The Anosognosic’s Dilemma: Something’s Wrong but You’ll Never Know What It Is (Part 2)

Dr. Babinski (Courtesy of the Clendening History of Medicine Library, University of Kansas Medical Center)

By ERROL MORRIS
NYT

(This is the second part of a five-part series.)

2. The Illness Of Doubt: Everyone Poisons Himself in His Own Way

June 11, 1914. In a brief communication presented to the Neurological Society of Paris, Joseph Babinski (1857-1932), a prominent French-Polish neurologist, former student of Charcot and contemporary of Freud, described two patients with “left severe hemiplegia” – a complete paralysis of the left side of the body – left side of the face, left side of the trunk, left leg, left foot. Plus, an extraordinary detail. These patients didn’t know they were paralyzed. To describe their condition, Babinski coined the term anosognosia – taken from the Greek agnosia, lack of knowledge, and nosos, disease. [13]

I want to draw attention to a mental disorder that I had the opportunity to observe in cerebral hemiplegia, which consists in the fact that patients seem unaware of or ignore the existence of their paralysis . . . .

One such patient . . . hit by left hemiplegia has largely maintained her intellectual and affective faculties, for many months. She remembered past events well, was willing to talk, expressed herself correctly, her ideas were sensible; she was interested in persons known to her and asked about new people . . . No hallucinations, delirium, confusional state, confabulation. What did contrast with the apparent preservation of intelligence of this patient was that she seemed to ignore the existence of a nearly complete hemiplegia, which she had been afraid of for many years. Never did she complain about it; never did she even allude to it. If she was asked to move her right arm, she immediately executed the command. If she was asked to move the left one, she stayed still, silent, and behaved as if the question had been put to somebody else.

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