The difficult, really impossible problems he had trying to understand the relationships expressed in grammatical constructions gave rise to a more profound problem: the impossibility of recovering any of the knowledge he had acquired through years of study.
What one learns in school and in his specialized field fits into an entire framework of ideas, the whole body of knowledge that education represents. One cannot simply “recall” mathematics any more than he can “recall” Marx’s Capital. To learn and understand means to absorb ideas which the memory retains in a succinct form as a kind of survey or digest. At a later date, this knowledge can be revived and expanded upon. One can of course temporarily forget certain principles of mathematics or heredity, but this “forgotten” information readily recurs when one refreshes his memory. Knowledge is not stored in the memory like goods in a warehouse or books in a library, but is preserved through a succinct system of codification that creates a framework of ideas. Hence, whatever the memory has retained in this concise way can be revived and developed.
This is precisely the faculty that was missing in this patient whose injury had destroyed the very sectors of the cortex which digest and convert successive pieces of information into succinct patterns one can grasp simultaneously. As soon as he tried to recover the knowledge he had once had, this became apparent. And it was a loss that struck him as catastrophic:
I remember nothing, absolutely nothing! Just separate bits of information that I sense have to do with one field or another. But that’s all! I have no real knowledge of any subject. My past has just been wiped out!
Before my injury I understood everything people said and had no trouble learning any of the sciences. Afterwards I forgot everything I learned about science. All my education was gone.
I know that I went to elementary school, graduated with honors from the middle school, completed three years of courses at the Tula Polytechnic Institute, did advanced work in chemistry, and, before the war, finished all these requirements ahead of time. I remember that I was on the western front, was wounded in the head in 1943 when we tried to break through the Germans’ defense in Smolensk, and that I’ve never been able to put my life together again. But I can’t remember what I did or studied, the sciences I learned, subjects I took. I’ve forgotten everything. Although I studied German for six years, I can’t remember a word of it, can’t even recognize a single letter. I also remember that I studied English for three straight years at the institute. But I don’t know a word of that either now. I’ve forgotten these languages so completely I might just as well never have learned them. Words like trigonometry, solid geometry, chemistry, algebra, etc., come to mind, but I have no idea what they mean.
All I remember from my years in the secondary school are some words (like signboards, names of subjects): physics, chemistry, astronomy, trigonometry, German, English, agriculture, music, etc., which don’t mean anything to me now. I just sense that somehow they’re familiar.
When I hear words like verb, pronoun, adverb, they also seem familiar, though I can’t understand them. Naturally, I knew these words before I was wounded, even though I can’t understand them now. For example, I’ll hear a word like stop! I know this word has to do with grammar—that it’s a verb. But that’s all I know. A minute later, I’m likely even to forget the word verb—it just disappears. I still can’t remember or understand grammar or geometry because my memory’s gone, part of my brain removed.
Sometimes I’ll pick up a textbook on geometry, physics, or grammar but get disgusted and toss it aside, since I can’t make any sense out of textbooks, even those from the middle school. What’s more, my head aches so badly from trying to understand them, that one look is enough to make me nervous and irritable. An unbearable kind of fatigue and loathing for it all comes over me.
