Cotswold Life

He­len Thom­son

How do you deal with a man who thinks he’s a tiger? Katie Jarvis talks to the au­thor and neu­ro­sci­en­tist about the work­ings of the hu­man brain

- • He­len Thom­son is ap­pear­ing at Cheltenham Science Fes­ti­val on Thurs­day, June 7 at 1pm to speak about The World’s Strangest Brains. For full de­tails, visit chel­tenham­fes­ti­ or call the box of­fice on 01242 850270. • For more on He­len and her book, United Arab Emirates · Al Ain · Journey · Cambridge University · Tony Blair · Iraq · Oliver Sacks

So what was it like…” I ask He­len Thom­son, “talk­ing to a man who thought he was a tiger?” I don’t mean that this man – Matar, a vil­lager from the United Arab Emi­rates – is prone to imag­in­ing what it might be like to be a tiger. Or that he par­tic­u­larly ad­mires or feels an affin­ity with large cats.

Noth­ing fan­ci­ful. Noth­ing metaphor­i­cal.

This is a man who, when­ever in the grip of his idio­syn­cratic delu­sion, looks in the mir­ror and sees re­flected there – with­out a

shadow of a doubt – orange fur struck through with black stripes. Who feels his fin­gers stretch­ing and bend­ing into ra­zor-sharp claws. Who is so ter­ri­fied of at­tack­ing some­one – in his tiger state – that he locks his door and binds his limbs tightly in a sheet. Once, he weighted his shoes with con­crete blocks. “I just want to stop my­self from hurt­ing any­one,” he says, with un­bear­able poignancy.

There he is, in Al Ain Hos­pi­tal, where he’s agreed to meet He­len: his thick black beard slightly grey­ing; heav­ily lined chubby cheeks; long white kan­dura swathing his un­mis­tak­ably hu­man form, topped with white head­dress.

“I don’t know why I’m a tiger,” he ex­plains, sadly. “I just know I am.”

There are some mo­ments you al­ways re­mem­ber be­cause (rare as they are) they changed your world-view. On first read­ing Oliver Sacks’s 1985 mas­ter­piece, The Man Who Mis­took His Wife for a Hat, was one such for me. Here was a world of won­ders. True won­ders. Pa­tients whom Sacks had treated – as an in­no­va­tive neu­rol­o­gist – whose brain con­di­tions ren­dered them alien be­ings. Twins whose low IQ meant they could nei­ther read, nor per­form mul­ti­pli­ca­tion; yet they could pluck prime num­bers out of the air like swifts snatch­ing at bee­tles. A young man who be­lieved his own leg was a sev­ered ‘other’, cru­elly placed in his bed as a prank. And, of course, the epony­mous man who couldn’t vis­ually dis­tin­guish his wife from his hat.

Jour­nal­ist He­len Thom­son also read this book with fas­ci­na­tion. With a de­gree in neu­ro­science and an award-win­ning ca­reer writ­ing about the brain (and other cut­ting-edge science sub­jects), she felt it was time to re­visit Sacks’s idea: the idea that ab­nor­mal brains tell us some­thing par­tic­u­lar of what it is to be hu­man.

But her newly-pub­lished book – Un­think­able: An Ex­tra­or­di­nary Jour­ney Through the World’s Strangest Brains – does some­thing a lit­tle dif­fer­ent. Her bizarre thinkers (in­clud­ing Gra­ham, who be­lieved him­self to be dead; Sharon who can’t find her way around the most fa­mil­iar of rooms; and Joel, a doc­tor, whose ex­treme em­pa­thy means he phys­i­cally feels the pain of his ev­ery pa­tient) are not looked at in any clin­i­cal set­ting. He­len wanted to see them in their own world; to ask: What is it like? What is it like to be you? The seeds of the idea were sown, He­len Thom­son tells me, when she came across an ex­treme case of face-blind­ness a decade ago. It was in a jour­nal-pa­per – sci­en­tific and anony­mous – de­scrib­ing a woman who not only could not recog­nise fa­mous peo­ple; she couldn’t even iden­tify mem­bers

of her own fam­ily by sight.

As He­len read through, ques­tions popped into her head that the sci­en­tists sim­ply didn’t ad­dress.

Like, I sug­gest, sim­i­larly in­trigued: What hap­pened when this woman bumped into some­one she knew in the street?

“Ex­actly! I wanted to know: What hap­pens when you wake up next to your hus­band? Does he look like a stranger to you?”

The up­shot is, He­len tracked this woman down (I’m so taken with the story that I for­get to en­quire how) and asked her all those nat­u­rally fas­ci­nat­ing ques­tions. The kind of ques­tions you’d ask some­one in the pub vol­un­teer­ing a bizarre nugget about them­selves. Or that you’d men­tion, your­self, in the midst of de­scrib­ing your own idio­syn­cra­sies.

How does some­one who can’t recog­nise ANY faces cope? What strate­gies do they use? What em­bar­rass­ing sit­u­a­tions has it led to? Is it best to ‘fess up or would that risk of­fend­ing peo­ple who just don’t get it? So?

