Epilepsy in literature

Aspects of epilepsy in fiction

01. To experience, and live with epilepsy in fiction

Living with epilepsy often leads to restrictions which have been depicted with empathy by various writers.

In "The Bachelors" by Muriel SPARK, a naturally sociable young man with epilepsy gradually develops into a loner. His friends deal with him with increasing embarrassment and perplexity, and a love affair fails when his girl becomes too patronizing.

Disregarding the risks inherent in seizures may be dangerous even in fiction. The epileptic main character in Mordecai RICHLER'S "The Apprenticeship of Duddy Kravitz" suffers a car accident caused by a seizure, and becomes paraplegic. A fore-runner of the self-help movement, he single-handed starts a small journal for people with epilepsy. Death by drowning in a seizure occurs in Bernard MAC LAVERTY'S "Lamb", and in Susan HILL, "A Bit of Singing and Dancing".

To see another person having a seizure may come as a shock to a character with epilepsy (SPARK, "The Bachelors") but it may also be enlightening for somebody who has no own recall of his seizures (Mary Jo PUTNEY, "Dearly Beloved").

Internal and subjective aspects of seizures are described by DOSTOYEVSKY, and by
- Ernesto DALGAS, "Lidelsens vej" (Denmark)
- Margiad EVANS, "A Ray of Darkness"
- Janet FRAME, "Owls Do Cry"
- Thom JONES, "The Pugilist at Rest", "The Black Lights", "A White
Horse"
- Thomas PYNCHON, "The Crying of Lot 49" and "Gravity's Rainbow"
- Rosita STEENBEEK, "De laatste vrouw" (Netherlands)
- Alfred TENNYSON, "The Princess"
and, in a very special variant, in the phantastic novel "Die andere Seite" ("The Other Side") by Austrian Alfred KUBIN, where a whole population (the population of a dream?) experiences the epileptic fits of their ruler.
As far as it is known, these writers all have intimate knowledge of seizures either from their own experience or that of a person close to them.

Some of the characters in these books reflect in some detail upon the epileptic experience, as also happens in
- Susan HAWTHORNE, "The Falling Woman"
- Connie PALMEN, "De Wetten" (Netherlands)
- Mary Jo PUTNEY, "Dearly Beloved" (The epileptic father).

An interesting case is Norvegian writer Tryggve ANDERSEN who in his novel "Mot kvæld" ("Towards Evening", 1900) drew upon complex own experiences including visual hallucinations which only years later were diagnosed as epileptic.


02. Images of seizures

Descriptions of seizures are often found in literature. They are everything from vague and schematic to precise and detailed. Some are sober and objective and others, exaggerated and appalling.

Some descriptions clearly reflect the authors' imaginations about what an epileptic seizure probably looks like, and not all writers have been so lucky as to get close to reality. Those who failed most include
- Raymond CHANDLER, "The Big Sleep"
- Ingeborg DREWITZ, "Eingeschlossen" (Germany, where, like in Ken KESEY'S "Cuckoo's Nest" a diagnosis of epilepsy is sufficient reason for long-term admission to a closed psychiatric ward)
- Brigitte KRONACHER, "Das Taschentuch" (Germany)
- Wolfdietrich SCHNURRE, "Die Verbündeten" (Germany)
- Hilde SPIEL, "Das kleine Weh" (Austria)

The exaggerated description of a seizure happening in the street in "The Bachelors" by Muriel SPARK is in fact based on an authentic fortuitous observation by the author which became the starting-point for the novel. This may remind us of the old medical experience that chance observers of an epileptic seizure often experience it as much more dramatic than it is, and overestimate its duration.

How a grand mal seizure impresses unprepared observers is perhaps best described by Siri HUSTVEDT in "The Blindfold". Another example is Dannie ABSE, "Ash on a Young Man's Sleeve".

Good examples of realistic seizure descriptions which may be based upon observation or thorough investigation can be found in
- (ANONYMOUS) "Ching Ping Mei" (febrile convulsions)
- Wilkie COLLINS, "Poor Miss Finch" (versive evolving to
generalized tonic-clonic seizure)
- Hubert FICHTE, "Das Waisenhaus" (Germany, self-induced
photosensitive seizures)
- Thom JONES, "Dynamite Hands" (left temporal lobe seizure with
oral automatisms)

Histrionic descriptions of epileptic seizures were given by Karl IMMERMANN in "Die Epigonen" (Germany, 1823), and Mario VARGAS LLOSA in "La tia Julia y el escribidor" (Peru, 1977).

