The Man Who Mistook His Wife for a Hat: "Eyes Right!"

Mrs S., an intelligent woman in her sixties, has suffered a massive stroke, affecting the deeper and back portions of her right cerebral hemisphere.

Sometimes, she will put on lipstick, and make up the right half of her face, leaving the left half completely neglected: it is almost impossible to treat these things, because her attention cannot be drawn to them ('hemi-inattention') and she has no conception that they are wrong.

Knowing it intellectually, knowing it inferentially, she has worked out strategies for dealing with her imperception.

This usually suffices—after all, she has now eaten seven-eighths of the portion—but she may, if she is feeling particularly hungry or obsessive, make a third turn, and secure another sixteenth of her portion (leaving, of course, the remaining sixteenth, the left sixteenth, on her plate).

This usually suffices—after all, she has now eaten seven-eighths of the portion—but she may, if she is feeling particularly hungry or obsessive, make a third turn, and secure another sixteenth of her portion (leaving, of course, the remaining sixteenth, the left sixteenth, on her plate).

It would seem far simpler for her to rotate the plate than rotate herself. She agrees, and has tried this—or at least tried to try it. But it is oddly difficult, it does not come naturally, whereas whizzing round in her chair does, because her looking, her attention, her spontaneous movements and impulses, are all now exclusively and instinctively to the right.

But it is oddly difficult, it does not come naturally, whereas whizzing round in her chair does, because her looking, her attention, her spontaneous movements and impulses, are all now exclusively and instinctively to the right.

Especially distressing to her was the derision which greeted her when she appeared only half made-up, the left side of her face absurdly void of lipstick and rouge.

Especially distressing to her was the derision which greeted her when she appeared only half made-up, the left side of her face absurdly void of lipstick and rouge.

For now, using the video screen as a ‘mirror', she did see the left side of her face to her right, an experience confounding even to a normal person (as anyone knows who has tried to shave using a video screen), and doubly confounding, uncanny, for her, because the left side of her face and body, which she now saw, had no feeling, no existence, for her, in consequence of her stroke.

For now, using the video screen as a ‘mirror', she did see the left side of her face to her right, an experience confounding even to a normal person (as anyone knows who has tried to shave using a video screen), and doubly confounding, uncanny, for her, because the left side of her face and body, which she now saw, had no feeling, no existence, for her, in consequence of her stroke.

‘Take it away!' she cried, in distress and bewilderment, so we did not explore the matter further.

The matter is so physically, indeed metaphysically, confusing that only experiment can decide.

I cannot forbear quoting Mesulam's eloquent formulation of ‘neglect'...

Patients with unilateral neglect behave not only as if nothing were actually happening in the left hemispace, but also as if nothing of any importance could be expected to occur there.