Therapists tried to teach him. He struggled to recover a small part of the knowledge he’d lost and would sit for hours over a problem or theorem he formerly would have grasped immediately. And it was all in vain:
M.B., a young an who recently got his degree in philosophy, tried to teach me geometry. At first he used a text from the middle school to explain some concepts in geometry like “point,” “line,” “plane,” and “surface.” Then he began to discuss theorems. Now the strange thing was that I remembered I once knew these theorems, even though I couldn’t understand any of them. I’d even forgotten what “plane,” “line,” and “surface” meant, and though M. B. explained them several times, I still couldn’t remember or understand them. And I felt awkward, knowing how senseless and muddleheaded I must have seemed. So while he talked I just kept saying “yes, yes” as though I understood everything, though I couldn’t follow any of his explanations. I couldn’t catch the words he was using or understand them. I had to rely mostly on pictures—drawings and sketches of figures. Without them, none of the verbal explanations “got through” to me. I always had to compare the writing above the sketches—”This is a line, a point, a plane”—with the actual drawing. But I still can’t explain or define any of these concepts no matter how many times I go over the explanations. All this seems strange, even to me. My head always aches and seems to be in a fog, as though I were drunk all the time. Somehow I can’t understand words like “surface,” “circumference,” or any kind of line—even plane lines and figures. All I can make out is what I get from the sketches or drawings in the book, not from written or oral explanations. I can’t figure out what “degrees in an angle” or a “curve” mean. They don’t get through to me. I have no trouble understanding plane, graphic figures, but I can’t understand a freestanding figure with volume, in which you have to visualize, rearrange, and get an idea of one thing in relation to everything else. I know (though it’s hard for me) how to figure the area of a rectangle from the number of centimeters on two sides. And I know that the length squared gives you the area of a square. But I just can’t figure out what the “degrees in an angle” or a curve mean and connect them to anything specific like the area of the earth.
M. B. even tried to teach me the following theorem: “The exterior angle of a triangle that is not adjacent to an interior angle is greater than each of the interior angles.” At first I couldn’t understand any of these terms and their definitions (adjacent, angle, interior, exterior), but they made some sense after I looked at sketches of lines. The problem is that the theorems follow one after the other, and you have to be able to remember them. And this is impossible for me. I have to compare and try to remember what words like smaller and larger mean—what they refer to in a theorem like this. I know what smaller and larger mean in terms of amounts. But when a sentence has several words in between these terms, I have trouble understanding what they mean (I don’t know if they refer to what precedes or what follows them). I have to rely on something definite, as in that simple question about the elephant and the fly. Then I can understand what the word bigger refers to. After a long struggle 1 finally can understand a theorem but I forget it as soon as I go on to the next one.
I always have to wrestle with the definitions of words and ideas I come across. I might have remembered the words in that theorem M. B. gave me after a month or two of daily practice, but he introduced new theorems and definitions. And since I couldn’t remember either the theorems, the words in the definition, or the concepts, I got absolutely nothing out of the lessons. That’s the way it goes with me. If I want to remember something—even one theorem – I have to spend a month or two on it. With my “aphasic” memory, I wouldn’t have any more luck with theorems or concepts than I do with words. And unless I had a chance to recall a particular theorem once in a while, I’d forget it completely, just as I’ve forgotten all the other theorems I tried to learn.
So it turns out that because my memory is so bad I’ll never understand anything about geometry, grammar, physics, or any other science. What’s happened to my life is simply terrible. This strange illness I have is like living without a brain. What I remember one minute is gone the next, so that I can’t understand theorems or even simple things in my surroundings.
He had difficulty not only with complex systems of ideas like geometry, physics, and grammar, but with the simple arithmetic processes taught in the first years of elementary school. His experience with these showed that simple numerical systems were no less difficult for him than complex scientific concepts:
Because of my injury I forgot how to reckon numbers. At first I didn’t know a single number (I’d forgotten them just as I’d forgotten the letters of the alphabet). And so once again I was seated beside a teacher, hoping I’d soon wake up from this strange and terrible dream.
I’d look at a number for a while, but if I couldn’t remember it, I’d just have to wait until it came to me. Finally I recalled the first number—1—and began to recite the “numerical alphabet” to myself, going up to 7, and almost shouting to my teacher as I pointed to the 7 in the chart. But sometimes I just couldn’t tell whether 6×6 equaled 36, 46, or 40. Some times (I myself noticed this) I wasn’t even sure how much 2 × 2 were. Some sort of blight seemed to make my damaged mind go blank. Until recently I was still confused about multiplication tables.
In this respect I was like a five-year-old child. I didn’t know a single number at first. Once I started studying, I progressed much faster than I had with letters, because the numbers are so much alike. All you have to do is remember the first ten. After that they’re repeated, except for some slight changes or additions to them.
My teacher also wanted me to recite the numbers in reverse order, but this was dreadfully hard. But then I made some progress. When I’d counted up to 10, my teacher would ask me to remove the last number and go back down the list. I still couldn’t say the word “nine” right away but had to count from 1 to 8 to do that.