Pseudoepileptic seizures are described in
- Isabel ALLENDE, "De amor y sombra" (Chile)
- Thomas MANN, "Bekenntnisse des Hochstaplers Felix Krull"









03. Variability of epilepsy in fiction

In the public, epilepy is often used as a synonym for the generalized tonic-clonic (Grand mal) seizure. Fiction conveys a much more differentiated view including milder seizure types, benign courses of epilepsy and successful treatments. Sometimes, specific causes of epilepsy are mentioned.
In particular, post-traumatic epilepsy is well-known to literature, and found in the following books
- Agatha CHRISTIE, "The ABC Murders"
- Wilkie COLLINS, "Poor Miss Finch"
- Catherine COOKSON, "The Gillyvors"
- Patricia CORNWELL, "From Potter's Field"
- Michael CRICHTON,"The Terminal Man"
- Tony FENNELLY, "The Closet Hanging"
- Thom JONES, "The Pugilist at Rest. Stories"
- Ulla LACHAUER, "Paradiesstraße" (Germany)
The seizures in the autobiographical novel "De laatste vrouw" by Dutch writer Rosita STEENBEEK were caused by intracerebral bleeding. They start with a visual aura in the anopic hemifield.
Febrile convulsions appear in various works such as
- Wilkie COLLINS, "Jezebel's Daughter"
- Thomas MANN, "Buddenbrooks"
- Anna WIMSCHNEIDER, "Herbstmilch" (Germany)
Severe and lethal cases of febrile convulsion are to be found in "Niels Lyhne" by Jens Peter JACOBSEN (Denmark) and the anonymous medieval Chinese novel "CHIN P'ING MEI".
Prolonged epileptic twilight states are important features in
- George ELIOT, "Silas Marner"
- Tony FENNELLY, "The Closet Hanging"
- Thom JONES, "A White Horse" (In: "The Pugilist at Rest)
- Edgar Allan POE, "Berenice"
- Richard POLLAK, "The Episode" (probably autobiographic)
Absences are mentioned in
- Margaret ATWOOD, "Life before Man"
- Poul ØRUM, "Lyksalighedens ø" (Denmark)
- Kurt VONNEGUT "Hocus Pocus"
Photosensitive seizures are described in
- Michael CRICHTON, "The Andromeda Strain"
- Hubert FICHTE, "Das Waisenhaus" (Germany)
Highly interesting self-accounts of epileptic auras are given by DOSTOYEVSKY and by Margiad EVANS in "A Ray of Darkness"
Hungarian writer Frigyes KARINTHY, in "Utazás a koponyám körül" ("Travel around my head", 1937) knows that differences are made between various types of epilepsy, and that Jacksonian epilepsy is sometimes operable; he sees a film showing Harvey Cushing performing such an operation.
Purposeful acting and other pseudoepileptic seizures are well-known in literature, and mentioned in
- Isabel ALLENDE, "De amor y sombra" ("Of Love and Shadow")
- Thom JONES, "Silhouettes" (in: "The Pugilist at Rest")
- Ismail KADARé, "The Bridge with Three Arches" (Albanian)
- Thomas MANN, "Bekenntnisse des Hochstaplers Felix Krull"
- Georges SIMENON, "Maigret et les témoins récalcitrants"
- XENOPHON OF EPHESOS, "Abrokomes and Anthia, the Lovers of
Ephesos" (hellenistic trivial novel)
04. Psychoreactive epileptic seizures

The precipitation of epileptic seizures by psychical stress, anger, disappointment etc. is the most common stereotyped belief on epilepsy to be found in fiction. Some typical examples comprise

- Seizure precipitation by erotic arousal and sexual intercourse
- Andreas BURNIER, "Een tevreden lach" (Dutch)
- Ernesto DALGAS, "Lidelsens Vej" (Danish, autobiographic)
- Ken KESEY, "One Flew Over the Cuckoo's Nest"
- Elsa MORANTE, "La Storia" (Italy)

- Seizure precipitation by extreme emotional excitement
- Roger CAILLOIS, "Ponce Pilate" (France)
- Charles DICKENS, "Oliver Twist" (also by startle)
- Jean D'ORMESSON, "Histoire du juif errant" (France)
- Fyodor M. DOSTOYEVSKY, "The Idiot", "The Young Wife", "The
Brothers Karamazov", "Crime and Punishment"

- Seizure precipitation by conflicts
- Wilkie COLLINS, "The Dead Secret"
- Catherine COOKSON, "The Gillyvors"

  • Susan HOWATCH, "The Rich are Different"


05. Prejudices about epilepsy in fiction

Literary writers are not always free from the widespread prejudices about epilepsy. When they uncritically use them in their work, they may reinforce them, and one best-seller which spreads wrong ideas about epilepsy to a large readership could destroy the effects of many information campaigns.

