Titles of works are given in italics, quotations from literary works are in quotation marks. Italics within quotations are always the writer’s in the original.
The epileptic aura in literature: Aesthetic and philosophical dimensions. An essay
Article first published online: 7 JAN 2013
Wiley Periodicals, Inc. © 2013 International League Against Epilepsy
Volume 54, Issue 3, pages 415–424, March 2013
How to Cite
Wolf, P. (2013), The epileptic aura in literature: Aesthetic and philosophical dimensions. An essay. Epilepsia, 54: 415–424. doi: 10.1111/epi.12051
- Issue published online: 4 MAR 2013
- Article first published online: 7 JAN 2013
- Accepted October 15, 2012; Early View publication Xxxx XX, 2012.
- Epilepsy in literature;
In literary accounts of epilepsy the aura has a prominent place as the subjective aspect of the seizure experience. Descriptions by authors with their own aura experiences stand out by their precision and authenticity. Many different aura types are mentioned, but the ecstatic aura described by Dostoyevsky has received particular attention and is echoed in many later works. Some authors are interested primarily in the possibilities provided by auras to react, for example, by hiding, seeking help, counteracting the oncoming seizure, or taking measures to prevent damage. Others by their unique aura experiences are inspired to create specific literary flavors like oxymora, spectacular metaphors, or the depiction of complex perceptions and states of mind. Some authors, adding a philosophical dimension, proceed to analyze the consequences of patients’ subjective seizure experiences for their identity and their self-perception as creative or religious persons. To sum up, the works discussed herein strongly support that literary texts provide valuable insights beyond those of medical texts.
The Aura in Literature
There is an objective side and a subjective side to epileptic seizures. Some seizures present only with objective signs, others only with subjective symptoms, and many combine both aspects. For the life of a person with epilepsy, this distinction is utterly important because one of the most annoying problems with epilepsy is the disruption of the continuum of self-awareness by seizures and the fact that in a seizure one may act in ways that can provoke even strong reactions from others but which one is unaware of. In contrast, during subjective seizure symptoms perception of oneself and the world is preserved. The experiences at seizure onset, which are called auras, can be particularly valuable when they give a patient the possibility to stay at least partially in control and prevent if not the seizure itself then the possible damage it could cause. Therefore, it is perhaps not surprising that the aura is a feature of epilepsy relatively frequently appearing in literary accounts of epilepsy even if the writer has only secondary knowledge of epilepsy (Wolf, 2006).
Literary treatments of epilepsy provide insights that are different from those in medical texts because they are given from a different perspective. They can provide impressions that seizures make on uninitiated observers and, reflecting societal views, they are an important part of the cultural history of epilepsy (Wolf, 2000). Accounts of auras add the dimension of subjective seizure experiences or patients’ reactions to these. Auras are mentioned in many literary works (Table 1). The writers’ sources cannot always be identified, but many different aura types are known even to authors who do not draw on their own experiences. It is also interesting that many writers know about possibilities to react on auras or even counteract the development toward a seizure. At least one novel is based upon the writer’s being deeply impressed by having been told about this possibility by an affected person (M. J. Putney, personal communication, October 6, 1992).
|Dalgas, Ernesto 1871–1899||Lidelsens Vej||Complex visual illusion||No||2|
|Dostoyevsky, Fyodor M. 1821–1881||Idiot The Possessed (Devils)||Complex psychic prodrome ecstatic complex illusion, Ecstatic (isolated)||No No||2|
|Evans, Margiad 1909–1958||A Ray of Darkness||Experiential (isolated)||No||1|
|Hustvedt, Siri 1955b||What I loved||Complex visual||No||1|
|Jones, Thom 1945b||The Pugilist at Rest Black Lights||Ecstatic visual||No||3|
|Machado de Assis, Joaquím Maria 1839–1908||The Posthumous Memoirs of Bras Cubas Quincas Borba||Visual illusion Experiential||No No||2|
|Steenbeek, Rosita 1959b||The Last Woman||Visual||Hold back||1|
|Tracy, Terry 1968b||A Great Place For a Seizure||Multiple||No||1|
|Wagner, Erica 1967b||Seizure||Gustatory||Resist||1|
|Wassmo, Herbjörg 1942b||Karnas arv||Auditory?||Resist, prevent damage||1|
|Author||Title||Aura type||Reaction?||Author’s source (Infa)|
|Blixen, Karen (Tania) 1885–1987||Shadows on the Grass||Undefined||Seek help||Observation (1)|
