The Man Who Mistook His Wife for a Hat: “The Disembodied Lady”

What Wittgenstein writes here, of epistemology, might apply to aspects of one's physiology and psychology—especially in regard to what Sherrington once called 'our secret sense, our sixth sense'—that continuous but unconscious sensory flow from the movable parts of our body (muscles, tendons, joints), by which their position and tone and motion are continually monitored and adjusted, but in a way which is hidden from us because it is automatic and unconscious.

Our other senses—the five senses—are open and obvious; but this—our hidden sense—had to be discovered, as it was, by Sherrington, in the 1890s. He named it ‘proprioception', to distinguish it from ‘exteroception' and ‘interoception', and, additionally, because of its indispensability for our sense of ourselves; for it is only by courtesy of proprioception, so to speak, that we feel our bodies as proper to us, as our ‘property', as our own.

Specifically, he wonders—and one in turn may wonder whether these thoughts were perhaps incited by his working with patients, in a hospital, in the war—he wonders whether there might be situations or conditions which take away the certainty of the body, which do give one grounds to doubt's one body, perhaps indeed to lose one's entire body in total doubt.

Christina was a strapping young woman of twenty-seven, given to hockey and riding, self-assured, robust, in body and mind.

She was admitted to hospital three days before the operation date, and placed on an antibiotic for microbial prophylaxis.

‘I can’t feel my body. I feel weird—disembodied.’

This was an amazing thing to hear, confounded, confounding.

There seemed to be a very profound, almost total, proprioceptive deficit, going from the tips of her toes to her head—the parietal lobes were working, but had nothing to work with.

There seemed to be a very profound, almost total, proprioceptive deficit, going from the tips of her toes to her head—the parietal lobes were working, but had nothing to work with.

She has no muscle or tendon or joint sense whatever. There is slight loss of other sensory modalities—to light touch, temperature, and pain, and slight involvement of the motor fibres, too.

And how, if one asked such a patient to move his legs, he was apt to say: ‘Sure, Doc, as soon as I find them.’

'What I must do then,’ she said slowly, 'is use vision, use my eyes, in every situation where I used—what do you call it?—proprioception before. I’ve already noticed,’ she added, musingly, 'that I may "lose” my arms. I think they’re one place, and I find they’re another. This "proprioception” is like the eyes of the body, the way the body sees itself. And if it goes, as it’s gone with me, it’s like the body's blind...'

She had, at first, to monitor herself by vision, looking carefully at each part of her body as it moved, using an almost painful conscientiousness and care.

That the brain’s visual model of the body, or body-image—normally rather feeble (it is, of course, absent in the blind), and normally subsidiary to the proprioceptive body-model—was it possible that this, now the proprioceptive body model was lost, was gaining, by way of compensation or substitution, an enhanced, exceptional, extraordinary force?

Normally this is subsidiary, and rather unimportant in speaking—our speech remains normal if we are deaf from a head cold, and some of the congenitally deaf may be able to acquire virtually perfect speech.

For the modulation of speech is normally proprioceptive, governed by inflowing impulses from all our vocal organs.

And soon I saw that her sitting was, indeed, a pose, consciously or automatically adopted and sustained, a sort of forced or wilful or histrionic posture, to make up for the continuing lack of any genuine, natural posture.

It was a stagey, theatrical voice—not because of any histrionism, or perversion of motive, but because there was still no natural vocal posture.

And with her face, too—this still tended to remain somewhat flat and expressionless (though her inner emotions were of full and normal intensity), due to lack of proprioceptive facial tone and posture, unless she used an artificial enhancement of expression (as patients with aphasia may adopt exaggerated emphases and inflections).

And society lacks words, and sympathy, for such states. The blind, at least, are treated with solicitude—we can imagine their state, and we treat them accordingly.

The lack of social support and sympathy is an additional trial: disabled, but with the nature of her disability not clear—she is not, after all, manifestly blind or paralysed, manifestly anything—she tends to be treated as a phoney or a fool.

For, in some sense, she is ‘pithed’, disembodied, a sort of wraith.

She has lost, with her sense of proprioception, the fundamental, organic mooring of identity—at least of that corporeal identity, or ‘body-ego’, which Freud sees as the basis of self: ‘The ego is first and foremost a body-ego.’

And there is this specific, organically based, feeling of disembodiedness, which remains as severe, and uncanny, as the day she first felt it.

There are brief, partial reprieves, when her skin is stimulated.

She goes out when she can, she loves open cars, where she can feel the wind on her body and face (superficial sensation, light touch, is only slightly impaired).

She has succeeded to an almost incredible extent in all the accommodations that will, courage, tenacity, independence and the plasticity of the senses and the nervous system will permit.

She has faced, she faces, an unprecedented situation, has battled against unimaginable difficulties and odds, and has survived as an indomitable, impressive human being.

She has faced, she faces, an unprecedented situation, has battled against unimaginable difficulties and odds, and has survived as an indomitable, impressive human being.

She is one of those unsung heroes, or heroines, of neurological affliction.