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this program was sponsored by the Jesse and John Dan's fund since 1962 these lectures have been a forum for distinguished scholars of national and international reputation who have
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concerned themselves with the impact of science and philosophy on man's perception of a rational universe [Music] good evening ladies and gentlemen
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honored guests it's a pleasure and an honor to introduce this year's Dan's lecture dr. Oliver Sacks I've met dr. sacks only once before briefly when he
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was a visitor at Yale University so my main qualification for introducing him tonight is that like dr. sacks I too am a neurologist a neurologist as most of you know is a medical subspecialists who
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diagnoses and treats diseases of the nervous system it may be worthwhile therefore to mention a few things about neurologists as a backdrop for listening to our honored guest tonight before I do
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this let me tell you what I know about dr. sacks he was born in London and came to the United States in 1960 he comes from a medical family his mother was a surgeon
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his father and brother general practitioners dr. sacks himself studied medicine and became a neurologist he is currently professor of neurology at Albert Einstein College of Medicine
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in New York City he is famous because of the wonderful books that he's written which draw heavily on his experiences as a neurologist these books have inspired plays and opera and the movie awakenings
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in his leisure time he loves to swim as I threatened earlier I will say a few things about neurologists in the hope that this will help the audience better
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understand where dr. Sachs is coming from specifically I will draw your attention to three traits which characterize many of the neurologists that I have come to know by nature
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neurologists tend to be very curious rather than being frustrated by the intricacies of the brain they are stimulated by its mystery secondly
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neurologists are very careful observers much of what we do to understand neurological disease is accomplished by just by observing our patients as dr. sacks points out so eloquently in his
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books much can be learned about patients with neurological impairment by closely observing them a day to day activities the third quality which I strongly associate with practitioners of
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neurology is a philosophical bent of mind many of us practicing neurology came to this specialty because we were interested in how the mind works questions like memory learning
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personality and creativity intrigued us as we gradually accepted that the brain is the organ of mind we were attracted to the study of the brain in the context
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of neurology doctor sax is richly endowed with these three qualities his fascinating stories about neurological patients strongly reflect his intense
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curiosity and his great observational skills he is a modern philosopher who has translated his observations on the neurologically impaired into delightful
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prose and given us brilliant insights into the complexities of being human it is with great pleasure that I introduce to you tonight's speaker dr. Oliver Sacks
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[Applause] it's going to take a little while to to warm up I've finally had some trouble since the movie of awakenings because I'm and people have been saying that I
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especially when I adjust my glasses that I imitate Robin Williams needless to say it was the other way around and it was uncanny at one point because
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he had all my gestures and all my mannerisms and and all my points of view and my memories and then but in particular is very odd having one's
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gestures appropriated books one's identity is partly lodged in one's gestures and and for about two years afterwards I became almost parkinsonian by
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reaction or I would just keep my hands in my pockets I it's lovely being here
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in Seattle again although terrifying seeing this this sea of faces in front of me I gave a talk this afternoon and it was a nice friendly informal one I
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think the where 80 people there and I didn't have to have a microphone and I I hope one can relax and this one in the
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same way I was here in Seattle a few months ago in relation to doing some work with the deafblind community and Seattle more
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than any city in the world has a large deafblind community I first encountered this community when I came here in 1990 I'm still audible
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No I think I'm probably trying as it were to hear to hear myself at the back and I'm not quite sure if I if I can or not in 1990 I met some of the deafblind
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community I'd never really met a deafblind person who no one knew of Helen Keller I thought these were isolated miserable disabled people I was invited to a deafblind social which was
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very astounding and these people said come and stay with us for a while and write a nother book called feeling voices but anyhow Seattle has been
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immensely hospitable to the deafblind and has made support systems and an educational and work opportunities possible which are nowhere else in the world and I think my theme insofar as
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I'm gonna have a theme is going to have to do with identity and disease [Music] and typically the deaf community is very
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sensitive to this and they in fact have two ways of spelling death or two ways of writing death death with a small D means hearing impaired deaf with a big D
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means part of a linguistic community part of a community with its own sensibility its own language its own culture its own perspective its own art its own humor and everything so d with a
