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MAN AGAINST HIS BRAIN

By DIANE JOHNSON; Diane Johnson's most recent novel is ''Persian Nights.''

Published: October 2, 1988

Memories of Amnesia

MEMORIES OF AMNESIA By Lawrence Shainberg. 219 pp. New York. Paris Review Editions/ British American Publishing. $16.95. 

Certain books, whether on submarine warfare or courtroom procedure or, above all, medicine, attract by their ability to draw us into unfamiliar worlds and even by their unfamiliar language, which makes us feel, inevitably, the respect we always feel for those who, in their mysterious cleverness, speak a language we cannot understand. A great deal of the charm of Lawrence Shainberg's curious novel ''Memories of Amnesia'' lies in the arcana of the neurosurgeon's technical life, and a great deal in the witty metaphysics of the narrator. It is a novel in which a consciousness reports on its own deterioration. 

It begins with the world-famous neurosurgeon, Dr. Isaac Drogin, and his assistant Eli, performing a delicate feat of brain surgery on Lucinda (an idiot savant suffering from epilepsy) in the hope of locating and removing the cells in her brain that contribute to her seizures. The patient is conscious, under local anesthesia, so that while the surgeons peer into her brain, mapping its functions, she is able to tell them what she sees and feels. 

At the outset, the story of Lucinda's operation might be one of those case reports by Dr. Oliver Sacks, told in the same sympathetic, bright, informative, equable, slightly condescending physicianly tone. There is much rather repellent but riveting detail: ''The craniotomy was a large one, requiring an opening in her scalp and skull - what we called a 'flap' - that stretched from the crown of her head backward toward her hairline, then forward on a line just above her ear to a point two centimeters in front of the ear.'' All at once, in a chilling moment, Dr. Drogin swoops away the draperies covering her face and says ''Hello, Sarah.'' 

''Standing on my left, Eli nudged me with his elbow. ' ''Lucinda,'' ' he whispered. 'Name's ''Lucinda,'' boss.' '' This is the first sign of Dr. Drogin's own brain damage. As the day progresses, he becomes alternately more fascinated and more frightened by his symptoms. His colleague Eli (whom he begins to miscall Elmore) agrees with the diagnosis of brain damage. Dr. Drogin explains that the phenomenon that is causing it is circularity, ''excessive reflection within the brain about the brain itself. . . . Ever since I'd begun performing this operation, I'd had the fantasy of performing it on myself, watching it all with mirrors, forcing my brain, in other words, to process images of itself.'' ''Is there a neurosurgeon alive who hasn't imagined operating on himself?'' They decide to operate, with Drogin's wife Martha (or Marjorie? or Marcia?) acting as nurse. Drogin watches his own brain in a mirror as Eli and he begin the meticulous process of mapping its functions. 

Here is the ultimate metafictional combat, of a man against his brain. In the surreal world of the novel, where the doctor/narrator is unconstrained by the convention by which a first-person storyteller still exists at the end of his tale to be able to tell it, the denouement does not preclude his telling us afterward about the unsuccessful (or triumphant) conclusion in which he is not restored to health and sanity. The subject of the novel is the fulfillment of Dr. Drogin's fantasy, or, if one searches for a larger meaning, the logical end of modern self-consciousness. 

Lawrence Shainberg is the author of ''Brain Surgeon: An Intimate View of His World.'' His first-person narrator, Dr. Drogin, is both surgeon and patient. But this is not to be an absorbing human drama of the struggle of Dr. Drogin against his illness and its effect on his family. Instead it is an exercise in paradox, with interesting ruminations on the nature of thought itself. 

Part of the novel's organizing joke, by which the doctor is the patient, depends on the reader's knowing something of the lore of neurosurgeons, according to medical lore the prima donnas of surgeons, whose exacting and peculiar task, cutting up brains, licenses famous tantrums and famously peremptory behavior. To such a figure, we are allowed to suppose, the slightly fantastic notion that his own brain could turn on him must seem more preposterous and amusing than it might to those of us who fully expect our brains to turn on us any day, and indeed have already begun to detect signs of it. Of course we all (at least those of a certain age) can identify with the surgeon forgetting Lucinda's name. As a description of this dreaded human condition, brain damage, his fable embodies strangeness and horror in a most immediate way. 

But the narrator, Dr. Drogin, goes on to explain why the first of his symptoms, calling Lucinda Sarah, was even more sinister and pathological than that which we all notice happening to us, because he had meant to call her Sarah. Brain damage (he never gives his condition a more specific name) can affect intention as well as behavior. His (our?) problem is not merely dysfunction of language but dysfunction of will. 

Someone has plausibly pointed out that Descartes had got it wrong - that we are, therefore we think, that thought is a chemical and electrical process that, given our biological existence, we cannot avoid. It is this mechanical, material, merely geographical and unavoidable aspect of thought that normally interests the neurosurgeon, but it is the accidental byproduct, self-consciousness, that threatens Drogin. ''For reasons we've never been able to understand,'' he tells us, ''the belief in a 'self' or a 'mind' external to the brain has been selected during the course of evolution as advantageous to the species. . . . Once I understood that the belief in 'self' was the ultimate neurological function, I had no choice but to sabotage my brain by every means available.'' 

In this he is admiringly assisted by his wife, Martha, a splendidly comic character. She's into meditation and Eastern philosophies, so she is enthusiastic about what she imagines to be the point of Drogin's sudden affectation of symptoms - the loss of ''self.'' Every new evidence of pathology, especially the willed aspect of his self-destruction, the process by which he approves of his brain's rebellion, prompts her admiration. ''You've risked everything! You've got more courage than anyone I know! You've challenged your brain! Rebelled against the tyranny of thought! The whole charade of language and memory.'' 

