TED2009
Oliver Sacks: What hallucination reveals about our minds
Oliver Sacks: El que les al·lucinacions ens revelen sobre la ment
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El neuròleg i escriptor Oliver Sacks ens parla de la síndrome de Charles Bonnet, per la qual persones amb disminució visual experimenten al·lucinacions lúcides. Ens descriu les vivències dels seus pacients amb una minuciositat entranyable, i ens explica la part biològica d'aquest fenòmen tan poc conegut.
Oliver Sacks - Neurological anthropologist
Since "Awakenings" stormed the bestseller lists (and the silver screen), Oliver Sacks has become an unlikely household name, single-handedly inventing the genre of neurological anthropology. Full bio
Since "Awakenings" stormed the bestseller lists (and the silver screen), Oliver Sacks has become an unlikely household name, single-handedly inventing the genre of neurological anthropology. Full bio
Double-click the English transcript below to play the video.
00:12
We see with the eyes,
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Hi veiem amb els ulls
00:15
but we see with the brain as well.
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però també hi veiem amb el cervell.
00:18
And seeing with the brain is often called imagination.
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Veure-hi amb el cervell se sol anomenar imaginació.
00:22
And we are familiar with the landscapes of our own imagination,
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Estem familiaritzats amb els paisatges de la nostra imaginació,
00:27
our inscapes. We've lived with them all our lives.
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els paisatges interiors. Hi hem conviscut tota la vida.
00:31
But there are also hallucinations as well,
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Però també existeixen les al·lucinacions.
00:35
and hallucinations are completely different.
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I les al·lucinacions són una altra cosa.
00:38
They don't seem to be of our creation.
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No semblen creacions nostres.
00:40
They don't seem to be under our control.
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No sembla que les puguem controlar.
00:42
They seem to come from the outside,
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Sembla que vinguin de fora,
00:44
and to mimic perception.
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i que imitin la percepció.
00:47
So I am going to be talking about hallucinations,
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Ara us parlaré sobre al·lucinacions.
00:51
and a particular sort of visual hallucination
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I una mena d'al·lucinacions visuals
00:55
which I see among my patients.
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que veig en els meus pacients.
01:00
A few months ago, I got a phone call
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Fa uns mesos, em van trucar
01:04
from a nursing home where I work.
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d'una residència on treballo.
01:06
They told me that one of their residents, an old lady in her 90s,
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Em van dir que una senyora de més de 90 anys
01:11
was seeing things,
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veia coses.
01:13
and they wondered if she'd gone bonkers
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I es preguntaven si s'havia grillat
01:16
or, because she was an old lady,
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o, com que era una senyora gran,
01:18
whether she'd had a stroke, or whether she had Alzheimer's.
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si havia tingut un ictus, o si tenia Alzheimer.
01:21
And so they asked me if I would come and see Rosalie,
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Em van demanar que visités la Rosalie,
01:26
the old lady.
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la senyora gran.
01:28
I went in to see her.
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Vaig anar-la a veure.
01:30
It was evident straight away
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De seguida va ser evident
01:32
that she was perfectly sane
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que estava bé de seny,
01:35
and lucid and of good intelligence,
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lúcida i intel·ligent.
01:38
but she'd been very startled and very bewildered,
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Però estava espantada, i molt estranyada,
01:42
because she'd been seeing things.
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perquè veia coses.
01:45
And she told me --
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I em va dir --
01:48
the nurses hadn't mentioned this --
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les infermeres no ho havien esmentat--
01:50
that she was blind,
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que era cega,
01:52
that she had been completely blind from macular degeneration for five years.
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que s'havia quedat cega del tot, per degeneració macular, feia 5 anys.
01:57
But now, for the last few days, she'd been seeing things.
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Però que ara, els dies passats, veia coses.
02:00
So I said, "What sort of things?"
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Li vaig dir: "Com ara què?"
02:03
And she said, "People in Eastern dress,
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I em va respondre: "Gent amb roba oriental,
02:06
in drapes, walking up and down stairs.
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amb cortines, que pugen i baixen escales.
02:10
A man who turns towards me and smiles.
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Un home que es gira cap a mi i em somriu.
02:13
But he has huge teeth on one side of his mouth.
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Amb unes dents molt grosses en un costat de la boca.
02:17
Animals too.
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I també animals.
