- reason why sacks loves lauria: puts subject back to the disease
sacks interview
- importance of storytelling to the scientific aspect of the discovery
- case history of science with sensibilities and structure of a novel
- “portraits of patients”
sack’s critiques of the neurosciences of his time
- a science that includes narrative is what he calls “romantic.”
- analytical complement by narrative
3 main ingredients to romantic science:
1. privileges subject and lived experience of illness - kleinman: experience of suffering - abstract qualities of an illness divorced with the subject
2. privileges story-telling and narrative over conceptual classification
3. exploration of the elemental and the concrete comes before than bowers of abstract and categorisation
- concerns existential dimension of neurological diseases
> how disease affect personality/individual being of his patients
“SUBJECT” : what is a subject without a reality?
CRITIQUE OF IMPERSONAL NEUROLOGY
- brain as a computational organ - forgets the patient’s essential being
- brain disorders in indextricable conjunction with patient’s experience
- intersection of body and mind between physiological and the physical
- story-telling is an important aspect in scientific understanding, compiling explanations
PATIENTS ARE TRAVELLERS
- patients are travellers in unimaginable land
- another dimension of human existence we have no access to
- not victimising the patient, but rather exploration and curiosity - empowering
> looking at disease differently, outside of simple binary
DISEASE AND CREATIVITY
- archetypal sense of a hero: his patients strive to overcome limitations from disease
- although in all cases there’s no happy ending bcs of incurable diseases, each provide profound moral lessons - highlight resilience of human being themselves, keen to highlight the creative sense
- sacks wonder about the soul of his patients - korsokov’s syndrome “lost of mariner” story - “de-souling”
- pithed: loss sense of within - no longer having the sense of the body - the disembodied lady
- diseases put subject into question - erases subject before he/she got the disease
- how patient thrives in his/her own way - creation plays crucial role in this
> Dr. P’s paintings: can recognise abstract shapes but not regular faces
“There is often a struggle, and sometimes even more interestingly, a collusion
REDEFINING DISABILITY AND DISEASE
- ray, suffers from turret syndrome: turning his own disease into resource of artistic creation
- emphasising on the creative moment - what can the body still do instead of fixing it
“a disease is never a mere loss or excess. There is always a reaction on the part of the affected organism or individual, to restore, to replace, to compensate for and to preserve its identity, however strange the means may be.” (4)
BRODY CONNECTION: PATIENT-DOCTOR RELATIONSHIP - observing and listening
Lecture 10
ROMANTIC SCIENCE PT 2
- “clinical tales” - stories of a doctor’s observations and recollections of a patient’s specific disease.
> why “tales”?
- they have some fiction, narrative formula
- they have a moral lesson
> tales related to recognised neuropathologies
4 thematic sections:
- losses
- excesses
- transports
- the world of the simple
sacks add short intro to each section - the main concept
how the concept:
BOTH
ORGANISES our scientific understanding of the neurological disorder
i.e. diseases as a loss, scientifically classifying the disease
AND
LIMITS our ability to fully recognize and appreciate the resillience, uniqueness and creativity of each of his patients
i.e. world of the simple - ppl with down syndrome - ppl who have these disorders have a different value of experiencing the world that is more valuable, has a set of values - offers shift of perspective
RHETORICAL PATTERNS OF SACKS’ CLINICAL STORIES
- “rhetorical” pattern: arrangement of arguments and story - one story reinforces the other
> thematically group stories
process of every story:
- each story has a general description of how he met the patient
- moment of perplexity: followed by a test of some kind with the problem related both to the nature of the disease and to the way the patient lives it
- what his story is, general diagnosis, moment of perplexity - encounter with the patient, relate the problem back with the scientific literature to work out his own solution
- focus turns back to patient (turning point), doctor observes patient in his/her own environment, outside of codified testing (medical lab)
- observing the patient in her own environment produces the most important revelations and insights
> i.e. rebecca in her home - pg 178/chapter 21: how she perceives her own home, sacks for once sees her to appreciate her powers to see her world as poetic, intelligent and whole.
> i.e. twins: only when he sits down with the twins, joins prime numbers game rather than have them respond to him, he gets a glimpse of their iconic memory
THE THERAPEUTIC MOMENT
- observing patients in their own environment makes the doctor coequals with patient - page 75 - “are coequals, on the same level, each learning from and helping the other and between them arriving at new insights and treatment.”
- “the actual moment of discovery” (72)
THE QUESTION OF SOCIAL ADAPTION
- social effect: deficit and function
- i.e. twins got separated to make them socially adaptable, and individually they did. but together, their shared pleasure in numbers, they have lost “the personal and emotional centre of their lives” (200).
> medical institution don’t take into account the emotional aspect of keeping people together
WHOSE INTERESTS DO MEDICINE SERVE WHEN IT COMES TO SOCIAL ADAPTION?
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