|Frame, Janet 1924–2004||Owls Do Cry||(poetic)||No||Brother (1)|
|MacLaverty, Bernard 1942b||Lamb||Auditory, happiness||No||Own and others’ observations (1)|
|Merz, Klaus 1945b||Im Schläfengebiet||Epigastric, olfactory, gustatory||No||Father (1)|
|Nesser, Håkan 1950b||Och Piccadilly Circus ligger inte i Kumla||Gustatory||Counteract||Friend (1)|
|Putney, Mary Jo ?||Dearly Beloved||Somatosensory||Counteract||Friend, patient (1)|
|Sand, George 1804–1876||La mare au diable||Unknown||Hide||Observation (1)|
|Tennyson, Alfred 1809–1892||The Princess||Derealisation||No||Father (2)|
|Author||Title||Aura type||Reaction?||Author’s source|
|Beckett, Samuel 1906–1989||Molloy||Undefined||Prevent fall||?|
|Crichton, Michael 1942–2008||The Terminal Man||Olfactory||No||Medical textbooks|
|Findley, Timothy 1930–2002||The Piano Man’s Daughter||(visual, poetic)||Counteract||?|
|Frazer, Margret (Pseudonym for duo Gail Frazer and Mary Monica Pulver)||The Murderer’s Tale||Somatosensory||Hide, seek help||?|
|Guimarães Rosa, João, 1908–1967||O grande Sertão||Somatosensory||No||?|
|Harding, Paul 1967b||Tinkers||(poetic)||Hide||?|
|Jensen, Johannes V. 1873–1950||Himmerlandshistorier||Undefined||Prevent damage||Observation?|
|Kristeva, Julia 1941b||Possessions||Dysphasic||No||?|
|Lander, Leena 1955b||Tulkoon myrsky||Paraphasias||No||?|
|Monikova, Libuše 1945–1998||Der Taumel||Visual||Resist||?|
|Muir, Richard ?||The Miniature Man||Complex visual, clearsight||Provoke, arrest||Own experience?|
|Percy, Walker 1916–1989||The Last Gentleman The Second Coming||déjà vu||No||Medical textbooks|
|Pynchon, Thomas 1937b||The Crying of Lot 49 Gravity’s Rainbow||(metaphoric) Olfactory, experiential||No||Own experience?|
|Restrepo, Laura 1950b||Dulce compañia||(poetic)||No||?|
|Salzmann, Mark 1959b||Lying Awake||Visionary||Use for poetry||Professional information|
|Wolos, Andrej 1955b||Churramobod||(poetic)||No||?|
This essay deals with a series of literary texts that go beyond operational aspects of auras, some taking the readers into fascinating aesthetic and philosophical spheres. Thus, in Swedish writer Håkan Nesser’s fine developmental novel Och Piccadilly Circus ligger inte i Kumla, mastering the aura becomes a metaphor of maturation.
The aura as a challenge: Nesser
Seventeen-year-old Mauritz, who tells the story in the first person singular, is diagnosed with epilepsy. His seizures start with an experiential aura, and he discovers by chance that they can be aborted at the aura stage when he strongly focuses his attention on something else. He learns to do this and to fight seizures off. Following successful arrest of several auras the seizures no longer recur. In the same period he is exposed to a violent event in his close neighborhood and his first love where he experiences fulfilment, and then disappointment. Mastering of his seizures mirrors his maturation during these months, and his last aura develops into a complex scene summing up all related experiences that he now will leave behind. Writers of fiction do not intend to write clinical case histories, and Nesser in this scene definitively moves from medical facts into fiction. The medical nucleus was a friend of Nesser’s who as an adolescent was rather proud of his epilepsy because “it enabled him to see things and experience emotions and ‘worlds’ that were not open to ‘ordinary’ people. A mystery and a door into the unknown” (H. Nesser, personal communication, February 4, 2012). Like him, Mauritz would not want to be without this experience.
The aura as a means of protection: Sand, Jensen, and Harding
If auras last long enough they can be used to seek help or shelter, alert somebody, or hide away. This possibility has also found its way into literary works, based upon the authors’ own experiences (Rosita Steenbeek, The Last Woman) or in portraits of historical persons with epilepsy. George Sand in The Devil’s Pool speaks with much sympathy of a person in the village attached to her manor house, grave-digger Bontemps. He has epilepsy and hides away when he feels a seizure coming in order not to distress his family.
Danish Nobel laureate Johannes V. Jensen in his Stories from Himmerland (the writer’s native region) depicts a local character called The Lindby Hunter. He leads a solitary life hunting and fishing out in the moor, occasionally coming into the villages to spend time with the children who love him or for a game at cards and perhaps a fight. Sometimes in a village he has a seizure and people are terrified. In one dense and impressive scene out in the wilderness he feels a seizure coming and carefully arranges everything around him so he will not be hurt. Both these historical patients came into literature as tragic figures, as in the end they are found dead in places where they had hidden, Bontemps from a fall from the hayloft, the Lindby Hunter in his winter shelter, apparently a case of sudden unexpected death in epilepsy (SUDEP).