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small deaf with a small D is a disease deaf where the large D is an identity [Music] now I
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think that whatever happens to one medically especially if one works as I do with people who have lifelong or chronic
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diseases may force a change of identity [Music] and recently I'm ice I somehow wonder one to get this this
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mirror what you know III think someone else is going to have to modify things because it's something to do with interpersonal space when it when it's there
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and incidentally I'm so just as an aside but I partly consists of asides and questions of interpersonal space are extremely important for people with Tourette's syndrome and who especially
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in in restaurants can't bear to have their back to anyone I think we all sometimes uncomfortable having people behind us but people with Tourette's syndrome may need to sort of lunge out
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and touch people who are sitting behind them and they feel that people behind them are violating their space and - and were to prevent that or in retaliation
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they will violate it back and once when I was on the west coast I had dinner with three people who had - it's and and all of them laughed for the corner seat
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one of them could could get it it's on that occasion people with Tourette's can often have rather accelerated thought and use all sorts of our
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association may be exceptionally rapid and after having dinner with three people with Tourette's I started to feel that I was the abnormal one this is salutary when this occurs I had
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something similar when I went to Gallaudet to the University of the death and once saw a thousand students signing to one another I was foolish enough to
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use the term hearing impaired and I was told sharply than I was sign impaired and ZM well I think I probably want to tell you
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some stories as I write them here in the book I somehow have to preserve my own identity despite the microphone you seen if it's like this you know I I find
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myself assuming a sort of crouched crouched identity and I think I will get into a story straight away when you are a physician as opposed to a
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scientist you don't so much have a systematic program of work or projects as you are dependent on people who phone you up right - at a letter right - a
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letter or knock on the door and in fact almost all the seven stories I tell here occurred in the first place because I got a letter or phone call
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one of them the first one started from a letter received in 1986 from a man who told me that's a good idea in fact you should all feel free to take
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your your jackets off no I can't take this off I've got a microphone on it I used to feel self-conscious about this but um at my age or stage what does it
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matter but it may call it but it's how they distant thunder or maybe a bit maybe like mount Mount st. Helens preparing to to erupt I got a letter from this man who told me
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that he had been a that he was an artist obviously quite a successful artist he'd been in good health he was an artist actually quite an abstract
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expressionist quite eminent for his use of colour and then something had happened he had had a head injury and he had suddenly lost the ability to perceive color
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my vision was such that everything appeared to me as if viewing a black and white television screen he went around to some of my colleagues went
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ophthalmologists he went to neurologists and a hypnosis I can't distinguish colors his first thought and his first hope was that this was a hysterical condition and he was both relieved and
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saddened when this wasn't the case he says my brown dog is dark gray tomato juice is black to go into somewhat more detail and he said that could I see him could I
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understand could I help did I have any experience of this did I know what was going on I said I'd never encountered such a
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situation but being a neurologist I was curious and I would like to meet him I would like to listen to him and to try and figure out what was going on and
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what one might do when I saw him he gave me a more detailed story this has obviously been quite a massive car accident the side of the car was stove
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in there was a concussion was an amnesia he seemed to be okay the next morning he drove to work he knew it was a bright crisp sunny day but had looked like a
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flop like Seattle it was gray and misty nebulous out-of-focus and no I actually I love Seattle you know I I come from a rainy
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country myself he was stopped by the police who told me been through two red lights did he realize this and he said no he hadn't seen any red lights the police thought he looked sort of ill and
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confused but since in New York State at least this is no excuse for criminal behavior they gave him a ticket and told him to go to hospital well he went on to his
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studio and I've said that his work was was always charged with kala and he saw his own paintings evacuated of color
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gray nebulous black-and-white meaningless no when color is integrated into one world picture visit is for all
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of us most of us I think one may not realize the particular how much it's a vehicle for feeling for meaning for ordering for categorization you might
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think loss of color big deal so what you know the world is less colorful it was far less meaningful didn't make sense to him he got into a panic he didn't know what was happening he didn't know what might
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happen he wondered if he was going blind mad dying he laughed home no doubt threw more red lights to see his wife
