Narrated by: Kate Hood. Length: 10 hrs and 51 mins. Publisher's Summary When Nikki Stern left suburban Melbourne for Europe in the early s, little did she know that her life was about to change dramatically. More from the same Author The Former Assassin. What members say Average Customer Ratings Overall.
Amazon Reviews. No Reviews are Available. Sort by:. Most Helpful Most Recent. After Beatrice Webb voiced disapproval of Wells' "sordid intrigue" with Amber, he responded by lampooning Beatrice Webb and her husband Sidney Webb in his novel The New Machiavelli as 'Altiora and Oscar Bailey', a pair of short-sighted, bourgeois manipulators. Between —, novelist Elizabeth von Arnim was one of his mistresses.
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Wells dedicated his longest book to her The World of William Clissold , In , when she left Gorky and emigrated to London, their relationship renewed and she cared for him through his final illness. Wells asked her to marry him repeatedly, but Budberg strongly rejected his proposals. In Experiment in Autobiography , Wells wrote: "I was never a great amorist, though I have loved several people very deeply". Director Simon Wells born , the author's great-grandson, was a consultant on the future scenes in Back to the Future Part II One of the ways that Wells expressed himself was through his drawings and sketches.
One common location for these was the endpapers and title pages of his own diaries, and they covered a wide variety of topics, from political commentary to his feelings toward his literary contemporaries and his current romantic interests. During his marriage to Amy Catherine, whom he nicknamed Jane, he drew a considerable number of pictures, many of them being overt comments on their marriage.
During this period, he called these pictures "picshuas". He also wrote realistic novels that received critical acclaim, including Kipps and a critique of English culture during the Edwardian period , Tono-Bungay. Wells also wrote dozens of short stories and novellas, including, "The Flowering of the Strange Orchid", which helped bring the full impact of Darwin 's revolutionary botanical ideas to a wider public, and was followed by many later successes such as " The Country of the Blind " According to James Gunn , one of Wells's major contributions to the science fiction genre was his approach, which he referred to as his "new system of ideas".
While neither invisibility nor time travel was new in speculative fiction, Wells added a sense of realism to the concepts which the readers were not familiar with. He conceived the idea of using a vehicle that allows an operator to travel purposely and selectively forwards or backwards in time.
The term "time machine", coined by Wells, is now almost universally used to refer to such a vehicle. Being aware the notion of magic as something real had disappeared from society, he, therefore, used scientific ideas and theories as a substitute for magic to justify the impossible. Wells's best-known statement of the "law" appears in his introduction to The Scientific Romances of H. Wells ,. As soon as the magic trick has been done the whole business of the fantasy writer is to keep everything else human and real.
Touches of prosaic detail are imperative and a rigorous adherence to the hypothesis. Any extra fantasy outside the cardinal assumption immediately gives a touch of irresponsible silliness to the invention. An enthusiast of random and irresponsible violence, Griffin has become an iconic character in horror fiction. Radioactive decay plays a much larger role in The World Set Free This book contains what is surely his biggest prophetic "hit", with the first description of a nuclear weapon.
The rate of release is too slow to have practical utility, but the total amount released is huge. Wells's novel revolves around an unspecified invention that accelerates the process of radioactive decay, producing bombs that explode with no more than the force of ordinary high explosives—but which "continue to explode" for days on end. Wells also wrote non-fiction.
When originally serialised in a magazine it was subtitled "An Experiment in Prophecy", and is considered his most explicitly futuristic work. It offered the immediate political message of the privileged sections of society continuing to bar capable men from other classes from advancement until war would force a need to employ those most able, rather than the traditional upper classes, as leaders.
Anticipating what the world would be like in the year , the book is interesting both for its hits trains and cars resulting in the dispersion of populations from cities to suburbs; moral restrictions declining as men and women seek greater sexual freedom; the defeat of German militarism , and the existence of a European Union and its misses he did not expect successful aircraft before , and averred that "my imagination refuses to see any sort of submarine doing anything but suffocate its crew and founder at sea". His bestselling two-volume work, The Outline of History , began a new era of popularised world history.
It received a mixed critical response from professional historians. Many other authors followed with "Outlines" of their own in other subjects. From quite early in Wells's career, he sought a better way to organise society and wrote a number of Utopian novels. The first of these was A Modern Utopia , which shows a worldwide utopia with "no imports but meteorites, and no exports at all";  two travellers from our world fall into its alternate history. The others usually begin with the world rushing to catastrophe, until people realise a better way of living: whether by mysterious gases from a comet causing people to behave rationally and abandoning a European war In the Days of the Comet , or a world council of scientists taking over, as in The Shape of Things to Come , which he later adapted for the Alexander Korda film, Things to Come.
This depicted, all too accurately, the impending World War , with cities being destroyed by aerial bombs. Men Like Gods is also a utopian novel. Wells in this period was regarded as an enormously influential figure; the critic Malcolm Cowley stated: "by the time he was forty, his influence was wider than any other living English writer". Wells contemplates the ideas of nature and nurture and questions humanity in books such as The Island of Doctor Moreau. Not all his scientific romances ended in a Utopia, and Wells also wrote a dystopian novel, When the Sleeper Wakes , rewritten as The Sleeper Awakes , , which pictures a future society where the classes have become more and more separated, leading to a revolt of the masses against the rulers.