The importance of hiding away is drastically illustrated by the epileptic father in Tinkers by Paul Harding when once, having an aura (“the sparkle and tingle of an oncoming fit”), he does not manage to hide away from his children and has a severe seizure at Christmas dinner. Eventually this event will dissolve his family.
Very brief auras can be frustrating for a patient who senses a possibiliity to take some protective action only to realize that it is not feasible because there is not enough time. This is, for example, expressed by Mischa, the protagonist in Terry Tracy’s A Great Place for a Seizure, who reflects the writer’s own experiences with having epilepsy.
In contrast, longer auras can provide valuable substrates for literary treatment.
The insider’s view: Wagner
She felt it all begin to recede. A breath of cold metal, high in the back of her throat. The wrong end of a telescope. Was he watching her? She dug her nails into her wrist to hold herself in place, felt her chest rise and fall. She would not go over the edge of it. She would resist. … There was applause. Something had happened. The metal breath drew back, a steel sea receding, and Janet relaxed, her body let out of itself, suddenly tired, suddenly warm.
Between the beginning and the end of this scene, which takes place during a concert, there is a stage of suspense where Janet, Erica Wagner’s novel Seizure’s protagonist, is only partially aware and partially responsive to what is going on around her and the person at her side, her lover.
According to Erica Wagner’s Wikipedia biography and confirmed by her (E. Wagner personal communication, September 26, 2012) “as a child she suffered from epilepsy.” Her view is the insider view, different from Nesser’s, more accurate, more detailed, trying to put into words both the aura symptoms and the perceptions in the semiconscious state during aura and seizure—the two not being as clearly separated as epileptologists are used to assume.
We are entering a sphere where patients, as already indicated by Nesser, may treasure auras as unique experiences that go beyond the realm of collective knowledge. This outstanding quality of the aura is probably nowhere better expressed than in some literary works, most of them based on the authors’ own aura experiences, several being great literature.
Prolonged and isolated auras, and subjective and objective signs and symptoms: Dostoyevsky
Fyodor Mikhailovich Dostoyevsky not only used his epilepsy experiences many times in his fiction but included leading characters with epilepsy in three of his most important works (Prince Myshkin in The Idiot of 1868/69, Kirillov in The Possessed of 1871/72, and Smerdyakov in The Brothers Karamazov of 1879/80). One of the aspects that received particular attention in this respect, both by the general public and neurologists, was Dostoyevsky’s description of an ecstatic aura. This aura type was documented with a right temporal lobe ictal electroencephalography (EEG) by Cirignotta et al. (1980) after Gastaut in his William G. Lennox Lecture (Gastaut, 1978) had eloquently denied its existence.
Two epileptologic aspects of Dostoyevsky’s accounts have received little attention. In The Idiot, two seizures occur, and both are preceded by a slow build-up of premonitory symptoms, which strictly speaking qualify as prodromes (Scaramelli et al., 2009) rather than auras as they do not immediately precede the seizure. Vogel (1961) has insisted upon the mastery with which Dostoyevsky describes this slow, apparently predestined development. It ends with a severe seizure occurring in the moment when Rogozhin, Myshkin’s friend-enemy, steps forward to kill him. Whereas this prodrome is described from the subjective perspective of Myshkin’s perceptions and emotions including a first account of the ecstatic aura, the outside view of the changes in his behavior and language during the prodrome is presented with the second seizure. This description is particularly interesting because the increasing exaltation indicating the preictal condition is at first halted by Myshkin’s shocking experience of breaking, in his agitation, a precious Chinese vase. Dostoyevsky knew the possibility of seizure arrest, but he also knew that the interruption is not always definite. The prodrome after an interval resumes and ends in a seizure.
Literary works often contain more or less explicit references to the work of other authors, but what appears as a literary reference can also be coincidental or represent a literary type. Such instances are in this essay referred to as “related.” Thus, the only other literary example known to this author where a seizure is presented both from the subjective and the objective perspective is, without apparent reference to Dostoyevsky, in another Russian novel (Wolos, Churramabad).
