19
A Digression on the Question of Reliability and the Nature of Romantic Science
But—and here I want to shift keys, maybe even modulate from the major down to a minor register for a while before returning to the main chronological procession (which now, alas, is beginning to rush toward its conclusion)—the thing is that Oliver’s blithe confession of his own prosopagnosia shaded into a wider concern on the part of many regarding the extent to which this albeit thoroughly engaging chronicler (who couldn’t even keep faces straight, for God’s sake) could be relied upon more generally: The ongoing suspicion, that is, that he was sometimes making things up, exaggerating, fantasticating, seeing more than was there, or even things that weren’t there.1 All the variations on Michael Neve’s critique.2
As for the original misgiving here, the question of whether Oliver’s admitted prosopagnosia might be seen to undercut his reliability on other scores, it seems to me that the very opposite was the case. For one thing, he lavished a far more focused level of attention on his patients than on others in his social world. (He once recalled for me how the remarkable photographic memory that had helped him sail through college and medical school completely disappeared soon thereafter. At first he fretted that he might be entering an early-onset Alzheimer’s. But in fact, he came to understand that his wide-ranging memory was just becoming more selective, and focusing in particular on his patients.) Beyond that, it may well have been in compensation for the prosopagnosia that he started taking such thorough case notes on every single patient interview he undertook, taking the notes in the first place and then retaining them long after he was legally required to. (I myself can relate to the latter: I have a terrible innate memory for specific incidents and conversations, even just a few hours after the fact—spoons and forks all over again—which is one of the reasons I am such a ferocious note-taker; as a reporter, I’m not unlike the severe asthmatic who overcompensates himself into becoming a professional soccer player. And something similar may have been going on with Oliver as well.)
As for the wider misgiving, however—the nagging suspicion that Oliver at least occasionally exaggerated or confabulated or the like, or that the things he was seeing were at best anecdotal and of no wider medical use—misgivings that Oliver confessed to sometimes having himself (as he said of his Leg book, every charge that was being waged against him, he had at one point or another hurled against himself, only more severely), the question, that is, of his general trustworthiness, relevance, and reliability, there it seems to me that a wider-ranging consideration may be in order.
After all, as sympathetic a friend and colleague as Jonathan Miller had at one point in our conversation conceded how “you begin to wonder. When you visit the cases he talks about, none of them really exhibit any of the features that he claims they have. A lot of medical people I think are very, very suspicious of what he says about the cases he talks about in Awakenings. And I know friends of mine who’ve actually seen them say they are not quite what he says.” And indeed, these sorts of reservations were often expressed to me, especially in the early days when I was just getting started on my profile, by doctors and medical writers with whom I would broach the subject.
However, such misgivings were directly countered by the countless testimonials I collected during the years of my research, from colleagues and patients and reporters and friends and documentarians alike, to the effect that as unlikely and almost unbelievable as many of Oliver’s reports might have seemed, they’d all seen it, too, and could corroborate his descriptions and vouch for his clinical trustworthiness.
ISABELLE RAPIN
Well, there’s no doubt that many people don’t see his work as serious science. But for example, remember how he described that very rapid change in some of his patients, how they would go from being totally Parkinsonian to completely not, just like that, in an instant. When he described that in Awakenings, people thought he was making it up, but today this phenomenon is called the “on-off effect” and is well known and well recognized. So you see, I think he’s an excellent observer.
DUNCAN DALLAS
As I say, when you first saw the patients who’d survived the time of Tribulation, you didn’t really believe all the things Oliver was ascribing to them, but the more time you spent with them, the more you began to realize how their inner lives were in fact still quite dense with experience, and then, when coupled with the films Oliver himself had been taking earlier on, both before and after L-DOPA, you could see that it was all true.
MARGIE KOHL
Whatever other license Oliver may take at times, what he says about the patients is true.
He trained me. I am a fantastic observer today, and it is all thanks to him. “Go in there,” he would say, “and tell me what you see.” Most neurologists are so stuck in their checklists and their Medicare-mill fifteen-minute drills that they miss everything; Oliver missed nothing.