The narrator, having been trapped on an island of animals vivisected unsuccessfully into human beings, eventually returns to England; like Gulliver on his return from the Houyhnhnms , he finds himself unable to shake off the perceptions of his fellow humans as barely civilised beasts, slowly reverting to their animal natures.
Wells also wrote the preface for the first edition of W. Barbellion 's diaries, The Journal of a Disappointed Man , published in Since "Barbellion" was the real author's pen name , many reviewers believed Wells to have been the true author of the Journal ; Wells always denied this, despite being full of praise for the diaries. In , a Canadian teacher and writer Florence Deeks unsuccessfully sued Wells for infringement of copyright and breach of trust, claiming that much of The Outline of History had been plagiarised from her unpublished manuscript,  The Web of the World's Romance , which had spent nearly nine months in the hands of Wells's Canadian publisher, Macmillan Canada.
Wells, and the Mystery of the Purloined Past. This re-examines the case in relation to McKillop's book. While having some sympathy for Deeks, he argues that she had a weak case that was not well presented, and though she may have met with sexism from her lawyers, she received a fair trial, adding that the law applied is essentially the same law that would be applied to a similar case today i. In , Wells predicted in The Shape of Things to Come that the world war he feared would begin in January ,  a prediction which ultimately came true four months early, in September , with the outbreak of World War II.
In , he published a collection of essays on the future organisation of knowledge and education, World Brain , including the essay "The Idea of a Permanent World Encyclopaedia". Prior to , Wells's books were widely read in Germany and Austria, and most of his science fiction works had been translated shortly after publication. At a PEN conference in Ragusa , Wells refused to yield to Nazi sympathisers who demanded that the exiled author Ernst Toller be prevented from speaking. Seeking a more structured way to play war games, Wells also wrote Floor Games followed by Little Wars , which set out rules for fighting battles with toy soldiers miniatures.
After dinner, Jerome began shooting down toy soldiers with a toy cannon and Wells joined in to compete. Wells visited Russia three times: , and During his second visit, he saw his old friend Maxim Gorky and with Gorky's help, met Vladimir Lenin. In his book Russia in the Shadows , Wells portrayed Russia as recovering from a total social collapse, "the completest that has ever happened to any modern social organisation.
President Franklin D. Roosevelt , Wells went to the Soviet Union and interviewed Joseph Stalin for three hours for the New Statesman magazine, which was extremely rare at that time. He told Stalin how he had seen 'the happy faces of healthy people' in contrast with his previous visit to Moscow in Stalin enjoyed the conversation and replied accordingly. Before he left, he realized that no reform was to happen in the near future. Wells's literary reputation declined as he spent his later years promoting causes that were rejected by most of his contemporaries as well as by younger authors whom he had previously influenced.
In this connection, George Orwell described Wells as "too sane to understand the modern world". Chesterton quipped: "Mr Wells is a born storyteller who has sold his birthright for a pot of message".
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Wells had diabetes ,  and was a co-founder in of The Diabetic Association now Diabetes UK , the leading charity for people with diabetes in the UK. During the interview, by Charles C Shaw, a KTSA radio host, Wells admitted his surprise at the widespread panic that resulted from the broadcast but acknowledged his debt to Welles for increasing sales of one of his "more obscure" titles. Wells died of unspecified causes on 13 August , aged 79, at his home at 13 Hanover Terrace, overlooking Regent's Park , London. You damned fools". A commemorative blue plaque in his honour was installed by the Greater London Council at his home in Regent's Park in He foresaw world wars creating a federalised Europe.
Britain, he thought, would not fit comfortably in this New Europe and would identify more with the US and other English-speaking countries. This was an extraordinary insight for an author writing in , and it made a deep impression on Winston Churchill. Winston Churchill was an avid reader of Wells' books, and after they first met in they kept in touch until Wells died in His efforts regarding the League of Nations , on which he collaborated on the project with Leonard Woolf with the booklets The Idea of a League of Nations , Prolegomena to the Study of World Organization , and The Way of the League of Nations , became a disappointment as the organization turned out to be a weak one unable to prevent the Second World War, which itself occurred towards the very end of his life and only increased the pessimistic side of his nature.
Wells wrote in his book God the Invisible King that his idea of God did not draw upon the traditional religions of the world:.
This book sets out as forcibly and exactly as possible the religious belief of the writer. Putting the leading idea of this book very roughly, these two antagonistic typical conceptions of God may be best contrasted by speaking of one of them as God-as-Nature or the Creator, and of the other as God-as-Christ or the Redeemer. One is the great Outward God; the other is the Inmost God.
The first idea was perhaps developed most highly and completely in the God of Spinoza. It is a conception of God tending to pantheism, to an idea of a comprehensive God as ruling with justice rather than affection, to a conception of aloofness and awestriking worshipfulness. The second idea, which is contradictory to this idea of an absolute God, is the God of the human heart.
The writer would suggest that the great outline of the theological struggles of that phase of civilisation and world unity which produced Christianity, was a persistent but unsuccessful attempt to get these two different ideas of God into one focus. Later in the work, he aligns himself with a "renascent or modern religion Of Christianity , he said: "it is not now true for me. Every believing Christian is, I am sure, my spiritual brother Of other world religions, he writes: "All these religions are true for me as Canterbury Cathedral is a true thing and as a Swiss chalet is a true thing.
