The Man Who Mistook His Wife for a Hat: "Rebecca"

Rebecca had a partial cleft palate, which caused a whistling in her speech; short, stumpy fingers, with blunt, deformed nails; and a high, degenerative myopia requiring very thick spectacles—all stigmata of the same congenital condition which had caused her cerebral and mental defects.

Rebecca had a partial cleft palate, which caused a whistling in her speech; short, stumpy fingers, with blunt, deformed nails; and a high, degenerative myopia requiring very thick spectacles—all stigmata of the same congenital condition which had caused her cerebral and mental defects.

She was very fond too of stories, though she never learned to read (despite assiduous, and even frantic, attempts), and would implore her grandmother or others to read to her.

She was very fond too of stories, though she never learned to read (despite assiduous, and even frantic, attempts), and would implore her grandmother or others to read to her.

Though conceptually (and ‘propositionally’) inept, she was at home with poetic language, and was herself, in a stumbling, touching way, a sort of ‘primitive’, natural poet.

Metaphors, figures of speech, rather striking similitudes, would come naturally to her, though unpredictably, as sudden poetic ejaculations or allusions.

Her grandmother was devout, in a quiet way, and this also was true of Rebecca: she loved the lighting of the Sabbath candles, the benisons and orisons which thread the Jewish day; she loved going to the synagogue, where she too was loved (and seen as a child of God, a sort of innocent, a holy fool); and she fully understood the liturgy, the chants, the prayers, rites and symbols of which the Orthodox service consists.

Her grandmother was devout, in a quiet way, and this also was true of Rebecca: she loved the lighting of the Sabbath candles, the benisons and orisons which thread the Jewish day; she loved going to the synagogue, where she too was loved (and seen as a child of God, a sort of innocent, a holy fool); and she fully understood the liturgy, the chants, the prayers, rites and symbols of which the Orthodox service consists.

Her grandmother was devout, in a quiet way, and this also was true of Rebecca: she loved the lighting of the Sabbath candles, the benisons and orisons which thread the Jewish day; she loved going to the synagogue, where she too was loved (and seen as a child of God, a sort of innocent, a holy fool); and she fully understood the liturgy, the chants, the prayers, rites and symbols of which the Orthodox service consists.

Superficially she was a mass of handicaps and incapacities, with the intense frustrations and anxieties attendant on these; at this level she was, and felt herself to be, a mental cripple—beneath the effortless skills, the happy capacities, of others; but at some deeper level there was no sense of handicap or incapacity, but a feeling of calm and completeness, of being fully alive, of being a soul, deep and high, and equal to all others.

When I first saw her—clumsy, uncouth, all-of-a-fumble—I saw her merely, or wholly, as a casualty, a broken creature, whose neurological impairments I could pick out and dissect with precision: a multitude of apraxias and agnosias, a mass of sensorimotor impairments and breakdowns, limitations of intellectual schemata and concepts similar (by Piaget’s criteria) to those of a child of eight.

When I first saw her—clumsy, uncouth, all-of-a-fumble—I saw her merely, or wholly, as a casualty, a broken creature, whose neurological impairments I could pick out and dissect with precision: a multitude of apraxias and agnosias, a mass of sensorimotor impairments and breakdowns, limitations of intellectual schemata and concepts similar (by Piaget’s criteria) to those of a child of eight.

But the tests had given no inkling of anything but the deficits, of anything, so to speak, beyond her deficits.

They had given me no hint of her positive powers, her ability to perceive the real world—the world of nature, and perhaps of the imagination—as a coherent, intelligible, poetic whole: her ability to see this, think this, and (when she could) live this; they had given me no intimation of her inner world, which clearly was composed and coherent, and approached as something other than a set of problems or tasks.

They had given me no hint of her positive powers, her ability to perceive the real world—the world of nature, and perhaps of the imagination—as a coherent, intelligible, poetic whole: her ability to see this, think this, and (when she could) live this; they had given me no intimation of her inner world, which clearly was composed and coherent, and approached as something other than a set of problems or tasks.

Is it possible, I wondered, that this being before me—at once a charming girl, and a moron, a cognitive mishap—can use a narrative (or dramatic) mode to compose and integrate a coherent world, in place of the schematic mode, which, in her, is so defective that it simply doesn’t work?

