Into the Silent Land

Paul Broks trained as a clinical psycholog is t at Oxfo rd

Universi ty and went on to special ize in neuropsycho logy .

He has pursued a career combin ing both clinical pract ice

and fundamental brain research. He l ives in Cornwa l l and

is currently a Senior Clinical Lecturer in N e u r o p s y c h o l o g y

at P lymouth University. He wri tes a regular co lumn for

Prospect magaz ine and his w o r k has appeared in the Sunday

Times, Sunday Telegraph, Guardian, Daily Telegraph and

Granta. Into the Silent Land w a s shortl isted for the Gua rd i an

First B o o k Award 2003.

F r o m the reviews:

'Into the Silent Land is a smal l , s t range, beautiful g e m . . . B r o k s

is as much poet as s c i en t i s t . . . Indelible. ' Atul G a w a n d e ,

author of Complications

'Beautifully written and beautifully thought through. '

Professor Steven R o s e , author of The Making of Memory

'Into the Silent Land is as tonishing - a mix of real-life

neurological cases , science f ic t ion , r andom quips and deeply

personal r eve l a t i ons . . . T h e b o o k has no right to hang

together, but somehow it does , quite beautifully. '

S imon Hattenstone, Guardian

'R ive t ing . ' T o n y Gui ld , Independent

' I m p r e s s i v e . . . B r o k s ' s bes t s t o r i e s . . . p rove that all human

be ings are , as he puts it, ' s tory- tel l ing machines ' . Faced with

the material reality of the brain and the infinite configurations

of the mind, we realize that we are "at one level, no more

than meat ; and, on another, no more than f ic t ion". '

G a b y W o o d , Observer

'A debut of considerable quality. ' Rober t Macfar lane,

Sunday Times

' B r o k s has expressed what will surely be the twenty-first

cen tury ' s central angs t with sensitivity and e legance. '

Jeffrey Gray , TLS

'Into the Silent Land shows how people adapt to

ext raordinary c i r c u m s t a n c e s . . . Fasc inat ing . '

Ka th Murphy, Scotland on Sunday

' B r o k s enters the silent land with arc lights b l a z i n g . . .

Conf ron ted with bra ins and relationships that are fragile

and prov is iona l , B roks kindles compass ion and inspires. '

C l ive C o e n , Times Educational Supplement

'Into the Silent Land outlines what can happen after

severe brain-injury — and I am n o w increasingly fascinated

by what the brain i s capable of and w h y ' Sheena M c D o n a l d ,

Sunday Herald B o o k s of the Year

'A rare b o o k of s tagger ing bril l iance, l eav ing readers with

much to consider about their own l ives. ' Good Books Guide

'S tudded with dazzl ing insights and a great deal of food for

thought. ' T e s s Taylor , San Francisco Chronicle

'B roks is a gifted wr i t e r . . . H i s depict ions of patients is

heart-wrenching. ' Beth Greenbe rg , Boston Globe

'Writing beautifully about our mos t unbeautiful cogni t ive

apparatus , Broks descr ibes its rumpled surfaces , its ne twork

of neurons, its deep, secret spaces with such care that the act

itself powerfully i l luminates the bra in ' s creative capaci t ies . '

Lauren Slater, Elle

Into the Silent Land

Travels in Neuropsychology

PAUL B R O K S

Atlantic B o o k s

L o n d o n

First published in hardback in Great Britain in 2003

by Atlantic Books , an imprint of G r o v e Atlantic Ltd

Thi s paperback edition published by Atlantic Books in 2004

Copyr ight © Paul Broks 2003

T h e moral right of Paul Broks to be identified as the author of

this work has been asserted in accordance with the Copyright ,

D e s i g n s and Patents Act of 1988.

T h e author and publisher wish to thank the following for

permiss ion to quote from copyrighted material:

Dannie A b s e for 'In the T h e a t r e ' from Collected Poems,

1948-1976(London: Hutchinson 1977); the Estate of Gilbert Ryle

for The concept of mind (London: Hutchinson 1949).

All rights reserved. No part of this publication m a y be

reproduced, stored in a retrieval system, or transmitted in any

form or by any means , electronic, mechanical , photocopying,

recording or otherwise, without the prior permiss ion of both

the copyright owner and the above publisher of this book.

Earl ier drafts of a number of chapters have appeared in Prospect magazine.

' T h e Seahorse and the A l m o n d ' was published in earlier form in Granta magazine.

9 8 7 6 5 4 3 2 1

A C 1 P catalogue record for this b o o k is available from the British Library.

I S B N 184354 0 3 4 7

Printed in Great Britain by Mackays of Chatham pic, Chatham, Kent

Atlantic B o o k s

An imprint o f G r o v e Atlantic L t d

O r m o n d H o u s e

2 6 - 2 7 Boswell Street

L o n d o n

W C 1 N 3 J Z

For Sonja, Daniel and Jonathan

The brain is wider than the sky,

For, put them side by side,

The one the other will include

With ease, and you beside.

Emily Dickinson

C O N T E N T S

ONE Swallowing the Dark

Different Lives 3

The Space behind the Face 17

The Seahorse and the Almond 22

The Sword of the Sun 39

Soul in a Bucket 42

In the Theatre 57

A-Z 65

The Mirror 67

The Visible Man 71

TWO The Spark in the Stone

I Think Therefore I Am Dead 89

Vodka and Saliva 105

Body Art 114

The Story of Einstein's Brain 117

Articles of Faith 123

Right This Way, Smiles a Mermaid 132

THREE No Water, No Moon

The Ghost Tree (1) 147

The Ghost Tree (2) 158

The Dreams of Robert Louis Stevenson 171

Voodoo Child (Slight Return) 181

Mr Barrington's Quandary 196

Out of Darkness Cometh Light 200

To Be Two or Not to Be 204

Gulls 226

Further R e a d i n g

Acknowledgemen t s

237

246

O N E

Swallowing the Dark

Different Lives

' W h y does raw meat g i v e me a h a r d - o n ? '

T h i s is Michael, chopping sirloin ready for the stir-fry. T y p i ­

cally, he is g o i n g to the trouble of p repar ing a g o o d lunch: bee f

in hoi-sin sauce . H e ' s bough t s o m e beer, too. W e ' r e dr inking

straight from the can. A m y , his girlfriend, sits at the kitchen

table reading a magaz ine .

'Michael, ' she says , without look ing up.

Michael sl ides the diced bee f into the w o k where it sizzles in

the hot oil .

'Easy , Amy. Only a twitch. ' He winks at m e , then d r o p s what

he is do ing and strides out of the r o o m . ' H a v e a listen to this, ' he

calls over his shoulder and soon the place is awash with cascades

of sound - brittle a rpegg io s , tumbl ing f ragments of melody. I t

is very loud.

Michael returns, f ingertips to temples, head tilted back .

'Koto , ' he says . ' J apanese . As ton ish ing . '

F r o m this angle the dent in his head , about three inches up

from the right eyebrow, is m o r e noticeable.

3

P A U L B R O K S

4

N e x t d a y I 'm over at S tuar t ' s . We sit in his stuffy front room.

An orna te b lack c lock (his early-retirement present) cl ings to

the wall like a huge fly. As I s t ruggle with milky tea, Stuart locks

me in his g a z e . He is about to say something , but doesn ' t . I t is a

l ong pause . Eventual ly he speaks .

' I don ' t love y o u any more , do I , l o v e ? '

T h e w o r d s are intended for his wife, Helen, who sits beside

him. ' N o , love , ' she replies. ' S o you say. '

T h e r e is silence aga in , except for the tick of the insectoid

c lock. T h e dent in S tuar t ' s head is above the left eyebrow.

Michael had c l imbed a tree to retrieve an entangled kite. He

needn ' t have bothered because the wind gus ted and the kite

drifted d o w n of its own accord , but he was high up by then. He

w a s cal l ing someth ing to A m y , but she couldn ' t make i t out.

Her d reams recall how abruptly his voice was stifled by the

creak and crack of a branch, and the wind-whipped silence of

the free fall as his b o d y cleared the b o u g h s . Concea led within

thick tufts of m e a d o w g r a s s w a s a spur of rock. A m y ' s dreams

a lso record the c rack of head hitting s tone. T h a t ' s what wakes

her.

T h e fall fractured Michael 's skull and released a flash flood of

b leeding into the right frontal lobe . ' I thought his number was

up, ' the su rgeon told m e , and had said as much to A m y as she

kept vigi l over Michael ' s coma tose body. ' N o point beat ing

about the bush , ' said the doctor . But , after three days and nights,

Michael c a m e b a c k to life — with a different number.

S tua r t ' s twist of fate w a s a m o t o r w a y pile-up. A bolt snapped

and blasted like a bullet from the vehicle in front. It came

I N T O T H E S I L E N T L A N D

through the windscreen, th rough his forehead and tore deep

into the left frontal lobe .

Desp i te the immedia te displacement of s o m e brain matter,

loss of consciousness w a s brief, as i s some t imes the case with

penetrating missi le wounds . He told the pa ramedics he w a s fine

and had better get h o m e now, but they saw the brain stuff

gell ing his hair and put him in the ambulance . S o o n the su rgeons

were working to extract the foreign b o d y from the interior

of Stuar t ' s head, a p rocess that a l so meant d i spos ing of s o m e

adjacent brain t issue. Part of Stuart went with it.

By these means , Prov idence has created mi r ro r - image

lesions of the brain. As a neuropsycholog is t , my role is to c o m ­

pare the consequences . Stuart now has t rouble get t ing started.

Helen encourages him out of bed in the morn ing , points him in

the direction of the ba th room, has his clothes ready, and ge ts

him breakfast before g o i n g to work . S h e leaves him lists of

things to do a round the house , and magaz ines and puzzle b o o k s

to fi l l the hours . But when she returns she often finds him where

she left him, sitting in si lence. She ' l l go over and h u g him and

he ' l l return the embrace , but i t ' s perfunctory.

He doesn ' t love her any more . I t ' s the plain truth and she

accepts it. Stuart is not to b lame . What he feels towards Helen is

what he feels towards all other peop le , including himself: indif­

ference. T h i s absence of emot ion frees him to tell the truth:

'Helen, I don ' t love you any more . '

Stuart can read p e o p l e ' s m o o d s and mot iva t ions , bu t lacks

the emotional charge of empathy. I ask what he feels about the

little girl who w a s abducted and murdered last year. He k n o w s i t

was a dreadful thing to happen. T h e y should h a n g the murderer

5

P A U L B R O K S

6

or chop his bal ls o f f but , no, i t doesn ' t make him feel anything

very much . T h e n , he s ays , i t ' s funny but he never used to

bel ieve in capital punishment .

Michael, on the other hand, has trouble s topping. A m y has to

rein him in. He ' l l talk to s t rangers in the street, he'll tell them

they ' re beautiful, or their children are , or their pets. He wants to

touch. He wants to celebrate . B e g g a r s b r ing a tear to his eye . He

once g a v e a m a n his coat and a £10 note. People take advantage.

Michael ' s empathic response is hair t r iggered, but more

complex social calculat ions befuddle him. When he f i rs t came

h o m e from the rehab centre his tastes were plain. A m y said he

l ived on fish f ingers and L e d Zeppelin. Michael said i t was like

g o i n g back in t ime. H e ' d a lways liked these things and now he

didn ' t feel he should pretend otherwise . F ine , said Amy. But she

wou ld not tolerate the po rn v ideos . L i k e Stuart , Michael no

longer feels the need to diss imulate .

' H o w do y o u feel in yourself , S tua r t ? ' I ask .

'All right. '

'Are y o u mise rab le? '

' N o . '

'Are you h a p p y ? '

' I don ' t think so . ' He turns to Helen. 'Am I h a p p y ? '

Helen looks at me . I l ook at Stuart . T h e quest ion g o e s round

in a circle.

Michael saw me off a t the front door . He w a s c lose to tears.

He pul led me to him and kissed me on the cheek. Fo r an instant

I thought he w a s g o i n g to say he loved me .

* * *

I N T O T H E S I L E N T L A N D

T h e bald head swivels . T h e vo ice honks like a k laxon ac ros s the

senior c o m m o n r o o m : ' I never m a k e mis takes . ' T h e r e is a

rustling of newspapers and clear ing of throats .

Martin has superior intelligence - my tests confirm it, and

he holds a master ' s degree in mechanical engineer ing — but he

happens to be autistic and has a p rob lem with v o l u m e control . Is

that a reason to bar him from the S C R ? N o . We ' l l enjoy our

coffee.

H e ' s been do ing one of his par ty pieces: calendar calculat ion.

Martin can g ive you the day of the week for any date y o u care to

mention, and h e ' s spot on every t ime, s e ldom taking m o r e than

a couple of seconds . H e ' s happy to ob l ige and s eems d i s a p ­

pointed when I soon run out of da tes I can vouch for.

' H o w do you do it, Martin? Y o u didn ' t even think about the

last one. '

T h e target date w a s 18 March 1988 (my son ' s b i r thday) .

'F r iday ' was the instant response .

' T h a t was easy, ' he says , ' I went to the dentist the d a y before . '

He grins with satisfaction.

I t ' s hard to tell his age . T h e face is lined but unweathered.

H e ' s wear ing a silver puffa jacket, s ta -pressed t rousers at half-

mast , and trainers. For ty-e ight g o i n g on fourteen. T h a t should

be 'trainer' in the singular. I t ' s on his right foot.

' I see you ' re wear ing odd shoes , ' I say.

'Yes , ' he replies. ' I t ' s Wednesday. ' I wait for further explana­

tion, but none is for thcoming.

When I first saw Martin, for clinical assessments , he turned

up with his parents and they 'd put him in a suit. H i s shoes were

polished, and matched. He hardly said a word . Today , in his

7

P A U L B R O K S

8

casual attire, he is voluble . Before long , inevitably, he drops

into the g r o o v e of his special interests. T h e r e are several . One is

the Beat les . He k n o w s the record ing and release dates of every

record. Another is the ra i lways. He has memor ized the regional

t imetable, of cou r se , but what really fascinates him is the m o v e ­

ment of coal freight w a g o n s . T h e n there is astronomy, which,

currently, is his main preoccupat ion .

' D o you know how m a n y stars there are in the un iverse? ' he

asks . ' T e n to the power of twenty-two. '

I make a little b lowing sound and shake my head. He looks

p leased .

'Actually, ' I say, ' I read somewhere that if you think of each

star as a gra in of sand it wou ld take all the beaches and deserts

on the planet to match the number of s tars in the universe . '

I thought this wou ld impress him, but he ignores me . He

b e c o m e s agi ta ted, starts rocking back and forth on the edge of

his seat . W h e n he s tops he says , ' I don ' t think so . '

I a sk him if he thinks there is intelligent life out there a m o n g

all those gra ins of sand. He looks puzzled and I realize he ' s

taken the quest ion literally, so I clarify. A g a i n , the grin.

' Y e s , ' he s ays , ' there i s . ' T h e smile is sustained. I t is evidently

a conso l ing thought .

Beth jo ins us . S h e ' s one of our research assistants. I t ' s time to

go to the lab for the test ing sess ion. Mart in 's face lights up. He

has taken a shine to Beth.

'And what have you been up t o ? ' she asks him.

' I ' v e been masturba t ing quite a lot, ' he replies, as if through

a tannoy. I p ress mouth agains t knuckles to b lock the laughter.

I t ' s no g o o d . I snort and c o u g h .

I N T O T H E S I L E N T L A N D

' Excuse me , ' I say and c o u g h aga in for g o o d measu re . I t ' s

unprofessional , I know, but he cracks me up. I 'm only human.

I 'm not trying to make Martin look r idiculous. He is r idiculous.

L o o k at him in his daft clothes, b o o m i n g on about masturbat ion

and coal freight w a g o n s and the number of s tars in the un iverse .

I t ' s undeniable. A n d I reckon i t ' s a snub if you don't acknowl ­

edge his absurdity. I f you are to e n g a g e with Martin you must ,

to some extent, enter his wor ld .

'Martin, ' I say. ' T h i s is funny. Do you mind if I l a u g h ? '

' N o , ' he says . 'P lease l augh . '

But, given permiss ion , I f ind the humour soon d i sso lves , and

I 'm left sitting red-faced with tears on my cheeks and everyone

looking at me instead of him. I even f ind myse l f ponde r ing

Martin's confident assert ion of the existence of extraterrestrial

life. We are alone in the universe or we are not, I think. Either way,

how astonishing. We grin at each other.

His head is abnormal ly la rge , as is the brain that f i l ls it. My

col leagues and I have taken measurements . We are profil ing his

cognit ive strengths and l imitations and sett ing these agains t

detailed magnet ic resonance observa t ions of his brain. He is an

enthusiastic research participant and has c o m e to see h imsel f as

a neuro-engineer ing prob lem.

He has a theory. In his v iew aut ism is all about flow d y n a m ­

ics. Most of the t ime his thought p rocesses are stuck in the left

hemisphere of his brain. Consequent ly , his thinking is r igid,

categorical, and analytic. I f he could unblock the channel of

the corpus cal losum, which links the two s ides , then the s t reams

of the left and right brain wou ld m e r g e and he wou ld be

whole. Ordinary consc iousness wou ld f lour i sh . T h i s happens

9

P A U L B R O K S

10

somet imes , he bel ieves . Fo r br ief per iods the world takes on

a different appearance . He is m o r e relaxed and it is less of an

effort to connect with peop le . T h i s is where masturbation

c o m e s in: o r g a s m detonates a dam-bus t ing explosion in the

right hemisphere .

As Beth sees Martin to the door , I catch a fragment of their

conversat ion.

' B u t i f your boyfr iend leaves you . . . " he says .

'We ' l l s ee , ' s ays Beth.

Mart in 's gr in has an unworldly beauty.

* * *

It w a s her seventh birthday, E l l i e ' s father is telling me , a clear

m o r n i n g in Apri l . T h e y had s topped to chat to a neighbour.

Ell ie w a s los ing pat ience. She wanted to ride her new bicycle.

He can see i t now, blue and silver chrome, dazzl ing in the sun­

light. A n d then, ' S h e w a s ly ing in the middle of the road , dead

still. It w a s like the wor ld had s topped, except for me . When I

go t c lose the rest caught up; the screech of tyres, the bicycle

sc rap ing ac ross the road . S o m e o n e sa id , " O h my g o o d L o r d ! ' "

His mind held a contradict ion as he looked down on his

daughter ' s b o d y : She's not badly injured and, at the same time,

She's dead. Nei ther w a s the case . N o t the latter because , of

cou r se , she is here , a y o u n g w o m a n now, squeezing his elbow;

and not the former. Her a r m s were g razed , nothing serious, and

her face w a s unblemished. But what her father could not see was

the fractured parietal bone and the s low seepage of b lood into

the right hemisphere of E l l i e ' s brain.

I N T O T H E S I L E N T L A N D

I t would be a week before she opened her eyes . But she w a s

not dead. A n d through the tunnel of intensive care — she in

coma , he consciousness flayed — E l l i e ' s father found the

strength not to pray. His prayer less vigi l w a s rewarded. El l ie

recovered and, months later, returned to school . He d r o p p e d

her off at the ga te and says he b lubbered so much on the dr ive to

work he had to stop the car. J o y can be so p rofound i t bo rde r s

on grief.

Ellie never regained the full s trength of her left a r m and leg ,

and she tired easily, but it d idn ' t s top her jo in ing in with the

other children. She s t ruggled to concentrate and keep p a c e in

some lessons , but that was to be expected. No one pushed her;

she pushed herself. She found a talent for l anguages and is now

prepar ing to go to university. So wha t ' s the p rob lem?

'Parallel parking, ' s ays El l ie , ' and over taking. '

She has difficulty j u d g i n g speeds and distances. S h e ' s twice

failed the dr iv ing test. Is i t anything to do with her bra in injury

and, if so , can I help?

I finish my assessments at the next appointment . El l ie has

worked hard at tests of spatial awareness , motor co-ordinat ion ,

concentration, and reaction t ime. T h e results show p rob lems

consistent with her brain injury. She senses this and, with a kind

of desperat ion, offers to take me for a dr ive . I accept .

' D o you want me to c o m e ? ' asks her father.

' N o , ' I tell him, ' g o and have a cup of tea. '

At f i rs t El l ie seems unsure where the car is parked. I t ' s an old

Citroen, the colour of tomato soup .

'Where shall I g o ? ' she says .

'Anywhere. Jus t dr ive a round. Go left here, then next right. '

11

P A U L B R O K S

A n d so we g o , me g iv ing directions. I have to admit she ' s

pret ty g o o d . Ten minutes into the dr ive nothing untoward has

happened and I 'm beg inn ing to quest ion the value of my tests.

T h e r e ' s no doubt she had p rob lems , but here we are in the real

wor ld and s h e ' s do ing fine.

El l ie has s teered the car into the middle of the road ready to

turn ac ross the o n c o m i n g traffic back into the hospital car park.

T h e indicator clicks as we wait. I t ' s a comfor t ing sound. Tick,

tick, tick. A l m o s t hypnot ic . T h e r e ' s a s teady flow of traffic, so

El l ie wai ts . Tick, tick, tick. T h e n a g a p ; nothing for fifty yards ,

space enough to get ac ross . But we don ' t move . Tick, tick, tick.

Another line of traffic d raws towards us , headed by a white

r emova l s van with Y O U R M O V E ! splashed across the front. Tick,

tick, tick, Y O U R M O V E !

T h e i m a g e of the van now filling my retina and flashing into

my brain takes the quick-and-dir ty route via the thalamus and

straight to the securi ty moni tors of the amygda la , deep in the

tempora l lobe . Action stations! No need to trouble the higher

cortical centres just yet, because someth ing has impelled Ellie to

turn ac ross the traffic and we are g o i n g to hit the van. Consc ious

del iberat ion wou ld be a hindrance. T h i s is bas ic survival . My

a r m s fly up and my head jerks s ideways . T h e amygda la screams

instructions to the brain s tem, s ignal l ing the release of chemi­

cals into the b loods t ream and, th rough a clatter of synaptic

activity, ga lvan iz ing the au tonomic nervous sys tem. T h i s is red

alert!

T h e n I b e c o m e aware of the p i g squeal of tyres — the van ' s ,

not ours . My cortex is c o m i n g b a c k on-line; reflective con­

sc iousness restores itself. We roll serenely on and I g lance back

12

I N T O T H E S I L E N T L A N D

to see the van pull ing away. Ellie remains unper turbed.

We are back in my office. 'It w a s a c lose call , ' I say.

' O h ? '

' I thought that van was g o i n g to hit u s . '

'What v a n ? '

I tell her that we could a r range for a m o r e advanced a s s e s s ­

ment of her dr iving skills, and that she is obl iged to inform the

dr iving licence authority of her condit ion.

' I a lready have , ' she says .

But I can't encourage her to drive. I see a d a m a g e d brain

encased in a tonne of metal cruising down the motorway, through

rush-hour traffic, through residential areas where children are

riding their birthday bicycles. T h e d a m a g e is beyond repair.

' I came to you for help, ' s ays El l ie . Her father g ives me an

empty ' T h a n k you ' as they leave.

A few months later I get a call from El l ie . She has taken her

dr iving test for a third t ime and pas sed . 'I thought y o u ' d like to

know,' she says .

I picture her father s tanding bes ide her. W h a t ' s that on his

face? Absolu t ion?

* * *

Mrs O ' G r a d y i s showing me pho tographs . T h e r e are three

a lbums opened out on the coffee table. T h e r e she is at K a t i e ' s

wedding; small , nervous , and neat in a pa le green suit. T w o

months on, there she is at S tephan ie ' s . B e i g e this t ime.

' I feel guilty, ' she confides. ' I still haven ' t told Steph. Do y o u

think I shou ld? '

13

P A U L B R O K S

14

' Y e s , ' I say. ' She ' l l unders tand. '

I decl ine a second cup of coffee and gather my stuff to leave,

but I 'm not g o i n g yet because Mrs O ' G r a d y has g rabbed my

a rm. She leads me to a corner of the r o o m and stands back with

an air of curiosity. She s tares , s teps forward, s tands back again .

She can ' t m a k e me out. T h e facial musculature shapes appre­

hension, bu i ld ing to dread. T h e n she g o e s blank.

She walks to the other s ide of the r o o m , smacking her lips

and t u g g i n g her collar. I follow her to the kitchen where she

s tands by the s tove p icking her nose . T h e n she f i l ls the kettle, but

doesn ' t switch i t on. She fetches m u g s from the cupboard and

p laces them on a tray. F r o m time to t ime she seems to be aware

that there is s o m e o n e else in the r o o m . She looks at me , but I am

too much to fa thom. I feel semi-transparent . I speak, but there is

no response . Am I really here?

She f i l ls the m u g s with cold water f rom the kettle and carries

the t ray into the l iv ing r o o m . We sit in silence. I 'm thankful this

hasn ' t deve loped into a thrashing, foaming, full-blown fit . After

a while she reaches for the third a lbum.

' T h i s o n e ' s the hol idays , ' she says . 'Tener i fe . ' But she knows

someth ing is w r o n g when she sees plain water in the m u g s .

M r s O ' G r a d y takes br ief excurs ions from consciousness .

T h e s e are k n o w n as au tomat i sms , a feature of her epilepsy. T h e

consc ious mind switches off, but the bodi ly apparatus carries

on in a m o r e or less purposeful fashion: feeding the cat, walking

round the supermarket , boa rd ing a bus . H a d she reached for

the b read knife and p lunged it through my heart I doubt she

wou ld be convic ted of murder . T h e law makes provis ion for

au tomat i sms .

I N T O T H E S I L E N T L A N D

Watching Mrs O ' G r a d y ' s unoccupied b o d y scutt l ing about

I thought of her as a zombie . Students of consc iousness are fond

of zombies . N o t the Hait ian l iving dead or shambl ing ghou l s

of the Twilight Zone, but far s t ranger inhabitants of the wor ld of

philosophical conjecture. T h e s e creatures l ook and act like o rd i ­

nary people ; they walk , talk, s ing, l augh , and weep , have love

affairs, raise families, get drunk, a r g u e about poli t ics. T h e y are ,

in fact, like us in every w a y but one: they lack consc ious aware ­

ness. The i r brains regulate internal states of the b o d y and

control outward behaviour , but that 's all. Whi le the rest of us

move about in a bright pod of consc iousness , zombies just m o v e

about. The i r philosophical pu rpose is to crystall ize the mind-

b o d y problem. Is i t logical ly poss ib le to subtract mental life

from the work ing brain, in which case there wou ld be scope for

zombies (dual i sm)? Or are brain activity and consc iousness one

and the same thing (mater ia l i sm)? No doubt Mrs O ' G r a d y

would have someth ing to say on the matter.

T h e trouble is , not all of her excurs ions are so brief; hence

Mrs O ' G r a d y ' s guilt over S tephan ie ' s wedd ing . Her m e m o r y

holds no trace of the occas ion . Physica l ly she w a s there. Y o u

can see her in the photos . But she w a s not there mentally, at least

not in full. It was too protracted an ep i sode to fit the conven­

tional scheme of an epileptic au tomat i sm. More likely her brain

had settled into a stable pattern of dysfunct ion with low-level

epileptic d ischarges j a m m i n g the t ransmiss ion of sensory infor­

mation into memory . Her awareness wou ld have been a fragile

membrane of impress ions f loa t ing be tween ' now ' and ' then ' ,

but never quite connecting.

The re are other c i rcumstances in which human be ings appear

15

P A U L B R O K S

16

to act purposeful ly without the benefit of self-awareness. S l eep ­

walk ing is a g o o d example . I w a s in the C o m b i n e d Cade t Force

in my teens. O n e night, at camp, I somnambula ted through the

bar racks and mis took the N C O s ' quarters for the lavatory. I

shuffled in and urinated over one of the officers as he slept.

Unfortunately, the fol lowing m o r n i n g I w a s fully conscious .

H o w convenient i t would be somet imes to turn off con­

sc iousness and carry on with ord inary behaviour. Imagine

flicking a switch on difficult days and flipping into oblivion,

k n o w i n g that your b o d y will continue g o i n g about its normal

bus iness . No one would notice. A p r e - p r o g r a m m e d wake-up

call would return you to sentience in t ime for a film or the

football . Cont ro l led au tomat ism might be preferable to per iods

of physical or emot ional d iscomfor t , or sheer bo redom. I f

everyone had a consc iousness switch then the world , most of

the t ime, wou ld be teeming with zombies . Perhaps i t a lready is.

Wha t t roubles Mrs O ' G r a d y is that she remembers one

w e d d i n g and not the other: K a t i e ' s , but not Steph 's . I t seems

unfair. In truth, she s ays , i t ' s not so much that she can' t r emem­

ber as the feeling that she wasn ' t actually there. L ike she didn't

bother to turn up. I 'm not g o i n g to debate i t with her and, for

her own peace of mind, I think she should talk it through with

her daughters . Bu t if they couldn ' t tell, what difference does

it make?

Later , ly ing in bed , I confess to my wife that I am a zombie .

We had a malfunction with the transcranial magnet ic s t imula­

tor. I t zapped my awareness modu le . I thought she should know,

but best not b reak it to the kids just yet. I say I hope it won' t

change the w a y she feels about m e . She is a l ready asleep.

The Space behind the Face

T h e illusion is irresistible. Behind every face there is a self. We

see the signal of consc iousness in a g l e a m i n g eye and imag ine

some ethereal space beneath the vault of the skull, lit by shifting

patterns of feeling and thought , charged with intention. An

essence. But what do we find in that space behind the face, when

we look?

T h e brute fact is there is nothing but material substance: f lesh

and b lood and bone and brain. I know, I 've seen. You l ook

down into an open head, watching the brain pulsa te , watching

the surgeon tug and p robe , and you unders tand with absolute

conviction that there is nothing m o r e to it. T h e r e ' s no one there.

I t ' s a kind of l iberation.

T h e illusion is irresistible, but not indissoluble . I t is m o r e

than twenty years since I b e g a n my clinical t raining at a rehabil­

itation hospital for people with neurologica l d i sorders . I w a s a

student of clinical psychology , but w a s drawn mos t ly to neuro l ­

ogy. For as long as I could remember I had been interested in the

workings of the brain and, one w a y or another, as clinician or

17

P A U L B R O K S

18

scientist, I expected to make a career in neuropsychology, the

science of brain and mind. Neuro- rehab was a g o o d place to

start.

O n e of the patients w a s a seventeen-year-old b o y who had

s tepped into an empty lift shaft through which he fell three

f loors , a lmos t to his death. T h e su rgeons had done their best to

p iece him together aga in , but now the d o m e of his shaven head

w a s asymmetr ica l : convex on the r ight, concave on the left, with

a deep oval depress ion like the shell of a hard-boiled e g g

cracked with a spoon .

H i s face worked relentlessly, wri thing with anger and dread.

Most ly anger. He wou ld g rowl and grunt , and somet imes

howl, but , apar t f rom occasional vol leys of obscenity, he w a s

incapable of speech. T h i s i s not u n c o m m o n . People without

ord inary speech due to brain injury somet imes have the capa­

city to s u m m o n up the vilest g o b s of abuse . I didn ' t know that at

the t ime. It came as a shock. Some t imes they can also s ing, but

this b o y never s ang . He sat contorted in his wheelchair, head

turned s ideways and b a c k at an uncomfortable angle , l imbs

buckled with spasticity, a s t ream of sal iva dribbling from the

corner o f his mouth .

T h e pr iap ism w a s a f inal , humil iat ing twist. D u e to a quirk of

the d a m a g e to his nervous sys tem he w a s continually troubled

by a painful erection. T h e y o u n g w o m e n tending him — nurses,

phys ios , and occupat ional therapists — pretended not to notice.

I felt pi ty for him, but a lso revuls ion. As a raw trainee not yet

accl imatized, I found him g ro te sque . What disturbed me most

w a s the f l ickering screen of his face: bleak images of a soul in

torment . Or so I imagined . T h e n I began to consider what

I N T O T H E S I L E N T L A N D

might remain of a ' sou l ' or a ' s e l f ' . I b e g a n to doubt there w a s

anything at all g o i n g on behind that face. He should be allowed to

die, I thought, and not just for his own sake. H o w did he l ook to

his mother? C o u l d she even bear to l ook?

T h e chaos of his face drained my sympathy. I t b roke the

rules. A face should al low public access to the pr ivate self. I t ' s an

ancient convention of the human race . T h e r e is a universal

system of s ignals . But this y o u n g man ' s facial d i sp lays worked

like a subterfuge, deny ing knowledge of what lay behind.

Perhaps nothing lay behind.

Then , one day, I happened to be a round when the b o y ' s

mother came to visit . I watched as she cradled his b roken head

in her a rms . Fo r the t ime that she w a s with him, but not much

longer, an extraordinary t ransformat ion came over his face. I t

became still. T h e rage subs ided . He seemed to regain his

humanity. Here were two selves , not just a mother and a b roken

shell of a son. T h e whole w a s grea ter than the s u m of its par ts .

Maybe it w a s a failure of imagina t ion that led me to sense a

seeping away of the b o y ' s self once his mother had g o n e , but the

capacity I d iscovered in myse l f to see a fellow human be ing as

less than a person w a s an appal l ing revelation. In such c i rcum­

stances how are we to dis t inguish failure of empathy from val id

observat ion? Perhaps they amount to the s a m e thing.

N o w my own son has turned seventeen, the s a m e a g e as the

eggshell boy. He w a s in the vo id of pre-bir th when our friend

made his lonely descent through the lift shaft. To disturb s o m e ­

one from a state of non-exis tence is a terrible responsibili ty.

L o o k at what can happen.

I have a m e m o r y of be ing with my son when he w a s four

19

P A U L B R O K S

years o ld . I t is deep winter. We have to go out, so we leave the

w a r m t h of our house for the freezing night air. T h e r e are few

lights in the v i l lage and the sky is full of stars. We are hardly

beyond the front d o o r when he starts coughing .

'Are y o u all r igh t? '

' I t ' s okay, ' he s ays , ' I think I just swal lowed s o m e dark. '

He has the not ion that darkness is a substance. It will make

you choke if y o u swal low too much in one go . I could have put

him straight with s o m e prosa ic account of the cough ing reflex

be ing t r iggered by the shock of the cold air rather than a mouth­

ful of da rkness , but I didn' t . I s tashed away the treasured image

and left him with the vers ion of reality fashioned by his infant

brain.

Real i ty is under constant review. Twenty- three centuries

ago , Aris to t le be l ieved that the heart must be the source of

mental life because of its dynamic action and its warmth . T h e

function of the bra in , he thought , w a s to cool the b lood . He

built his c o s m o l o g y on the bel ief that the Ear th stands mot ion­

less at the centre of the universe , a fixed point about which the

sun and the m o o n and the stars revolve . Aris tot le w a s w r o n g on

every count , but his e r roneous beliefs - the product of intuition

and i l lusion — served him well enough . A n d though we now

k n o w immeasurab ly m o r e than Aris tot le about the workings

of the h u m a n b o d y and the structure of the c o s m o s , we should

not de lude ourse lves by thinking that we have arrived at some

pr iv i leged end-point of intellectual evolut ion.

We still live by intuitions and i l lusions, especially when our

thoughts turn inwards . T h e bright , intangible qualities of sub­

ject ive experience have yet to be reconciled with the dark

20

I N T O T H E S I L E N T L A N D

substance of the brain, but that space behind the face is still lit

by the mind ' s eye . Irresistibly, we still see the v is ion of minds in

the light of other p e o p l e ' s eyes . C o s m o l o g i e s c o m e and g o , but

i f this illusion beg ins to fade then so d o e s the observer .

* * *

I 've been t rying to think of the eggshel l b o y ' s n a m e . I could

have g iven him a name . All the others have p s e u d o n y m s . It

wasn ' t deliberate. I didn ' t choose to deny him a n a m e . But when

the story was finished, I saw he didn' t have one . A n a m e wou ld

humanize him, ' s o m e o n e said . 'Ca l l him John or S teven or

R i c h a r d . . . '

On reflection, I thought it might do just the oppos i te .

21

The Seahorse and the Almond

Whisky on top of wine w a s a mistake. T h i s morn ing i t has left

me feeling fractionally too embod ied ; too aware of the weight

and m o v e m e n t o f my head, the bulk o f my tongue .

I w o k e late, b reak ing from a thick crust of sleep not much

before eight. H a l f an hour later, I 'm walk ing to work , without

hurry, but keep ing pace with the traffic. I t ' s a couple of miles. It

will do me g o o d . D o w n pas t the pa rade o f shops , past the odd

juxtaposi t ion of cas ino and funeral parlour , past the terraced

houses at the fringe of the park , and on up the other s ide of the

urban val ley towards the d rab monol i th on the b row of the hill.

T h e Dis t r ic t Genera l Hospi ta l i s visible from mos t of the city.

T o d a y i t is f ramed by a sky the co lour of cement.

N a o m i is deep ins ide . I t is her nineteenth birthday. She is on

a bed be ing pushed by a porter a l o n g shiny floors, into lifts and

out ac ross m o r e shiny f loors . She is tired, hav ing been awake

since the b reak of day, well before the neurophys io logy techni­

cians c a m e to g lue e lectrodes to her scalp. T h e y left her with a

M e d u s a ' s head o f a n g r y serpents .

22

I N T O T H E S I L E N T L A N D

Arr iv ing at nine, I go straight to the ang iog raphy suite where

preparat ions are in hand for N a o m i ' s ordeal . T h e central cham­

ber is small , about the size of a suburban l iv ing r o o m . It is

brightly lit and c r a m m e d with X - r a y equipment , moni tors , and

control panels . T h e centrepiece i s the na r row bed upon which

the patient, when she arrives, will be laid. T h e w a y i t tapers at

one end reminds me of an i roning boa rd . In the corner a quiet

man from Medical Il lustrations is set t ing up his v ideo camera

ready for the show. E E G technicians in white and rad iographers

in blue filter in and look busy.

We are g o i n g to interfere with the work ings of N a o m i ' s

brain, anaesthetizing each hemisphere in turn with injections

of Amyta l , a fast-act ing sedat ive. O u r a im is to isolate and inter­

roga te one side of her head and then the other. Strictly,

'anaesthet ize ' is incorrect since the brain has no sensory recep­

tors. It is a lways in a state of anaesthesia .

T h e radiologis t appears . ' D o we have a pa t ient? ' We do.

N a o m i is sitting up in her mobi le bed , which has been parked

just down the corridor, nowhere in particular. It has arr ived as

i f by t ime-lapse pho tog raphy m o v i n g from one indeterminate

station to the next, and now here she is . She looks lonely, so I go

and chat with her for a while. I wish her happy birthday.

I like N a o m i . I 've go t to k n o w her well these pas t few

months, watching her p rog re s s through an obstacle cour se of

investigations ( E E G , M R I , v ideo telemetry, n e u r o p s y c h o l o g y )

that will lead, she hopes , to the su rgeon ' s list, to the opera t ing

theatre and to the carv ing away of a small s treak of scarred

brain tissue - the source of her epilepsy.

Her faith in the doc tors and su rgeons is absolute . T h e f i ts will

23

P A U L B R O K S

24

cease . Al l will be well . A n d when she is seizure-free she will

go to university. Perhaps she will take a gap -yea r and travel to

Aust ra l ia . In t ime, she will apply for a driver 's licence. A n d so

on. She is incorrigibly optimist ic . It may be a feature of her

brain pa thology.

H e r boyfr iend, whose name I have forgotten, is less san­

gu ine . Unl ike N a o m i , he can see the possibil i ty of failure. He

unders tands that the operat ion might not work . 'You ' re such a

pess imis t , ' N a o m i told him when I saw them both in the clinic.

I 'd be the s a m e . Be troubled, Naomi. A little. The surgeon, if he

gets his hands on you, is going to open your head and take a piece

of you away. Too much faith and expectation can be counter­

productive. I think these things, but this is not the time to voice

my concerns . It is a t ime for uncondit ional reassurance - not my

s t ronges t suit, but a necessary part of the repertoire, and well

pract ised .

Meanwhile , the radio logis t is sifting through his tray of para­

phernal ia and realizes someth ing is miss ing . ' D o we have any

A m y t a l ? ' N o , not yet. O u r batch of the stuff looked suspi ­

c ious ly cloudy, poss ib ly contaminated. No problem. A call to

P h a r m a c y and we are assured that a supply of the d rug is

a l ready on its w a y from the Radcl iffe Infirmary. W h y i t has to

c o m e all the w a y from Oxfo rd I 've no idea. I don ' t enquire.

T h i s morn ing ' s p rocedure — a Wada test — is the final hurdle.

I f N a o m i pa s se s the test she advances to the surgeon ' s list. She is

p repared . Yes terday she rehearsed the protocol with one of my

co l leagues from the N e u r o p s y c h o l o g y Unit . She lay on her

back , raised both a r m s to the vertical, counted up to twenty,

imagined (at a round ten) that her left a rm had become limp and

I N T O T H E S I L E N T L A N D

let i t d rop to her s ide . T h i s is what happens when the d r u g hits

the right side of the brain. T h e n they went th rough the mot ions

o f testing. N a o m i per formed s o m e s imple act ions ( ' T o u c h

your nose . . . c lose your eyes . . . b low . . . ' ) ; recited the d a y s

of the week and counted backwards from ten. She descr ibed

a picture ( 'A man up a ladder, a b o y with a ball , a gir l , a kite,

a d o g and a cat, a pond , ducks . . . ' ) ; n amed objects; read sen­

tences; did mental arithmetic. T h e instructions and ques t ions

were rapid-fire. Amyta l is fast act ing, but its effects are short­

lived. In the test p roper the injected half-brain will s leep for just

two or three minutes — while we conduct our bus iness with its

wakeful twin.

My col league arrives carry ing a c l ipboard, a s topwatch, and

two black r ing-binders . On her w a y into the angio suite she

exchanges smiles and words with N a o m i , whose bed has n o w

moved closer to the main door . T h e r e ' s a smile for me too. She

already knows about the delay with the Amyta l . T i m e for a

coffee. We sit next to the machine that spills out the X - r a y n e g ­

atives and flip through N a o m i ' s case notes. He r his tory is

unremarkable. It all started with a fever when she w a s small .

S h e ' d been off colour for a couple of days , then seemed to p ick

up. Her mother wasn ' t sure , but in the end d ropped her off at

nursery school on the w a y to work .

Midway through the morn ing N a o m i fell asleep in the sand­

pit, or so the teachers thought . When she couldn ' t be roused

they called an ambulance . She started shaking before she fell

asleep, the other children said . T h e doctor thought i t w a s p r o b ­

ably a febrile convuls ion: not to worry, a lot of k ids are p rone to

seizures i f their temperature c l imbs too high. T h e y mos t ly g r o w

25

P A U L B R O K S

26

out of it. A n d so , i t s eemed , she did. But the fits returned on the

first t ides of menstruat ion.

T h e y were shadowy figures with a pungent smell of electric­

ity, a sensed presence , but no one there. O d d to identify the

smell of a seizure with electricity, which is odour less , but apt for

an electrical s to rm in the brain.

T h e ethereal v is i tors are part of the epileptic aura, a state of

altered awareness that serves to forewarn of an approaching

seizure. I t a lso has another, more visceral , feature. N a o m i says i t

feels like a spar row fluttering its w ings in the pit of her s tomach.

T h e bird ascends to her throat, b e c o m e s trapped, and s t ruggles

to e scape . Up to this point , under the gather ing g l o o m of the

b ra ins to rm, in the c o m p a n y of the empty shadows and the spar­

row, she is fully consc ious and can articulate her experiences.

T h e n the s to rm breaks and she is swept beyond reflection. Her

eyes b e c o m e g lazed and empty. She tugs at her clothes, smacks

her l ips, and keeps wip ing her nose with the back of her hand.

I ' ve seen her in this state. She has gone with the wraiths. T h e y

have left an automaton, act ing out a purposeless , robotic routine.

After the tone p o e m of the aura — the unformed images , the

unnameab le scents — and after the rhythmic automat isms, there

somet imes fol lows a third, catastrophic, movement . Abou t one

in five of her attacks turns into a general ized seizure, what

wou ld once have been called a g rand mal . First , her muscles

contract and she falls to the g round , somet imes spurt ing b lood

as her jaw c lamps shut and her teeth sink into her tongue . She

s tops breathing and, unconsc ious , she urinates. T h e n come the

convuls ions — l imbs jerking mechanical ly for several minutes —

fol lowed by release into a deep sleep.

I N T O T H E S I L E N T L A N D

Despi te inventive cocktai ls of anti-epileptic medicat ion, with

dosages a lmost to toxic levels, the frequency of N a o m i ' s

seizures has steadily increased. N o w she ge t s them a lmos t every

day. She is desperate for a cure and wil l ing to take risks.

T h e planned operat ion has an ungain ly name : a m y g d a l o -

hippocampectomy, so called because i t involves removal of the

amygdala (from the Greek for ' a l m o n d ' ) and part of the ad ja ­

cent structure, the h ippocampus ( ' s e a h o r s e ' ) . Each half of the

brain contains an a lmond and a seahorse . T h e pu rpose of the

Wada test is to clear a w a y for the operat ion. We k n o w it is the

right side of N a o m i ' s brain that bea r s the scar t issue and dr ives

the seizures because w e ' v e seen the brain scans and w e ' v e

logged the clinical s igns . But we are a lso mak ing an assumpt ion ,

possibly unwarranted, that her left hemisphere , which looks

normal , is functioning normally. O u r test will help de termine

whether this is true. (It is 'Wada ' , by the way, not ' W A D A ' as

I 've just been reading in the case notes ; a c o m m o n error. T h e

procedure is named after Juhn Wada , the J a p a n e s e - C a n a d i a n

neurologist who f i rs t p roposed its u se . I t must be d i sappoin t ing

to be elevated to the status of an e p o n y m only to be mistaken for

an ac ronym.) We need to be as sure as poss ib le that there is no

'silent lesion' on that healthy side; in other words , a malfunction

that hasn' t shown up on the brain scans . Appea rances can be

deceptive. Brain t issue can look clean and p lump, but without

putt ing it to the test one can ' t be sure of its integrity.