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but she had been transformed to she had become an animated gray statue as he said and when he looked at his own flesh this
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was gray as well and then in an agony he closed his eyes to conjure up the way things should look and it didn't work his imagination was
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black and white as well Karla had been deleted from his imagery and his memory as it had from his perception and he felt desperate the world his wife
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looked unpleasant to him he looked intolerable to himself everything looked impoverished ugly grotesque he couldn't imagine going on he thought it was the
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end of him as an artist the end of him as a human being he couldn't even bear his dog and when I saw him three weeks later he had just purchased a Dalmatian food look awful and abnormal to him and
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by the same token I've mentioned he described tomato juice looks black the only things which didn't look wrong to him were foods which were black and white and so he was sort of living on
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black olives and and yogurt pretty much when I saw him and he was very depressed well the function of neurologists dr. ranson tells us is to diagnose and cure
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diseases of the nervous system it was relatively easy to a certain what had happened and to put things in simple terms
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he had severely damaged two areas at the back of the brain in the visual cortex which are necessary as neurologists say to construct color color isn't out there
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we make color on the basis of our brains have to make it on the basis of very elaborate comparisons and visual data and the parts of his brain which were
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involved in this were out of action interestingly he could clearly discriminate wavelengths but he couldn't correlate wavelengths to produce the subjective sensation or consciousness of
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color and if this happens to this little area of the brain which is called a v4 I will say this you know simply so that I don't have to say this area of the brain each
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time if v4 is knocked out you not only can't see color you can't imagine color you can't remember color you can't dream in color and you can't have a migraine in color
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and I don't know whether many of you have migraines colored my grades but you know there I do sometimes and that can be very pleasant sort of chromatic
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fringes around the migraine but his migraines had become black and white he had also had a rare quality called synesthesia he was very fond of music
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and music would automatically generate for him a play of colors and the colors being very specific so that sort of G sharp was always blue or whatever and
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this had ceased as well [Music] I didn't know whether there would be any recovery and I had to say this to him I knew of no way of promoting recovery I
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and basically I said in the meanwhile I think you have to adapt to your world or the world you're in [Music]
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now what then happened is really a stunning example of adaptation and transformation and this for him had a
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rather a dramatic start about a couple of weeks after I had seen him he was again driving to work although he couldn't work at this time
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but he liked to drive to the studio and he saw the sunrise and he sees red as black he saw really this enormous black Sun lies he said it was like some huge
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nuclear explosion it was very dramatic it was apocalyptic he wondered whether anyone in the history of the world had ever seen the Sun Rise in such a way before and it challenged him creatively
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and he went and did a painting nuclear sunrise this was his first black-and-white painting [Music] I think I'm going to read for a little
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bit from his story though I don't know whether I should or not but I color color
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you all have to adapt but I can't and maybe it's something erotic color perception had been an essential part known yet not only of his visual
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sense but his aesthetic sense his sensibility his creative identity in the central part of the way he constructed his world and now color was gone not only in perception but an
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imagination in memory as well but first he was intensely furiously conscious of what he had lost though conscious so to speak in the manner of an amnesiac he would glare tan
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orange in a state of rage trying to force it to resume its true color he would sit for hours before his to him dark gray lon
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trying to see it to imagine it to remember it his green he found himself not only in an impoverished world but in an alien
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incoherent and almost nightmarish one but then with the apocalyptic sunrise and his painting of this came the first hint of a change an impulse to construct
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the world anew to construct his own sensibility and identity anew and this started then to enter his life and to enter his art so that the total other
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must the alienness of his world would at first had such a quality of horror and nightmare came to take on for him a strange fascination and beauty
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[Music] so he was becoming a different person values were changing the ugly had become beautiful and what had become what was
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impoverished started to become rich for him he started to change his habits he found the night a night life peculiar congenial they seemed to be designed he
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once said in terms of black and white he started becoming a night person that in his own words took to exploring other cities other places but only at night