There they are, and they have served a purpose, they have worked. Only they are not true for me to live in them. They do not work for me". The science fiction historian John Clute describes Wells as "the most important writer the genre has yet seen", and notes his work has been central to both British and American science fiction. This was a dazzling display of new thought, endlessly copied since.
A book like The War of the Worlds inspired every one of the thousands of alien invasion stories that followed. It burned its way into the psyche of mankind and changed us all forever. Beresford ,  S. Fowler Wright ,  and Naomi Mitchison ,  all drew on Wells's example. Wells was also an important influence on British science fiction of the period after the Second World War, with Arthur C. Clarke  and Brian Aldiss  expressing strong admiration for Wells's work.
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Among contemporary British science fiction writers, Stephen Baxter , Christopher Priest and Adam Roberts have all acknowledged Wells's influence on their writing; all three are Vice-Presidents of the H. Wells Society. He also had a strong influence on British scientist J. Haldane gave several lectures about these topics which in turn influenced other science fiction writers. In the United States, Hugo Gernsback reprinted most of Wells's work in the pulp magazine Amazing Stories , regarding Wells's work as "texts of central importance to the self-conscious new genre".
Le Guin  all recalled being influenced by Wells's work. Sinclair Lewis 's early novels were strongly influenced by Wells's realistic social novels, such as The History of Mr Polly ; Lewis would also name his first son Wells after the author. In an interview with The Paris Review , Vladimir Nabokov described Wells as his favourite writer when he was a boy and "a great artist. In an apparent allusion to Wells's socialism and political themes, Nabokov said: "His sociological cogitations can be safely ignored, of course, but his romances and fantasies are superb.
Jorge Luis Borges wrote many short pieces on Wells in which he demonstrates a deep familiarity with much of Wells's work. Wells literary papers and correspondence collection. The collection includes first editions, revisions, translations. The letters contain general family correspondence, communications from publishers, material regarding the Fabian Society, and letters from politicians and public figures, most notably George Bernard Shaw and Joseph Conrad. From Wikipedia, the free encyclopedia. For other uses, see H. Wells disambiguation. English author. Photograph by George Charles Beresford , Main article: Political views of H.
Main article: H. Wells bibliography. Campbell were the inaugural deceased members of the Science Fiction and Fantasy Hall of Fame , inducted in and followed annually by fiction writers Wells and Isaac Asimov , C. Wells — Version details — Trove". Retrieved 25 March Revised 18 May The Encyclopedia of Science Fiction sf-encyclopedia. Retrieved Oxford Dictionary of National Biography. Oxford University Press. Borgo Pr. The Independent. Warren Wells: Traversing Time. Wesleyan University Press.
The Telegraph. Retrieved 14 March Nobel Prize. Thus at the time of her catastrophe, and for about a month afterwards, Christina remained as floppy as a ragdoll, unable even to sit up. But three months later, I was startled to see her sitting very finely — too finely, statuesquely, like a dancer in mid-pose. And soon I saw that her sitting was, indeed, a pose, consciously or automatically adopted and sustained, a sort of forced or willful or histrionic posture, to make up for the continuing lack of any genuine, natural posture.
Similarly with her voice — she had at first been almost mute. This too was projected, as to an audience from a stage. It was a stagey, theatrical voice — not because of any histrionism, or perversion of motive, but because there was still no natural vocal posture. He was greatly intrigued when I told him about Christina and showed him some films and tapes of her — many of the suggestions and formulations here are, in fact, his.
But all these measures were, at best, partial. They made life possible — they did not make it normal. Christina learned to walk, to take public transport, to conduct the usual business of life — but only with the exercise of great vigilance, and strange ways of doing things — ways which might break down if her attention was diverted. Thus if she was eating while she was talking, or if her attention was elsewhere, she would grip the knife and fork with painful force — her nails and fingertips would go bloodless with pressure; but if there was any lessening of the painful pressure, she might nervelessly drop them straightaway — there was no in-between, no modulation, whatever.
Thus, although there was not a trace of neurological recovery recovery from the anatomical damage to nerve fibers , there was, with the help of intensive and varied therapy — she remained in hospital, on the rehabilitation ward, for almost a year — a very considerable functional recovery, i. It became possible, finally, for Christina to leave hospital, go home, rejoin her children.
She was able to return to her home-computer terminal, which she now learned to operate with extraordinary skill and efficiency, considering that everything had to be done by vision, not feel. She had learned to operate — but how did she feel? Had the substitutions dispersed the disembodied sense she first spoke of? The answer is — not in the least. She continues to feel, with the continuing loss of proprioception, that her body is dead, not-real, not-hers — she cannot appropriate it to herself. She can find no words for this state, and can only use analogies derived from other senses: T feel my body is blind and deaf to itself She has no words, no direct words, to describe this bereftness, this sensory darkness or silence akin to blindness or deafness.
She has no words, and we lack words too. And society lacks words, and sympathy, for such states. The blind, at least, are treated with solicitude — we can imagine their state, and we treat them accordingly. Are you blind — or blind-drunk? The lack of social support and sympathy is an additional trial: disabled, but with the nature of her disability not clear — she is not, after all, manifestly blind or paralyzed, manifestly anything — she tends to be treated as a phony or a fool.