O n e of the targets for surgery, the h ippocampus , is a vital

component of the bra in ' s m e m o r y circuitry, essential for l ay ing

down new traces. We need to know, above all, whether the left

hemisphere of N a o m i ' s brain i s up to the task of sus ta ining bas ic

27

P A U L B R O K S

m e m o r y functions. To the extent that each of us is the sum of

our memor ie s , the h ippocampus is the instrument by means

of which we assemble ourse lves . Every th ing accessible to

consc ious recall has been registered and recorded through its

channels.

What were y o u do ing ten minutes ago? W h o was the last

pe r son y o u spoke to? What did you have for breakfast? What

did you do yesterday, last weekend? When was the last t ime you

wept , and why? Conjure an i m a g e of your f i rs t school , the face

of your teacher, your best friend. R e m e m b e r your f i rs t kiss.

A n d then, stretching to the mental horizon, rising through the

squal ls and sunshine of personal experience, picture the tower­

ing stacks of information in the public domain ; the raw

materials of culture. What d o e s the word ' en t ropy ' mean (or

' t h e ' o r ' w o r d ' o r ' m e a n ' ) ? H o w do you use a telephone? W h o

is the president of the Uni ted States? At what temperature does

water freeze? W h o wrote King Lear? Wha t is the function of the

l iver? All this information, personal and public , f inds its way

into m e m o r y by w a y of the h ippocampus .

As an aid to recall, medieval scholast ics developed elaborate,

architectural sys t ems of mental image ry — 'Thea t res of

M e m o r y ' or ' M e m o r y Pa laces ' - through which they would

take imag ina ry strolls, depos i t ing or retr ieving nuggets of

information at s t rategic locat ions. I like the idea that the Keeper

of the G a t e s is as fragile a creature as the seahorse . It doesn ' t

take much — a stroke of the su rgeon ' s knife — to finish it off and

c lose the entrance for g o o d . T h e f low of information s tops .

If, as p lanned, the su rgeon were to remove the right h ippo­

campus , but i t turned out that N a o m i had no spare capacity in

28

I N T O T H E S I L E N T L A N D

the left, then the operat ion would , in a sense , cause N a o m i her­

self to stop. She would form no new memor i e s of events or facts

beyond her present age of nineteen. I t would not prevent her

from g rowing old, but her age ing b o d y wou ld forever house the

mind of a nineteen-year-old girl .

Such things happened in the early days of epi lepsy surgery. A

handful of people , most famous ly a y o u n g mechanic known as

patient ' H M ' , ended up with dense and irreversible amnes ia ,

unable to retain new information for m o r e than a few minutes at

a t ime, and so unable to establish memor ies . You could visit HM

every day for a year and each t ime he wou ld greet you as a

stranger. L e a v e the r o o m for ten minutes and on your return he

would have no idea who you were .

Since then surgeons have restricted their interventions to just

one side of the brain, but even so there have been similar d i sa s ­

ters where it was not established prior to surgery that the other

side was in g o o d work ing order. T h a t ' s the reason w e ' r e here

today, I remind myself, g o i n g th rough these arcane rituals. We

want N a o m i to continue in mind as well as body.

I f the h ippocampus is the ga t eway to memory , one can p ic ­

ture the amygda la as hous ing the levers of emot ion . I t links the

informat ion-processing activities of the higher, cortical areas of

the brain — the machineries of l a n g u a g e , percept ion, and

rational thought — to deeper, older structures concerned with

the regulation of emot ion and mot ivat ion. In short , i t tells us

how to feel about what we are thinking and perceiv ing, and how

to act on those feelings. Patients with d a m a g e to the a m y g d a l a

on both sides of the brain inhabit a wor ld devo id of emot ional

contour and colour. Dimin i shed insight into their own feelings

29

P A U L B R O K S

and behaviour is mir rored by a distorted perception of the e m o ­

tional l ives of others.

So the stakes are high for N a o m i : m e m o r y and emotion. We

need to ge t this right.

T h e Amyta l arr ives, del ivered by motorcycle courier. He

hands over a Jiffy b a g that a nurse opens to find two phials

containing a plain l iquid, the stuff that will shortly work its spell

on N a o m i ' s brain. O u r patient is now stretched out on the spe ­

cial bed , at the centre of things, wait ing. Her head rests on a

small square cushion. She is covered to the neck with a green

surgical sheet except for an exposed patch around her groin ,

where , hav ing adminis tered a local anaesthetic and m a d e a small

incision, the radio logis t is work ing to ga in access to the femoral

artery. N a o m i ' s face at the top of the sheet and this framed

expanse of pa le f lesh and pubic hair (and now b lood from the

cut) seem quite unrelated. Many people are surprised to learn

that the mos t feasible route to the brain for these purposes is by

w a y o f the gro in .

T h e catheter, a length of ultra-fine plast ic tubing, is inserted

and pushed , inch by inch, a long the femoral artery, up through

the a b d o m e n and into the chest . Its journey is visible, magnified

graini ly in spectral shades of grey, on the X - r a y monitors . I

watch as it finds its w a y to N a o m i ' s heart and from there to the

junction with the internal carot id . She , too, is watching. She can

see her insides on the moni tors suspended overhead which, with

exquisi te integrat ion of hand and eye , the radiologis t uses to

f ind his w a y from gro in to gu t to heart to brain. Nex t , a rad io-

o p a q u e dye is p u m p e d through the newly installed plastic piping

to f lood the b lood vesse ls of the brain.

30

I N T O T H E S I L E N T L A N D

T h e radiologis t takes a few X - r a y snaps to confirm that we

have reached our intended destination on the cerebrovascular

map. Stationed at N a o m i ' s midriff, he offers an occas ional word

of reassurance, and g lances now and then in her direction. He

means well , but the exchanges between them are perfunctory.

She, for her part , is be ing a g o o d patient. Her b o d y is pass ive ,

receptive. Her face shows bare ly a trace of emot ion , but when

the nurse brushes a strand of hair f rom her forehead, N a o m i ' s

eyes moisten.

We have here N a o m i the body, N a o m i the mind, and N a o m i

the person. T h e s e , at least , are the differences of emphas is

across the professional d ivis ions of labour. T h e rad io logis t

works in the realm of the flesh. He k n o w s the intricacies of

the vascular sys tem and is on g o o d terms with the ghos t s of his

X - r a y machine. I , the neuropsychologis t , will short ly s ignal a

pharmacologica l invasion and deconstruct ion o f N a o m i ' s mind.

T h e nurse, for now, is with N a o m i the pe r son .

We are all set to start. N a o m i has her a r m s raised and beg ins

to count. I l ook to my col league s tanding oppos i te with her

black folders, s topwatch, and c l ipboard, ready to assis t with test

materials and record responses . T h e neurophys io log i s t s are a

few feet back moni tor ing every squ igg le of b ra inwave activity

siphoned through the l ong bridal veil of mul t i -coloured leads

attached to N a o m i ' s head.

After a nod from m e , the radio logis t starts to inject the

Amyta l . It takes effect in a few seconds and I g r a b N a o m i ' s a rm

as i t swoons , gu id ing i t to rest at her s ide . At that momen t of col ­

lapse , the catching of the lifeless a rm, someth ing col lapses

inside me too and I catch myse l f thinking, What am I doing here f

31

P A U L B R O K S

32

I 'd rather be somewhere else, well away from this unwholesome

mind meddl ing . But here lies N a o m i . T h e r e is work to do and,

after all, better to be do ing this to a relative stranger than to

s o m e o n e y o u love . T h a t would be unbearable . She looks

remarkably calm and ordinary g iven that her right cerebral

hemisphere , half her brain, is now temporar i ly defunct. H o w

ordinary she looks .

I am clear about the pu rpose of the test, but curious to know

what is happening to ' N a o m i the pe r son ' , a question entirely

peripheral to the immedia te medical concerns . Our procedure is

pha rmaco log ica l , not surgical ; the altered state is transient. But

while the d r u g works its influence we have , effectively, ampu­

tated one side of her brain. I wonder if, with half of the brain

c losed d o w n , we are e n g a g i n g with just one half of the person.

Psycho log i s t s used to be obsessed by the duality of the brain.

'Funct ional a s y m m e t r y ' w a s a hot topic when I w a s an under­

g radua te in the 1970s. T h e bel ief was that the two halves of the

brain pe r fo rm distinct, though complementary, functions: left

hemisphere for l anguage , right for spatial awareness ; left for

rhythm, right for me lody ; rationality / intuition; analysis /

synthesis , and so on.

At the centre of attention at that t ime, scientifically and i m a g ­

inatively, were the so-cal led ' spl i t -brain ' studies. Split-brain

su rgery w a s a radical method of treating people who suffered

from severe and intractable epi lepsy — patients tormented by

frequent, debil i tat ing seizures that could not be controlled by

any other fo rm of treatment.

Epi lept ic seizures are caused by abnormal bursts of electrical

activity in the brain. T h e rat ionale for split-brain surgery -

I N T O T H E S I L E N T L A N D

commissuro tomy — w a s that cutting the co rpus ca l losum, the

main channel of communica t ion between the two hemispheres ,

would confine the abnormal electrical activity to one side of the

brain and so prevent the deve lopment of major seizures .

I was not much concerned with the clinical aspects of this

operation. I had no part icular interest in epilepsy. Wha t

intrigued me was that the spli t-brain patients were thought

experiments made flesh. T h e y fell into the ca tegory of phi lo­

sophical conundrum that also includes the 'brain in the v a t ' , the

'brain t ransplant ' , and science f ict ion fantasies about te leporta-

tion and mind duplication.

T h o u g h t experiments are ' Imag ine i f . . . ' scenar ios des igned

to challenge our ordinary intuitions. In the seventeenth century

John L o c k e explored the concept of personal identity by i m a g ­

ining an exchange of brains between a prince and a cobbler. It is

psychological continuity that counts , he concluded. T h e prince

' goes with ' his brain and now f inds ' h i m s e l f in the b o d y of the

cobbler (and vice ve r sa ) . More recent var ia t ions on the theme,

some inspired directly by the split-brain cases , are less s t raight­

forward.

What i f s o m e o n e ' s cerebral hemispheres are d iv ided and

transferred separately (memor ies , character traits and al l) to the

heads of two different people? What i f you swap a hemisphere

with your best friend, or your wors t enemy? Which of you is

which? T h e r e would be s o m e continuity in these cases , but

not unity. Convent ional notions of persona l identity wou ld be

seriously challenged.

But the split-brain cases were not flights of phi losophical

fancy. T h e y were real peop le with a real and irreversible su rg i -

33

P A U L B R O K S

34

cal divis ion of the brain. Inevitably they provoked as much

phi losophical interest as scientific. L ike many others, my own

imagina t ion w a s captured by the sugges t ion that, in dividing the

brain, the su rgeon ' s knife was also d iv id ing consciousness and

therefore d iv id ing the person . T h e very idea of bisecting the

l iv ing, consc ious brain clean down the middle was bizarre and

absurd . It had a touch of the macabre , a whiff of the chamber of

hor rors . T h e r e are many weird creatures in the menager ie

of neurologica l disorder , but the split-brain patients were of

the purest s t rangeness . I w a s drawn in.

' S t r ange ca se s ' , c lose ly observed , have an important place in

the neurologica l literature. Alexander Lur ia , a major figure in

the history of neuropsychology , w a s a master of case descrip­

tion and a persuas ive advoca te of ' romant ic sc ience ' .

' W h e n done properly, ' he sa id , 'observat ion accomplishes

the classical a im of explaining facts, while not los ing sight of

the romant ic aim of preserv ing the manifold richness of the

subject . '

I don ' t hesitate to r ecommend the popular writ ings of Lur ia ,

Ol iver Sacks , and others to students as a w a y of introducing

them to the field, but I recognize that part of the appeal , part of

that 'manifold richness of the subjec t ' , has little to do with sci ­

ence or phi losophy. I t has more to do with the intrinsic

fascinat ion of the aberrant and the bizarre. Morbid fascination

would not be too wide o f the mark .

In this l ight, neurological case histories have a certain Gothic

appeal . Rep lace the dark forests, the c r a g g y mountains, the

ruined abbeys , and the elemental s to rms of the traditional

Goth ic tale with a desola te urban landscape . L e t a dilapidated

I N T O T H E S I L E N T L A N D

modern hospital stand for the c rumbl ing medieval cast le with its

labyrinthine pas sages , g l o o m y dungeons , and torture chambers .

T h e white-coated, mad scientist in his cobwebbed laboratory,

amid van de G r a a f genera tors , l ightning conductors , and the

paraphernal ia of alchemy, b e c o m e s the g r een -gowned su rgeon

in the sterile g leam of the opera t ing theatre, knife in hand, ready

to rework the bra in ' s s l imy fabric. At the centre of i t all is the

monster, wai t ing for the life force from the heavens to jolt its

dead l imbs, and the patient, brain exposed to the air, wai t ing for

the blade.

A n d here I am now, in the shadow of Dr Frankenstein,

having isolated one half of N a o m i ' s brain, about to e n g a g e in a

d ia logue w i t h . . . what? A person? A half -person? H a l f a bra in?

It doesn ' t feel as if I 'm deal ing with s o m e fragment of a mut i ­

lated self. N a o m i ' s spirits seem to lift. She answers my ques t ions

obl igingly and follows instructions with hardly a m o m e n t ' s

hesitation. T h o s e three short minutes f ly by. ' Y o u ' v e done ve ry

well, ' I tell her.

T h e d r u g wears off. T h e left a r m has returned to life and the

E E G trace i s back to normal . Her eyes are c losed and N a o m i

looks as i f she is asleep. We k n o w she isn' t from the rhythms of

the E E G - her brain is idl ing in a comfortable alpha rhythm,

indicating relaxed wakefulness. It is t ime for the next s t age of

the procedure , to see whether she r emembers anything from

the d rug phase . Fo r N a o m i , this element of the ritual is crucial .

Failure here would outweigh success at any other s t age . I f she is

to proceed to surgery she must pas s my m e m o r y tests.

S h e ' s not do ing so well. Come on, Naomi, come on, I 'm think­

ing. ' T h e picture, N a o m i , what can you r e m e m b e r ? '

35

P A U L B R O K S

36

Perplexity, then a burs t of information: 'A man on a ladder,

a d o g chas ing a cat, a p o n d with s o m e ducks on it, a girl with a

kite, a b o y with a bal l . ' Al l , unfortunately, from the picture she

w a s shown at yes te rday ' s rehearsal .

Fo rma l test ing comple ted , I ask N a o m i how she found the

experience.

' N o p rob lem, ' she says . 'It w a s a breeze . '

T h e bra in ' s l anguage circuits are usual ly located on the left

s ide , so dis turbance or comple te loss of speech is the typical

r e sponse to injection of the left hemisphere . In other w a y s the

effects are less predictable. S o m e patients appear confused and

disor iented, s o m e b e c o m e agi ta ted, s o m e disinhibited. Others ,

like N a o m i , just look desola te .

H e r head is still, but her eyes flash left and right. She will not

respond to my s imple c o m m a n d s : 'Touch your nose , N a o m i ,

touch your nose . ' No th ing . When we get to D a y s o f the Week

she tries very hard, but all we get is 'Fa - fa - fa - fa - fa . . . ' On

C o u n t i n g B a c k from T e n she approximates the number words ,

but ge ts locked in a persevera t ive loop: 'Tern, nipe, ape , ape ,

ape , a p e . . . ' She looks a t the picture and has an u rge to point a t

things: ' D a , da . '

F o r a while she seems to be w a r m i n g to the task, appears

e n g a g e d , but her concentrat ion suddenly fades. At one point she

looks me in the eye and chuckles wickedly, then another wave of

emot ion sends her in a different direction. Her eyes dart left and

right again . She looks terrified; she looks feral.

' F ine , N a o m i , just f ine, ' I say as we complete the routine.

'Re l ax , w e ' r e nearly there now.' We retire to a side room

leav ing N a o m i to rest and recover from the d rug .

I N T O T H E S I L E N T L A N D

T h e speech dis turbance confirms for us that N a o m i ' s

l anguage control centres are located pr imari ly in the left hemi­

sphere. T h i s is important for the su rgeon to know, g i v i n g him

greater licence for excurs ions into the right tempora l cortex if

necessary, with minimal risk of d isrupt ing l a n g u a g e functions.

And when i t comes to m e m o r y test ing there are no surpr ises .

Her failure to recall or recognize mos t of the test i tems confirms

that we were p lac ing unreasonable demands on the d a m a g e d

right h ippocampus: taunting the crippled seahorse .

T h e one exception is her accurate recall of the mental arith­

metic task. Under the d r u g she had stared at the sum printed

on the test card and sa id , 'Sebber , seffen, f ife, f ife, five. ' N o w ,

correctly, she recalls, ' Fou r plus f ive equals nine. ' I ' ve seen this

before. Somehow, I think, numerical information must ga in

back-door access to the left hemisphere in a w a y that verbal

information cannot.

Recall of the experience of left hemisphere suppress ion is a lso

less predictable than for shutting down the right hemisphere.

S o m e patients have no recollection of events at all, at least noth­

ing they can put into words . Others have at least partial insight

into the frustrations of their t emporary loss of speech. S o m e ,

like N a o m i , just tell tales. ' O h , i t w a s okay, ' she says . Well,

perhaps she did have some slight p rob lems with her speech at

first, but after that she was fine. Maybe it w a s a bit different to the

f irst time around, but not much, not really. Qui te enjoyable. T h i s

is the left hemisphere confabulat ing. It does this for all of us ,

every waking moment . I t edits our consc ious experiences, makes

them comprehensible and palatable. It is the brain 's spin-doctor .

* * *

37

P A U L B R O K S

T w o things disturb me dur ing the night. O n e is the hoarse , sotto

voce ba rk of an urban fox, receding in triplets down the street.

T h e other is a f ragment of d ream, sharp enough to wake me . I

s tagger , g i d d y from be ing spun in a la rge machine they called an

Accel lo t ron . It has m a d e me invisible, temporarily. I see my

daughter sitting in the ga rden and approach her. I speak. She

looks at m e , but her eyes cont inue searching. I have, truly,

b e c o m e invisible. T h e r e ' s no w a y I can reassure her. She is

terrified when I touch her hand. I 'm terrified.

N e x t day, f irst thing, I 'm sitting in my office watching the

v ideo of N a o m i ' s Wada test. I t ' s easy to miss important details

in the pat ient ' s responses so we a lways check the video. The re

w a s someth ing I failed to catch. T h e left hemisphere is sup­

pressed and the or igin of N a o m i ' s f ragmented, mumbl ing

speech is uncertain. It could be the left hemisphere running on

empty or pe rhaps i t is c o m i n g from the other side of the brain.

Ei ther w a y i t ' s hard to make out what s h e ' s saying. For a

moment , her confusion s eems to subs ide and there is a look of

accusat ion in her eyes .

'Wata fam, ' she says , 'dooneer . '

I listen c losely a second and third time and realize i t ' s a

quest ion: 'Wha t the fuck am I d o i n g he re? '

38

The Sword of the Sun

I had never been much aware of my father's g lass eye, just as I

had never really noticed his foreign accent. We were sw imming

some distance from the shore. Fourteen years old, I w a s w a y

ahead. He called and I turned to find him treading water, right

hand covering the empty cave of his eye-socket , g o o d eye

exploring the g l immer ing depths. T h e fugitive eye stared up at

us from the seabed. I p lunged like a pearl diver, fol lowing its g a z e

all the w a y down, and snatched it up with a handful of sand.

Tha t evening, sk imming s tones into the sunset , I returned in

imaginat ion to the ocean floor. It w a s a cold and lonely p lace .

T h e n i t occurred to me that, depr ived of an obse rv ing eye , the

ocean was nothing. Such power! I c losed my eyes and i t w a s

gone .

Years later I read Italo Ca lv ino ' s Mr Palomar. It stirred m e m ­

ories. T h e e p o n y m o u s hero g o e s for an evening swim. As the

sun goes down i t sends a dazzl ing band of l ight ac ross the sea .

L o o k i n g back to the shore , Mr Pa lomar sees the sun ' s reflection

as a shining sword in the water. He swims towards it, but the

39

P A U L B R O K S

sword retreats with every s t roke and he is never able to overtake

it. Wherever he m o v e s he remains at the s w o r d ' s tip. It follows

him, 'poin t ing him out like the hand of a watch whose pivot is

the sun ' . He realizes that every bather experiences the same

effects of the light. Sa i lboards change their appearance as they

c ros s the reflection, co lours are muted , bodies silhouetted.

Wha t if all the swimmers and sa i lboarders return to the shore,

he wonder s , where wou ld the sword end?

Mr Pa lomar unders tands that nothing he sees exists in nature.

Na tu r e is a bundle of abstract ions — particles in fields of force.

T h e sun, the sea , the sword , and the sa i lboarders are inside his

head. H e f l o a t s a m o n g phantoms.

T h e sword of the sun c leaves the universe in two: there is

object ive reality — remote abstract ions without point of view —

and there is Pa lomar ' s pr ivate universe , the mi rage of human

percept ion. ' I am swimming in my mind; this sword of light

exists only there. ' But what kind of thing is Mr Palomar , the

Perceiver? No doubt he wou ld see himself, as I see myself, as a

s ingular , unified be ing , cont inuous with his child self as I am

cont inuous with the b o y d iv ing for his father's eye, m o v i n g

from fixed pas t to uncertain future. L ike the sun ' s reflection, this

is an i l lusion.

In the a n g i o g r a p h y suite, pe r forming a Wada test, I was the

il lusionist. O u r brain d r u g cleft the y o u n g w o m a n in two. T h e

left-brain vers ion of N a o m i w a s different from the right. Ms

Lef t -brain w a s talkative and cheerful. Ms Right-bra in was

unsett led, mute , m o r o s e . When the w o r d s f ina l ly broke

through, she hadn ' t a clue where she was . 'What the fuck am I

d o i n g he re? ' I ' ve never heard Ms Left-brain swear. Afterwards,

40

I N T O T H E S I L E N T L A N D

when the d r u g wore off, Ms Left-brain spoke for the whole

person. 'It was a breeze, ' she said . T h e r e w a s no recollection of

Ms Right -bra in ' s discomfort . I t had been edited out of the story.

O n e might think that the se l f is d iv ided in such c i rcum­

stances, but this would be to swal low the il lusion of unity; to

imagine in the f irst place that there is s o m e 'whole thing ' to be

fractionated. T h e r e isn't . F r o m a neuroscience perspect ive we

are all divided and discont inuous. T h e mental p rocesses under­

lying our sense of self — feelings, thoughts , memor i e s — are

scattered through different zones of the brain. T h e r e is no

special point o f convergence . No cockpit o f the soul . No sou l -

pilot. T h e y c o m e together in a work of f ict ion. A human be ing

is a story-tel l ing machine. T h e self is a story.

T h i s is not to say that our l ives are f ict ions. Unlike Rob inson

C r u s o e or E m m a B o v a r y we are embedded in a universe with

physical and moral d imens ions where every thought and action

splinters into a million consequences . R e a d e r s of F lauber t ' s

Madame Bovary will vary in their reactions to its heroine as she

makes her way through the novel , but her life and thoughts are

f ixed. She will a lways mar ry Char les , fall prey to the a b o m ­

inable Rodo lphe , and die her horrible death. I t ' s different for us

meat puppets . We don ' t know where our l ives are g o i n g . What

the fuck am I doing here? I often wonder .

W h o tells the s tory of the self? T h a t ' s like ask ing who thun­

ders the thunder or rains the rain. It is not so much a quest ion of

us telling the s tory as the s tory telling us .

N o t so long a g o I asked my dad if he remembered the t ime I

rescued his eye from the bo t tom of the sea .

' N o , ' he said .

41

Soul in a Bucket

I once met a y o u n g m a n who w a s convinced his head was full of

water and contained a fish rather than a brain. It was quite a

l a rge fish, someth ing like a trout, and it unsettled him to think

of i t l iv ing in such c ramped condit ions. He no longer had need

of a brain since all his thoughts and behaviour were under the

control o f the C I A .

Mos t of us bel ieve that the head contains a person: a self.

H e r e ' s one , at the front of a lecture hall, spil l ing words that

seem to c o m e from nowhere . T h e r e , in the auditor ium, are 200

other se lves . R o w s of heads . Fo r each head to represent the

locat ion of a consc ious se l f requires a further, inferential, step, a

mental p roces s I am power less to resist.

T h e s a m e applies when we reflect on our own identity. We

create our selves by inference: automatical ly and irresistibly. In

d o i n g so we ride the rails of the deepes t human convention, but,

at root , it is just that: a convention. T h e self is not an intrinsic

feature of the brain and it is poss ib le to b e c o m e derailed —

th rough psychos i s , like the man with the fish in his head, or as

42

I N T O T H E S I L E N T L A N D

a result of brain d a m a g e . T h e degrada t ion of personal i ty is a

neurological commonplace .

Mary had suffered a brain haemor rhage ; to be prec ise , a

ruptured anterior communica t ing artery aneurysm. T h e arterial

wall had a lways been defective ( though she w a s not to k n o w )

and now, in her fiftieth year, the sac had burs t , pou r ing b lood

into the frontal lobes . T h e su rgeons opened up her head and

fixed a clip to stem the flow. She had been c lose to death. T h r e e

weeks later, sitting in my office, it w a s difficult to s tem the flow

o f words .

' I ' v e got a p o e m I wro te it yes terday well I haven ' t written it

down it just c a m e to me when I w a s sit t ing look ing out the

window at the lawn and these m a g p i e s c a m e v ic ious things you

wouldn ' t want to leave a baby outs ide they 'd peck its eyes out

like they do the sheep they attack in pa i rs they swoop d o w n and

confuse the sheep one then the other we had a kitten c l imbed an

apple tree i t did they flapped a round her p o o r thing w a s terrified

I threw a stone we shook the biscuit box to ge t her down . '

She paused . She had forgotten the p o e m .

'Where was I ? ' she said .

I didn' t say a word as I reached for the black case containing

my test equipment, and avoided eye contact . If I d idn ' t speak

and I didn't look , Mary would stay silent. Without the t r igger of

a word or a g lance she sat, if not exactly still ( she w a s a lways

fidgeting with the but tons on her b louse ) then at least quiet . But

to let slip a careless word or g lance w a s to open the s luice. I

quickly released the c lasps on the case and took s o m e clean his­

tory sheets from a tray on my desk . Mary didn ' t m o v e a musc le .

She was not even fiddling with her but tons. I wondered how

43

P A U L B R O K S

l ong we could sit there like this, mot ionless and quiet. T h e

silence didn ' t t rouble her.

She seemed absorbed by a picture pos tcard pinned to the

boa rd behind my desk . It showed a Mediterranean scene, a sea ­

s ide town with a pine-fringed golden beach and blue sea , and a

seafront p r o m e n a d e with colourful shops and restaurants.

M A J O R C A b lazed diagonal ly, upper left, in curly yel low letters. It

had been there since the summer and now looked incongruous

beneath the seasonal tinsel and plastic holly my secretary had

s tuck about the p lace . A little Chr i s tmas tree sat on the filing

cabinet in a clutter of cards .

We b e g a n with quest ions about orientation. T i m e , place, and

person: the when, where , and who co-ordinates of personal

awareness . I t ' s important to exercise discretion. O n e doesn ' t

want to insult the patient by asking over ly simplistic questions.

But , with Mary, i t w a s appropr ia te to start with the basics .

Personal orientation w a s one of her p rob lems .

'Wha t day is i t ? '

' W e d n e s d a y '

' G o o d . A n d the da t e? '

' I s it the twenty-four th? '

'Actual ly i t ' s the sixteenth. What month is i t ? '

' J u l y '

'Wha t makes you think i t ' s J u l y ? '

' I t ' s w a r m in here. ' She undoes a button, then another.

' I should keep your b louse on, Mary, ' I tell her. We move on.

'Where are we n o w ? '

'At the hotel . '

'And what is the name of the town we are in? '

44

I N T O T H E S I L E N T L A N D

' I don ' t know,' she says . 'Majorca , somewhere . '

I ask her name. She g ives me a p i ty ing look .

'Me? I 'm Mary Magp ie . W h o did you think I w a s ? '

* * *

I 've been project ing images of the brain on to a la rge screen. At

f i rs t they were hyper-real 3 - D images , labelled and co lour -

coded to illustrate the anatomical landmarks . T h e cerebral

hemispheres looked like they were m a d e of shiny plast ic. But

now I am working on a m o r e schematic picture. A large b lock of

colour — hot mustard yel low — slides down behind m e , cas t ing a

trompe l 'oeil shadow against the pale screen. It bears the legend

C E R E B R A L C O R T E X and signifies the appara tus o f the consc ious

self.

T h e hall is full and the students are attentive. T h e y seem to

have enjoyed watching the shapes and w o r d s g l ide ac ross the

screen, falling into place with PowerPoint precis ion as the brain

assembles itself. I am pleased with my picture. It is like a w o r k of

art. T h e lecture hall as gallery.

In the shadows, on a table next to the i l luminated screen there

is another exhibit. It is hidden from view, but in a few minutes I

shall take it from its container and hold it aloft for the audience

to admire . Fo r now, we contemplate the d i a g r a m . It p rov ides a

standard representation of the major anatomical d ivis ions

(hindbrain, midbrain, forebrain) and s o m e of the componen t

structures (cerebel lum, thalamus, basal gang l i a , neocor tex) .

T h i s is an introductory lecture. I keep it s imple , but m o v e

swiftly through the lower structures like a child ascending a

45

P A U L B R O K S

c l imbing frame, eager to reach the top. I am most interested in

what g o e s on in the higher reaches, the zones containing the

interlinked sys tems of perception and thought, memory and

emot ion . Consequent ly , my account of the hindbrain and mid­

brain structures is crisp. I encourage the students to imagine that

we are c rawl ing th rough the b a s e of a gargantuan skull and

c lamber ing up the bra ins tem. I t has the girth of an oak. We p ro ­

ceed under the shadow of the great lobes of the cerebral

hemispheres that l oom like thunderclouds. I t ' s the higher

branches we aspire to, w a y up in the g l o o m . I ask them what

they think they would see .

'No th ing , ' one of them answers correctly, ' i t ' s pitch black. '

'Sh ine a l ight, ' I say.

' H o w old are y o u , M a r y ? '

'Twenty-four . '

'And your children, how old are they? '

' E m m a ' s twenty-two, T o m ' s nineteen. '

I explained to Mary that we were in a hospital . D i d she know

why she w a s there? Yes , she told me . S h e ' d had an aneurysm,

but they 'd put i t right. She would be g o i n g home soon . In fact

she wou ld leave as soon as we had finished. I t w a s a pity her

sister had to s tay behind. He r sister? Yes , s h e ' d had an aneurysm

too, but she wasn ' t d o i n g so well . She would have to stay on the

ward a little longer.

Mary w a s b e c o m i n g agitated now. She s tood up and made for

the door .

' G o t to g o , ' she sa id . ' I left the b a b y '

'Wha t b a b y ? '

46

I N T O T H E S I L E N T L A N D

'My baby, ' she said. ' I left i t in the ga rden . T h o s e m a g p i e s will

have its eyes out. '

T h e baby w a s born last month. T h e y opened M a r y ' s head ,

and then they delivered her baby. It was a beautiful little gir l , but

there was a problem with her brain. It could be an aneurysm.

Perhaps they'll open her head as well.

Shine that light at the g l o s s y unders ide of the temporal lobe ,

directly above , and you will see that the outer surface is

wrapped in a sheet woven from an exquisi te material . N e x t

slide: T h i s is the ' g rey matter ' . I t covers all of the major lobes .

In reality the colour would be a dull, g r ey -b rown , but here we' l l

g ive it a silver sheen. D i s s o l v e into the fibres of this material .

Picture an exotic, i l luminated ga rden . See what makes i t gl isten.

T h e objects all a round ( 'neurons ' ) are certainly plant-like —

roughly spherical pods with slender, b ranching tendrils (the

'dendri tes ' ) and a longer p rocess (the ' a x o n ' ) extending from

one end. T h e axons, too, can be seen to branch into a number of

finer strands, each with a but ton-shaped endfoot that attaches to

a dendrite, or to the cell body, of another neuron.

It is a dense matrix of interconnection. A b o v e and below, near

and far, the neurons pulse and g low in a silent, iridescent fugue as

electrochemical signals traverse the long axons and influence the

target cell. Next slide: Here , for our benefit, packets of light shoot

along the axons and cause the cells to which they are linked to

g low either red or blue. R e d s ignals a state of excitement. T h e

target cell itself is now encouraged to fire pulses a long its own

axon to cells further a long in the network. Blue s ignals inhibition

and the target cell s tops firing. In effect, each neuron is either ' on '

47

P A U L B R O K S

48

or 'of f ' , generat ing pulses or ceasing to generate pulses. Neurons

are the bas ic functional units of the brain and that is their task: to

fire or not to fire. I t ' s all they do. Whichever region of the cortex

you plunge into, the scene is the same.

Where is the mind in this tangled w o o d of neurons and nerve

fibres? It isn ' t anywhere . A n d the self? What did you expect? A

genie in a bot t le?

Gottfr ied Leibniz , the eighteenth-century philosopher and

mathematician, per formed a similar thought experiment. He

imagined 'a machine whose construct ion would enable i t to

think, to sense , and to have percept ion ' and, further, that the

machine is ' enlarged while retaining the s a m e proport ions , so

that one could enter into it, just like into a windmil l ' . What does

he find in the interior of the mind-making machine? '. . . only

par ts push ing one another, and never anything by which to

explain a percept ion ' .

T h e en igma of personal identity may have a dark s ide. In his

e ssay 'Sor ry , but Your Soul Jus t D i e d ' T o m Wolfe imagines an

apocalypt ic near future where advanced methods of brain

i m a g i n g will strip away the i l lusion of self. People will realize

that all they are look ing at is a piece of machinery, devoid of

self, mind, or soul . At this point , he says , ' s o m e new Nie tzsche '

will step forward to announce the death of the soul and 'the

lurid carnival that will ensue m a y make the phrase "the total

ecl ipse of all va lues" seem tame. '

It is t rue. Neurosc ience is fast deve lop ing the technical and

conceptual wherewithal to reveal in fine, bare detail the neuro-

bio logica l substra tes of the mind. Perhaps it will despoil a

sacred myth — the myth of selfhood and souls . A n d , if so,

I N T O T H E S I L E N T L A N D

we may be wander ing innocently into the open ing phase of a

dangerous g a m e . O u r ethics and sys tems of just ice, our entire

moral order, are founded on the notion of society as a collective

of individual selves — au tonomous , introspect ive, accountable

agents. If this self-reflective, mora l agent is revealed to be

illusory, what then?

Values may have more to do with primit ive ideas about ghosts

in machines than we care to think, and perhaps by us ing the tools

of neuroscience to deconstruct the se l f we run the risk of split­

ting a social a tom and releasing forces beyond our present

comprehension. Cou ld ' the century of neu rosc ience ' really

signify the death of the self and the col lapse of all va lues? I

think Wolfe honours neuroscience unduly. He is seduced by the

gadge t ry and the g a u d y images . You don ' t need futuristic new

technologies to expose the brute fact that there ' s nothing but

meat inside our heads. W e ' v e known this down the a g e s .

I t dawned on me s o m e t ime a g o that I w a s no longer e s p e ­

cially interested in the brain. Or rather, that my interest w a s

expanding outwards from the brain itself. It was as if I had been

in a congested city, g a w p i n g at the c rowds and the architecture

and the traffic from g r o u n d level. A n d now I was r is ing above

the bui ldings and the streets to take in a different perspect ive . I

could see suburbs and fields and rivers beyond and, in the d i s ­

tance, other towns and cities. Ci t ies don ' t float in a v a c u u m , and

neither do brains.

What became clear was that the brain could not be fully

unders tood if you treated it as an isolated object. I had underes ­

timated how tightly the bra in ' s functions are b o u n d to the rest of

the body and, at the same t ime, how deeply they are e m b e d d e d

49

P A U L B R O K S

50

in the wider physical and social landscape . No brain is an island.

W h e n M a r y ' s husband came to visit he had a ca lming effect.

T h e y seemed to function as a unit. M a r y ' s behaviour meshed

into the networks of partnership and so became more coherent

and consistent . In any relationship each person is partly defined

in te rms of the other. So , for Mary, her husband ' s presence was

a gu ide to self-definition. He prov ided a template. He drew

from her a behavioura l repertoire and a mental structure to

complement his own, and the centre of gravi ty lay between

them. T h e r e w a s stability, a kind of equil ibrium. T h i s effect was

not of his del iberate do ing . T h a t ' s just the w a y i t happens.

I f M a r y ' s heart or lungs or liver had been the pr imary site of

pa thology, rather than her brain, i t would be possible to describe

the d i sease in te rms of its effects on that particular o rgan system

in relation to the overall functioning of the rest of her body.

T h e function of the heart is to p u m p b lood , the liver secretes

bi le , the lungs enable the supply of oxygen to the b lood , and in

each case the frame of reference for a description of function is

the individual o rgan i sm. In defining brain function we have to

go beyond this, extending the frame of reference beyond the

sys tems of the body.

T h e brain evo lved as a means of orchestrat ing adaptive

interaction between the o rgan i sm and the world . To achieve this

i t mus t maintain both an inward and an outward orientation,

moni tor ing and regulat ing the state of var ious internal sys tems,

while at the s a m e t ime responding to the flow of events in the

external wor ld . In fact, as well as p lay ing its part in monitor ing

the b o d y ' s internal milieu, the brain must control interactions

with two kinds of external environment .

I N T O T H E S I L E N T L A N D

Accord ing to Western intellectual tradition, which dist in­

guishes between Nature and Cul ture , we have a cur ious , duplex

kind of existence. We m o v e in a natural realm of t ime, space ,

and matter and, concurrently, through a socio-cul tural d imen­

sion of people and ideas , a wor ld saturated with cus toms and

beliefs, rituals, traditions, laws, convent ions, fashions, lan­

g u a g e , arts, and science. In the f i rs t wor ld we are subject ,

ultimately, to the laws of phys ics and, in the second , to the influ­

ence of cus toms, beliefs, rituals, t radit ions, etc.

An emerg ing theme in neu ropsycho logy is that, just as i t has

functional sys tems devoted to percept ion of, and interaction

with, the physical environment , so the brain has evo lved s y s ­

tems dedicated to social cogni t ion and action. It constructs a

model of the o rgan i sm of which it is a part and, beyond this,

a representation of that o rgan i sm ' s p lace in relation to other,

similar, o rgan isms: people . As part of this p roces s i t a ssembles a

' se l f ' , which can be thought of as the device we humans employ

as a means of negotiat ing the social environment .

T ight ly bound to l anguage , these brain mechan isms are the

channels through which b i o l o g y finds express ion as culture, a

means of distributing mind beyond biological boundar ies . But i f

culture is in this w a y an extension of b io logy , an important

question arises: must we also accept that neurosc ience has

boundaries which deny full access to an unders tanding of brain

function? In other words , is neuroscience adequa te to its pr i ­

mary task — unders tanding the brain — or, to tackle the ' b i g '

questions (relating to self-awareness and persona l identi ty)

must we turn to other forms of science and scholarship?

To achieve s o m e unders tanding o f M a r y ' s condit ion we are

51

P A U L B R O K S

obl iged to skirt these fuzzy boundar ies of b i o l o g y and society.

B e y o n d account ing for her illness in te rms of physical pathol­

o g y and apprecia t ing its consequences at the personal level, we

mus t try to unders tand what mechanisms might be opera t ing at

the intersection of the b iological (the bra in) and the social (the

s e l f ) . A major chal lenge for neuroscience in the twenty-first

century will be to try to figure out how brains and selves go

together.

We build a s tory of ourse lves from the raw materials of lan­

g u a g e , memory , and experience. T h e idea o f the 'narrat ive s e l f

has a l ong history, with roots in Buddhis t teaching. Accord ing

to the doctr ine of Anattavada, the self is no more than the

a g g r e g a t e of an individual 's thoughts , feelings, percept ions and

actions. T h e r e is no central core or ' e g o ' . D a v i d H u m e , in the

eighteenth century, took a strikingly similar line. For him, the

extension of the se l f beyond such momen ta ry impress ions was

a fiction. Danie l Dennet t has offered a contemporary version,

emphas iz ing the power of l anguage in g iv ing coherence to our

exper ience over extended per iods . Acco rd ing to Dennet t , the

se l f is bes t under s tood as an abstract 'centre of narrative

g rav i ty ' .

Confabula t ion is the inadvertent construction of an er ro­

neous self-story, s ignifying the neurological breakdown of the

storyteller. I t takes different forms, somet imes mundane , s o m e ­

t imes fantastic. As in M a r y ' s case , i t is typically associated with

d a m a g e to the frontal lobes and is p robably due to a combina­

tion of things. M e m o r y disorder is one ingredient. In particular,

confabula tors have p rob lems with contextual memory . T h e y

m a y retain the kernel of s o m e autobiographical event or

52

I N T O T H E S I L E N T L A N D

episode , but fail to anchor it in a specific t ime or p lace . Memor ies

drift loose , images coll ide.

T h e n there is disinhibition of associa t ions . Words , thoughts ,

and memor ies reach consc iousness through a p roces s of natural

selection. Fo r every item of awareness there is a mult i tude of

suppressed alternatives reverberat ing through the neural nets.

T h e confabulator 's theatre of consc iousness i s c rowded with

gatecrashers ( imaginary babies , magp ies , the number twenty-

four) . T h e reduplication of relatives or the creation of

imaginary children is a c o m m o n theme.

Finally, there is a dis turbance of the neuropsycholog ica l

mechanisms responsible for maintaining a distinction between

the external world and internally generated thoughts and

actions (falling into the frame of a seas ide pos tcard , you are

transported to the island of Majorca) .

I reach into the shadows behind the screen and retrieve a smal l ,

semi-transparent plastic bucket. I dip into the bucket and fish

out a human brain. I have no idea to w h o m the brain be longed .

I can't tell if i t ' s male or female, black or white, or, with any reli­

ability, its a g e . I may even have passed this person on the street.

In its natural state, encased within the skull, brain matter is

gelat inous. T h i s brain, fixed in formalin, has a sol id , rubbery

feel and would carve like a very tender tuna steak.

It looks small and lacklustre after the br ight pictures on the

screen, but i t holds the interest of my audience. T h e end-of-

lecture rustling of papers s tops . All eyes turn towards the g r e y -

brown object as I point out the major landmarks . In te rms of

impart ing factual knowledge about the structure and functions

53

P A U L B R O K S

of the brain, the main pu rpose of my lecture, this little coda

adds nothing. Yet the students leave with something they

wouldn ' t o therwise have had: a clearer sense of the brain as a

b io logica l object; a physical m a s s as well as a textbook concoc­

tion of co lours and neat abstract ions. I t will help them

appreciate the distinction between the brain and the self.

W h e n the A p o l l o as t ronauts went to the m o o n and brought

b a c k pictures of our planet of oceans and c louds hanging over a

g r e y m o o n s c a p e in the middle of a b lack nowhere, i t changed

the w a y we saw ourse lves . We knew already that we inhabited

the surface of a smal l , spinning sphere that rolled around an

ord inary star, a t the e d g e of an unremarkable galaxy, just one of

indeterminate bil l ions in a vast , indifferent co smos . But now,

occupy ing a few degrees of retinal space , comfortably absorbed

in the folds of the visual cortex, a mere port ion of the visual

f ie ld, we saw our h o m e in its true co lours . I t w a s precious and

vulnerable , a small fragile object , a thing we should take care of.

I t w a s , indeed, our h o m e . We might have extrapolated these

sentiments from the knowledge we already posses sed , but the

images set off an interplay of intellect and imaginat ion that

m a d e the new perspect ive irresistible.

Some th ing similar happens when y o u see a brain. Imag ina ­

tion infiltrates intellect. You get a sense of location and

vulnerabili ty. O u r home .

T h e hall empties , but a few students stay behind for a closer

look . T h e y want to touch it. A y o u n g w o m a n asks i f she might

hold the brain . She dons rubber g l o v e s and takes the specimen in

her cupped hands. T h e r e is wonder and apprehension on her

face . Y o u see this look on the faces of small children holding

54

I N T O T H E S I L E N T L A N D

caterpillars. A y o u n g man turns the brain over to examine its

unders ide. He picks at the s tump of a severed artery. Another

tests the weight , feeling the d rop of the object first in the left

hand then the right. He says i t ' s odd , but your head doesn ' t feel

this heavy.

Six months later Mary c a m e to the outpatients ' clinic. I t w a s

a routine follow-up. She did not remember me but , a l though her

m e m o r y was still poor , she had m a d e g o o d p r o g r e s s in other

areas. The re w a s no longer the prol ixi ty of speech or the f rag­

mented attention that had characterized her behaviour before .

In particular, over a per iod of two hours of interviewing and

neuropsychological testing, I detected no s igns of confabula­

tion. T h e n , work done , idly chatting as we wai ted for her

husband to collect her, I asked what p lans she had for the week ­

end.

' O h , ' she said. ' I ' d like to watch the b a d g e r s aga in . '

'Rea l l y? '

'Yes , in the f ield over the back wall . Y o u can see them from

the garden shed. ' She w a s look ing a t my name- t ag . ' B r o c k the

badger , ' she said .

Mary ' s husband arrived and they left together. I never saw

them again and I didn ' t ask him about the b a d g e r s at the bo t tom

of the garden.

Like the surface of the Ear th , the brain is pret ty much

mapped . T h e r e are no secret compar tments inaccessible to the

surgeon ' s knife or the magnet ic gaze of the brain scanner; no

mysterious humours pe rvad ing the cerebral ventricles, no soul

in the pineal g land, no vital spark , no spirits in the tangled

55

P A U L B R O K S

56

w o o d . T h e r e i s nothing you can' t touch or squeeze , weigh and

measu re , as we might the physical propert ies of other objects.

