In the short video, the man (whose name escapes me) is living with his parents in his old house, and has been for several months. He says that although he is not convinced that the people living with him are his real parents, he is no longer difficult or hostile to them because they seem like good people and they take good care of him. He says the same of his house, which he no longer recognizes as his own. His parents say they are taking baby steps, and that their relationship has much improved from the earlier days. This video was extremely haunting, in a way that was different from the coldness exhibited by Mark towards Karin, in that this man was simply coexisting with his parents because it was convenient and posed no threat to him. All of his past relationships and memories with his parents had evaporated on his end, and he had simply accepted that. While Mark often puts up some sort of fight towards Karin, acknowledging her presence and significance if not as her sister as a caretaker, the other man does not even feel the need to do that. He lives in his fake house because it is shelter, and cohabitates with his fake parents because they cook for him. And while the omnipresent narrator of the video insists that he is making progress and that there is hope that his emotional connections will be restored, it is hard to believe when watching the video.

In the same class, we briefly covered what happens in the brain that causes Capgras. It is speculated that the reason Capgras sufferers may recognize loved ones and simultaneously not recognize them is that connection between emotion and face recognition and memory is damaged (Please tell me if this is not right…my poor memory has suffered over the many months). Therefore, when Mark looks at Karin, he recognizes her face but does not feel the flood of emotion one might feel towards one’s sister; love, affection, irritation, etc. Mark’s brain then rationalizes that since it doesn’t emotionally react towards his sister, then she cannot logically be his actual sister. It is this reason also that Capgras patients hardly ever believe it is themselves who are the cause of it. This is a prime example of both the fragility of the brain and it’s amazing prowess, in this case occurring at the same time.

I enjoyed The Echo Maker. Powers is obviously a very skilled writer; utilizing many literary tools and layered narrative to tell the story. The balance between fiction and disorder was even, in that though the plot was centered around Mark’s Capgras, there were other elements interwoven into it that made it an interesting read without relying solely on the disorder. Powers was informed and respectful and chose a syndrome that lent itself well to fiction writing. While the book itself could have been a more exciting read--the smoothness of the flow became a bit tiring--I think Powers successfully relayed both a story and a course on Capgras.

The Echo Maker

I want to apologize, first, for this tardy write-up. The truth is, I’ve been struggling to think of anything very insightful to say about The Echo Maker. But, after a lot of hemming and hawing, I think I may have something at least vaguely interesting. It has to do with the omnipresence of the brain and brain science and how some of the material, including The Echo Maker, has proposed implicitly, thrown into doubt, reconfigured, or destabilized fundamental notions of who we are. Explaining how I got onto this line of thinking will require some anecdotes.

There’s an odd experience we have when we’re reading about a topic that is novel to us, as much of neuroscience is novel to me. It’s the same thing we experience when we learn a new word. We start to see it everywhere. Now that I know a bit more about Parkinson’s, now that I know a bit more about autism, now that I know a bit more about epilepsy, synaesthesia, Capgras syndrome, agnosia, etc., examples of atypical brain development and of brain damage appear in news stories constantly; they come up in my conversations with friends and relatives; books relating to them seem to materialize out of nowhere; the reading assignments in other academic courses bring them up; my own short stories begin to swirl around related themes. In the past two or three weeks, this has been uncannily true for me, and it’s gotten me to think in new ways about some of what we’ve read.