This is what happens to those with disorders of the hidden senses it happens also to patients who have vestibular impairment, or who have been labyrinthectomised. I did move like everyone else? I want proof. They scoop out the centre, the spinal cord, they pith them Step up, come and see Chris, the first pithed human being. This sensation was so novel that at first it quite bewildered me.
I felt like asking someone constantly if I were really George Dedlow or not; but, well aware of how absurd I should seem after such a question, I refrained from speaking of my case, and strove more keenly to analyze my feelings. At times the conviction of my want of being myself was overwhelming and most painful.
It was, as well as I can describe it, a deficiency in the egoistic sentiment of individuality. And there is this specific, organically based, feeling of disembodiedness, which remains as severe, and uncanny, as the day she first felt it. There are brief, partial reprieves, when her skin is stimulated.
She goes out when she can, she loves open cars, where she can feel the wind on her body and face superficial sensation, light touch, is only slightly impaired. She cannot be certain of her body — what would Wittgenstein have said, in her position? In an extraordinary way, she has both succeeded and failed. She has succeeded in operating, but not in being. She has succeeded to an almost incredible extent in all the accommodations that will, courage, tenacity, independence and the plasticity of the senses and the nervous system will permit.
She has faced, she faces, an unprecedented situation, has battled against unimaginable difficulties and odds, and has survived as an indomitable, impressive human being. She is one of those unsung heroes, or heroines, of neurological affliction. But still and forever she remains defective and defeated. Not all the spirit and ingenuity in the world, not all the substitutions or compensations the nervous system allows, can alter in the least her continuing and absolute loss of proprioception — that vital sixth sense without which a body must remain unreal, unpossessed.
Her life is unprecedented. Postscript Now Christina has company of a sort. I understand from Dr H. Schaumburg, who is the first to describe the syndrome, that large numbers of patients are turning up everywhere now with severe sensory neuronopathies. The worst affected have body-image disturbances like Christina.
Most of them are health faddists, or are on a megavitamin craze, and have been taking enormous quantities of vitamin B 6 pyridoxine. He had seemed very nice, very normal, all day — indeed, until a few minutes before, when he awoke from a snooze. He then seemed excited and strange — not himself in the least. He had somehow contrived to fall out of bed, and was now sitting on the floor, carrying on and vociferating, and refusing to go back to bed.
Could I come, please, and sort out what was happening? When I arrived I found the patient lying on the floor by his bed and staring at one leg. His expression contained anger, alarm, bewilderment and amusement — bewilderment most of all, with a hint of consternation. I asked him if he would go back to bed, or if he needed help, but he seemed upset by these suggestions and shook his head. I squatted down beside him, and took the history on the floor. He had come in, that morning, for some tests, he said.
He had felt fine all day, and fallen asleep towards evening. When he woke up he felt fine too, until he moved in the bed. He was stunned, at first, with amazement and disgust — he had never experienced, never imagined, such an incredible thing. He felt the leg gingerly. At this point he had a brainwave. He now realized what had happened: it was all a joke! A rather monstrous and improper, but a very original, joke! Half the staff were drunk; quips and crackers were flying; a carnival scene.
Obviously one of the nurses with a macabre sense of humor had stolen into the Dissecting Room and nabbed a leg, and then slipped it under his bedclothes as a joke while he was still fast asleep. He was much relieved at the explanation; but feeling that a joke was a joke, and that this one was a bit much, he threw the damn thing out of the bed.
But — and at this point his conversational manner deserted him, and he suddenly trembled and became ashen-pale — when he threw it out of bed, he somehow came after it — and now it was attached to him. I thought a cadaver was just dead. But this is uncanny! Take it easy! It looks like nothing on earth.
How can a thing like that belong to me? He looked terrified and shocked. Please allow us to return you to bed. But I want to ask you one final question. Postscript Since this account was published in A Leg to Stand On, , I received a letter from the eminent neurologist Dr Michael Kremer, who wrote: I was asked to see a puzzling patient on the cardiology ward.
He had atrial fibrillation and had thrown off a large embolus giving him a left hemiplegia, and I was asked to see him because he constantly fell out of bed at night for which the cardiologists could find no reason. When I asked him what happened at night he said quite openly that when he woke in the night he always found that there was a dead, cold, hairy leg in bed with him which he could not understand but could not tolerate and he, therefore, with his good arm and leg pushed it out of bed and naturally, of course, the rest of him followed.
He was such an excellent example of this complete loss of awareness of his hemiplegic limb but, interestingly enough, I could not get him to tell me whether his own leg on that side was in bed with him because he was so caught up with the unpleasant foreign leg that was there. Given this history, and her pathetic condition — with spasticity and athetosis, i. She was neither. Quite the contrary: she spoke freely, indeed eloquently her speech, mercifully, was scarcely affected by spasticity , revealing herself to be a high-spirited woman of exceptional intelligence and literacy.
Miss J. There was no impairment of elementary sensation, as such, but, in dramatic contrast, there was the profoundest impairment of perception. She could not recognize or identify anything whatever — I placed all sorts of objects in her hands, including one of my own hands. This is very strange, I said to myself. How can one make sense of all this? Her hands would seem to have the potential of being perfectly good hands — and yet they are not.
Had she been carried about, had everything done for her, in a manner that had prevented her from developing a normal pair of hands? And if this was the case — it seemed far-fetched, but was the only hypothesis I could think of — could she now, in her sixtieth year, acquire what she should have acquired in the first weeks and months of life?