02:19
I see a white building. It's snowing, a soft snow.
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Veig un edifici blanc. Neva, una neu tova.
02:22
I see this horse with a harness, dragging the snow away.
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Veig un cavall, amb arnès, que retira la neu.
02:27
Then, one night, the scene changes.
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Llavors, una nit, l'escena canvia.
02:31
I see cats and dogs walking towards me.
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Veig gats i gossos que vénen cap a mi.
02:33
They come to a certain point and then stop.
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Fins que arriben en un punt i s'aturen.
02:36
Then it changes again.
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Llavors torna a canviar.
02:38
I see a lot of children. They are walking up and down stairs.
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Veig tot de criatures. Pugen i baixen escales.
02:41
They wear bright colors, rose and blue,
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Van vestits de colors vius, rosa i blau,
02:44
like Eastern dress."
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com les robes orientals."
02:47
Sometimes, she said, before the people come on,
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De vegades, deia, abans de veure gent
02:50
she may hallucinate pink and blue squares on the floor,
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al·lucinava quadres roses i blaus a terra,
02:54
which seem to go up to the ceiling.
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com si pugessin fins al sostre.
02:57
I said, "Is this like a dream?"
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Li dic: "Com si fos un somni?"
03:01
And she said, "No, it's not like a dream. It's like a movie."
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I diu: "No, un somni no. És com una pel·lícula."
03:04
She said, "It's got color. It's got motion.
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Diu: "Té colors. Té moviment.
03:07
But it's completely silent, like a silent movie."
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Però completament en silenci, com una pel·lícula muda."
03:11
And she said that it's a rather boring movie.
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Va dir que era una pel·lícula una mica avorrida.
03:13
She said, "All these people with Eastern dress,
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Diu: "Tot de gent amb vestits orientals,
03:16
walking up and down, very repetitive, very limited."
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que pugen i baixen, molt repetitiu, molt limitat."
03:21
(Laughter)
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(Rialles)
03:23
And she has a sense of humor.
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I tenia sentit de l'humor.
03:25
She knew it was a hallucination.
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Sabia que era una al·lucinació.
03:27
But she was frightened. She'd lived 95 years
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Però estava espantada. Tenia 95 anys
03:29
and she'd never had a hallucination before.
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i no havia tingut mai cap al·lucinació.
03:32
She said that the hallucinations were unrelated
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Em deia que les al·lucinacions no tenien relació
03:35
to anything she was thinking or feeling or doing,
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amb res del que pensava, sentia ni feia.
03:39
that they seemed to come on by themselves, or disappear.
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Que semblava que li venien soles, i marxaven soles.
03:43
She had no control over them.
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No les podia controlar.
03:45
She said she didn't recognize
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Em va dir que no reconeixia
03:47
any of the people or places
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ni la gent ni els llocs
03:49
in the hallucinations.
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de les al·lucinacions.
03:51
And none of the people or the animals,
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I que ni la gent ni els animals
03:53
well, they all seemed oblivious of her.
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li feien gens de cas.
03:57
And she didn't know what was going on.
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I que no sabia què passava.
03:59
She wondered if she was going mad
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Es preguntava si s'estava tornant boja,
04:01
or losing her mind.
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o si perdia el cap.
04:03
Well, I examined her carefully.
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Doncs la vaig examinar atentament.
04:05
She was a bright old lady,
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Era una senyora molt eixerida.
04:07
perfectly sane. She had no medical problems.
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Amb el cap molt clar. No tenia problemes mèdics.
04:11
She wasn't on any medications which could produce hallucinations.
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No prenia cap medicament que li pogués produir al·lucinacions.
04:15
But she was blind.
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Però era cega.
04:17
And I then said to her,
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Llavors li vaig dir:
04:19
"I think I know what you have."
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"Crec que ja sé què li passa."
04:21
I said, "There is a special form of visual hallucination
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"Hi ha un tipus concret d'al·lucinacions visuals
04:25
which may go with deteriorating vision or blindness.
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que es dóna quan hi ha visió deteriorada o ceguesa."
04:29
This was originally described," I said,
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"Ho va descriure per primera vegada", li vaig dir
04:32
"right back in the 18th century,
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"en el segle XVIII,
04:34
by a man called Charles Bonnet.
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un home que es deia Charles Bonnet.
04:37
And you have Charles Bonnet syndrome.