So y o u will search in vain for any semblance of a self within the

structures of the brain: there is no ghos t in the machine. It is

t ime to g r o w up and accept this fact. But , somehow, we are the

p roduc t of the operat ion of this machinery and its p rogress

th rough the physical and social wor ld .

Minds emerge from p rocess and interaction, not substance.

In a sense , we inhabit the spaces between things. We subsist in

empt iness . A beautiful, l iberating, thought and nothing to be

afraid of. T h e notion of a tethered soul is crude by compar ison.

Shine a l ight, i t ' s obv ious .

In the Theatre

In the days before brain scans i t w a s imposs ib le to locate

tumours beneath the surface of the brain with any precis ion.

Surgeons blindly poked a round in the soft t issues, caus ing

untold d a m a g e in the p rocess .

T h e poet-physician Dann ie A b s e wro te a p o e m , ' In the

T h e a t r e ' , in which he recounts a ha r rowing experience

described by his father, Dr Wilfred A b s e . I first read this p o e m

when I was a student and it raised the hairs on the back of my

neck. It concerns an ep isode that occurred in 1918 while A b s e

senior was assis t ing at a brain operat ion.

His voice introduces the p o e m . T h e patient, he tells us , i s

fully awake throughout the operat ion under a local anaesthetic,

while the fingers of L a m b e r t R o g e r s , the su rgeon - ' r ash as a

blind man ' s ' — crudely search for the tumour in the brain t issues

- 'all somewhat hit and mi s s ' . T h i s , s ays Dr A b s e , is one ope ra ­

tion he will never forget. T h e p o e m , and the operat ion, opens

with reassuring words for the patient:

57

P A U L B R O K S

58

Sister saying — 'Soon you' l l be back on the ward,'

sister thinking — 'Only two more on the list,'

the patient saying — 'Thank you, I feel fine';

small voices, small lies, nothing untoward,

though, soon, he would blink again and again

because of the fingers of Lambert Rogers,

rash as a blind man's, inside his soft brain.

If items of horror can make a man laugh

then laugh at this: one hour later, the growth

still undiscovered, ticking its own wild time;

more brain mashed because of the probe's braille path;

Lambert Rogers desperate, fingering still;

his dresser thinking, 'Christ! Two more on the list,

a cisternal puncture and a neural cyst.'

Then, suddenly, the cracked record in the brain,

a ventriloquist voice that cried, 'You sod,

leave my soul alone, leave my soul alone,' -

the patient's dummy lips moving to that refrain,

the patient's eyes too wide. And, shocked,

Lambert Rogers drawing out the probe

with nurses, students, sister, petrified.

'Leave my soul alone, leave my soul alone,'

that voice so arctic and that cry so odd

had nowhere else to go — till the antique

gramophone wound down and the words began

to blur and slow, '.. . leave .. . my... soul... alone ...'

to cease at last when something other died.

And silence matched the silence under snow.

I N T O T H E S I L E N T L A N D

T h e poem no longer chills me . W h y ? Perhaps I am a m o r e

sophisticated reader of poet ry n o w and see too clearly the

boards and backdrop of a me lod rama . But I don ' t think so. It is

obviously meant to be theatrical and , to my mind, conveys

authentic d rama . It is a fine p o e m . It still packs a punch. But it

doesn ' t unsettle me as i t once did.

Perhaps my experiences as a clinician over the years have left

me desensitized to human suffering or lacking appeti te for the

bizarre and extraordinary. I hope not, and don ' t think so.

Inevitably, one deve lops s t ra tegies for self-preservat ion.

Anyone who has worked with patients on acute hospital w a r d s

will tell you that you cannot resonate with every t remor of feel­

ing, and that somet imes there are v is ions of horror and raw fear

that can only be observed obliquely.

Perfect, constant empathy in such c i rcumstances wou ld be

suicidal. But i t is less a p rocess of desensit izat ion than one of

becoming acclimatized. T h e r e is a difference. T h e former s u g ­

gests an atrophy of feeling, the latter is merely to b e c o m e

accustomed to different condit ions. W h e n the profess ional

facade slips in the presence of persona l suffering, as i t d o e s from

time to t ime, the pain still penetrates. A n d as for indifference to

the bizarre and extraordinary, the ve ry oppos i te is t rue. F r o m

where I stand, in early middle a g e , the universe l ooks as

myster ious and absurd as ever - human be ings especially. T h e

older I get the more astonished I am by the plain fact of my own

existence and consc iousness , let a lone s t range and dis turbing

neurological cases .

T h e reason the p o e m has lost its power to g i v e me g o o s e p i m ­

ples comes down, I think, to that word ' sou l ' . Fo r full effect it

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60

requires an acceptance, at s o m e level, that souls exist. Cons ider

the pivotal moment when, defenceless against the surgeon ' s

frantic fingers, the dy ing brain asserts itself: Leave my soul alone,

leave my soul alone. T h i s feels like the intrusion of a supernatu­

ral force. Someth ing other than the brain, and something other

than the patient even, seems to have entered the scene. It is hard

to identify the vo ice with the soft mass of the inert brain, and it

is dis tanced from the patient, whose b o d y now becomes a ven­

tr i loquis t ' s dummy, mouth ing w o r d s as if to the sound of a

cracked record. T h e y are w o r d s of despair. T h e eerie intruder

w a s reluctant to manifest itself, one feels, but had no choice.

N o w , i f you had asked me twenty-odd years ago whether I

thought there were such things as souls I would have said that of

course there were not. U n d e r g o i n g training in clinical and sci­

entific disciplines, I wou ld have considered such talk to be

pr imit ive and pre-scientific. ' S o u l ' implied a spiritual substance

of s o m e kind, a mental essence or ego acting behind the material

scenes of brain structure and function, gu id ing and controll ing

and, i f you chose to bel ieve it, su rv iv ing the death of the body.

I t carried connotat ions of the supernatural , representing ideas

that I found at best misgu ided or intellectually inelegant, at

wors t sinister and re t rogress ive .

I t ook the v iew that the mind w a s the product of the brain in

its interactions with the physical and social world . I still hold

that view. T h e difference in my emotional response to the poem

then and now requires a more subtle explanation.

I think it has to do with a change in background intuitions, as

o p p o s e d to foreground beliefs. When I first encountered the

p o e m I explicitly denied the existence of souls , but there was a

I N T O T H E S I L E N T L A N D

part of me still begui led by the imaginat ive power of the term.

It feels natural to bel ieve that someth ing like a soul exists. It m a y

indeed be natural in the sense that evolut ion has shaped our c o g ­

nitive architecture in w a y s that p red i spose us to bel ieve in the

separation of mind and brain.

We live in a social as well as a physical wor ld , and negotiat ion

of our complex social environment requires the attribution of

mental states (feelings, beliefs, des i res , intentions) to ourse lves

and others, perhaps inevitably inclining us to bel ieve that the

world contains two sorts of stuff, material and immater ia l .

Dua l i sm m a y have deep evolut ionary roots . We all feel that, as

well as a brain, someth ing else occupies the interior of our head

and the heads of other peop le — an irreducible mental co re , the

origin of thoughts and actions. It is a primit ive belief, but it is

compell ing.

It may follow that a bel ief in souls (or implicit bel ief or half-

belief or quas i -be l ief ) is a necessary condit ion for o rd inary

human interaction. We v iew ourse lves as integrated mental

entities with an agenda of intentions and actions, authors of our

own destiny. In a mora l universe , pe rhaps that is the only con­

ceivable w a y to v iew other people too.

All I can say is that now, when the b r a i n / s o u l / p a t i e n t p leads

Leave my soul alone, it s eems to me less like the intrusion of a

supernatural force. N o t h i n g has entered the scene. T h e r e is still

a desperat ion for survival , but this, I n o w see , emanates from a

stark no man ' s land between the muti lated t issues of the bra in ,

the sound waves of 'that voice so arct ic ' , and the horrified

response of the onlookers . T h e r e is horror still, but not super ­

natural horror.

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Perhaps , over the years , my immers ion in the rationalism of

clinical science has rusted those machineries of imagination

that genera te bel ief in supernatural souls — or half-belief or

quasi-belief . Perhaps this should wor ry me; I may have lost

someth ing . But I prefer to think that the screen between the two

doma ins — scientific unders tanding and primitive imaginat ion —

has b e c o m e m o r e transparent, a l lowing a clearer v iew in both

direct ions.

Certainly, I feel better able to cope with ambiguity. The re is

scientific rationality and there is imaginat ion. Somet imes they

coincide, and all peop le have elements of both. T h e poem

bet rays an ambigui ty about the reality of souls . T h e fearful

w o r d s crank out through the antique g r a m o p h o n e of the vocal

appara tus , blurr ing and s l o w i n g , ' . . . leave . . . my . . . soul. . .

alone...' - an i m a g e of a soul less mechanism - but they are said

to cease at last only 'when something other died'.

S o , it doesn ' t chill me as it used to, but I feel another response.

Behind the horror I see m o r e clearly now there is also pity. T h e

brain thinks i t ' s a soul . T h e r e is real pa thos in that.

I m a y not bel ieve in souls , but I still find brain surgery discon­

certing, and this is partly why A b s e ' s p o e m retains some of its

original power . T h e experience of witnessing an operation on

the brain is, in certain respects, quite different from other kinds

of surgery. Al l surgical procedures are invasive, but neuro­

surgery s eems like the ult imate intrusion. In abdominal and

cardiothoracic operat ions you see the surgeon bur row into the

pat ient ' s body, expos ing the inner work ings - the pumps , the fil­

ters, the p ipes , the va lves . I t can be shocking, but we have this

w a y of separa t ing ideas of 'the pe r son ' from what i s happening

62

I N T O T H E S I L E N T L A N D

to 'the person ' s b o d y ' . T h e person , one tends to imag ine , i s

elsewhere dur ing the invasion of her innards; she has with­

drawn to a safe , anaesthetized place ( somewhere in the head,

our intuitions tell u s ) .

It is a different matter when the contents of the skull are open

for inspection and prey to the su rgeon ' s knife. T h e r e can be no

question of any ' re locat ion ' to another part of the body. I t

would be absurd to think of the ghost ly se l f retreating to s o m e

other o rgan or l imb. At the same instant one unders tands that

there is, of course , no ghos t ly self in the first p lace . W h e n we

see the brain we realize that we are , at one level, no m o r e than

meat; and, on another, no m o r e than fiction.

T h e same insight — at once mundane and myster ious — is a

potent element of the f amous Zapruder footage of the Kennedy

assassination. Recall the images and you will k n o w what I mean .

Jackie Kennedy in the Da l l a s sunshine, in her pretty pink, pil l­

box hat, scrambl ing to retrieve the debris of her husband ' s

shattered head from the back of the l imousine . She finds a piece

of something and tries to replace it. Or so i t appears . Wha t g r im

desperat ion; what appal l ing intimacy.

T h o s e g l impses o f naked brain are an epiphany. T h e Mos t

Powerful Man in the World , smil ing immorta l ly and w a v i n g to

the c rowds just now, has had the top of his head b lown away. I t

is not just that he, like all of us , is vulnerable , or that his phys i -

cality is so brittle. N o r is i t even the suddenness of his transition

from human be ing to inert substance. Wha t locks these i m a g e s

into place is the exposure of the g rey-p ink brain. If that is what

T h e Most Powerful Man in the World can be reduced to, i f that

is what he is, then there is no hope for the rest of u s . We knew it

63

P A U L B R O K S

64

anyway, but our awareness of the fact is intensified by the drama

and the mythic status of the actors . T h a t is the horror of the

f i lm. A n d when you watch, do you not sense a f l icker of self-

pi ty? Desp i t e myself , I fear for my soul .

A-Z

A former neurosurgeon co l league , recall ing his training days ,

has a s tory about walk ing through the streets of L o n d o n with a

fellow student of surgery. His friend s topped , mid -conve r sa ­

tion, evidently troubled. T h e y had reached a small s ide street.

T h e man was b e c o m i n g agi tated and kept look ing up a t the

street name.

' T h i s street, ' he sa id , ' is not in the A - Z . '

A n d i t wasn ' t . T h e y checked. T h e wou ld -be su rgeon had a

remarkable visual memory . For no part icular reason he had set

himself the task, successfully accompl i shed , of memor iz ing the

entire A - Z street m a p o f L o n d o n . A n d now he had s tumbled

upon a mismatch. T h e m a p of his imagina t ion wou ld have to be

amended in one small detail, enough to make it superior to the

published vers ion.

His problem though (and ult imately what barred his w a y to a

career in neurosurgery) w a s that his exceptional power s of v i s ­

ual imagery were exceptional only in two d imensions . A m o n g

other attributes of intellect and temperament , the pract ice of

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P A U L B R O K S

66

neurosurgery demands an ability to think in three dimensions.

T h i s man w a s like Mr Squa re , the lowly, two-dimensional

character in Edwin A b b o t ' s nineteenth-century satirical tale

Flatland: A Romance of Many Dimensions. Mr Square has no

inkling of a geome t ry beyond the plane of Flat land until, one

night, he is visi ted by L o r d Sphere , a be ing from the land

of three d imens ions (appear ing to him as a circle, magical ly

chang ing shape ) . Fa i l ing to convince by explanation, L o r d

Sphere peels his humble acquaintance from Flatland and f l ings

him into Space land , p rov ing that there is, indeed, a world of

three-dimensional objects . It is a revelatory, l ife-transforming

experience. But , of course , on his return, he fails miserably to

pe r suade his fellow Fla t landers of the existence of this other

wor ld and the H i g h Priests (who are circular) condemn him as a

d a n g e r o u s heretic.

T h e trainee su rgeon ' s A—Z of the brain lacked the necessary

third d imension . He wasn ' t able to inhabit the metropol is of the

brain in the w a y a neurosurgeon must .

N e u r o p s y c h o l o g y requires four d imensions . At least.

The Mirror

Judy gets home from work . She pou r s herself a mart ini , pu ts a

record on the hi-fi and d rops into a soft leather chair. God s h e ' s

t i r e d . . . She s leeps. A n d y can read the bed t ime stories . T h e little

girl kisses her s leeping mother and, reluctantly, g o e s to bed .

When J u d y wakes , the r o o m is semi-dark . She sits bol t

upright and flinches from the pain in her head. T h e r e is no

music . She tries to fix her posi t ion. I m a g e s of the dai ly routine

tumble together: get up, go to work , c o m e home . A cat stretches

on the back of a chair by the window. T h e r e is enough of the

fading light to br ing its g inger fur to life. But J u d y ' s cat is a

tabby.

An unfamiliar man enters the r o o m : late midd le -aged , g r ey

hair. He gl ides by, g lanc ing briefly in her direction, and switches

on a lamp in the corner. It casts a cone of light upwards to the

ceiling.

' D i d you say something , J u d e ? '

N o w that the light is on she sees that the r o o m is a lso

unfamiliar.

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68

Where am I? Who is this?

J u d y has a habit of twist ing and pull ing at her wedd ing ring

when s h e ' s s t ressed. T h e r ing has g o n e .

' J u d e , ' the m a n says , ' I don ' t k n o w what you ' re on about . '

She is ask ing for her daughter and husband. T h e man leaves and

a w o m a n enters. She kneels by the s ide of the chair and takes

J u d y ' s hand. I t ' s a gent le interrogat ion.

' I ' m J u d y Jenkins . I 'm thirty-nine — and I don ' t know where

the b l o o d y hell I am! '

But she k n o w s the year: 1976.

T h e Pr ime Minister? ' H a r o l d Wilson . '

T h e man ' s vo ice breaks in, but J u d y cuts him short.

' D o n ' t tell me I 'm get t ing mixed up! ' she snaps . ' I know what

year it i s . '

N o w h e ' s in front of her ho ld ing up a newspaper , pointing to

the date at the top of the p a g e : Saturday, 10 April 1999. A shaft

of log ic breaks the frame.

'Fetch me a mirror . '

* * *

1999 'And then I sa id , "Fetch me a mirror ." I said I 'd be an old w o m a n

in 1 9 9 9 . . . ' S h e ' s tell ing me the s tory again . I t must be the fourth

or fifth t ime. I 'm not really l istening. I don ' t need to. I t ' s the

s a m e story.

T h e neuroscient is t Michael Gazzan iga quotes John Updike

and Ra lph Waldo E m e r s o n : 'A thread runs through all things:

all wor lds are s t rung on it, as beads : and men, and events, and

life c o m e to us , only because of that thread. ' In other words

I N T O T H E S I L E N T L A N D

( says Updike) our subjectivity domina tes outer reality, ' and the

universe has a personal structure ' .

Accord ing to Gazzan iga , the brain has a dedicated sys tem for

binding the s trands of a mult i tude of special ized brain modu le s

into a single thread of personal experience. He calls it ' the Inter­

preter' and locates it in the left cerebral hemisphere . T h e

Interpreter identifies patterns of connect ion between disparate

brain sys tems and correlates these with events in the external

world. T h i s g ives unity and continuity and enables each of us to

create a personal life story.

J u d y ' s mirror arr ives. She sees that her face is wrinkled and

gaunt , her hair short and grey. It must be a dream, she thinks. I t ' s

too much to take in all at once . She panics and tries to s tand, but

her left leg is para lysed by the s troke. She loses consc iousness .

When she wakes there is a man leaning over her, p ress ing a

mask to her face; a soldier perhaps , though his uniform is too

gaudy for the military. She senses movement and vibrat ion and

recognizes the sounds of an engine g o i n g through the gea r s . She

is in some kind of vehicle.

'Take i t easy, Judy, ' says the man in uniform, ' you ' re g o i n g to

be just fine. '

The re are red and g rey blankets and cylinders , tubes and

leads, plastic boxes , instruments with dials , and other i tems of

equipment. A n d there, sitting oppos i te , is the grey-ha i red man .

He leans in closer to her. ' W h a t ' s that? ' he asks .

' H a s anyone told A n d y ? ' she mumbles .

T h e erasure of twenty-three years i s remarkable enough .

J u d y ' s personal life over that per iod is a comple te blank. She can

only comprehend the bit terness of her d ivorce from A n d y in the

abstract, and the grey-ha i red man, with w h o m she has been

69

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70

l iv ing for the pas t eighteen years , is a stranger. T h e same goes

for public events. ( 'Margare t T h a t c h e r ? ' ) But equally striking is

the w o r k of J u d y ' s Interpreter, her teller of tales. Its s t ruggle for

continuity is heroic . With nothing else to hand, i t reaches back

m o r e than two decades to find material for a story. It br idges

the twenty-three years as if they were twenty-three minutes.

* * *

2002

'And then I sa id , "Fetch me a mir ror" . . . '

Beaten into submiss ion by the logic of an unknown present,

p lus the irrefutable evidence in the mirror, J u d y ' s Interpreter

has reset the c lock and set about the bus iness of regulat ing a

different life. Very little m e m o r y has returned, but things are

g o i n g fine with the grey-ha i red man, and J u d y is a grandmother

now.

T h i s kind of amnes ia is extremely rare. I have come across

only one other case that bears compar i son to J u d y ' s . Tha t

patient, too, m a d e an astonishingly smooth adjustment to her

new ci rcumstances . H o w resilient peop le are. I f one day you

woke up to find that y o u had been t ransformed into a gigant ic

insect, the chances are you wou ld just get up and carry on with

your new life.

* * *

2003

'And then I sa id , "Fetch me a mir ror" . . . '

The Visible Man

As J a m e s M o o n awoke one m o r n i n g after dis turbing d reams , he

found himself t ransformed into an anatomical i l lustration. He

rose from his bed thinking all w a s as i t should be and headed for

the ba throom, the first routine act of another routine day. But ,

looking in the mirror, he noticed that the d o m e of his head had

become transparent.

The re , bathed in a g l o s s y light, w a s his brain, look ing like a

vivid picture from the p a g e s of a tex tbook or a h igh-resolut ion

computer graphic . T h e outer surfaces , the grea t convoluted

lobes of the cerebral hemispheres , were rendered in pastel

shades with sculptural clarity: compac t , rounded , so l id , with

sharp contours defining the major anatomical d ivis ions .

T h e frontal lobes (pa le m a u v e ) were packed just behind the

forehead. T h e temporal lobes (powder blue) we re to either s ide

at the level of the ears . A b o v e and somewhat behind these were

the parietal lobes ( champagne ) and, at the back , the occipital

lobes ( j ade) . T h e n , as you wou ld expect , there were cu taway

views from the s ide , from above , and face-on, reveal ing s t ruc-

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tures deep beneath the surface. T h e s e were coded with bolder

co lours : cobalt b lue , lemon, cherry red, o range , purple .

T h e closer he looked, the more J a m e s saw. N o t just the bulb­

ous , fruit-like forms of the putamen and the g lobus pall idus, and

the flat-topped oval of the thalamus at the centre, or the

sweep ing , overarch ing curves of the fornix and the caudate. But

there, like bright clusters of je l lybeans, were the s u b c o m p o ­

nents of these structures: the pulvinar, the lateral geniculate

body, the dorsomedia l nucleus. He did not yet know the names

of these things, but he would .

Of course, it's a dream, he thought , I'm still asleep. But the

mundane objects of the ba th room s tood in their usual places

and on the sill w a s a copy of yes te rday ' s newspaper , just as he

had left it, a picture of a w o m a n smil ing on the front page . Wind

and rain beat agains t the w indow pane . He would seek advice

without delay.

S o , lit tering c rumbs of breakfas t toast as he went, J a m e s

g r a b b e d his hat (a g reen canvas one like anglers wea r ) , s lammed

the front door behind him, and set off for the medical centre.

O n e corner of the wai t ing r o o m w a s partit ioned as a chil­

dren ' s p lay area. I t w a s strewn with soft toys and plastic bricks in

p r imary colours . A small child sat in the middle , t ugg ing a string

from the back of a p ink doll .

' I ' m so happy, ' said the doll . T h e child chuckled as the string

slid b a c k inside.

All the while G r e g knew that, beneath the hat, his head was

still g l o w i n g like the aurora boreal is . And wouldn't that amuse the

child, he thought . He resisted the temptation, however, and was

soon called through.

72 •

I N T O T H E S I L E N T L A N D

73

' H o w can I he lp? ' said Dr Vesal ius .

J a m e s removed his hat. 'Wel l? ' he asked. ' H a v e you ever seen

anything like i t? '

T h e mult icoloured radiance seemed brighter than before . I t

shone like a halo. If Dr Vesal ius w a s shocked he didn ' t show it.

A true profess ional , he just leaned forward, p ress ing together

the tips of his fingers.

'Yesterday all was well , ' J a m e s explained. ' T h e n this m o r n ­

ing I wake up to find my head transparent and my brain a

f i r e w o r k d i s p l a y '

' I see , ' said Dr Vesalius. He said he would make a r r ange ­

ments for J a m e s to meet a specialist .

On the w a y out there was another child p lay ing with the dol l .

She pulled gr imly a t the str ing. ' I ' m so happy. I 'm so h a p p y . . . '

the doll kept saying , though the child w a s not amused . J a m e s

lifted his hat briefly, but it m a d e no difference.

* * *

What had caused those nightmares? T h e prev ious evening,

J a m e s had eaten a light supper and drunk no more than a finger

of whisky. Bored with T V , he had searched for something to read

and found an old illustrated encyclopaedia , which he took to bed .

Idly turning the pages , he came ac ross a picture of a rock

pool . He remembered i t well from his chi ldhood. T h e water w a s

clear as g lass . B lue-grey rocks thrust up th rough a bed of

smooth pebbles and sand towards a summer sky. A b o v e the

water-line there were barnacles bak ing in the sunshine, a few

limpets and whelks — snail-like things with curly shells.

P A U L B R O K S

74

Musse ls clustered and tumbled through the f i lmy surface of

the water and into the psychedel ic world below, which was

b r i m m i n g with all kinds of life: crabs and shrimps, s lugs and

starfish, sea anemones , spindly prawns , and gr im-faced little

f ishes dar t ing th rough the b ladderwrack and brown seaweed. I t

still fascinated him, still d rew him into the scene, but not quite

th rough the p a g e and into the water as before .

L o o k i n g at the picture now, through adult eyes, was oddly

dis i l lusioning. He had often walked a long the beach at low tide

and had yet to find a rock pool so stuffed with life and colour.

But i t wasn ' t just disi l lusionment. T h e r e was something else

equal ly unsett l ing. He closed the b o o k and w a s soon asleep.

In one d ream he found h imsel f tightly bound , head to toe,

scarcely able to breathe. Aware of a sl ight swaying motion, he

had the sense that he w a s l odged high in the branches of a tree or

suspended in a net of s o m e kind. T h e r e w a s a nauseat ing jolt,

and another, as if he were be ing d r a g g e d a long like coal in a

sack . O n e part icularly violent jerk pulled the binding from his

eyes and what he saw wrenched his gut .

Wha t had appeared to be the shadow of a black awning

turned out to be the bel ly of a mons t rous spider. He tried to

b reak free, but i t w a s use less and he w a s soon embraced by the

beas t ' s s laver ing maw. T h e r e w a s no pain, just warmth and

mois ture . As the b o n d s b roke he saw his own disintegrating

b o d y : his segmented b rown belly, his six trembling legs , the

m e m b r a n e s of his buckled wings . He called out, but his voice

w a s a twittering squeak .

A n d now this. J a m e s stared, without expression, a t the

mirror , then sank into an armchair . He felt inordinately weary.

* * *

I N T O T H E S I L E N T L A N D

It was dark when the doorbel l rang . A pastel g l o w fol lowed

J a m e s down the d ingy hallway, reminding him of the state of

his skull. He took the f isherman's hat f rom the coa t -hook and

placed i t on his head before opening the door . T h e r e s tood

Millie, in a swirl of rain and autumn leaves .

She had brought with her two b a g s full of b o o k s , which she

was now stacking up on the kitchen table.

' T h e s e are from the library, ' she sa id , ' a s reques ted . ' A m o n g

others, there w a s a medical textbook, an atlas of neuroanatomy,

and a mass ive tome called Elements of Cognitive Neuroscience.

'And this one I bought . ' She handed over a s l im paperback :

Neuroscience for the Brainless.

T h e y sat a t oppos i te ends of the so fa , Millie with a r m s

folded, J a m e s g r ipp ing the br im of his hat. She w a s look ing

away as she spoke: ' A l l right, keep i t on . ' Her cheeks were red.

After unpacking the b o o k s she had chased J a m e s a round the flat,

snatching at his hat. It was a g a m e at first, she thought , but then

he shouted at her to leave him a lone . T h e y sat in si lence.

'Okay , ' he sa id , ' I ' l l take it off.'

T h e delicate spray of light danced about his head and he

wondered why he should have been so coy with Millie. W h y

should she not see this mos t enchanted part of h im, this magica l

wellspring - the source of his thoughts , his hopes and beliefs,

and of his love for her?

'Well, ' she sa id , 'what w a s all the fuss a b o u t ? '

He might have been compar ing fossil spec imens or s emi ­

precious stones. ' T h e co lours are different, ' he noted, 'but the

shapes are the s a m e . '

75

P A U L B R O K S

76

Elements of Cognitive Neuroscience was propped up on the

kitchen table next to a shaving mirror. A picture of the brain

filled most of one page. Millie stood behind him, her eyes roving

from the picture to the face in the mirror to the top of James's

head. He watched her reflection looking down on to the shim­

mering surface of his cerebrum, her eyes wide, transfixed,

confused.

'I can see it's going to take me a while to find my bearings,'

said James, staring at his hand, but Millie had already left the

room.

Make a fist with fingers wrapped around thumb. This is the

brain. Palm upwards, the outer ridge of the forearm becomes

the spinal cord. It turns into the brainstem at the wrist. Now look

at the fleshy part leading up to the base joint of the thumb. This

is the hindbrain. The protruding base joint itself represents the

cerebellum, which is the most prominent feature of the hind-

brain. In reality it looks like a kind of vegetable outgrowth at

the brain's rear underside.

Moving upwards and into the tunnel of fingers, the shaft of

the lower thumb bone represents the top end of the brainstem.

This is known as the midbrain. Finally, there is the forebrain —

the upper thumb bone, hidden under the fingers, and the fingers

themselves. Each finger stands for a division of the topmost part

of the brain — the cerebral cortex. Starting with the index finger,

we have the occipital lobe (ok-SIP-itul), the parietal (puh-RYE-

etul), the temporal and the frontal lobe. The upper thumb bone

represents various forebrain structures that lie beneath the

cerebral cortex (the amygdala and hippocampus, for example).

I N T O T H E S I L E N T L A N D

There you have it. The gross anatomy of the brain — or half

of it. The brain is a double organ with two mirror image sides.

Put both fists together to get the full picture.

Bruno Aldaris, Neuroscience for the Brainless

T h o u g h it was plain to see that his brain w a s a physical mass ,

like a hand or a foot, J a m e s found the compar i son of brain and

fist mildly disconcert ing and soon returned to obse rv ing the real

thing.

I t was Mil l ie 's idea to go to the Chinese restaurant. J a m e s

wore a baseball cap.

'You need to get yourse l f out of yourself , ' she sa id .

T h e y drank white wine and J a m e s b e g a n to unwind. He even

squeezed her knee under the table.

' I t ' s go ing to be all r ight, ' he said on the w a y home . 'You ' l l

see . '

T h i s be ing a Friday, Millie s tayed the night, but w a s too tired

to make love .

* * *

T h e dawn light seemed to g r o w in s teps as i f the Ear th ' s rotat ion

had developed a fault. J a m e s lay l istening to the rain, d ipp ing in

and out of sleep. Millie lay bes ide him. He watched her d r e a m ­

ing through the blind saccades of her l idded eyes . H e r brain w a s

in darkness , but the d reams , no doubt , were as br ight as day.

He must have drifted off again because , next, he w a s aware

of the smell of fresh coffee. Millie had been out for cro issants

and newspapers . J a m e s didn ' t think his brain w a s a sight for

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78

the breakfas t table and remembered to put on his hat before

g o i n g th rough to the kitchen, but Millie, through a mouthful of

croissant , told him instantly to take it off.

She returned to her newspaper . He picked up the medical

textbook, scanning the list of contents as if reading from a

menu: Dementia; Cerebrovascular Disease; Hydrocephalus;

Epilepsy; Extrapyramidal Disease; Cerebral Tumours; Demyeli-

nating Diseases; Diseases of the Spinal Cord; Motor Neurone

Disease. T h a t ' s just Neu ro logy . N o t even half of Neuro logy .

T h e n there ' s Cardiovascular Disease; Endocrine Disease; Haema-

tological Disease; Gastrointestinal Disease; and Cancer.

He w a s impressed by the myr iad forms o f demise . G o d was

an inventive des t royer as well as an artful creator. It had never

occurred to J a m e s that the work ings of the b o d y could break

down in so m a n y w a y s . But his condit ion was nameless .

He had two mir rors now, us ing them in combinat ion for the

difficult s ide and rear v iews , and was t rying to match the text­

b o o k d i a g r a m s with the polychromat ic contours of the object

filling his head.

' I t ' s a beautiful machine, ' he said a loud , though there was no

one else a round. Millie had left him to it. ' O r is it a p lace? '

T h e b o o k s differed in emphasis . S o m e were concerned with

sys t ems and functions, others , especial ly the atlas of neuro­

anatomy, concentrated m o r e on the bra in ' s geography,

conjur ing s t range undula t ing landscapes . C o m b i n i n g the differ­

ent images , J a m e s pictured a metropol is , at once futuristic (full

of mys te r ious machines) and ancient (the Greek and Lat in

names evoked classical t imes) . Seen this way, his brain became a

labyrinthine structure with vaults and chambers , floors and

I N T O T H E S I L E N T L A N D

screens, columns, pa thways , b r idges , canals and aqueducts , with

streams of information flowing in every direction. Am I in there

or out here? he wondered .

'Am I out here or in there? '

First the thought, then the words . T h o u g h t . Speech .

Though t . Speech. Al ternat ing be tween the two, eyes fixed on

the image in the mirror, he noticed a pattern, an ebb ing and

f lowing of activity on the outer surface of the left frontal lobe .

As he spoke, the soft m a u v e luminescence seemed to harden

momentari ly into a brighter g laze that d i sso lved as the ut terance

s topped. L o o k i n g closer, he saw s t rands of light cas t ing back

and forth between the frontal area and the blue recesses of the

temporal lobe. A n d w a s that a fainter pu lse , deep down? Prob­

ably the thalamus, he thought, consul t ing the atlas.

Am I in there or out here? T h e m o r e J a m e s stared into the

mirror, the more perplexed he became . He began to feel

detached from his brain — a remote observer . It acquired the

aura of something alien, an object quite separa te from him. He

would concentrate on a patch of colour or listen to a sound

or perform an action or think a thought — Elephants are large

mammals. Six sevens are forty-two. Democracy is a good thing. I

love Millie — and there, plain to see , were the correlated brain

patterns.

But the activity associated with thoughts and act ions w a s not

the same as his consc ious awareness of those thoughts and

events. H o w could i t be? He w a s look ing in from the outs ide ,

like watching goldfish in a bowl . Goldfish and o n e ' s percept ion

of them are not the s a m e thing. T h e m o r e he gazed upon it, the

more J a m e s felt that he w a s someth ing other than his brain.

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80

A n d where do thoughts and feelings c o m e from? Not me, he

thought , because he saw that every fluctuation in the f low of

experience, every intention and action, w a s anticipated by d is ­

tinct t remors of activity ac ross the bra in ' s surface. It was not a

case of thinking or do ing someth ing and watching the brain

follow step or dance in synchrony. His brain was ahead of him.

Ideas were bubbl ing up in the neuronal cauldron a g o o d half-

second before they appeared in consc iousness , even thoughts

about thinking thoughts , and thoughts about thoughts about

thinking thoughts . So who w a s stirring the mental broth? A n d i f

he were a mere spectator, what exactly was his vantage point?

But then, just as a d rawing of a cube seems to change per­

spect ive , continually j umping inwards and outwards , he would

switch to a different view. T h e object in his head would absorb

and begui le him, and he wou ld identify more closely than ever

with its work ings . That's it, he thought. That's what I amount to.

This is my sum total. There is no one stirring the broth. The func­

tions of the brain have a life and logic of their own. Thoughts,

feelings, and intentions produce me, not the other way around.

He c a m e to the conclus ion that he was neither in there nor out

here. Bo th perspect ives were false. He wasn ' t anywhere.

In the evening J a m e s and Millie went to the cinema. J a m e s

kept his hat pul led firmly down. It w a s hardly the place to have

o n e ' s head blaz ing like a beacon .

* * *

A v a g u e curiosi ty d rew him back to the encyclopaedia . There

w a s someth ing w r o n g with the rock poo l , he was sure . T h e

I N T O T H E S I L E N T L A N D

plants, pebbles , and fishes were d isplayed as t reasured objects in

a g lass case , the exhibits separa ted evenly one from another in a

perfectly il luminated three-dimensional space . T h e artistry w a s

calculated. T h o s e beautiful things were intended to be m e m o ­

rable. He knew he would have no difficulty recogniz ing a rock

goby if ever he saw one, or a cushion starlet or a chameleon shrimp.

Yet, a l though the picture w a s c r a m m e d with information,

he could appreciate what w a s lacking. T h e r e w a s no sense of

process or behaviour , nothing of the s t ruggle for existence in the

world-between-t ides. O n e did not see the mons t rous d o g whelk

devour ing the barnacles or bo r ing into the shell of a mussel to

suck out its innards, or the invisible a lchemy of the seaweeds ,

absorbing sunshine, synthesizing foods from water and carbon

dioxide, releasing l ife-sustaining oxygen into the water.

T h e scene w a s altogether too benign . A rock pool is , in

reality, a precar ious place . To survive is to mesh with complex

networks of behaviour and intricate pat terns of phys ics and

chemistry, all shaped minutely by the ebb and flow of the tides

and the rotation of the Ear th . T h e life of the rock poo l is a

fragile product of the microscopica l ly small and the as t ronomi­

cally large.

But that was not it. I l lustrations only ever g i v e a snapshot .

He reached for one of the shiny new textbooks and set i t

a longside the encyclopaedia . T h e brain pictures were bright ly

coloured like the rock pool and, in the s a m e way, were con­

cerned with categorical clarity: this little fishy is the hippo­

campus, this the medulla, this the cerebellum. T h e creatures

f loated in suspension beneath the rippling surface of the cortex.

T h e f low of time had s topped. T h e r e w a s no hint o f dynamics

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P A U L B R O K S

82

at the mic roscop ic level or of forces in the world beyond

the b o u n d a r y of the skull, both of which shaped the activity of

the brain, just as the life of the rock pool was shaped by photo­

synthesis and the gravi tat ional influence of the moon .

I t w a s then that an uns teadying thought s w u n g into J a m e s ' s

head . He watched i t d rop from the frontal cortex and circle the

l imbic lobe . A brain, like a rock poo l , he realized, is a lso a most

precar ious habitat. T h e life of the se l f depends absolutely on

the integrity of brain function.

A n d then he saw what i t w a s about the rock pool that really

t roubled him. T h e r e w a s a creature he hadn' t noticed before, a

squat , sp idery thing, du l l -grey and ug ly compared to the rest.

It lay beneath a brittle star, part hidden by a curtain of brown-

weed and the c laws of a shore crab. T h i s little fellow didn' t figure

in the key. It d idn ' t have a number. Perhaps it had crawled

from behind a rock. Perhaps the picture had other dimensions

after all.

He looked at the mirror, into his brain. A n d there i t was , the

sp idery thing.

* * *

Dr S t roop ' s office on the fourteenth f loor of the Distr ict G e n ­

eral w a s a shambles . T h e r e were box f i les , case notes, books

piled all over the p lace , and cardboard boxes full of other stuff.

On top of the f i l ing cabinet, caught in a shaft of late afternoon

sunlight , w a s a plast ic mode l of the brain, somewhat larger than

l ife-size. Its co lours s eemed to f i l l the r o o m and J a m e s felt

uneasy sit t ing near to it.

I N T O T H E S I L E N T L A N D

' I f ind that mos t people try to ignore it,' he sa id , rol l ing his

eyes upwards , 'but i t must be of s o m e profess ional interest to

you . '

' O h , what ' s that? ' asked Dr S t roop .

' T h e colour cod ing i s much the s a m e as yours . Do you

mind? ' J a m e s lifted the plastic brain from its stand and ran his

f ingers over the surface. ' T h e frontal lobes are quite similar, and

the parietal, but my temporal lobes are blue and these occipital

lobes are a darker shade of green . '

He leaned forward for Dr S t roop to get a better view, but the

doctor didn' t seem very interested. Ra i s i ng his eyes , J a m e s

caught him looking at his watch. He wou ld have asked him

about the spidery thing — perhaps he wou ld be able to identify it

— but could see that he was well behind with his clinic and didn ' t

want to cause further delay. Br ing ing the consultat ion to a c lose ,

Dr S t roop muttered someth ing about 'd iagnos t ic inves t iga­

tions ' and said that a r rangements would be m a d e for a brain

scan. Hardly necessary in my case, thought J a m e s .

T h e next t ime they met, Dr S t roop had a s o m b r e look , but he

spoke kindly.

' D o you have anyone with y o u ? '

' N o , ' said J a m e s . T h e doctor asked him to sit down .

'We have your pictures, ' he said with an uncertain smile . He

slid a large square film under the clip of a wal l -mounted light

box and flicked the switch. T h e i m a g e of J a m e s ' s brain w a s

monochrome and murky, except for one feature. C o u l d that be

the spider, sitting p lump and bright in the middle? If so , i t had

been busy. Skeins of cobweb spread like the w ings of an angel ,

one into the right hemisphere , and one into the left.

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P A U L B R O K S

'Wha t i s i t ? ' sa id J a m e s .

'A butterfly g l i oma . '

T h a t sounded rather beautiful.

'A tumour. '

T h a t evening as he splashed water on his face, J a m e s noticed

someth ing in the pa lm of his cupped hand, or rather something

about it. It w a s the left hand. T h e skin w a s paler, like g reasep roo f

paper . T h e r e were shapes beneath: t racings of tendons, bones ,

and b lood vesse ls . He inspected the rest of his body. His a rms

and l egs looked f ine , as did his chest and abdomen. He turned

his penis left and right and lifted it to see the unders ide . He care­

fully checked the soles of his feet. Every th ing seemed normal .

T u r n i n g a w a y from the mirror, he looked across his shoulder

and saw that his lower back w a s translucent. Spinal column,

pelvic bones , and ribs were clear to see . A n d parts of the inter­

nal o rgans : s tomach , liver, intestines.

He w a s s truck by h o w densely packed they were , not f loa t ing

l oose like odd - shaped ba l loons as they somet imes appear in

tex tbooks . But the colours! T h a t couldn ' t be right: ice-blue

s tomach , c r imson liver, o range intestines, and the bones were

white as a ghost - t ra in skeleton 's .

I t d idn ' t s top there. T h e fol lowing m o r n i n g he sat once more

with his mi r rors and b o o k s . I t w a s odd that he hadn ' t noticed the

butterfly w i n g s before , but hav ing seen them on the brain scan

picture and k n o w i n g exactly where to look , he could now trace

their outl ine.

Butterfly glioma c a m e under Cerebral Tumours in the medical

tex tbook. T h e p r o g n o s i s w a s poor , but how fortunate he was

84

I N T O T H E S I L E N T L A N D

to have been spared the psychiatr ic s y m p t o m s that, accord ing

to the book , were often associated with such growths . Hi s

thoughts turned to Millie. An image of her face shone as br ight

as stained g lass in his m ind ' s eye . Where w a s that, exact ly?

Neither in there nor out here. A n d where exactly w a s Millie? Was

it days or weeks since he had seen her?

'Millie, where are y o u ? ' he called out.

' I 'm right here, J a m e s , ' came the familiar vo ice . He could see

her now, in the mirror. ' L o o k , ' she said . He saw beneath her

naked breast a beat ing heart, all bright co lours .

Millie faded. His reflection w a s all that remained. S ta r ing

hard into the mirror, his face somet imes a s sumed a sinister

aspect. With no discernible change in express ion, i t suddenly

f i l led with menace and contempt. He wou ld cover his eyes and

shake his head to break the spell. But this t ime he w a s s low to

react. T h e malice surged from the mirror and poured th rough

his helpless eyes. It breached the wall of the retina and hurtled

down the visual pa thways deep into his brain. He felt it. He

watched it all the way.

T o o late. He was gone . N o w there was no face in the mirror ,

or rather there were remnants of a face. T h e r e w a s nerve and

muscle , bone and cart i lage, l idless eyes and skinless l ips.

Abstract shapes . L igh t and shade .

He had searched in vain for a scintillating rock poo l . T h e

ones he found were bleak puddles compared to the picture in the

encyclopaedia. N o w J a m e s s tood naked a t the e d g e of the sea ,

the bones of his skeletal toes submerged in d a m p sand , his skele­

tal hand outstretched against white waves and g rey c loud , salt

spray fresh in his transparent nostrils. T h e chill of the water

85

P A U L B R O K S

l app ing at his ankles shot neuronal needles to his testicles, half

p leasure , hal f pain. He spread his fingers for inspection — white

b o n e , skin, musc le , veins — then bunched them into fists.

' I am J a m e s M o o n , the Visible Man! ' he said in a half-shout

that w a s swept away by the ocean wind the moment the breath

left his t ransparent l ips. ' T h i s is what I am! '

H i s thoughts leapt and curled within the folds of his brain.

Sharp as lasers , they were cas t ing shadows across the sky.

86

TWO

The Spark in the Stone

I Think Therefore I Am Dead

I am sitting alone in the small seminar r o o m on the tenth floor.

Th i s is known as ' H a r r y ' s r o o m ' . I am at the head of a l ong oak

table, working at a laptop computer . T h e d o o r is at my back and

the single window at the other end of the r o o m sheds a thin,

early evening light. T h e r e are glass-f ronted oak cabinets a long

the walls , left and right. On the shelves are rows of d isplay jars

containing specimens of human brain, each suspended in a

liquid the colour of watery p iss . T h i s i s H a r r y ' s collection. T h e

specimens are ar ranged accord ing to pa tho logy : tumours , ce re ­

brovascular d isease , degenera t ive d isorders , and so on. T h e r e

are whole brains, hal f brains, and parts of brain, sl iced and s e g ­

mented. C l o s e to my right shoulder, there swims a cerebel lum.

T h e r o o m is ineffably still. A m o n g the relics of natural

disease and degenerat ion sit three vic t ims of unnatural v i o ­

lence. Thei r stories intertwine. T h e f i rs t bra in w a s caught with

the second bra in ' s wife and was dispatched with a pistol shot to

the back of the head. After put t ing an end to its wife, the second

brain f inal ly dispatched itself. T h e w o m a n ' s brain, third in line,

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P A U L B R O K S

90

comple tes the set. He r s is perfectly intact. She go t it in the heart,

accord ing to Harry. I once told him I thought she might have

been better p laced between the other two, to keep the rivals

apart .

' E v e n in death, ' I sa id , ' you can sense their contempt for one

another. '

I t didn ' t seem to wor ry him. A n d , anyway, I wondered, what

w a s she do ing here? Her brain didn ' t illustrate a pa thology of

any kind. H a r r y ' s response w a s that she exemplified the normal ,

intact brain. He wouldn ' t concede that in displaying the speci­

mens in this w a y he had also created a tableau, showcas ing the

fickle heart as much as the fragile brain. Al l the same , it was a

tale he seemed fond of telling.