Was there any precedent? Had anything like this ever been described — or tried? She did not need just to recover her hands, but to discover them — to acquire them, to achieve them — for the first time: not just to regain a dissociated gnostic system, but to construct a gnostic system she had never had in the first place. Was this possible? Madeleine, in contrast, had no repertoire of memory for she had never used her hands — and she felt she had no hands — or arms either.
She had never fed herself, used the toilet by herself, or reached out to help herself, always leaving it for others to help her. She had behaved, for sixty years, as if she were a being without hands. Madeleine was agreeable to all this, indeed fascinated, but puzzled and not hopeful. This may be so when we face moral or existential dilemmas, but not where movement and perception have their origin. I thought of the infant as it reached for the breast.
After this first act, this first perception, progress was extremely rapid. As she had reached out to explore or touch a bagel, so now, in her new hunger, she reached out to explore or touch the whole world. Eating led the way — the feeling, the exploring, of different foods, containers, implements, etc. Had she not been of exceptional intelligence and literacy, with an imagination filled and sustained, so to speak, by the images of others, images conveyed by language, by the word, she might have remained almost as helpless as a baby.
A bagel was recognized as round bread, with a hole in it; a fork as an elongated flat object with several sharp tines. And this sort of recognition, not analytic, but synthetic and immediate, went with a vivid delight, and a sense that she was discovering a world full of enchantment, mystery and beauty. The commonest objects delighted her — delighted her and stimulated a desire to reproduce them. She asked for clay and started to make models: her first model, her first sculpture, was of a shoehorn, and even this was somehow imbued with a peculiar power and humor, with flowing, powerful, chunky curves reminiscent of an early Henry Moore.
And then — and this was within a month of her first recognitions — her attention, her appreciation, moved from objects to people. There were limits, after all, to the interest and expressive possibilities of things, even when transfigured by a sort of innocent, ingenuous and often comical genius. Now she needed to explore the human face and figure, at rest and in motion. Her hands, only such a little while ago inert, doughy, now seemed charged with a preternatural animation and sensibility. They were, one felt, not just the hands of a blind woman exploring, but of a blind artist, a meditative and creative mind, just opened to the full sensuous and spiritual reality of the world.
These explorations too pressed for representation and reproduction as an external reality. She started to model heads and figures, and within a year was locally famous as the Blind Sculptress of St. Her sculptures tended to be half or three-quarters life size, with simple but recognizable features, and with a remarkably expressive energy. For me, for her, for all of us, this was a deeply moving, an amazing, almost a miraculous, experience.
What wonderful possibilities of late learning, and learning for the handicapped, this opened up. And who could have dreamed that in this blind, palsied woman, hidden away, inactivated, over-protected all her life, there lay the germ of an astonishing artistic sensibility unsuspected by her, as by others that would germinate and blossom into a rare and beautiful reality, after remaining dormant, blighted, for sixty years? Postscript The case of Madeleine J. Within a year I had encountered another patient Simon K.
While Mr K. Now we had been alerted by Madeleine J.
And, indeed, we soon found that what had been achieved with Madeleine could be achieved with Simon as well. He had no impulse to sculpt, to make reproductions — he was not a natural artist like Madeleine. But still, after a half-century spent virtually without hands, he enjoyed their use in all sorts of ways. This is the more remarkable, perhaps, because he is mildly retarded, an amiable simpleton, in contrast to the passionate and highly gifted Madeleine J. It might be said that she is extraordinary, a Helen Keller, a woman in a million — but nothing like this could possibly be said of simple Simon.
And yet the essential achievement — the achievement of hands — proved wholly as possible for him as for her. It seems clear that intelligence, as such, plays no part in the matter — that the sole and essential thing is use. Such cases of developmental agnosia may be rare, but one commonly sees cases of acquired agnosia, which illustrate the same fundamental principle of use. Typically this feeling of de-realization, if it occurs, is absolutely sudden There is, as it were, a critical functional and ontological threshold. As soon as the hands and feet are re-realized, with use, there is a complete reversal of the physiological picture.
Known in antiquity, phantoms were described and explored in great detail by the great American neurologist Silas Weir Mitchell, during and following the Civil War. I have been particularly interested, myself, in these peripheral determinants. Phantom Finger A sailor accidentally cut off his right index finger. For forty years afterwards he was plagued by an intrusive phantom of the finger rigidly extended, as it was when cut off.
Whenever he moved his hand toward his face — for example, to eat or to scratch his nose — he was afraid that this phantom finger would poke his eye out. He knew this to be impossible, but the feeling was irresistible. He then developed severe sensory diabetic neuropathy and lost all sensation of even having any fingers. The phantom finger disappeared too.
How often does a peripheral pathological disorder have the same effect? Disappearing Phantom Limbs All amputees, and all who work with them, know that a phantom limb is essential if an artificial limb is to be used. I am quite certain that no amputee with an artificial lower limb can walk on it satisfactorily until the body-image, in other words the phantom, is incorporated into it. On the fifth or sixth slap the phantom suddenly shoots forth, rekindled, fulgurated, by the peripheral stimulus.
Only then can he put on his prosthesis and walk. What other odd methods one wonders are used by amputees? Positional Phantoms A patient, Charles D. In consequence he found himself lurching and pitching, unless he looked down at his feet. Vision was necessary to show him the true position of his feet and the floor — feel had become grossly unstable and misleading — but sometimes even vision was overwhelmed by feel, so that the floor and his feet looked frightening and shifting.