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and he would go to Boston and Baltimore go into little diners talk to people he said gradually I am becoming a night person it's a different world it's a whole new world
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now we're now three years after what happened he has had no recovery of color but he's having a very full and active
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and life at that time he I felt he still mourned Carla in a way but at the same time he now said that he thought his vision had changed for the better he
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said it had become highly refined privileged he felt that he saw a world of pure form uncluttered by color subtle textures and patterns obscured for the
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rest of us because of their embedding and color now stood out for him and at that point the technical term for this as a Croma tapasya so he came to see his a Croma top SIA is
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a strange gift one which had assured him into a new state of sensibility and being now at that point some notion
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of a treatment or a cure came up it was based on some rather esoteric theoretical notions that one might be able to retrain other parts of the visual cortex to perform the
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correlations which are necessary to see color what was striking was his response to this suggestion in the first months after his injury he said he would have embraced such a suggestion done anything
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possible to be cured but now that he conceived the world in different terms and again founded coherent and complete he thought the suggestion unintelligible
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and repugnant he said he could no longer imagine what the restoration of color would be like and thought it would be grossly confusing
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and might force a welter of irrelevant sensations on him the well in terms of his painting then at that point he had moved into a strong
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and productive phase his paintings were highly successful and everyone said what happened to the old man he's moved into a wonderful black-and-white period and
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very few people knew that behind us there was a physiological necessity and indeed a neurological catastrophe but the point is that the catastrophe had in
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a way been turned round and put to creative use so in summary the terrible time for this man Isaacson his name was was when he
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had lost his world his familiar world and didn't have anything to replace it when he was between worlds there's some
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lines and lines of Matthew Arnold and Dover Beach about being between two worlds one dead the other powerless to be born and it's when one is between
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those two worlds that things are unbearable and you can't imagine how to go on but then he made a transit from
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one world to another now this is not you know a recommendation for a coma tapasya no be glad that you don't have it but if
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you do get it if one does get it this is extremely rare I should say then something like what happened to this man is to be looked for does this happen to
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everyone who has a coma top SIA I don't know I think here the sheer creative force of the the need to construct a coherent beautiful visual world on the one hand
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made the loss of color so terrible but also on the other hand made it possible to provide such a successful reconstruction now I think I want to take a bit of
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water but you know sipping water sort of rather a private activity and I'm afraid I made choke in front of of all of you I'm sorry I haven't looked in your
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direction over there I realized there were another 7,000 people I don't think it's neurological in my hat book the man who mistook his wife for a hat
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I mention a patient a woman who following a stroke has a strange neglect or inattention to one side of reality she doesn't look to the left if she doesn't see anything to the left she
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doesn't acknowledge the left half of her own body and she has lost the concept of left us and she lives in a bisected what we would call a bisected world or
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although for her to complete world I'm not sure whether or not this is happening to me but how the eye
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did wonder very much after seeing this man what it might like what it might be like to be born totally colored to be born
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totally colorblind and 18 months ago I had an interesting experience which I have not written about here but which I have written about in a book which I
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finished on Wednesday and and I hope we'll see the light of day it's one of its one of sort of two stories or two booklets
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I went 18 months ago to an island and Micronesia where a significant proportion of the population is born totally colorblind this is a very rare
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situation in the general population about one and fifty thousand but on this island a third of the people carry the gene for a Croma Tashia [Music]
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there's no interesting reason for this which was 200 years ago well in the 70s from the 1770s there was a typhoon which almost wiped out the island reduced the
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population from 900 to 15 but there was 15 people who vertically repopulated the island which involved a little little incest
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and whatnot and cause the concentration of this this gene when I was a boy I loved reading stories by HG Wells and
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and I still do I one of his stories is called the the country of the blind and it describes how a traveler lost and in the mountains of South America blunders
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into an isolated mountain valley and he is then intrigued and puzzled at the houses which are parti-colored and he thinks the people who built these must
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have been as must be as blind as bats and he finds that this is indeed the case that there's a community which has been there for three centuries they had an eye disease and the early in the 17th