At first I had a lot of trouble adding (after all, I was just learning how to count again). I always had to recite the “numerical alphabet”; I couldn’t remember any number on the spot. For example, O. P. would ask: “If you add 10 and 15, how much will you have?” First I had to count up to 10 and pronounce it before I understood what number it designated. Then I counted from 10 to 15, so that I’d know what number that was. From there I had to count on my fingers up to 25.
Subtraction was much harder. O. P. would ask: “If you take 10 from 20, what will you have left?” I’d start to reckon it. First I’d recite the numbers up to 20, then run through the first ten again in order to be able to say the number 10. I realized that 10 and 10 were 20 so that if I struck one of the io’s out, I’d have 10 left. I solved the problem but very, very slowly. Then I figured out how to reckon by tens instead of ones (I didn’t do it out loud, but whispered to myself). I went a little faster this way, but it was still very hard going.
At first O. P. asked me to memorize the multiplication tables. I tried to do it but was always confusing them. True, I remembered some of them right away (1 × 1, 2 × 2, 3 × 3, etc). After that I remembered the 5’s table and could recite it up to 10 × 5. But even with this I frequently had trouble forgetting.
And when O. P. started talking about the “minuend,” “subtrahend,” “remainder,” and “sum,” “multiplicand,” and “dividend,” I just looked at her—I listened to those words which seemed familiar, but I couldn’t remember what they meant.
It was easier for me to figure numbers if I wrote them down, but it was very hard to do this in my head, and I always had to use long roundabout methods. If O. P. asked me to subtract 17 from 32 in my head, I’d have to set to work very slowly counting and recounting. I’d also have to ask her to repeat the numbers a couple of times. Then I’d start counting: “Take 2 from 32. That leaves 30. Add 3 to 17 and you get 20. Take 20 from 30. That leaves 10. 7 from 10 leaves 3. Add 10 to 3, you get 13. There was 2 left from 30, so add that to 13, and you’ll get 15. If I hadn’t used this roundabout method, and gone back and forth like this, I couldn’t have done it. When I can write numbers down, it’s easier for me, much quicker.
I already knew the meaning of simple terms like “addition” and “subtraction” (put together and take away), “multiplication” and “division,” but sometimes I’d forget them just when I wanted to use them. I just couldn’t remember ideas like “difference” and “quotient.”
I was always confusing numbers and couldn’t get the answers when I tried to add or subtract in my head. At first I had a hard time understanding square roots. I’d quickly forget how to get the square root of 49, 0.49, 4, and 0.4—I didn’t pick up things like this immediately.
At first my teacher showed me how to figure numbers (add and subtract them) and a little later began to teach me the multiplication tables. After a few months I remembered most of them, but I often confused numbers from different tables and sometimes wasn’t sure how much a simple thing like five 6’s were.
Recently my teacher tried to give me some simple arithmetic problems. By then I had already learned to add, subtract, multiply, and divide like children do in elementary school. But when she started talking about the “subtrahend,” “difference,” and “quotient,” I couldn’t remember these ideas, I just sensed they were familiar. Naturally, after a short time I understood them. But I couldn’t recall words like “item” and “difference,” and I couldn’t apply them when I tried to work on a problem. I tried to figure out whether “quotient” had to do with subtraction, addition, or division. My teacher would prompt me, but by that time I’d forgotten what the word “difference” meant.
This was a terrible hindrance in his daily life. He couldn’t even figure out how much to spend at the store or how to count his change.
Often I’m not sure whether five 5’s are 25, 35, or 45, and I’ve completely forgotten some of the less obvious examples, like 6 × 7.1 have to run through the multiplication table to find the answer. Naturally, I have no trouble figuring out whether an answer is right when I’m at home and can write the numbers down. But if I try to figure them in my head while I’m taking a walk or buying something at the store, I always make mistakes.
So I don’t try to figure money myself when I buy food at the store. I just tell the cashier I have to get a half kilo or a kilo of something, I put the money down, and I get a stamped receipt and change from her. Then I go to the clerk who weighs out what I want to buy. But I hardly ever try to add up how much I have to spend at the store.
