September 18, 2019--The Man Who Mistook a Chipmunk for His Wife

A friend asked me to repost this. So here it is. It first appeared in June, 2018--

Neurologist and author Oliver Sacks was an acquaintance who wrote widely for lay readers about the complex world of mental "disorders." 

I put disorders in quotation marks since in his writing he challenges many of the traditional paradigms that classify many mental conditions as abnormal and as cognitive deficits. 

In my favorite of his books, The Man Who Mistook His Wife for a Hat, in four sections Sacks presents a series of brief case studies focused on aspects of neurology. 

In the first part he discusses neurological conditions that are usually construed to be deficits in normal brain function. Taking a very different tack, he argues that the medical community tends to define almost all divergent neurological conditions as some kind of deficit.

But, he claims, this paradigm is too narrow because it marginalizes these conditions, making it difficult to understand their full range of function, and that the traditional medical classification system also underestimates individuals' abilities to find ways of compensating for atypical mental function. 

In other words, the deficit model often leads to a lack of empathy and nuance and gets in the way of a full understanding of what is almost always characterized as illness and thus impedes effective ways of working with individuals who present unusual behaviors. Including behavior experienced by Dr. P., someone Sacks worked with for a number of years who had a rare form of "face blindness" that left him unable to distinguish between his wife's face and his hat. The man who mistook . . .

I thought about Sacks and the book late last week while standing in the road with George Lindberg, a close friend, who was asking me how my Parkinson's is progressing.

"The meds seem to relieve much of the tremor in my right hand," I said, "It's my only symptom thus far. So I'm feeling optimistic about the situation."

I extended my hand to show him. "That looks pretty good," he said, "Do you notice any things that cause increased tremoring?"

"When I have any anxiety, which I am prone to have, it does increase the tremor. In fact, it's happening right now. Maybe because we're talking about it." 

To show him I extended my arm again and my right hand was shaking quite visibly. "It stops right away if I tell myself to calm down." I showed him how that works. In a few seconds my hand completely calmed down.

"Does your neurologist say what might be in the offing?"

"In fact the last time I saw him I asked about that--'How long will it be before I'm like Michael J. Fox?'"

"I like that and I like Michael J. Fox," George said.

"I do as well. The doctor asked again how old I am and when I reminded him he said, 'In your case you'll be long gone before that happens.'" Liking how that sounded he smiled. Which is unusual for him.

"So I have something to look forward to," I said.

"What's that?" he asked.

"I said, also smiling, 'Being dead.'"

"That sounds good to me," George said, playfully referring to me.

"One thing, though," I added, "There's this commercial on TV for a med that claims it can lessen the delusions and hallucinations that supposedly 50 percent of people with PD will experience. That doesn't sound so good to me."

"Again," George said,"before that happens maybe you'll be fortunate enough to be long gone." He's a good kidder, which I like about him.

"What's that?" I said to him with my hand flapping.

"What are you pointing at?"

"Down the road, all the rustling in those bushes." I indicated where with my steady hand.

"I can't see what you're referring to," he said, "It would be strange since there's no wind."

"Rona's doing a lot of pruning. Maybe that's her in those bushes." I pointed again down the road where it looked to me like she was working. "But that would be unusual since that's really not on our property, though the owner of the log cabin, who's rarely here, likes it when Rona neatens things up."

George and I stood there peering at the bushes that were in rapid motion. At least they looked that way to me.

"Maybe it's a bear," Kidding, George said.

"Do we have bears here?" I asked taking him seriously.

"Not usually" he said, "Though strange things happen all the time. The berries are starting to set so bears could be lurking."

With that there was increased movement in the bushes. I clutched the shovel I had with me, getting ready for I knew not what.

And just as quickly, all movement ceased and popping out from the bushes was not Rona or a bear but a chipmunk that preceded to bounce across the road.

I'm not sure what George made of all this, but I was thinking about Oliver.