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century and now for 15 generations not only has everyone been blind but the cultural memory of seeing of sight of a
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visual world has completely disappeared and well speaks of of new imaginations and new sensibilities being forged with
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the senses they have the sighted traveler immediately thinks that he can that he can sort of take command over
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these poor disabled people but he soon finds his mistake he in fact is only his blundering around and falling over in this village they have constructed which
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is which suits them and after a while in fact very soon it's clear that they regard him as demented and indeed as delusional and a subject of peculiar
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hallucinations produced by these mobile objects in his face their own eyes have atrophied somewhat and they they think
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he's very pitiful but they you try and teach them about the world which he doesn't seem to understand after a while he falls in love with a girl in the valley and
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they say yes he can stay he can marry provided he will allow excision of these unpleasant mobile pathologies in his face which are productive of
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hallucinations and I this came to me somewhat when I went to the island of the colorblind partly feeling these are pitiful people and then partly getting
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the opposite reaction that I and some of the color normal so-called color normal people who went along were in fact regarded as distracted half the time by
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something either non-existent or trivial we talked about colors and this and that instead of paying attention to the wheel visual world and there was a rather nice demonstration of this
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I bought one prop unless I edit the there are a lot of bananas on the island and I said to one of the colorblind people how can you tell when a bananas ripe you know how do you know whether
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it's green or yellow and he didn't say anything but he went away and came back with a bright green banana and I said look it's grossly unripe and he said
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well try it and I did so and it was delicious and ripe and he said you see we judge things by texture by form by smell by feel and not just by color and
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he brought her to here's a way he made me feel that my world picture at least my banana picture was a superficial one because I'd just gone by color it is his banana
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um i I think I want to talk a little bit I'm going to find myself a little bit [Music] powerful isn't it distant thunder
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I'm going to tell you something about another it's only I'm not watching the time and I don't have a clock and does it matter okay so the the saga of the colorblind artist
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started with a letter now the saga the paradoxical saga of another case I described here started with a phone call
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I got a phone call from from Oklahoma a pastor telling me that his blind son-in-law had just had a surgery to
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give him vision not so much to restore vision as to give him vision for the first time and on the one hand he said the operation had been wonderful and he saw everything but there was a little
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snag he recognized nothing could I know it was there anything I could do about this illuminate [Music]
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I'm very impulsive and when I get these phone calls I tend to sort of take the next plane down so I went down to see I called him Virgil but his real name is
00:39:39
Shirl and let me tell you this although you're not supposed to know it in case I caught him sure by mistake sure well
00:39:56
Scholz story was this he had been born with pretty poor vision and had never seen very much and then in his second
00:40:11
year he had had a meningitis and encephalitis and retinitis would have blown what vision he had he had few if any reliable visual
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memories he'd been gone to a school for the blind and he'd lived the life of a blind man he worked as a masseur in the
00:40:37
local YMCA and his he was quite adept at crossing the road looking after his own needs and his life seemed to be in equilibrium until he met the
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the rather missionary minded daughter of the pastor who had phoned me and she felt that something needed to be done for sure in particular he was a
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poor blind isolated man and he needed to be given his sight back and he needed to be married and preferably both at the same time and indeed her fantasy was that his
00:41:27
first vision would be of his beautiful bride and the Isle of the church well it didn't quite work out like that there had been some thought in the past
00:41:46
that surgery might help so he had very very dense cataracts on the other hand as even people with a densest cataracts can he could distinguish light and
00:42:00
darkness he could see the shadow of a hand move in front of his face as you can if you close your eyes it really wasn't clear yes you can
00:42:16
now I say these things glibly and then I and then I suddenly become uncertain but it was nice nice one can demonstrate it it really wasn't clear however how much
00:42:32
retinol function had survived all all might have been restored after this retinitis which he had as a child and anyhow a a surgeon was found who was
00:42:48
prepared to try and his wife was eager for the operation sure was sort of passive and said well you know that's about say he said they're your eyes he said well let my
00:43:02
eyes but you know if you want to operate do so so the operation was done he described to me how when 24 hours later
00:43:13
the bandage was taken off there was a very tense expectant silence they either expected him to say hallelujah you know I can see or to say
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I see nothing now what happened was neither of these things there was a long strange minute which grew longer and longer when he seemed to be looking
00:43:40
around in an unfocused way and then his surgeon said well and then she'll sort of focused in his direction
00:43:51
what he said was to me later was that since he knew voices came from faces he had to assume that the whereabouts of