The physician as artist is in some way more sympathetic than the physician reporting on his metier. However fascinating the medical case report, there is something finally patronizing about the real doctor's point of view as he recounts, no matter how sympathetically, the deficiencies and pathology, the luckless limitations of the wretched victims of the afflictions that interest him. Most medical writing has the strange quality of being about the doctor, demonstrating that he is, first and most surprisingly, literate, then that he is caring, perspicacious and so on. The reader finds this reassuring in its implication that doctors may indeed, as we hope, be omniscient and superhuman. But it is the omniscient authorial point of view without the novelist's responsibility to puzzle out a denouement. By writing a novel from the brain's point of view, Mr. Shainberg bravely assumes the novelist's liabilities, and, mostly, surmounts them by his bold fictional strategy. 

For example, he describes the process of brain mapping, in which the surgeon stimulates the brain with an electrode, determines what the patient sees or feels, then inserts a little ticket (white for motor, blue for language, orange for psychic affect) and keeps an elaborate catalogue of which ticket designates what function, proceeding in this fashion toward whatever group of cells he wishes finally to excise. But we are being told this by a brain-damaged neurosurgeon! Is this brain mapping really something neurosurgeons do? The circularity of the brain thinking about itself is elegantly echoed by the formal convention of the novel by which the whole reliability of this particular text is called into question. 

A character in John Updike's recent novel ''S.'' remarks ''that language is stranger than it seems. It conveys meaning . . . but it also makes a tribal code, a way to keep out others. It is of that intricacy which in paper currency is meant to defeat counterfeiters.'' In ''Memories of Amnesia'' we have (we assume) the authentic language of neuroanatomy rendered more convincing by its faintly translated quality (''Feeling bereft, just on the verge of panic, in fact, I made a conscious, a willful decision, embracing 'Martha' with conviction that was transparent in its insincerity, thinking 'Martha, Martha, Martha, Martha, Martha,' as if to seduce my brain, as if by repetition it could be persuaded of what it knew to be incorrect''). 

The writing reminds the reader of certain fictional ancestors of this work, perhaps Milan Kundera - there are echoes in the unappealing doctor, and in the satirical treatment of the wife, with her karate instructor and Zen altar. And the surrealism of the operating theater reminds one of Kafka's schematized world, pared to its elements of torture and terror - electroencephalographs, optic lobes, oscilloscopes. But where Kafka was preoccupied with the structure and power of the unseen other, Mr. Shainberg indulges Drogin in the fancies of his own brain. The numerous meditations on consciousness draw the reader too into those moods in which, in childhood perhaps, he meditated on infinity. One also learns a lot about the brain. 

Some patients, Drogin muses, afflicted with amnesia, ''blame themselves as if by an act of will or concentration their memory will improve. 'Think, dammit, what was her name?' . . . In effect, their symptoms make them feel guilty. People of the opposite inclination, on the other hand, feel no guilt at all. Why should they when, as they see it, their brains are doing everything? When even laziness or selfishness is neurochemical? Blaming yourself for what your brain is doing is like blaming yourself for the behavior of a stranger.'' It would be nice to report that, having pinpointed philosophical questions central to many issues in modern life, Dr. Drogin (or Mr. Shainberg) had also resolved them, but of course that would be far beyond the responsibility of a novelist (or a neurosurgeon). In engaging them at all, he has produced a distinctive, absorbing and amusing work. 'LIKE AN IRONY MACHINE' 

Lawrence Shainberg began his second novel, ''Memories of Amnesia,'' in 1979 to explore the ways in which the brain can impede functioning of the mind, believing that ''any self-conscious novelist is basically trying to solve his own brain damage by writing.'' 

He believes that the brain ''has an endless appetite for explanation, and also endless resistance to being explained.'' 

In an interview at his Greenwich Village office, with a model of the brain on the windowsill, the 52-year-old writer observed: ''The ability to laugh at the brain is liberation from it. But the degree to which one identifies with one's brain is the degree to which one suffers.'' 

A freelance journalist for over 25 years, he stopped work on the novel to research and write ''Brain Surgeon: An Intimate View of His World.'' He maintains that every human brain becomes caught in a continuous neurological tape loop of preoccupation with self-realization. 

He has a personal interest in exploring nonclinical brain dysfunctions because ''my father-in-law had a stroke and was dealing with problems very much like my own as a writer. He was obsessed with memory, he was obsessed with language. The more he concentrated on those functions, the more they failed him.'' 

However, brain damage can be a difficult subject to approach directly through fiction. ''The reason writers don't mention it is that it would banalize the book. If you say Don Quixote has brain damage, the book's over.'' He paused. ''I wanted to see how much a book could tolerate of the literal terminology.'' BENJAMIN STROUSE 

 

New York Times, Diane Johnson's review- PDF


Memories of Amnesia

What happens to a neurosurgeon when his own brain becomes unhinged? In this grimly fascinating, frightening and painfully funny novel, seasoned brain surgeon Izzac Drogin swings between panic, false elation, immobility, fits and denial as he experiences symptoms first of amnesia, then of epilepsy and worse. Between her yoga classes and requests for a separation, his wife Millie (or is it Marjorie? or Martha?) accuses him of faking his forgetfulness; her martial arts instructor checks out his vibrations; Izzy's father, also a neurosurgeon, tries to map his troubled circuits; and his mother believes his growing incoherence is a ploy to evade adult responsibilities. Only a colleague, Eli, gets to the bottom of his condition, and the craniotomy he performs with Drogin's assistance must be every neurosurgeon's darkest fantasy direct visual and manual exploration of one's own neurological labyrinth. Shainberg, author of the nonfiction Brain Surgeon , here probes the mind's fragile grip on reality and sense of self. The reader's head is set spinning in a novel that says: it could happen to any of 

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