Examples are found of the
- prejudice of violence in
- Raymond CHANDLER, "The Big Sleep"
- Michael CRICHTON, "The Terminal Man" (which provoked many
counter-reactions)
- Doris GRUMBACH, "Chamber Music"
- prejudice of unfitness for marriage in
- Catherine COOKSON, "The Gillyvors" (where it is refuted)
- Rosamunde PILCHER, "The Shell Seekers"
- Hilde SPIEL, "Das kleine Weh" (Austria)
- Barbara WOOD, "Green City in the Sun"
- prejudice of the epileptic personality (even preceding the seizu- res) in
- Joan AIKEN, "The Weeping Ash"
- Thom JONES, "The Pugilist at Rest"

More often, however, works of fiction critically describe characters with epilepsy who suffer under the prejudices of their fellows, even following a single seizure. Good examples of this are
- Agatha CHRISTIE, "The ABC Murders"
- Hubert FICHTE, "Das Waisenhaus" (Germany)
- Susan HOWATCH, "The Rich Are Different"
- Rona JAFFE, "Class Reunion" and "After the Reunion"
- Siegfried LENZ, "Deutschstunde" (Germany)
- Wolfdietrich SCHNURRE, "Die Verbündeten" (Germany)
(The three German titles all describe the dangerous turn these prejudices took under the Nazist rule).

Some epileptic characters in books anticipate the prejudices, and retreat spontaneously. This happens for example in
- Michael CRICHTON, "The Andromeda Strain"
- Susan HOWATCH, "The Rich Are Different"
- Terry MCMILLAN, "Disappearing Acts" (where the person's friends,
however, are quite upset that she should have expected them to
be influenced in their relations to her by prejudices)
- Rosamunde PILCHER, "The Shell Seekers"
A very touching example of a person hiding because of his epilepsy is a young boy in Primo LEVI'S account of the liberation from Hitler's concentration camp, subsequent seclusion in a camp of Stalin's, and final transport back to Italy, "La tregua". The boy appears on the train out of nowhere, and moves to another wagon after each seizure. It remains a puzzle how he has managed to survive.

Raymond QUENEAU, in "Le dimanche de la vie" (France), turns against prejudices and opposes them with the sympathy and solidarity of other characters. These are also the prevailing attitudes of the neighbours in George ELIOT'S "Silas Marner" and, indeed, quite a few other literary works.


06. Epilepsy and prophecy, epilepsy as the "sacred disease"

Many cultures and periods have related epilepsy with shamanism, clairvoyance and prophecy.

Albanian Ismail KADARé'S novel "The bridge with three arches" takes place in the 14th century. A political agent under disguise as a travelling visionary introduces himself by acting an epileptic seizure as a kind of credential of his prophetic powers.

In Tahar BEN JELLOUN'S "L'enfant de sable" and "La nuit sacrée" (Maroc), epileptic Fatima is the only one who intuitively understands the secret that her "cousin Ahmed" is really a woman. Her seizures are understood as a visitation by demons - like in the epileptic boy in the Gospels.

Judas Ischariotes in "Ponce Pilate" by Roger CAILLOIS (France) consciously accepts the role of the traitor to enable Jesus' necessary martyrdom. "Possessed by demons", he has a big scene with Pilate which ends in his breaking down in an epileptic seizure.

Similarly, in Salman RUSHDIE'S "Midnight's Children", the prophecy of the central character's life by a dubious future-teller in Delhi finishes in this person's having an epileptic seizure, whereas the false prophetess Ayesha in "Satanic Verses" is "possessed by the demon of epilepsy". This has been seen as a reference to conjectures that Mohammed, the Prophet, could have had epilepsy.

For the theologians of various religions in Wilton BARNHARDT in "Gospel" there is no doubt that both Mohammed and Saint Paul were epileptic.

DOSTOYEVSKY compared his own mystic-religious aura experience to a vision of Mohammed. His epileptic character Prince Myshkin in "The Idiot" was conceived as a Jesus figure.

The epileptic boy Useppe in "La storia" by Elsa MORANTE is typologically an example of the "god-child" or child Jesus, and the child born in Phyllis Dorothy JAMES' "The Children of Men" with the auspices of being the redemptor of the human race is the son of a father with epilepsy and a mother with a physical handicap.

Two modern versions of the Iliad comprise characters with epilepsy: a brother of Kassandra who shares her prophetic abilities in "Elena, Elena, amore mio" by Luciano DE CRESCENZO (Italy), and in "Firebrand" by Marion ZIMMER BRADLEY, an Apollo priest who is punished with "the falling sickness" for an attempt to seduce Kassandra wearing the mask of the god.

Epilepsy inflicted as a punishment by God is an aspect of the "sacred disease" which is also found in DICKENS' "Oliver Twist".