00:44:05
the voice was a face although for him it was only a confusion a chaos of color and movement without clear boundary is not clearly distinguished from the
00:44:20
background he had no visual concept of a face you may say wasn't there an instant transfer of the tactile concept no there wasn't
00:44:33
nor was there any transfer of even while the simple tactile concepts you know this sort of thing had been discussed in the 17th century as a is a philosophical
00:44:45
problem melina the Irish philosopher you know I can I'm still conscious of you people there intermittently Molina had a congenitally blind wife and
00:45:01
he wrote to John Locke about her or in more general terms he said if a blind person could recognize a globe or cube by touch and was then given vision where
00:45:15
they'd recognize a by vision and Locke discusses this and he thinks the answer is No there had been a somewhat similar discussion by the way by Leibniz and
00:45:30
Leibniz thought yes Leibniz thought the squares are squares are Square and that's that but in fact the first surgical
00:45:46
testing of this came pretty soon came in 1728 when a surgeon called chiseled 'm removed congenital cataracts from a 15 year old boy and like Cheryl this 15
00:45:59
year old boy saw everything recognize nothing and in particular could not recognize simple geometrical shapes so a touch triangle is not the same as a
00:46:12
visual triangle on what seems to us to be the unity of consciousness and perception depends on a correlation of all the senses of a
00:46:28
most intricate and continuous and automatic sort which goes on in the first weeks of life is we're growing up this hadn't happened with show
00:46:41
and his brain had never learned to make sense of visual stimuli and then of course he hadn't had any visual stimuli and you want to see if I can
00:47:02
I need to quote something now this is a rare situation there there have been a few dozen cases reported in the last 250
00:47:15
years but all of them are essentially identical and one can take any case history from chiselled onwards and it will almost do for the others so let me choose something from another
00:47:33
patient but this could be sure during these first weeks after surgery I had no appreciation of depth or distance street lights were luminous stains stuck
00:47:46
to the window panes and the corridors of the hospital were black holes when I crossed the road the traffic terrified me even when I was accompanied I'm very insecure while walking
00:47:59
indeed I am more afraid now than before the operation it was very very similar with shell now he gradually learned
00:48:16
in general terms what a face looked like though even a year after surgery he couldn't tell individual faces he was very bewildered by perspective by the
00:48:30
fact that objects changed their appearance from different angles there was nothing in his other senses which had any analogy to this
00:48:45
he couldn't judge size or distance Richard Gregory a psychologist in England has given a beautiful case history of this and describes how one of his patients look now to the window at a
00:48:59
bus approaching thought it was an animal of some sort sure had been able to cross the road quite well with his stick but now after
00:49:11
the operation objects of of incomprehensible size and speed hurtled down on him and he was really in great danger
00:49:27
[Music] I've mentioned that he was a master at the YMCA and he knew the bodies of his clients by touch very well when he could
00:49:40
see them he got extremely confused he also got rather horrified at blemishes and the skin and discolorations and this and that it was a great though we effortlessly
00:49:59
make sense of the visual world he couldn't it was a great cognitive strain for example when he was shaving and now he tried his best and he was start shaving
00:50:12
I'm not the best person to demonstrate this III even forgotten how one I haven't shaved since I was 18 and but um I gather in shaving you sort of you look
00:50:25
at your face in a mirror and you hold a razor in the hand and he would start to do this and it would be reasonably successful but then the face would
00:50:36
decompose would dis limb would lose its boundaries would start to regress to what the suit to this blur which the surgeons face had looked like and at
00:50:48
that point he could no longer continue unless he unless he closed his eyes were turned off the light and and did it by touch I watched him eat and there was a
00:51:02
similar experience at first he he skewered things quite quite accurately with a fork and then this clearly got more and more difficult and finally he ended up using his hands which which was
00:51:16
his usual way and now the story has a very complicated twist which I think I won't go into but the net effect of this
00:51:31
was that he lost the vision which had been given to him and the his wife was very distressed and
00:51:43
regarded this as a catastrophe the surgeon put this down a surgical failure but showed himself showed an odd equanimity about it all and and though
00:51:59
he didn't quite say this it was obvious that in some sense he he had been returned to a world in a way of seeing
00:52:12
that her habits and strategies which which he was at home with and familiar so again here's this business of being between two worlds at the beginning
00:52:34
there was amazement wonder and sometimes joy it was great courage it was an adventure an excursion into a new world the like of which has given too few but
00:52:46
then came the problems the conflicts of seeing but not seeing not being able to make a visual world and at the same time forced to give up his own he found
00:52:58
himself between two worlds at home and neither a torment from which no escape seemed possible but then paradoxically the release was given in the form of a
00:53:12
second and now final blindness a blindness he received as a gift now at last he is allowed to Nazi allowed to escape from the glaring
00:53:25
confusing world of sight and space and to return to his own true being the intimate concentrated world of the other senses that had been his home for almost
00:53:36
50 years now I don't know whether this is a happy story or an unhappy story but it's a complicated story and a paradoxical story and again bears on the
00:53:52
fact that we can't decide what doctors can't decide no one can decide what's best for someone else one of the epigraphs I give at the start of the
00:54:05
book were something said by the great Canadian physician OWSLA when he said ask not what disease the person has but rather what person the disease has
00:54:19
and [Music] now I should say that it has been somewhat different for some of the people who've had this sort of surgery
00:54:30
some of them have at least made a partial accommodation it's not clear what makes this possible in the case of Richard Gregory's patient who was a
00:54:41
highly intelligent highly motivated man who in the 1919 50s found out he'd had his eyes severely scarred in the first weeks of life and
00:54:53
when corneal transplantation became possible he wanted to be one of the first and he was but his he'd been a brilliant blind mechanic very much