T h e material substance of the brain was bread and butter to

Harry, a neuropathologis t , but not to me . I remember the

ambiva lence I felt when I first held a human brain in the palm of

my hand, the fascination but a lso the distaste. I was surprised,

and m o v e d , by how heavy i t was . Perhaps a part of me had

expected it to be weight less , like a mental image or a train of

thought . I w a s eager to confirm for myse l f that the internal

s tructures matched the familiar textbook pictures but, s o m e ­

how, felt disinclined to start cutting. I imagined the wor lds it had

created: sky, c louds , peop le , p leasure , and pain. Everyth ing. I t ' s

all in there.

'I could be bounded in a nutshell and count myse l f a king of

infinite space , ' said Hamle t , 'were it not that I have bad dreams. '

T h e infinite space w a s within the shell of his head. A n d so,

inescapably, were the d reams . But looking around now at these

dead still, g r ey -be ige objects i t is hard to see them as erstwhile

I N T O T H E S I L E N T L A N D

progeni tors of infinite space . T h e y each represent the oppos i te :

a singularity. A point at which the universe has co l lapsed . I love

the stillness of this p lace and the hum of the void — the sense of

worlds dissolved and diss ipated pass ions . I t f i l ls me with a sense

of being. I am not yet pickled meat .

T h e light is fading and the pale amber sky at the hor izon

almost matches the colour of the l iquid in the jars . T h e r e is a

s ingle, bright star.

My area of supposed expert ise, neuropsychology , i s the s u b ­

ject about which I feel the mos t p rofound ignorance . I am

ignorant of many things. Fo r instance, I k n o w nothing of the

Russian l anguage . Q u a n t u m phys ics i s beyond me . Keynes ian

economics? T h e work ings of the internal combus t ion engine?

Irish political history? My knowledge consis ts of v a g u e not ions

poor ly unders tood , loose ly g ra sped general principles, and co l ­

lections of disjointed facts. But I could take lessons in Russ i an

and m u g up on Irish history and the other things. I will never

master the mathematics required for a p roper unders tand ing of

quantum mechanics, but I can appreciate someth ing of the

f lavour of the subject from the popular wri t ings of exper ts in the

field, and take comfort from the fact that, fundamentally, it

seems to be beyond them, too. But when i t c o m e s to under­

standing the relationship between the brain and the consc ious

mind, my ignorance is deep and there is nowhere to turn.

An ocean of incomprehension heaves beneath the tex tbook-

confident surface of plain facts and technicalities that I present

to my col leagues and patients. I have a clear picture of the m a t e ­

rial components of the brain and am prepared to ad lib at length

about features of its functional architecture — the interlocking

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P A U L B R O K S

sys tems and subsys tems of percept ion, memory , and action. But

quite h o w our brains create that private sense of self-awareness

we all float a round in is a mystery. I have no idea how the trick is

achieved.

Wouldn ' t i t be absurd for an airline pilot to deny knowledge

of the principles of flight, or for a physician to claim ignorance

of the bas ics of human phys io logy and ana tomy? Yet I , a neuro­

psycholog is t , can g ive no sat isfactory account of how the brain

genera tes consc ious awareness . W o r s e still, I f ind myse l f edg ing

towards a doubt that it means anything at all to say that the brain

genera tes consc iousness .

Hard ly anyone visits H a r r y ' s r o o m these days . The re are

small commit tee meet ings once a month and an occasional jour­

nal club. Otherwise , it is used as I am us ing it now, as a quiet

space for catching up with d ischarge letters and clinical reports.

I t w a s never u sed much for seminars and Harry, of course ,

doesn ' t c o m e here any more .

I ' ve been t ry ing to finish a report . T h e patient, Jeanie , has a

dement ing illness and seems to be rapidly fading away. She is

only f i f ty- three. I t ' s not Alzhe imer ' s , I 'm pretty sure of that, but

we have yet to c o m e up with a firm d iagnos is . I saw her this

m o r n i n g in a s ide r o o m . She had been shar ing a bay with five

other beds on the main neu ro logy ward until a couple of nights

a g o when she b e c a m e agi tated and began to develop delusional

ideas about the other patients. A nurse found her at three in the

m o r n i n g pack ing a case and prepar ing to leave.

' I don ' t want to cause trouble, ' Jeanie had said in a whisper,

'but I 'm not like the rest of them. I shouldn ' t be here. T h e y ' r e all

lesbians . '

92

I N T O T H E S I L E N T L A N D

T h i s morn ing she w a s cheerful. An order ly had just b r o u g h t

her a cup of tea. Her daughter , L i s a , w a s feeding her baby on the

other side of the bed . L i s a visi ted every day. We sat and chatted

with sunshine s t reaming through the uncurtained window.

Jeanie was happy, though increasingly preoccupied with

thoughts of death.

' I ' ve often wondered , ' she sa id , 'what happens , medica l ly

speaking, when you die . ' She wanted to k n o w the p rocedure

when a patient died on the ward . H o w could the doc to r s be sure

someone was dead? Where did the b o d y g o ? W h o took it?

'We have work to do, ' I sa id , 'shall we press o n ? '

First , I checked her orientation for t ime, p lace , and pe rson .

Fine . She knew who I was , where we were , the d a y of the week ,

and the month. She w a s quick to supply au tobiographica l infor­

mation and seemed fully aware of her current c i rcumstances .

Next , I began to p robe different aspects of mental function with

some standard beds ide tests. O n e of these w a s a verbal fluency

task in which she had to generate w o r d s with a des igna ted initial

letter. T h e first letter w a s 'F'.

'F i re , flag, funeral, ' she said. 'Will that d o ? '

'Tell me s o m e more — as m a n y as you can, ' I u rged her, bu t

the allotted sixty seconds ran d ry with nothing m o r e to show.

She managed just one word for 'A' and another three for ' S ' .

F r o m letter fluency, we moved on to categories .

' L e t ' s see how many different kinds of four - legged animal

you can think of,' I said, and Jeanie pinched the b r idge of her

nose . Ha l f a minute went by with no response . T h e baby, now

asleep in her carrycot , began to stir, then settled. I reminded

Jeanie of her task.

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P A U L B R O K S

' Y o u know, ' she told m e , ' I seem to be hav ing problems with

this one . Fou r - l egged animals? For s o m e reason I can only think

of three- legged animals . ' I noticed the trace of a smile on L i sa ' s

l ips, but her eyes were as dull as lead.

I realize that it might seem mad to quest ion the role of the

brain in consc iousness . T h e r e can be no doubt that brains and

sel f -awareness are in c lose al ignment. My brain and I are never

far apart , and I accept that I am sitting here, in Ha r ry ' s room,

with my l iving brain, consc ious and self-aware, whereas those

lifeless spec imens in the oak cabinets are not. I am thinking

thoughts , l istening, and looking . I can hear occasional sounds of

traffic from the street far be low and, unexpectedly, faint ripples

of harps ichord mus ic from somewhere a long the corridor. T h e

taste of coffee is still in my mouth and I feel the contact between

e lbow and table, knuckles and chin, as I lean forward to read the

text on the computer screen.

With consc ious deliberation I have been str inging words

together on the screen in front of me through the play of f ingers

on keyboard , intermittently catching and turning over unso­

licited, idle thoughts and images . (At one point , I f ind mysel f

h u m m i n g a B o b Marley tune. It drifts in from nowhere.) And

there, through the window, I see a star, a hundred million miles

away, but s imul taneously a lso in my head. Its image enters my

eye and f low-char ts through the visual sys tems of my brain,

f inds a link with m e m o r y and l anguage and, from outer space ,

ga ins a n a m e and a location in semantic space : 'Venus ' .

S o , d o e s consc ious awareness have a physical location: mine,

here and now, in H a r r y ' s r o o m , precisely somewhere between

my ears? Self-evidently, i t seems . But then, go into the skull;

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I N T O T H E S I L E N T L A N D

visit the bra in ' s interior work ings and you will find that there is

nothing much to see . N o t a spark of colour or whisper of sound

and no s igns of intelligent life. As you wander th rough this

silent land you can descr ibe its g e o g r a p h y adequate ly enough in

the third person , but, quite obviously , not the first.

F r o m this van tage point i t s eems self-evidently true that con­

sciousness does not have a part icular locat ion. It is no m o r e to be

found in the hills and dales of the frontal lobes or on the s lopes

of the Rolandic f issure than in the chair you are sit t ing on . T h e

more you search the terrain, the c loser your analys is of sub ­

stance and structure, the faster the wi l l -o ' - the-wisp recedes . We

are embodied , but nowhere traceable within the physical s t ruc­

tures of the body. I don ' t be l ieve in immaterial mind stuff or

souls detachable from bod ies , and I 'm not say ing that the brain

isn't necessary for consc iousness . Whether it is sufficient is

another matter.

Jeanie g rew tired of my tests. She w a s los ing concentrat ion.

In the middle of s o m e mental arithmetic, she s lowed to a s top

and I let her sit and stare for a while. L i s a w a s sitting back in her

chair, head resting agains t the wall , eyes c losed . T h e baby w a s

fast asleep. Hospi ta ls are never quiet, but you f ind pockets of

resignation and weariness where t ime itself s eems beca lmed .

T h e sounds of the outs ide wor ld are distant and abstract . We

each withdrew into our private wor lds . Jean ie , I a l lowed myse l f

to imagine , was roaming s o m e high plateau of bewi lderment in

pursuit of three- legged animals ; the baby w a s drifting content­

edly on a pond of mother ' s milk. But I did not p re sume to

imagine what L i s a w a s thinking.

Consc iousness is a puzzle . F r o m one perspect ive i t s eems that

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96

i t must have a physical location ( p e o p l e ' s pains and pleasures go

where peop le g o ) , yet, from another, the s a m e sugges t ion seems

faintly absurd . O n c e inside the head i t becomes clear that con­

sc iousness is not a ' thing' to be located. A n d even if we think of

it as a ' function' or a ' p roces s ' rather than a ' thing' , what sense

d o e s it make to say that the crucial elements reside in this or that

region of the bra in? N o r d o e s consc iousness depend in some

mys te r ious w a y on the integrated functioning of the whole

brain . I have seen many patients who, as a result of surgery,

injury, or d i sease have had much less than whole brains and they

seemed perfectly consc ious as far as I could tell. I 'm sure they 'd

tell you they were .

Fo r Wittgenstein, phi losophy w a s not so much about finding

solut ions to puzzles as about correct ing fundamental misunder­

s tandings . T h e phi losopher ' s treatment of a quest ion, he said, is

like the treatment of an il lness. O u r minds are knotted with mis ­

concept ions about the wor ld and the job of phi losophy is to

unravel the knot , or, as he sa id , to show the fly the way out of

the fly-bottle.

T h e r e w a s a t ime — before the b rash intrusion of cognit ive

science - when the 'm ind-body p rob lem ' lived quietly in the

clois ters of academic phi losophy, no trouble to anyone. T h e s e

days , the redefined f ield of ' consc iousness s tudies ' is a garden of

del ights , s w a r m i n g with phi losophers and scientists of every

str ipe. D e b a t e is lively, somet imes strident, and with the neuro-

scientists shout ing loudest of all above their noisy brain

scanners , mos t do not notice the f ly buzzing frantically to escape

the fly-bott le. T h e y are engrossed . H o w does the mental arise

from the material? H o w can subjective experience be reconciled

I N T O T H E S I L E N T L A N D

with that s o g g y m a s s occupy ing the skull? T h e y are full of con ­

f idence, too. Mos t of them expect a solut ion. T h e chimera of

consciousness rises like a vapou r and entices them to bel ieve

that it really is just a matter of t ime before a w a y is found of

accounting for subject ive, f irst-person phenomena in object ive,

third-person terms. Desp i t e the p rod ig ious amoun t of intellec­

tual energy that has been driven into this enterprise in recent

years , philosophical and scientific, i t s eems to me that the fly is

still stuck in the bott le.

Eventually, Jeanie sa id , 'Am I d e a d ? '

I didn' t respond immediately. L i s a ' s eyes remained c losed

and I let the silence flow. Jeanie smi led . Her face w a s lit with a

benign perplexity.

' I 'm just wonder ing , ' she said . ' H a v e I d i e d ? ' T h e r e w a s a

smear of toothpaste a round the corner of her mouth . She didn ' t

seem to notice the droplets of tea spill ing on to her d ress ing-

gown. But there w a s a glint in her eye. She w a s deve lop ing her

theme. 'In the middle of the night I w a s convinced, ' she sa id . ' I

thought they would come to take me away. N o , I wasn ' t afraid.

I waited to see what would happen. A n d then s o m e o n e did

come . It was a tall man. He just watched, and I tried to s ay s o m e ­

thing, but my lips wouldn ' t m o v e . T h e n the tall man left. He

didn' t say a word either.'

L i s a spoke. ' W e ' v e been through this before , M u m . You ge t

confused somet imes . You ' r e not g o i n g to d ie . N o t for a l ong

time. '

G iven the uncertainty of her mother ' s d iagnos i s this w a s , of

course , not necessari ly the case . Jean ie g a v e no indication that

she was listening.

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' I can ' t say for sure that I am dead, ' she continued, 'but things

are not the s ame . I don ' t feel real. It seems to me I might be dead. '

Her express ion d immed . ' H o w would I know if I was d e a d ? '

Jean ie w a s well oriented for t ime, p lace , and person. She

knew the day and the month, the n a m e of the town we were in

and the hospital , and she w a s clear about her name , age , and

address . As for be ing dead or al ive, she w a s all at sea. I wrote on

my notepad: Cotard's?

I once saw an old w o m a n who w a s profoundly depressed.

' B u r y m e , ' she said . 'You might as well , I 've been dead for

s o m e t ime. '

She bel ieved her insides had rotted away. I tried to reason

with her, bu t i t w a s useless . ' L o o k , ' I said, 'you ' re here talking to

m e . H o w can you b e d e a d ? '

' Jus t w o r d s , ' she replied. A wor ld of shadows f l ickered

a round her, human figures came and went, the curtains bil­

lowed , nights fell, d a y s b roke . But she felt no connection with

any of this. T i m e hol lowed her carcass and words fell dead at

her feet. J u s t words . T h a t w a s the f i rs t t ime I 'd come across

C o t a r d ' s s y n d r o m e , which is usual ly associated with severe

depress ion , but is somet imes seen in cases of neurological dis­

ease . T h e pe r son sinks into a nihilistic delusional state, often, as

in this case , to the extent that they bel ieve they no longer exist.

T h e condit ion takes its name from the French psychiatrist

Ju l e s C o t a r d who, in 1882, published a series of case studies

of peop le suffering what he referred to as le delire de negation.

T h e clinical presentat ion differed somewhat from patient to

patient, but de lus ions o f self-negat ion were c o m m o n . T h e s e

ranged from the bel ief that parts of the b o d y were miss ing or

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I N T O T H E S I L E N T L A N D

had putrefied, to the comple te denial of bodi ly existence. T h e

expressed belief that one is dead is not a defining feature of the

syndrome. In fact, of the eight ' p u r e ' cases repor ted by C o t a r d

(excluding a further three with concomitant persecutory de lu­

sions or other debilitating i l lness) only one embraced death as

an explanation of her condit ion. Others s l ipped into non-exis t ­

ence, or skirted the abyss , s o m e h o w defying the convent ional

understanding that ceas ing to exist mus t be tantamount to

death. T h e r e were even s o m e patients locked in the paradoxica l

state of denying their bodi ly existence yet at the s a m e t ime

bel ieving themselves to be immorta l .

What drives such s t range de lus ions? D e p r e s s i o n is usual ly a

factor, but is not a lways present . Jean ie , peer ing quizzically into

the void , is not depressed . Her case , at least , calls for a neu ro -

biological explanation. O n e possibil i ty is that the exper iences

arise from a disturbance of brain mechanisms which ordinari ly

bind sensation and thought to the neural sys tems under ly ing

emotion. T h i s ancient duty is per formed by the l imbic sys tem,

deep inside the cerebral hemispheres . A pr ime function of this

sys tem, an evolut ionary raison d'etre, is to create states of readi­

ness for action. I t d o e s this through the implementat ion of

so-cal led 'affect p r o g r a m s ' .

If your sensory sys tems inform you that there is a c razed-

looking man fast approach ing with an axe , your b o d y will enlist

the affect p r o g r a m identified with fear. Before you have t ime

even to experience terror, before the eye-bu lg ing , vo l tage su rge

of awareness, var ious physio logica l sys tems will have reconfig­

ured themselves in preparat ion for a response . Y o u will turn and

run. T h e thought ' I am terrified' will follow hot on your heels ,

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though , mos t likely, will have entered the past tense by the time

it catches up. 'I w a s terrified,' you will later recall.

But what is this 'I ' that c la ims the terror, and what is the 'you '

that reflects upon the experience? It is not a s ingle thing, or a

thing at all. It is , in its mos t primit ive form, a principle of b io ­

logical organizat ion. T h e affect p r o g r a m s , so this story goes ,

not only gu ide adapt ive interaction with the external world but,

as a by-produc t of this p rocess , they also form the biological

point of or igin of the self. By imbuing perceptions, thoughts,

and act ions with an emot ional hue (however pale) they g ive

cohes ion to experience.

Fee l ings are generated which form the bas is of our sense of

identity, creat ing the condit ions for ownership of thoughts and

for agency in the control of actions. T h e s e perceptions,

thoughts , wishes , beliefs, ut terances, and act ions are mine. I feel

it. The i r c o m m o n cause is centred upon my needs and mot iva­

tions, m a d e manifest through the affect p r o g r a m s of my limbic

brain. I feel I think, therefore I am. N o t e that this is merely a

functional descr ipt ion of the b iological roots of the self. D o n ' t

a sk where the feeling of the feeling c o m e s from; or the feeling of

the feeling of the feeling. Such quest ions tighten the knot.

B e y o n d this unelaborated , b iological core there are , of

cou r se , d imens ions of the se l f with a pas t and a future as well as

a raw present: in narrat ive te rms, the autobiographical self. In

C o t a r d ' s s y n d r o m e , however , the core has d isso lved . Cogni t ion

is decoup led from feeling and, consequently, thoughts and

act ions have no f ixed moor ings . T h e r e is no ' I ' left to claim own­

ership. It d is integrates ; the f ragments drift apart . O n e patient

bel ieved she had b e c o m e little more than fresh air: ' Jus t a voice ,

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and if that goes , I won ' t be anything. ' If the vo ice went she

would be lost and wouldn ' t know where she had g o n e , she said .

Jeanie became fascinated with her teacup.

' L o o k at this, ' she said . ' I s i t real? H o w can I tell? It doesn ' t

look real. ' She contemplated the object as if i t had just mater ia l ­

ized out of thin air, then her gaze turned to me . 'And what about

y o u ? ' she said. 'Are you rea l? '

I had s topped taking notes and sat , hands c lasped over my

head, ponder ing the innocent quest ion. 'Be l ieve me , ' I sa id , ' I ' m

real and so are you . Take my word for it.'

' I think I can trust you , ' she sa id , but she wasn ' t sure .

S o m e phi losophers (d ismissed by others as 'Myster ians ' )

a rgue that the 'problem of consc iousness ' exceeds human mental

capacity in the way that differential calculus or the concept of

democracy are beyond the intellectual s cope of a rabbit or a

pigeon. I find this v iew curiously comfort ing, but then I 'm m o r e

of a clinician than a scientist. In my trade, unlike science, incor­

rigible optimism can be counter-product ive. S o m e prob lems

have no solution. But if there is a w a y to untie this knot of knots

perhaps the f irst m o v e is to acknowledge that we are not only

physically embodied, but also embedded in the wor ld about us .

T h e mind may be local to the b o d y and the brain, but i t is also, in

different ways , distributed beyond biological boundar ies .

T h e notion of 'the extended m i n d ' has been ga in ing currency

in cognit ive science, but similar ideas were deve loped m o r e than

f i f ty years a g o by the Russ ian neuropsycholog is t A lexande r

Lur ia . For Lur ia , psychologica l phenomena were part o f the

natural world and so subject to the laws of nature, but he a lso

recognized that the structure of the mind has social d imens ions .

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102

He thought that scientific p s y c h o l o g y should be al igned with the

b io logica l sciences, but bel ieved that one could never fully

unders tand the relationship between the brain and the mind by

treat ing the brain as a c losed biological sys tem. T h e working

brain has to be unders tood not only as part of a larger biological

sys tem (the rest of the b o d y ) , but a lso as a component of the

wider social sys tem. What we refer to as the ' se l f ' is a product of

b io logica l and social forces ar is ing from the interaction of indi­

vidual , isolated, brains . T h e r e is no spark in a s ingle stone but,

s t ruck together, two s tones can start a blaze.

T h e chal lenge for neuroscience will be to fit the brain (a b io ­

logical object) and the self (a social construct) within a c o m m o n

f ramework of unders tanding. T h e brain sciences m a y have to

open up to a ' socia l p a r a d i g m ' . Far from be ing the Ho ly Grai l of

neurosc ience , the search for consc iousness within the circuitry

of an individual brain can lead only to fool 's go ld . Sant iago

R a m o n y Cajal (joint winner of the 1906 Nobe l Prize for his

w o r k on the structure of the neuron and one of the founding

fathers of m o d e r n neurosc ience) once said: 'As long as our

brain is a mystery, the universe , the reflection of the structure of

the brain, will a lso be a m y s t e r y ' We and the world are tightly

intertwined. T h o u g h we m a y not have a special place in the uni­

ve r se , the universe , as far as we can ever understand it, has a

special p lace in u s .

'I think I can trust you . I think. I think . . .' J e an i e ' s words

were s t rugg l ing for life. Her gaze drifted over the pale-blue

paint on the wall . 'I think I can. ' M o v i n g with a mother ' s g race ,

L i s a lifted the s leeping baby from the cot and placed the bundle

of blankets and pink f lesh in J e a n i e ' s a rms . Jean ie kissed her

I N T O T H E S I L E N T L A N D

granddaughter and began to weep . I t w a s t ime for me to go .

'Mum' s more herself after a g o o d cry,' sa id L i s a .

' T h a t makes sense , ' I told her.

Ju les Co ta rd died a t the a g e of forty-nine. He succumbed to

diphtheria after nurs ing one of his children to recovery. I recall

this fossilized fact of b iog raphy as I s tack my case notes . T h e

g low of the computer screen is now brighter than the sky and,

when the machine shuts down , H a r r y ' s r o o m is a lmost dark .

Paradoxically, as the g l o o m descends , the jars a long the wal ls

gain a kind of luminescence, as i f they have absorbed s o m e of

the receding light. My report is finished. T h e laptop lid c loses

with a satisfying click and I go ac ross to take a c loser l ook at one

of the brain specimens. I lean c lose to read the printed label:

Subarachnoid haemorrhage.

' H o w ' s it go ing , H a r r y ? ' I say.

How's it going, Paul?

Me?

There's no one else.

I was lost in thought.

What were you thinking about?

Noth ing much.

The immensity of the universe, the mystery of

consciousness, and the finality of death, no doubt.

Yes.

Fetch me a Gauloise!

103

I t wou ld be g o o d to cause a stink.

I'd love a cigarette.

I t mus t be torture.

Tell me more about the woman who thought she was

dead.

I ' ve nothing to add .

There's plenty more you could say.

But I 'm not g o i n g to.

Why not?

L e t the s tory stand. I t ' s truer to life. I don ' t

a lways k n o w the final ou tcome — and that applies

to Jean ie .

The diagnosis, at least. The prognosis.

H a s h i m o t o ' s d i sease . Uncertain .

So there was hope?

I t ' s an inflammation of the brain.

Vodka and Saliva

T h i s afternoon I d rove to the beach. T h e r e were no takers so I

went alone, or rather, i t w a s me and the d o g . A d o g is c o m p a n y

if you don ' t think about it too hard, which mos t ly I don ' t .

I t had blown up chilly by the time we go t there, but I s tr ipped

to my shorts and went in, caut iously at first. T h e water w a s

aggress ively cold. T h e only w a y to p roceed w a s not to think but

to act, so I instructed my b o d y to trot forward and dive into the

next wave . Dutifully, it d id , a l though I watched the approach ing

wave with trepidation. Under the water there is actually a

dull ing of sensation, as i f consc iousness i tself is momentar i ly

submerged in the thrum of the ocean, then it returns with full

force. I surfaced and rolled on to my back , g a s p i n g with the

cold, a rms and l egs dr iv ing the water, intensely aware of every

startled neuron. I w a s enveloped by sea and sky, but n o w felt

detached from both. T h e d o g paddled bes ide me showing no

signs of discomfort .

Descar tes bel ieved that d o g s , indeed all animals , are uncon­

scious automata . An animal sc reaming in pain is like the ch iming

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of a c lock. My faithful friend is a machine. Its fidelity is merely

reflexive. It doesn ' t feel the cold . Intr iguing, then, to learn that

the grea t m a n himsel f kept a pet d o g , Mister Scratch, of which

he w a s very fond.

'I k n o w that I exist , ' said Desca r t e s , ' the quest ion is, what is

this " I " that I k n o w ? ' He w a s quite sure the ' I ' that he knew was

not his body. ' I am not this a s semblage of l imbs, ' he said, but of

course he knew he was . Jus t as , a t one level, he must have

bel ieved that Mister Scratch had s o m e degree of conscious

awareness . He w a s far too clever to feel affection for an au toma­

ton, surely.

I might not be as clever as Descar tes , but I trust my intuitions,

and i t s eems to me that my b o d y is an important part of the ' I '

that I know. It is the physical appara tus over which I have direct

control , the thing I u r g e to dive into icy waters , the thing that

g o e s to w o r k and sees patients and g ives lectures. I never leave

h o m e without it.

My b o d y has certain boundar ies ( roughly defined by my

skin) , which g ive it a characteristic shape ; and as I steer it from

one p lace to another my thoughts and experiences go with it. I f

y o u are hav ing a bad t ime for s o m e reason and I say 'My

thoughts are with you , ' don ' t bel ieve me . My thoughts are very

much with me. A l w a y s . Bel iev ing that thoughts are displaced

from your b o d y or that other p e o p l e ' s thoughts can be inserted

into your head, is a s ign of mental illness.

My b o d y is, without doubt , a part of what I think of as my

' s e l f . I t ' s the part of my se l f that can be weighed and measured;

it casts shadows , and it has proper t ies in c o m m o n with other

physical objects like trees and fi l ing cabinets, cars , and planets.

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' B o d y is a port ion of the soul d i scern 'd by the f ive senses , ' sa id

Will iam Blake.

I have a s t rong sense that I am located in my body. I dr ive my

car to the beach and I dr ive my b o d y into the cold shock of the

waves . On the w a y to the beach I see h e d g e r o w s and trees f lash

by through the windscreen of the car and , trott ing into the

water, I see the waves and the sky as if f rom behind the wind­

screen of my eyes. I feel located in my b o d y and I identify with

it in other ways , too. Fo r example , if I see it a m o n g other bod ie s

pictured in a pho tograph I might say someth ing like ' T h a t ' s m e '

or ' T h e r e I am. ' I 'd say someth ing similar even about an old

photograph showing me as a baby, despi te the fact that the b o d y

bears no resemblance to the one I currently have .

I f someone passes my b o d y in the street they might , i f they

recognize it, offer a greet ing, us ing my n a m e . A n a m e is another

way we have of thinking about our se lves - a label to identify

our bodies and mark their act ions. ' T h a t ' s Paul over there, run­

ning into the sea . ' O n e can change o n e ' s n a m e , but not o n e ' s

body.

So , I feel I occupy my b o d y (there is no s t ronger intuition)

and, with that, comes a sense of ownership and agency. I t ' s

my b o d y and I control it. I make it do things. My b o d y a lso

contributes to my sense of continuity — the feeling that I am the

same person from one day to the next. W h e n I l ook in the mirror

each day I expect to see the s a m e thing, m o r e or less . I 'd be

surprised if one day I looked in the mirror and saw N e l s o n

Mandela or a w o m a n or a giant moth . I 'd be rattled.

Identifying the se l f with the b o d y seems reasonable enough ,

but there are s o m e prob lems . For example , the boundar ies of

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the b o d y are not so easy to define. H o w much a part of us are our

hair or our f ingernai ls? What about bod i ly f lu ids? What about

food? I pick a s t rawberry from a basket , I swal low it and

i t b e c o m e s incorpora ted into my body. At what point does i t

b e c o m e a par t of my b o d y and so a part of me?

As a student I had tutorials with the famous psychiatrist

An thony Storr . He w a s a relaxed teacher, very charming, and

I 'm sure I learned someth ing about psychotherapy. But all I can

recall is one of his thought experiments .

He asked us to cons ider how often we swal low our own

sa l iva . We do i t all the t ime, of course , without thinking. T h e n

he invited us to imag ine that, instead of swal lowing, we spat

into a tumbler. H o w wou ld we n o w feel about s ipping from a

tumbler full of our own spit? I t ' s the s a m e stuff, but no thanks!

N o t even with ice , l emon , and a la rge dash of vodka . W h a t ' s

the difference? A b o u n d a r y has been c rossed . As the ph i loso­

pher Dan ie l Denne t t puts it, once someth ing is outs ide our

b o d i e s i t b e c o m e s alien and susp ic ious , not quite part of us ,

some th ing to be rejected. T h e spit in the tumbler has

' r enounced its ci t izenship ' . Boundar ies and border controls are

important .

Dennet t a lso reminds us that the society of the human b o d y

has m a n y interlopers — bacteria , v i ruses , microscopic mites —

not all ' enemies within ' or even tolerated parasi tes . S o m e , like

the bacter ia in our gu t , are vital to survival . I identify with my

body, but not with any of these b u g s , or i tems of food pass ing

th rough my digest ive sys tem or, indeed, with any particular part

of my b o d y on a larger scale — my knees , my knuckles , the b lood

cours ing th rough my veins. I could lose an a rm or a leg or a pint

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of b lood and I would still be me . Perhaps i t ' s the idea of hav ing

a body that really matters .

I may feel that I inhabit and control a b o d y and that such feel­

ings are fundamental to my sense of self, but there are m a n y

features of my b o d y over which I have no direct control . I can ' t

s top the age ing p rocess . I can ' t s top it deve lop ing a tumour or a

degenerat ive brain d i sease , i f that 's what the genes dictate. A n d

there are mill ions of phys io logica l p rocesses g o i n g on inside me

that I scarcely know about , let a lone control .

A l though I can claim a better than ave rage k n o w l e d g e of

human biology, I have only a general notion of what my inter­

nal components are. Many intelligent peop le with a perfectly

functional sense of se l f haven' t a clue about what g o e s on inside

them. It is largely irrelevant to the everyday bus iness of be ing a

person. Jus t as when you drive a car you don ' t really need to

know how the engine works .

Even when you consider those things that we directly take

charge of, the activities of the b o d y through which we exercise

our free will (voluntary movements of the l imbs, f ingers, head ,

vocal apparatus , e tc . ) , even here, the degree of control i s s o m e ­

times so poor that we achieve effects in the wor ld quite oppos i te

to those we intend. T h e practice of decept ion is a case in point .

When people display express ions for emot ions they are not feel­

ing, or say things inconsistent with their actual state of mind

or their true beliefs, there are often counter -s ignals that g i v e

them away. T h i s applies whether we are ly ing or, for the best of

reasons, s imply t rying to g i v e a false impress ion to d i sgu i se the

true state of affairs.

Paul Ekman , a pioneer in the s tudy of emot ional express ions ,

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P A U L B R O K S

lists s o m e of these tell-tale s igns : ' a movement of the body,

an inflection to the vo ice , a swal lowing in the throat, a deep or

shal low breath, l ong pauses between words , a slip of the tongue,

a microfacial express ion, a gestural slip . . .' L i e s can be per­

fo rmed beautifully, says E k m a n , but usual ly they are not. A n d

then there are occas ions when we behave with perfect control of

our act ions, but our behaviour is , a t s o m e level, not what we

wish or intend. We act agains t our better judgement ; we yield to

temptat ion.

W h e n I finished that last pa rag raph I got up and went to the

lavatory. I have absolute ly no idea h o w I did it. I became aware

of an ' u r g e ' to g o , I s tood and found myse l f walking to the bath­

r o o m where , magical ly , effortlessly, I hosed urine into the toilet

bowl . D o n ' t ask me how. I take it for granted that I can just

' think i t and do i t ' . T h e co-ordinated neural , musculo-skeletal

and urogeni ta l activities involved in the enterprise of gett ing up

and g o i n g to the lava tory are incredibly complex. I just made it

happen. I have phenomenal control over neurobiological

p rocesses that no one in the world fully comprehends , and I

don ' t even have to think about it.

I t reminded me to make the point that even when we have

excellent control over our voluntary act ions, and at every level

intend to per form them, we still don ' t unders tand precisely how

an act of will ge ts translated into a complex sequence of b io log ­

ical activity (or vice v e r s a ) .

S o , we can see that the b o d y is an important feature of the

w a y we think about ourse lves - i t s eems natural to believe that

each of us owns a b o d y and that we have control over it. But we

can a l so see that i t is difficult to identify the ' s e l f with the ' b o d y '

110

I N T O T H E S I L E N T L A N D

as a whole (because the boundar ies are fuzzy) , or with any

particular part of the body. Fur the rmore , our control over our

bodies , and our unders tanding of the p rocesses involved, is

variable. Perhaps, as I say, i t ' s the idea of hav ing a b o d y that

really matters .

One might think that the face has s o m e special a l ignment

with the self. No other object projects such an aura of vitality,

and this vitality seems to come from within. F a c e s are points of

convergence between people ; where we seem to locate the

essence of another person , and where we tend to locate our­

selves: somewhere behind the eyes. In his novel Immortality,

Milan Kundera writes: 'Without the faith that our face expresses

our self, without that bas ic i l lusion, that arch-i l lusion, we

cannot live or at least we cannot take life seriously. '

Imagine i f someone you k n o w were suddenly to unde rgo a

radical t ransformation of his or her facial features. T h e y still

have a face, a regular one , but a different one . Is it poss ib le to

believe i t ' s the s a m e person? What i f they now look just like

someone else you know? Or what i f they resemble y o u ? N o w

imagine that person with no face at all. C a n you even think of

them as a person? Wha t is it you are thinking about?

We treat the face as an emblem of the self. It generates potent

illusions. Kundera might be r ight to say i t wou ld be hard to

function as a human be ing without embrac ing the emblem and

seeing the illusion. But it wou ld be a mistake to identify faces

with selves. T h e face is just another b o d y part . People with hor­

rendous facial disfigurements have no less a sense of se l f than

people who have lost an a rm or a leg . In s o m e respects , perhaps ,

their sense of self is intensified.

111

P A U L B R O K S

112

T h e face is just a f leshy structure animated by muscles

attached to the bony structures of the skull. I t contains informa­

tion about our identity (who we a re ) , our sex and our age (which

are important facets of the 'public s e l f ) , who and what we are

in te rms of the object ive, social facts of the matter. You can

think of these as 's tat ic ' features of the self in so far as they are

relatively f ixed and enduring.

T h e n , th rough changes in patterns of muscular activity

( ' express ions ' , ' g a z e ' ) , the face transmits s ignals about other,

m o r e dynamic , features such as our emotional state, our focus of

interest, and our immedia te intentions. T h e s e have a double

aspect ; part public , part pr ivate . You can use facial information

to make inferences about my mental state and behavioural dis­

posi t ions . To that extent the information is 'public ' because it is

there for anyone to see . But you can ' t know my thoughts and

feelings directly. You can ' t experience them.

We see and hear and speak through the face, creating the

impress ion that consc iousness , ' the stuff of the se l f ' , is concen­

trated there, even though there are no g rounds for bel ieving it

is really any m o r e ' t he re ' than in the right e lbow or the small

of the back . T h i s i s because there i s no ' se l f s t u f f ' to be located.

T h e r e is nothing in, or behind, the face except for organic

matter, and nothing to sugges t that the b iological material of the

head, as o rgan ic matter, has a greater propensi ty for 'self­

h o o d ' than the material stuff of other regions of the body.

T h e r e just isn't.

Trave l l ing in thought from the posi t ion of participant-

observer in the physical and social wor ld ' through ' the face and

into the machinery that lies behind we are transported, like

I N T O T H E S I L E N T L A N D

113

Alice through the looking g l a s s , to a very different wor ld . We

go from a bright place of pe r sons , se lves , and subject ive exper i ­

ence, to a dark, silent, enclosed, wor ld of phys ics , chemistry,

and bio logy. It is a myster ious journey.

Body Art

T h e r e ' s s o m e o n e here to see me . S h e ' s c o m e to talk about her

research project . S h e ' s looking for a P h D supervisor .

'H i , I 'm K a r a , ' she s a y s , drifting in like scented smoke.

' I ' m m o r e of a neuro man , ' I 'd told her over the phone. ' I 'm

not sure I can help. ' I tried to put her off. I said I knew s o m e ­

thing about b o d y - i m a g e changes caused by brain d a m a g e , and

self-mutilat ion in the mental ly disturbed, but nothing about the

cult of extreme b o d y modification. She wouldn ' t be deterred,

and here she is , open ing a folder to show me s o m e samples .

T h e thing that f irst catches my eye is a c lose-up colour photo­

g r a p h of a man with his t ongue hang ing out. T o n g u e s , a lmost .

It is split f rom the b a s e , g iv ing it a wicked, reptilian look. You

can a lmos t see it flicker. K a r a has a gl is tening stud in the middle

of her own tongue . I t ' s difficult to ignore once you notice.

T h e tone of the Informat ion Sheet is reassur ing. I t could be

from a pr ivate hospital b rochure . I learn that The most popular

method of tongue splitting is surgical. I m a g e s of D I Y enthusiasts

with razor b lades and sc issors rapidly fade. No th ing of the sort.

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I N T O T H E S I L E N T L A N D

T h e operation is quick and high-tech, performed by an oral-

maxiofacial (s ic) surgeon using an argon laser. T h e tongue is slit

in a single sweep, the laser cauterizing as it cuts. L o n g - t e r m side

effects are played down. T h e r e m a y be minor changes in s o m e

speech sounds , i t s ays , and, physiological ly , the number of taste

buds increases to cover the extra surface area. E l sewhere , a

woman reveals i t took about three weeks before she could eat

comfortably and control both tongues. No cla ims are m a d e for

the gas t ronomic or sexual advan tages of the split t ongue , but I

begin to wonder.

The re are many other images . S o m e are relatively mundane

(tattooed penises , nipple pierc ings , scarification, b rand ing) and

some bizarre, like t ransdermal implantat ion. K a r a shows me

pictures of men with objects inserted into the forehead or scalp.

T h e y look like Star Wars characters . I cast my eye over a report

on non-psychotic self-cannibalism (autophagy), and another on

apotemnophilia, which, I learn, refers to a c rav ing for a m p u ­

tation, somet imes satisfied through the services of qualified

surgeons .

B o d y art has filtered into the mains t ream. A l m o s t e v e r y b o d y

has a tattoo or a piercing these days . T h e s a m e g o e s for b o d y

modification: breast implants , nose jobs , l iposuct ion, anorectic

dieting, body-bui ld ing . K a r a condemns it all as a hopeless str iv­

ing for unobtainable ideals of conventional beauty and eternal

youth (the women in Vogue, the men on the cover of Men's

Health), culturally sanctioned and commercia l ly dr iven. S h e ' s

right, of course . Ex t reme b o d y modification, however , is the

antithesis. I t ' s about redefining the aesthetic, even the b o u n d ­

aries, of the body.

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P A U L B R O K S

'And what about c i rcumcis ion? ' she s ays as an afterthought.

K a r a , by the way, is distract ingly beautiful.

Search ing for c o m m o n g round , we skim across b o d y - i m a g e

dis tor t ions in neurologica l d i sorders such as epi lepsy and

s t roke. We discuss hysterical para lys is , phantom l imbs, and

t ranssexual ism. I tell her about anosognos i a , which means ' lack

of knowledge of i l lness ' . People with severe neurological d is ­

abilities — quadr ip legia , say — somet imes show a complete lack

of awareness of their condit ion. ( I remember once chatting

with a m a n who w a s para lysed from the neck down. He was

tell ing me about his p lans to go rock c l imbing at the weekend.) I

ag ree that ' b o d y i m a g e ' is a fascinating area for research, but

can ' t immedia te ly see a point of connection between Kara ' s

interests and my own. I tell her I'll think about it.

At h o m e , I s tand naked in front of the ba th room mirror. N o t

exact ly Men's Health, I think. What might a little b o d y art do for

me? I tell my wife I 'm thinking of hav ing my penis tattooed.

'Wha t do you have in m i n d ? '

'Wolverhampton Wanderers'

She looks at me . ' O r m a y b e just Wolves'

116

The Story of Einstein's Brain

Einstein: shock-haired and sockless genius , avuncular symbo l

of pure intellect, head in a whirlwind of equat ions and spiral l ing

galaxies , cultural icon. L o g o : E = m c 2 . Scientist , s a g e , humani ­

tarian, ambiguous pacifist, lousy husband, negl igent father, and

now, what ' s left of him, f ragments of brain in a jar.

N o t long after Einste in 's death in 1955, Ro land Bar thes called

his brain a mythical object , a paradoxica l conflation of man ,

magic , and machine. Nea r ly fifty years on, the myth remains

potent. To look at any brain is to confront a deep mystery. Y o u

fall into the frame of an imposs ib le picture, an Escher stairway,

ascending and descending a t the s a m e t ime. T h e brain can ' t be

the theatre of consc iousness — i t ' s a solid object — and yet it mus t

be because you are contemplat ing the scene on the f loodl i t s tage

in your own head. But , looking at pho tog raphs of Eins te in ' s

brain - snapped in the interlude between extract ion from

the cranium and decimation at the hands of Princeton H o s p i ­

tal 's duty pathologis t , T h o m a s Harvey — you feel the pull of

myth as well as mystery. It is difficult not to see the object

117

P A U L B R O K S

as a sacred relic. T h i s is the thing that bent the universe and

humbled t ime.

T h e r e w a s rumour and speculat ion about the brain from the

start: i t w a s huge and s t range , and then again i t was myster i­

ous ly tiny, the size of a walnut. In fact, it looked ordinary and

we ighed 2.7 pounds . A b o u t ave rage . I t w a s removed within

seven hours of death, we ighed fresh, then f ixed in formalin.

After i t had been pho tog raphed from all s ides, and measured

with call ipers, the cerebral hemispheres were separated and

diced into 240 blocks . T h e n the brain d isappeared . I t followed

H a r v e y into obscurity.

S o o n after the autopsy, H a r v e y had announced that E in ­

stein 's bra in would be used for scientific research and there was

a tussle for posses s ion between Princeton and N e w York ' s

Montefiore Medical Center . T h e y both lost out. Harvey simply

t o o k the pieces h o m e with him and s tored them in cookie jars .

N e v e r mind his lack of qualifications for the job (he was a clini­

cal pa thologis t , not a neuroscient is t ) , he would be the one to

unlock the secret of Einste in 's brain.

T h e pa thologis t w a s accused of a smash -and-g rab exercise

and, though H a r v e y a lways maintained he had acted on the

authori ty of Einste in 's executor, Ot to Nathan , not many

be l ieved him. Na than called him a thief and a liar and Harvey

eventually left Pr inceton under a c loud, al legedly fired for not

rel inquishing the brain. He vanished from the scene — but he

h u n g on to his cookie ja rs . In 1978 Harvey w a s tracked down by

Steven L e v y , a journal is t work ing for the New Jersey Monthly.

L e v y found h im l iv ing in Wichita , K a n s a s . T h e remnants o f

Eins te in ' s bra in were in a box marked Costa Cider.

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I N T O T H E S I L E N T L A N D

T w o decades later another journal is t turned up : Michael

Paterniti. T h e Keeper of the Brain w a s then well into his eight­

ies and l iving in a basement back in Princeton. Toge the r they set

off for Cal ifornia in a rented Buick Skylark with Eins te in ' s

brain stashed in the trunk, floating in a Tuppe rware container.

Paterniti wanted to explore rumours that i t might be c loned, or

sold to Michael J ackson for mil l ions of dol lars , but H a r v e y

wasn ' t say ing very much.

T h e y ended up a t the h o m e of Eins te in ' s g randdaughter ,

Evelyn , who seemed less in awe of the relic than anyone else .

Paterniti 's own reactions were complex . ' I never thought that,

holding Einstein 's brain, I 'd s o m e h o w imagine eat ing it,' he said

at one point. T h e n , at a seedy motel on the w a y h o m e , he slept

with it: ' I go to bed . I put Einste in 's bra in on one pi l low and rest

my own head on the other next to it, six inches a w a y '

What about the science? Was Einste in 's bra in in any w a y

extraordinary? Desp i t e H a r v e y ' s p l edge , no s tudy w a s con­

ducted for three decades after the contentious autopsy. By now

he had begun to mail bits of brain to prominent neuroscient is ts ,

people better placed than he to examine the material .

Four sugar cube-sized pieces arr ived at Marian D i a m o n d ' s

Berkeley office in a mayonnaise jar. She examined the cellular

structure of the specimens microscopical ly , finding an unusu­

ally high ratio of glial cells to neurons in the inferior parietal

lobe, an area known to be associated with mathematical and

spatial reasoning. N e u r o n s are the bas ic functional units of the

brain and the glia p rov ide the metabol ic and structural suppor t

required for them to do their work .

As for overall anatomy, the first s tudy appeared in 1999.

119

P A U L B R O K S

120

Sandra Wite lson of McMaster Universi ty, Ontario, had re­

ce ived, unsol ici ted, a p a c k a g e of brain pieces which she and her

co l l eagues set about we igh ing , measur ing , and compar ing with

other brains . A g a i n , the inferior parietal lobe s tood out as

unusual , be ing 15 per cent larger than normal ; and the Sylvian

f issure, which marks the temporal-parietal boundary, took an

o d d upward turn.

Such observat ions have been d ismissed in some quarters as

little m o r e than primit ive, bump-fondl ing phrenology. Einstein,

they say, would have been appalled by the crudity of the science.

