Saturday, October 28, 2017

‘Internal amputation’

I was reading A Leg to Stand On by Oliver Sacks, a physician by profession. He injured his leg while climbing a mountain and found himself on the opposite side of the table from what he was used to - he was now the patient. The injury was severe but straightforward to fix but the psychological effects were much more complicated. Sacks experienced paralysis and an inability to perceive his leg as his own, instead seeing it as some kind of alien and inanimate object, over which he had no control. He says that it felt as if  he had had an 'internal amputation'. The book is an account of Sacks’ ordeal and subsequent recovery.

My stroke happened over 18 years ago and my memories of the early months are hazy. In fact I now have to refer to the early posts in my blog to recall certain details. Certain experiences that Sacks describes seemed similar to mine so I will give them here. He describes the first time a physiotherapist had visited him and asked him to move his leg a week after it had been put in a plaster cast but he had failed to move it:
The session with Miss Preston left me pensive, and grim. The strangeness of the whole thing, and the foreboding I felt...now hit me with full force, and it could no longer be denied. The word 'lazy' that she had used, struck me as silly - a sort of catchword with no content, no clear meaning at all. There was something amiss, something deeply the matter, something with no precedent in my entire experience. The muscle was paralyzed - why call it 'lazy'? The muscle was toneless- as if the flow of impulses in and out, such as normally and automatically maintain muscle tone, had been completely suspended. Neural traffic had stopped so to speak, and the streets of the city were deserted and silent.
[SNIP]
It was the deadness of the muscle which so unnerved me. And deadness was something absolute, unlike tiredness or sickness. This was what I had felt, and suppressed, the previous evening: the sense, the foreboding, that the muscle was dead.It was, above  all, its silence which conveyed this impression - a silence utter and absolute, the silence of death. When I called to the muscle, there was no answer. My call was not heard, the muscle was deaf.
I did not get these feelings all at once after the first session of physiotherapy. I was unconscious during the first few physiotherapy sessions and was only aware that I was being pulled this way and that by somebody or something. Once the Chinese philosopher Zhuangzi dreamt he was a butterfly happily fluttering around doing as he pleased. He suddenly woke up and didn't know if he was Zhuangzi who had dreamt that he was a butterfly, or he was a butterfly who had dreamt that he was Zhuangzi. I was in a similar state of confusion when I started regaining consciousness after my stroke and the above feelings crept in over many subsequent days.

After his initial physiotherapy session, Dr. Sacks sunk into despair. He quotes Nietzche, ‘If you stare at the abyss, it will stare back at you.’ All the experience he had accumulated previously  were totally useless in ‘the limbo of Nowhere’. It seemed to him that he had ‘fallen off the map, the world, of the knowable’. He felt a great sense of fear because not only was his knowledge useless now but had now ‘the sense and feeling of passivity’ which he found humiliating. But after a few days he mysteriously began to change – ‘to allow, to welcome this abdication of activity’.  He writes:
Thus my limbo….started as a torment, but turned into patience, started as hell, but became a purgatorial dark night; humbled me, horribly, took away hope, but, then, sweetly-gently, returned it to me a thousandfold, transformed.
In this limbo, when I journeyed to despair and back - a journey of the soul, for my medical circumstances were unchanged,...and in an agreement, not uncordial, between my physicians and myself not to make any reference to 'deeper things' - in this limo, this dark night, I could not turn to science. Faced with a reality, which reason could not solve, I turned to art and religion for comfort. It was these, that could call through the night, and these only,could communicate, could make sense, make more intelligible - and tolerable. 'We have art, in order that we may not perish from the truth' (Nietzsche).
Art certainly is a comfort (for eg., listening to Kunnangudi Vaidyanathan on the violin is divine; for Tamilians, here is him playing some great songs on the violin) but religion never appealed to me even though I was surrounded by it. Since most people are religious, especially in India, I must be a mutant. Although personally nothing has changed, I have become more sympathetic to religion than before. Rubbishing religion and putting science and technology on a pedestal has harmful consequences. 

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