If a man has lost a leg or an eye, he knows he has lost a leg or an eye; but if he has lost a self—himself—he cannot know it, because he is no longer there to know it.
Perception is never purely in the present – it has to draw on experience of the past; this is why Gerald M. Edelman speaks of "the remembered present." We all have detailed memories of how things have previously looked and sounded, and these memories are recalled and admixed with every new perception.
"Every act of perception," Edelman writes, "is to some degree an act of creation, and every act of memory is to some degree an act of imagination.
We see with the eyes, but we see with the brain as well. And seeing with the brain is often called imagination. And we are familiar with the landscapes of our own imagination, our inscapes. We've lived with them all our lives. But there are also hallucinations as well, and hallucinations are completely different. They don't seem to be of our creation. They don't seem to be under our control. They seem to come from the outside, and to mimic perception.
Music can lift us out of depression or move us to tears - it is a remedy, a tonic, orange juice for the ear. But for many of my neurological patients, music is even more - it can provide access, even when no medication can, to movement, to speech, to life. For them, music is not a luxury, but a necessity.
It really is a very odd business that all of us, to varying degrees, have music in our heads.
Several times I have started apologizing to large, clumsy, bearded people and realize that it's a mirror. But it's even gone a stage further than that. Fairly recently, I was in a cafe in Chelsea Market with tables outside and while I was waiting for my food I was doing what people with beards often do: I started to preen myself and then I realized that my reflection was not doing the same thing. And that inside there was a man with a beard, possibly you, who wondered why I was sort of making faces at him.
I always wanted to get people's stories and access to their lives. I feel I'm at the interface of biography and biology, person and person-hood. I remember one man with Tourettes, who wrote and said that he had 'a tourettised soul', it affects one and one affects it—there's a liaison of a sort. A condition is sometimes a collusion, and sometimes a compromise.
Although it's up to me as a neurologist to diagnose the disease and to think in therapeutic terms, I always want to address the person as much as the disease, and I'm very glad my own doctor feels similarly. I'm not just a case to him, I'm a person responding to the situation. So I somehow sit between the biology and the humanist point of view.
Almost unconsciously, I became a storyteller at a time when medical narrative was almost extinct. This did not dissuade me, for I felt my roots lay in the great neurological case histories of the 19th century (and I was encouraged here by the great Russian neuropsychologist A. R. Luria). It was a lonely but deeply satisfying, almost monkish existence that I was to lead for many years.
At 11, I could say "I am sodium" (Element 11), and now at 79, I am gold.
At nearly 80, with a scattering of medical and surgical problems, none disabling, I feel glad to be alive — "I'm glad I'm not dead!" sometimes bursts out of me when the weather is perfect.
One has had a long experience of life, not only one's own life, but others', too. One has seen triumphs and tragedies, booms and busts, revolutions and wars, great achievements and deep ambiguities, too. One has seen grand theories rise, only to be toppled by stubborn facts. One is more conscious of transience and, perhaps, of beauty. At 80, one can take a long view and have a vivid, lived sense of history not possible at an earlier age.
I cannot pretend I am without fear. But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers.
Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.