07. Epilepsy as an hereditary disease

Opinion investigations reveal that epilepsy is frequently believed to be an hereditary disease whereas, in reality, epilepsy genes transfer a risk rather than a disease, and only a minority of patients have close relatives with seizures.

In literature, this aspect is repeatedly encountered as in the following examples.

Susan HOWATCH, "The rich are different": multiple affected persons in a family.
Mary Jo PUTNEY, "Dearly Beloved": a father and his son born out of wedlock develop a relation through the epilepsy they both suffer from.
Elsa MORANTE, "La storia" (Italy): a mother and her two sons, central characters of the novel, all have seizures.
Thomas BERNHARDT, "Amras" (Austria): a mother and son with epilepsy.
Phyllis Dorothy JAMES, "The Children of Men": when humanity is about to be extinct by ubiquitous sterility, a person who had epilepsy as a young man belongs to those who are excluded from the regular tests for recurring fertility. (Eventually he will beget the first child born again).
In "Paradiesstraße" ("Paradise Street") the oral autobiography of East Prussian farmer Lena Grigoleit, recorded and edited by Ulla LACHAUER, Mrs. Grigoleit meets in Stalinist banishment to Siberia the very helpful and caring family of an Estonian protestant minister where the mother and both children have epilepsy. (Her own daughter later develops posttraumatic epilepsy).
08. Epilepsy as destiny and as a challenge

Disease and disability as an affliction and destiny is an archetypal motive of narrative. This aspect can also been followed throughout the history of epilepsy in literature:

There are ancient legends of healing like in the gospels which can be mentioned along with the modern legendary tales of George ELIOT ("Silas Marner") and Joseph ROTH ("Hiob", Austria), and with epilepsy as a prototype of infirmity and mendicancy (ANONYMOUS, French 13 th century, "Aucassin et Nicolette", but still found in newer (Rimbaud's poems "Les Assis" and "Les Pauvres à l'Église") and newest literature (Don DELILLO, "The Angel Esmeralda", USA 1995; Jean D'ORMESSON, "Histoire du Juif errant", France 1990; Richard FORD, "Independence day", USA 1995; Margriet DE MOOR, "De virtuoos", Netherlands 1993).

Fatalistic attitudes towards epilepsy are conveyed in João GUIMARãES ROSA "Grande Sertão" (Brazil), Bernard MACLAVERTY, "Lamb", Elsa MORANTE, "La storia", Mervin PEAKE, "Titus Groan", Rosamunde PILCHER, "The Shell Seekers", George SAND, "La mare au diable", Georges SIMENON, "Le haut mal", Hilde SPIEL, "Das kleine Weh" (Austria).

Being afflicted by a grave disease like epilepsy can raise the question "Why?", especially when the affected one is a child (Elsa MORANTE, "La storia" (Italy), Mary Jo PUTNEY, "Dearly Beloved").

The reaction of a parent or other responsible person "I will take you to the best doctors available to get you a cure" (Tahar BEN JELLOUN, "L'enfant de sable"; Barbara WOOD, "Green City in the Sun") may turn out to be a mere exclamation of concern rather than a serious resolution.

Against this background, characters who take up the challenge and struggle against the disease instead of fatalistically accepting it, may appear as heroes of everyday life. Apart from books reflecting autobiographic experience (DOSTOYEVSKY, Margiad EVANS, probably Thom JONES, Kenzaburo OE, Richard POLLAK) such examples are found e.g. in Janet FRAME, "Owls Do Cry", Susan HOWATCH, "The Rich Are Different", Ulla LACHAUER, "Paradiesstraße" (Germany), Mary Jo PUTNEY, "Dearly Beloved", and Mordecai RICHLER, "The Apprenticeship of Duddy Krawitz").



09. Images of doctors in fiction treating epilepsy

In older literature, the doctor is the obvious authority in all matters of health and hygiene, illness and death. He is part of the life sphere of the patients, and this situation remains unquestioned even if there is reason for some caricature.

George Eliot, Silas Marner (1861), when the villagers suggest
smoking a pipe as a remedy for Marner's seizures: "This advice
was sanctioned by Dr. Kimble, on the ground that it was as well to try what could do no harm - a principle which was made to answer for a great deal of work in that gentleman´s medical
practice."

For the doctor in the 19 th century, however, it is more common to be competent and caring .

Wilkie Collins, Poor Miss Finch (1872): "Before I could speak,
he was in convulsions on the floor at his doctor's feet. ´Good
God, what is this!' I cried out. The doctor loosened his cravat, and moved away the furniture that was near him. That done, he waited - looking at the writhing figure on the floor. 'Can you do nothing more?' I asked. He shook his head gravely. ´Nothing more.' - 'What is it?' - 'An epileptic fit.'"

