Confabulations!

This is a fun one I've been meaning to blog about for a while. Its connection with empathy will become clearer later when I'm less lazy. For now, consider this part I in a series of posts which are meant to be striking reminders of why not to judge others too harshly. Weird things are afoot in the human brain, our own included. Today we'll talk about

Anosognosia: a condition in which a person who suffers from a disability seems unaware of or denies the existence of his or her disability.

Patients with anosognosia are often otherwise rational, intelligent people. Consider the case of patients who suffer single-hemisphere strokes, causing partial paralysis--without knowledge of it:

One of the best-known victims of the condition was Supreme Court justice William O. Douglas, who suffered a right-hemisphere stroke in 1974 that paralyzed his left side and eventually forced his retirement. He initially dismissed the paralysis as a myth, and weeks later he was still inviting reporters to go on hiking expeditions with him. When one visitor asked about his left leg, he claimed that he had recently been kicking 40-yard field goals with it in the exercise room and soon planned to try out for the Washington Redskins.

Mrs. M.'s form of anosognosia is even more extreme: she not only flatly denies she is paralyzed, she refuses to admit that the limp limb on the left has anything at all to do with her. One such anosognosiac became so incensed that somebody else's leg was cluttering up his hospital bed that he heaved the thing out and was subsequently amazed to find himself on the floor. Another claimed that the arm on the left belonged to his daughter, who was trying to seduce him.

...

Neuroscientist Edoardo Bisiach at the University of Milan in Italy reported one 74-year-old stroke patient who repeatedly claimed that his left hand belonged to the doctor examining him. The doctor finally grasped the paralyzed hand between his own two and held it up to the patient's face.

"Whose hands are these?" he asked.

"Your hands," the patient replied.

"How many of them?"

"Three."

"Ever seen a man with three hands?" the doctor asked.

"A hand is the extremity of an arm," said the patient. "Since you have three arms, it follows that you must have three hands."

This would all be humorous but for the pause it should give us:

"Looking at patients like Mrs. M. can be spooky at first," says Ramachandran, a neuroscientist and physician at the University of California at San Diego, and the Salk Institute nearby. "But then you realize you're really looking at yourself, in amplified form."

It makes one wonder to what extent we all confabulate in our seemingly honest, rational lives.