Have readers encountered this intermediate stage — of positional phantoms or illusions — due to an acute and reversible tabetic delirium? The experience this patient recounts reminds me of a singular experience of my own, occurring with the recovery from a proprioceptive scotoma. There and then I perceived the source of the commotion. The source was my leg — or, rather, that thing, that featureless cylinder of chalk which served as my leg — that chalky-white abstraction of a leg. Now the cylinder was a thousand feet long, not a matter of two millimeters; now it was fat, now it was thin; now it was tilted this way, now tilted that.
It was constandy changing in size and shape, in position and angle, the changes occurring four or five times a second. Phantoms — Dead or Alive? The literature is confusing, but patients are not — and they clarify matters by describing different sorts of phantoms. It goes away, when I strap the prosthesis on and walk. Thus, Dr Jonathan Cole, a former student of mine and now a spinal neurophysiologist, describes how in a woman with persistent phantom leg pain, anesthesia of the spinous ligament with Lignocaine caused the phantom to be anaesthetized indeed to disappear briefly; but that electrical stimulation of the spinal roots produced a sharp tingling pain in the phantom quite different from the dull one which was usually present; whilst stimulation of the spinal cord higher up reduced the phantom pain personal communication.
No problem — none that I know of How could I be tilted without knowing I was? I want to see for myself, and I want you to see too. What a fine old chap, I thought. Alert, bright as a button. Good for a hundred. He was walking, now, confidendy, swiftly, but canted over, improbably, a good twenty degrees, his centre of gravity way off to the left, maintaining his balance by the narrowest possible margin. No problems — I walked straight as a die. He was profoundly shocked when he saw himself on the screen. But there are other senses — secret senses, sixth senses, if you will — equally vital, but unrecognized, and unlauded.
These senses, unconscious, automatic, had to be discovered. And the complex mechanisms and controls by which our bodies are properly aligned and balanced in space — these have only been defined in our own century, and still hold many mysteries. Perhaps it will only be in this space age, with the paradoxical license and hazards of gravity-free life, that we will truly appreciate our inner ears, our vestibules and all the other obscure receptors and reflexes that govern our body orientation.
For normal man, in normal situations, they simply do not exist. Yet their absence can be quite conspicuous. If there is defective or distorted sensation in our overlooked secret senses, what we then experience is profoundly strange, an almost incommunicable equivalent to being blind or being deaf. The old man suddenly became intent, his brows knitted, his lips pursed. He stood motionless, in deep thought, presenting the picture that I love to see: a patient in the actual moment of discovery — half- appalled, half-amused — seeing for the first time exactly what is wrong and, in the same moment, exactly what there is to be done.
This is the therapeutic moment. You think with me — there must be an answer! Is there a sort of spirit level in the brain? Parts of the inner ear are indeed physically — literally — like levels; the labyrinth consists of semicircular canals containing liquid whose motion is continually monitored. It is this synthesis that is impaired in Parkinsonism. The most profound and most practical studies of such integrations — and of their singular disintegrations in Parkinsonism — were made by the late, great Purdon Martin and are to be found in his remarkable book The Basal Ganglia and Posture originally published in , but continually revised and expanded in the ensuing years; he was just completing a new edition when he died recendy.
This controller or higher authority must be informed of the state of stability or instability of the body. This triple control system, he implies, is such that one sense, one control, can compensate for the others — not wholly since the senses differ in their capabilities but in part, at least, and to a useful degree. Visual reflexes and controls are perhaps the least important — normally. So long as our vestibular and proprioceptive systems are intact, we are perfectly stable with our eyes closed. We do not tilt or lean or fall over the moment we close our eyes. But the precariously balanced Parkinsonian may do so.
One often sees Parkinsonian patients sitting in the most grossly tilted positions, with no awareness that this is the case. But let a mirror be provided, so they can see their positions, and they instantly straighten up. Proprioception, to a considerable extent, can compensate for defects in the inner ears. As the patients become practiced, as this becomes second-nature, they are able to stand and walk — not perfectly, but with safety, assurance, and ease.
Purdon Martin was endlessly thoughtful and ingenious in designing a variety of mechanisms and methods that made it possible for even severely disabled Parkinsonians to achieve an artificial normality of gait and posture — lines painted on the floor, counterweights in the belt, loudly ticking pacemakers — to set the cadence for walking. In this he always learned from his patients to whom, indeed, his great book is dedicated. He was a deeply human pioneer, and in his medicine understanding and collaborating were central: patient and physician were coequals, on the same level, each learning from and helping the other and between them arriving at new insights and treatment.
But he had not, to my knowledge, devised a prosthesis for the correction of impaired tilting and higher vestibular reflexes, the problem that afflicted Mr MacGregor. This could tell me, tell my eyes, if I was tilting. But then it might become second-nature, automatic. Okay, Doc, so what do you think?
We first experimented with a sort of pendulum, a weighted thread hung from the rims, but this was too close to the eyes, and scarcely seen at all. Then, with the help of our optometrist and workshop, we made a clip extending two nose-lengths forward from the bridge of the spectacles, with a miniature horizontal level fixed to each side.
