The ceiling outside The science and experience of the disrupted mind

Arikha (Passions and Tempers: A History of the Humours) explores the body and brain connection and meaning of self from the perspective of a philosopher and the grieving daughter of a person with dementia. The author details the ways several mental and neurological illnesses affect how the perception of self, time, and space can change owing to physiological and psychological differences. Arikha, not herself a clinician, sits in on clinical sessions of a neuropsychiatric unit and presents examples of various cases and conditions in which a patient has lost their sense of self. The author draws connections from each case to modern and classic neuroscience and psychology. Arikha also draws connections to her own experience as a daughter of a woman whose dementia has progressed. Where the work includes descriptions of research, medical histories, or psychological foundation, narrator Fenella Fudge is easy to understand and speaks clearly, while treating the stories of individual humans, including the author's, with sensitivity. VERDICT Approachable and humanizing, this work is made accessible by the narrator's flowing, conversational style. A worthwhile purchase.--Diana Rocha

A lucid examination of the self in crisis. For 18 months, Arikha, a philosopher and author of Passions and Tempers: A History of the Humours, attended weekly clinical meetings in the neuropsychiatry unit of the Pitié-Salpêtrière hospital in Paris, observing patients who presented difficult, sometimes bizarre, symptoms to their assembled medical team. Like neurologists Oliver Sacks and Antonio Damasio, Arikha, who calls herself a "science humanist," reflects on these patients in her investigation of overarching questions about consciousness, identity, affliction, and memory. The many cases include a woman in her 30s who could not recall 10 years of her life; a man whose personality split into two identities; an 82-year-old woman, nearly blind, experiencing visual hallucinations; a 50-something married father of five who felt haunted, hearing things and sensing invisible presences. Some symptoms were somatic: One woman's hand became "the locus for all her anxiety, fear and frustration." One man lost all feeling on his left side and then could not form new memories. Prominent among these cases was Arikha's mother, a poet and memoirist who was sinking inexorably into dementia, her memory "shunting her from place to place, as if she were ice skating blindfolded." Her mother's mind takes a central place in this wide-ranging, engaging study that encompasses philosophy, history, medicine, memoir, and science. "This book," she writes, "is about both the self as it studies itself, and the self as it loses itself"; how each of us makes our felt experiences coherent; how memory affirms our identity; and the ease with which our "planned trajectories" can rupture and plummet us into illness. "Our self in time," writes the author, "is but a thin gauze wrapped around the shifting elements we are made of." The book is also about the limits of medical and scientific knowledge to treat patients who defy categorization, to empathize with their experience, and to ameliorate their pain. A luminous, intellectually dense meditation on mind. Copyright (c) Kirkus Reviews, used with permission.