It was perhaps fortunate that I chanced to see Rebecca in her so-different modes—so damaged and incorrigible in the one, so full of promise and potential in the other—and that she was one of the first patients I saw in our clinic.

Her speech was again ejaculated, 'Jacksonian', in brief utterances of grief and lamentation.

The work of grief was slow, but successful, as Rebecca, even when most stricken, anticipated. It was greatly helped by the synagogue, and the religious community, above all by the rites of 'sitting shiva', and the special status accorded her as the bereaved one, the chief mourner.

The work of grief was slow, but successful, as Rebecca, even when most stricken, anticipated. It was greatly helped by the synagogue, and the religious community, above all by the rites of 'sitting shiva', and the special status accorded her as the bereaved one, the chief mourner.

During the intervening months (between my first seeing her, in April, and her grandmother's death that November) Rebecca—like all our 'clients' (an odious word then becoming fashionable, supposedly less degrading than 'patients'), was pressed into a variety of workshops and classes, as part of our Developmental and Cognitive Drive...

It didn't work with Rebecca, it didn't work with most of them. It was not, I came to think, the right thing to do, because what we did was to drive them full-tilt upon their limitations, as had already been done, futilely, and often to the point of cruelty, throughout their lives.

To use another piece of jargon, we were far too concerned with 'defectology', and far too little with 'narratology', the neglected and needed science of the concrete.

Very young children love and demand stories, and can understand complex matters presented as stories, when their powers of comprehending general concepts, paradigms, are almost non-existent.

With Rebecca—and with other defectives allowed, or encouraged in, a personal development—the emotional and narrative and symbolic powers can develop strongly and exuberantly, and may produce (as in Rebecca) a sort of natural poet—or (as in José) a sort of natural artist—while the paradigmatic or conceptual powers, manifestly feeble from the start, grind very slowly and painfully along, and are only capable of a very limited and stunted development.

With Rebecca—and with other defectives allowed, or encouraged in, a personal development—the emotional and narrative and symbolic powers can develop strongly and exuberantly, and may produce (as in Rebecca) a sort of natural poet—or (as in José) a sort of natural artist—while the paradigmatic or conceptual powers, manifestly feeble from the start, grind very slowly and painfully along, and are only capable of a very limited and stunted development.

Rebecca realised this fully—as she had shown it to me so clearly, right from the very first day I saw her, when she spoke of her clumsiness, and of how her ill-composed and ill-organised movements became well-organised, composed and fluent, with music; and when she showed me how she herself was composed by a natural scene, a scene with an organic, aesthetic and dramatic unity and sense.

And then, with that power for the apt model or metaphor I so admired, and which was so well developed in her despite her low IQ, she looked down at the office carpet and said:
'I'm like a sort of living carpet. I need a pattern, a design, like you have on that carpet. I come apart, I unravel, unless there's a design.’

I thought: can one have a raw carpet without a design? Could one have the design without the carpet (but this seemed like the smile without the Cheshire cat)? A 'living' carpet, as Rebecca was, had to have both—and she especially, with her lack of schematic structure (the warp and woof, the knit, of the carpet, so to speak), might indeed unravel without a design (the scenic or narrative structure of the carpet).

'I must have meaning,' she went on. 'The classes, the odd jobs have no meaning...What I really love,' she added wistfully, 'is the theatre.'

We removed Rebecca from the workshop she hated, and managed to enroll her in a special theatre group. She loved this—it composed her; she did amazingly well: she became a complete person, poised, fluent, with style, in each role.

This procedural defect, or motor idiocy, as one might call it, which completely defeats any ordinary system of rehabilitative instruction, vanishes at once if music is the instructor. All this, no doubt, is the rationale, or one of the rationales, of work songs.

What we see, fundamentally, is the power of music to organise—and to do this efficaciously (as well as joyfully!), when abstract or schematic forms of organisation fail.

And in drama there is still more—there is the power of role to give organisation, to confer, while it lasts, an entire personality.

The capacity to perform, to play, to be, seems to be a ‘given' in human life, in a way which has nothing to do with intellectual differences. One sees this with infants, one sees it with the senile, and one sees it, most poignantly, with the Rebeccas of this world.