We fiddled with various designs, all tested and modified by Mr MacGregor. He donned them. They looked a bit cumbersome and odd, but scarcely more so than the bulky hearing-aid spectacles that were coming in at the time. And now a strange sight was to be seen in our Home — Mr MacGregor in the spirit spectacles he had invented and made, his gaze intensely fixed, like a steersman eyeing the binnacle of his ship. This worked, in a fashion — at least he stopped tilting: but it was a continuous, exhausting exercise.
We had several other patients with Parkinsonism who also suffered from impairment of tilting reactions and postural reflexes — a problem not only hazardous but also notoriously resistant to treatment. Mrs S. She has perfectly preserved intelligence — and humor. She sometimes complains to the nurses that they have not put dessert or coffee on her tray.
Sometimes she complains that her portions are too small, but this is because she only eats from the right half of the plate — it does not occur to her that it has a left half as well. She knows it intellectually, and can understand, and laugh; but it is impossible for her to know it directly. Knowing it intellectually, knowing it inferentially, she has worked out strategies for dealing with her imperception.
She cannot look left, directly, she cannot turn left, so what she does is to turn right — and right through a circle. Thus she requested, and was given, a rotating wheelchair. And now if she cannot find something which she knows should be there, she swivels to the right, through a circle, until it comes into view. She finds this signally successful if she cannot find her coffee or dessert. If her portions seem too small, she will swivel to the right, keeping her eyes to the right, until the previously missed half now comes into view; she will eat this, or rather half of this, and feel less hungry than before.
But if she is still hungry, or if she thinks on the matter, and realizes that she may have perceived only half of the missing half, she will make a second rotation till the remaining quarter comes into view, and, in turn, bisect this yet again. This usually suffices — after all, she has now eaten seven-eighths of the portion — but she may, if she is feeling particularly hungry or obsessive, make a third turn, and secure another sixteenth of her portion leaving, of course, the remaining sixteenth, the left sixteenth, on her plate. It may look funny, but under the circumstances what else can I do?
She agrees, and has tried this — or at least tried to try it. But it is oddly difficult, it does not come naturally, whereas whizzing round in her chair does, because her looking, her attention, her spontaneous movements and impulses, are all now exclusively and instinctively to the right. Especially distressing to her was the derision which greeted her when she appeared only half made- up, the left side of her face absurdly void of lipstick and rouge.
That is, as someone else, facing her, would see her. We tried a video system, with camera and monitor facing her, and the results were startling, and bizarre. This is a pity because, as R. Gregory also wonders, there might be much promise in such forms of video feedback for such patients with hemi-inattention and left hemi-field extinction. The matter is so physically, indeed metaphysically, confusing that only experiment can decide.
Postscript Computers and computer games not available in , when I saw Mrs S. I could not make reference, in the original edition of this book, to a very important book which came out almost simultaneously: Principles of Behavioral Neurology Philadelphia: , edited by M. Marsel Mesulam. Patients with unilateral neglect behave not only as if nothing were actually happening in the left hemispace, but also as if nothing of any importance could be expected to occur there.
There he was, the old Charmer, the Actor, with his practiced rhetoric, his histrionisms, his emotional appeal — and all the patients were convulsed with laughter. Well, not all: some looked bewildered, some looked outraged, one or two looked apprehensive, but most looked amused. The President was, as always, moving — but he was moving them, apparently, mainly to laughter. What could they be thinking?
Were they failing to understand him? Or did they, perhaps, understand him all too well? It was often said of these patients, who though intelligent had the severest receptive or global aphasia, rendering them incapable of understanding words as such, that they none the less understood most of what was said to them. Their friends, their relatives, the nurses who knew them well, could hardly believe, sometimes, that they were aphasic. This was because, when addressed naturally, they grasped some or most of the meaning. With the most sensitive patients, it was only with such a grossly artificial, mechanical speech — somewhat like that of the computers in Star Trek — that one could be wholly sure of their aphasia.
Why all this? Preserved — and often more: preternaturally enhanced This too becomes clear — often in the most striking, or comic, or dramatic way — to all those who work or live closely with aphasiacs: their families or friends or nurses or doctors. At first, perhaps, we see nothing much the matter; and then we see that there has been a great change, almost an inversion, in their understanding of speech. Something has gone, has been devastated, it is true — but something has come, in its stead, has been immensely enhanced, so that — at least with emotionally laden utterance — the meaning may be fully grasped even when every word is missed.
This, in our species Homo loquens, seems almost an inversion of the usual order of things: an inversion, and perhaps a reversion too, to something more primitive and elemental. And this perhaps is why Hughlings Jackson compared aphasiacs to dogs a comparison that might outrage both! Thus the feeling I sometimes have — which all of us who work closely with aphasiacs have — that one cannot lie to an aphasiac. He cannot grasp your words, and so cannot be deceived by them; but what he grasps he grasps with infallible precision, namely the expression that goes with the words, that total, spontaneous, involuntary expressiveness which can never be simulated or faked, as words alone can, all too easily We recognize this with dogs, and often use them for this purpose — to pick up falsehood, or malice, or equivocal intentions, to tell us who can be trusted, who is integral, who makes sense, when we — so susceptible to words — cannot trust our own instincts.