I am not so sure . T h e r e is a picture of the Grea t Man undergoing

E E G bra inwave recording — his head an explosion of wild hair

and electrode leads — while he is be ing asked to 'think of relativ­

i ty ' . He w a s clearly g a m e for a laugh. A n d the b u m p at least has

a plausible location g iven Einstein 's mathematical p rowess and

what we a l ready k n o w about the organizat ion of brain func­

tions. It is something.

S o m e years a g o my y o u n g son and I were in a shoe shop in

C a m b r i d g e when in c a m e Stephen H a w k i n g in his motorized

wheelchair. No present -day scientist matches Einstein 's

celebrity, but H a w k i n g c o m e s closest . L ike Einstein he symbo l ­

izes pure intell igence. T h e shining mind in the shrivelled b o d y

has entered the popula r imaginat ion . I 've yet to see his wasted

shape on a T-shi r t or his m u g on a m u g , but he has appeared in

ep i sodes of Star Trek ( rubb ing shoulders with Einstein and

N e w t o n ) and The Simpsons. As Ro land Barthes remarks, be ing

turned into a car toon is a s ign that one has b e c o m e a legend.

T h e r e w a s a w o m a n helping him and they were looking at a

rack of cheap trainers. H a w k i n g didn ' t seem very interested,

I N T O T H E S I L E N T L A N D

though i t was hard to tell. My son went c lose up and stared and

I expected him to say someth ing indiscreet, but he lost interest.

T h e trainers he was eyeing were a cut above Hawking ' s . He w a s

not impressed , though I felt peculiar ly touched. T h i s w a s the

man who visited black holes from his wheelchair and surfed

event horizons. A n d he did so in T r u - F o r m trainers. Bar thes

would have liked that. I t would have signified someth ing .

A n d now Einstein 's brain is back at Pr inceton Hospi ta l .

Actually, not as such. It has a new owner, one Ell iot K r a u s s ,

pathologist . He keeps it in a jar somewhere secret .

They're perpetuating the myth.

Har ry?

I didn't mean to startle you. But they are, don't you

think?

T h e paradoxical conflation o f man , m a g i c , and

machine?

Quite.

Neurosc ience thrives on paradoxical conflations.

Conflat ing mind and matter seems paradoxica l to

most people .

Yes. It's hard to equate mental life with the sludgy

stuff of the brain. We should never lose sight of the

fact that the brain is a dollop of mush. I should

know.

O k a y - man, m a g i c , machine, and mush .

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P A U L B R O K S

But trying to explain the genius of Einstein by

measuring his bumps with callipers! It's phrenology.

T h e r e ' s only so much you can do. H e ' s been

dead half a century. His brain is all in bits.

I am thankful for small mercies.

122

Articles of Faith

neuropsychology: noun [mass noun] the study of the relationship

between behaviour, emotion, and cognition on the one hand, and

brain function on the other.

The New Oxford Dictionary of English

Articles of faith:

1. T h e brain is the o rgan of the mind.

2 . T h e mind is modular .

3 . T h e modular i ty of mind is reflected in the work ings of

the brain.

The brain is the organ of the mind. No one doubts that the brain

is the root of all behaviour and experience. If you b low out the

contents of a pe r son ' s head — as schoo lboys used to b low out the

contents of b i rds ' e g g s — you are , l ikewise, left with an empty

shell.

The mind is modular. Mental life is d iverse and divis ible . T h e

mind is not a monoli th . We dist inguish the colour of an apple

123

P A U L B R O K S

124

from its shape , weight , and texture as we lift it from the fruit

bowl ; and as we take a bite we separa te the snapping , crunching

sound from the taste of the juice . T h e n , looking back on the

exper ience , we seg rega te raw sensation from the images we

hold in memory .

Percept ion and m e m o r y are just two domains . T h e mind is a

much b roader confederat ion. T h e r e is also reason, emotion,

l a n g u a g e , mot iva t ion , and action. T h e s e facets of mind func­

tion independently, at least to s o m e degree . It is possible to find

malfunction in one doma in a longs ide normal operat ion in

others. An amnes iac appreciates all of the sensory dimensions

of eat ing an apple , but has no recollection of the experience an

hour later. T h e n aga in , s o m e o n e with diminished senses but

m e m o r y intact — a blind person , say — has no difficulty remem­

ber ing . N o n e o f this offends c o m m o n sense .

The modularity of mind is reflected in the workings of the brain.

Mental functions are b io logica l ly compartmental ized. Different

brain sys tems subserve different psychologica l functions. I t

fol lows that specified d a m a g e to the brain has predictable func­

tional consequences .

* * *

mind: noun 1 the element of a person that enables them to be

aware of the world and their experiences, to think, and to feel;

the faculty of consciousness and though t . . .

brain: noun 1 an organ of soft nervous tissue contained in the

skull of vertebrates, functioning as the coordinating centre of

sensation and intellectual and nervous activity . . .

I N T O T H E S I L E N T L A N D

125

self: noun (pl. selves) a person's essential being that

distinguishes them from others, especially considered as

the object of introspection . . .

The New Oxford Dictionary of English

A foreigner visiting Oxford or Cambridge for the first time is

shown a number of colleges, libraries, playing fields, museums,

scientific departments and administrative offices. He then asks

'But where is the University? I have seen where the members of

the Colleges live, where the Registrar works, where the scien­

tists experiment and the rest. But I have not yet seen the

University in which reside and work the members of your Uni­

versity.' It has then to be explained to him that the University is

not another collateral institution, some ulterior counterpart to

the colleges, laboratories and offices which he has seen. The

University is just the way in which all that he has already seen is

organized.

Gilbert Ryle, The Concept of Mind

T h e self has no locat ion, however natural i t s eems for us to

believe otherwise. Ry le w a s reconfiguring the ' m i n d - b o d y

problem' , the ancient mystery: how do mental events arise from

physical substance? His sugges t ion w a s that, contrary to the

assumptions of many phi losophers and psycholog is t s , i t w a s a

mistake to put mind and b o d y on the s a m e plane of analys is — a

'ca tegory mis take ' . Jus t as the s tranger could not find ' the

universi ty ' beyond the labs , offices, and p lay ing fields, so we are

hard put to discover any trace of a consc ious mind, or self, in the

P A U L B R O K S

126

brain. T h e r e is no ghos t in the machine. Minds are the product

of bra ins , and se lves depend upon minds , but they require dif­

ferent fo rms of unders tanding.

I am us ing a personal computer to type these words . T h e y

appear on the screen by virtue of the word process ing software,

essential ly a set of instructions installed in the computer. T h e

opera t ions of the software are realized through the hardware of

the compute r ' s electronic microcircuitry. Deta i led knowledge

of the hardware is of little help in unders tanding the software,

and vice versa . Both hardware and software are irrelevant to the

content of the text. I happen to be writ ing about minds , brains,

and se lves , but it could be anything — a gu ide to sea fishing, a

suicide note or a J a p a n e s e haiku. T h i n k of the brain as the hard­

ware , the mind as the software, and the self as the text on the

screen.

In fact, why not a haiku?

A true enigma:

The self looks inward and finds

Nothing hut neurons.

No m o r e haikus, I p romi se .

* * *

Like the symbol on a dol lar bill, my eye floats above a pyramid.

T h e four s ides of the pyramid represent the person, the mind,

the bra in , and the wor ld .

W h e n I 'm with a patient I 'm aware , at different t imes, of each

I N T O T H E S I L E N T L A N D

side of the pyramid . Mostly, my attention is d rawn to the person.

I t is a person who has come to see me or who is visi ted by me on

a hospital ward. It is a person who reports a s y m p t o m of s o m e

kind ( ' I 'm having problems with my m e m o r y ' ; ' I can ' t concen­

trate on anything' ; ' I b reak down in tears if s o m e o n e says a kind

w o r d ' ) . The re is a lways an ' I ' . A n d even when — especial ly

when — the 'I ' is de formed by injury or d i sease , when it is s u b ­

merged or dispersed and has no voice , I strive to make it visible

and coherent. T h i s is as much for my benefit as theirs.

A n d then I g lance across the plane of the mind. 'You ' r e

having problems with your m e m o r y ? ' I say. 'Tel l m e , in what

way does your m e m o r y let you d o w n ? ' I ques t ion and p r o b e ,

seeking clues to the nature of the p rob lem. I k n o w that memory ,

and therefore m e m o r y disorder , takes m a n y forms . I can use

special tests to help define and quantify the disorder . It is a lso

important to know whether other components of the pat ient ' s

mental appara tus are showing s igns of wear and tear.

T h e confederation of mental p rocesses we call ' the m i n d ' can

break down in w a y s not a lways evident to the pe r son whose

mind i t is. T h e y might complain of m e m o r y impai rment , but

unknown to them there could be other p rob lems : subtle changes

in perception, say, or reasoning or emot ion. I take note of their

symptoms , but all the while I am looking for other s igns .

Next , my gaze shifts to the third surface of the py ramid . T h i s

is when I consider s igns and s y m p t o m s in relation to the w o r k ­

ings of the brain. I might , for example , take certain failures of

memory to indicate a particular form of brain d i sease . Or , con ­

versely, I might u se knowledge of a pat ient ' s bra in d isorder to

guide my unders tanding of their psychologica l condit ion. My

127

P A U L B R O K S

You sound like an expert.

I am.

So you didn't mean what you said before:

that neuropsychology was what you felt most

profoundly ignorant about. It was a rhetorical

shimmy.

N o t entirely. I t ' s easy enough to clip definitions

and bas ic assumpt ions together. L ike I said, I

could ad lib about the structure and functions of

the brain - no prob lem. A n d , true, those Art icles

of Faith get me th rough the work ing day.

But?

T h e r e ' s someth ing quirky at the philosophical

centre o f neuropsychology . An incompleteness.

T h e Art ic les of Fai th sugges t an integrity that,

I fear, doesn ' t actually apply.

No science is whole. Physics hasn't got a Theory of

128

observa t ions are set a longs ide other forms of evidence, includ­

ing the physical invest igat ions of neurologis ts and surgeons ,

and the images m a d e avai lable via bra in-scanning machines.

T h e fourth s ide of the pyramid represents the world. Here , I

am concerned with how the person , g iven their brain disorder

and mental profile, can best adjust to the world around them.

H o w will they get by? For the person concerned this is, of

course , the only quest ion that matters .

Everything. Einstein died intellectually frustrated.

If any science arrived at a state of completion,

the scientists would lay down their tools. Job

done. And there are definitely strange things

at the philosophical heart of modern physics.

Why should you wrestle with doubt?

For all I know, physicis ts will one day formulate

their T h e o r y of Every th ing . But I 'm inclined

to think that our goal of descr ib ing mental life

in terms of brain activity is not entirely feasible.

I wonder if the enterprise is quixotic .

Why?

Because . . . O h , I don ' t know. Wha t w a s that

description of D o n Quixote? A muddle -headed

fool with frequent lucid intervals? G e t b a c k to

me when I 'm lucid.

But does it stop you doing your job?

N o .

Then why play The Knight of the Doleful

Countenance?

Have you read Cervan tes?

No.

Me neither.

I N T O T H E S I L E N T L A N D

Are you saying that the Articles of Faith are fine

as far as they go—but they don't go far enough?

Something is lacking?

My concern is that the Art ic les of Fai th d i s regard

some important features of mental life, which,

if we are ever to achieve a coherent science of

129

P A U L B R O K S

mind and brain, will either have to be brought

into the frame of neuroscience — or thrown out.

Such as?

T h e things that matter mos t to us : consc ious

experience and our sense of self.

Is neuropsychology concerned with such things?

Of course . I 've m a d e a l iv ing by virtue of the

fact that the brain is a very flimsy construction.

Its functions are easi ly warped by disease and

injury. T h e r e ' s no shor tage of tales to tell of

fragile brains and shattered selves .

Indeed.

T h e quest ion is, how best to tell them: as the

science of the brain or the art of be ing human?

T h e hidden contrapt ions of the illusionist or the

il lusion itself?

Surely, for a clinical practitioner, both perspectives

are necessary. Sometimes you are talking about the

brain, and sometimes about the person, the self,

consciousness and all.

O n e has to be bi l ingual , switching from the

l anguage of neuroscience to the l anguage of

experience; from talk of 'brain sys tems ' and

' p a t h o l o g y ' to talk o f ' h o p e ' , ' d r ead ' , ' pa in ' ,

' j o y ' , ' l o v e ' , ' l o s s ' , and all the other animals ,

fierce and tame, in the zoo of human

consc iousness .

Then you seem to have tied the package: brain and

person complete. Where's the strange philosophical

centre?

I N T O T H E S I L E N T L A N D

I have come to realize how deeply o d d it is to

assume that brains and selves converge .

You think they don't go together?

I think they don ' t go together in w a y s that

contemporary neuroscience would recognize .

But they go together?

What do you take me for?

131

Right This Way, Smiles a

Mermaid

Midtown Manhattan. T h e power w a s out. I s tood at the window

as veins of l ightning crackled over the Genera l Electric bui lding

a b lock away. Its giant , ga lvan ic throes were startling. T h e thun­

der rol led th rough my gu t as i t rattled the windows and humbled

the monumenta l architecture. A n d then, an ocean of rain. N e w

Y o r k w a s Atlantis . I could see f ishes and whales and mermaids .

W h e n the s to rm died the power w a s still out.

I lay on the bed , drifted into a s lumber and woke to find a girl

s tanding at the window, look ing out as I had looked out upon the

s to rm.

' D o n ' t be afraid, ' she sa id , still watching the rain, which was

gent le now. ' C o m e with m e . '

We left by a d o o r I hadn' t noticed before. I followed her

down dim-li t corr idors and ver t ig inous stairwells, then out into

the swir l ing street where a car w a s wait ing.

'R igh t this way, ' she smiled.

We were somewhere on the U p p e r Eas t S ide . I recognized

132

I N T O T H E S I L E N T L A N D

her at once, even in the g l o o m : Col l icula B r o d m a n n , President

of the Academy.

'Neurosc ience is a b road church, ' she sa id , 'but there is con ­

cern that you may be drifting towards Myster ianism. ' O u t the

window a blue whale d ipped majestically over Central Park .

' O h ? '

' T h e Discipl inary Counci l has received a complaint . '

I took the envelope and read the letter. I t accused me of

br inging my profess ion and the broad church of neuroscience into

disrepute (the s a m e phrase) on account of my anti-scientific

posture and espousal of Mysterian philosophy.

' D o e s this constitute a charge of s o m e k ind? ' I asked.

' N o , ' said Col l icula , 'but there are procedures . '

'Am I to be c h a r g e d ? '

' T h a t ' s a matter for the Invest igatory Panel . T h e y will first

consider your response . '

Th ree solemn f igures entered the r o o m .

'Now?' I sa id .

'Yes , i f you are wil l ing. '

I t was hard to tell who was speaking . T h e three were seated

in shadow s o m e distance away. T h e n the man on the left —

Number 1 — drew a candle to him and started to read from a file.

I recognized my own words : My area of supposed expertise,

neuropsychology, is the subject about which I feel the most profound

ignorance.

He looked up from the f i le . ' I g n o r a n c e ? '

'P rofound ignorance , ' I confirmed.

' I f I were a patient of yours , wou ld I be comfor ted to hear

your proclamat ions o f i gno rance? '

133

P A U L B R O K S

' P ro fess iona l s should acknowledge their limitations, ' I said.

T h e candle pa s sed to N u m b e r 2 , a w o m a n . She began reading

from her file. My w o r d s again: I find myself edging towards a

doubt that it means anything at all to say that the brain generates

consciousness.

T h e r e w a s a l ong pause which, perhaps , I was expected to f i l l .

' Y o u are a profess ional neuropsycho log i s t ? '

' Y e s . '

' H a v e you ever been certified insane? '

N u m b e r 3 w a s a man: Far from being the Holy Grail of neuro­

science, the search for consciousness within the circuitry of an

individual brain can lead only to fool's gold.

He w a s direct. ' Y o u bel ieve that the relationship between

mind and matter is unfa thomable . In other words , you are a

Myster ian. '

' N o . I wouldn ' t be so bo ld . '

'And yet you find comfort in Myster ianism. '

'I am a clinician. I have it ingrained in me that some problems

have no solut ion and that there are t imes when it is wise to

accept the fact. As Wittgenstein said, the phi losopher 's treat­

ment of a quest ion is like the treatment of an illness. But if the

d i sease is incurable, then so be it. I 'm comfortable with the idea

of not hav ing solut ions to every prob lem. I guess there 's a lso a

part of me that likes mys te ry for mys te ry ' s sake. Omniscience

wou ld be insufferably tedious . '

'And as far as consc iousness is concerned, the disease is

incurab le? '

' C o u l d b e . I don ' t know. I 'm indifferent to the mind-body

p rob lem. ' T h i s w a s not true; or rather i t w a s not the whole truth.

134

I N T O T H E S I L E N T L A N D

'Bu t do you, or don ' t you , bel ieve that neuroscience can find

the solut ion? '

' I 'm not sure neuroscience has even found the p rob lem, ' I

said. ' T h e fly is still s tuck in the bot t le . '

Coll icula offered me a g l a s s of wine. 'Wha t do you be l i eve? '

she asked.

'Noth ing , ' I replied. ' Some t imes I wonder " H o w d o e s meat

become m i n d ? " and i t s eems absurd . '

' Indeed. '

'Then , other t imes, I see it as a pseudo-prob lem, a screen of

confusion. . . '—I realized we were sitting at a table, eat ing dinner.

I had food in my mouth. I chewed and swal lowed before finish­

ing the sentence — ' . . . behind which there is an empty space . '

T h e food was g o o d . T h e wine w a s g o o d . Col l icu la , I now

noticed, was naked. So was I and, before long , we were mak ing

love; she writhed warmly beneath me on the g l a s sy f loor . T h e r e

was an aquar ium be low with sharks g l id ing and smaller f ishes

darting. How do I know this isn't a dream? I wondered .

N o w I was standing, naked, before the three so lemn figures.

I seemed to be g iv ing a presentation. I looked at N u m b e r 1 and

said: ' S o m e people bel ieve that the universe and every th ing in it,

including human minds , is m a d e of physical stuff.'

'Material ism, ' he said .

I turned to N u m b e r 2: ' T h e oppos i te v iew is that reality is

non-material; physical objects and events are manifestat ions of

mental ac t iv i ty '

' Ideal ism, ' she said .

' T h e y bel ieve the physical world is a f igment. T h e universe

exists entirely on a mental or spiritual p lane . '

135

P A U L B R O K S

136

' H m m . '

' S o m e vers ions of ideal ism don ' t deny the physical world,

bu t s ay we can ' t have direct knowledge of it. Objects and events

are mental construct ions because they come to life only in the

arena of the mind. '

' T h e unobse rved tree fall ing in the forest makes no s o u n d ? '

' Y e s . A n d there are no green leaves on the branches or dap ­

pled sunlight on the forest f loor . T h e creaking, crashing sounds

of a fall ing tree, the image of leaves and greenness , and notions

of sunl ight and dapp l ing are all construct ions of the mind. '

N u m b e r 3 w a s about to speak , but I cut him short. I had to

p ress on: ' T h e third opt ion is dua l i sm. Dua l i s t s bel ieve that the

wor ld is c o m p o s e d of bo th physical and mental stuff.'

' D u a l i s m is dead in the water, ' said N u m b e r 1. 'Modern

science has no place for dual i sm. '

' B u t intuitively it feels right, ' I added . ' E v e n to materialists

and idealists who reject the idea intellectually. Even to you ,

perhaps . ' He did not dissent . ' E v e r y normal person believes

they have a b o d y and mos t tend to think there is more to them

than that. T h e y feel they have mental qualit ies distinct from

their flesh-and-blood physical appara tus . Many people -

p robab ly mos t — bel ieve they have souls that will survive the

death of the body. '

' I h o p e you are not g o i n g to defend a bel ief in souls and

spiri ts , ' said N u m b e r 2 .

'Cer ta in ly not. '

N u m b e r 1 returned to his earlier quest ion: 'Are you a

Mys te r i an? '

' N o . '

I N T O T H E S I L E N T L A N D

' Then you accept that science will so lve the puzzle of con ­

sciousness; it is merely a matter of t ime? '

'And research funding, ' interjected N u m b e r 3, to the a m u s e ­

ment of the others.

' N o , ' I said.

N u m b e r 2 told me I w a s confused. N u m b e r 1 wondered

whether I had misheard his quest ions . I told him I 'd heard

him perfectly well but that, with respect, his ques t ions were s im­

plistic.

I knew what I wanted to say. I wanted to say someth ing about

the problem of consc iousness be ing built into science itself, but

I hadn't thought i t through and, suddenly aware of my naked­

ness, was los ing the thread of my argument .

' L e t ' s go back to Descar tes , ' I sa id , as much to myse l f as to

the others. I was looking for a w a y through.

'Must w e ? ' T h i s w a s N u m b e r 2 .

'Yes we must , ' I said. 'We must . '

I s trode over to where the three were seated, leaned forward,

and rested my e lbows on the table directly in front of N u m b e r 2.

' H e has a lot to answer for.' She smiled, rather sweetly I thought .

I reminded them that the mind -body prob lem, the beas t we

grapple with today, is a l egacy of the dualist ideas formulated

by Rene Descar tes in the seventeenth century. He w a s not the

first phi losopher to dist inguish between mind and body, but he

crystallized that distinction and so set the te rms of all s u b s e ­

quent debate about their relationship. In the p roces s he released

a pack of t roublesome dichotomies into the Western w a y of

thinking: mind versus matter; subjective ve r sus object ive;

observer versus observed.

137

P A U L B R O K S

138

' Y o u can ' t b lame i t all on Desca r t e s , ' said N u m b e r 3.

' O f cour se not, ' I said. 'Dual i s t ic thinking runs through

every major rel igion - they all p romote the fallacious idea that

b o d y and soul are separa te entities. '

N u m b e r 1 pointed out , correctly, that the idea a lmost cer­

tainly predates o rgan ized rel igion by many thousands of years .

He said i t went back to the dawn of human history. I agreed . In

fact, I bel ieved it w a s part of our b io logica l make-up. I said that,

quite probably , we were innately pred isposed to think in terms

of the separa t ion of minds and bod ies . T h e idea was built into

the hardware of the human central nervous sys tem.

Evo lu t ion has endowed us with brains that are naturally

inclined to certain w a y s of thinking about people , especially

when it c o m e s to interpreting their mental states. It was a conse­

quence of l iv ing in complex social g r o u p s , and a by-product of

the evolut ion of l anguage . We continually, and effortlessly, p ic­

ture each other 's thoughts and intentions. We form assessments

of what peop le 'have in m i n d ' - p resuppos ing that there are

such things as minds . We are all mind-readers . A n d the same

mental machinery enables us to form an idea of ourse lves as

unified and cont inuous be ings - to make sense of what is go ing

on with regard to our own mental states. People with impover­

ished mind- read ing skills (such as autistic peop le ) , or with rich

but unreliable interpretations of their own and others ' mental

activities (like schizophrenics) are severely d isadvantaged.

Wha t Desca r t e s did , in effect, was to take this primordial

intuition — the separa teness of b o d y and mind — and build a

sys tem of ph i losophy a round it. A n d the ideas he formulated

have b e c o m e ingra ined in our w a y of thinking. His division of

I N T O T H E S I L E N T L A N D

mind and matter, and the demarcat ion of subject ive and ob jec ­

tive realms of knowledge , laid the foundat ions of the m o d e r n

scientific age .

T h e mind-body problem and science itself s tem from the

same split in the fabric of reality. T h i s creates fundamental

problems for a science of consc iousness . Science p roceeds by

systematic observat ion and experimentat ion. T h e whole point

is to provide factual, public , knowledge about the wor ld as it is,

independent of personal feelings and opinions , s tr ipped of s u b ­

jectivity — in other words , to p rov ide objective knowledge. But

consciousness , in essence , is subject ive and pr ivate . I can i m a g ­

ine your experiences, but I don ' t have them, and y o u can never

have mine. Exper ience is a first-person bus iness . Science oper­

ates in the third person.

' S o , ' I sa id , ' consc iousness poses a forbidding chal lenge for

science. What makes science s t rong as a means of unders tand­

ing the outer, material world — object ive, third-person obser ­

vation — is precisely what makes it ineffectual when it c o m e s to

understanding the "inner wor ld" of consc iousness . '

'We can s tudy brain states and functions, ' said N u m b e r 3.

'S imply recognize that brain activity and consc iousness are one

and the same thing and the p rob lem g o e s away. '

' Somet imes I see it that way, and somet imes I don ' t . '

'Because you can ' t make up your m i n d ? '

' N o , because there 's more than one w a y of seeing. I agree that

every conscious mental event, each and every thought and e m o ­

tion, is g rounded in s o m e physical state of the brain. But there

are objective, third-person descript ions of the brain and its func­

tions; and then there are subjective, first-person experiences. '

139

P A U L B R O K S

140

'And never the twain shall meet? Is that what you ' re s a y i n g ? '

'Wha t I think I 'm say ing is that phenomenal consciousness -

the raw feel of experience — is invisible to conventional scientific

scrutiny and will forever remain so. I t is , by definition, sub­

jective — whereas science, by definition, adopts an objective

s tance. Y o u can ' t be in two places at once . You either experience

consc iousness " f rom the ins ide" (a p a n g of hunger, the blueness

of the sky, the chill of an autumn breeze , sunlight dappl ing the

forest f loor) or you v iew i t " f rom the ou t s ide" (var ious configu­

rat ions of neural activity and pat terns of behaviour associated

with different bodi ly states and condit ions in the external envi­

ronment ) . Science can s tudy the neural activity, the bodi ly

states, the environmental condit ions, and the outward behav­

iours — including verbal behaviours that stand for different

states of awareness ( " T h a t hurts"; " T h i s tastes like chocolate" ;

" M y heart leaps up when I behold / A ra inbow in the s k y . . . " ) ,

but the quali ty — the feel — of our experiences remains forever

pr ivate and therefore out of bounds to scientific analysis . I can't

see a w a y round this. Pr ivateness is a fundamental constituent of

consc iousness . '

N u m b e r 2 s ighed wearily. Suddenly, and uncharacteristically,

I felt a su rge of anger.

'And don ' t try to define it away! ' I shouted. ' D o n ' t tell me

consc iousness s imply doesn ' t exist in the material universe —

that there is just the brain and its functions — because , from

where I stand, it fucking does! A n d , unless you ' re a zombie or a

roo t vegetable , i t d o e s for you , too. '

I instantly regret ted my outburst . Aware again of my naked­

ness , I felt r idiculous. ( N e v e r ge t angry with your clothes off .)

I N T O T H E S I L E N T L A N D

But, I thought, that 's precisely the point. From where I stand.

Only I occupy my posi t ion. O n l y you occupy yours .

'Might there be a convergence of the subject ive and the

objective if we had a detailed knowledge of our brain states,

plus a more refined technical vocabu la ry to descr ibe t hem? ' It

was Coll icula speaking.

' N o , ' I said. 'Wordswor th could recast the descript ion of his

heart leaping up at the sight of a ra inbow in te rms of photons of

refracted sunlight s t imulat ing the cells of his retina, in turn

generat ing specific patterns of electrochemical activity th rough

his brain, in turn leading to st imulation of the adrenal g land , in

turn caus ing a fluctuation in the rhythm of his heart. I am not

convinced this takes us any further. It is still "h i s " eye , "h i s "

brain, and "h i s" heart that are the focus of interest, not those of

Keats or Co le r idge . I t is the v iew from where he s tands . He is ,

essentially, irreducibly, descr ib ing a personal point of view, not

a pattern of neural s igna ls . '

' I fail to see the relevance of poetry, ' said N u m b e r 2. So I

quoted another poet .

'Rober t Fros t said that "Poet ry is what is lost in translat ion. It

is also what is lost in interpretation." L ikewise , consc iousness is

lost in translating from first-person experience to thi rd-person

description of brain states. O n e can accept , as I do , that all

psychological activity depends on neuronal activity, and one

can chart the neural substrates of this or that psycholog ica l

process , but the poet ry of consc iousness has been lost in the

interpretation. '

'Brain activity and consc iousness are one and the s a m e

thing, ' said N u m b e r 3.

141

P A U L B R O K S

142

' Y e s , there ' s truth in that statement. '

'The re fo re , s ince neuroscience is best placed to describe the

work ings of the brain, i t is clearly best placed to g ive an account

o f consc iousnes s? '

' N o . I t doesn ' t follow.'

' I despair , ' said N u m b e r 2 under her breath.

' S o m e people have a rgued that consc iousness i s double

aspect , ' I sa id . 'It has an objective and a subjective s ide. It is

un ique in that respect and so can' t be treated in quite the same

w a y as other natural phenomena like c louds or flowers or

pebbles , which can be unders tood from a purely objective

s tandpoint . T h e r e is nothing mystical about subjective reality; i t

is just different f rom the object ive, science-friendly variety. It is

just as real, just as material , and has nothing to do with the kind

of immaterial mental stuff that Desca r t e s bel ieved in. Mental

events are based in physical events — the two coincide perfectly.

T h e subject ive and the object ive are different takes on the same

under ly ing reality. But the subjective realm is out of bounds to

science. '

'Are these your be l ie fs? ' N u m b e r 1 asked.

C o m e to think of it, I really wasn ' t sure , and the words

spilled out in the thinking: ' I ' m really not sure . '

' S o , what do y o u be l i eve? ' Col l icula demanded for a second

t ime.

I w a s about to repeat 'No th ing ' , which w a s , in fact, as c lose to

the truth as anything else I might have said, but I didn' t want

them to think I w a s be ing perverse ; and I didn ' t want to be there

all night. So I t o o k the easy opt ion. I p layed it straight down the

line.

I N T O T H E S I L E N T L A N D

' I am a materialist , ' I said. 'I bel ieve that the wor ld and every­

thing in i t is made of physical stuff and, whatever the or ig ins of

the universe, we are a natural p roduc t of its material evolut ion:

sentience, intellect, emot ions , mora l codes and all. All behav­

iour and experience, all knowledge and unders tanding of the

world and ourselves , depend upon the work ings of a physical

device: the brain. '

The re was a murmur of approva l .

' G o o d . Perhaps, after all, you are not a Myster ian. '

T h i s was a non sequitur. Myster ianism and mater ia l ism are

not mutually exclusive. But I let it pass . Perhaps I w a s , pe rhaps

I wasn ' t . W h o cares? At any rate, the three figures seemed

happy with my pronouncement . T h e y gathered their pape r s and

were gone ; oddly, though, I didn ' t see them leave.

Tha t could have been that; except now I found Col l icu la sit­

ting astride me , her face lit by the jade waters of the aquar ium

below.

'What do you really be l i eve? ' she asked.

'I meant what I said about mater ial ism, and I meant what

I said about subjective experience be ing beyond the reach of

science. But , in truth, I really don ' t have firm beliefs on the

matter. I look at the mind-body p rob lem one w a y and it s eems

to evaporate . I l ook at it another and I 'm tantalized. '

'Perhaps there 's m o r e than one p rob lem, ' she said . ' O r per­

haps you are more than one person . '

I was deep inside her now and couldn ' t care less .

143

T H R E E

No Water, No Moon

The Ghost Tree ( l )

I drive across town to the infirmary. J a k e is on one of the

orthopaedic wards . T h e beds are packed in rows a long the wal ls .

When I arrive his wife is at his beds ide . She looks about seven­

teen, a year or two younger than J a k e . T h e r e is no talk be tween

them - a bubble of silence. I get the impress ion there has been

no conversation for some t ime.

He is the image of Chris t on the C r o s s . Matted curls of b lack

hair drop over sunken cheeks. His forehead is b ru ised and

scabbed where a crown of thorns might have been and a bed

sheet, crumpled at his hol low midriff, serves as a loincloth. Hi s

lean, pale, upper b o d y bears other scars of the smash : b r o a d

purple grazes and yel lowing contusions . But a t the bo t tom of

the bed there is nothing. T h e implod ing metal of the car severed

one leg a t the moment of coll ision. T h e other, mang led beyond

redemption, was surgical ly r emoved in the hours that fol lowed.

If he is a car thief, then J a k e has paid a high price for his mi s ­

demeanours . Only now, as the bandaged s tump appears from

under the sheet, do I notice that his right hand is a lso miss ing .

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148

He g ives a handless w a v e to an old man in a wheelchair.

W h e n I p ick up the medical file from the nurs ing station the

charge nurse tells me of J a k e ' s disturbed behaviour. Yesterday

he w a s incontinent and smeared his faeces into his wounds . I am

not l ook ing forward to this. I feel cowardly. I want to turn and

go . But when we speak he i s perfectly pleasant. He seems com­

p o s e d , even tranquil . He puts me a t my ease . T h e pain i s

tolerable now, he tells me . Yesterday i t d rove him mad .

' W h e r e d o e s it hur t? ' I ask.

'Lef t foot , ' he says .

I run th rough s o m e routine quest ions about levels of con­

sc iousness and recall of events in the hours immediately

fol lowing the accident. J a k e can' t remember.

' H e was consc ious , ' s ays the child br ide .

' H o w can y o u be so s u r e ? ' I ask.

She knows because J a k e had activated the d ia l -home function

on his mobi le phone , perhaps adventi t iously as a result of the

impact or in a moment of lucidity. T h e r e was no one home when

the phone rang . T h e answer ing machine took the message and

s tored it until she returned next morn ing from her night shift at

the filling station. J a k e w a s call ing for her, wail ing like a baby.

I do my stuff and leave. I 've had enough . It is only four in the

afternoon and I 'm due to attend a meet ing later on, but I phone

in with an excuse and head for home .

It is a s u m m e r ' s evening, g r ey and overcast , perfectly still

except for a tiny plane d ron ing through low c loud , in and out of

visibility. There are people in there, I think, but only with an effort

of imagina t ion . F r o m this dis tance, who would care i f i t fell

f rom the sky?

I N T O T H E S I L E N T L A N D

I am sitting out in the garden and I mus t have dozed of f

because the student dissertation I w a s reading has fallen to the

g round , face down. My coffee is s tone cold . Evidently, I 've been

asleep for s o m e t ime.

I pick up the dissertat ion, which opens at a p a g e containing

images of a series of brain scans. I k n o w the pe r son whose bra in

this is. MJ17 says the capt ion, p rese rv ing anonymity, but I k n o w

her as M a g g i e . She is one of my research patients. I recall the last

t ime I saw her. It must be a couple of months ago . She greeted

me , as usual , like an old friend, taking both of my hands in hers

and gr ipping them w a r m l y for a g o o d minute. She took my a rm

as we walked down the hal lway and into her l iv ing r o o m . T h e n ,

while I 'm exchanging pleasantries with her husband , D o n ,

Magg ie touches my cheek. She really has no idea who I am. H e r

memory is a void . T h i s , and the lack of inhibition, is a result of

the disfigurement of her brain.

The re are blades of g r a s s on the p a g e from the freshly m o w n

lawn and the pictures of the brain have a kind of vegetable

quality. Figure 1, I read, Coronal T1-weighted magnetic resonance

images through the amygdaloid complex and hippocampal regions.

I am looking inside M a g g i e ' s head. She was p robab ly h u m m i n g

a tune to herself as these pictures were be ing taken. When she is

not talking she is h u m m i n g or s ing ing . D o n doesn ' t compla in .

T h e pictures are mos t ly grey. D e n s e material , like bone ,

shows up white. Darke r regions signify lower densi ty: the black

butterfly of the lateral ventricles, filled with fluid rather than

brain t issue; the shadowy recesses of the outer convolut ions .

L ike a cauliflower. L a r g e areas of the anterior temporal lobes

have been eaten away by the virus . T h e s e , too, show as black.

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P A U L B R O K S

M a g g i e w a s unlucky. T h e b u g — herpes simplex — is very like the

c o m m o n cold sore v i rus , but i t found a w a y into her brain. Then

aga in , s h e ' s lucky, too. L u c k y to have survived . D o n thinks so.

W h o am I to s ay she isn ' t?

Lit t le white a r rows have been super imposed on either side of

each picture to identify the reg ions of dark space normally

occupied by the a m y g d a l a and the h ippocampus : the almond

and the seahorse , vital components of the machineries of

m e m o r y and emot ion . The i r loss i s what makes M a g g i e inter­

es t ing for sc ience.

As a clinician I have a duty to be scientifically informed and

inquisi t ive. S o m e o n e sits before me in the clinic. T h e y have a

fault with their neural machinery and I need to appreciate its

characterist ics. T h e y speak of s y m p t o m s , I listen and look for

s igns . I hypothesize . I test and deduce . I refer, as needs be , to the

scientific literature. But I fail if, as part of this p rocess , I do not

a l so e n g a g e with the patient in an ordinary, human way. O n e has

to absorb s o m e o n e ' s personal concerns to understand their

predicament . It is , after all, the person who is ill, not the neural

machine .

T h i s af ternoon, with J a k e , I had found it difficult to maintain

the necessary ba lance be tween detachment and absorpt ion. D i s ­

pass iona te analys is had g iven w a y to emotional synthesis. T h e

mutilated y o u n g man with the phantom limb, his calm civility,

the devot ion of his y o u n g wife, the cutting desperat ion of the

m e s s a g e on the answer ing machine: i t w a s too potent a mix and

I w a s caught of f -guard .

A n d now I seek sanctuary in the sol i tude of my garden and a

retreat into sleep, science, and abstract ion — the dissertation: the

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I N T O T H E S I L E N T L A N D

soothing icons of a bug-ea ten brain. I t ' s an effective remedy.

H o w comfort ing to lose sight o f M a g g i e and contempla te

instead MJ17 .

It is get t ing dark now. T h e c louds have thinned and a crescent

m o o n is visible. At the bo t tom of the ga rden there is an apple

tree. It looks tired and forlorn. T h i s , instantly, is h o w I see it. It

is an old tree, bear ing fruit for the last t ime. I see not just the

fading shape of the trunk, the twist ing branches , the leaves

darkening in the g l o o m and the pa le , ha l f -grown apples ; I see

the age of the tree and its wear iness . I have in mind the sharp

taste of the fruit. T h i s is how i t appears to m e . A n d h o w do I

know it is bear ing fruit for the last t ime? Because I realize it is

not there at all. My brain has conspired with the fail ing light to

conjure a f leeting illusion of the tree from memor i e s of similar

grey evenings a year ago , before it w a s felled by a Feb rua ry ga le .

It is a ghos t tree, rooted only in thought .

* * *

I am in a church. It w a s once a church, anyway. N o w i t ' s a uni­

versity bui lding. I 'm here for a s y m p o s i u m and peop le are

milling around drinking coffee before the final m o r n i n g sess ion.

I keep an eye on the time because I 'm present ing a paper .

T h e p r o g r a m m e has reunited me with two co l leagues from

my pos tgraduate days . I haven ' t seen them for twenty years . We

stand in a triangle. Mundane facts of b iog raphy slot together as

planks in the conversat ional p la t form. We all have wives , and

children, and d o g s . Rick affects embarrassment . So bou rgeo i s .

W h y haven ' t we had m o r e interesting l ives?

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P A U L B R O K S

152

' Y o u don ' t like commitment , you get marr ied. You don ' t

want kids, they take over your life. You get a d o g , you ' re forever

s c o o p i n g shit into plast ic b a g s . '

S teve and I concur, but we don ' t mean it either.

S teve has been in the Uni ted States for ten years and his voice

fol lows mid-Atlant ic contours . ' I g u e s s the myth of romantic

love is where the rot sets in, ' he s ays , ' i f you let it.' L i fe and rela­

t ionships are m o r e r andom than we think but, in the end, most

of us fall into a pattern. With w h o m , i t doesn ' t much matter. I t ' s

the pattern that counts . ' I f you don ' t relinquish the myth, you ' re

b o u n d to be d isappointed . But if you don ' t bel ieve i t in the f irst

p l a c e . . . '

I c l imb the spiral s ta i rway to the upper lecture theatre. T h e

sun-filled, s ta ined-g lass window sends curves of purple, yellow,

and red a long the steel handrails . T h e hall itself is cool and

dark . I t f i l ls the higher reaches of the nave . My audience trickles

in. T h e r e aren' t m a n y and they scatter about the place like a

congrega t ion .

With a click of the m o u s e , a quotat ion rolls across the screen

behind me : We should take care not to make the intellect our god.

It has, of course, powerful muscles, hut no personality. Tha t was

Einstein. I t sets the tone of my talk, which is about how the

brain genera tes emot ions and how emot ions regulate social

behaviour .

T h e r e are structures for ana lys ing the geomet ry of the face,

and others for interpreting the mean ing of express ions . T h e s e

feed into sys t ems for decod ing p e o p l e ' s intentions and disposi ­

t ions, calculat ing their desi res and beliefs. T h e n there are

mechan i sms for select ing p r o g r a m s of action, for shifting gear

I N T O T H E S I L E N T L A N D

and manoeuvr ing the vehicle of the ' s e l f ' th rough the social

landscape.

T h e amygda la is a crucial component of the social brain. I t

acts as a control centre l inking higher cortical p rocesses , includ­

ing rational thought, to the m o r e ancient emot ional machiner ies

lower down. In particular, it is bel ieved to be involved in the

product ion of fear and anger.

On the screen now is a l a rge , m o v i n g , talking, ges tur ing

image of M a g g i e (aka M J 1 7 ) . She is hav ing a g o o d laugh with a

research assistant. T w o gir ls together. I t ' s M a g g i e back in her

twenties telling r isque stories about her b o s s . He w a s a one.

Somewhere , off-camera, D o n ' s gent le voice coaxes her back on

to safer g round . He doesn ' t want to cause embarrassment . I ' ve

set the v ideo in the w r o n g p lace . I intended to show M a g g i e and

D o n talking about their Spanish holiday. But at least the audi ­

ence can see she is not a cabbage . She is upbeat and animated,

eager for company. I'll have to tell the s tory myself .

T h e y ' d been out for a meal . T h e two b o y s leapt f rom

nowhere. T h e r e was shout ing and push ing . T h e y g r a b b e d

Magg ie . D o n w a s thrown back agains t a wall . O n e hand g r ipped

his throat, the other took his wallet. But D o n is a b i g man . He

fought back. He g a v e the boy a pound ing . A n d all the t ime, with

D o n ' s amygda lae trilling like fire bel ls , jol t ing his b o d y from

visceral fear to thrashing, mechanical anger, pupi ls di lated, car­

diovascular sys tem in overdr ive , b lood dra ining from gut to

straining muscles , fists like hammers - all the t ime M a g g i e

smiles benignly. T h e fluid-filled spaces in her head where the

amygda lae used to nestle are poo l s of tranquillity.

Back a t the hotel, D o n w a s still shaking. M a g g i e couldn ' t

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154

fa thom it. She thought the b o y s were just larking around.

So far, so g o o d . No amygda la , no fear. I t ' s a nice anecdote to

co lour the s tandard explanat ion of fear product ion: the cortex

perce ives , the a m y g d a l a interprets and t r iggers a response. But

then, b a c k h o m e , M a g g i e sits watching T V . I t ' s a soap opera .

T h e r e ' s a spark of aggress ion between two female characters,

nothing extreme or out of the ordinary. I t gets to her, though,

enough to swipe her breath, and start her heart thumping.

' N o , don ' t , ' she says . ' P l ease , no!'

Fear rises until the flesh of her face is pulled taut in a rictus of

terror. T h e anecdote now becomes a window of insight into the

true functions of the amygda l a . At any rate, that 's the way I

present it. Evidently, fear can be t r iggered without involvement

of the amygda l a . Its function is to perform appraisals of danger.

M a g g i e , minus a m y g d a l a , is obl iv ious to the real threat of the

m u g g i n g , but shows excess ive fear in response to an innocuous

T V p r o g r a m m e .

' Interest ing, ' s o m e o n e says , 'but only anecdotal . '

I have to agree . But I 'm all for anecdotes .

In his presentation Steve talks about his d o g . He grants the

animal a rudimentary sensory awareness, but nothing like human

consciousness . His wife and kids disagree. T h e y value emotion

over intellect. T h e y are convinced the d o g has feelings — primi­

tive and unarticulated but, at root, like ours . What perplexes

Steve is that he can't help behaving as if he believes this too.

' I g u e s s i t ' s my social brain, ' he says .

' I t ' s a s ign that you ' re human, ' I tell him.

* * *

I N T O T H E S I L E N T L A N D

155

M a g g i e ' s story appeared in an article I wro te for a magaz ine .

T h e m u g g i n g anecdote can also be found in the d iscuss ion sec ­

tion of a scientific paper I co-authored a few years ago , where

Maggie is referred to as ' Y W ' . A l though I think it g ives an

insight into the functions of the amygda la , as my critic in the

audience said, the evidence is only anecdotal . But evidence like

this would be hard to c o m e by experimentally, for practical and

ethical reasons. Clinical anecdotes are not only an invaluable

source of inspiration for m o r e systematic theoretical and exper i ­

mental studies, they are somet imes important in their own right.

Shortly after the s tory appeared in the magaz ine I received a

letter from a reader who, like M a g g i e , had quite recently suf­

fered herpes simplex encephalitis. I'll call him Anthony. It w a s a

remarkable letter. With An thony ' s pe rmiss ion , here are s o m e

extracts:

I continue to experience the two effects that you write about.

I have both the reduced sense of personal danger, and the

physical reaction to argument or conflict. On the one hand I

have become a risk-taker, e.g. dangerous jay-walking (and I

had a period of shoplifting), while on the other hand, I have to

leave a room (escape) if anyone raises their voice, even mildly.

I no longer watch TV because I cannot stand the 'tension' that

stories create . . .

An thony ' s combinat ion of ' fear lessness ' (or ' r eck lessness ' )

on the one hand, and over-sensi t ivi ty to mild conflict and d ra ­

matic tension on the other clearly resembles s o m e features of

M a g g i e ' s behaviour . Qui te likely there is a degree of over lap in

P A U L B R O K S

156

their patterns of brain pathology. This would not be surprising

since herpes simplex has a predilection for certain areas of the

brain (the temporal and orbitofrontal regions in particular). But

what distinguishes Anthony's account is how insightful and

articulate it is. Maggie would have had difficulty expressing her

thoughts in this way.