In the same period, however, doctors in Dostoyevsky's novels can display cold materialism as in "The Brothers Karamasov" (1879) where the physician finds Smerdyakov's mortal status epilepticus in the first place a beautiful scientific observation. The counterpart is the idealist Prof. Schneider in "The Idiot" (1868) who treats the impoverished Prince Myshkin for nothing, and even feeds him and pays his travel back to Russia. But the figures of this author are complex, and Prof. Schneider also takes the Prince as an onlooker to an execution by the Guillotine, a memory which haunts his dreams.

In modern times, doctors in literature seem to have much more become specialists with a specific and restricted rôle in the complexity of life. They are at the same time more powerful than before, in consequence of the great possibilities of modern medicine, and more open to criticism if they fail to fulfil the great expectations with which they are met. Often, they are busy and inaccessible. They frequently remain nameless. Modern doctors may have quite egotistic aims when they talk with a patient:

Thom Jones, The Pugilist at Rest (1991): "My sister brought a
neurosurgeon over to my place - not some V.A. butcher but a guy from the university hospital. He was a slick dude in a nine- hundred-dollar suit. He came down on me hard, like a used-car salesman. He wants to cauterize a small spot in a nerve bundle in my brain. That's why he made a personal visit to my place. A house call. Drumming up some action to make himself a name."

This, however, is not the image of the doctor for this author (who could very well have epilepsy himself). He presents us with many other varieties. One of them is very much remembered as the good old house doctor by a patient during his recovery from an ictal fugue:

Thom Jones, The White Horse: "He quite clearly remembered the
voice of his doctor, the large, high-ceilinged consulting room
... a statue on the doctor's desk. ... He did know that the man had been more than a doctor to him - he had been a good friend as well, a man whom <he> loved very much."

Australian writer Susan Hawthorne is another author who writes out of her own experience. Her image of a neurologist in "The Falling Woman" (1992) is "a composite picture of several who ranged from v. good + personable to v. good + difficult to relate to. ... I had no worries about their skill; it was only in the area of personal contact, question answering where they lacked some of the basics" (pers. comm.).
Her character Stella criticizes her doctor during the ward round, and he tells her not to upset herself. She answers:

"I'm not upset. I'm angry. And for good reason. It's been an
utter waste of time being here. You don't know anything more
about me. If you listened to me you'd find out more than by
disrupting my life, drawing up charts and making me have
unnecessary chest x-rays."

Richard Pollak , an American writer who also has disclosed that he has epilepsy, compares in his detective novel "The Episode" (1986) two neurologists in a very similar way. The first remains distant when his patient phones him deeply shocked by the reappearance, after many years, of a seizure. He only gives some advice over the phone. This makes him lose his patient when the latter finds a lady neurologist who takes good time to explain him much about epilepsy which he didn't know before. It also turns out that his first neurologist lacked in competence as in his treatment he had failed to take care of the patient's on-going absences.

The most colourful picture of a doctor treating patients with epilepsy is given by Penelope Farmer in her novel "Snakes and Ladders" (1993) which draws from her experiences with an epilepsy project in developing countries in which she was involved. This man is a Bengali who practices in rural Pakistan and gets patients from all over the country.

"He's charismatic, he has brilliant eyes, very big, and wears a brilliantly coloured Filipino shirt. In fact that's what he looked like, a Filipino healer, a dead ringer - one of those guys who pull chicken blood out of your stomach. You could just see this guy at it, I tell you. But in fact he specialises in epilepsy. .. The fact is, he said, epilepsy is easy for me to treat in these conditions. I bring in fifteen men at once and I ask them questions. And I'm supposed to know within two minutes what's the matter with them, without even touching them, just looking into their eyes and seeing their souls. To diagnose epilepsy straight off, you don't need an examination. If you know how to take a history of a seizure all you need to do is work it out."
He does not try to dissuade the patients from their belief that epilepsy is caused by evil spirits because he knows they would not believe him. He says: "If you take your pills twice a day, the evil spirits will leave you alone." Because "how can you treat a patient if you don't know what he thinks caused his disease, whatever it is?"





10. Treatment of epilepsy

To-day, epilepsy is usually seen as a disorder which is treated with drugs and, in some cases, brain surgery. Antiepileptic drug treatment has become quite rational, with well-titrated, serum-level controlled monotherapy as the gold standard. The patients need to be well-informed to take their necessary share in the responsibility.
There is just one work of fiction which gets this across, and even compares expert and less expert therapy (Richard POLLAK, "The Episode", with autobigraphic knowledge and the intention to inform).
Otherwise, epilepsy therapy in fiction looks very different from this.

