“Was he happy to see you, when you came around to visit?” I ask.
“Yes, he’d say that he missed us and it was lovely to see us and he’d be this wonderful person, but after a while you’d know the time had come to leave because he’d get fidgety, he’d want to get back to his painting. The moment you walked out of the door, it was like you didn’t exist.”
Tommy’s endless creativity eventually drove Jan away.
“I don’t blame her,” said Tommy. “I was a completely different person.”
“It was hard,” says Shillo. “We all felt a little pushed out by his art, but we just accepted it—it was doing him so much good.”
I asked Tommy whether his sudden love of art took him by surprise. Had he had any interest in it before?
“No, I’d never even picked up a paintbrush,” he said. “Never been in an art gallery,” he added as an afterthought. “Except maybe to steal something.”
* * *
Flaherty knows personally what it is like to have a sudden and uncontrollable urge to do something creative. Following the death of her premature twins, she suffered from postpartum mania.7
“I couldn’t sleep. All I wanted to do was talk, but because I’m an introvert I started writing it down instead,” she told me. “Some primitive area of my brain was saying, ‘Holy shit, something’s going wrong, you gotta do something.’” She was flooded with ideas and for four months could do nothing but write. She realized that her mania resembled something called hypergraphia, which can occur alongside epilepsy and result in the intense desire to write. She decided to write a book about her experiences. “My writing a book was a way to understand myself,” she said, “but also, if you’re writing all the time and no one reads it then you’re just crazy, but if you’re an author then it’s a good thing.”
A year later, history repeated itself and she again gave birth to premature twins, though thankfully this time they survived. But once again she suddenly had the uncontrollable urge to write, mixed with periods of depression. Over the years, medicine and exercise have helped her control the condition.
The emergence of an uncontrollable creative drive has been termed sudden artistic output. It means that the brain can no longer inhibit certain behaviors. Tommy is one of a handful of famous cases in the scientific literature.
Another is Jon Sarkin, who in 1989 suffered a traumatic hemorrhage after an operation to fix a blood vessel that was pressing on his auditory nerve, making his ears ring. Months into his rehabilitation, Jon started to draw. Months turned into years and he became consumed by the need to paint all the time. He sold his chiropractor’s office and became a full-time artist, whose work can sell for $10,000 apiece.
Then there’s Tony Cicoria, an orthopedic surgeon who lives in upstate New York. In 1994, he was at a lake for a family gathering when he went to a pay phone to call his mum. Moments after he ended the call, a bolt of lightning struck him and he crashed to the ground. A nearby nurse brought him around with CPR. A month after the accident, Cicoria had returned to work, mostly feeling fit and well, when over a period of a few days he was overcome with a desire to listen to piano music. He began to teach himself how to play the piano and later began to hear music playing constantly in his head. Neurological scans at the time showed nothing amiss, and when offered newer techniques he politely declined, stating that his music was a blessing, and not something that he desired to question.
In 2013, I came across another case of sudden artistic output, in a paper that described a woman who had arrived at a hospital in the UK complaining of memory problems and a tendency to lose her way in familiar locations.8 She was diagnosed with epilepsy and treated with the drug lamotrigine. As her seizures receded, a strange behavior took hold—she began compulsively to write poetry. She often used irregular rhythm and rhyme for comic effect, a style her husband described as “doggerel.” I have one of her poems framed in my study:
To tidy out cupboards is morally wrong
I sing you this song, I tell you I’m right.
Each time that I’ve done it, thrown all out of sight,
I’ve regretted it.
Think of the treasures now lost to the world
Measureless gold, riches unfurled,
Diamonds, sapphires, rubies, emeralds—you must have had them,
All tucked well away. So
To tidy out cupboards, throw rubbish from sight
(Even the poems you write up at night)
Is morally wrong.
So I’m keeping this one.
The relationship between art and brain damage is a complex one. The reasons suggested for these rare cases of sudden artistic output are speculative at best, but Flaherty proposes that they may include an increase in dopamine. Dopamine is used all over the brain and is important for motivation and producing a drive toward things that make you happy. If you have too much dopamine, though, it can lead to disinhibited behavior. Those affected might start gambling, partake in riskier activities and show compulsive behaviors, including a sudden urge to draw or play music. It is a side effect that has been noted in people with Parkinson’s who are on high doses of L-Dopa, a drug that increases dopamine to replace that lost through the disease.
Disinhibition of brain pathways is also seen in Tourette’s syndrome, whereby people find it difficult to suppress inappropriate words and noises. Interestingly, this behavior is often accompanied by a substantial creative drive.
It’s not possible to say exactly what Tommy’s trigger was, says Flaherty. Perhaps the stream of ideas and concepts was his muse; perhaps an increase in dopamine created the obsession, perhaps putting paintbrush to paper helped him make sense of it all. Whatever the cause, she says, “It was clear that painting gave him an extreme sense of well-being.”
* * *
I often wondered whether Tommy’s new personality allowed him to reflect on how he used to be, how he had treated his family. But despite having told me about several aspects of his past—his childhood, the drugs and the fights—when I asked him these questions, he said he remembered almost nothing about his old life.