Kirillov, the epileptic character in The Possessed, who gives a more elaborate description of the ecstatic aura, is not aware that his experiences have anything to do with epilepsy because he has never had a seizure, whereas he has one or two auras per week. It is Shatov, his interlocutor, who tells him that these perceptions indicate epilepsy and he presumably will end up by having seizures. The interesting question is how Dostoyevsky knew about the possibility that isolated auras may precede the manifestation of full seizures for a long period of time. This was not common medical knowledge at the time. Shatov in the novel tells Kirillov that he has heard that epilepsy always begins in this way; he has met an epileptic who described to him exactly the same perceptions preceding a seizure. This informant may easily have been Dostoyevsky himself. There is still much uncertainty about the onset of his epilepsy: did it start at age 7, 18, 25, or even later (Voskuil, 1983)? Perhaps Dostoyevsky put the solution here.
Echoing the ecstatic aura: Klaus Merz, Thom Jones, and Bernard McLaverty
Dostoyevsky’s description of the ecstatic aura has found many echoes in literature, only some of which will be mentioned here.
The epileptic characters in the work of Swiss Klaus Merz are based upon memories of his father (K. Merz, personal communication, November 13, 1999). Walter in his story In the Temporal Region would wish just once to experience the “aura of happiness of epileptics” of which he has read so much but which never preceded all his minor or major seizures, the “beguiling aura, a happiness of which the thoroughly healthy even don’t dare to dream.” He visualizes a photograph he has seen of a naked young man having an erection as he is provoking a photogenic seizure by looking toward the sun and waving his spread fingers before his eyes (Fig. 1). “One should not wake up again afterwards. Or only as a converted. On the way to Damascus.” But he has only unpleasant auras with epigastric and olfactory-gustatory sensations and belongs to “the common category of people with the falling sickness who would give much to get rid of the always threatening shadow once and for all.”
The photograph (Fig. 1) and the yearning after an epileptic experience with happiness do not belong to the real person’s history (personal communication, May 29, 2012). Expressing his love for his father, they are the writer’s additions just as the allusions to Dostoyevsky and Saint Paul whose conversion following the blinding apparition of Jesus in a great light on his way to Damascus has by some been interpreted as an epileptic seizure.
The religious motive and a reference to Saint Paul are also found in the following example.
Thom Jones, a Vietnam veteran, was an amateur boxer and has temporal lobe epilepsy. That the first-person narrator of his story The Pugilist at Rest is a Vietnam veteran and has temporal lobe epilepsy resulting from a boxing trauma indicates that Jones in this story (and others) strongly drew on his own experiences even if it does not necessarily mean the story is autobiographical. In another story, A Midnight Clear, a character with epilepsy introduces himself as “a man of Dostoyevskian complexity” and in Pugilist the ecstatic aura is in focus: “Dostoyevsky experienced a sense of felicity, of ecstatic well-being unlike anything an ordinary mortal could hope to imagine. … He said he wouldn’t trade ten years of life for this feeling, and I, who have had it, too, would have to agree. I can’t explain it, I don’t understand it—it becomes slippery and elusive when it gets any distance on you—but I have felt this down to the core of my being. Yes, God exists! But then it slides away and I lose it. I become a doubter.” He talks of Muhammad, Saint Paul, Joan of Arc, all of whom he believes to have had epilepsy: “Each of these in a terrible flash of brain lightning was able to pierce the murky veil of illusion which is spread over all things. Just so did the scales fall from my eyes. It is called ‘the sacred disease.’”
The title of another story in the collection, The Black Lights, an oxymoron to which we will return when we discuss Margiad Evans, refers to ictal visual hallucinations. It could be based on the experience of intensely black phosphenes in the aura.
Another example is Lamb by Bernard Mac Laverty. In this novel, 12-year-old Owen has secondarily generalized tonic–clonic seizures (GTCS) starting with a weird auditory aura.
‘When you are writing on a blackboard – and the chalk slips – and you scrape your nail against it. It’s not like that. It’s like that only it’s nice. It’s like that only it’s a nice feeling. Everything is right. Everything’s in its right place … it’s the right colour, the right smell. Sometimes I get a smell that … It’s beautiful….’
The word coming from Owen sounded strange.
‘The whole thing is … beautiful. I … I be happy. Just say … somebody who really loves the sound of his nails scratching down a blackboard, then that’s what it’s like. I be that happy.’
Owen stopped talking with a shrug and a twist of his mouth. They were both quiet.
‘It sounds a bit daft,’ said Michael eventually.
‘It’s hard to explain.’
‘So it seems. But I think I understand what you’re getting at.’
‘I would like to be like that all the time,’ said Owen. …
‘A permanent fit?’ said Michael.
The boy nodded.
‘Sometimes I feel like that.’