“She said she doesn’t recog­nise her hus­band as such, but she’s not stupid. So she knows that’s her hus­band for ev­ery other rea­son you know that the per­son next to you is your hus­band.

“But when the two of them started dat­ing, he would come into a restau­rant and she wouldn’t know who he was; she hadn’t learned to recog­nise his clothes or gait or hair­style. In fact, she al­most kissed an­other per­son be­cause she thought that was her date.”

Those sorts of ques­tions might seem a bit light­weight, “But, ac­tu­ally, they’re the ones that have these great sto­ries at­tached to them. The things that tie us all to­gether are sto­ries. They’re the kind of things that make our lives spe­cial.”

She’s ab­so­lutely right, of course. Which is what makes Un­think­able un­put­down­able. So when He­len meets 57-year-old Gra­ham in his tiny, smoky mo­bile home, she finds out the things we’d all be won­der­ing. This poor chap was go­ing through his sec­ond divorce when, in a fit of se­vere de­pres­sion, he climbed into a bath hold­ing a plugged in hairdryer. When he came to (mirac­u­lously, he sur­vived), he knew he was dead.

“I just had this blank mind and I knew – I couldn’t say why – I just knew that I didn’t have a brain no more.”

He­len con­sid­ers this, as she sits op­po­site him in his liv­ing room. “And at no point did you think, ‘Okay, I know I must have a brain be­cause I am sit­ting here breath­ing?’”

“No. I didn’t know what to make of it. I didn’t know how I could breathe or talk when my brain was dead. I just knew it was.”

What is so fas­ci­nat­ing, as she runs through her sto­ries, is the way the peo­ple in ques­tion are so con­vinced – be­yond doubt

– by their fan­tas­ti­cal il­lu­sions. Gra­ham’s is a rare but known con­di­tion, Co­tard’s, that was first doc­u­mented (as He­len dis­cov­ered, while ner­vously leaf­ing through a frag­ile, leather-bound book at Cam­bridge Univer­sity) back in the 16th cen­tury by an­other science writer, Lev­i­nus Lem­nius. He told the story of a man who, like Gra­ham, was so con­vinced by his own ‘death’ that he re­fused to eat or drink. As he lay dy­ing – from real star­va­tion, by this point – his in­ven­tive friends hatched a plot. They dressed up in shrouds – as if they, too, were dead – and sat them­selves round the ta­ble in his par­lour, eat­ing and drink­ing. Re­as­sured, the man-whomis­took-him­self-for-a corpse joined them for a meal.

To any­one free from sim­i­lar delu­sions, these ex­pe­ri­ences defy be­lief (to use oxy­moronic terms).

“But hav­ing had hal­lu­ci­na­tions my­self, I know how re­al­is­tic they can be,” He­len ex­plains. “I used to have hypnopom­pic hal­lu­ci­na­tions [hal­lu­ci­na­tions ex­pe­ri­enced while awak­en­ing] when I was lack­ing sleep and go­ing through a stress­ful pe­riod.”

For a cou­ple of years, she’d of­ten wake to ‘see’ peo­ple in her bed­room.

“The first few times, it was ab­so­lutely ter­ri­fy­ing. I don’t think any­body who hasn’t ex­pe­ri­enced a hal­lu­ci­na­tion of one kind or an­other can ever un­der­stand how real it is; there is seem­ingly no dif­fer­ence be­tween it and some­body re­ally be­ing there.

“But as I be­gan to learn about these hal­lu­ci­na­tions and un­der­stand them, I got some con­trol over them. I re­mem­ber Oliver Sacks say­ing sim­i­lar things when I once in­ter­viewed him [lucky her!]: that when he started hav­ing hal­lu­ci­na­tions as he lost his sight, he ac­tu­ally be­gan to en­joy look­ing at what he called the ‘the­atre of his mind’.”

In­deed: with her de­gree in neu­ro­science, He­len is well placed to ex­plore the ori­gins of some of these brain anom­alies – and fas­ci­nat­ing they are, too. Take the case of Joel, the doc­tor, whose em­pa­thy is so ex­treme, he feels other peo­ple’s pain, emo­tions and even touch­sen­sa­tions. Once, in a lec­ture the­atre, he felt a hand clos­ing round his throat. Taken by sur­prise, he soon re­alised that no one was touch­ing him; but his lec­turer, speak­ing at the front, had his hand round his own throat.

He­len’s ques­tions – as al­ways – are spot on. Can Joel use his hy­per-em­pa­thy to help his pa­tients? Can he ever turn it off? And what’s it like when he sees a pa­tient die? (‘“To put it sim­ply,’ he says, ‘it’s as if I’m dy­ing as well. There’s this very pow­er­ful mo­ment just be­fore death of let­ting go.’”)

But she’s also ex­cel­lent at ex­plain­ing – as far as sci­en­tists can – how these con­di­tions can oc­cur. In Joel’s case, most peo­ple are pro­grammed, from new­born on­wards, to mimic oth­ers: ac­cents, fa­cial ex­pres­sions, body lan­guage. Yet, at the same time, most of us can main­tain a sense of sep­a­ra­tion. With Joel – and peo­ple like him – neu­ro­sci­en­tists have dis­cov­ered less brain mat­ter in their tem­poropari­etal junc­tion: the area of the brain that helps dis­tin­guish where our bod­ies end and oth­ers be­gin.