An acquaintance--Jeremy--who’s becoming a friend and whom I met through another acquaintance had, I noticed shortly after we’d been introduced, some habits in his conversation and in his Web correspondence (e-mail and instant messages) that could be construed as rude or, at the least, bizarre. For instance, in the middle of an IM conversation, he would disappear abruptly, while still ostensibly signed on, and come back forty minutes later, saying he’d gotten so involved in his music (he’s a composer) that he’d forgotten we were talking. This happened more than once. I also noticed, while I was with him in person, that, if I said anything ironic or sarcastic, he would pause and look blankly at the floor for a moment, then register the joke and laugh. He wasn’t big on prolonged eye contact either--which was fine by me, initially, since I think intense eye contact can easily become more creepy than polite. But his eye contact was so brief and so rare that I started to think something in this social situation was awry. I was beginning to take some offense, privately, to these various gestures, but didn’t say anything because I knew I was construing them as rude when, conceivably, no disrespect was intended. Then one time he mentioned in passing “having A.S.,” but didn’t elaborate, either assuming I knew what he was referring to, or testing whether I did, and the context gave me no clues, other than that it was a medical issue. The only “A.S.” I could think of on the spot was Ankylosing spondylitis, a rare form of arthritis--how I know of that A.S., I couldn’t say. Anyway, when I responded with something about Ankylosing spondylitis, he looked at me as though I had just broken into a foreign language that sounded funny to uninitiated ears. “No,” he said, “Asperger’s syndrome”--which I did in fact know some rudimentary information about. Suddenly, all the potentially offensive ambiguities in our interactions were explained. And of course I felt like a serious, serious idiot. A psychology student in neuropsychology class, I should have known. And Ankylosing spondylitis was a comically absurd guess. It struck me how much and how concretely our everyday interactions are shaped by the vicissitudes of the brain, and how a knowledge of the brain casts a different and brighter light on those interactions, bringing clarity as well as new questions when previously indistinct details are revealed, as in a picture moved to a different and better lit setting. And not just our everyday interactions but the big stuff too. We can see a similar phenomenon in The Echo Maker, where an alteration in a single brain has amazingly widespread effects, altering in turn whole sensibilities, whole relationships and families, whole lives.

Not long after the awkward and embarrassing incident above, it was announced on the news that the actress Natasha Richardson--daughter of Vanessa Redgrave, wife of Liam Neeson--had died because of a seemingly--but really only seemingly--minor head injury, which she sustained when she fell during a skiing lesson, after which she was talking and laughing and refused medical help. She died of apparently serious brain damage, which I won’t bother to explain here, two days later. That evening, when two American parents heard of her death and the circumstances surrounding it, they thought of their seven-year-old daughter, who had had a head injury, seemed to be fine at first, but had after two days, when they went to see her to bed, begun to complain of a headache--a pattern almost exactly like Richardson’s last days. Making the connection, the parents called their pediatrician, the girl was transported by helicopter to a hospital equipped to deal with the injury--which was the same as Richardson’s after all--and she survived basically unscathed. Then I heard on the news about a lawyer in the Midwest who was using the possibility that his client had Asperger syndrome as a defense in a murder case, claiming that his client was “laboring under it” so that he “didn’t know the nature of his actions or that they were wrong.” Wisely, the judge rejected this defense. Still, knowing what I know about Asperger’s, I found the lawyer’s attempt outrageous. When I mentioned the story to Jeremy, he explained much more precisely that such a defense wouldn’t make sense with this particular form of autism, but could make more sense--he said this with an air of caution--with other forms, although it would be a controversial argument even then. He spoke, moreover, about the dangers of conflating neurological and psychiatric phenomena and the misuse of neuroscience--this surely rings a bell with members of our class. The brain, with both its power and its vulnerability, shapes our lives in real ways, on the individual level, and our world, on a societal level.

These coincidences and parallels reached a peak this afternoon when I was having lunch with a friend, who’s a novelist and professor. He mentioned, apropos of something else, having been on the committee that voted to give the National Book Award to Richard Powers for The Echo Maker. My friend, however, was the only person not to vote in favor of Powers’s book, which he said he hated. He said, furthermore, that he sees psychology currently and increasingly replacing philosophy and making it irrelevant, and he sees neuroscience replacing psychology; and this made him nervous, deeply nervous. When you study literature, it is sometimes said, philosophy is always right around the corner; but more and more it is psychology and neuropsychology that are around the corner, as Richard Powers unquestionably knows. Given my friend’s age and education, I should think that The Echo Maker violates fundamental ideas he holds about what literature is and ought to be. My friend, when we were discussing another thing entirely, mentioned that he’d recently met Oliver Sacks at a lecture and that they’d been e-mailing since, planning eventually to get together. They’d been talking about what “apprehension” means, from the perspective of a writer and that of a neuropsychologist. My friend said, fittingly, “I think I may be afraid of Oliver Sacks.” The brain, brain damage, brain science--they are omnipresent and to some people a major threat, a threat to aesthetic, intellectual, moral, legal, and philosophical views. I will admit, I felt a twinge of anxiety when reading The Echo Maker, because it gets at such visceral and deeply embedded fears and destabilizes some of our smug sense of safety, constancy, comfort, and so on.