Luria: The Man with the Shattered World.
Rather than ask specific questions and make criticisms of the book
I've decided to explain a little of what Luria says in each of the
20 or so chapters. Hopefully this will be of more use to those of
you who haven't read the book and will give you a taste of the
moving account of a man who experienced the profound loss that
Zasetsky (Z) went through. The book involves quotes from Z's diary
and commentary from Luria.
1. The past
Z has childhood memories of a basically happy, peaceful childhood.
2. War
Remembers going to war.
3. After being wounded
Z remembers coming to, after being hit in the head by a bullet, and
not remembering anything. "My head seemed completely empty , flat,
hadn't the suggestion of a thought or memory, just a dull ache and
buzz, a dizzy feeling." Then clusters of memory returned (e.g. his
name). "I'm in a kind of fog all the time, like a heavy half sleep."
4. The rehabilitation hospital
Z feels life is over but that "something keeps insisting I have to live."
He had difficulty understanding or identifying things in the environment.
5. Our first meeting
3 months after being wounded Z meets Luria. "He did not understand
my questions at first, and even after he did, he had difficulty
replying." Z lacks meaning , e.g. "Where's my left hand?.....What
does right mean?....." However, he kept an immediate grasp of the
world and sensitivity to experience allowing him to evaluate each
and every failure.
6. Excerpt from case history no. 3712
Parieto-occipital region of left hemisphere and medulla damage.
7. A brief summary of brain anatomy. The first digression
There was damage to the tertiary area of the visual cortex but not
to the primary or secondary areas. This means that whilst he could
still see and perceive discrete objects he could not combine
impressions into a coherent whole. Also, the tertiary area of this
area (of the left hemisphere) are involved in language functions. As
well as a means of communication language is fundamental to
perception, memory, thinking and behaviour. "It organises mental
life."
Z's frontal cortex was not damaged, hence the ability to "recognise
his defects and wish to overcome them."
8. First steps in a shattered world
Luria sets the scene for examining parts of Z's journal, in the next
few chapters, that relate to different kinds of problems he
encountered.
9. His vision
At first he could not perceive a thing then, when he could,
fragments didn't form complete objects. He had to guess what
assembled fragments meant. Also, the right side of his visual field
was "an even grey vacuum".
10. His body
His sense of his body had changed. He experienced fragmentation of
his body and certain body parts would feel large or small. For
example, "...my head is the size of a table". Also, he forgot where
body parts were and had to `hunt' for them.
11. Space
He adjusted to these body problems but other disturbances persisted.
Examples of `spatial disturbances' were not knowing which hand to
extend to shake hands and getting lost when going for a walk. When
he left hospital and returned home he did not recognise his home
town. Indeed, "space `made no sense to him'" and so it lacked
stability.
12. Reading
The realisation that you can't read must be as confusing as it is devastating.
13. A student again
Relearning the alphabet was a very slow process. Progress was made
by associating a letter with a word that began with that letter.
Reciting letters out loud was more successful than visualising
letters. It took an incredible effort to make small improvements.
14. Writing, the turning point
Writing was even harder than reading to start with. "I'd just
forgotten how to use a pencil." Then he discovered he could write
automatically (as opposed to the way children do) even though he had
trouble reading his own writing. After intensive training he could
almost write as well as he did before being wounded. He decided to
write a journal describing what had happened to him and the struggle
it took to start recovering what he had lost.
15. `The story of a terrible brain injury'
He worked on the journal everyday for 25 years. Although he could
write he had great difficulty being able to express ideas in words.
Hence, very slow progress.
16. Why did he write?
A question he asked himself many times, especially as it was such a
demanding and exhausting task. He decided it was worth it as he was
not fit for anything else. Through his writing he could create a
coherent view of what his experiences and desires were. Basically,
it gave him a reason to live.
So, setting the scene for the next few chapters, Luria says "if we
follow him step by step, we may unravel some of the mysteries of the
human brain."
17 `My world has no memories'
Z's memory problems were the ones that most disturbed him. He
couldn't remember the words for objects and if he could it took a
lot of effort to do so. He had to "learn to recognise objects and
try to associate them with words."
18. `My memories came back from the wrong end'
When he started to remember things they were from his distant past
(i.e. childhood) and not his recent past. Eventually he remembered
events up to his being wounded and then some memories of the
hospitals he'd been in. However, he could not summon these memories
at will and he had trouble visualising images of things and making
associations.
19. The peculiar features of his `speech-memory'
Z referred to the above problems as being due to a loss of `speech-memory'.
Two points are re-emphasised. Firstly, that Z lost the link between
words and their meaning. And secondly, that he had to actively
search through lots of familiar words before stumbling on the right
one for a particular object.
20 On recollecting words: the second digression
Luria suggests that the problem with Z's `speech-memory' originates
from the disruption of the parts of the cortex that control the
analysis and organisation of complex associations into a coherent
framework. So, for example, even if he did remember a correct word
then associations would continue and he would forget the right word.
21 Restricted to undeciphered words, disembodied ideas
Analysis of a short comprehension test shows Z could only understand
one word at a time and not combine them to form the intended image
main point. This problem also meant he couldn't formulate and
express his own ideas coherently.
22. Grammatical constructions: the third digression
Luria demonstrates how intricate grammatical construction can be in
instances such as sub clauses, inversions and the implications of
different case endings.
Z was only able to understand sentences in which the word order
coincided with the sequence of actions. e.g. `The man read the paper
then had breakfast' but not `The man had breakfast after reading the
paper', and he couldn't differentiate between `The circle over the
cross' and `The cross over the circle'.
He relates Z's inability to grasp linguistic relationships to his
difficulties with spatial relationships and suggests these two
functions are based in the same area of the cortex.
23. `All my knowledge is gone'
His problems in understanding grammatical constructions led to the
impossibility of recovering any knowledge he had acquired before he
had been wounded. e.g. counting, playing chess etc.
24. A story that has no end
Luria concludes by saying Z still struggles on with his writing, not
understanding why this happened to him, but still wishing to wake up
from a dream.
25. `Were it not for war...' In place of an epilogue
A short piece of anti-war rhetoric. e.g. "were it not for war, the
world would have become a great place to live long ago. In this age
we have the opportunity... to feed, clothe and shelter all of
mankind..."
A well as providing a moving account and fascinating insight into
the experience of a devastating disability this book puts Z's
observations into a concise theoretical framework. Definitely a read
I'd recommend.
Richard
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