These problems were not limited to computing numbers. He could not play chess, checkers, or even dominoes, games he had played so well formerly he almost invariably won.
Before I was wounded I was pretty good at almost any game, but afterwards I forgot how to play them. It was years after my injury before I even tried to play checkers, chess, and dominoes, and I never really learned them again.
Before the war I was a good chess player. But from the time I was wounded I forgot how to play the game or what the pieces were named. I forgot them just as I’d forgotten numbers and the letters of the alphabet.
I tried to play chess with some beginners, but it took me a long time to figure out how to move. I still can’t remember the names of the pieces while I’m actually playing. Sometimes I remember the knight (the horse) and the king (the tsar), but the rest have slipped my mind and I haven’t been able to recall them during these past twenty years.
In the hospital I used different names for the pieces—I called the queen tsarevna (when I could remember that word) and the king tsar. When it came to the knight, I’d think of Budenny’s horse. For the rook and the bishop I substituted the words officer and crown. As long as I could remember these words, it was easier, but I’d often forget them while I was playing. And I had the same problems I do with reading. My eyes could only see two or three figures on the board. Since I could see only a small part of the board, I’d always forget about the other figures there and lose track of them. And I couldn’t even plan one move in advance.
Still and all, I did start to play again. To be more exact, I began to learn the game. Pretty soon I knew how to move the pieces and remember their names, even though I’d often confuse them. It was particularly hard to keep them in mind while I was actually playing. I still have trouble remembering and try to play now without naming the pieces, because I can’t think of the words right away. First I played with beginners who didn’t know the game at all, and later with patients who weren’t exactly beginners but didn’t play too well because they’d also had head wounds. It takes an awfully long time to decide how to move. Often I confuse pieces and lose track of others on the board.
I can’t plan or foresee moves, since I have so much trouble remembering. But I can plan one move in advance, even though I can’t remember the previous move that’s been made. I play badly because of my bad memory and eyesight. I can’t really see the pieces on the board and always have to keep looking back and forth to get the layout. But it’s so hard! I get a terrible headache and pressure in my body from playing and feel even dizzier. My head’s in a fog, I see everything as though I were in a half-sleep—and this is reflected in the way I play chess.
Practically the same thing happened with checkers. Though I must admit I was a good player before my injury, afterwards I forgot this game too. When I saw people playing checkers in the hospital, the game looked familiar. But when I actually tried to play with one of the patients, I forgot how many squares to move or in which direction. On the whole, I couldn’t remember much about the game. So instead of playing with me, the fellow started teaching me. This was amusing, but a hard thing for me to swallow. Soon I learned how the checkers and “kings” moved and could usually remember the words for them during the game. This was far simpler than remembering the names of chess pieces. Still, I had some problems even with checkers. I often had to think a while about each move, got confused, forgot what moves had been made, and could only think one move ahead. I had no more idea of what my opponent was doing in checkers than I did in chess.
The same was true of dominoes. While I was playing it seemed easy enough to count the dots on the pieces (twelve is the maximum on any one of them), but it was hard for me to keep details in mind. I’d forget what a player had put down and couldn’t add the dots on the pieces quickly. I’d become so nervous and anxious from playing that it seemed better to give it up. It took me so long to think about the pieces, the people I played with got angry with me. And I’d always lose, no matter who I had for a partner, since I’d forget which piece a player had used the minute he put it down. There may be only twenty-eight pieces in dominoes but there are forty-nine combinations of figures. Could I possibly remember that many? Why do I have so much trouble playing that I can never win? Before I was wounded, I could beat anyone at dominoes, so the game bored me and I hardly ever played. Now that I’ve been injured, I can’t get the point of such a simple game. And so I go on playing it because my memory (which has to reason even in a game like this) and my eyesight took such a beating from that wound.