And when I asked her directly about the charge that Oliver made things up, Kohl responded emphatically:
I know the charge is not true, and I was there. Sure, he would occasionally attribute a higher vocabulary to some of the patients—Maria, for instance, was uneducated and he made her language flow, but this was as much as anything out of respect for her, an honoring and cherishing of her—and in a wider sense he embellished nothing. And many of the patients did talk fluently and with great subtlety.
But you had to be willing to sit at the bedside and listen. They didn’t just up and tell you these things. You had to establish rapport and a context.
With Leonard, for instance, most people had never gotten to him because (and I am speaking here of the years before L-DOPA) they wouldn’t spend the time with him: He was very slow, each letter might take a minute for him to spell out on his board, and everyone else would limit themselves to yes or no questions. But Oliver sat it out.
And even, elsewhere in our conversation, Jonathan Miller himself:
Well, he is unreliable only in the sense that it would be very difficult to accommodate some of his work within the body of neurology as it stands today. On the other hand, he also appeals to and represents some aspects of classical neurology which the modern reductionist neurology hasn’t accommodated itself to. This curious sort of infinity that does exist within each individual self, which simply doesn’t get treated in ordinary neurology.
Beyond such testimonials, in further adjudicating the question of Oliver’s overall reliability, one needs to consider the sorts of distinctions Oliver himself has made: How, for example, he may at times not see things directly but “imagines” his way to the truth, which is to say that he gives articulation to the otherwise inarticulate through an act of active imaginative projection, one that he subsequently confirms through further observations (and corroborates in the prior literature). Such a method may indeed run counter to the strictures of conventional positivist science, with its insistence on valuing only that which can be measured and quantified (ideally by way of double-blind and peer-reviewed experiments), but Oliver’s entire point is that certain things cannot be quantified (such as, precisely, the depth of experience—“Sometimes,” he once told me, “I feel like I am not so much interested in phenomena as in the resonance of phenomena, what it is like to live with the phenomena”), and that such quantifying studies by definition have to carve out a scrupulously circumscribed portion of clinical reality, when what he is often trying to gauge, access, evoke, and address is the wider reality, in its entirety, of the patient’s experience.
Here, as well, we are broaching into the terrain of his entire critique regarding the necessary limitations of computers and artificial intelligence (“Although people regularly talk about ‘personal’ computers, interface is the one thing you can’t do with them”), which is almost always a stand-in for his critique of positivism in general. Not that positivist research is without its uses (far from it!), but that positivism can only take one so far, and it doesn’t get to dictate the lack of validity of anything beyond its ken. Just because something can’t be quantified doesn’t mean it is not there (here we verge back on the terrain of Jane Goodall and the qualitative change in her capacity for observation that occurred when she started giving her chimpanzees names rather than assigning them numbers). “The other day,” Oliver told me at one point, regarding his colleague and former Luria student, “I called Nick Goldberg ‘my bête noire and favorite adversary’ and he was honored. Anyway, Nick says neurology is hardware and neuropsychology is software. But isn’t there anything else? Granted, sickness is stripping people down to their robotics—and damaged robotics at that—and I know robotics. Indeed, I know it better than most. But I also know that there’s more than robotics to human experience. Admittedly, as there is a robot in me, there is also a roboticist. But there’s also an eideticist. And you have to get from the Robot to the Creature, which is what Kant is all about.”
This, too, is where Leibniz comes in for Oliver. What he particularly treasured in Leibniz was his monadology, the notion that reality was made up of a vast latticework of wholes, every one of which reflected back the entire infinity of the universe (the whole business of the macro in the micro, the infinite one could find reflected in even the most infinitesimal, an essentially kabbalistic notion, and indeed, Leibniz was consulting with kabbalists when he was developing it), and that therefore, as a result, the true doctor (and Oliver considered Leibniz “the ultimate physician”) has to deal with the whole person (one infinite monad to another, an “I” to a “Thou”), not just the fragmented facets delivered forth by all the ever more narrowly siloed specialists and their ever more narrowly slicing and dicing quantitative diagnostic tools.