Michael who as “Brother Sebastian” served in an Irish Catholic order’s correction home but could not tolerate the loveless, close to sadistic atmosphere of the place has escaped from there and taken Owen with him. He is attached to the boy since he has rescued him from getting severe burns on a radiator when in a seizure in the gym he had been caught behind some wall-bars. Fatherless Owen at a certain moment had said that he didn’t care whether he died or not, and Michael “was taking on the task of giving him something to live for.” But simple-minded Michael who is “not fit to live in the world” soon after the escape loses control of the situation and in despair ends up by drowning the boy “in the happiness of a seizure” which he provoked by substituting something ineffective for the boy’s antiepileptic drug.
The epilepsy story in Lamb has many sources of seizure observations (including the fall on the radiator) by the author and others, memories of Dostoyevsky’s aura, and the Roman notion of committing suicide in a moment of triumph or intense happiness. A parable of misdirected love and the Northern Irish civil war, Lamb was written “out of the anger directed against organized religion (Catholic) in Ireland and republican violence. People who say they love their country are actually destroying their country – just as Michael says he loves the boy but destroys him” (B. Mac Laverty, personal communication, October 7, 2002).
We ignore if, in the following work, the description a long period with only isolated auras is deliberately related to Dostoyevsky’s The Possessed, but it seems possible.
Aura and clearsight: Richard Muir
Little is known about the American writer Richard Muir and how he came by his expertise about epilepsy. His character Julian Papp in his novel The Miniature Man of 1987 shares with Kirillov that he has only isolated auras but in addition has the ability to “manage” the auras, both evoking and stopping them (Fenwick & Brown, 1989a,b). His auras have the specific feature of elevating his state of mind to a higher level of awareness, and he uses them during games of chess where he “would use to see the right moves. I’d go to a special place in my mind, completely relax, and when I came back the moves were obvious.” This special place he evokes by beating an irregular time with his thumbs, and he poetically describes it thus: “wind breathing soft gentle meadowscents and meadowcolors walking (touch me touch me) passing through the air molecules of air pulsebeat footfall time adrift (she) yes (touch me hold my hand) the meadow smiling as we walking floating reaching touch to touching palm to palm two palm prints pressing lines whose fates conjoined inscribe the way so clear so clear so clear” [writer’s italics]. It lasts only seconds. The central metaphor is that of a meadow that returns in repeated descriptions.
But in a competition with a Grandmaster that develops into a winning chance he gets so excited that he loses control, and the evoked aura turns into his first generalized tonic–clonic seizure. Afterward the aura loses its magic power, his standard in chess deteriorates, and in consequence he attempts suicide.
The aura as a metaphor: Thomas Pynchon
Another American writer who strictly makes a secret of himself is Thomas Pynchon. Epilepsy appears in several of his novels, for example, as “an odor, one he knows but can’t quite name, an aura that threatens to go epileptic any second,” in Gravity’s Rainbow of 1973. This is a quite precise qualification of an olfactory aura as an experience familiar but ultimately indescribable (Schwabe et al., 2008).
More extraordinary, however, is his use of the aura in The Crying of Lot 49 of 1966, a parody of a mystery novel. In this dense, intricate literary text, the epileptic aura becomes the “master metaphor” (Fowler, 1984), a true literary gem that provides possible access to the many enigmas of the novel that have intrigued literary scholars (e.g., O’Donnell, 1991). Oedipa Maas, the novel’s leading character, tries to disentangle a secret and visits a person who could know something about it. She has the immediate (and correct) impression that this person will become central to the further development: “She could, at this stage of things, recognize signals like that, as the epileptic is said to – an odor, color, pure piercing grace note announcing his seizure. Afterward it is only this signal, really dross, this secular announcement, and never what is revealed during the act, that he remembers. Oedipa wondered whether, at the end of this (if it were supposed to end), she too might not be left with only compiled memories of clues, announcements, intimations, but never the central truth itself, which must somehow each time be too bright for the memory to hold; which must always blaze out, destroying its own message irreversibly, leaving an overexposed blank when the ordinary world came back.”
In this highly complex metaphor the part of the seizure for which consciousness is lost stands for an unobtainable central truth, and the aura, for the presentiment of this truth’s revelation. There are several secondary metaphors embedded in the central metaphor: the grace note (Fig. 2) from the field of music for the aura, the overexposed blank from the field of photography for the overwhelming power of the seizure itself. That the announcement by the aura is called secular reminds the reader that there exists also a biblical announcement (Fig. 3)—one of a few indications of a religious subtext in the novel.
Pynchon indicates a feeling in the sufferer of an epileptic fit that during the seizure there may be some awareness of something great and extraordinary that only is not remembered. Jensen (see above) seems to indicate something similar when he says about the Lindby Hunter that he “had the depth of nature and times in him without knowing it” and, describing him at the end of a seizure: “His face had a smile of intimate smug secrecy, as if he knew a good deal but would not share it with the first comer. But then he regained consciousness completely, looked around himself frightened and wiped the scum from his face.” Jensen must have observed this.
