The homeless alcoholic who sacked his butler
LOST AND FOUND by Jules Montague (Sceptre £20)
If we lose our memories, do we lose ourselves? If our personalities change radically through illness, in what ways are we still the same people?
These are just two of the many questions that Irish neurologist Jules Montague poses in this remarkable book. ‘I have taken a journey through who we become when memories evaporate and personality shifts and consciousness ebbs and flows,’ she writes.
It’s well worth accompanying her on this journey, although some of the places she visits are disturbing.
Memory’s greatest enemy is probably Alzheimer’s — 47 million people worldwide are living with the disease, with one new case every 3.2 seconds. Its consequences, as it erodes sufferers’ ability to remember who they are, are devastating.
But other neurological complaints, while rarer, can be equally destructive. what to make of the man given the name Benjaman Kyle? found semi-naked and unconscious, behind a Burger King in Richmond Hill, Georgia, he had almost complete amnesia. One of the few things he did remember was once eating a grilled cheese sandwich at the Indiana State fair.
Some patients fill the gaps in their memories with their own, often strange, inventions. Montague writes of a man named Charlie who sat in her clinic and cheerfully told her he’d just fired his butler for stealing a combine harvester.
He had also recently returned from a children’s charity where he handed out prizes and had a go on a pink trampoline. Charlie, a homeless alcoholic, wasn’t really lying. He believed what he was saying.
As Montague puts it: ‘The patient with implausible tales cannot remember that he cannot remember.’
It’s as well to remember how malleable memory is. During a Nineties experiment, two psychologists convinced a quarter of participants that they had been lost in a shopping mall as a child, even though they hadn’t. Many recalled the trauma in vivid detail. ‘I was crying,’ one said. ‘I thought I’d never see my family again.’
And not only can we remember things we never experienced, we forget experiences that should be unforgettable.
Montague, whose family come from India, has vivid memories of childhood holidays in Assam. Yet she cannot recall a safari with her uncle to track down a one-horned rhinoceros. They found one, her parents tell her. How could she have forgotten
something so memorable? Loss of memory, the glue that binds together the story of our lives, is not the only kind of damage neurological disease can inflict.
Some patients suffer loss of personality. Political orientations change. Right-wing authoritarians become bleeding-heart liberals. Atheists might undergo religious conversions.
And occasionally, new talents emerge alongside distressing changes in behaviour.
Montague quotes the case of a businessman who developed dementia. he started to undress in public. he shoplifted and insulted strangers in the street.
At the same time, he began to paint. he had never shown any previous interest in art, but his paintings were precise, detailed and skilful. The most extreme examples of personality change occur in those suffering from multiple personality disorder. Experts are warier of diagnosing this than they once were. It first came to public attention with Sybil, the subject of a bestselling 1973 book and a TV mini- series starring Sally Field. Sybil, real name Shirley Mason, was apparently possessed by a host of identities, including Peggy Ann, Peggy Lou, a small child named Ruthie, Marcia, who was an artist and writer, and two male carpenters called Mike and Sid. The effect of Sybil’s story was dramatic. Before publication of the book, there had been 200 documented cases. Between 1985 and 1995, there were an estimated 40,000.
In 1979, Ken Bianchi, charged with several murders, argued that it wasn’t him, but his alter ego, Steve, who had committed them. his credibility was undermined when it was discovered that he had watched the TV show of Sybil in his cell just before his interviews with psychiatrists.
Like the late Oliver Sacks, Jules Montague writes about bizarre cases. She tells us of conditions such as ‘negative heautos copy’, in which you are unable to see your own body as you stare down at it or look in a mirror.
And yet, she is also writing about what it is to be human and the surprising fragility of our sense of self. Lost And Found is a profoundly moving, revelatory book.