Granted, Oliver sometimes pushed this critique too far. But here I’m reminded of a seminal clarification the great religious historian Donald Nicholl offered us back in my days at Santa Cruz: He spoke of the value of heresies, and more specifically of the way that in the decades of the early church fathers, heresies were defined as long-suppressed aspects of the truth that then got idolatrized as the whole truth. Their problem was hence not so much one of verity as one of proportion. And in those terms, it seems to me that when it came to his critiques of positivism, more often than not Oliver stayed on the proper side of right relation. (Even though he once quipped to me how “At my symbolic best, I aspire to Donne, at my conceptual best, to Wittgenstein, but sometimes, I grant, I get overDonne.”)
But there was a still-wider issue here, that of the very nature and facticity of narrative itself (whether any story, any tale, can ever be strictly true3), a question to which Oliver alluded in another typewritten letter he sent me some months after the first round of attacks on his Leg book.
January 11, 1985
Dear Ren
The reviews which bothered me most of ALTSO (in the LRB, and a very similar one in the TLS, I don’t think you saw it) [were those that contained] the imputation that I had lied … here, and therefore everywhere as well. And of course, this readily ties in with self-doubt and accusation, and conceivably, too, an impulse to lie (or at least to “enhance”: the TLS reviewer spoke of “dramatic enhancement,” and you yourself said yesterday, “Ollie, come on!”).
I could not, I think, lie “phenomenologically” (I mean, about phenomena)—because I love them too much, and they do not admit of any lies.
Or, as he’d put it that other time: “It wouldn’t be home […] unless potassium carbonate were exactly like potassium carbonate. That’s why truthfulness is so important.”
Continuing on:
I may indeed (this is difficult for me to judge, because I am so intuitive, and there is a borderland somewhere between “glimpsing” and “guessing”) say more than I am absolutely sure of—this was the case with “Dr. P,” [the original man who mistook his wife] and therefore of the extreme pleasure when I came across Macrae’s description of an almost identical case.
What is very important to think clearly on, though, and to discuss—and I think I will follow your advice and do this at the next Narrative seminar—is the business of “telling a tale,” finding or imposing dramatic organization, over and above, but never violating a phenomenological description. And the business as to whether there “is” any such organization in reality, e.g., in the case of being ill, or sustaining some damage … Michael Neve, in the LRB, felt “the story” took over, had to proceed with its own inexorable momentum. There may be something in this, but not in the pejorative way he means. The 1974 experience was organized “dramatically,” the 1984 one [when Oliver broke his other leg on the eve of the Leg book’s publication] was not (was hardly an “experience,” just a boring, meaningless consecution of events…)
The extent, generalizing, to which “Life” is just a boring, meaningless consecution of events … and the extent to which it constitutes, is constituted on, organized as, experienced as … a story … (this would have been your challenge too, perhaps not unlike Shengold’s, in trying to make a “narrative” of my “life.”)
[…]
Anyhow, love, OliverSB
Luria reserved the term “romantic science” for the sorts of extended storytelling he chose to engage in across the latter half of his life in The Man with a Shattered World, The Mind of a Mnemonist, and the like (in contradistinction to the other kind of more conventional scientific investigation at which he also excelled) and for the sorts of truths he felt could only be arrived at by such storytelling. And Oliver followed his hero in that characterization.
The passage from my conversation with Jonathan Miller, quoted earlier in this chapter (about how one couldn’t help but begin to wonder about Oliver’s veracity), was itself sandwiched between two countervailing senses of the situation. I’d begun by asking about the various imputations of exaggeration and the like, and he’d shot back: “But they’re all true! And at the same time, yes, completely mad.”4
And onward through the point about his friends who’ve seen some of the instances in person and claim that things are not precisely as Oliver says they are: “But the fiction is so luminous and so beautiful that in a way, it’s beside the point, because the fictions become more important. And the facts seem almost like impudent irrelevancies. There’s a tremendous overlap between him and Borges in some ways.”
