Oliver Sacks

The late 19th-century neurologist Hughlings Jackson said that he had never been consulted for ‘reminiscence’ as the sole manifestation of epilepsy. But I have – in particular, for the forced or paroxysmal reminiscence of tunes, and, less commonly, of faces or scenes. Wilder Penfield was able to elicit such recalls – the forced replaying or reminiscence of what he called ‘fossil memories’ – by stimulation of the exposed cerebral cortex. I have had this described to me by my own patients – as a rather rare symptom in migraine and, quite frequently, in post-encephalitic patients ‘awakened’ by L-DOPA. And it may occur, as Hughlings Jackson notes, in the course of some seizures.–

The scientific study of the relationship between brain and mind began in 1861, when Broca, in France, found that specific difficulties in the expressive use of speech (aphasia) consistently followed damage to a particular portion of the left hemisphere of the brain. This opened the way to a cerebral neurology, which made it possible, over the decades, to ‘map’ the human brain, ascribing specific powers to equally specific ‘centres’ in the brain.

In 1974 I was tossed off a cliff. The circumstances were slightly absurd: I was on a mountain in Northern Norway, and I had a contretemps with a bull. It was a very isolated area, and no one knew where I was. I was alone, with a grossly injured and useless left leg. I thought I would die, but to my surprise I was saved. A reindeer-hunter found me, a posse carried me to the nearest Arctic village, ambulance and plane conveyed me to London. The next morning I was scheduled for emergency surgery.

In 1884-5 Gilles de la Tourette, a pupil of Charcot, described the astonishing syndrome which now bears his name. ‘Tourette’s syndrome’, as it was immediately dubbed, is characterised by an excess of nervous energy, and a great production and extravagance of strange motions and notions: tics, jerks, mannerisms, grimaces, noises, curses, involuntary imitations and compulsions of all sorts, with an odd elfin humour and a tendency to antic and outlandish kinds of play. In its ‘highest’ forms, Tourette’s syndrome involves every aspect of the affective, the instinctual and the imaginative life; in its ‘lower’, and perhaps commoner, forms, there may be little more than abnormal movements and impulsivity, though even here there is an element of strangeness. It was well recognised and extensively reported in the closing years of the last century, for these were years of a spacious neurology which did not hesitate to conjoin the organic and the psychic. It was clear to Tourette, and his peers, that this syndrome was a sort of possession by primitive impulses and urges: but also that it was a possession with an organic base – a very definite (if undiscovered) neurological disorder.