And what dogs can do here, aphasiacs do too, and at a human and immeasurably superior level. In this, then, lies their power of understanding — understanding, without words, what is authentic or inauthentic. Thus it was the grimaces, the histrionisms, the false gestures and, above all, the false tones and cadences of the voice, which rang false for these wordless but immensely sensitive patients. It was to these for them most glaring, even grotesque, incongruities and improprieties that my aphasic patients responded, undeceived and undeceivable by words.
It is, incidentally, a common term in the U. For such patients, typically, the expressive qualities of voices disappear — their tone, their timbre, their feeling, their entire character — while words and grammatical constructions are perfectly understood. A former English teacher, and poetess of some repute, with an exceptional feeling for language, and strong powers of analysis and expression, Emily D. Emily D. But this, it so happened, was also limited, because she had a malignant glaucoma, and was rapidly losing her sight too.
What she then found she had to do was to pay extreme attention to exactness of words and word use, and to insist that those around her did just the same. Prose, she found, might compensate, in some degree, for lack of perceived tone or feeling. It did not move her — no speech now moved her — and all that was evocative, genuine or false completely passed her by.
Deprived of emotional reaction, was she then like the rest of us transported or taken in? By no means. His word-use is improper. Either he is brain-damaged, or he has something to conceal. And so cunningly was deceptive word-use combined with deceptive tone, that only the brain damaged remained intact, undeceived. Either the function like a capacitor or fuse is normal — or it is defective or faulty: what other possibility is there for a mechanistic neurology, which is essentially a system of capacities and connections?
What then of the opposite — an excess or superabundance of function? Neurology has no word for this — because it has no concept. A function, or functional system, works — or it does not: these are the only possibilities it allows. They receive it in psychiatry, where one speaks of excited and productive disorders — extravagances of fancy, of impulse And they receive it in anatomy and pathology, where one speaks of hypertrophies, monstrosities — of teratoma. But physiology has no equivalent for this — no equivalent of monstrosities or manias.
And this alone suggests that our basic concept or vision of the nervous system — as a sort of machine or computer — is radically inadequate, and needs to be supplemented by concepts more dynamic, more alive. This radical inadequacy may not be apparent when we consider only loss — the privation of functions we considered in Part One. But here, we might say, he is letting himself go, being playful, or, simply, just being faithful to his clinical experience, though at odds with his own mechanical concepts of function such contradictions were characteristic of his genius, the chasm between his naturalism and his rigid formalism.
We have to come almost to the present day to find a neurologist who even considers an excess. I find the latter by far the more interesting and original of the two, for it is, in effect, an exploration of imagination and memory and no such exploration is possible to classical neurology. In Awakenings there was an internal balance, so to speak, between the terrible privations seen before L-Dopa — akinesia, aboulia, adynamia, anergia, etc. And in this we see the emergence of a new sort of term, of terms and concepts other than those of function — impulse, will, dynamism, energy — terms essentially kinetic and dynamic whereas those of classical neurology are essentially static.
We see in the Mnemonist — or in my own over-energized, galvanized patients on L-Dopa — a sort of animation gone extravagant, monstrous, or mad — not merely an excess, but an organic proliferation, a generation; not just an imbalance, a disorder of function, but a disorder of generation. We might imagine, from a case of amnesia or agnosia, that there is merely a function or competence impaired — but we see from patients with hypermnesias and hypergnosias that mnesis and gnosis are inherently active, and generative, at all times; inherently, and — potentially — monstrously as well.
Thus we are forced to move from a neurology of function to a neurology of action, of life. Traditional neurology, by its mechanicalness, its emphasis on deficits, conceals from us the actual life which is instinct in all cerebral functions — at least higher functions such as those of imagination, memory and perception.
It conceals from us the very life of the mind. It is with these living and often highly personal dispositions of brain and mind — especially in a state of enhanced, and thus illuminated, activity — that we shall be concerned now. This danger is built into the very nature of growth and life. The paradox of an illness which can present as wellness — as a wonderful feeling of health and well- being, and only later reveal its malignant potentials — is one of the chimaeras, tricks and ironies of nature.
It is one which has fascinated a number of artists, especially those who equate art with sickness: thus it is a theme — at once Dionysiac, Venerean and Faustian — which persistently recurs in Thomas Mann — from the febrile tuberculous highs of The Magic Mountain, to the spirochetal inspirations in Dr Faustus and the aphrodisiac malignancy in his last tale, The Black Swan.
I have always been intrigued by such ironies, and have written of them before. People complain of feeling ill — not well. Some patients realized this, had premonitions — but some did not. Thus Rose R. Something awful is coming. His sense of harmony and ease and effortless control was replaced by a sense of too- muchness This is the simultaneous gift and affliction, the delight, the anguish, conferred by excess.
It is a feverish energy, a morbid brilliance. The human dilemmas, in such situations, are of an extraordinary kind: for patients are here faced with disease as seduction, something remote from, and far more equivocal than, the traditional theme of illness as suffering or affliction. And nobody, absolutely nobody, is exempt from such bizarrenesses, such indignities. In disorders of excess there may be a sort of collusion, in which the self is more and more aligned and identified with its sickness, so that finally it seems to lose all independent existence, and be nothing but a product of sickness.
It was well recognized and extensively reported in the closing years of the last century, for these were years of a spacious neurology which did not hesitate to conjoin the organic and the psychic. It was clear to Tourette, and his peers, that this syndrome was a sort of possession by primitive impulses and urges: but also that it was a possession with an organic basis — a very definite if undiscovered neurological disorder.