“I sometimes hear my mammy’s voice,” he said, “and suddenly get a taste of a past, but it’s not really remembering. People have told me about my life by their stories, but I don’t know what the hell they’re talking about.”
“You don’t remember how you used to act?” I asked.
“No. When I woke up I found it difficult to recognize people. Bits about my childhood came back but not everything. I found out a lot through stories that people tell me. But sometimes I think they’ve made the stories into a kind of Chinese whispers. Their stories become bigger, so I take no notice of them. My memory starts at 2001.”
But when I ask Shillo about this apparent memory loss, she tells a different story. “Dad would often apologize for how he had been in the past,” she says. “He would always say his memory wasn’t that great, but in reality, if you were reminiscing about the past, his memory was incredibly good.
“I think in reality, he just didn’t want to spend too much time delving into his memory to see what was there. He didn’t want to fully remember who he was before, because he was so emotional after the accident, the things he’d done would have been a lot harder to deal with.”
I ASKED TOMMY whether he preferred his new personality to what he remembers of the old one.
“The best thing that happened to Tommy McHugh,” he said, “was having a stroke while doing a poo.”
I laughed.
“You just have to accept this alien, unknown identity,” he said. “Then you adapt and start to live again.”
Tommy said he felt that during his rehabilitation a lot of his doctors were trying to find the old Tommy, rather than embrace the new one. “Helen, none of this is just about me,” he said. “There’s a world of people like me living out these strange new worlds of brain repair. And a lot of them don’t have anything or anybody to help them express what’s going on.”
<
br /> Tommy was so impassioned by this issue that he started giving talks to other stroke survivors, to encourage them to embrace their new mind, rather than trying to capture all the aspects of their old one.
“Our brain is repairing itself, and sometimes that’s in new, constructive ways and sometimes it’s in negative ways. We need to be able to talk about the strange things that happen to us, because getting a bit of support and understanding in recovery can make 100 percent difference. What a lot of people forget is that we’re alive, we’ve survived this really hard adventure.
“Those of us who have had strokes and can walk and talk need to let other people know that it’s not the end of the world, it’s a beginning—a chance to improve one’s mind and not be put on a shelf and labeled as a brain-damaged buffoon.”
I ASK SHILLO whether she thinks her dad seemed happier after the stroke.
“Definitely,” she says. “His old behavior was a result of this heaviness that he felt. There used to be this switch in his head that you’d see when he would suddenly realize he had gone too far and he’d think”—she whispers as Issac is in earshot—“‘I fucked up, I might as well go the whole way and take everybody down with me.’
“He would ruin everything because he thought he’d already gone too far into this lonely, dark and scary place. After his strokes, he was certainly a much more balanced, settled, happier person. He liked himself, whereas I don’t think he did before. No matter how frustrated he got, he never got dark, he never let it send him down. He’d just step back and take another route. It took us a long time to accept that there wasn’t going to be any more dark times.”
Redemption, that’s what it came down to, says Shillo suddenly, as the rain begins to fall heavily against the kitchen window and I notice how late it has gotten. “It was a chance for him to make things right.” To make up somehow, perhaps unconsciously, for the “dark times” that he had once led.
“People think a horrific brain injury is the end and I’m not so sure it was for Dad. It gave him a fresh start and there’s not many people who are capable of having that in life. He was able to wipe the slate clean, and he took advantage of that. He started again as a good person.”
* * *
It’s not often that we take the time to consider our personality, who we are and how we make our choices. Perhaps it’s because we tend to think our personalities are innate, that they are what they are. I can’t help wondering whether knowing more about the mechanisms that help to build them could help us navigate life a little more successfully. Perhaps even make us all a little happier.
In 2007, a team lead by Anita Woolley answered part of this question. She started by giving almost 2,500 people a questionnaire that assessed their ability to think about the properties of objects or their spatial location—a method that allowed her to figure out whether they were “top-brainers” or “bottom-brainers.” For example, participants were asked to recount what someone had been wearing at a recent dinner party—an answer that is accomplished primarily using the bottom brain, which stores visual memories of color and shapes. They were also asked questions that involved spatial manipulation, such as imagining how the Statue of Liberty might look if rotated. This spatial imagery is accomplished primarily by the top brain. Woolley’s team then chose 200 people who scored highly in the top-brain tasks but low in the bottom-brain tasks, or vice versa.
Next, they split the group into pairs and asked them to navigate a virtual maze. At various sections of the maze were little greebles. Greebles are computer-generated objects that don’t obviously resemble anything in real life. Sometimes a particular greeble would pop up twice in different parts of the maze.
One of the pair had to navigate the maze using a joystick; the other was tasked with tagging duplicated greebles of the same shape. Unbeknown to the volunteers, each was given a role that suited their strengths or deliberately went against them. So in some trials a person who was great at using their spatial top brain would be asked to navigate, and their partner—a bottom-brainer who was good at object recognition—would tag greebles. In the opposite condition their roles were reversed. In a final set of experiments, both people in the pair were top- or bottom-brainers.