In the older literature (e.g. Johann Gottlieb SCHUMMEL, "Empfindsame Reisen durch Deutschland", 1772; Karl IMMERMANN, "Die Epigonen", 1823/35), non-pharmaceutical treatments can be found. A passage in the CHIN PING MEI suggests that the antiepileptic effect of arousal stimuli may have been known to medieval Chinese doctors.

To counteract and arrest a commencing seizure by mental concentration is a possibility mentioned in "Dearly Beloved" by Mary Jo PUTNEY who had heard about it from an acquaintance with epilepsy.

"Prayer and fasting" is supposed to expel the demons of epilepsy according to the Gospel of ST. MARK. In Bavaria in 19.., the nuns in charge of an orphanage still send a child with epilepsy to a wise woman for prayers (Hubert FICHTE, "Das Waisenhaus").

DOSTOYEVSKY'S Prince Myshkin in "The Idiot" returns greatly improved from Switzerland and a treatment based on cold water, gymnastics, and education.

Silver nitrate, a common treatment in the 19 th century, cures the seizures in "Poor Miss Finch" by Wilkie COLLINS. In two modern novels taking place in the 1920ies (Barbara WOOD, "Green City in the Sun", and Janet FRAME, "Owls Do Cry"), bromide is the only known drug. Quite opposite, the epileptic character in Catherine COOKSON, "The Gillyvors" is, in 1883, treated with a new drug which does not prevent but alleviate the seizures. The drugs most used in fiction are still phenytoin and phenobarbital, often in combination. Treatment with Phenytoin becomes a clue in Patricia CORNWELL'S mystery "From Potter's Field".

Janet FRAME knows that drugs may help provided they are taken. This unfortunately cannot be said of, amongst others, Rona JAFFE, Terry MCMILLAN and Susan HOWATCH. There are other authors who at least know that epilepsy is a treatable disorder (Raymond CHANDLER), and that drugs may have some importance whereas their withdrawal may cause seizures. (Tony FENNELLY in "The Closet Hanging"; Bernard MACLAVERTY)

For quite some characters in fiction it is obvious that drugs are there in order to be thrown away (Andreas BURNIER, Janet FRAME in "To the Is-Land", autobiographic, Ken KESEY). Others take them or not according to how they just feel (Rona JAFFE, Susan HOWATCH Terry MCMILLAN), or they forget to have their prescription renewed (Rosita STEENBEEK).

Fear of side effects is sometimes mentioned (e.g. Thom JONES, Elsa MORANTE), and Connie PALMEN has her epileptic character in "De Wetten" ("The Laws") give a subtle account of the side effects of the drugs which he gratefully takes because they control his seizures.

Absurd ideas about how drugs in development are tested can be found in Muriel SPARK'S "The Bachelors" and Günter WALLRAFF'S "Ganz unten" (Germany) whereas a large comparative study of two antiepileptic drugs features prominently in Penelope FARMER'S "Snakes and Ladders", and is based on the author's authentic experiences with such a project.

Brain surgery is proposed to the hero in "The Pugilist at Rest" by Thom JONES, but unfortunately surgery for seizures somehow gets mixed up here with psychosurgery. This is in contrast to Hungarian writer Frigyes KARINTHY who in "Travel Around My Head" (1937, the history of his own operation for a cerebellar tumour) knows that Jacksonian epilepsy may be operable and reports that he has seen a film showing Harvey Cushing performing such an operation.

In Michael CRICHTON'S science fiction thriller "The Terminal Man" a new treatment is developed which consists in implanting into the brain a computer/stimulator which detects commencing seizure activity and interrupts it by a stimulus. However, an unforeseen reinforcement loop develops, and the results are dreadful.

A more appropriate view of epilepsy surgery can be found in a poem by Suzanne YANKO, an Australian lady who has undergone successful epilepsy surgery:



To Max

For some, the left. Yours - right.
... and mine.

The sharp steel shapes strong links,
Through healing hands so fine.

The brain was cut - but not the heart,
And so we two were moved to play our part:

Your dancer's body sun-burst through chill wards;
Sparked laughter carried on a gusty breeze;
My hands - like silk, you said - shook loose the words,
To tell of life renewed; a hope to hold
and ease
their dark-pained nights.

Now you have left. Go well then, all is right.

(from Sue Goss (Ed.): Epilepsy. I can live with that. Writings by people with epilepsy.)

11. Epilepsy in the detective story

Some people during an epileptic seizure or twilight state can perform rather complex acts for which later they have no recall. This opens possibilities for the detective story.

The solution of the riddle in Raymond CHANDLER'S "The Big Sleep" consists in a young woman's having shot, in a psychomotor seizure, her brother-in-law who had not responded to her erotic approaches. The story clearly reveals the fundamental technical weakness of this kind of plot: as soon as the epilepsy becomes known, the clue is too obvious, but it is bad sport if a pivotal clue remains completely hidden to the end. In "The Big Sleep", in addition, conscious revengefulness and unconscious murder get mixed up, and the epilepsy history is, on the whole, unconvincing.