The combination of an utterly recluse life with intimate knowledge of aura experiences could indicate that both Muir and Pynchon have epilepsy themselves. But the power of literary imagination must not be underestimated, and there is of course also the possibility that they have gained their knowledge by thorough research, and if the diagnosis is theirs and they want to be silent about it we have to respect that.
To talk about epilepsy without naming it: Machado de Assis
It is a strange coincidence that three 19th century writers who belong to the greatest masters of their national literatures had epilepsy, Dostoyevsky of Russia, Flaubert of France, and Machado de Assis of Brasil. Joaquím Machado de Assis came from humble origins but became the founder and first president of the Brazilian Academy of Letters, a central figure of the literary life of his time. To be the son of an illiterate washerwoman in Rio de Janeiro and a mulatto he considered as sufficient stigma for one person to carry so he tried to keep his epilepsy (probably right temporal lobe epilepsy, Guerreiro, 1992) a secret. This was neither successful nor necessary. The secret was so public that even a newspaper photo exists of his having a “syncope” in a public place in Rio (Fig. 4). But his amiable, encouraging personality and commitment made him such a respected and beloved person that his having seizures did not damage his reputation (Yacubian & Caboclo, 2010).
According to literature (Guerreiro, 1992), he never mentioned epilepsy in his work. But that he tabooed the term doesn’t mean that he didn’t talk about epilepsy. At least two remarkable aura descriptions can be identified, the first in his novel The posthumous memoirs of Brás Cubas. In chapter XLI “The hallucination” Bras Cubas pays a visit to his fiancée Virgília at her home. He is in agitation because the same afternoon he has accidentally encountered his earlier mistress Marcela who has become ugly and disfigured by smallpox. As he is talking with Virgília, her beautiful face all of a sudden looks disfigured like Marcela’s. As he stares at her, some moments later the illusion dissolves, she is her lovely self again, but her attitude toward him has completely changed, become cold and distant. Soon afterwards the engagement is broken from her side. No explanation is given in the novel but we may infer that our hero following an aura with a visual illusion had a psychomotor seizure during which he behaved strangely, perhaps indecently.
Of interest, the only other detailed literary description of an ictal visual illusion based on the writer’s own experiences belongs to the same period (Danish writer Ernesto Dalgas’Suffering’s Way). It also occurs in a moment of strong erotic significance and has a decidedly moribund hue (Wolf, 1973). Some literary zeitgeist may have come into play here beyond the personal experience, and we must remember that literary writers use their material freely even if it has autobiographic roots.
Machado’s second account of an aura in his novel Quincas Borba is much more intricate. Some features of this novel seem to represent a homage to Dostoyevsky’s The Idiot. Like Prince Myshkin, protagonist Rubião is a naive young bachelor who has inherited a substantial sum of money and travels to the capital with great expectations but no specific plans. On the train he meets a businessman with whom he establishes a friend–enemy relationship and will later compete with over a woman. He falls into the company of low bohemians and sycophants who deprive him of his wealth and he ends in misery. Like Myshkin, he significantly becomes witness of the execution of a death sentence.
An experiential aura relates the memory of the execution to a scene years later when in the narrated time Rubião is in great emotional upset after a meeting with his friend’s wife who neither accepts nor definitely rejects him as a lover. He is undecided what to do as he has a bad conscience about wooing his friend’s wife but remains strongly attracted by her. He approaches a stand where three coachmen compete for his hire. His continued indecision, now about which coach to choose, evokes the earlier scene where he followed the crowd to the public hanging of a culprit unable to decide to turn away. The vivid recall of the scene is intermingled with the voices of the coachmen that he still perceives. The remembered scene ended, at the moment of the hanged man’s death, by Rubião’s uttering a cry and “losing perception.” The narrated scene ends with a gap after which Rubião finds himself being driven away in one of the coaches and the coachman chatting with him. There is little doubt that Machado not only reports here two seizures in moments of great emotional upset and connected by his undecidedness. He also does it in a way that is a perfect illustration of Gloor’s (1990) characterization of an experiential aura as creating “in a patient’s mind experiences, usually from his personal past, that have a compelling immediacy similar to or sometimes even more vivid than those occurring in real life. It is this quality of being like a real life experience which justifies the term ‘experiential’. … Experiential phenomena … typically combine elements of perception, memory and affect.”
