Always interesting if never-ending discussion. Hope to get around to putting some remarks on paper and sending them off to JNNP (or at least post them here).
Meanwhile, two favorite quotes come to mind:
When I asked the neurologist for a prognosis, he soberly declared, it could get better, it could get worse, it could stay the same. I burst out laughing. He did not see the joke.
Siri Hustvedt, The Shaking Woman or A History of My Nerves
I solve the mind-body problem by stating that there is no such problem. There are, of course, plenty of problems concerning the “mind”, and the “body”, and all intermediate levels of integration of the nervous system. What I wish to emphasize is that there is no problem of “mind” versus “body”, because biologically no such dichotomy can be made. The dichotomy is an artefact; there is no truth in it, and the discussion has no place in science in 1943… The difference between psychology and physiology is merely one of complexity. The simpler bodily processes are studied in physiological departments; the more complex ones that entail the highest levels of neural integration are studied in psychological departments.
Stanley Cobb, Borderlands of Psychiatry (1943)
- Neuropsychiatry
- Review
‘A Leg to Stand On’ by Oliver Sacks: a unique autobiographical account of functional paralysis
+ Author Affiliations
1Department Clinical Neurosciences, University of Edinburgh, Edinburgh, UK
2Newcastle University School of Medicine, Newcastle Upon Tyne, UK
3Department of Psychiatry, University of Edinburgh, Edinburgh, UK
4Neurorehabilitation, Astley Ainslie Hospital, Edinburgh, UK
- Correspondence to Dr Jon Stone, Department Clinical Neurosciences, Western General Hospital, Edinburgh EH4 2XU, UK; jon.stone@ed.ac.uk
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Contributors JS conceived the article, all authors contributed to writing.
- Received 19 March 2012
- Revised 20 April 2012
- Accepted 24 April 2012
Abstract
Oliver Sacks, the well known neurologist and writer, published his fourth book, ‘A Leg to Stand On’, in 1984 following an earlier essay ‘The Leg’ in 1982. The book described his recovery after a fall in a remote region of Norway in which he injured his leg. Following surgery to reattach his quadriceps muscle, he experienced an emotional period in which his leg no longer felt a part of his body, and he struggled to regain his ability to walk. Sacks attributed the experience to a neurologically determined disorder of body-image and body ego induced by peripheral injury. In the first edition of his book Sacks explicitly rejected the diagnosis of ‘hysterical paralysis’ as it was then understood, although he approached this diagnosis more closely in subsequent revisions. In this article we propose that, in the light of better understanding of functional neurological symptoms, Sacks’ experiences deserve to be reappraised as a unique insight in to a genuinely experienced functional/psychogenic leg paralysis following injury.