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I vostè té la síndrome de Charles Bonnet.
04:40
There is nothing wrong with your brain. There is nothing wrong with your mind.
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No té cap problema al cervell. No ha perdut el seny.
04:42
You have Charles Bonnet syndrome."
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Té la síndrome de Charles Bonnet."
04:45
And she was very relieved at this,
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Es va quedar molt descansada
04:48
that there was nothing seriously the matter,
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de saber que no tenia res de greu,
04:52
and also rather curious.
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i també encuriosida.
04:55
She said, "Who is this Charles Bonnet?"
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Em va preguntar: "Qui és aquest Charles Bonnet?
04:57
She said, "Did he have them himself?"
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També tenia el mateix?"
05:00
And she said, "Tell all the nurses
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I em deia: "Digui a totes les infermeres
05:03
that I have Charles Bonnet syndrome."
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que tinc la síndrome de Charles Bonnet".
05:06
(Laughter)
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(Rialles)
05:08
"I'm not crazy. I'm not demented. I have Charles Bonnet syndrome."
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"No estic boja. No repapiejo. Tinc la síndrome de Charles Bonnet".
05:12
Well, so I did tell the nurses.
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Així ho vaig dir a les infermeres.
05:14
Now this, for me, is a common situation.
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Aquesta situació, la veig força sovint.
05:17
I work in old-age homes, largely.
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Sobretot a les residències de gent gran.
05:19
I see a lot of elderly people
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Veig molta gent gran
05:21
who are hearing impaired or visually impaired.
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amb deficiències d'oïda o de vista.
05:25
About 10 percent of the hearing impaired people
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I un 10% de la gent amb sordesa parcial
05:27
get musical hallucinations.
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tenen al·lucinacions musicals.
05:30
And about 10 percent of the visually impaired people
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I un 10% de la gent amb ceguesa parcial
05:33
get visual hallucinations.
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tenen al·lucinacions visuals.
05:35
You don't have to be completely blind,
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No cal ser cec del tot,
05:37
only sufficiently impaired.
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només tenir una deficiència parcial.
05:39
Now with the original description in the 18th century,
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A la descripció original del segle XVIII,
05:43
Charles Bonnet did not have them.
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en Charles Bonnet no ho patia.
05:45
His grandfather had these hallucinations.
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Era el seu avi que tenia aquestes al·lucinacions.
05:48
His grandfather was a magistrate, an elderly man.
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El seu avi era jutge, un senyor gran.
05:51
He'd had cataract surgery.
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S'havia operat de cataractes.
05:54
His vision was pretty poor.
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Tenia molt poca vista.
05:56
And in 1759, he described to his grandson
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I el 1759 li va explicar al seu nét
06:01
various things he was seeing.
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algunes coses que veia.
06:03
The first thing he said was he saw
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El primer que va dir que veia
06:05
a handkerchief in midair.
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era un mocador que volava.
06:07
It was a large blue handkerchief
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Era un mocador gros i blau
06:09
with four orange circles.
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amb quatre cercles de color carbassa
06:11
And he knew it was a hallucination.
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Ell sabia que era una al·lucinació.
06:14
You don't have handkerchiefs in midair.
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Els mocadors no volen.
06:16
And then he saw a big wheel in midair.
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També veia una roda grossa volant.
06:20
But sometimes he wasn't sure whether he was hallucinating or not,
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Però de vegades no estava segur si eren al·lucinacions o no
06:25
because the hallucinations would fit
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perquè les al·lucinacions encaixaven
06:27
in the context of the visions.
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en el context de la visió.
06:29
So on one occasion, when his granddaughters were visiting them,
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Una vegada, que les seves nétes l'havien anat a veure,
06:32
he said, "And who are these handsome young men with you?"
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els digué: "Qui són aquests nois tan ben plantats?"
06:37
And they said, "Alas, Grandpapa, there are no handsome young men."
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I elles van respondre: "Ai, avi, aquí no hi ha cap noi ben plantat."
06:41
And then the handsome young men disappeared.
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I llavors els nois van desaparèixer.
06:45
It's typical of these hallucinations
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És típic que aquestes al·lucinacions
06:48
that they may come in a flash and disappear in a flash.
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vagin i vinguin de cop i volta.
06:51
They don't usually fade in and out.
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No solen desaparèixer a poc a poc.