These problems affected not only his skill at chess, checkers, and dominoes. Almost any social situation—conversation, movies, concerts—became impossibly difficult. Simple scenes of everyday life were all he could understand in movies. Anything more complicated hardly made sense to him:
I go to the movies quite often. I like watching films, it makes life less boring. The only problem is that since I was wounded I can’t read print on the screen, my reading is too slow for that. By the time I’ve figured out a few words, new material appears on the screen. And I can’t see the entire screen, just a part to the left of center. If I want to see the whole picture I have to keep glancing back and forth at different parts of the screen. That’s why I tire so quickly and get a splitting pain in my eyes and head. Since I can’t read any of the print, I don’t understand silent movies. When there is a sound track, and I don’t have to read anything, I still have trouble understanding. Before I’ve had a chance to figure out what the actors are saying, a new scene begins.
On the whole, I only understand very simple things that are familiar to me from childhood. If something in a movie makes the audience laugh, I sit there wondering what’s so funny. The only thing I can understand is when two people start to argue, fight, and knock each other down. I can figure that out without words. But after I’ve seen a film, I can’t remember a thing about it, even though it seemed to me I did understand some of it.
The same thing is true about concerts. I see and hear the performers but can’t understand the words in the songs; I don’t have enough time to grasp them. They’re just words to me, I can’t keep them in mind – they disappear in a minute.
He liked music as much as before and easily remembered the melodies of songs, if not the words. This meant that songs also seemed fragmented, consisting of a melodic part he could understand and a content that made no sense at all.
It’s like what happened to my memory and speaking ability. I have the same problem with the words of a song as I do with conversation. But I can grasp the melody automatically, just as I was able to recite the alphabet automatically before I learned to recognize letters.
This was another instance of the split that had formed because some brain functions had remained intact while others had been destroyed completely. Hence, though he was unable to grasp the point of a simple conversation, or of many grammatical constructions, he left us an amazingly precise description of his life. It required superhuman effort for him to write one page of this journal, yet he wrote thousands. Despite his inability to cope with elementary problems, he was able to present a vivid account of his past. Furthermore, he still had a powerful imagination, a marked capacity for fantasy and empathy. Let us run through some of the pages of his diary in which he tried to imagine lives totally unlike his own:
Say I’m a doctor examining a patient who is seriously ill. I’m terribly worried about him, grieve for him with all my heart. (After all, he’s human too, and helpless. I might become ill and also need help. But right now it’s him I’m worried about—I’m the sort of person who can’t help caring.)
But say I’m another kind of doctor entirely—someone who is bored to death with patients and their complaints. I don’t know why I took up medicine in the first place, because I don’t really want to work and help anyone. I’ll do it if there’s something in it for me, but what do I care if a patient dies? It’s not the first time people have died, and it won’t be the last.
I can imagine what it would be like to be a famous surgeon who has saved many lives. People are grateful to me, they call me a “savior.” I’m happy I can do this since I value human life. On the other hand, I can imagine being a different type of surgeon. I haven’t got a big reputation because I often slip up, though it seems to me no fault of mine, the patient’s, or my attitude. Anyway, I prefer the theater, dances, parties, and an easy life to medicine. My own comfort is what matters, though naturally I don’t admit this to people.
But I can picture an entirely different life, that of someone who works as a cleaning woman. Life is hard, but what can I do? I’m not intelligent enough for any other kind of work and can hardly read or write. And now I’m old.
If I were a great engineer, running a factory would be no problem since I’d have connections with lots of other factories and managers. Naturally life would be much easier for me than for a cleaning woman or a longshoreman.
But what if I were a woman with a disease that made my head swell up so badly I was practically out of my mind with pain, and I screamed at everyone in the hospital night and day. I still wouldn’t want to die. I’m upset about my son whose skull was fractured so badly in back he’s brain-damaged, can hardly see, feels dizzy all the time, and has become illiterate. I’m also worried because I don’t know what’s become of my other son. The last I heard he was with the troops in Lithuania in 1941. All this grief torments me night and day.
His vivid imagination had not been damaged by his injury. (Some neurologists believe this faculty is controlled by the right hemisphere of the brain.) It afforded him some momentary relief from the effort of coping with a world that had become so incomprehensible.