Bioethics and the breakdown of the bicameral mind: Sacks and Luria revisited [Book Review]

Journal of Medical Humanities 10 (1):26-44 (1989)
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Abstract

Since antiquity, individuals have attempted to relate mental processes to circumscribed areas of the brain. In 1935 the neurologist Wilder Penfield purported to know, “the humming of the mind's machinery, and where words come from,” after he electrically stimulated areas of the exposed human cortex. Recent theories have suggested a functional separation of the dominant and the nondominant hemispheres, the right brain/left brain concept of thought and personality. One author has even proposed that human consciousness and modern civilization developed when the bicameral mind broke down, and the left brain achieved mastery over the right nondominant temporal lobe.Compared to these mechanistic approaches to brain function and human personality, the Russian neurologist, Alesandr Romanovich Luria, and his American follower, Oliver Sacks, have developed a more intellectually satisfying and clinically useful approach which relies on a fuller understanding of the doctor-patient dialogue and the clinical tale. An analysis of Luria's writing about language reveals that mechanistic approaches to language are inadequate; a review of the work of several well-known poets confirms that knowing what a poem means involves more than a recital of its localized contents. Similarly, an examination of three of Sack's clinical tales suggests that even those patients who are grossly awry on a synaptic level can be understood on a personal level to be worthy of respect and even honor. “Man is to himself the most wonderful object in nature; for be cannot conceive what the body is, still less what the mind is, and least of all how a body should be united to a mind. This is the consummation of his difficulties, and yet it is his very being.”Blaise Pascal,Pensees, (11,72)1

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