Catatonic

I remember the catatonic victims of the sleeping sickness epidemic on the Jersey Shore leftover from the early 20’s. Forty years later they sat frozen and staring like ancient mannequins in wheelchairs being pushed slowly along the boardwalk. Sometimes it was nurses in white uniforms pushing the wheelchairs. Sometimes it was just people, their children, apparently, or grandchildren. Some might have even remembered four decades before when this inanimate person they were pushing along was as animated as all the people on the boardwalk were now. The person in the chair just stared, frozen, never moving. People walked by, some unnoticing, some staring and whispering like we were doing. It was rude to stare, but it was the eeriest thing I’d ever seen when I was a kid. I couldn’t take my eyes off each of them. There must have been a convalescent home nearby. Maybe more than one. There had been thousands of people who’d been stricken with sleeping sickness in that part of New Jersey.

Encephalitis lethargica was the medical term for it. Victims could scarcely move. There were five million cases world wide in the 1920’s, a third of them died (in comparison the Spanish flu pandemic killed 10 to 20% of its victims.) Nearly all the rest recovered fully, except the small percentage who never unfroze. There were probably hundreds of those people in New Jersey, especially on the Jersey Shore, where the disease had clustered. No one knew why there were so many cases in that part of Jersey then, I have no idea how much more they know now. I read once that doctors theorized it might have been some bizarre after effect of the Spanish Flu that had swept the world a couple years before, like how you get shingles if you had chickenpox. Not everyone who had chickenpox gets shingles. Not everyone who got the Spanish flu came down later with encephalitis lethargica. Apparently it’s still unproven. All they know for sure is that it’s only seen in very rare instances anymore. No epidemics. It’s forgotten.

But when I saw Awakenings four decades later it brought all those memories back. A beautiful summer evening in Asbury Park. I was eight or nine or ten. A statue rolled by in a wheelchair. Then another. Are they dead, I asked. No, the poor things are alive, they just can’t move. Like they’re frozen? Yes, but look at their faces, my grandmother said. The one being wheeled past was smiling. I still remember that frozen, unlaughing smile. The eyes looked at me, through me. The hand waved, never moving.

Everybody on the Shore knew what they were. They got the sleeping sickness and never recovered, my grandmother whispered, Lord have mercy on them. I don’t think I heard it called encephalitis till years later, and I never knew their catatonia was a particularly tragic variant of Parkinson’s Disease till I read Oliver Sacks’ medical memoir. I just knew sleeping sickness came from a mosquito bite, though it didn’t. It was some viral thing. African Sleeping Sickness was passed on by a bite from a tse tse fly, and terrified folk wisdom assumed this sleeping sickness came from a mosquito bite, like yellow fever. A frightened public mixing up epidemics. I know I was terrified of being bitten by a mosquito and freezing and staring, but my mom said it didn’t happen anymore. My terror subsided and we moved to California and I never saw one of those profoundly paralyzed victims of encephalitis lethargica again. They became part of my collection of Jersey Shore memories with the elm trees and salt water taffy and the sad but funny bloated faces of puffer fish left way up the beach after a storm.

A lifetime later the memory is still vivid as I remember the people in their wheelchairs on the Asbury Park boardwalk. Watching them stare frozen as the summer crowds streamed past them, as the years streamed past them, as time itself streamed past them. I feel a dead chill inside. A ten year old’s quiet terror. Stop staring, my grandmother said.

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Oliver Sacks

One of Oliver Sack’s great unnoticed achievements was helping to bury Freud. By displaying in clear prose how behavior and thinking and observations are shaped by neurological processes, and not by subconscious fears and desires and the misdirected horniness that cannot be named, he undermined for millions of readers the entire basis of so called Freudian science. Freud’s work was mostly nonsense. It was highly imaginative, quite brilliant, and in a time when almost nothing was known of the actual workings of the brain (probably 99.99% of all of today’s knowledge of what the brain is, how it developed and how it functions has been uncovered in the past 25 years) Freud’s theories seemed plausible. Obsolete theories have a way of lasting in the public eye long after their scientific invalidation. People retain what they learned in school for life, and everyone took a psychology course or three. Sadly, just about everything we learned in those psychology courses prior to the 1980’s or ’90’s (depending on how hip your professor was) has turned out to be irrelevant if not flat out wrong. And we learned a lot of Freud. Of course we did. He was to psychology then what Charles Darwin was to biology. He was the big thinker.

But in all those Oliver Sacks best sellers, Freud never comes into the picture at all. Sacks lays out the neurology, the actual brain processes, making it all beautiful and real and utterly fascinating. And his observations were fact-based and scientifically proven, that is there was a rigorous testing procedure to establish those facts. Freud was guessing, fantasizing really. About as close as I remember anything being proven in psychology class was Pavlov’s salivating dogs and some of Skinner’s disturbing behavioral experiments with his own children. Otherwise we just took it all on faith. But Sack’s stories–case studies, really, beautifully written–were so factual and real they rendered Freudian theory for his readers as unplausible as any pseudo-science. He didn’t even have to tell us so. It’s just that for people who read Sacks–and millions did–Freudian theory just suddenly seemed kind of absurd. Shelf it with phrenology, physiognomy, eugenics and Lysenkoism. Freud was that wrong. There was simply no evidence of his theories in the brains of the people Sacks had treated. Of course not. These people were all neurons and brain regions and wiring gone synaptically, tragically wrong. He could explain his patients’ sometime bizarre conditions by showing us just what was wrong, neurologically. It might be weird and counter-intuitive, but it made sense. We can only imagine how a strict Freudian analyst would have diagnosed a man who mistook his wife for a hat.

Oliver Sacks was a key figure in changing the way people see the brain. His little true life stories allowed us to grasp the stunning complexity of neuroscience. The public’s image of what we fundamentally are shifted dramatically. Where once we were all Oedipal, it might now just be a few neurons shook loose. Sacks made the brain understandable to the layman, the real brain, full of flesh and blood and neurons and thought. We became us, the real us, and not a caricature with a fondness for Mom…and just in time, too. I mean the thought of a strictly Freudian Facebook is just too weird to think about.

Oliver Sacks and somebody's brain. (Photo by Adam Scourfield for AP)

Oliver Sacks with somebody’s brain. (Photo by Adam Scourfield for AP)