The more you read of He­len’s

‘How does some­one who can’t recog­nise ANY faces cope?’

book, I sug­gest to her, the more you won­der not so much ‘How can brains go wrong?’ but ‘How can they go right?’ This seem­ingly end­less com­plex­ity of 100 bil­lion neu­rons, act­ing and in­ter­act­ing in per­fect bal­ance.

“Yes, that is some­thing I was con­stantly aware of, meet­ing these peo­ple. But I guess that also led me on to think­ing: What is nor­mal? Be­cause – and I hope this comes across in the book – by look­ing at the ex­tremes of how brains can be dif­fer­ent, you re­alise these are skills and abil­i­ties that we all pos­sess; it’s to do with where we all sit on that spec­trum of ‘nor­mal­ity’.

“And I hope this all adds to that con­ver­sa­tion of how we de­fine men­tal health.”

So let’s fin­ish by re­turn­ing to Matar, the man who be­lieves him­self to be a tiger. Be­cause his story – told by He­len with her con­stant sense of com­pas­sion and un­der­stand­ing – grabbed me for sev­eral rea­sons.

Of­ten – it seems to me (though I’m no neu­ro­sci­en­tist) – we be­lieve peo­ple not be­cause they’re log­i­cal but be­cause they them­selves are con­vinced. Tony Blair (ar­guably) on the need for the Iraq War; preach­ers, with claims for reli­gion; al­ter­na­tive heal­ers whose ‘pow­ers’ have nev­er­the­less been thwarted by dou­ble-blind ex­per­i­ments. A part of us seems com­pelled, against logic, to be­lieve in their be­lief. (And you can see in that all sorts of phe­nom­ena, from witches to ghost sto­ries.)

Be­cause there’s no doubt, from her de­scrip­tion, that part of He­len, sit­ting lis­ten­ing to Matar, felt she was in the pres­ence of a wild an­i­mal.

She nods. She’s care­ful to point out that - de­spite the stigma - ag­gres­sion and vi­o­lence are not al­ways linked to schizophre­nia in the way the press would of­ten have us be­lieve.

“I did know that, at some time in the past, Matar had tried to at­tack a bar­ber, so there was an el­e­ment of dan­ger, I guess. But he had been well for a while; he’d come to the hos­pi­tal of his own free will for an in­ter­view and was happy to be in­ter­viewed. There was no rea­son to sus­pect he would have a re­lapse.” So it came as a com­plete sur­prise – to He­len and to the two physi­cians with them – that Matar be­gan to ex­pe­ri­ence his delu­sion as he spoke with her.

“It was a ter­ri­fy­ing ex­pe­ri­ence,” she tells me. “It was very quiet and you could see he was hav­ing this in­ter­nal strug­gle. His hands were stretched and his fin­gers were bend­ing in this re­ally re­al­is­tic claw-like man­ner; and these growls were com­ing from him. It’s hard to ex­plain with­out sound­ing like he’s act­ing.

“There was a si­lence while this was go­ing on and none of us moved. I did gen­uinely feel – I was sit­ting right next to the door – that, if I tried to make any move­ment, he might ac­tu­ally at­tack me. So I did think to my­self: What would a prey­ing preda­tor do? Ob­vi­ously, that’s ridicu­lous be­cause he’s a hu­man be­ing hav­ing a se­vere health is­sue; but it was so re­al­is­tic that that’s how I was feel­ing: Don’t make any sud­den move­ments.”

It was a brief ex­pe­ri­ence and Matar soon be­came lu­cid again.

But it gave He­len an in­sight into other such doc­u­mented con­di­tions. A 34-year-old woman who ar­rived, ag­i­tated, at an A&E depart­ment, be­fore sud­denly jump­ing around like a frog, dart­ing out her tongue to catch flies. Or an­other who felt she was get­ting smaller and smaller and turn­ing into a bee.

Were there any strange con­di­tions He­len couldn’t track down?

“A few. There is an en­tire com­mu­nity of peo­ple in Africa who can­not feel fear; they are all very closely re­lated, which is why the con­di­tion has per­sisted. At the time [of re­search­ing], it was im­pos­si­ble to get to them, but it’s one I’d love to look into.

“A re­ally in­ter­est­ing as­pect of not feel­ing fear is that you rarely tell lies. If you think about it, it makes sense: We lie be­cause we are fear­ful of the con­se­quences of truth.”

But for all those wait­ing for the next in­stal­ment, there’s a rather dif­fer­ent new brain He­len Thom­son needs to ex­plore: She’s ex­pect­ing a baby in the sum­mer.

She laughs. “A first chal­lenge. And then I might think about the next book.”

‘It was a ter­ri­fy­ing ex­pe­ri­ence. His hands were stretched and his fin­gers were bend­ing in this re­ally re­al­is­tic claw­like man­ner’

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