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Friday, February 19, 2016

The Case of Mr. Thompson

This is the most brutal and depressing description of someone's mental condition I have ever read. This sounds like a nightmare. The worst part is the patient not even having the cognitive ability to realize the state that he is in.
The author is describing the patient "Mr. Thompson." The patient is unable to form new memories and his working memory is essentially a few seconds long. He forgets everything after that brief duration and has to start from the beginning over, and over, and over, and over again.
The following quotes are from the book The Man Who Mistook His Wife for a Hat by Oliver Sacks.
He remembered nothing for more than a few seconds. He was continually disoriented. Abysses of amnesia continually opened beneath him, but he would bridge them, nimbly, by fluent confabulations and fictions of all kinds. For him they were not fictions, but how he suddenly saw, or interpreted, the world. Its radical flux and incoherence could not be tolerated, acknowledged, for an instant--there was, instead, this strange, delirious, quasi-coherence, as Mr. Thompson, with his ceaseless, unconscious, quick-fire inventions, continually improvised a world around him--an Arabian Nights world, a phantasmagoria, a dream, of ever-changing people, figures, situations--continual, kaleidoscopic mutations and transformations.
[He was] continually creating a world and a self, to replace what was continually being forgotten and lost. Such a patient must literally make himself (and his world) up every moment... Deprived of continuity, of a quiet, continuous, inner narrative, he is driven to a sort of narrational frenzy--hence his ceaseless tales, his confabulations, his mythomania. Unable to maintain a genuine narrative or continuity, unable to maintain a genuine inner world, he is driven to the proliferation of pseudo-narratives, in a pseduo-continuity, pseudo-worlds peopled by pseudo-people, phantoms...
Here is a man who, in some sense, is desperate, in a frenzy. The world keeps disappearing, losing meaning, vanishing--and he must seek meaning, make meaning, in a desperate way, continually inventing, throwing bridges of meaning over abysses of meaninglessness, the chaos that yawns continually beneath him...
He can never stop running, for the breach in memory, in existence, in meaning, is never healed but has to be bridged, to be 'patched', every second. And the bridges, the patches, for all their brilliance, fail to work--because they are confabulations, fictions, which cannot do service for reality, while also failing to correspond with reality...
Our efforts to cure Mr. Thompson will all fail--even increase his confabulatory pressure. But when we abdicate our efforts, and let him be, he sometimes wanders out in the quiet and undemanding garden which surrounds the Home, and there, in its quietness, he recovers his own quiet. The presence of others, other people, excite and rattle him, force him into an endless, frenzied, social chatter, a veritable delirium of identity-making and seeking; the presence of plants, a quiet garden, the non-human order, making no social or human demands upon him, allow this identity-delirium to relax, to subside, and by their quiet, non-human self sufficiency and completeness allow him a rare quietness and self-sufficiency of his own, by offering (beneath, or beyond, all merely human identities and relations) a deep wordless communion with Nature itself, and with this the restored sense of being in the world, being real.

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