The chapter begins with Oliver Sacks having a strange conversation with a man named William Thompson, an ex-grocer who suffers from Korsakov’s Syndrome and lives in a hospital. Thompson greeted Sacks as an old friend and asked him what meats he wanted to pick up from the grocery. Then, not thirty seconds later, he said that Sacks was a butcher down the street; then he said that Sacks was a mechanic who’s just pretending to be a doctor. Then he asked Sacks, once again, what meat he wanted from the store.
Unlike most of the other chapters in the book, Chapter Twelve begins en medias res (in the middle of the action), so that, initially, we don’t really understand what’s going on with William Thompson. This is a clever approach, because it gives a sense of the flux and constant confusion that surrounds Thompson’s existence.
William Thompson’s case of Korsakov’s caused him to remember nothing for more than a few seconds. He sometimes identified himself as multiple people, often in the course of the same conversation. Thompson’s condition was especially strange because it required him to improvise new identities for himself from second to second. Clearly, Thompson had brilliant powers of invention.
Every case of Korsakov’s is unique, because every patient finds a different way to adjust to the absence of memory. Thompson compensates for his condition by improvising new identities for himself, suggesting the importance of having memories of a stable identity (something that most people take for granted).
Why, Sacks asks, did William Thompson make up identities for himself? Perhaps the reason was that, unlike most people, Thompson lacked any true identity—he had no memory beyond what happened a few seconds before, so he had no understanding of what his life had been like and, therefore, what kind of person he was. In the absence of an identity, Thompson made one (or more) up. Thompson was a natural comedian, with a great sense of timing—but his comedy was tragic, because it appeared that Thompson sincerely believed himself to be all these different people.
Thompson’s improvisational talents seem to stem from his desperation to “be someone,” rather than become lost in the constant flux state that is the Korsakov’s patient’s curse. Yet at the same time, it’s suggested that his incredible inventiveness is also a result of (or at least emphasized by) his illness.
One day, Sacks was talking with William Thompson in a restaurant, when Thompson looked outside and said, “There’s my brother, Bob.” Sacks ignored Thompson’s comments, assuming them to be elaborate lies—but then Bob poked his head in and greeted Mr. Thompson as his brother. However, William didn’t treat Bob Thompson any differently than he treated other people. When Bob mentioned that their brother George Thompson had died years before, William brushed off the news as a joke.
William Thompson is cut off from other human beings to a degree that would be utterly incomprehensible to most people—he doesn’t even seem to have a close emotional bond with his brother, and doesn’t understand that his other brother died years ago. Trapped in the present, Thompson is alienated from his friends and family.
It’s instructive to compare William Thompson with Jimmie G., the Korsakov’s patient from Part One. Jimmie G.’s life is suffused with loneliness, tempered by his own peacefulness. It’s difficult to feel terribly sorry for William Thompson because he’s such a buoyant guy. And yet, his gift for talking is also his curse, because it alienates him from his peers in the long term. Furthermore, William seems to lack the ability to “feel” any profound emotions.
Like Jimmie, Mr. Thompson tries to compensate for his lack of memory (and, therefore, self-awareness); however, Thompson does so by crafting literal, verbal identities for himself, whereas Jimmie seems to do so by latching onto a sense of the divine and a stable institution, the Catholic Church. Thompson’s attempts to connect with other people through humor and talk are successful in the short-term (since people seem to like him) but tragic in the long-term.
In the writings of the neurologist A. R. Luria, one often comes across examples of patients who have serious afflictions but don’t realize it, and, indeed, don’t realize how alienated they’ve become from other people. Such patients will often adopt similar attitudes—a kind of nonchalance whose purpose seems to be to mitigate their alienation. In general, Luria discussed the principle of “equalization”—the changes in the affect of patients designed to compensate for their conditions. Certain patients with Korsakov’s, such as Jimmie G., find ways to connect with other people in spite of their disorder, while others, such as William Thompson, do not. But even William experiences moments of peace. When he’s alone, Sacks says, William becomes quiet and calm, and seems to recover a sense of “being in the world.”
Here, Sacks introduces the principle of equalization: the ways that patients with neurological afflictions adjust to their problems by altering their attitude or affect. Throughout the book, and on a less clinical level, Sacks shows how patients compensate for their conditions in a variety of ways. Notice that Sacks believe that, on some level, patients are trying to adjust to their condition in order to maintain a sense of being in the world—a phrase that Sacks borrows from the work of the philosopher Martin Heidegger (reminding us of Sacks’s vast intelligence and erudition, and of the abstract, philosophical implications of his neurological findings).