Then he went on to describe somewhat different symptoms

of a kind I hadn't come across before.

Thankfully, some earlier symptoms that directly linked words

and emotions have subsided. I used to 'feel' words. Whenever I

heard or spoke a word or phrase indicating a physical state, I

would automatically feel the state as well. So I know exactly what

is meant by 'gut-wrenching' or 'toe-curling'. It was very discon­

certing whenever people asked me whether I ever felt sad or hurt

or afraid. Not only had I felt these things - who wouldn't when a

virus starts invading your brain! — but I felt them equally

strongly every time I was asked.

A third set of symptoms concerned Anthony's ability to

communicate in face-to-face interactions with others. These

symptoms are reminiscent of those reported by people with

Asperger's syndrome or high-functioning autism. They are

intriguing in the light of current theories about the brain disor­

der that may underlie autism. A number of influential scientists

have implicated the amygdala.

I can no longer 'read between the lines' either, and I take

people's language literally - I get little clue from their

I N T O T H E S I L E N T L A N D

expressions. This can be hilarious, but is also very frustrating.

Luckily, I am currently living with Australian friends, who

value straight talking, so I have less trouble 'reading' them than

I do the typical contorted English relation between words and

feelings.

He elaborated on this in a subsequent communication:

Nowadays, finding it hard to distinguish levels of meaning

in people's words, I am very concerned that everything be

straight and true and meaningful - otherwise I do not under­

stand. Linked to this, I will tell anybody anything - what my

parents don't know about my previous sex life isn't worth

knowing!

. . . The virus ate my shame.

157

The Ghost Tree (2)

Char les could hear the su rgeons talking. O n e of them was

angry. T h e y were g o i n g to start cutting. T h e r e were fingers a t

his abdomen . Nex t , there would be a knife. T h i s couldn ' t be . He

mus t tell them: Don't cut! I'm still awake! Please, not yet!

T h e w o r d s fo rmed in his brain, but their p a s s a g e to the vocal

appara tus w a s b locked. He lay mot ionless and mute as the blade

sliced his f lesh. T h e pain f lung him from his body. L o o k i n g

d o w n on the scene from the ceil ing, he saw that the angry

su rgeon w a s still compla in ing about something. Char les felt

p rofound unease , not tranquillity or indifference, as some have

descr ibed . H o w w a s he to get back?

T h e experience left him with a post- t raumatic stress disorder

— flashbacks, n ightmares , panic attacks. N o w he was seeking

compensa t ion . Int ra-operat ive awareness is an acknowledged

p rob lem. Effective anaesthesia requires the judicious mixing

and matching of d r u g s to patients and condit ions. I t is not all

or nothing, like flicking a light switch. Different operat ive p ro ­

cedures demand different depths of anaesthesia, and patients

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I N T O T H E S I L E N T L A N D

vary in terms of their response . Currently, there is no whol ly

reliable method of detect ing awareness . T h e r e are bound to be

mistakes.

Perhaps one or two patients per thousand opera t ions are able

to recall events occurr ing dur ing surgery. T h e figures are higher

for obstetric and cardiac procedures , which require l ighter

anaesthesia. ( T h i s d o e s not include those who m a y be aware a t

the t ime, but who subsequent ly fail to recall .) But while intra­

operative awareness is a recognized complicat ion of surgery,

the out -of -body experience ( O O B E ) is not.

I didn't think it would help Char les ' s case . H e ' d be labelled

a fantasist, which would be unfair because O O B E s , too, are

relatively c o m m o n — around fifteen per cent of the general p o p u ­

lation admit to hav ing experienced one . I d idn ' t think that

Char les ' s soul left his b o d y — because I don ' t be l ieve in detach­

able souls — but I could fully accept that he had experienced a

frightening hallucination. T h e r e are many fo rms of intermit­

tent psychosis .

I spent my first term at universi ty l o d g i n g with a rather dour

working-class family on the outskirts of Sheffield. I'll call them

the Fancys , though their real name was less plausible . Mrs Fancy

fed me porr idge for breakfast . Somet imes I 'd ge t back late, the

worse for wear, and somet imes I didn ' t c o m e back at all. I think

she found me difficult. Breakfas ts were bleak. We didn ' t have

much to talk about .

Then one morn ing she started telling me about Aunt Judi th ,

how she was a lways we lcome to d rop in, of cou r se , but , dear oh

dear, how she picked her t imes. She had turned up in the middle

of the night again . T h r e e in the morn ing . Th i rd t ime this week .

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160

It w a s tiring, especial ly for Mr Fancy who was on the early shift.

Aun t Judi th w a s lonely. She would chat for an hour or so, and

then she wou ld go home . I said I hadn' t been disturbed, which

w a s true. I hadn ' t heard the doorbel l — or perhaps she had her

own key? Aunt Judi th had no need of doorbel l or key I was told.

She had a gift. She could project her spirit. A n d three times that

w e e k she had projected herself through the night air to the foot

of Mr and Mrs F a n c y ' s bed . She lived in Scot land.

A day or two later Mr Fancy raised the matter again . (I

wouldn ' t have dared . ) He knew I was in on the story.

' Y o u ' v e heard all about our Judi th , I gather. I t ' s a bit of a

nuisance, ' he said, and then carried on assembl ing his son ' s train

set on the f lowery carpet in front of the g a s fire. T h e four-year-

old lay supine . N o t h i n g m o r e w a s said .

Jus t before I left the Fancys I had an unsettl ing experience. I

w o k e in the early hours , aware of someth ing g lowing faintly in

the corner of the r o o m . My heart thumped an offbeat. When

I turned to look , it wasn ' t Aunt Judi th I saw but a Chr is tmas

tree. I 'd go t back late, let myse l f in, helped myse l f to a snack,

then g o n e straight to bed . I hadn ' t noticed a tree. H o w could I

not have not iced? I go t up for a c loser look . I brushed a branch

and caught the scent of the pine needles.

Re tu rn ing to bed I w a s soon asleep, but someth ing else d is ­

turbed m e . Perhaps it w a s vo ices in the street. I can' t remember.

But I do remember get t ing up to shut the window and noticing

that the tree had g o n e . It appeared from nowhere, then, silently,

it d i sappeared . It w a s there. I touched it. I could smell it.

I slept in. Winter sunshine filled the r o o m . T h e Chris tmas

tree looked splendid, red baubles and silver tinsel splintering

I N T O T H E S I L E N T L A N D

the light. So there was a tree. I tried to get up, but found I w a s

paralysed. I looked at my right a r m and willed it to m o v e . I c o m ­

manded it to m o v e . It s tayed put. When I tried to sit up or roll

over nothing happened. I panicked. On the inside I w a s a twist­

ing fury, but the shell of my b o d y remained mot ionless . I g a v e

up the s t ruggle , overwhelmed by an intuition that if I tried any

harder I would break through the shell and float away.

I c losed my eyes. T h e r o o m was still a b lock of sunlight when

I opened them again , but there was no tree.

I now recognize this as a lucid d ream, an hal lucinatory state

in the hinterlands of s lumber where the mind is alert, but the

body remains bound by the para lys is of s leep — the intersection

of dream life and reality. Perhaps intra-operat ive awareness is

like this. I t ' s happened several t imes since, and each t ime I found

mysel f restrained by the s a m e forceful intuition. N e x t t ime I'll

grit my teeth and let go .

* * *

N o t long a g o I was renting a cot tage on the e d g e of D a r t m o o r .

It was a Sunday afternoon and I 'd been work ing at a g l a s s -

topped table by the window. I w a s tired. I hadn ' t slept well the

previous night. N o w I s topped, transfixed by mus ic .

I often work to mus ic — usually Bach or Mozart . T h i s w a s

Bach; a partita for so lo flute, endlessly circl ing and c l imbing,

falling and rising, br ight lines of sound fi l l ing the air. Grea t

music cancels the distinction between the external wor ld and

our inner life. I was absorbed , but, also, i t w a s me who was

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162

absorb ing . I w a s at the centre of a machine of sound , but the

machine w a s a lso within m e .

I first saw the ge e se in reflection, through the smoked g lass

surface of the table, s w i m m i n g in a bronze pool of sky. The re

were three. I looked up at the w indow to watch them speeding

south-west under c louds that now looked unnaturally white and

patches of sky unnatural ly b lue . I felt d i sembodied . It was as if

I were inside the co t tage , si t t ing at the table by the window and,

at the s a m e t ime, f lying with the geese , high over the D e v o n ­

shire w o o d s and fields. I w a s dis located and distributed, just as

the gee se were s imul taneously in one place and another: out

there, and here in the wor ld beneath the g lass - topped table.

T h i s w a s not an ou t -o f -body experience. I t was not unpleas­

ant or d is turbing in any way. Subdued by fat igue, introverted by

sol i tude , e levated by the ext reme beauty of the music , my per­

cept ions and sense of se l f had been momentar i ly reconfigured.

O u r b o d y schema is surpr is ingly malleable . V. S . Ramachan -

dran and his co l leagues have devised s o m e simple exercises to

illustrate this fact. I somet imes use them to enliven dull lectures.

H e r e ' s an example .

Fi rs t , put on a blindfold and have s o m e o n e sit in front of you,

facing in the s a m e direction. T h e n let another person take your

right hand and start t app ing and s t roking the nose of the person

in front of you with your index finger, while at the same time

us ing their own left hand to tap and stroke your nose . I t ' s best i f

the tapp ing and s t roking alternate in r andom sequences, and

they mus t be synchronous — that is, a t a p / s t r o k e on the other

pe r son ' s nose must be matched by a t a p / s t r o k e on your own

nose . After a while, thirty seconds or so , you may begin to feel

I N T O T H E S I L E N T L A N D

that you are tapping your own nose at a r m ' s length, as if, like

Pinocchio 's , i t has g r o w n e n o r m o u s or is floating out there in

front of you.

I t ' s even possible to project sensat ions on to inanimate

objects. T r y this. You need a table and a friend. Sit with a hand

under the table, hidden from view, while your friend t a p s /

strokes the surface of the table and s imul taneously t a p s / s t r o k e s

your hidden hand. I t ' s crucially important that y o u don ' t see

what ' s go ing on under the table — that wou ld ruin the effect, but

as you watch your fr iend's other hand you should g radua l ly feel

the tapping and s t roking sensat ions ar is ing from the table itself.

When it works (which isn' t a lways ) , the effect is compel l ing .

You know at a rational level that the surface of the table is

beyond the boundar ies of your body, but that ' s not the w a y i t

feels. T h e phenomenal experience overr ides the rational ana ly­

sis. T h e table has been temporar i ly incorpora ted into your b o d y

schema. I t has b e c o m e part of ' you ' .

So , even on as fundamental a matter as where ' y o u ' are in

relation to your body, the consc ious , reflective se l f is easi ly

deceived.

I liked the story of the Christmas tree, she said.

Thanks .

Why do you call it a lucid dream? Perhaps it was

some other kind of vision.

'What other k ind? '

Hypnagogic imagery.

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P A U L B R O K S

O h .

Or do I mean hypnopompic?

T h e y ' r e both fo rms of dream-like imagery a t

the edges of s leep, when you ' re d ropp ing off or

wak ing up. H y p n a g o g i c i s when you ' re d ropp ing

off. But , anyway, no, i t wasn ' t either of those.

Don't most people fall asleep with random thoughts

and pictures floating through their mind?

I suppose they do

So what's special?

H y p n a g o g i c images are m o r e v iv id . T h e r e ' s

more clarity and detail. T h e y seem more

a u t o n o m o u s as well. T h e y have a life of their

own. I used to ge t beautiful, weird scenes go ing

through my sleepy head as a child — later, too,

on into my teens and early twenties. It rarely

happens now. I t ' s a pity. I miss them.

What did you see?

I t usual ly started with faces. T h e y loomed up

from nowhere . T h e first one a lways took me by

surpr ise . T h e y were quite ordinary, anonymous

faces mostly, but somet imes they would morph

into ga rgoy l e s or gobl ins . T h e y seemed real.

As bright a s television.

Just faces?

N o . Some t imes i t w a s m o r e elaborate — parades

of little peop le , all br ight co lours like a medieval

pageant . T h e y seemed to have a life of their

own. I t w a s fascinating, and totally beyond my

control . I used to watch the little people stroll ing

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I N T O T H E S I L E N T L A N D

by. T h e y a lways seemed to be g o i n g somewhere .

S o m e of them would be car ry ing packs o r

pushing carts. I w a s a spectator, on the sidelines,

watching from a dis tance. I knew they wouldn ' t

bother me . I wasn ' t really part of it. I couldn ' t

enter the scene. A l though somet imes i t did seem

like they 'd sensed my presence. O n e or two

would step outs ide the f low, c o m e c lose and

look directly towards me . But their eyes were

unseeing, like I w a s behind a one -way screen.

I could see them, but they couldn ' t see me . Yet

for a moment they sensed I w a s there. I had no

influence over the behaviour and appearance

of these creatures, or the wor ld they inhabited.

Where did they come from?

My brain, o f course . S o m e hidden corner o f

my mind.

Ah, hut which undiscovered territory?

T h e fascination for me w a s — still is — that this

s t range, nocturnal wor ld w a s the produc t o f my

brain and yet I had no consc ious control over the

shape it took. I remember once looking c losely at

a banner s o m e of the little fellows were car ry ing.

I t was beautifully embroidered , fantastic co lours

— most ly reds and go lds . A n d I thought I

couldn' t poss ib ly create someth ing so beautiful.

I was somet imes amazed by what I saw.

It convinced me that I w a s just one p roduc t

of my brain 's activity — a w a v e of consc ious ,

self-awareness on the surface of an ocean .

You needed convincing? I thought you were a

psychologist.

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P A U L B R O K S

Well, obviously , I knew that a lot of mental life

g o e s on be low the level o f awareness . T h a t ' s

or thodox cogni t ive psychology. A n d I know the

Freudian stuff, and J u n g . But these pictures put

abstract theory in the shade . I sp rang from the

s a m e source as the ga rgoy le s , the gobl ins and the

colourful pageants — the same brain — but I felt

no connect ion with them.

Do you think their little lives went on when you

weren't looking?

N o w , that wou ld be eerie. I 'd prefer to think

they didn ' t . I 'm sure they needed an observer

to b r ing them to life.

Perhaps we all do.

My brain conjured them up, and they required

a sol i tary spectator — me — but once the spoo l s

were rol l ing I p layed no part . Rober t L o u i s

S tevenson had similar experiences. He put them

to g o o d use . A lot of his stories were based on

d r e a m s or hypnagog ic imagery.

Which?

Jekyl l and H y d e , for one.

No, which: dreams or hypnagogic imagery?

Some t imes he seems to be talking about one,

and somet imes the other. F r o m what he says

about Jekyl l and H y d e i t was probably based

on a true nightmare . But at other t imes he seems

to be descr ib ing hypnagog ic stuff. He had this

technique for get t ing into hypnagog ic states.

S o m e t i m e s he would lie in bed resting his e lbows

on the sheets with his a rms point ing upwards ,

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I N T O T H E S I L E N T L A N D

poised to d rop i f he nodded off. T h a t w a y

he could drift into the h y p n a g o g i c wor ld and

stay alert enough to watch the show without

d ropp ing off completely. He talks a lot abou t

little people , too - the little peop le who run

the d ream theatre.

Did they wear medieval clothes?

N o , their cos tumes were G e o r g i a n .

And all this is different from lucid dreams?

I can't speak for others, but in my experience

lucid d reams and hypnagog ic image ry are very

different. H y p n a g o g i c images are realistic in the

w a y that v ideo images are realistic. Y o u can

observe them minutely, like when I looked c lo se -

up at the banner. T h e co lours were v iv id . I could

see the thread. But also, like a v ideo , y o u realize

you ' re not part of it.

And in a lucid dream you are?

For m e , lucid d reams seem absolutely real.

You ' re right there in the thick of it, and even

though you twig at s o m e s tage and start to

appreciate that i t ' s a d ream or hallucination,

and you beg in to think it th rough rationally -

even so , i t still s eems real. T h a t Chr i s tmas tree

was there in the corner of the r o o m as far as

I could tell. I went up c lose and touched it.

Had you been overdoing the jazz cigarettes or

anything?

N o . Or anything.

Were you scared?

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P A U L B R O K S

More perplexed than scared. Excep t for the

feeling of para lys is a t the end. T h a t w a s

frightening. You ' r e s tuck there power less and

you start to think anything could happen. T h e n

there ' s the feeling that you might just pop out

of your skin and fly out the window. I 've talked

to peop le w h o ' v e had full-blown out -of -body

experiences and s o m e of them descr ibe a

whoosh ing , v ibra t ing sensation just at the point

of depar ture . I ' ve had the s ame , but that 's where

I s t rugg le hard to s tay put. I t ' s a long t ime since

I had one of those d reams , but next t ime I really

might try to let go . I doubt it, though. I 'm a

coward . I 'm a lways too terrified by the thought

of not get t ing back . Discre t ion is the better part

o f valour .

But you don't really think it's possible?

I f you mean someth ing supernatural like my

soul s l ipping out of my skin and flying around,

no, I don ' t think i t ' s poss ib le . But the thought is

still terrifying. I don ' t bel ieve in ghos t s , but, on

ba lance , I 'd rather pitch my tent on a campsi te

than in a g raveya rd .

So you think it's possible in a different sense?

I think ou t -o f -body experiences are real

experiences, just like the phantom Chr is tmas tree

w a s real to m e . A lot of people say they have

them. But there ' s a natural explanation, like

there is for other i l lusions and hallucinations.

What is it?

I don ' t know.

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I N T O T H E S I L E N T L A N D

Where would you start to look for an explanation?

You could start with the phys io logy . T h e r e ' s

a pattern. It s eems to happen either in states of

low arousal or very high arousa l . I t can happen

— probably mos t often d o e s happen — just ly ing

in bed . But i t can also happen when the pe r son is

in mortal danger — hang ing over a precipice , say.

But , for me , the first p lace to start looking for

explanations wou ld be at the neuropsycholog ica l

level — analyse which brain sys t ems might be

involved.

So, what do you think?

I think i t ' s someth ing to do with distort ions

o f b o d y schema.

You mean body image?

N o t quite. B o d y i m a g e is how you as a pe r son see

yourself . I t ' s like a mental picture y o u have of

your own b o d y and i t ' s tied up to your feel ings

about it; your attitude towards it. B o d y schema is

more like the bra in ' s work ing model of the body.

And this can go wrong?

I t can go w r o n g in all sorts of w a y s . Obvious ly ,

there 's normal ly a tight relationship be tween the

b o d y and the self. You don ' t get one without the

other. But in s o m e w a y s the relationship is looser

than we tend to think. I t ' s quite subtle. I t isn ' t

that difficult to trick your brain and twist its b o d y

schema out of shape .

So when someone is having an out-of-body

experience the conscious, thinking part of them is

somehow dislocated from their body schema. The

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P A U L B R O K S

different brain systems have got temporarily

decoupled.

Someth ing like that. T h e b o d y schema and the

consc ious self are usual ly in synch. But at the

brain sys t ems level they can be separated to some

deg ree . T h e y ' r e d issociable .

It's plausible, I suppose. But a little prosaic, don't

you think? Much more exciting to imagine

disembodied sprits whizzing off to adventures on

the astral plane.

Exci t ing , but barmy.

By the way, I sa id , who are you?

But she w a s a l ready fading back into the lush darkness behind

my eyel ids.

170

The Dreams of

Robert Louis Stevenson

The past is all of one texture - whether feigned or suffered -

whether acted out in three dimensions, or only witnessed in that

small theatre of the brain which we keep brightly lighted all night

long, after the jets are down, and darkness and sleep reign

undisturbed in the remainder of the body.

Robert Louis Stevenson, 'A Chapter on Dreams'

I stood already committed to a profound duplicity of life . . .

both sides of me were in dead earnest. . .

Dr Jekyll

The Strange Case of Dr Jekyll and Mr Hyde (1886) , the classic

tale of a divided self, reflects s o m e of the mora l and intellectual

preoccupat ions of the Victorian era: g o o d versus evil; reason

versus pass ion; rel igion ve r sus science; civilization ve r sus

savagery ; order versus chaos — but w a s a lso bo rn of the doub le -

ness within its author, Rober t L o u i s S tevenson.

A world traveller and adventurer, S tevenson wro te the s tory

in the sedate Engl ish seas ide town of Bournemou th . To all

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P A U L B R O K S

appearances he w a s leading the sort of life he would previously

have despised: 'Respectabil i ty, dullness, and similar villas

encompassed him for miles in every direction, ' wro te his s tep­

son . But the outward i m a g e of bland respectability masked the

subvers ive machinat ions of his inner wor ld ; and here we have a

template for Jekyll and Hyde.

T h e s tory is prefigured in S tevenson ' s earlier life and work.

As a child he had been fascinated by the s tory of D e a c o n

B r o d i e . Wil l iam Brod i e (accorded the title ' D e a c o n ' as head of

a gu i ld ) w a s a respectable Ed inburgh cabinet-maker by day, but

by night w a s the leader of a g a n g of thieves. He was hanged for

his c r imes in 1788. T h e s tory so intr igued y o u n g L o u i s that, a t

the a g e of fourteen, he drafted a p lay about Brod ie . A later ver­

s ion, Deacon Brodie, or the double life, was published in 1879, and

per fo rmed in Bradford three years later. Its themes were day

and night, g o o d and evil, and the duali ty of human personali ty:

expos ing the depravi ty that might lurk beneath a veneer of

civility. Bol t ing the d o o r and d iscard ing his dayt ime garb,

B rod i e d e c l a r e s : ' . . . by night we are our naked s e l v e s . . . the day

for them, the night for me . '

As a y o u n g man eager to slip the gr ip of Calvinist ic conven­

tion in b o u r g e o i s Ed inburgh , S tevenson cultivated his own,

m o r e ben ign , duali ty of character. He and his friend, Charles

Baxter , ' a s sumed the l iberating roles of Johnson and T h o m s o n ,

heavy-dr inking , convivial , b l a sphemous iconoclasts , whose

sense of humour wou ld have been a little too s t rong for the

S tevensons ' Her io t R o w d rawing - room ' ; in which gu ise , ' they

could ful l -bloodedly enjoy those pleasures denied to Stevenson

and Baxter , and to Dr Jeky l l ' . ( I quote from E m m a Le t ley ' s

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I N T O T H E S I L E N T L A N D

introduction to the Oxford Wor ld ' s C lass i c s edition of Dr Jekyll

and Mr Hyde.)

But there was a deeper divis ion in S tevenson ' s psyche than is

revealed by g l impses of his chi ldhood obsess ions , the student

role-playing, and the subvers ive imaginat ion . I t t ook the fo rm

of a dissociation. Dissoc ia t ion is a psychiatr ic term that refers to

the splitting of mental p rocesses from mains t ream consc ious ­

ness. T h e separated part of the mind seems to maintain a life of

its own. In S tevenson ' s case the dissociat ion w a s evident in his

dream life, and in the important part that d reams p layed in the

creative process . He g ives a vivid account of this in the essay 'A

Chapter on D r e a m s ' , in which he writes about h imse l f in the

third person. In chi ldhood he had been 'an ardent and u n c o m ­

fortable dreamer. When he had a touch of fever at night, and the

room swelled and shrank, and his clothes, hang ing on a nail,

now loomed up instant to the b igness of a church, and now drew

away into a horror of infinite distance and infinite littleness, the

poor soul was very well aware of what must f o l l o w . . . sooner or

later the n ight-hag would have him by the throat, and pluck

him, s t rangl ing and sc reaming , f rom his s leep. '

T h e swell ing and shrinking, l o o m i n g and receding, are

examples of micropsia and macrops ia , pathological dis tor t ions

in the perception of the size or shape of objects which c o m e

under the generic head ing of 'me tamorphops i a s ' . Microps ia

refers to an i l lusory reduction in an objec t ' s s ize, mac rops i a

to the opposi te . I l lusions of this sort are often repor ted in

temporal lobe epilepsy, but m a y be exper ienced in other

neurological condit ions, including migra ine . T h e y can a lso be

caused by fever, as S tevenson ' s account sugges t s , and m a y

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P A U L B R O K S

174

be quite c o m m o n in chi ldhood in the absence of illness. I cer­

tainly remember hav ing such ep isodes as a y o u n g child. T h e

descript ion of things l o o m i n g up ' to the b igness of a church'

and then d rawing away ' into a horror of infinite distance and

infinite l i t t leness' captures the feeling quite brilliantly.

Many of S tevenson ' s chi ldhood dreams were far from fearful

or dis turbing. ' H e would take long, uneventful journeys and see

s t range towns and beautiful places as he lay in bed. ' T h e dreamer

(that is, S tevenson) had 'an odd t as te ' for the Georg ian period —

consistent with his interest in D e a c o n Brod ie — and this 'began to

rule the features of his d r e a m s . . . ' T h e n , as a student, he began

to dream in sequence , 'and thus to lead a double life — one of the

day, one of the night—one that he had every reason to believe was

the true one , another that he had no means of p rov ing false. '

O n e exhaust ing sequence o f recurrent d reams was ' enough

to send him, t rembling for his reason, to the d o o r s of a certain

doc tor ' . T h e d ream had him in a surgical theatre, 'his heart in his

mouth , his teeth on edge , see ing mons t rous malformat ions and

the abhorred dexterity of su rgeons ' . T h e n he would return to

his l o d g i n g s at the top of a tall bui ld ing on the H igh Street. At

least , he tried to return. Instead he found himself endlessly

c l imbing stairs to reach the top floor, his clothes wet, all manner

of peop le brush ing past him on their w a y down: ' beggar ly

w o m e n of the street, great , weary, m u d d y labourers , poor

sca recrows o f men , pa le pa rod ies o f w o m e n . . . ' When , f i n a l l y ,

he saw the light of dawn breaking through the windows he

would g i v e up the ascent, turn, and go back down to the street

' in his wet clothes, in the wet , h a g g a r d dawn, t rudging to

another day of monstros i t ies and opera t ions ' .

I N T O T H E S I L E N T L A N D

A n d then there came a turning point. He 'had l ong been in

the cus tom of setting h imsel f to s leep with ta les ' , but , he says ,

these were ' i rresponsible inventions ' ; tales told for the teller 's

pleasure that would not stand the scrutiny of a critical reader.

T h e y lacked all the important elements of g o o d storytel l ing,

such as plausible characters, a consistent structure, and a c o m ­

pelling plot.

His dreams, like mos t p e o p l e ' s , were ' tales where a thread

might be d ropped , or one adventure quitted for another, on

fancy 's least sugges t ion . So that the little peop le who m a n a g e

man ' s internal theatre had not as yet received a ve ry r igorous

t r a i n i n g . . . ' T h i s is his first mention of 'the little p e o p l e ' .

S tevenson 's d reams m a d e wonderful raw material for his

narratives and came to play an increasingly important role in his

creative life. T h e tales began to sell and, ' H e r e w a s he, and here

were the little people who did that part of his bus iness , in quite

new condit ions. ' A greater discipline w a s required. ' T h e stories

must now be t r immed and pared and set upon al l-fours, they

must run from a beg inning to an end and fit (after a manner )

with the laws of l i f e . . . '

Storytel l ing had b e c o m e a bus iness , not only for S tevenson ,

but also for the little people who ran the d ream theatre. But , he

says , they unders tood the change as well as he. 'When he lay

down to prepare himself for s leep, he no longer sough t a m u s e ­

ment, but printable and profitable tales; and after he had dozed

off in his box-sea t , his little people continued their evolut ions

with the s a m e mercantile des igns . '

O n e such dream story is descr ibed at length. I t is wor th

recounting in detail before hear ing S tevenson ' s appraisa l . He

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P A U L B R O K S

176

tells i t 'exact ly as i t came to h im' . T h e dream casts him as 'the

son of a very rich and wicked m a n ' , a landowner, whom he has

avo ided by l iv ing abroad much of the t ime. On his return to

E n g l a n d he finds that his father has taken a y o u n g wife, who is

treated cruelly. F o r reasons not entirely clear to the dreamer,

father and son agree that they should meet, but, through pride

and anger, neither will condescend to visit the other; so they

meet on neutral g r o u n d , 'a desola te , sandy country by the sea ' .

T h e y quarrel and, ' s tung by s o m e intolerable insult ' , the

younger man strikes the other dead .

A b o v e suspicion for the murder, he inherits his father's

estates and finds himself installed under the same roo f as the

widow. T h e two of them ' l ived very much a lone, as people may

after a be reavemen t ' , but shared meals , spent evenings together,

and g radua l ly deve loped a friendship. T h e n the atmosphere

changes . T h e dreamer senses that the w o m a n harbours suspi­

cions about his guilt . He d raws back from her company 'as

men d raw back from a precipice suddenly d i scovered ' . But the

attraction w a s now so s t rong that 'he would drift again and

again into the old intimacy, and again and again be startled back

by s o m e sugges t ive quest ion or s o m e inexplicable meaning in

her eye . So they l ived at c ross purposes , a life full of broken

d ia logue , chal lenging g lances , and suppressed pass ion . '

T h e n one day, he sees the w o m a n sl ipping out of the house.

He pursues her to the station and on to the train, which takes

them to the seas ide , where he fol lows her out over the sandhills,

to the ve ry site of the murder .

' T h e r e she b e g a n to g r o p e a m o n g the bents, he watching her,

f lat upon his face; and presently she had someth ing in her hand

I N T O T H E S I L E N T L A N D

— I cannot remember what it was , but it w a s deadly evidence

against the dreamer — and as she held it up to look at it, pe rhaps

from the shock of the discovery, her foot s l ipped, and she hung

at some peril on the brink of the tall sand-wreaths . He had no

thought but to spr ing up and rescue her; and there they s tood

face to face, she with that deadly matter openly in her hand — his

very presence on the spot another link of proof . '

T h e y return to the train a rm in a rm, journey h o m e and settle

to an ordinary evening. Conversa t ion has been kept to the triv­

ial. Al though the w o m a n was about to say someth ing after her

rescue, he had cut her short. N o w , expect ing her to denounce

him at any moment , ' suspense and fear d r u m m e d in the

dreamer 's b o s o m ' . But she does not denounce him. N o r does she

in the days to follow. In fact, her disposi t ion g r o w s more kindly.

In contrast, the dreamer, burdened with suspense , 'was ted away

like a man with a d i s e a s e ' . Unable to bear it any longer he

ransacks the w o m a n ' s r o o m while she is out. He d iscovers the

damning evidence a m o n g her jewels. A n d , as he stands hold ing

the object ( 'which was his l i fe ' ) in the palm of his hand, t ry ing to

fathom why she should have sought it, kept it, but never used it,

the door opens and the w o m a n enters the room.

' S o , once more , they s tood, eye to eye , with the evidence

between them; and once more she raised to him a face b r imming

with some communicat ion; and once m o r e he shied away from

speech and cut her off. But before he left the r o o m , which he had

turned upside down, he laid back his death-warrant where he

had found it; and at that, her face l ighted up. T h e next thing he

heard, she w a s explaining to her maid , with s o m e ingenious

falsehood, the disorder of her things. '

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178

T h e d ream story reaches its cl imax the fol lowing morning at

breakfas t . T h r o u g h o u t the meal she had ' tortured him with sly

a l lus ions ' but now, with the servants gone , he bursts from his

reserve and confronts her. W h y w a s she treating him so? She

knew everything. W h y did she not s imply denounce him? W h y

mus t she torture h im? He asks over and over. She , too, has

s p r u n g to her feet, pa le faced.

'And when he had done , she fell upon her knees , and with

outstretched hands: " D o you not under s t and?" she cried. " I

love you ! ' " At this point , 'with a p a n g of wonder and mercantile

del ight , the d reamer a w o k e ' . T h e story, he subsequently real­

ized, had 'unmarketable e lements ' , which is why he presents it to

us in this br ief form and didn ' t make more of it. But i t serves to

illustrate his point that the little people are 'substantive inven­

tors and per formers ' .

' T o the end they had kept their secret. [The dreamer] had no

g u e s s whatever at the mot ive of the w o m a n — the hinge of the

whole well- invented plot — until the instant of that highly dra­

mat ic declarat ion. It w a s not his tale; i t was the little people ' s !

A n d observe : not only w a s the secret kept, the story was told

with really guileful craftsmanship. T h e conduct of both actors is

(in the cant phrase ) psychologica l ly correct, and the emotion

apt ly g radua ted up to the surpr is ing cl imax. I am awake now,

and I k n o w this t rade; and yet I cannot better it. I am awake, and

I l ive by this bus iness ; and yet I could not ou tdo — could not per­

haps equal — that crafty artifice . . . by which the same situation

is twice presented and the two actors twice b rought face to face

over the evidence , only once it is in her hand, once in his - and

these in their due order, the least dramatic first. T h e more I think

I N T O T H E S I L E N T L A N D

of it, the more I am moved to press upon the world my question:

Who are the Little People? T h e y are near connections of the

dreamer 's , beyond doubt; they . . . share plainly in his training;

they have plainly learned like him to build the scheme of a con ­

siderate story and to ar range emot ion in p rog re s s ive order ; only

I think they have more talent; and one thing is beyond doubt ,

they can tell him a s tory piece by piece , like a serial , and keep

him all the while in ignorance of where they a im. '

Stevenson concedes that the Litt le People (or ' m y Brownie s ' )

do half his work for him while he s leeps . He a lso speculates

that they might well do the rest for him as well , when he is

wide awake. T h i s is a cur iously m o d e r n insight, in line with

current views on the importance of unconsc ious p rocesses in

cognition.

'For myse l f — what I call I , my consc ious ego, the denizen of

the pineal g land unless he has changed his residence since

Descar tes , the man with the conscience and the var iable bank-

account, the man with the hat and the boo t s , and the pr iv i lege of

vot ing and not car ry ing his candidate at the general elect ions —

I am somet imes tempted to suppose he is no story-teller at all,

but a creature as matter of fact as any cheesemonger or any

cheese, and a realist bemired up to the ears in actuality; so that,

by that account, the whole of my published fiction should be the

single-handed product o f s o m e Brownie , s o m e Famil iar , s o m e

unseen c o l l a b o r a t o r . . . '

S tevenson wonders whether his role might best be under­

stood as an adviser and enabler; he edits the s tories; he dresses

them in his finest p rose ; he per forms the labor ious task of sit t ing

at the table and writ ing the words down; and he prepares and

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180

delivers the manuscript . But can he, he wonders , actually claim

to be the author of the stories?

T h e s tory of Jekyl l and H y d e a lso has its or igins in a dream.

S tevenson had for s o m e t ime been t rying to find a vehicle to

explore 'that s t rong sense of m a n ' s double be ing ' . As well as the

p lay about D e a c o n Brod ie , he had already written a s tory with

that theme, The Travelling Companion, but this had been

returned by an editor on the a m b i g u o u s g rounds that it was a

'work of genius and indecent ' . S tevenson was not happy with i t

either — he d i sagreed that it w a s a work of genius — and

des t royed the manuscript .

T h e n , he s ays , he hit certain 'financial fluctuations' , which for

two d a y s forced him to rack his brains 'for a plot of any sor t ' for

a saleable story. A n d then, on the second night, he had a night­

mare , sc reaming so loudly his wife felt she had to wake him. He

w a s not best p leased. ' I was d reaming a f ine b o g e y tale, ' he told

her. Never the less , he had m a n a g e d to secure s o m e key elements

of the s tory: 'I d reamed the scene at the window, and a scene

afterward split in two, in which H y d e , pursued for some crime,

took the powder and underwent the change in the presence of

his pursuers . ' T h e rest of the story, he says , 'was m a d e awake,

and consciously, a l though I think I can trace in much of it the

manner of my Brownies ' , add ing that they 'have not a rudiment

of what we call a consc ience ' .

Consc i ence makes cowards o f us all.

Voodoo Child (Slight Return)

Ten minutes to go. I 'm g o i n g to round off my lecture with a

story. I scan the audi tor ium. T h e students are still attentive,

pens and notepads at the ready. A pale girl in the front row has

a small tape recorder and reaches into her b a g for a replacement

cassette. A p igeon settles on the sill outs ide one of the high

windows and, watching it, I forget momentar i ly what I w a s

about to say. T h e n i t c o m e s back to me : R o b e r t ' s story.

O n e day, in the foothills of middle age , Rober t took a l ong

look at himself in the mirror. T h e reflection sent an unequivocal

message . Li fe was running out and he w a s g o i n g nowhere . He

was stale: bored with his job, out of love with his wife , stifled by

his family, disenchanted with himself. But what s t ruck him

much harder, gr ipped him and shook him to the core of his

being, was the thought that at the end of this d reary line of days ,

there was oblivion. It was time for a change.

Tha t day on his way to work he s topped at the newsagents , as

usual , to buy a newspaper . He paid for i t but , on the w a y out,

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when the shopkeeper wasn ' t looking , Rober t took a chocolate

bar f rom a shelf and sl ipped it into his pocket . T h i s little act of

theft w a s cur iously energizing. H i s senses felt stripped and raw

and he ran back to his car in a whorl of elation. He drove faster

than he should , but, instead of g o i n g to work , he travelled 320

miles from Yorkshire to Cornwal l . By early evening, he found

h imsel f sitting on a beach , in the face of a w a r m sea breeze.

Rober t w a s profoundly happy.

T h e sun set, i t g r e w dark and chilly, but he stayed there all

night, conceding to sleep only as the sun rose in another part of

the sky. C o u l d he be sure i t w a s the same sun? he wondered . He

returned h o m e late in the day with no explanation except the

truth and spent another s leepless night placat ing his distressed

wife . She demanded a more plausible vers ion of events.

'Robert, what were you thinking o f ? ' she said .

He said h e ' d been thinking about everything and had put a

few things straight in his mind.

L i fe reverted to routine for a couple of weeks. T h e n , dr iving

h o m e from w o r k one Fr iday evening, Rober t switches on the

car radio and hears an interview with Jul ian Bream, the classical

guitarist . At one point the interviewer asks Bream what he

thinks of 'electrically amplified gui ta rs ' . ' T h e electric bass is

fine,' he s ays , but otherwise h e ' s not impressed. What does he

think of J i m i Hendr ix as a player? Rober t detects a note of con­

descens ion in the interviewer 's voice at the mention of Hendrix,

bu t thinks i t ' s a g o o d quest ion, one he himself would have

wanted to put . He waits for the reply. Don't let me down, Julian,

he thinks. T h e r e i s no le t-down. ' H e w a s brilliant, ' says Bream,

leav ing the interviewer momentar i ly f lummoxed. Rober t gets

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another burst of energy like the one he had when he stole the

chocolate bar.

He turns round the car, heads back into town at speed and

pulls up on the pavement outs ide a musical instruments s tore .

T h e shop is set to c lose in five minutes and the sales staff are

cashing up. He tells them he mus t have a Fender Stratocaster ,

the guitar Hendrix played. T h e y obl ige . Rober t b u y s an ampl i ­

fier to go with it and a b o o k containing note-by-note

transcriptions of Hendr ix s o n g s . T h i s c o m e s to nearly a thou­

sand pounds .

'But Rober t , ' s ays his wife when he ge ts h o m e , ' you can ' t

even play the guitar. '

He tells her he is g o i n g to learn.

But that night all elation has drained away. He lies awake

until the early hours in a state of agi ta t ion, to rmented by

thoughts of fading into nothingness , accompanied by gu t -

churning feelings of the proximity of death. Tonight, tomorrow,

just around the corner. It's coming, it's coming. He is c lose to panic .

It's coming, it's coming. T h e next day, out of nowhere , he

announces to his wife that their mar r i age is over and he leaves

her, the house , the children, and his new guitar , never to return.

Robert g o e s back to Cornwal l , where he f inds a bar job ,

g r o w s his hair, cultivates a tanned and weathered look and

becomes , in effect, s o m e o n e else .

T w o years later, l iv ing a lone in a threadbare bed-s i t in the

suburbs of a northern city, Rober t can scarcely recollect the

Corn i sh interlude. T h e r e are f ragments , images f rom s o m e o n e

e l se ' s memory , but they don ' t cohere — a blue l ampshade , a

rainy night, the shiny, stainless-steel surfaces of a hotel kitchen,

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184

a w o m a n ( Jack ie? J e n n y ? ) , a fistfight, the sea . It is hard to pull

together thoughts from one minute to the next.

He feels nauseous . Someth ing rises squ i rming from the pit of

his s tomach to his gullet . In the ba th room mirror, his reflected

face s eems drained of any meaning , a lmost the absence of a

reflection. He s tands s tar ing for a while, then turns on the wash­

bas in tap, turns it off, turns it on aga in , off, on, before crashing

to the floor. H i s l imbs stiffen, then jerk fiercely for several

minutes , as a sp read ing patch of urine darkens his trouser leg .

H e s leeps .

T h i s is R o b e r t ' s third or fourth seizure this week. T h e next

happens in the middle of a supermarket and, afterwards, he ' s

taken to hospital . T h e doc tors are concerned that, despite

recover ing from the fit, he has remained inert and disoriented.

T h e y invest igate with head scans and find a large mass in the

orbitofrontal region of the brain. It turns out to be a menin­

g i o m a . T h i s is a tumour, intrinsically benign , which has invaded

the outer cover ings of the brain. I t has been g r o w i n g for several

years . By dis tor t ing the frontal lobes of Robe r t ' s brain, i t was

reshaping the very pe r son he felt h imself to be . T h e y operate.

T u m o u r excised, Rober t enquires of his nurses most days :

' W h e n are my children c o m i n g ? ' and ' C a n I go home n o w ? '

T h e lecture seems to have g o n e well enough . T h e s e neuro-

gothic tales general ly do. I tell them ' R o b e r t ' s s to ry ' is a

somewha t embell ished account of a real case . I 've tinkered with

s o m e of the b iographica l information and, of course , the

pat ient ' s n a m e w a s not really Rober t , but the clinical details are,

in essence , faithful. T h i s man really did leave his family on an

impulse fol lowing several ep isodes of uncharacteristically

I N T O T H E S I L E N T L A N D

185

eccentric behaviour, including acts of petty theft and spon ta ­

neous trips to seas ide towns and other p laces . He really did

spend sums of money he could ill afford on luxury g o o d s like

musical instruments (which he could not p l a y ) and expensive

clothes (which he might , or might not, wea r ) .

He was a J imi Hendr ix fan, too. A la rge , iconic i m a g e of the

great man stared from his b e d r o o m wall at the rehab unit. H e n ­

drix, at least, remained constant in his life. Whether or not he

s tood in conference with the mirror in the w a y I descr ibe at the

beginning and the end, I 've no idea. I threw that in. Perhaps ,

somewhere , I had in mind the i m a g e of Jekyl l s tanding before

the mirror as he watches his t ransformation into H y d e , and

then, at the end, perhaps i t w a s D r a c u l a , bereft of soul , bereft of

reflection. I don ' t know. I t ' s only just occurred to me . After the

operation he really did expect to return to the b o s o m of his

family, unaware that they had long since m o v e d on.

When did the s low tumour take root? H o w long had i t been

g rowing and heaving its bulk into his frontal lobes , ins idiously

recalibrating his personal i ty? A men ing ioma like R o b e r t ' s can

take years to develop, eventually b e c o m i n g a stable feature of

the intracranial landscape . T h e brain can, up to a point , a c c o m ­

modate a s low-g rowing m a s s without be t ray ing major clinical

s igns or symptoms . I t depends on the rate of g rowth and where

i t ' s located. S o m e people g r o w old and die never k n o w i n g that

for half their life or m o r e they were harbour ing a ben ign brain

tumour. Perhaps they never k n o w who they might have been.

I once saw a man in his seventies admit ted to hospital for

investigation of a stroke. He turned out to have a tumour the

size of an o range nestl ing in the parietal lobe of his brain. I t had

P A U L B R O K S

186

nothing to do with the s t roke, had probably been there for

decades and wasn ' t , apparently, g iv ing him any trouble. I t had

b e c o m e a part of him.

Perhaps Rober t wou ld have left his wife and children

anyway. Perhaps he was restless and bored , or depressed. A

mid-l ife crisis. It could be that the tumour just hastened the

p rocess or even had nothing at all to do with his impulsive deci­

s ion to pack his b a g s and go . We can' t rule this out entirely, but

I think not. Impai rments of social judgement , impulsive behav­

iour, and all the rest that emerged through Rober t ' s personali ty

change are a c o m m o n consequence of d a m a g e to the frontal

lobes .

Unl ike the man with the s t roke, Robe r t ' s tumour was causing

him trouble . He deve loped epilepsy. But suppose he hadn't .

S u p p o s e there had been no obv ious medical complicat ions, that

the tumour w a s just there, nudg ing and n iggl ing , resetting the

dials of R o b e r t ' s personali ty. Would there have been g rounds

for s ay ing that his behaviour was pathological? N o . You would

say it was a mid-l ife crisis .

Desp i t e my undisguised haste to d raw the proceedings to a

c lose (I have a train to catch) there are several quest ions. S o m e

are technical, but they are most ly about the story, as a story. Fair

enough .

' H a v e y o u ever cons idered all this from a Christ ian perspec­

t ive? ' asks the pale girl at the front as , finally, I gather my notes.

' N o , not really, ' I say rather briskly. 'Perhaps we can discuss

i t next w e e k ? '

' B u t what happened to Rober t in the e n d ? '

' H e b e c a m e profoundly depressed . '

I N T O T H E S I L E N T L A N D

I spare her the information that after be ing d i scharged from

his rehab hospital , there were two botched suicide at tempts

before he finally succeeded in kill ing himself. T h i r d t ime lucky.

I have this unnecessary image of Rober t hang ing h imse l f with

Hendrix s inging ' V o o d o o C h i l d ' in the background : And if I

don't meet you no more in this world / I'll meet you in the next one.

/And don't he late . . . It didn' t happen that way.