The aura experience as a creative gift: Margiad Evans
In the above, several examples have been given in which aura experiences were transformed into great literature, but one writer directly discussed the role of her auras for her creativity. Margiad Evans at 49 years died of a brain tumor that had caused epilepsy with a first GTCS at age 41, on May 11, 1950. She wrote a book (A Ray of Darkness) on this and all that happened in the year leading up to the event. The seizure made her aware that for many years already she had had isolated auras, and in numerous reformulations (Schwabe et al., 2008) she tried to describe these. Examples are: “Moments when I was quite literally conscious and unconscious at the same time,”“like a tiny wheel – the wheel say, of a watch, whirring at blurring speed, quite soundlessly, in my head while I went on with whatever I was doing, guided by the consciousness left over rather than the consciousness of the moment” or, reminiscent of Marcel Duchamps’Nu descendant un escalier (Fig. 5), “when they have happened to me while crossing a room I have, if I may so illustrate it, left myself on one side and come to myself on the other, while feeling an atom of time divided the two selves, as the room might divide the figures of myself, supposing any one could create two figures of me.” This created a fear of a real split in her, a “terror of mental disorder.” But it also seemed to be “poetry born into the world no less surely than if it had been written. Poetry, not poems. To see, or to observe one thing, and at the same instant for the soul (it is too instantaneous for the mind) to give birth to its matching half, its sunny shadow. Such swift mental images I had constantly and they made me very happy. For that was why I was born, to be able to do just that and nothing else.”
What Evans describes here is a literary figure, the oxymoron (see also Thom Jones, above), which is defined as an expression uniting two irreconcilable opposites. Starting with Autobiography in 1943, Evans’ work abounds in oxymora (Table 2), whereas in her earlier books they are missing. The writer in A Ray of Darkness is unable to tell when her auras did start; maybe already in childhood, maybe later. If the oxymora in her work indeed are indicators of her auras, the year 1943, when she was 34, is a terminus ante quem, at least for auras including this quality. Another indicator is that, according to Ray of Darkness, the “spells became more frequent and longer and darker during the year 1948 than at any other time in my life.” Indeed there is a cluster of oxymora in The Old and the Young, which was written in 1948, and they include notions of darkness (Table 2).
|In: “Autobiography” (1943)|
|Wind... fell like a whip and a caress|
|The peace of being in the fight|
|A dark white sky|
|Shaded by light|
|Free, even of liberty|
|Murmur of sight, vision of sound|
|In: The Old and the Young (1948)|
|Light of darkness|
|Duet for one voice|
|Awake [by] an eruption of sound which she hadn’t heard|
|A silent voice|
|In: A Ray of Darkness (1952)|
|When is light so expressed as at midnight, or darkness so clear as at noonday?|
|Ray of darkness|
Auras: the ontological dimension: Salzman, Evans, Dostoyevsky, and Hustvedt
A fictitious character with epilepsy whose seizure experiences are at the basis of her creativity is Carmelite nun Sister John of the Cross in Mark Salzman’s Lying Awake. In her convent and the community she is cherished for her spiritual poetry, which is based on powerful ecstatic visions. The discovery that these are symptoms of temporal lobe epilepsy caused by a brain tumor shakes her entire understanding of herself. Who is she, if what she considered a great gift from God, something which made her unique, is nothing but the symptom of a disease? Is she utterly worthless? Must not her fellow sisters feel deceived by her? Is her faith genuine or spurious? Salzman was inspired to this novel by Oliver Sacks and St. Teresa of Avila (Lloyd, 2001). He presents Sister John’s dilemma with remarkable insight and empathy but not with the authenticity characteristic for authors who describe their own experiences.
Margiad Evans after her first GTCS developed additional subjective seizure symptoms, and they provided her with a quite different type of experience that added an ontologic dimension to her ailment: “The old idea of demoniac possession, I am sure, arose not from the onlookers of sufferers in fits but from the sufferers themselves. Because in the violent attacks one feels as though the body has been entered by a terrific alien power; and that that power is trying, after entrance, to push its way out again.”
This is how being seized by epilepsy can feel, apparently quite in contrast to the ecstasies of Kirillov in Dostoyevsky’s The Possessed. But these, beyond the perception of perfect eternal harmony, also include an ontologic dimension: the absolute joy is uncanny. Reminiscent of the “overexposed blank” in Pynchon’s metaphor, the soul would be dissolved if this experience of “terrible clarity” lasted more than 5 seconds. A human being in its earthly shape could not bear it; one has to undergo a physical transformation or die.