00:55:06
admired by his colleagues and very bold he would sort of go for bicycle rides holding the shoulder of someone else um when he was given a vision he could
00:55:18
recognize nothing he became a Ginoza --q by the man who mistook his wife for a hat was agnostic he could see but not see in his case he was agnostic because
00:55:30
the associational parts of the brain had been destroyed by disease ensures case because these parts had never developed Gregory's patient after six months of
00:55:44
hope and trying went into a decline became very depressed and died I'm about to sneeze and I can't it's an odd business as well
00:55:58
anyhow well the feeling is gone now it's one doesn't realize the limits of language doesn't want when when twice if
00:56:12
one tries to describe the feeling of wanting to sneeze and something as simple as that shows shows how helpless we are to describe subjective States I mean let alone sort of complex moral or
00:56:25
aesthetic states recordin describe how to sneeze not clear whether Gregory's patient committed suicide but but he at one point Gregory's patient says the
00:56:37
blessing has become a curse so so then this is a sort of cautionary tale of them of not rushing in too much now I
00:56:55
wondering if I should talk a little a bit about Tourette's or autism [Music] um one of the people I described in my
00:57:12
book was a man I saw at a conference with sudden thematic tics lunges hoops and I wondered what sort of a life this
00:57:27
man could have and I was incredulous when he told me that he was a surgeon I said you're joking you know what one of these one of these moves you know and
00:57:41
y'all had the aorta into and he said no it was not like that and he I do like the sign for cutting the aorta to it
00:57:54
it's not does not use that often instead I do hope that there are some members of the of the deaf community here anyhow he invited me to visit him
00:58:12
he he worked in a relatively small community in Western Canada [Music] I actually couldn't imagine him working in New York which is which is very
00:58:29
brutal but in this town of 20,000 he was obviously fully accepted by his patients his colleagues his community when patients first saw him they they
00:58:41
were in fact might be somewhat worried or or perhaps the GP but there still are still general practitioners might say I think you need a surgical opinion or
00:58:53
maybe surgery go see dr. Barrett they would say he does have some odd behaviors and and he says things suddenly but it doesn't matter none of
00:59:08
this happens when he's operating and he's a marvelous surgeon and a marvelous person well anyhow I went along to see him it he picked me up at the airport and there was a sort of strange skipping
00:59:23
drive and convulsively touching the ground as we went along and then we got to his house he had two dogs which I believe are on Malamutes your your thing
00:59:38
yeah but they have to use [Music] I'm a cat person but there were two Malamutes and I was taught by the by the the symmetrical he
01:00:00
has a passion for symmetry when I had seen him in the car he he would stroke his moustache like this and and touch the steering wheel and everything had to be symmetrical and
01:00:14
he had these two Malamutes and he he patted each of them rapidly seven times and and then his two sons
01:00:24
came up they were treated as individuals and that was that was very nice to see well I may be may be I'm going to read
01:00:41
you a little bit so I went to two outpatients and one of his ticks by the way was to say hideous hideous videos and I was some rather worried because
01:00:54
one of his patients I don't know if some of you have seen the Wade read about the Elephant Man or that his last patient was someone who had this condition you
01:01:07
know who had enormous sort of aprons of of this strange pathological tissue hanging from from the armpits and elsewhere and
01:01:20
[Music] and I was afraid Binet would say hideous and even though it was a tick what the effects of this might be and I was interested that at one point he dusted
01:01:32
and didn't say anything more he thanks he wasn't conscious of this but I once somehow felt that there had been a tactful apakah P a tactful abbreviation of the
01:01:46
word by his unconscious well anyhow after the outpatients I I scrubbed with him Friday is operating day for Bennett he was scheduled to do a
01:02:03
mastectomy and I was eager to join him and see him in action its outpatients and one thing one can always concentrate for a few minutes but how would he conduct himself in a lengthy difficult
01:02:16
procedure demanding intense unremitting concentration not for seconds or minutes but for hours Bennett preparing for the operating was a startling sight
01:02:30
you should scrub next to him his young assistant said is quite experience it was indeed for what I saw in the outpatient clinic was magnified here constant sudden darting x' and reaching
01:02:44
x' were the hands almost but never quite touching his unscrewed and stare our shoulder his assistant the mirror sudden lunging 's and touchings of his
01:02:55
colleagues with his feet and the barrage of vocalizations who do you who you suggestive of a giant owl the scrubbing over Bennett and his assistant were gloved and gound and
01:03:10
moved to the patient already anesthetized on the table they look briefly at a mammogram on the x-ray box and Bennett took the knife made a bold
01:03:22
clear incision there was never any hint of ticking or distraction and moved straight way into the rhythm of the operation 20 minutes past 50 70 100
01:03:38
the operation was often complex vessels to be tied nerves to be found but the action was confident smooth moving forward at his own pace with never the slightest hint of Tourette's not because it had been suppressed or
01:03:58
held in but because simply there was never any impulse to take most of the time when I'm operating it never even crosses my mind that I have to s Bennett says his whole identity at
01:04:14
such times is that of a surgeon at work and his entire psychic and neural organization becomes aligned with this active focused at ease unter etic
01:04:28
it is only if the operation is broken for a few minutes to review a special x-ray for example that Bennett unoccupied remembers that he is tourette
01:04:40
ik and in that instant becomes so and then as soon as the flow of operation in assumes the Tourette's the Tourette ik identity vanishes once again and his assistants were still astounded
01:04:55
by this and Bennett himself is astonished and quizzed me is he peeled off the gloves on the neurophysiology of at all in all sorts of performance
01:05:11
whether it's music or performance or surgical performance or swimming performance or sexual performance whatever performance seems to be
01:05:24
possible for people even with very severe turrets and the turrets can disappear at the time she since I think of swimming and turrets
01:05:37
one man I saw would swim the length of the pool perfectly perfectly but he'd have a sort of convulsion as he turned around at the end and then he would swim
01:05:47