My train is more than half an hour late and I kill t ime in a

bookshop . I now regret not a l lowing the pale girl m o r e t ime. She

seemed genuinely dis t ressed. I resolve to seek her out after the

next lecture and make amends . But now I 'm on the train. I have

a beer in one hand and, in the other, the paperback I ' ve just

bought . I t ' s about c o s m o l o g y and I 'm t rying to get s o m e i m a g ­

inative purchase on the immensi ty of i t all. I t ' s the kind of thing

I somet imes read as a w a y of winding down . T h e grandi loquent

p rose (velvet mantle of the night... cosmic symphony of the heav­

ens), and the b ig , round numbers (four hundred billion galaxies)

have a sooth ing effect.

C o s m o l o g y and neuropsycho logy have absurdi ty in

common . T h e raw facts are s t range beyond imaginat ion .

I t sets me thinking about how the physical forces that twist

the galaxies and roll the train a long the track connect with the

social and psychologica l forces that animate the passenger s .

Tha t recalcitrant child and his wea ry mother, the old couple

sitting in silence, the w o m a n oppos i te who catches my eye , d i s ­

plays a mic romomenta ry f l icker of an eyebrow and smiles as the

young man with an obscene m e s s a g e printed on his T-shi r t takes

the seat beside her. Fleetingly, she and I were complicit. I entered

her mind and she entered mine. We can plot the mot ions of the

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188

planets , but how do you measure the force of a g lance , or the

weight of a smile?

Th ink ing these thoughts and looking at the people around

me I entertain myse l f by see ing them for what, at one level of

descript ion, they certainly are: complex biological machines.

Physical objects . I take a little thought journey behind their eyes

and all I see is darkness ; then, looking to the window, against the

dark , I see myse l f looking back at m e , lost in a confusion of first

and third pe r son . T h e image in the window resembles a machine

like the others on the train, but with an involuntary flip from

third pe r son to f irs t , I 'm back now on this s ide of the reflection,

sitting in my own clear capsule of consc iousness . I buy the illu­

s ion that other peop le inhabit similar capsules , but obvious ly

they don ' t . A n d from their perspect ive neither do I .

I ge t another beer. I l ook aga in at my reflection. It chuckles.

W h e n finally I get h o m e , I feel profoundly content, immersed in

my family. Secure , immutable , invulnerable, immortal . As

Rober t once felt, perhaps .

* * *

T h e pale girl is not here today. N o t in the front row, anyway. I 'm

early and I watch the students as they file in. T h e rows fil l up, but

she is not here. S o m e la tecomers arrive f ive, ten minutes into my

lecture, but she is not a m o n g them.

I p ick up where we left off last week, point ing out that illness

of va r ious kinds m a y indirectly affect the w a y we see ourselves ,

bu t that neurologica l d i sease somet imes g o e s straight to the core

and distorts the pe r son in essence . L ike parasit ic wasp larvae

I N T O T H E S I L E N T L A N D

devour ing a l iving caterpillar from the inside, a d i sease can

penetrate the substructures of the self — the neural sys t ems con­

trolling long- term m e m o r y or those that regulate emot ion or

the hatching of intentions or the shap ing of beliefs. I remind

them of Rober t ' s s l ow-g rowing tumour and how he c a m e to see

the world in a different way. He thought differently, behaved

differently, felt differently about the peop le a round him. Was

the Robert who impulsively bough t expensive clothes and e lec­

tric gui tars , who stole chocolate bars , m a d e impromptu trips to

seaside towns, and finally walked out on his wife and children —

was he the same Rober t who, previously, had been so devo ted to

his family, worked hard to pay the bills, who would never have

dreamt of stealing anything, and didn ' t take risks or get into

f ights? If not, when did Jekyll b e c o m e H y d e ? Was there a s ingle

incident or a s ingle day that might be said to mark the transi­

tion? Is it possible to pin it down to a s ingle moment? D o n ' t we

all do rash and stupid things from time to t ime? H o w many add

up to a personali ty change?

Then the return journey. Robe r t ' s tumour w a s r emoved and

he was back to someth ing like his former self. Something l ike.

He yearned for his wife and kids. He wanted them back . But in

other w a y s he was irretrievably different, intellectually and

emotionally. His mental powers were diminished. He b e c a m e

forgetful and couldn' t concentrate. He couldn ' t p lan things

from one day to the next; his v iew of the future w a s foreshort­

ened. His face was pressed agains t the wall of the present , but

the past was at his shoulder. It was where he felt he be longed ; in

the golden valley of the t ime before the tumour. More than that,

i t was where he often bel ieved himself to be .

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T h i s w a s not a wistful dwel l ing on the past . Somet imes he

w a s confused to the extent that he bel ieved nothing had

changed . His wife wou ld c o m e to collect him. She would. S h e ' d

be here soon . T h e y would pick up the children from school

together. T h e y wou ld go home . T h e pas t was like a radio jingle;

not much tone or melody, but i t w a s in his head and would not

leave him a lone . T h e n there w a s the depress ion - and in one of

these black t roughs he took his own life. What relationship did

pos t -opera t ive Rober t have to his former selves? What was his

' real ' se lf? What w a s his identity?

I realize I 'm waffling. S o m e of the students are shuffling in

their seats . T h e y have c o m e to depend on lectures structured

like se l f -assembly furniture manuals , with handouts and web

p a g e s full of d i a g r a m s and f low charts, bullet points and refer­

ences. Y o u g i v e them L e g o bricks of fact and opinion and you

tell them precisely how they fit together. I 'm thinking aloud. It

d is turbs them.

' D o n ' t wor ry about the precise meanings of terms like self

and personal identity,' I say. Ord ina ry l anguage notions will do

for now. Actually, I 'm inclined to think that ordinary l anguage

not ions are about as g o o d as i t ge ts when i t comes to talking

about 'personal identi ty ' and the ' s e l f ' , but I don ' t mention this.

' T h i n k of your self. Y o u know, that which you think roughly

defines you, the consc ious be ing sitting here in this lecture

theatre; that which dis t inguishes you from the person sitting

next to y o u or s o m e o n e somewhere else do ing someth ing differ­

ent. Or a co rpse . '

A co rpse? Where did that come from? But then an image of

last n igh t ' s s t range d ream f loats before me . Matilda, one of the

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I N T O T H E S I L E N T L A N D

junior doctors , was there. We had the top half of a m a n ' s b o d y

ready for dissection. N e x t thing I know, the head is separa ted

from the torso. T h e r e ' s Mattie, m e , and s o m e other ma le , I don ' t

know who. I feel squeamish , but try not to let it show. R e l u c ­

tantly, but deftly, Mattie ge ts started with a cranial saw.

At some level I knew it was a d ream because sawing th rough

the skull of a cadaver invariably releases the smell of bu rn ing

bone - think of that acrid smell of the dent is t ' s drill bo r ing

into your teeth. But there ' s no odour . No sound even. S o o n

the top of the skull is r emoved and we are look ing inside at the

remnants of the brain, except i t looks more like a m a s s of mel ted

candle wax than a brain. I can sense Mat t ie ' s d i sgus t . She's going

to be sick, I think. A n d she is - just a little, in the efficient, m e a s ­

ured way that cats are sick — straight into the opened head and

over the waxy brain.

T h i s job is get t ing to me . Perhaps there ' s a part of me t rying

to tell me something. As i f repulsed by my pr ivate thoughts (are

they hovering like a pol luted mist above my h e a d ? ) , a w o m a n at

the back of the hall s tands up and makes her w a y to the exit.

T h e dream replays itself like a scene from a film. I mere ly

observe. T h e macabre narrat ive has nothing to do with me .

I didn't plan or construct it. It appeared fully fo rmed in my

dream. If someone had told me this s tory yesterday, as a d ream

vignette of their own, I would not have c la imed rights of o w n ­

ership. I t would have seemed novel and unfamiliar. If over

breakfast this morn ing I had been asked about my d ream last

night, I might well have been unable to remember . I usual ly

can't .

T h e scene unfolded while the consc ious , reflecting, del iber-

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192

at ing 'I ' was do rman t and, by the t ime 'I ' returned to wakeful­

ness , i t had retreated into s o m e secret compar tment of my brain,

like a hermit crab folding back into its shell. Synaptical ly

encrypted to surv ive the transition between sleep and wake­

fulness, the virtual shell then travels with me to the university. I

b r ing i t to the lecture. A n d then at s o m e unconsc ious signal , or

pe rhaps for no reason at all, the crab emerges and the dream

s tory unravels in the middle of my talk. I t has nothing to do

with m e .

T h e audience settles down when I show them d iag rams of

the brain and tabulate s o m e of the clinical syndromes associated

with d a m a g e to the frontal lobes :

1. Dysexecutive type (dorsolateral d a m a g e ) ; impaired j u d g e ­

ment and difficulties with p lanning and problem-solv ing .

L a c k pers is tence or, the oppos i te , persist in per forming an

action well beyond the point of usefulness or appropr ia te­

ness ( ' pe r severa t ion ' ) .

2. Disinhibited type (orbitofrontal d a m a g e ) ; behaviour is s t im­

ulus-dr iven. T h e balance between internally generated

act ions and those t r iggered by external objects and events is

lost . T e n d to be distractible. S h o w impoverished social

insight .

3. Apathetic type (mediofrontal d a m a g e ) ; apathy and indiffer­

ence , loss of initiative, lack of spontaneity; impoverishment

of speech and thought; reduced behavioural output.

I ask them whether Rober t ' s behaviour fits any of these schemes,

while reflecting, privately, that my teaching style today has per-

I N T O T H E S I L E N T L A N D

haps displayed elements of the first and second s y n d r o m e , i f not

the third.

In conclusion, I quickly review the main themes of the lec­

ture and we finish ten minutes early. T h e r e are no quest ions .

T h e pale girl is not here to ask whether I have considered it all

from a Christ ian perspect ive . I wish she were .

T h i s train's on t ime, m o r e or less . I t ' s seven o ' c lock and

darker than it should be for the t ime of year. Sudden ly I feel

tired. Perhaps I 'm b rewing a cold. O n e of the students pressed a

b o o k about Buddh i sm into my hands as I w a s leav ing the lecture

hall. T h e r e ' s s o m e stuff about suffering and death set t ing the

co-ordinates for life. I 'm not in the m o o d . I mus t have been

twenty minutes on the s a m e p a g e .

At the station, as peop le are boa rd ing the train, I watch a m a n

and a w o m a n on the platform. T h e y are embrac ing passionately ,

say ing their goodbyes . I 'm reminded of what s o m e o n e once

said about par t ings: how the instant they ' re g o n e the pe r son y o u

were with seems m o r e powerfully present than ever before .

Absence is tangible. T h e man gets on the train, the w o m a n

remains on the platform. He looks red eyed and quite shaken. I

watch the face of his g i r l f r i end /wi fe /mi s t r e s s as we pull away.

It has a chilling composure . It is a b locking face, deny ing entry

and exit. He won ' t see her again .

He sits just ac ross the aisle from me and I feel an irrational

u rge to g ive him the b o o k about Buddh i sm. I put i t as ide and

turn to the bundle of papers I picked up at the university. I still

have a p igeonhole , even though i t 's a year since I left. T h e

Departmental Commi t t ee minutes are at the top of the pile

but, beneath this, someth ing catches my eye: a note about the

193

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194

suicide of an undergradua te . A w o m a n , a final-year student. It

is not a n a m e I recognize . T h e train clatters across some points,

c lackety-clack, and my s tomach turns.

' T h a t girl who killed herself. Wha t did she look l ike? '

I 'm home . At last I 've found my old address b o o k and I 'm

phon ing a former co l league at the university, the one who per­

suaded me to do the lectures. He is s luggish . I t is well past

midnight .

' I ' m sorry, ' I say. ' I t ' s late . '

' N o , i t ' s okay. '

'Wha t did she look l ike? '

' I don ' t know. I ' ve no idea. '

I t takes presence of mind to put an end to o n e ' s own life.

Suic ide m a y be the bitter fruit of hopelessness and despair, but i t

is a lso the end point of a dec i s ion-making process . T h e r e seems

to be a ' let t ing g o ' , an acceptance of the idea of death that

induces clarity of thought and peace of mind. T h o s e c lose to a

suicide often report that the pe r son seemed happier or more

tranquil than usual in their final hours . T h e r e ' s something I read

somewhere — I can ' t p lace it — about the causes of suicide and

h o w they are not a lways obv ious or predictable and how, i f

s o m e o n e is in a particular frame of mind, it doesn ' t take much to

tip them over — an innocent remark misinterpreted; a gesture

misperce ived .

I 've thought about the pale girl a lot this past week, but

haven ' t fol lowed it up. I don ' t want to appear morbid or obses ­

s ive . I could have m a d e discreet enquiries, found s o m e pretext.

It wou ld have been a normal thing to do. But I didn' t , for my

own sake . I did not want to see myself behaving in that way,

I N T O T H E S I L E N T L A N D

betraying s igns of culpability. I 'm not culpable. Yet m o r e than

once I have pictured a counter-factual wor ld where I 'm the per­

fect, patient teacher. ' H a v e you ever cons idered all this f rom a

Christian perspec t ive? ' she asks , and I say : 'Tel l me what you

mean, exac t ly ' T h e n we have a conversat ion for five, ten,

twenty minutes; however long it takes for me to listen to her

concerns and put my own point of v iew gently and consider­

ately, without crushing her. A n d then I wou ld have caught my

train, because i t was half an hour late anyway and in my wry,

atheistic way I would have const rued this as a beneficent nod

from the Creator , a little thanks-for- taking-the-trouble ges ture .

I think about her now as I rush to my lecture. T h e train w a s

late. T h e hall i s full. T h e y ' r e wai t ing. S h e ' s wai t ing. T h e r e she

is in the front row with her mini cassette recorder. Where have

you been? I want to ask her. Where were you?

195

Mr Barrington's Quandary

I t ' s C l a r a , my trainee, on the phone , asking me to come and see

Mr Barr ington . I 'm forming a picture as I make my way down

the corr idor to the outpatient clinic. Mid-fifties, light g rey suit,

wet , b lue eyes , sandy hair, mois t handshake, the hint of a s tam­

mer. I saw him a couple of weeks ago . T h e r e before me as I enter

the r o o m is a midd le -aged man, the s a m e suit, the same eyes. But

this man is complete ly bald . Hi s head glistens under the strip

l ighting. T h e r e are tears f i l l ing his eyes and he is sweating

profusely. He looks globular , dr ipping wet to his bones . I t ' s a

feature of his medical condit ion.

T h e y had started their assessments , C la ra explains, but Mr

Bar r ing ton quickly b e c a m e distressed and felt unable to con­

tinue. She tells me this in just those te rms, as if reading from a

set of notes . I make a pretence of jot t ing down some notes of

my own, but what I have written, and am now tilting towards

C l a r a is: What happened to his hair?

Mr Barr ington i s ahead of me . 'You ' r e probably wonder ing

what happened to my hair. '

196

I N T O T H E S I L E N T L A N D

Apparent ly it fell out at the weekend, mos t ly dur ing Sa tu rday

night while he lay in bed t rying to sleep. It c a m e out in c lumps as

his head tossed and turned on the pillow, cover ing the sheets and

sticking to his perspi r ing skin. He tried to b rush it away, but the

sheets were damp and he w a s afraid of wak ing his wife. Severa l

times he went to the ba th room to d i spose of the hair he had

gathered, each time noticing in the mirror, without part icular

dismay, the virgin patches of skin advanc ing ac ross his head.

'You weren ' t conce rned? ' I ask .

' N o . I t ' s the least o f my worr ies . '

Anyway, he had lost a few c lumps over the week , so i t wasn ' t

that much of a shock when the whole lot fell out. H e ' s been

under a terrible strain, he explains, and things seem to have

come to a head. I note the unintended pun. L a n g u a g e has a life

of its own. H e ' s had these things p lay ing on his mind, he s ays ,

this thing in particular.

'Would you like to talk about i t ? ' I ask . 'Are y o u able t o ? '

Mr Barr ington d rops his face in his hands and sobs . Be tween

bubbl ing sniffs and quiver ing exhalat ions he asks pe rmiss ion to

remove his jacket. He also removes his tie. H i s c ream shirt is

marked with a bib of sweat down to the fourth but ton and there

are large ovals of dampness under the armpits . He regains his

composure and is s teel ing h imsel f to say someth ing , but is not

quite ready.

'Why don ' t you take a break , ' I say, 'ge t a breath of fresh air.

Then , i f you like, you can c o m e back and we'll chat. We'll leave

the tests for now.'

Mr Barr ington just stares at the floor between us . N o , he s a y s ,

he must talk. I t ' s dr iv ing him m a d . But he remains hesitant. H i s

197

P A U L B R O K S

g a z e retreats to his feet. T h e n , looking in C la ra ' s direction, he

s ays i f we don ' t mind he thinks h e ' d find i t easier i f . . .

C l a r a unders tands . 'I ' l l see you later,' she says , and leaves.

Mr Barr ington g a z e s out of the window across the suburbs

towards the distant hills, his wet, b lue eyes unblinking. He isn't

admir ing the view. He is adrift somewhere in a vast , inner space ,

the exhausted prey of a relentless emotional predator: guilt . I

shake his s o g g y hand at the end of the sess ion. He is very gra te ­

ful. I l istened. I advised . Ou t s ide it has started to rain.

Clinical supervis ion . While C la ra fills the kettle, I think back

to Mr Barr ington . I see his a r m s swing down at his sides, his

head roll back . I hear the sustained, oscil lat ing g roan like a child

exhausted by a bout of c ry ing . T h e n the confession: a single,

w e e d y act of marital infidelity, a l ong time ago. His wife never

knew. H e ' d a lmost forgotten.

'Bu t now i t 's p l ay ing on your consc ience? ' I 'd said, which

w a s feeble in the c i rcumstances . T h i s was not a wasp at a picnic.

It w a s a skewer ing torment .

H i s hair had fallen out. T h e s to rm t roopers of the super-ego

were d o i n g their wors t , c o m m a n d i n g him to put the record

s traight with his wife. But i t would break her heart, wouldn ' t it?

W h a t w a s he to d o ?

'Tel l me what to do , ' he said . ' P l ease . '

I wonder if we can disentangle the d i lemma from the disease .

T h e provis ional d i agnos i s is mul t isys tem atrophy, a degenera­

tive condit ion. I t carr ies a p o o r p rognos i s . Perhaps he ' s clearing

the decks . But the d isease is affecting his brain, so the urge to

c o m e clean, and the inability to decide what to do about i t might

a lso be unders tood in neurologica l te rms.

198

I N T O T H E S I L E N T L A N D

I once m a d e a h o m e visit to see a head-injured patient. S o m e ­

one had swung a basebal l bat through the front of his skull . A

year on and he w a s do ing as well as could be expected. He c a m e

to greet me at the front door , but as he put his hand forward he

noticed a milk bottle on the doors tep . Before his hand connected

with mine he was bending to pick up the bott le. He had a lmos t

reached i t when he began to straighten aga in and turn towards

me , only to change tack and bend to the doors tep . He s t ra ight­

ened again . He bent. He straightened. He bent. He shifted his

weight and shuffled, s t rugg l ing to execute one or other of the

action plans hopeless ly misfiring in the mutilated circuitry of his

frontal lobes: motor dysexecutive syndrome. Finally, I picked up

the bottle and gave i t to him. We wou ld have been there all d a y

otherwise. Perhaps Mr Bar r ing ton ' s quandary is a case of mora l

dysexecutive syndrome .

Cla ra returns with m u g s of tea. I feel inclined to keep Mr

Barr ington 's secret. He w a s naked enough . I won ' t tell her, not

yet anyway. Perhaps not at all, perhaps I'll take charge of the

case , and then she need never know.

199

Out of Darkness Cometh Light

Molineux. T h e h o m e of Wolverhampton Wanderers . I t ' s a long

w a y to c o m e for a football match. T w o hundred miles and more

f rom h o m e . I still can ' t get used to the new s tadium, all pale

br ick and mus ta rd-co loured steel. When we arrive I feel I

should be somewhere else. T h e Molineux of old was j agged and

dark — a place of wrough t iron, rough concrete, and foul smells.

N o w even the lavator ies are spruce and well lit. A fan stands at

the urinal with a pie in his free hand.

I r emember the club mot to —Out of darkness cometh light—as

my sons and I ascend the s teps to the Stan Cul l is stand, formerly

the Nor th Bank . By the s tandards of Anfie ld 's Spion Kop or the

Hol te E n d a t Villa Park , the Nor th Bank w a s small . F r o m other

par ts of the g r o u n d i t looked hunched and hooded , especially on

floodlit, rainy nights . But the acoust ics were demonic . T h e

noise of the c rowd w a s a beast . I t su rged up to the rafters and

bel ted the r o o f like Beelzebub. At such t imes the Nor th Bank

w a s a s ingle vocal appara tus , the crowd a s teaming tongue in a

b lack throat.

200

I N T O T H E S I L E N T L A N D

But the terraces are gone . T h e swir l ing m a s s of f lesh i s no

more . S ing ing and chanting are m o r e sporad ic and usual ly fizzle

out. N o w we sit on plastic seats , listen to anodyne p o p over the

PA, watch men dressed as car toon animals wander ing the

touchline, careful not to s t ray into opposi t ion territory for fear

of inciting the crowd. ( T h e r e is hostility enough in the vo ices

around us — this is Wolves v. West B r o m w i c h Alb ion ; an acrid

domest ic squabble . ) A n d then J e f f Beck c o m e s over the P A :

' H i - H o Silver L in ing ' . T h e c rowd ga lvan izes . I t ' s an anthem. I

find mysel f s inging a long to the chorus: ' . . . and i t ' s H i - H o

W O L V E R H A M P T O N ! ' My sons look a t me uncomfortably. I

s ing the next chorus, but with less gus to . T h i r d t ime round I 'm

silent. I look about me and am visi ted by doubt . Is this

Molineux? Is it me?

T h e other day I showed my students a video. T h e scene is a

clinic room. A y o u n g man and an old man sit facing each other.

T h e y o u n g man is taking a history, put t ing quest ions , carefully

probing the old man ' s observat ions and recollections. T h e old

man concentrates, g iv ing each quest ion careful thought , but i t is

clear from his responses that, despi te appearances (he smiles

readily, seems fully engaged and has put on a suit for the occa ­

s ion) , there are great vo ids between the sparse constel lat ions of

recollection.

He has a brain d isease and can hardly carry memor i e s from

one day to the next. I m a d e the v ideo m o r e than twelve years

ago. T h e old man and my younger se l f are pe r fo rming a famil­

iar routine. He is dead n o w and i t occurs to me that every

molecule of my younger se l f has been replaced with the p a s s a g e

of t ime. In a sense , neither of those bod ies has surv ived .

201

P A U L B R O K S

202

Similarly, nothing remains of the b o y who s tood on the terraces.

S o , what surv ives? What makes us the same person from one

year to the next, one week, one day, one minute to the next?

S o m e phi losophers have emphas ized conscious recollection.

Cont inui ty of the pe r son is down to continuity of memory. If I

can reclaim the thoughts and experiences of the young clinician

in the v ideo or, further back , the b o y on the terraces, then we are

the s a m e person . T h a t ' s not difficult. I have clear memor ies of

m a k i n g the film and can picture the pat ient ' s wife off-camera.

My impress ions of the old s tadium also remain vivid . I see

myse l f ar r iv ing, as usual , an hour before k ick-off and taking my

place halfway up the terraces or, when I was small , at the trench

wall right behind the goa l . I recall the o range gravel surround­

ing the pitch and the lurid green of the g r a s s , the smells of

cigaret te smoke and O x o . I have a mental image of the a s y m ­

metric outline of the s tands, so clear I could d raw you a picture.

A n d , a l though much is a blur, I can conjure snapshots of certain

g a m e s and goa l s . I saw these things from a particular perspec­

tive. Mine. I w a s there. It w a s me .

But there ' s a p rob lem with this line of reasoning: amnesia.

What if I couldn't r emember these things? Would disruption of

m e m o r y decouple me from the child I once w a s ? Suppose I

retained a m e m o r y link with the y o u n g clinician and that he, in

turn, could recall the b o y (whereas I can ' t ) . It would lead to the

conclus ion that the younger man and myse l f were the same

pe r son , that he and the b o y were the s ame , but that the b o y and

I were not.

A n d then there ' s my patient. H i s p rob lem was with recent

memory , not remote . In all l ikelihood he forgot the v ideo after a

I N T O T H E S I L E N T L A N D

few days , but would have had no trouble reminisc ing about his

childhood. Was the old man fused with his child-self, but d i s lo ­

cated from the person he had been a week a g o ?

Another v iew is that we should abandon the idea of a pers is t ­

ing ego. A person is more like a club — a football club, s ay -

existing by consensus , capable of dissolut ion and reconsti tu-

tion. Wolverhampton Wanderers twice went into l iquidation in

the 1980s; the current p layers weren ' t even bo rn when I started

coming to matches; the s tadium was demol i shed and rebuilt.

Noth ing tangible survives , yet here we are still — me and the

Wolves.

T h e image of my ten-year-old se l f b r ings a churning to my

chest. I feel an urge to h u g my sons , but resist. T h e y ' r e too

b ig and wouldn ' t thank me . We settle in to the match. We lose

one-nil. T h e exit from Wolverhampton is d reary and slow, but

spirits are lifting by the time we reach the motorway. We m a d e

the trip for the s a m e fixture last season . T h e match v ideo is

advertised for sale on the club websi te . I ' ve decided to b u y it.

We' l l look for ourse lves behind the goa l , halfway up in the Stan

Cull is stand. I 'm g o i n g to watch me and my kids not get t ing any

older in a universe where the score will a lways be Wolves 3,

Alb ion 1. I t ' s a restricted universe , but reliable.

203

To Be Two or Not to Be

He had a wild l ook about him. Cof fee stained the front of his

white lab coat , though now he w a s sw igg ing water from a milk

bot t le .

'Ca l l me D e r e k , ' he said .

T h i s w a s , I reckoned, the thirteenth t ime I 'd been here. He

never r emembered me .

D e r e k w a s from long ago. He appeared to function now as a

technician, but in the old days he w a s a philosopher, hauled in to

adv i se on the metaphys ics and mora l s of the new technology.

He g a v e up phi losophy, hav ing solved all the problems that

interested him, and now enjoyed push ing buttons for a living.

As i t turned out, the metaphysical implicat ions of teleportation

seemed to be no m o r e profound than the metaphysical implica­

tions of T V . In any event, peop le soon go t used to the idea. You

s tepped into the boo th , you s tepped out somewhere else: across

the street or ac ross the solar sys tem.

Telepor ta t ion is speed-of- l ight swift. T h e journey to Mars,

which once took several weeks by conventional spacecraft, can

204

I N T O T H E S I L E N T L A N D

now be accomplished in a matter of minutes . You enter the

booth and, before you k n o w it, the d o o r sl ides open and y o u ' v e

arrived; delivered, br isk as a b lade of l ight, to the Mart ian

plains. Subjectively, i t ' s instantaneous. But , even now, m a n y

people misunders tand the bas ic principles. I t ' s a lways been the

way. H o w many unders tood the phys ics o f T V ? I t ' s the m e s ­

sage that matters, not the med ium. S o , too, with teleportat ion.

I t does not, as s o m e still imagine , involve breaking down the

b o d y to its constituent a toms and whizzing them of f for

reassembly at the destination point. Wha t travels be tween the

transceivers is not a s t ream of a toms but a s t ream of data . D e r e k

pushes the green button and the scanners plot the exact co -o rd i ­

nates of every a tom in your body. ( T h e r e are rough ly ten bill ion

billion billion of them; the devil is in the detail .) T h e informa­

tion is encoded and transmitted from this end and received and

decoded at the other, where the p rocess of reconstruct ion takes

place us ing locally available material . An a tom is an a tom is an

a tom, after all. T h e r e ' s nothing special about my a toms or

yours . T h e y don ' t carry ID labels.

O n e other detail: once the a tomic co-ordinates have been

plotted, the b o d y is annihilated. It is instant and painless; a fo rm

of vaporizat ion - or 'd i scorpora t ion ' , as they call it. T h i s hap ­

pens precisely at the point of t ransmiss ion. I t must . T h e event

and its t iming are determined by decree of the Subcommi t t ee on

Personal Identity.

W h y ? W h y dest roy the b o d y while the information is in

transit, before the replica has been constructed? Surely, i t wou ld

be better to wait those few minutes to make sure that the

reassembly instructions arrive in g o o d shape? You might think

205

P A U L B R O K S

so , and the Subcommi t tee considered the matter carefully

before ar r iv ing at a different view.

After much debate i t was decided that even br ief per iods of

' a synchronous parallel ex i s tence ' were unacceptable . In law,

b io logica l pe r sons take precedence over their digital form.

Des t ruc t ion of a l iv ing b o d y is deemed acceptable only if the

digital copy represents the ' latest ve r s ion ' . If a person continued

in b io logica l form until his or her copy arrived on Mars (or

wherever ) then the replica would be 'existentially asymmetr ic '

with the or iginal . As the data s t ream traversed the inter­

planetary vo id , the psychologica l life of the original would have

continued to evolve . T h e replica would , therefore, not strictly

be a replica. It would be a c lose match, but not exact.

To cut a l ong s tory short , i t w a s decreed that destruction of

the original in such ci rcumstances would be tantamount to

murder . T h e pe r son copied must be precisely the person who

arr ives, down to the last a tom of the last molecule of every

musc le and membrane , and every last nuance of the neural nets.

My thirteenth trip. S tepp ing into the cubicle still g ave me a

tickle of excitement. I w a s , after all, about to be obliterated. T h e

suspens ion of existence is brief. But i t ' s real. For the duration of

the t ransmiss ion I wou ld be dead , nothing and nowhere, every

a tom of my b o d y returned to chaos . My heart quickened a t the

thought . To step into the boo th w a s to make a leap of faith that

the technology wou ld hold g o o d , that I would be resurrected at

the other end.

S o m e t ime a g o D e r e k placed a s ign above the entrance, a

f ragment of an old p o e m : Do not go gentle into that good night.

I noticed it as I s tepped ac ross the threshold.

206

I N T O T H E S I L E N T L A N D

D e r e k ' s smil ing face appeared on a screen. ' R e a d y ? '

I was ready. I took a deep breath. You sense a feeble, m y o ­

clonic jolt, like s tumbling on the br ink of s leep, and there ' s a

momentary blackness . A n d that 's it. J o u r n e y ' s end. But this

time, when the door slid open, I realized I hadn ' t m o v e d a mil­

limetre.

'P rob lems , D e r e k ? ' I said.

He wasn ' t smil ing now. 'Shit , shit, shit, ' he mumbled .

It was some kind of malfunction. At least I'm still here in one

piece, I thought to myself. My atoms haven't been scattered to the

ether. Apparently, though, it w a s a c lose call (the back-up copy

process had also fai led) , and I had to admit that I w a s shaken.

Tempora ry oblivion was fine, but I wasn ' t p repared for the per­

manent option. T h e y took me to the on-si te medical facility

where I strolled through a b o d y scanner and go t an unsmi l ing

thumbs-up from the operat ive who then sent me on to Psycho l ­

ogy. Psych? T h e operat ive sh rugged : search me . Routine, I

thought.

I read the mental hygiene pos te rs as I sat wai t ing for the

psychologis t . She had appeared briefly to int roduce herself,

then left. She seemed f lus tered. T h e r e were raised voices s o m e ­

where. O n e of them w a s D e r e k ' s . I couldn ' t catch mos t of what

they were saying , but the female vo ice , the p sycho log i s t ' s

I assumed, said someth ing about this or that be ing a matter for

the Subcommit tee . D e r e k said someth ing indecipherable to

which a third, mascul ine, voice responded: ' O u t of the q u e s ­

tion!' What followed sounded like a scuffle. Nex t , the d o o r burs t

open and there was D e r e k .

'Someth ing extraordinary has happened, ' he said . ' I think

207

P A U L B R O K S

you ' r e entitled to k n o w - ' but that w a s all he had time to say. He

w a s set u p o n by three security g u a r d s and d r a g g e d away.

I don ' t trust psychologis t s . You get the hmms and the uh-huhs,

the nods , the d o g g y - f a c e express ions of concern, the uncondi­

tional posi t ive regard , the whole profess ional s imulacrum of

empathy, and then your hour ' s up and they ' re on to the next

client. It mus t take a certain thickness of skin or thinness of soul

to do that kind of stuff day in, day out. But this psychologis t was

flustered, which put me at my ease immediately. She didn't

k n o w quite how to play it, so I helped her out.

"What you ' r e telling m e , ' I sa id , ' is that I w a s scanned and d is ­

patched but — obviously , s ince I 'm here talking to you — not

vapor ized at the point of depar ture . ' She nodded . 'And at the

other end, meanwhile , my replica was assembled and is now

fulfilling my duties on M a r s ? '

' T h a t is correct . '

'Well , ' I sa id . 'Well , fuck me . What went w r o n g ? '

Actual ly, I w a s less taken aback than you might imagine.

H u m a n evolut ion has equipped the brain with an impressive

r ange of adapt ive responses for cop ing with all sorts of situa­

tions. It g e a r s up the b o d y for fight or flight in the face of

physical threat, to recoil from contaminat ion, to affiliate with its

fel lows, to mate and reproduce , and to come to terms with loss.

But self-duplicat ion was not a feature of H o m o sapiens ' envi­

ronment of evolu t ionary adaptedness out there on the

savannah . It takes a while to formulate a response .

I soon b e g a n to regard my replica as a kind of rival and won­

dered what i t w a s get t ing up to on my behalf. In human relations

similarity is often the fulcrum about which points of difference

208

I N T O T H E S I L E N T L A N D

work the greatest leverage . I t ' s what g ives a personal r ivalry its

edge in many cases .

A n d what was my replica 's v iew of events, I wanted to know.

Had i t expressed an opinion? At this, the p sycho log i s t ' s face

became g rave . Her m o d e switched from empathic therapist to

purveyor-of- the-party-l ine. T h i s w a s an except ional event, she

said. T h e Subcommit tee on Personal Identity w a s meet ing in

emergency sess ion at that ve ry momen t to decide the i s sue .

What had happened was in contravention of the Prol iferat ion

of Persons Ac t . I t was a ser ious matter. She w a s at l iberty only

to present me with the bare facts and regretted that she could not

enter into speculation about future deve lopments . N o , I wou ld

not at this s tage be permit ted to contact my wife or any other

members of my family, or friends, or co l leagues . Or anyone .

T h e Subcommit tee was expected to deliver a s tatement within a

day or two and until then I wou ld be their gues t . Wha t exact ly

was the issue that the Subcommit tee w a s in sess ion to decide?

She was not at liberty to say.

T h e y took me to a small r o o m that looked out upon a q u a d ­

rangle. A soli tary copper beech occupied the centre of the lawn,

its purpl ish-brown leaves sh immer ing in the evening sunshine. I

lay on my bunk and stared at the ceil ing. It g r e w dark. I longed

to speak to my wife and children, but communica t ion with the

outside world w a s forbidden. I wanted to reassure them that I

was okay. I would have called them by now in ord inary c i rcum­

stances. T h e y ' d be worr ied sick. Wha t had they been told? A n d

then, d ropp ing like a forge hammer from my head to my gut ,

this thought: The call has already been made.

In t ime, miraculously, I slept. It w a s a heavy, d reamless sleep,

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as if I 'd been d r u g g e d . Perhaps I had. But in the middle of the

night I woke to find a tall figure s tanding at the foot of the bed.

It remained mot ionless , its face in shadow. I would have been

first to speak , had the w o r d s not lost their tired way through the

somnolen t circuitry o f my brain.

'L i s t en , ' said the figure. 'L is ten . I think you are entitled to

know. '

I t w a s D e r e k . He explained, without preliminary. T h e Sub­

commi t t ee ' s quandary — my mortal p roblem — was this: given

the unfortunate turn of events , they were now debat ing whether

to al low me and my replica to continue to exist in parallel, and

thereby contravene the Prol iferat ion of Persons Ac t , or to have

one of u s , even at this late s t age , vapor ized . To be two, or not to

b e . It w a s a hard one to call, he said. In law, the creation of sur­

p lus individuals w a s a ser ious cr ime; the mirror image of

murder . To D e r e k ' s knowledge , my replica had not immedi­

ately been informed of the c i rcumstances , so had carried on as i f

noth ing untoward had happened. He could not say for sure that

i t had been informed even now. T h i s could be an influential

factor i f the Subcommi t t ee decided that one of us had to go.

If the repl ica 's relationship with my wife had evolved even to

the merest extent of a br ief televisual communicat ion then that

could weight the decis ion in favour of a l lowing the replica to

surv ive rather than m e . Discorpora t ion w a s not my preferred

opt ion. Bu t surely, I thought , the proposa l would not be carried

anyway. T h e y couldn't. I t w a s prepos te rous . H a v i n g presented

itself, the dread propos i t ion had to crank through the archaic,

c lockwork logic of the commit tee p rocess , but then, surely, i t

wou ld be thrown out.

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I N T O T H E S I L E N T L A N D

' I don ' t want to die , ' I told D e r e k .

' I t wouldn ' t be the end of the wor ld , ' he replied, which s truck

me as an odd thing to say.

Derek sat in the easy chair at the far end of the r o o m , still in

shadow. 'What ' s the difference? ' he said . ' S u p p o s e i t had g o n e

according to plan. You would have s tepped into the boo th , the

scanners would have done their stuff, your b o d y wou ld have

been zapped to zero, and your replica wou ld have appeared on

Mars, walking your walk and talking your talk. A n d that is what

has happened — that is what a lways happens — except this t ime

the zapping may have been a little de layed . '

T h e difference, D e r e k , I might have sa id , is that I 'm still

here, now, and, having had t ime to reflect, I don ' t think I want

to be zapped to zero, even though, twelve t imes before , this is

precisely what has happened.

Nevertheless , D e r e k had a point. E a c h of the p rev ious t imes

I 'd been teleported to Mars the experience w a s the s a m e . I

walked out of the booth with perfect recollection of the d a y ' s

events up to the point of s tanding in the transceiver on Ear th

and experiencing that familiar little jolt and the br ief b lackness ,

and then there I was taking in the Martian landscape . T h e r e w a s

perfect continuity. T h e twelfth t ime I r emembered the eleventh,

the eleventh time the tenth, and so on. A n d each t ime I could

reflect back not just on that d a y ' s events, but on events of the

previous day, too, the prev ious weeks and months and all the

years of my sentient, se l f -conscious life.

On arrival, I a lways called my wife, told her I w a s okay, that

I missed her already, and checked on the kids. T h e n I went about

my business . A n d when I slept I knew my d reams had m a d e

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212

their digital w a y ac ross the void with the rest of me . T h e y had

their familiar fabric, the usual blend of the mundane and the

myster ious . I dreamt of h o m e , of work , of ordinary things.

A n d then it w a s no surprise to meet the lost and the dead and run

unfettered by log ic and t ime through the streets of my child­

h o o d or take w ing over oceans and s t range cities; I dreamt secret

d reams . T h i s i s what had a lways impressed me most about tele­

portat ion. N o t only w a s the b o d y reconstructed in perfect

replica, and the consc ious mind, but the unconscious mind, too:

those things hidden from the obse rv ing ' I ' .

N o w my replica was d reaming those dreams, and before i t

slept it had called my wife, told her it missed her already, checked

on the kids, and gone about its business . It had done those things,

not I. We were not the s ame . I was flowing in a different stream

of consciousness . But i f the replica wasn ' t me now, how could i t

have been me on the previous twelve occasions? What did the

experience of perfect continuity amount to? Was i t no more than

the illusion of life d isguis ing a dozen deaths?

I t w a s just three weeks since I 'd last m a d e the trip. D i d that

mean that, as a sentient, se l f -conscious be ing , I was less than a

month old, exquisi tely configured from the chaos of a billion

bil l ion bill ion a toms and artificially equipped with the memory

banks and disposi t ions of a midd le -aged man? If so, my identity

w a s a fiction.

' T h e p rob lem, ' said D e r e k , ' is that mos t of us have false

beliefs about our own nature. People expect determinate

answers to ques t ions about personal identity: " Y e s , i t is the same

p e r s o n " or " N o , i t i sn ' t ." T h a t ' s one great misconcept ion. T h e

other is that personal identity matters in the first p lace. '

I N T O T H E S I L E N T L A N D

I experienced a s low infusion of anger, r is ing in my chest ,

diffusing to my face and fists.

' I t ' s fine for you , De rek , ' I sa id , ' to deny the impor tance of

personal identity and pontificate on the conceptual confusion of

anyone else on the planet who happens to bel ieve otherwise . Bu t

put yourse l f in my posi t ion. T h e r e ' s a distinct possibi l i ty that

I 'm about to be snuffed out. R igh t now my concerns about

whether I shall still be here by the weekend — or "zapped to

ze ro" as you indelicately put i t - seem real enough . A n d if I am

to be vapor ized, I 'm sure you ' l l have no difficulty g i v i n g a deter­

minate answer to the quest ion of whether I exist or not . '

'Well, ' he said, ' that 's not quite the point . '

I 'd been sitting on the edge of the bunk, but s tood now and

moved towards him. Both of my fists, I not iced, were t ightly

clenched.

'Derek , ' I sa id , ' y o u ' d better go , ' at which he raised a p laca ­

tory pa lm, acknowledged my dis tress , and said he w a s here to

help. In fact, h e ' d been through someth ing similar in the early

days , since when he had achieved a kind of insight. H i s travels

in phi losophy and daily exposure to the plain facts of te leporta­

tion had brought him to a vis ion of the self, which, once

absorbed, began a t once to d raw the st ing of death. T h i s mos t

natural of fears was revealed as synthetic. I t could be d i sman­

tled. Intellectually.

He had once watched h imsel f die , he told me . I t w a s one of

the first interplanetary teleportations. Hi s first, and only, visi t to

Mars . He entered the booth and fol lowed the usual p rocedures

and, sure enough, s tepped out into the reception zone at the

Martian base as i f he were s tepping out of his front door . I t w a s

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P A U L B R O K S

a b i g event in those days . T h e y were ready with champagne and

s m o k e d sa lmon to celebrate. At first no one in the reception

par ty w a s aware of the malfunction back on Earth. But then the

m e s s a g e c a m e through. Scanning and t ransmission had worked

a treat — of cour se they had, there he was , soak ing his reconsti­

tuted flesh in c h a m p a g n e — but the vaporizat ion phase had failed

to kick in.

D e r e k had arrived but , at the s a m e t ime, he hadn' t left. A n d

w a s i t for better or w o r s e that the Ear thbound version of Derek

had suffered fatal injuries in the p rocess? T h e discorporat ion

mechanism had stuttered and s topped. His whole b o d y blinked

on the brink of extinction, fading then regaining its shape, but

only at the cost of significant d a m a g e to the cardiovascular

sys tem. He wou ld be dead within a week.

D e r e k 2 had returned at once , not knowing what to expect.

'I tried to console him, ' he said, 'I told him I loved his wife;

I wou ld care for his children; I would finish the book he was

wri t ing. A n d , of course , from my perspect ive, nothing had

changed: they were my wife and children, i t w a s my b o o k and

it w a s my intention that I should finish it. So , I told him:

" D o n ' t despai r ; nothing will really change . " But he wept. He

said that no doubt I wou ld do all those things as well as he could,

and i t w a s s o m e consolat ion that his family would not suffer

the pain of bereavement , but the fact remained that within a

few d a y s he wou ld lose consc iousness for ever. T h i s would be

a terrible loss .

' H e had been thinking of a h o m e mov ie , the one where his

smi l ing daughter — my smil ing daughter — is s tanding in the

kitchen with a basket of s trawberries . S h e ' s about three years

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I N T O T H E S I L E N T L A N D

old. T h e r e is sunlight s t reaming th rough the w indow on to her

face. A n d she takes the fattest s t rawberry in the basket and

crams i t into her mouth; i t ' s so b i g she has to push i t in with the

palm of her hand. Her cheeks are bu lg ing as she s t rugg les to

chew. Her eyes are c losed . She is utterly absorbed , over ­

whelmed, by the experience of the fruit. She even sways a little

from side to s ide , as v i r tuoso violinists do. " T h a t ' s what i t ' s all

about ," he said. " C o n s c i o u s experience. A n d that is what I shall

lose; that beautiful smile , the taste of s t rawberr ies , fond m e m o ­

r ies ." A n d to that extent, he w a s r ight , ' said D e r e k . ' H i s

consciousness would fade , beyond darkness and silence to

oblivion. He would b e c o m e nothing.

' I was with him when he died. T h e r e w a s no one else a round .

We had agreed that i t would be in the best interests of the family

that they should never know of our duplicat ion. W h y should

they be t roubled? T h e r e w a s no need. Le t life go on as normal .

I admired his resolve at the end. I t m a d e me feel p roud . He so

wanted to see his loved ones for one last t ime, but under s tood

the distress and confusion i t would cause . So i t w a s just me

and him. I held his hand. A n d then life did go on as normal . I

went h o m e and h u g g e d my wife and children, and eventual ly

I finished my b o o k . '

' T h e n i t can ' t be denied that personal identity really d o e s

matter, ' I sa id . 'Your former se l f died a lonely death. His con­

sciousness switched off like a light. He lost everything:

beautiful memor ies , the love of his family, hopes and plans for a

future that he would never reach; life itself. T h o s e things m a d e

up his identity. No th ing m o r e mattered, and nothing mattered

more . '

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P A U L B R O K S

216

D e r e k leaned forward, e lbows on knees , thumbs to cheek­

bones , f ingers to forehead. 'Yes and no, ' he said.

We talked for hours , until the light of a g rey dawn conjured

shapes in the cour tyard as i f from imaginat ion. T h e copper

beech seemed reluctant to appear . Was this to be my last day?