Both Evans and Salzman address the challenge to the notion of identity that seizures may present to some patients. An author who discusses this from the related but different angle of the reality of experiences in an aura is Siri Hustvedt who has epilepsy motives in several of her novels. She has severe migraine with multiple visual symptoms, which she used in her novels The Blindfold and The Sorrows of an American. She believes that she also may have had a few isolated epileptic seizures (A Plea for Eros; The Shaking Woman). In her view, epileptic and migrainous auras are not categorically different, and she insists that “neurological debilities always have content” which “hard science has been loath to recognize” (The Sorrows of an American).
The following brings her close to Dostoyevsky (and Muir): “I have also had several euphoric episodes before getting sick, and despite the inevitable aftermath, I recall these moments with pleasure: My vision takes on a sudden heightened clarity that makes me imagine I am seeing what I normally can’t, and then, just as I remark to myself on the fantastic quality of my eyesight, I feel an overwhelming joy. Common wisdom designates this kind of happiness as aberrant, false, a mere trick of the brain that heralds an oncoming migraine or seizure, and there is some truth in this, but the experience is as real as any other, and it may be that trying to disentangle any emotion from the nervous system is futile. It is the interpretation that matters. However morbid my sensitivities may be, they are inseparable from the story of myself, and my reading of these peculiarities over time has been decisive in determining who I was and am” (A Plea for Eros).
Is rational insight the solution to Evans’ and Kirillov’s dilemma; is there anyway a categorical difference between the auras of epilepsy and migraine; or is it a personal matter? Whatever the answer, sharing with us their deliberations on their aura experiences, Dostoyevsky, Evans, and Hustvedt take us to an ontologic sphere where they are the experts and it becomes our, the neurologists, role to listen and learn.
When literary writers talk about epilepsy the focus is often on the aura. Writers who have met persons with epilepsy have been impressed by the ways they use the warnings to retain control. Writers with epilepsy have elaborated their unique subjective experiences into literature, sometimes great literature, or they have transposed them into a philosophical dimension. The works discussed herein strongly support that literary texts provide valuable insights beyond medical texts.
The author wishes to thank his many friends who over the years drew his attention to literary works where epilepsy is mentioned, sometimes by even sending the books. Great thanks are also due to the writers who very kindly were willing to answer questions and share the background on which they included epilepsy.
The author has no conflict of interest to disclose. He confirms that he have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.
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Original title, title of English translation and date of first original publication. English title in roman means that no English translation of the work has been published.
Molloy, 1950 (Molloy, 1950)
Blixen, Karen (Tania)
Skygger på græsset, 1960 (Shadows on the Grass, 1960)
The Terminal Man, 1972
Lidelsens vej (Suffering’s way), 1898
Dostoyevsky, Fyodor Mikhailovich
Idiot (The Idiot), 1868/69
Besy (Devils or The Possessed), 1871/72
Bratya Karamasovy (The Brothers Karamazov), 1879/80
The Old and the Young, 1948
A Ray of Darkness, 1952
The Piano Man’s Daughter, 1995
Owls Do Cry, 1957
The Murderer’s Tale, 1996
Guimarães Rosa, João
O grande Sertão: Veredas, 1956 (The Devil to Pay in the Backlands, 1963)
The Blindfold, 1992
What I Loved, 2003
Extract from a Story of the Wounded Self in: A Plea for Eros, 2006
The Sorrows of an American, 2008
The Shaking Woman or A History of My Nerves, 2009
Jensen, Johannes W.
Lindby-Skytten in: Himmerlandshistorier (Stories from Himmerland),
The Pugilist at Rest. Stories, 1991
Sonny Liston was a Friend of Mine. Stories, 1999: A Midnight Clear
Possessions, 1996 (Possessions, 1998)
Tulkoon myrsky, 1994 (May the storm come)
Mac Laverty, Bernard
Machado de Assis, Joaquím Maria
Memórias póstumas de Brás Cubas, 1882 (The Posthumous Memoirs of Bras Cubas)
Quincas Borba, 1891 (Quincas Borba)
Im Schläfengebiet (In the temporal region), in: Am Fuß des Kamels. Geschichten und Zwischengeschichten, 1994
Der Taumel, 2000 (Giddiness)
The Miniature Man, 1987
Och Piccadilly Circus ligger inte i Kumla, 2002 (And Piccadilly Circus is not in Kumla)
The Last Gentleman, 1966
The Second Coming, 1980
Putney Mary Jo
Dearly Beloved, 1990
The Crying of Lot 49, 1966
Gravity’s Rainbow, 1973
Dulce compañia, 1996 (The Angel of Galilea, 1999)
Lying Awake, 2000
La mare au diable, 1845 (The Devil’s Pool, several translations)
De laatste vrouw, 1994 (The last woman)
The Princess, 1847
A Great Place for a Seizure, 2011
Karnas arv, 1997 (Karna’s heritage)