perfectly again now you know one wonders what's going on in this man and in his brain when he moves from this Tourette
01:06:01
ik identity to the surgical identity it would be nice if one could do cat scans or something like this maybe as a metaphor this may do for you know all of
01:06:14
us have many many identities a day at sort of neurotic identities and creative identity ISM jealous identities and pedantic identities and magnanimous identity isn't and and so forth no I
01:06:29
think the neurology of identity is in a way as my theme but I can only describe it clinically it sort of what one what one needs to study now he forgets that he is to etic
01:06:46
or when he stops he remembers that he is torretta canned in that instant become so and when he said that I was reminded of a friend of mine a gifted artist who was parkinsonian
01:06:59
and I remember once when we were going to the Metropolitan Museum of Art his l-dopa Wharf and he started to to crunch up
01:07:14
into parkinsonism but he was able to give himself a shot of a drug called apomorphine which in a few seconds can alter things anyhow in about 50 or 60
01:07:26
seconds he straightened up and smiled and said I have forgotten how to be parkinsonian a very fascinating way of putting things and then he added he says in 40 or 45 or
01:07:40
50 minutes when the apomorphine wears off he says the dreadful knowledge will come back I will remember how to be parkinsonian and in that instant will become so
01:07:53
and here knowledge memory identity being option as you see all become one [Music]
01:08:07
in a way the color blind painter felt he had forgotten how to see color you know when he was glaring at an orange he was sort of trying to try to get the knack
01:08:19
people were they failure feel they they have forgotten words but in a way here wala that one is dealing with all sorts of neural knowledge and memory this is a
01:08:33
very simple kind and a very very special kind and you know I don't know you can't all be so healthy that you've never had a dental anesthetic or
01:08:47
possibly a spinal anesthetic certainly a dental anesthetic you know dentists no longer inject the inferior dental nerve on both sides if you do that you suddenly feel you have
01:09:05
no jaw you become a goon ethic III was speaking um I'm using all these classical words because of Michael Howard and you know and this is the this
01:09:19
is my my deference to the head of classics so we we've had sort of a pocke P and a gothic and you lose the sense of having a jaw in a strange way it is if
01:09:30
you never had a jaw it's a very odd experience it's um it's worth going through I I once had this myself and was in the sort of panic I grabbed the
01:09:43
dental mirror and which was and wasn't reassuring because I did see a visual jaw but it still didn't seem real because reality
01:09:55
can't be given by sight alone it depends on sensation from the body and proprioception in a more a spectacular way if one has a spinal
01:10:09
anesthetic and I don't mean just an epidural but a real spinal the sort of thing which which almost cuts the cordon - so to speak you don't just become numb
01:10:22
from the waist down you term you vanish you terminate here your body ego finishes here now you
01:10:34
might catch sight of a pair of legs seemingly attached you they're not your legs they're not yours and in a sense they don't look like flesh they almost
01:10:48
look like some old waxy anatomical specimen and they also they don't even look real I don't know whether any of you have had this experience which I
01:11:00
which I recommend I specifically I recommended in my book called a leg to stand on and I do in fact advise that the book be read under spinal anesthesia
01:11:17
because only then will you the reader know what I'm talking about now in a sense then when you have a spinal you
01:11:29
not only are unable to perceive your lower half but in some sense you forget it you can't remember it it's as if you have an amnesia for your lower half and
01:11:41
also you can't imagine it so that even though you may know things are going to come back in three hours this knowledge is entirely theoretical and in some
01:11:54
sense you know a delusion of always attached us to the experience I think this occurs in many other ways when one is parkinsonian one can't imagine being
01:12:08
non parkinsonian and when one is non parkinsonian one can't imagine being parkinsonian and when one is depressed sometimes and I think this is one of the cruelties and dangers of depression it is as if
01:12:21
one has always been depressed and as if one always will be and Anna knowledge that once you are smiling and enjoying things is you know is somehow not not
01:12:35
quite real this is this is certainly certainly one of the dangers and similarly in a sense the colorblind artist had developed a sort of amnesia
01:12:47
for color well I don't know what the time is and I mean I'm sort of rambling [Music] I know a
01:13:09
[Music] very gifted theoretic artists in Canada who declines to have his turrets treated
01:13:21
because he feels if it is treated he may lose some of his creativity or some of his self I don't know whether this is actually the case but it's a fear of his
01:13:34
last week I don't know if she came here she was certainly talked to the book shop Temple Grandin who is the brilliant
01:13:44
autistic woman who is who is a genius with cows but as puzzled by people although she says she is studying us
01:14:00
closely and and it was temple of course who said that she often felt like an anthropologist on Mars well she was actually here last week I don't know whether she talked here but I remember
01:14:14
in one of her lectures she said if I could snap my fingers and be normal autistic I wouldn't because being autistic is part of the way I am now
01:14:25
autism is not to be recommended spinals even spinals are not to be recommended none of these things are to be recommended but if they happen
01:14:41
in a way which can be not just merciful but highly creative one's identity neurological and psychic can be can be
01:14:57
reformed completely and to finish I think therefore that my theme and the book and my theme generally has to do
01:15:11
with us paradox and as what deaf people are already recognized so clearly in spelling death with a big D rather than a small D which is that out of disease
01:15:25
or out of a disorder can occur can come a health that there are many many ways many forms of health there are many ways of living fully and
01:15:39
and as a doctor and as a friend this is what one needs to look to to sort of find the fullest possible life for oneself or anyone else and you know we
01:15:51
we are all disabled I mean everyone is ill we're all damaged in various ways we probably get more damaged as we get older but it doesn't matter so long as
01:16:03
we live fully and so what I've tried to do here is to describe seven people who live fully and very fully despite what has happened to them and sometimes because of what what has happened to
01:16:16
them I hope to this is the case with myself and I hope is the case with you and I thank you [Music] you
01:17:01
[Music]
End of transcript