As you might expect, when the roles were suited to their brains the teams performed best. But here’s the rub: this occurred only when the task was completed in silence. In trials where the pairs were allowed to talk to each other, the incompatible teams suddenly did as well as those who were naturally suited to their tasks.9 When the researchers watched back the trials, they discovered that each person quickly took over the other’s role, helping them to achieve their assignment. In other words, complete strangers had spontaneously discovered their strengths and weaknesses and modified their behavior to get a job done.
Funnily enough, when two people who were both top-brainers or both bottom-brainers were allowed to talk, their results suffered more than when they worked in silence. Two people with the same abilities, trying to help each other with something neither was good at, just made matters worse.
What this experiment suggests is that it’s useful to know what kind of personality traits we possess, whether it’s using the Big Five or Kosslyn’s top-brain and bottom-brain modes. With that knowledge, we can be more productive both at work and at home. While none of us would want to experience a personality change as dramatic as Tommy’s, we may want to tweak our personalities every now and then to suit a particular challenge better.
For instance, if you come across a problem that you can’t solve, try thinking about it using the kind of strategy that doesn’t come easily to you. “It takes more effort to think in a different mode,” says Kosslyn, “but anyone can drop into any mode if you really try.”
Or, like the people in Woolley’s experiment, you could augment your skills and knowledge by working with people who have the skills that you lack. It’s as if you’ve borrowed a part of your companion’s brain, says Kosslyn, and by doing so have extended your own reach and capacities.
When I returned home from Shillo’s, I took Kosslyn’s online test to see what part of my brain dictated my life. It suggested that I have a strong tendency to rely on my top brain, and a lesser tendency to rely on my bottom brain. It rang true—I thoroughly enjoy making plans and carrying them out, but I am often too quick to pass over the finer details. My husband is the complete opposite, he is strongly bottom-brain biased—he’s very good at thinking about the details, but shies away from using them to initiate any plans. That particular trait used to frustrate me. But now I’m starting to see our relative skills and deficiencies in a different light. Together our personalities make the perfect team.
* * *
In September 2012, a few months after our final correspondence, and more than a year before I would come to meet his daughter, Tommy died of liver disease. When I heard of his death, I reread all of our conversations, emails and letters. The last email I ever received seemed a good place to start:
You have a new message from Tommymchugh2:
I look at my reflection in the mirror Helen. A stranger I see. But a happy one, xxxx to all.
Sylvia
An Endless Hallucination
Avinash Aujayeb was alone, trekking across a vast white glacier in the Karakoram, a mountain range on the edge of the Himalayan plateau known as the roof of the world. Earlier that morning he had left his two companions after feeling too exhausted to finish the journey to the summit. Faced with no option but to head back to camp, he set off down the mountain. He had been walking for hours, yet his silent surroundings gave little hint that he was making progress.
Suddenly, everything changed. A gigantic icy boulder loomed close one moment then far away the next. He glanced from left to right but couldn’t shake the feeling that he was looking at the world over his own shoulder. Concentrating on placing one foot in front of the other, he set himself small goals of reaching the next ridge or rocky outcrop. It seemed to take an hour to get from one ch
eckpoint to the next, yet when he looked at his watch, only minutes had passed.
As a doctor, Aujayeb made a mental checklist. He wasn’t dehydrated, nor did he have altitude sickness. He checked his heart rate and blood pressure—they were completely normal. So why couldn’t he shake the notion that he was dead?
Aujayeb was experiencing a vivid and prolonged hallucination, something that before 1838 was simply referred to as “a wandering mind.” It was the French psychiatrist Jean-Étienne Esquirol who first characterized a hallucination when he described it as something experienced by someone who “has a thorough conviction of the perception of a sensation, when a non-external object, suited to excite this sensation, has impressed upon his senses.”1 Or in other words, who saw something that wasn’t really there.
Hallucinations aren’t limited to images; they can appear as music, voices and even smells. They can last for seconds or for months, and are likely to have shaped our culture, religion and societies for centuries. In his book Hallucinations, Oliver Sacks wonders whether Lilliputian hallucinations, in which objects, people or animals seem smaller than they should be in real life, may have given rise to the elves, imps and leprechauns in our folklore. He suggests that terrifying hallucinations of a malign presence may have sparked the idea of demons, and that out-of-body hallucinations or hearing voices may have generated our sense of the divine.2
In the past, particularly in Western cultures, there has been a tendency to view hallucinations as a sign of mental malfunction. Yet in recent years episodes like those experienced by Aujayeb have forced scientists to rethink their ideas of hallucinations as purely a symptom of mental illness or the result of mind-altering drugs. They have begun to realize that hallucinations are neither uncommon nor always a sign of ill health.
One person who knows a great deal about this is Sylvia, a retired math teacher from north London. Despite being incredibly sharp, with excellent mental health, Sylvia has experienced a permanent hallucination every day of her life for the past decade. One morning in midwinter I went to meet her to find out more about this strange phenomenon. In learning more about her life, I came across the most startling discovery of my journey so far. I found that hallucinations are not only common, but vital to producing our perception of reality. So vital, in fact, that you’re probably hallucinating right now.3
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