In "Kun sandheden" ("Only the Truth") by Danish writer Poul ØRUM, the plot is more refined, and subtle doubts are cast on the provided solution that the leading lady character whose husband disposed of the body committed the murder during a period for which she has no recall - a "petit mal" seizure? But the seizures may be psychogenic, and she may feign the loss of memory to cover over for somebody else.

It is, however, interesting that characters with epilepsy in detective stories much more frequently appear as victims. This may occur in the way that suspicion is deliberately cast upon them, as happens in
- Agatha CHRISTIE, "The ABC Murders"
- Tony FENNELLY, "The Closet Hanging"
- Richard POLLAK, "The Episode"
Beyond the detective story, a theft is similarly fixed upon Silas Marner in George ELIOT'S novel, during one of his fugues.

But the person with epilepsy, defenseless in a seizure or in some way dependent from the murderer in consequence of epilepsy, may also become the direct victim of criminal assault. This happens in
- Patricia CORNWELL, "From Potter's Field"
- Tony FENNELLY, "Kiss Yourself Goodbye"
- Georges SIMENON, "Le haut mal"
Again, this motive remained not restricted to the detective story but appears for example in Bernard MAC LAVERTY'S master story "Lamb" where an epileptic boy is drowned during a provoked seizure as an act of misunderstood love.

Sudden unexplained death in an epileptic seizures provides a corpse which comes in handy in Agatha CHRISTIE'S "The Murder on the Links". She thinks of the same reason for death in "Nemesis".

The most commonplace reason to have a character with epilepsy in a mystery is found in "Maigret et les témoins récalcitrants" by Georges SIMENON, where he needed a reason for a male adult not to have a driver's licence.



12. Epilepsy in children's books

Children's books are often written with pedagogic intentions, at least as a side purpose. A well-written story may be an important source of information for a child, and children's books have also been used to give children insight into handicaps as an aspect of human life.

Epilepsy is a pedagogic topic in the following children's books

- Willi FäHRMANN, "Jakob und seine Freunde" ("Jack and his Friends")
- Gerd HEINEN, "Bei Tim wird alles anders" ("Everything Changes for Tim")
- Waldtraut LEWIN, "Alles für Cäsar" ("Everything for Cesar")
- Hansjörg SCHNEBLE, "Das Eigentor oder die Geschichte vom Peter Guck-in-die-Luft" ("The Own Goal or the Story of Peter Glance-in- the-Air")
- Silke SCHROEDER and Elisabeth REUTER, "Carla. Eine Geschichte über Epilepsie" ("Carla. A Story on Epilepsy")

SCHNEBLE is a child epileptologist and HEINEN, a psychologist who works with children with epilepsy. FäHRMANN is a well-known German author of children's books who wrote "Jakob" in response to an invitation by a child epileptologist.

Two British authors who write for children, Joan AIKEN and Penelope FARMER, have published fiction with epilepsy in it, but not for children.



13. Epilepsy as an element of literary structure

Writers have many reasons why they use a certain motive in their work. This is also true for diseases in literature including epilepsy. The writer of a story may be interested in epilepsy as such, or choose to construct his plot around a character with epilepsy. He may even use epilepsy to solve a major or minor problem in the construction of a novel, shockingly unusual as this may sound to patients and epileptologists.

A selection of works having central characters with epilepsy:

- Agatha CHRISTIE, "The ABC Murders"
- Wilkie COLLINS, "Poor Miss Finch"
- Catherine COOKSON, "The Gillyvors"
- Michael CRICHTON, "The Terminal Man" (problematic !)
- Fyodor M. DOSTOYEWSKY, "The Idiot", "The Devils", "The Brothers
Karamazov"
- George ELIOT, "Silas Marner"
- Hubert FICHTE, "Das Waisenhaus" ("The Orphanage", Germany)
- Janet FRAME, "Owls Do Cry"
- Bernard MAC LAVERTY, "Lamb"
- Elsa MORANTE, "La storia" (Italy)
- Kenzaburo OE, "Quiet Days" (Japan)
- Amos OZ, "To Know A Woman" (Israel)
- Connie PALMEN, "De Wetten" ("The Laws", Netherlands)
- George SAND, "La mare au diable" (France)
- Muriel SPARK, "The Bachelors"