Ryszard Kapuściński and Oliver at our home in Pelham, Joanna in the background
During the twenty years that I used to teach my annual Fiction of Nonfiction classes (surveying all the fictive elements of narrative nonfiction, from form and structure through voice and tone and irony and freedom and so forth), toward the end of the course, when we arrived at Oliver’s prose, I deployed a slightly different coinage: Rhapsodic Nonfiction. Here, I hooped Oliver and Ryszard Kapuściński (both of whom had often found their strict veracity called into question) as each being instances of the sort of practitioner who first approaches his subject across one sort of daily and immediate writing (daily dispatches as the premier foreign correspondent for the Polish Press Agency, in Kapuściński’s case; those 500-word clinical notes for every patient he saw across his entire career, in Oliver’s), and then years later might return to the same material in a conspicuously different register. Thus, for example, Kapuściński begins his legendary account of the final days of Ethiopia’s Haile Selassie, The Emperor, “In the evenings I listened to those who had known the Emperor’s court.”
“In the evenings,” which is to say when he had finished with his day job (filing those news reports). And “listened,” past tense, which is to say back then and over there. You can almost hear him swirling the whiskey in his snifter as he launches into his reverie-like tale before an intimate and rapt audience now that he is back home after his years of wandering. And as I argued in that “Allegories of Eastern Europe” piece, Kapuściński’s text, when it was published in 1978 in Warsaw, seemed to operate at four levels simultaneously: as more or less straightforward reportage; as a prophetic allegory of the situation in Poland at that very moment, deep into the corrupt regime of the Communist Party chieftain Edward Gierek and just two years from the coming upsurge of Solidarity (let those with ears to hear, hear); as a more general allegory of the precarious dynamics of any and every sort of imperial court; and finally, as literature of the highest order, where it took its rightful place on the shelf alongside Calvino, García Márquez, Kafka, and, yes, Borges. (Jonathan Miller, incidentally, once mounted a remarkably evocative adaptation of Kapuściński’s Emperor on the London stage.)
Oliver’s rhapsodic writings arise in a similar context, for not only can he do the other—he has, repeatedly, every day through his entire career, and to remarkable documentary effect—but these tales are pitched slightly differently, and they shimmer to similar effect (hence all the references to Arabian Nights entertainments and so forth, both on his own part and on that of others). He is writing for a different audience (though one that he dearly hoped would come to include his medical colleagues, responding in a slightly different way from their usual reaction) and not asking to be judged by the same actuarial quantitative peer-reviewed standards as more conventional medical researchers (though even he himself occasionally grew confused on this last point).
And yet, in another sense, he was asking to be so judged. Or rather, he was trying to advocate for and model a different sort of medicine on behalf of chronic, often institutionally warehoused and largely abandoned patients, especially those with massively enveloping syndromes that set them off at a nearly infinite remove, the sort of patients often referred to as “hopeless” or “mere vegetables.” And here—and this is something Oliver’s blithe critics often failed to notice—narrative of this sort was part of the therapy itself. Helping to turn an It back into an I, in Sister Lorraine’s evaluation. Or maybe a patient (an object) back into an agent (a subject). The therapy in question had to be intensely collaborative—patients who had been treated as mere thrown-away objects might well have long since lost any sense of their own capacity for agency and subjectivity. Trying to puzzle out their story, Oliver would often spend hours at a time with any single one of them (out of both compassion and fascination on his own part). Such people were privileged witnesses to and actors along the very remotest stretches of human possibility, and as such had marvelous stories to offer about such extreme vantages and experiences. The way a Parkinsonian can be jump-started, as it were, into fluid action by the mere extension of a friend’s helping hand, so Oliver would offer his collaboration, sharing the self-organizing capacity for narrative. Doctor and patients would work out (literally, “make up”) their stories together, and in so doing the doctor would help his patients to re-compose themselves. As such, narrative was not unlike Oliver’s beloved music, in that it allowed patients to be moved by what moved them. And the animating surround to the entire exercise was nothing less than love, understood, granted, in an impersonal Eliotian sense. (But just try to quantify that!)5
And the marvel of the whole thing was that, as the years passed, Oliver, by way of his stories (and in particular the tenor of those stories, the quality of their attentiveness), along with the example set by a few other similar visionaries, actually began to turn the tide on how conventional neurology was being taught and practiced. Not at all bad for a series of “mere anecdotes.”