D e r e k did mos t of the talking. He mus t have thought these

things th rough a thousand t imes before , but still there was a note

of u rgency in his vo ice , as if he were on the brink of a revela­

tion. I am not a phi losopher , and at t imes I found him hard to

follow, but I go t the gis t .

He explained that there were two w a y s of looking at a person

or, rather, two theories about what persons are , and what is

involved in their continued existence over t ime. T h e f irs t theory

he called E g o Theory . T h i s i s the intuitive, common-sense view,

but one that w a s held, a lso, by s o m e of the greatest phi loso­

phers , mos t f amous ly Rene Desca r t e s . I t m a d e sense to me , too:

I wake up in the morn ing ; I go to work ; I feel happy when things

go well and I feel frustrated when they don ' t ; I hold certain

beliefs about the wor ld and express var ious opinions and prefer­

ences: I used to like Beethoven, but n o w I prefer Mozart; I like

chocola te better than cheesecake; I enjoy walks in the country­

s ide ; I take the v iew that peop le should be kind to one another,

and I feel bad if I do the w r o n g thing. I act, I feel, I think, I

be l ieve , I g r o w older, and I change in other ways . But 'I ' am

a lways there at the centre of things as t ime g o e s by.

Wha t i s this ' I ' ? We ordinari ly claim ownership of our

act ions and thoughts and experiences: I did it; that 's my idea; I

feel hungry ; I intend to b u y a bir thday present for my daughter

I N T O T H E S I L E N T L A N D

. . . So the 'I ' is the experiencer of experiences, the thinker of

thoughts, and the doer of deeds . E a c h day is a blizzard of s ens ­

ations and thought pat terns, but I g i v e them coherence and link

them to my memor ies and my p lans for the future.

I t ' s natural to think in this way. We are the p rogen i to r s of

thoughts and actions and they are ours in the thinking and do ing .

Accord ing to E g o Theory , i t is this 'I ' that consti tutes the

essence of the person and which pers is ts over t ime. But , aga in ,

what is it? Descar tes bel ieved that the e g o w a s a purely mental

thing, a soul or spiritual substance, but y o u don ' t have to go

a long with that to accept the idea of the self, the ego , as a kind of

hub about which the wheel of experience revolves .

In this non-spiri tual sense the e g o is merely the subject of

experience, it is that which unifies s o m e o n e ' s consc iousness at

any given moment . I watch the sky l ighten, I see the leaves of

the copper beech gain colour, and I hear birds s ing ing . Wha t

g ives this scene its unity? Wha t pulls these disparate threads of

experience together? I do. T h e y are experiences had by m e , this

person, at this t ime. A n d the wheel rolls on through the years ,

account ing for the unity of my life.

T h e s e thoughts were running through my mind as D e r e k

spoke. I was thinking them. ' I can see ing nothing to d i sagree

with there, ' I told him.

D e r e k s topped talking and, for a moment , there w a s only

b i rdsong; then he turned to Bundle Theory . He said that like

many styles in art — such as Goth ic , b a r o q u e , and rococo —

Bundle T h e o r y owed its n a m e to its critics. But the n a m e w a s

g o o d enough. T h i s theory rejects the idea that act ions and e x p e ­

riences are owned by s o m e inner essence , e g o or ' I ' . T h e r e are

217

P A U L B R O K S

just sequences of act ions and experiences. No th ing more . Each

life is a l ong series — or bundle — of mental states and events,

bound together by var ious kinds of causal relation, such as

those linking the percept ion of a f ierce-looking d o g with the

emot ion of fear and the disposi t ion to run away, or the different

causal relations that hold between ep isodes of experience and

ep i sodes of memory . A n d that ' s all. T h e idea of a central ego, or

pe r son , contr ibutes nothing to our unders tanding of the unity

of consc iousness at any g iven t ime, nor d o e s i t pull the golden

thread of experience th rough a lifetime.

' S o , ' said D e r e k , ' f rom this perspect ive the ego is a hollow

fabrication, and y o u could even say that Bundle Theor i s t s deny

the existence of peop le . '

'Bu t that ' s absurd . '

' Y e s , ' he sa id , ' and you are not the f i rs t to say so. T h e

eighteenth-century phi losopher, T h o m a s Reid [he came to be

k n o w n as 'the c o m m o n - s e n s e phi losopher ' ] m a d e a similar

object ion. "I am not thought ," said Re id , "I am not action, I am

not feeling; I am someth ing which thinks and acts and feels."

Y e s , of course , that ' s what i t s eems like for all of us, and it 's

certainly the w a y we are used to talking about ourselves and

others — as if there really were s o m e central nucleus of a self, a

ghos t ly pilot set t ing the course and handling the controls.

" D o n ' t call me a sequence of events ," you say, "I am a person, a

person, a P E R S O N ! ' " D e r e k beat his fists on the a rms o f the chair

for emphas i s .

' F ine , ' he sa id . 'Bund le Theor i s t s accept this as a fact. But

they accept i t only as a fact of g rammar . People and subjects-of-

exper ience exist as a feature of the w a y we use our l anguage , but

218

I N T O T H E S I L E N T L A N D

in no other way. If you say there is m o r e to i t than this, if you say

there is someth ing behind the chains of interacting mental

events and brain functions, someth ing above and beyond ,

observ ing and control l ing, bundl ing it all together, ho ld ing its

shape from one day to the next, then the Bundle Theor i s t wou ld

say that you were profoundly mistaken. '

' I think you ' re beg inning to lose me now, ' I admit ted, ' I can

accept that there are many p rocesses g o i n g on in my brain of

which I am unaware , all sor ts of hidden machiner ies p r o d u c i n g

thoughts and percept ions, shaping speech-pat terns , influenc­

ing decisions and actions in w a y s too rapid or subtle to be picked

out by the spotl ight of consc iousness . But , once such things

are in the spotl ight , who or what is hav ing the experiences, if

not I ? '

T h e sense that I was author of my own thoughts and act ions

felt like more than a 'fact of g r a m m a r ' to me . D e r e k mere ly

replied that yes , i t was indeed difficult to accept the truth of the

matter. He said there w a s a conflict between scientific under­

standing and p e o p l e ' s ord inary intuitions about what they

believe themselves to be , because there is nothing in the brain

sciences to support E g o Theory .

Few, if any, neuroscientists bel ieve that there is anything cor­

responding to a se l f or ego distinct from a multiplicity of mental

states and their associated pat terns of brain activity. F r o m the

perspect ive of neuroscience, Bundle T h e o r y i s obv ious ly true.

But E g o T h e o r y won ' t go away. We can ' t shake i t off. T h e

beliefs that most of us hold about our cont inued existence over

time are built upon assumpt ions that E g o T h e o r y , or someth ing

very like it, is true.

219

P A U L B R O K S

220

' T h a t ' s what I meant , ' said D e r e k , 'when I said that most

peop le hold false beliefs about themselves . '

Bund le T h e o r y was not a new idea, he explained, just a diffi­

cult one to c o m e to te rms with. Its roots reached down to the

sixth century BC and the teachings of Siddhartha G o t a m a , the

Buddha , ' the enlightened o n e ' . Anattavada, the Buddhist d o c ­

trine of 'no sou l ' or 'no se l f ' , ho lds that people and selves have

only nominal existence (as opposed to actual exis tence) , mean­

ing they are just combinat ions of other elements. T h e self i s no

m o r e than a bundle of fleeting impress ions .

D e r e k quoted from m e m o r y a segment of s o m e Buddhist

text: 'A sentient being does exist, you think, O Mara? You are

misled by a false conception. This bundle of elements is void of

Self. In it there is no sentient being. Just as a set of wooden parts

receives the name of carriage, so do we give to elements the name of

fancied being.'

' N o w , ' he continued, 'when teleportation came a long many

people had g r a v e misg iv ings . T h e y saw i t not as the fastest

means of t ransport , but as a sure means of dy ing . T rue , i f you

submit to the p rocess , your replica turns out perfect in every

way, with an identical b o d y and brain and identical patterns of

mental activity, including m e m o r y sys tems replete to the last

a tom and iota of information. " B u t , " they said, "don't be fooled.

T h o u g h it might resemble you in every way, the replica will not

in fact be you . It will be s o m e o n e else. It can' t poss ibly be you

because your b o d y and brain have been des t royed . ' "

'And they were right, ' I sa id . 'My present predicament

p roves it.'

'Pe rhaps , ' said D e r e k . ' In a way. But not in any way that

I N T O T H E S I L E N T L A N D

really matters in ordinary life. N o t i f Bund le T h e o r y is true, as

I bel ieve i t to b e . T h e fact is that teleportat ion b e c a m e c o m m o n ­

place. I t became a tried and trusted m o d e of t ransport and no

one had any complaints . People went into the boo th and they

came out at the other end, intact in b o d y and mind. L i f e went on

as usual . Y o u ' v e done i t numerous t imes yourse l f and i t ' s never

been a problem, at least not until now. A n d I want to pe r suade

you that, even now, even if the Subcommi t tee c o m e s to the con­

clusion that you are to be vapor ized , i t isn ' t really as much of a

problem as you fear.

'Le t me put i t this way. E v e n though i t involves dest ruct ion of

the body and reconstruction us ing entirely new mater ials , we

should think of travelling by teleportation as no m o r e threaten­

ing or problematic than travell ing on l i fe ' s j ou rney from one

day to the next. What matters in both cases , in te rms of what is

preserved, is precisely the s ame : psychologica l continuity. We

are the same from one day to the next only in so far as the bundle

of mental states, actual and potential , that our brain takes with it

to sleep at night resembles the bundle that it wakes up with in

the morning . You survive from one day to the next because the

psychological links have been maintained.

' O n Tuesday you have a certain set of memor ie s and plans ,

aptitudes and disposi t ions. T h e s e flow from the ones you had on

Monday and are , in turn, causal ly linked to the ones you will

have on Wednesday, Thur sday , and Friday. A n d if, on Saturday,

you are teleported to Mars , your replica emerges with the very

same pattern of mental states, which will be carried forward to

the next day and the next and the next th rough the usual causal

links. The re is no break in the continuity of mental life. You and

221

P A U L B R O K S

your replica are psychologica l ly cont inuous at the deepest level.

A n d you mus t realize that the mechanisms of mental survival

over t ime in ord inary life really are no different, and that there

is no other kind of continuity that really matters. The re is no

point peer ing into the bundle , hop ing to catch a g l impse of some

elusive, obse rv ing ego. T h e r e isn' t one . T h e bundle i s all. '

I w a s beg inn ing to unders tand, but it didn' t help my case . I

might still have to face the prospect of an untimely death. I said

that Bundle T h e o r y might very well be true, as D e r e k believed,

and my mind would live on in replicated form — and, yes, there

w a s s o m e consola t ion in that. T h e replica moves forward in

t ime with my s tock of memor ie s and disposi t ions. I t can go on

to fulfil my plans and obl igat ions . Perhaps it really was the case

that, by any meaningful analysis of the nature of mental life, I

s tood in relation to my replica as I s tood in relation to the person

I w a s yes terday and the pe r son I might be tomorrow. But, at the

s a m e t ime, it w a s a lso clear that a branching had taken place.

Whi le the repl ica 's mind had rolled out with perfect continu­

ity from the mind I embodied at the point when D e r e k pushed

the green but ton to initiate the scanning p rocess , our minds had,

since then, b e g u n to d iverge as , minute by minute, we absorbed

different experiences. We did not know whether the replica had

even been informed of the teleportation malfunction. I f not,

then it wou ld be car ry ing on as normal — as me — happily un­

aware that a vers ion of its former self was languishing

miserab ly on a truncated branch line.

Would it care? I wondered . I liked to think that I (and there­

fore it) would feel compass ion . But really who knows how one

might react i f s o m e bizarre alternative vers ion of o n e ' s self

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I N T O T H E S I L E N T L A N D

showed up like the spectre at the feast, threatening to warp the

status quo? It could p rove a dreadful encumbrance .

I put it to D e r e k that my replica and I m a y once have been

identical, but we were g r o w i n g apart . We were deve lop ing

alternative points of view. We had b e c o m e different peop le i f

only in the restricted, l anguage-dependent sense that Bund le

Theor is t s al lowed talk o f people . A n d I , f rom my perspec t ive ,

did not relish the prospect of a premature death, notwithstand­

ing the considerable difficulties that future life with a dupl icate

would inevitably entail. ( A s the night w o r e on I had been think­

ing more and more about my wife and what her s t ra tegy migh t

be for coping with a duplicated husband. )

' I can understand, ' D e r e k said, 'that y o u don ' t want to d ie .

Even Bundle Theor i s t s don ' t want to d ie . Fo r mos t peop le the

truth of Bundle T h e o r y does not dispel the i l lusion of the ego .

T h e y cling to their false beliefs. ' But he also said that acceptance

of that truth could have a l iberating effect. A m o n g other things,

it opened the possibil i ty of looking at death in a different way.

He personal ly had found this to be the case . I t w a s l iberat ing

and consol ing. Before he had fully absorbed the truth of Bund le

T h e o r y he said that he had felt imprisoned in himself. H i s life

seemed like a g lass tunnel through which he w a s m o v i n g

faster and faster every year and, at the end of which, there w a s

nothing but darkness .

' N o w my view has changed. T h e wal ls o f the g l a s s tunnel

have dissolved. I live in the open air.' It had b rough t him closer

to people . He was less concerned about his own life and more

concerned with the lives of others. He cared less about his own

inevitable death. Mental events and experiences wou ld continue

223

P A U L B R O K S

to be a feature of the wor ld after his death, he said, and it was

true that none of these wou ld be linked to his present mental life

by the sort of direct exper ience-memory or intention-action

connect ions that shaped the exist ing bundle of experiences.

T h e r e wou ld be s o m e indirect connections, however — m e m o ­

ries of h im, thoughts influenced by his thinking, advice

fol lowed.

'We all make a mark , ' he said . ' T h e s imple facts of death are

this: that it will b reak the more direct relations between my

present mental events and mental events ar is ing in the future,

and that certain other relations will not be broken. Once the ego

is r emoved from the scene, that is all there is to it.'

I found this m o r e depress ing than uplifting. I told him that his

redescript ion of death seemed to me to reflect an impoverished

v iew of life. Perhaps it w a s better to anticipate los ing the self in

death than to deny it in life, a denial that, surely, amounted to a

form of nihilism. A n d , anyway, even i f Bundle T h e o r y was true

I could not bel ieve it. Intellectually, I could follow his a rgu­

ments and accept the facts of neuroscience but , psychologically,

it w a s imposs ib le to identify with his theory. It ran counter to

o n e ' s experience of the wor ld .

D e r e k ' s response , aga in , was that i t was difficult to g rasp

the truth, and if he w a s be ing charged with nihilism then he

wou ld accept that in so far as it applied to his v iew of the self.

T h e term, he reminded m e , is from the Lat in nihil, meaning

'nothing ' . 'It is perfectly true to say that the self is No Th ing . '

Otherwise , he rejected the charge . He said that in accepting the

truth of Bund le T h e o r y his appreciat ion of the value of life had

only been enriched.

224

I N T O T H E S I L E N T L A N D

Apparently, in f inding Bundle T h e o r y depres s ing and

unpalatable I was in g o o d company. D e r e k sa id that the ph i lo so ­

pher D a v i d H u m e , who had formulated an influential vers ion of

the theory in the eighteenth century, reflected on his own a r g u ­

ments and was pitched into a deep depress ion , the cure for

which was to get out m o r e - dining and p lay ing b a c k g a m m o n

with friends. A n d in the twentieth century, T h o m a s N a g e l also

came to the conclusion that, whatever the truth of the theory, it

was impossible for the human psyche to digest .

'De rek , ' I said, 'perhaps you should ge t out m o r e , too. R e d i s ­

cover your self. ' He rose from his seat , g r inn ing broadly , and

came across and s lapped me on the back .

'Maybe , ' he said. ' M a y b e not. ' T h e n he wished me luck and

was gone .

I dozed off and dreamt I was in the beautiful city of Venice,

in the Piazza San Marco. Bel ls were r inging and p igeons circled

and swooped . T h e r e were no peop le . T h e n , ac ross the square

from the direction of the Basi l ica , there appeared a y o u n g

couple. T h e y walked towards me . T h e w o m a n I recognized as

my wife, a younger vers ion , perhaps as she wou ld have been

when we first visited the city. T h e m a n had no face, just a

smooth plane of skin where the usual contours and orifices

should have been. T h e r e w a s no greet ing.

I woke to find that a white envelope had been pushed under

the door . It contained an invitation to appear before the S u b ­

committee on Personal Identity at eleven o ' c lock that morn ing .

I t was now ten. I showered , breakfas ted on bread , cheese , and

coffee, and prepared to meet my fate.

225

Gulls

' I ' v e go t a lump, ' my wife says . 'Fee l . '

I 'm watching the S unda y afternoon football and still have an

eye on the g a m e as she directs my hand to the outer curve of her

left breast . It is the s ixty-seventh minute. T h e r e is a lump.

'Wha t d o e s i t feel l ike? ' We are in the b e d r o o m now. She has

str ipped to the waist . I palpate the breast as if I 'm an expert.

'Wha t do you th ink? ' she says .

' T h e r e ' s a bump. More of a b u m p than a lump. '

T h e GP is reassur ing a t first, but deve lops doubts , and organ­

izes a referral to the breast clinic. Ka te returns tearful. We both

need cheer ing up, so we head for the coast , half-an-hour 's drive,

s topp ing to b u y sandwiches on the way. I t ' s a fine day, as bright

as the cal l ing gul ls . T h e tide is low and the sea is a hard blue. It

feels g o o d to be al ive. But later, in the pub, i t ' s my turn to be

tearful. T h e second beer helps.

T h u r s d a y week , the day of the appointment . We sit in the

g rey -b lue wai t ing r o o m at the breast clinic. T h e r e is a TV in the

226

I N T O T H E S I L E N T L A N D

227

corner with the sound muted. S o m e TV chef i s bak ing a bir th­

day cake. No one is interested.

O u r turn. T h r o u g h to the examinat ion r o o m , my semi-naked

wife looking fragile as the surgeon p rods and palpates and ge ts

to work with his blue marker pen. He doesn ' t say much . T h e

nurse does most of the talking. S h e ' s lovely.

Our turn again . Yes , there i s someth ing suspic ious on the X-

ray, the surgeon says . H e ' s g o i n g to do a core biopsy. Seven

s lamming shots of the silver gun , and each t ime he holds up the

phial to inspect the m a g g o t y p lugs of f lesh . H e ' s not quite ge t ­

ting what he wants . We ' l l have the results in a few days .

'But you don ' t like the look of i t ? ' I ask .

' N o . '

'You think i t ' s cancer. '

'Yes . '

T h e nurse specialist has joined us : bad news personified. T h e

surgeon leaves and i t 's the three of us in the examinat ion r o o m ,

K a t e ' s tears hot on my shoulder. T h e nurse sits quietly. I have

my back to her, which feels like a discourtesy.

I t ' s a nasty, sticky word , 'mas t ec tomy ' . I don ' t like the sound

of i t coming from the su rgeon ' s mouth . We are back in the

consult ing room. H e ' s plott ing the likely course : surgery,

chemotherapy, and radiotherapy, not necessar i ly in that order.

We don ' t go straight home . We stop by the r iverside and walk in

the woods . I can' t remember the last t ime I wept .

A week on. T h e y ' r e setting it up as a B a d N e w s Consul ta t ion .

T h e y have grave- jo l ly faces — profess ional wistfulness. But we

know already. The re isn't much by w a y of preliminary. T h e

surgeon squints over his spectacles .

P A U L B R O K S

228

' I t ' s a mal ignant , invas ive , ductal carc inoma, ' he says , with a

trace of apo logy . I s there anything else we want to know? H e ' s

not g o i n g to tell us unless we ask .

'Wha t about the h i s to logy? A r e the cells well , or poorly,

differentiated? '

'Poorly, ' he s ays , ' G r a d e 3. '

I t ' s a bad one . He replays the likely treatment scenario: four

cycles of neoadjuvant chemotherapy over three months; m a s ­

tectomy, fol lowed by radiotherapy. T h e plan is provisional ,

because if the chemo fails to shrink the tumour they'll br ing the

su rgery forward. Ar rangemen t s will be m a d e for bone and liver

scans . We can do b loods and a chest X - r a y straight away. I keep

s ay ing ' w e ' .

H o w o d d this is. T h e wors t news , but a sense of relief. I

have already pictured the su rgeon slicing off my wi fe ' s breast .

I have imagined it be ing thrown to was te . I have seen it rising

in s m o k e through the incinerator chimney. Yet there is comfort

in the thought of get t ing on with treatment. Whatever i t takes.

I t a lmos t feels re laxing to walk out ac ross the main concourse

of the hospital — like a depar ture lounge with its cafe and shops

- this p lace I know in a parallel professional life, out into the

sunlight.

T h i s t ime we don ' t weep by the r iverside or walk in the

w o o d s . We head for the supermarket . A famil iar- looking man in

shorts and T-shi r t is load ing his shopping into the back of a

Volvo. I t ' s a f a m o u s TV newsreader . I want to tell him our

news. B a c k h o m e we drink beer and eat curry and watch

football .

We are handed over to another su rgeon , a specialist in breast

I N T O T H E S I L E N T L A N D

reconstruction. Kate sits on the e d g e of the bed . T h e su rgeon

stands s t roking his chin, obse rv ing her bus t with the eye of a

sculptor. He s toops , presses and p robes the d iseased breas t , then

stands back for a fresh view. He takes out a little ruler and starts

measur ing. H e ' s we igh ing things up ; thinking on his feet. Yes ,

he says , we could go for a wide local excision instead of mas t ec ­

tomy. A n d now, despite myself , I find I 'm p lay ing D e v i l ' s

Advoca te . I 've read the latest New England Journal of Medicine

and understand that, all things be ing equal , less radical inter­

ventions are just as effective. But I need to hear it f rom the m a n

in the dark suit.

F ive months on, pos t -chemo, Ka te lies on a hospital bed ,

draped in drips and drains, recover ing from her second ope ra ­

tion in a month. T h e f irs t was to r emove the lump. T h i s one has

restored the breast to its original shape , though we have yet to

see the sculptor 's handiwork. She is swaddled in a 'bear hugger '

blanket, f i l led with w a r m air to aid the perfusion of b lood . With

her hair just starting to g r o w back she looks like the D a l a i L a m a ,

but much prettier.

* * *

T h e year before last. E v e n i n g on the terrace of a French seas ide

hotel, late summer , the sea as smoo th as mercury, the sky not yet

drained of its blue. T h e r e would be s tars , but t ime had s lowed.

Even the gul ls seemed suspended on the cool ing air, and m a d e

hardly a sound. T h e y are more sof t-spoken here. Ka te and I

were drinking cold beer, recover ing from the heat of the day,

our skin feeling full of the sun, our l imbs aching from a l ong

229

P A U L B R O K S

230

swim. We said little, but sat content watching the darkness

gather. T h e candle on the table remained unlit.

I b e c a m e aware of the man and w o m a n two tables a long . She

had said someth ing inaudible, to which he had replied 'Non,

merci,' bu t nothing else w a s said .

T h e man , about forty, sat hunched with a rms folded, as i f

constra ined by a straitjacket. H i s face had a drawn, intent look.

He could have been concentrat ing hard. F r o m time to t ime, his

lips pur sed and his right shoulder seemed to jerk forward a little.

I watched , discreetly. I noticed, too, the squ i rming movement of

his right hand. Pressed between forearm and b iceps of the left

l imb, i t w a s t ry ing to escape .

A waiter appeared from nowhere offering something, but

the w o m a n waved him away. Ka te had her back to all this and

couldn ' t see what w a s g o i n g on.

Somehow, the man and w o m a n on the terrace brought to

mind a scene from a novel I had been reading: Kundera ' s Immor­

tality. O n e of the characters , A g n e s , is lying in bed next to her

husband , Paul . Both have difficulty s leeping and A g n e s drifts

into a familiar fantasy about a kindly visitor from another

planet. T h e s t ranger tells her that in the next life she will not be

returning to Ear th .

A n d P a u l ? ' she enquires . N o , she i s told, Paul won ' t be s tay­

ing either. Wha t the s tranger needs to know is, do they want to

s tay together in the life to c o m e or never meet again? In Paul ' s

presence , A g n e s a lways knew she would be incapable o f say ing

that she no longer wanted to be with him. H o w could she?

Wouldn ' t that amoun t to s ay ing that there had never been any

love between them, that their life had been based on the illusion

I N T O T H E S I L E N T L A N D

231

of love? A n d for this reason she wou ld a lways capitulate.

Aga ins t her wishes she wou ld tell the s t ranger that of cour se

they wanted to remain together in the next life.

I put the s a m e quest ion to my wife. ' Imag ine , ' I sa id , 'a v i s i ­

tor from outer space joins us now at this table. He makes his

offer of another life beyond death, and g ives y o u a choice . Y o u

can make ar rangements for me to join you or you can decide

that, at the end of this life, we should part c o m p a n y never to

meet aga in . '

T h e hand escapes . I t wri thes from under the left forearm and

pushes forward, pa lm facing outward to the sea . T h e m a n ' s

expression d o e s not change, he looks straight ahead, but I see

that his knees are now pressed tight together and are e d g i n g to

the left as his upper b o d y twists to the right. T h e w o m a n takes

the errant hand and puts i t between her pa lms . She g u i d e s i t back

towards the man ' s chest. She holds it fast with her left hand and,

at the same t ime, reaches for his left with her right. Still he looks

straight ahead, does not speak . I watch as she refolds the a rms ,

pull ing them tight like a knot . T h e man g ives no a c k n o w l e d g e ­

ment. She returns to her seat.

Ka te was still thinking about the quest ion. T o o long , I

thought. I wouldn ' t bel ieve her now. T h e n , straight out , she

said: ' I ' d go i t a lone. Wouldn ' t y o u ? ' She said that one lifetime

was enough, however much you loved s o m e o n e .

T w o more couples c a m e to sit a t the table be tween us and the

French couple . I 'd seen them from a dis tance at the beach that

afternoon. At first I 'd a s sumed they were French, but there w a s

a self-deprecating jokiness about one of the w o m e n as she

s t ruggled, inelegantly, to ge t into a wetsuit . I thought it be t rayed

P A U L B R O K S

232

her as Eng l i sh . I w a s right. T h e y ordered a round of drinks,

then another, and another. The i r candle w a s lit, and it lit the red­

dening faces a round the table and gut tered in the g lass of the

accumula t ing bott les .

T h e French couple were away in the shadows. You could

hardly see them now. But a second and third time I noticed the

m a n ' s hand escape and, each t ime, saw the w o m a n retrieve it. He

jerked and writhed as she tied the a rms together, before settling

back into a bunched repose , set to unravel again at any moment .

It's Huntington's disease, I thought . St Vitus's dance. Poor man.

Poor woman.

T h e involuntary, chorei form movements are only the half of

it. T h e r e ' s the dement ia , too, and perhaps psychos is . T h e d is ­

ease is relentless and he will dance like a puppet to his death. His

fate w a s fixed at concept ion. A r o g u e gene , dormant for

decades , had struck, and his brain w a s crumbl ing at its core,

deep beneath the wrinkled mantle of the cortex, down in the

dark interiors of the basa l gang l ia , where actions are deciphered

from the codes of intention. A n d now all is confusion. The re are

act ions and intentions, but they don ' t necessari ly coincide.

Meanwhile , they will do their best , this couple , to deny the

terror and defy the puppeteer . T h e y will enjoy a summer ' s

even ing together out on the terrace.

I absorbed my w i f e ' s answer - I'd go it alone. Wouldn't you?-

and took another sip of beer.

'Would y o u ? ' I asked. S o m e o n e in the Engl i sh g r o u p

knocked an empty bott le o f f the table. It shattered on the

g r o u n d , burs t ing shards in every direction. I noticed that the

French couple were g o n e .

I N T O T H E S I L E N T L A N D

' S o , ' I said, ' i t ' s just the one l i fet ime? '

'Afraid so , ' she said . 'Bet ter make the mos t of it.'

Remember me when I am gone away,

Gone far away into the silent land;

When you can no more hold me by the hand,

Nor I half turn to go yet turning stay.

Christina Rossetti, 'Remember'

F U R T H E R R E A D I N G

Some of the following readings relate to particular chapters in

this book, others will illuminate its general themes. Still others are

recommended simply as sound introductions to neuroscience, neuro­

psychology, and philosophy of mind for those sufficiently motivated to

go beyond my case stories and other meanderings.

Recent years have seen the publication of several fine works of pop­

ular science devoted to neuropsychology, neuroscience, and related

topics. There are also some outstanding new textbooks. I can't think of

a better general introduction to brain science than Ian Glynn's An

Anatomy of Thought: the Origin and Machinery of the Mind (Weiden-

feld & Nicolson, 1999). Susan Greenfield's The Human Brain: A

Guided Tour (Phoenix, 1998) provides a useful brief survey; and for

those who prefer to be spoon-fed, Mind and Brain for Beginners by

Angus Gellatly and Oscar Zarate (Icon Books, 1998) is an entertaining

and informative cartoon book. Bruno Aldaris's Neuroscience for the

Brainless (Figment Books, 1994) which I quote in 'The Visible Man' is,

sadly, virtually unobtainable these days.

Also recommended is Phantoms in the Brain: Human Nature and the

Architecture of the Mind. (Fourth Estate, 1998) by V. S. Ramachandran

and Sandra Blakeslee. Ramachandran is a remarkably inventive neuro­

logical thinker and, among many other topics, this stimulating book

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238

has some interesting things to say about phantom limbs and the neuro-

biological bases of the body schema, complementing the impression­

istic treatment I accord these topics in 'The Ghost Tree' chapters.

Todd E. Feinberg's Altered Egos: How the Brain Creates the Self

(Oxford University Press, 2001) is another excellent collection of case-

study vignettes and theoretical speculations. Among other fascinating

material, it contains a chapter on the important (but in research terms

relatively neglected) phenomenon of confabulation, which topic

forms one of the strands of 'Soul in a Bucket'. I was amused to discover

that we both appreciate the utility of the eye and pyramid symbol,

though use it to quite different ends.

As for basic textbooks, I list my recommendations below. There

may be other books of equal merit, but these are the ones with which I

am familiar and they are very good indeed:

Gazzaniga, M. S., Ivry, R. B. and Mangun, G. R., Cognitive Neuro­

science: The Biology of the Mind, Second Edition (Norton & Co.,

2002).

Kolb, B. and Whishaw, I. Q., An Introduction to Brain and Behavior

(Worth Publishers, 2001).

Rosenzweig, M. R., Breedlove, S. M. and Leiman, A. L., Biological

Psychology: An Introduction to Behavioral, Cognitive, and Clinical

Neuroscience, Third Edition (Sinauer Associates, Inc., 2002).

It is important to note that there are different varieties of neuro­

psychology. One approach emphasizes functional anatomy and is con­

cerned with studying the neural bases of psychological functions.

Scientists working in this field are like mapmakers. Their mission is to

explore the neurobiological landscape, charting the relationship

between mental events and the structures and processes of the brain.

Localization and distribution of functions is the central concern. This

approach includes the classical method of examining the psychological

consequences of 'focal' (localized) brain damage as well as the newer

methods of cognitive neuroscience that use brain-scanning machines

I N T O T H E S I L E N T L A N D

239

to explore patterns of activity in the normal, intact brain. The above-

cited general texts are representative of this approach.

Other investigators—so-called cognitive neuropsychologists — have

relatively little interest in the details of brain function. They assume, of

course, that brain systems and mental life are intertwined, but their

primary concern is the structure of the mind, not the brain.

Cognitive neuropsychologists study the performance of the dam­

aged brain as a way of testing and refining theories of normal cognitive

function. They start with a theory of cognition — some model of short-

term memory, say, or of language production — and form hypotheses

as to how memory or speech might be affected by brain disorder.

The model gains support to the extent that patients' behaviour fits with

predictions. Alternatively, their test performance may challenge the

original model, leading to its modification or abandonment. What

matters is the robustness (or otherwise) of the theoretical models

rather than the precise nature of the underlying neurological disorder.

The best introduction to cognitive neuropsychology is Human

Cognitive Neuropsychology: A Textbook with Readings (Psychology

Press, 1996) by Andy Ellis and Andy Young. Alan Parkin's Explo­

rations in Cognitive Neuropsychology (Blackwell, 1996) is also excellent,

and The Handbook of Cognitive Neuropsychology (Psychology Press,

2000), edited by Brenda Rapp, is a useful source book.

The biological and psychological approaches are complementary.

Although considerations of anatomy and physiology may be second­

ary to their main enterprise, the fruits of the cognitive neuro­

psychologists' labours are directly relevant to an understanding of the

structure and functions of the brain. In order to know how psycholog­

ical functions are represented in neural systems the functions

themselves must be clearly delineated.

Modern clinical neuropsychology draws on both traditions, a fact

nicely illustrated in David Andrewes's comprehensive survey, Neuro­

psychology: From Theory to Practice (Psychology Press, 2001). I also

recommend The Blackwell Dictionary of Neuropsychology (Blackwell,

1996), edited by J. G. Beaumont, P. M. Kenealy and J. C. Rogers. Much

P A U L B R O K S

240

more than a dictionary, this is an excellent reference work containing

substantial entries on most aspects of clinical and experimental neuro­

psychology. The list of contributors is impressive.

For those specifically interested in psychiatric aspects of neurologi­

cal disorder the classic text is W. A. Lishman's Organic Psychiatry,

Third Edition (Blackwell Science, 1997). Although geared for a spe­

cialist readership, it is sufficiently lucid and digestible to be of interest

to the motivated lay reader.

The emerging discipline of cognitive neuropsychiatry puts the prin­

ciples and methods of cognitive neuropsychology to work in the field

of psychiatric research. Peter Halligan and John Marshall's Method in

Madness: Case Studies in Cognitive Neuropsychiatry (Psychology Press,

1996) provides a stimulating introduction. It includes a fine chapter on

Cotard's syndrome by Andy Young and Kate Leafhead ('Betwixt Life

and Death: Case Studies of the Cotard Delusion'), which helped shape

my thinking as I came to write 'I Think Therefore I Am Dead'.

Themes of consciousness, self, and personal identity thread right

through this book. I hope that professional philosophers will not find

my excursions into their territory too naive or superficial. If that is the

case I blame the following: David Chalmers, The Conscious Mind: In

Search of a Fundamental Theory (Oxford University Press, 1996);

Francis Crick, The Astonishing Hypothesis (Simon and Schuster, 1994);

Daniel Dennett, Consciousness Explained (Penguin Books, 1993);

Owen Flanagan, The Problem of the Soul: Two Visions of the Mind and

How to Reconcile Them (Basic Books, 2002); Gerald Edelman and

Giulio Tonini, Consciousness: How Matter Becomes Imagination

(Penguin, 2001); Nicholas Humphrey, A History of the Mind (Chatto

and Windus, 1992); Colin McGinn, The Mysterious Flame: Conscious

Minds in a Material World (Basic Books, 1999); Thomas Nagel, The

View from Nowhere (Oxford University Press, 1986); John Searle, The

Mystery of Consciousness (Granta Books, 1997); and Max Velmans,

Understanding Consciousness (Routledge, 2000).

It would take another long chapter to summarize the range of ideas

represented in these works (materialism, dualism, neural Darwinism,

I N T O T H E S I L E N T L A N D

Mysterianism, and so on), and I have resisted the temptation to offer

such a summary — for one thing I don't feel qualified to undertake the

task. Searle's highly readable book summarizes the thinking of some of

the key figures in the current debate, as well as presenting the author's

own views. If nothing else, it is worth reading for the testy exchange

between Searle and Dennett in which each accuses the other of 'intel­

lectual pathology'. It took me straight back to the school playground

{Fight! Fight! Fight!).

I find Searle's 'biological naturalism' hard to fathom, but generally

have difficulties fixing my own co-ordinates when it comes to the prob­

lem of consciousness. In 'Right this way, Smiles a Mermaid' the narra­

tor stands accused of being a 'Mysterian'. Owen Flanagan, I believe,

originally coined the term in honour (not quite the right word) of

Colin McGinn for propounding the view that the mind-body problem

is insoluble, or at least that we feeble-minded humans are incapable of

solving it. I am much drawn to McGinn's deeply subversive position,

but also find Dennett persuasive (as should be apparent throughout the

book). That's my problem.

For an incisive analysis of the neuropsychological bases of con­

sciousness, see Larry Weiskrantz's Consciousness Lost and Found: A

Neuropsychological Exploration (Oxford University Press, 1997). The

work of the neurologist Antonio Damasio has also been influential in

shaping my thoughts on consciousness, self, and related matters. See,

in particular, Descartes' Error: Emotion, Reason and the Human Brain

(Picador, 1995), and The Feeling of What Happens: Body, Emotion and

the Making of Consciousness (Heinemann, 1999). Joseph LeDoux's

Synaptic Self: How Our Brains Become Who We Are (Macmillan, 2002)

also makes an important contribution to our understanding of the

neurobiological underpinnings of the self. Again, for those who prefer

cartoon books, David Papineau and Howard Selina's Introducing

Consciousness (Icon Books, 2000) is a sparky introduction to the field of

consciousness studies.

In a recent collection of essays, Consciousness and the Novel (Seeker

and Warburg, 2002), the novelist and critic David Lodge offers some

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valuable insights concerning the representation of consciousness in

literature. Works of literature — in contradistinction to science -

describe 'the dense specificity of personal experience'. Science, from

its objective, third-person perspective, tries to formulate universally

applicable, general explanations. The subjective and the unique are

anathema to science. Lodge suggests that 'Lyric poetry is arguably

man's most successful effort to describe qualia' (the 'raw feels' of con­

scious awareness). 'The novel is arguably man's most successful effort

to describe the experience of individual human beings moving through

space and time.'

'To Be Two or Not to Be' draws heavily on the ideas of the philoso­

pher, Derek Parfit, and I took the liberty of using the name 'Derek' for

one of the central characters. Although most of what the fictional

Derek has to say is, I believe, representative of the real Derek Parfit's

ideas, there may be instances where the views of the two Dereks

diverge in more or less subtle ways. The best way to become

acquainted with Mr Parfit's thoughts on personal identity is to consult

his masterwork, Reasons and Persons (Oxford University Press, 1984).

Don't expect to read it in one sitting, however. A digestible account of

some of Parfit's ideas — and much else besides - can be found in

Jonathan Glover's I: The Philosophy and Psychology of Personal Identity

(Penguin Books, 1991).

I saw Parfit lecture on personal identity, around the time that

Reasons and Persons was published, in the Department of Physiology at

Oxford during a series of seminars on the science and philosophy of

mind. I thought at the time that he was saying something that was

either quite trivial (if entertaining) or extremely profound and not a

little disturbing. With the passage of the years I can see it was the latter.

I have to say that, like his fictional counterpart, he did have a slightly

wild look about him, and he was swigging water from a milk bottle

throughout his presentation.

The scientific paper to which I refer in 'The Ghost Tree (1)' was

co-authored with Andy Young and others and published in the journal

Neuropsychologia (P. Broks, A. W. Young, et al., 'Face processing

I N T O T H E S I L E N T L A N D

impairments after encephalitis: amygdala damage and the recognition

of fear', Neuropsychologia 36, pp.59-70, 1998). In 'The Ghost Tree (2)'

I refer to the concept 'the social brain' — the notion that the brain has

evolved systems dedicated to social perception and understanding. A

good general introduction to this way of thinking is Fridays Footprint:

How Society Shapes the Human Brain (Oxford University Press, 1997)

by Leslie Brothers. Simon Baron-Cohen makes a strong case for the

relevance of the social brain to an understanding of autism in Mind-

blindness (MIT Press, 1995).

'The Sword of the Sun' was inspired by a story of the same name in

Italo Calvino's Mr Palomar (Vintage, 1999), translated from the Italian

by William Feaver . In 'Vodka and Saliva' I quote from Paul Ekman's

Telling Lies: Clues to Deceit in the Marketplace, Politics and Marriage

(Norton, 2001). 'The Dreams of Robert Louis Stevenson' was inspired

by 'A Chapter on Dreams', which can be found as an appendix to The

Strange Case of Dr Jekyll and Mr Hyde and Weir of Hermiston (Oxford

World's Classics, 1998). The introduction by Emma Letley was very

helpful, as was Robert Mighall's introduction to the Penguin Classics

edition of Jekyll and Hyde (Penguin, 2002). 'The Visible Man', of

course, pays homage to Kafka's classic allegorical tale 'Metamorphosis',

available in The Complete Short Stories of Fran\ Kafka (Vintage Clas­

sics, 1999). 'In the Theatre' takes as its focal point Dannie Abse's dis­

turbing poem, 'In the Theatre (A True Incident)', from his Collected

Poems, 1948- 76 (Hutchinson, 1977). I had already drafted 'The Story

of Einstein's Brain' when I came upon Driving Mr Albert: A Trip Across

America with Einstein's Brain (Abacus, 2002), Michael Paterniti's enter­

taining account of his quest for the great man's grey matter and subse­

quent journey through America with it stashed in the trunk of his

Buick. In 'Gulls' I refer to Milan Kundera's Immortality (Faber and

Faber, 1991), translated from the Czech by Peter Kussi. In 'Soul in a

Bucket' I mention Tom Wolfe's essay, 'Sorry, but Your Soul Just

Died', which appears in Hooking Up (Jonathan Cape, 2000).

The Working Brain by Alexander Romanovich Luria (Penguin,

1973) is out of date, hard to obtain, and difficult to read — at least I

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244

found it so when I first came across it in my undergraduate days. I can't,

for these reasons, recommend the book as an introductory text, but I

cite it because its author has been a significant influence on my own

approach to clinical practice. Luria, to whom I refer more than once in

these pages, is one of the undisputed giants of neuropsychology, and

The Working Brain (published four years before he died) summarizes

his life's work. It presents a general theory of the organization of brain

function — the distillation of forty years' work by Luria and his collab­

orators — as well as a comprehensive survey of existing knowledge of

the classical domains of interest: the brain bases of perception, lan­

guage, memory, thought, and action. Anyone developing a serious

interest in the subject should at some stage track down, read, and

appreciate Luria for the breadth of his vision of brain science, his

recognition that the study of brain function is a multidisciplinary

enterprise, and his insight that, ultimately, it becomes necessary to con­

sider the brain in relation to other brains if one is to comprehend its

workings: neuropsychology has social dimensions as well as biological

and psychological. 'The eye of science,' he wrote, 'does not probe a

"thing", an event isolated from other things or events. Its real object is

to see and understand the way a thing or event relates to other things or

events.'

Luria should be read not least for his understanding that neuro­

psychology concerns individual human beings — patients — struggling

to make their way in a world rendered difficult and sometimes dis­

turbingly strange by their brain damage. As far as neuropsychology is

concerned, he was an advocate of 'romantic science' — recognizing the

importance of combining close observation of individual patients (and

understanding them as people) with a more systematic, 'classical'

understanding of the facts of neurological disorder derived through

conventional scientific method. This should be the aim of all clinicians

— not to lose sight of the unique in the context of the universal, and vice

versa.

Luria's scientific biography, The Making of Mind: A Personal

Account of Soviet Psychology (Harvard University Press, 1986), edited

I N T O T H E S I L E N T L A N D

by Michael and Shelia Cole, is a fascinating fusion of the personal, the

political, and the scientific. But he is best known as a master of the

extended case history, classic examples of which are The Man with

a Shattered World (Penguin, 1975) and The Mind of a Mnemonist

(Harvard University Press, 1986).

Another master of that genre is, of course, Oliver Sacks, whose

works I have studiously avoided while writing this book. His influence

was strong enough. I especially recommend The Man Who Mistook his

Wife for a Hat (Picador, 1986) and An Anthropologist on Mars (Picador,

1995). These collections of neurological case histories, full of warmth

and insight, embody the spirit of Alexander Luria, whom Sacks

acknowledges as an important influence. Like Luria, he appreciates

the complementarity of 'classical' and 'romantic' modes of under­

standing.

In the mid-1980s I was, for reasons not worth going into, somewhat

disillusioned with clinical psychology. I thought about an academic

career as a possible alternative, but did not relish the uncertain prospect

of drifting on to the trail of short-term, post-doctoral research

appointments with no guarantee of a proper job at the end. I might

easily have given up neuropsychology altogether at that point. I might

have been happy enough doing other things. Then I got a call from

Merck Sharp and Dohme, the drug firm ( 'America's Most Admired

Company' according to Fortune Magazine — I still have the commemo­

rative mug). The unexpected call came from Susan Iversen, at that time

Director of Behavioural Pharmacology at the MSD Neuroscience

Research Centre. They were setting up a clinical research unit, she

said, and would I be interested in joining them? I told her I knew noth­

ing about psychopharmacology. 'Don't worry, love,' she said, 'you'll

soon pick it up.' The advice was sound, and it is my advice to anyone

interested in finding out more about neuropsychology, but wary of

what might appear to be a rather daunting academic discipline: Don't

worry, love, you '11 soon pick it up.

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A C K N O W L E D G E M E N T S

Thanks to the patients whose stories lie at the heart of this book and

from whom I have had the privilege of learning about the human

dimension of neuropsychology, as opposed to what the textbooks

teach. I hope I have given something in return.

It is a plain fact that this book would not have been written without

the vision of my editor and publisher, Toby Mundy. The project was

Toby's idea in the first place and he has seen it through with great elan.

Apart from anything else, I thank him for his patience. It has also been

a pleasure working with the impressive Bonnie Chiang, and, previ­

ously, Alice Hunt at Atlantic Books. I am grateful to Ian Pindar who

read the penultimate draft in full and made numerous fine adjustments.

Warm thanks also to my friends at Prospect, in particular David Good-

hart and Alex Linklater, for the opportunity to write a monthly column

for a very fine magazine.

From the bottom of my heart, I thank my entire family for their

unfailing support down the years, but most of all my wife, Sonja, and

sons Daniel and Jonathan, to whom I dedicate this book. You are more

precious to me than ever.

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