Wednesday, August 6, 2008

The Man who Forgot How to Read -- Howard Engel

The brain is truly the most amazing organ, for in humans, in fact in all animals, it is the control centre of the central nervous system, responsible for all behaviour. The human brain contains roughly 100 billion neurons, linked with up to 10,000 connections each, all gathering and transmitting electrochemical signals. Usually it functions so well that very few of us think about how it works for it does its job so unobtrusively.

But for some, its normal function is disturbed, perhaps by trauma or disease or congenital or birth abnormalities and these people cannot move or behave in the way that the rest of us take for granted.

I have read several of the well known neurologist Dr Oliver Sacks' collections of case histories with great interest. But what about stories from the patient's point of view?

Recently via my book circulation group I read The Man who Forgot How to Read, by Canadian author Howard Engel who tells us of his experiences after he woke up one morning to find that he could no longer read while still being able to write, a rare condition with the long name alexia sine agraphia, literally inability to read without inability to write.

Of course Engel had suffered a stroke during the night and besides his inability to read he had other memory problems as well. Names of his friends escaped him, geography of his surroundings was incomprehensible and he could not distinguish an orange from an apple. He spent the next few weeks in hospital and then in a rehabilation facility, learning new strategies for coping with these problems.

This book is his story of his progress. He described learning to read again, letter by letter, at a snail's pace, very accurately, but the whole process was exhausting beyond belief. He also described how he developed the coping mechanisms to overcome his various deficiencies. Early on in his illness, he began to keep what he called a memory book, making notes about this and that but not being able to read them back at the time. He details the processes which he actually used to write another book in his Benny Cooperman detective series, based on the his exact experiences in hospital.

I found this book a fascinating read and had only admiration for how this man dealt with the blow that he had received. During his rehabilitative journey he contacted Dr Sacks and they became friends, with the result that he wrote an afterword to this book.

Engel was always a great reader and even when he could not read he continued to buy books and surrounded himself with them as always. As he says of himself:
I could no more stop reading than I could stop my heart. Reading was bone and marrow, lymph and blood to me.
Now that is a statement that resonated with me. All in all, an excellent read for anyone interested in the workings of the mind and how it is possible to overcome such a disability as Engel suffered and was able to return to his profession as a writer.


jams o donnell said...

THat looks like a fascinating read jmb.

In my final year of my physiology and biochemistry degree (1983/4) two of my eight modules were on brain function. One of my lecturers (Professor Kerkut) said that they might as well put write here be dragons over whole swathes of the brain. Advances over the last 25 years have gone some way to increasing our knowledge there is so much we don't know about the brain. I think that will be the case for a very long time to come.

Smalltown RN said...

Now that is one amazing person. I have read a couple of Dr. Sack's books all very interesting...when I was first diagnosed with Severe Atypical Migraines my sister gave me his book Migraine by Oliver Sacks....a very interesting book.

I have watched many a patient journey through their rehab, through sheer determination some have made astounding recovery...I must be honest I don't know if I would have that much courage to make the journey.....

Ian Lidster said...

I read this and found the premise horrifying. HL Mencken suffered a stroke a decade prior to his death. For his last 10 years he could no longer read nor write. It was horrific for him.

Liz said...

Not a good read if you're a hypochondriac though! I already worry about my brain misfunctioning!

CherryPie said...

Sound quite fascinating, but what an awful thing to happen.

Carver said...

I would like to read that JMB. I like the idea of reading in the patients words.

I've read the Man Who Mistook his Wife for a Hat, although I don't remember much of it. When you mentioned Sacks I knew I'd read something of his and looked it up and that's the one I have.

The brain is so remarkable. My mother's stroke (besides left sided paralysis) affected her attention span. She was so determined that recovery would mean driving but even though some of the paralysis was reversed, the way it was explained to us is that her attention span was such that she would never be safe to drive. She could read but we had to get her short things to read. Same thing with TV, she couldn't focus long enough for a whole program.

The odd thing to me is I would have missed the Berlin Wall coming down, if it hadn't been for her. I was so wrapped up in my mom's care and anything else was for my 4 year old that I tuned out the world. I walked in her room at the rehab hospital and she was in tears for the families she had watched being reunited as the Berlin Wall came down. Before that I wouldn't have thought she could focus on anything outside of what she was going through. The brain is an amazing thing.

Dr.John said...

I feel for the man. I didn't have to learn to read again but I did have to learn to walk when I came out of my coma.

MedStudentWife said...

I must get this book.... I loved Dr Sack's books,and having worked with departments that deal with stroke and head injury.... brain injury and how it affects us interests me, especially how I can take lessons learned to what I do now.

Moggs Tigerpaw said...

How terrible not to be able to read. the poor man.

Sean Jeating said...

Both fascinating and touching. Thanks for recommending this book, jmb.
I shall read it, that is if I can.

Barbara Martin said...

Thank you for posting such an interesting topic. Howard Engel gives writers of all genres hope to continue in their own quests.

jmb said...

It was fascinating Jams. You are so right for the the mysteries of the brain have certainly remain unsolved on many levels.
Indeed he is Mary Anne. People do have amazing determination when confronted by these setbacks.
Ian, I did not know that about Mencken but I cannot imagine how horrible that would be.
Perhaps not Liz, but I always hope these things will not happen to me.
Yes Cherie, wouldn't be horrible. But a good read.
I'm sure you would enjoy it Carver. What a shame about your mother. Still it could have been so much worse.
Dr John, I am sure that you had a very difficult time after your terrible illness. Luckily you did not have the reading problem.
I am sure you will find this worthwhile MSW, especially as you have a close interest.
Moggs I think it would be one of the worst things to happen to one.
I am sure you would find it interesting Sean, if you could fine it there and read it. :-)
Thanks Barbara, it was an incredibly interesting book to me and very inspirational.

Thanks to everyone for visiting and commenting.

leslie said...

What an amazing story and an amazing man to persevere in such a time of stress. I remember when my Dad had two major strokes within two days he lost his ability to read. But it slowly came back, thank goodness, because he really missed it while he recovered.

Colin Campbell said...

The diversity of the human condition is nothing short of amazing. It is amazing that so many of us make our way through life relatively unscathed.

Nunyaa said...

I have An Anthropologist on Mars and The Man Who Mistook his Wife for a Hat both excellent books and is great insight into the workings of the mind. Great post JMB :)

Welshcakes Limoncello said...

Very interesting post but the thought of not being able to read absolutely terrifies me, jmb.