Seizures are an important element in the plot of

- Andreas BURNIER, "Een tevreden lach" (Netherlands)
- Raymond CHANDLER, "The Big Sleep"
- Patricia CORNWELL, "From Potter's Field"
- Michael CRICHTON, "The Andromeda Strain"
- Tony FENNELLY, "The Closet Hanging", "Kiss Yourself Goodbye"
- Susan HILL, "In the Conservatory"
- Siri HUSTVEDT, "The Blindfold"
- Thom JONES, "The Pugilist at Rest" and "Cold Snap"
- Georges SIMENON, "Le haut mal" (France)

Seizures form a minor but functional part of the plot of

- "Chin Ping Mei" (anonymous, China)
- Charles DICKENS, "Oliver Twist"
- Ken KESEY, "One Flew Over the Cuckoo's Nest"
- Thomas MANN, "The Magic Mountain" (Germany)
- Amélie NOTHOMB, "Péplum" (Belgium)
- Thornton WILDER, "The Ides of March"

Epilepsy occasionally appears as a literary metaphor or simile.

Alfred TENNYSON in "The Princess" uses the experience of derealization in a psychomotor seizure as a metaphor of an ambivalent character disposition.
For Margaret ATWOOD in "Cat's Eye", a sudden intuition of life-changing significance is comparable to be seized by an epileptic fit.
The specific structure of the epileptic aura as an announcement of an experience which is too overwhelming to be retained by memory has been called the master metaphor in Thomas PYNCHON'S novel "The Crying of Lot 49".
In "Die letzte Welt" ("The Last World") by Austrian writer Christoph RANSMAYR, a highly artistic paraphrase of Ovid's, the transformation of a boy into a stone is forecast by his suffering from the "falling sickness" which for him continuously questions the reliability of things.



14. Writers with epilepsy

The best-known author who drew from his own experience when writing about epilepsy or creating a character with seizures was DOSTOYEVSKY. But quite a few other names deserve to be mentioned in this respect.

Margiad EVANS in "A Ray of Darkness" gave a fascinating and detailed account of the biographic developments leading up to her first convulsive seizure, and of the experience of sudden lapses of consciousness and falls.

Autobiographic novels were written by Dutch Rosita STEENBEEK ("De laatste vrouw" - "The Last Woman") and by Australian Susan HAWTHORNE ("The Falling Woman"). Especially in the latter, her experiences with seizures, diagnostic procedures and doctors feature prominently.

Richard POLLAK turned his own experiences into a kind of educational book on many aspects of epilepsy, in the form of a mystery novel.

The Danish author Ernesto DALGAS who, in "Lidelsens vej" ("The Road of Suffering"), described his own experiential auras, later wrote "Dommedags bog" ("Book of the Last Judgement"), an extraordinary phantasy based on his hallucinatory experiences in a florid psychotic episode. In about the same period, Norvegian writer Tryggve ANDERSEN in his novel "Mot kvæld" ("Towards Evening", 1900) drew upon complex experiences including visual hallucinations which only years later were diagnosed as epileptic.

Thom JONES' two collections of short stories, "The Pugilist at Rest" and "Cold Snap" include much autobiographic material, and it is tempting to assume that also his accounts are autobiographic of temporal lobe seizures caused by a boxing trauma in the leading character of numerous stories.

Similar deliberations may be suggested by the unusual expertise with which an author who is very silent about his person, Thomas PYNCHON, in "The Crying of Lot 49" and in "Gravity's Rainbow" talks about subjective aspects of epileptic seizures.

Akira KUROSAWA, the famous Japanese film instructor ("Rashomon", "Kagemusha", "Ran"), in his "Something like an autobiography" mentions frequent lapses of consciousness which he was not aware of himself, and which were diagnosed as epilepsy. This seems not to have impressed him in the least.

Two prolific writers who belong to the élite of world literature, Gustave FLAUBERT and Brazilian Joaquín Maria MACHADO DE ASSIS and who are supposed to have suffered from epilepsy, never mentioned the disorder in their work. Machado, in a later edition of his most famous work "Memórias Póstumas de Brás Cubas" even replaced a side observation in the first edition "I do not say that she rolled on the floor, epileptic ..." by "... that she rolled on the floor, in convulsions". In "Quincas Borba" of 1891, however, the hero witnesses the public execution of a murderer by hanging, gives a cry and loses perception. The scene is conspicuously reminiscent of a passage in the second chapter of DOSTOYEVSKY'S "The Idiot" (1868/69) which Machado certainly knew, and where the epileptic Prince Myshkin with great emotion reports and comments the execution of a murderer which his doctor had made him attend.
Australian Sue GOSS née Cooke, author of "Ragged Owlet", a detailed account of her experiences with epilepsy, under the auspices of the Epilepsy Foundation of Victoria, has collected and edited a volume of writings of people with epilepsy, "Epilepsy. I can live with that." It comprises both plain reports, and texts of literary ambition.

« Back