Maureen Sorbet & Marianne Rion
The book presented below was written by Oliver Sacks. He is a neurologist and professor at the Columbia University School of Medicine and he is still known for his neuroscience publications.
This book includes 24 essays and is entitled “The man who took his wife for a hat”. It describes various patients suffering from neurological pathologies (autism, Tourette’s syndrome, prosopagnosia…) that the author has met during his career. This book is particularly accessible to the general public and does not require any knowledge in medicine.
The title comes from an essay in the book on the case of a man who knew how to recognize objects, like a hat, but not faces, including his own and that of his wife. The author describes the case of a patient with visual agnosia and more specifically prosopagnosia. For each case, the author describes the cerebral pathology in question, the patient’s daily life as well as the mechanisms used by the patients to compensate for the capacity loss. This book can therefore be particularly useful with regard to the practice of neuropsychology in terms of rehabilitation as some compensatory tools used by the patients detailed therein can be transposed into the profession of neuropsychologist.
Here, we relate to describe the chapter “the lost sailor”, a case regularly encountered in our profession of neuropsychologist.
Jimmie G. is admitted to a psychiatric institute in New York at the age of forty-nine. He has kept very precise memories of his childhood in Connecticut, of his stint at high school where he was a brilliant student, and, in 1943, at the age of seventeen, of his incorporation into the Navy in which he did serve as a radio-electronics. He believes he is still in 1945 and behaves normally like a young man, except for his inability to remember his recent events. When he talks about the navy, his words do not seem to evoke the past but the present since Jimmy evokes perennial details. After leaving the navy in 1965, Jimmy started to drink a lot which led to more and more frequent memory problems. These alterations are part of a Korsakoff-type syndrome that corresponds to memory dysfunction due to high consumption of alcohol. However, even though his neurologist, Oliver Sacks, was able to make him aware for a few moments, at each session, that he was not 19, he could not remember because Jimmy was unable to form new memories.
Korsakoff syndrome is a neurological disorder due to excessive and prolonged alcohol consumption. This syndrome causes various cognitive difficulties that we can evaluate and interpret in the context of a neuropsychological management. Memory disorders are in the foreground with anterograde amnesia. There are also difficulties of a visual-constructive nature and the latter difficulty is an important disorder of executive functions (organization, inhibition, flexibility, updating).
What we also found very relevant in this chapter is the author’s paragraph on the importance of the patient’s well-being, regardless of the difficulties they encounter. The author wonders whether it is necessary to remain focused on important memory disorders as well as on ways to recover lost or deficient functions, which may sometimes not be recovered. He hypothesizes that focusing more on the individuality of the patient: his wishes, desires, feelings, would be a way to accompany that could modify the patient’s condition without working specifically, in this case for example, memory of Jimmy. At the end of this chapter, the author tells how rich Jimmy’s care has been. Indeed, Jimmy has never been able to recover his memory because amnesia is so profound, however, according to the author «he has become another man». While the author, at their first meeting, thought Jimmy condemned, he realized that a human management was also beneficial from a cognitive point of view. As a result of the work they did together, the agitation has diminished on the one hand and on the other hand attentional has abilities increased.
To conclude, this book delivers a lot of clinical cases that can be transposed into our professional practice. Reading these cases allows us to think about pathologies, but also, as we explained earlier, to think about our own practice.
Keywords : Korsakoff syndrome, Oliver Sacks, alcohol, memory disorder, clinical case
Words we have learned : perennial : éternel – deficient : lacune – foreground : premier plan – whether : si – well-being : bien-être
Reference :
Sacks, O. (1988). The lost sailor. In O. Sacks (dir.), The man who mistook his wife for a hat (p.41-60). Paris : Editions du seuil.