06:53
They are rather sudden, and they change suddenly.
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Són força sobtades. I canvien de sobte.
06:56
Charles Lullin, the grandfather,
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Charles Lullin, l'avi,
06:59
saw hundreds of different figures,
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veia centenars de figures diferents,
07:02
different landscapes of all sorts.
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paisatges de tota mena.
07:04
On one occasion, he saw a man in a bathrobe smoking a pipe,
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Un cop va veure un home en barnús, fumant amb pipa,
07:08
and realized it was himself.
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i es va adonar que era ell mateix.
07:11
That was the only figure he recognized.
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Era l'única figura que reconeixia.
07:14
On one occasion when he was walking in the streets of Paris,
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Una vegada, pels carrers de París,
07:18
he saw -- this was real -- a scaffolding.
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va veure -- això de debò -- una bastida.
07:21
But when he got back home, he saw a miniature of the scaffolding
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Però en tornar a casa, veia una bastida en miniatura
07:24
six inches high, on his study table.
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de 15 cm d'alçada, al seu escriptori.
07:28
This repetition of perception
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Aquesta repetició de les percepcions
07:31
is sometimes called palinopsia.
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de vegades s'anomena palinòpsia.
07:33
With him and with Rosalie,
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L'avi, com la Rosalie,
07:38
what seems to be going on --
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el que sembla que tenen --
07:40
and Rosalie said, "What's going on?" --
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com deia la Rosalie, "Què tinc?" --
07:42
and I said that as you lose vision,
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és que, en perdre vista,
07:45
as the visual parts of the brain are no longer getting any input,
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com que les parts visuals del cervell no reben cap input,
07:48
they become hyperactive and excitable,
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es tornen hiperactives i excitables.
07:51
and they start to fire spontaneously.
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I comencen a saltar espontàniament.
07:53
And you start to see things.
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I llavors comences a veure coses.
07:56
The things you see can be very complicated indeed.
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Les visions poden arribar a ser prou complicades.
07:59
With another patient of mine,
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Una altra pacient meva,
08:03
who, also had some vision,
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que encara tenia una mica de vista,
08:05
the vision she had could be disturbing.
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de vegades tenia visions pertorbadores.
08:09
On one occasion, she said she saw
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Una vegada em deia que havia vist
08:12
a man in a striped shirt in a restaurant.
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un home amb camisa de ratlles en un restaurant.
08:15
And he turned around. And then
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Que l'home es va girar, i llavors
08:17
he divided into six figures in striped shirts,
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es va dividir en sis figures idèntiques amb camisa de ratlles,
08:20
who started walking towards her.
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que caminaven cap a ella.
08:23
And then the six figures came together again, like a concertina.
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I llavors les sis figures es van tornar a ajuntar, com un acordió.
08:26
Once, when she was driving,
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Un cop, mentre conduïa,
08:28
or rather, her husband was driving,
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o, més ben dit, conduïa el seu marit,
08:30
the road divided into four
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la carretera es va dividir en quatre.
08:32
and she felt herself going simultaneously up four roads.
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I va sentir com si anés alhora per quatre carreteres.
08:36
She had very mobile hallucinations as well.
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També tenia al·lucinacions molt mòbils.
08:41
A lot of them had to do with a car.
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Moltes tenien a veure amb el cotxe.
08:44
Sometimes she would see a teenage boy
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De vegades veia un noiet adolescent
08:46
sitting on the hood of the car.
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assegut al capó del cotxe.
08:49
He was very tenacious and he moved rather gracefully
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Era molt ferm i es movia amb força agilitat
08:51
when the car turned.
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quan el cotxe girava.
08:53
And then when they came to a stop,
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I quan el cotxe s'aturava,
08:56
the boy would do a sudden vertical takeoff, 100 foot in the air,
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el noi de sobte sortia disparat, a 30 metres del terra,
08:59
and then disappear.
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i desapareixia.
09:02
Another patient of mine had a different sort of hallucination.
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Una altra pacient tenia al·lucinacions diferents.
09:07
This was a woman who didn't have trouble with her eyes,
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Era una dona que no tenia cap lesió als ulls,
09:10
but the visual parts of her brain,
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sinó a les parts visuals del cervell.
09:12
a little tumor in the occipital cortex.
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Un petit tumor al còrtex occipital.
09:15
And, above all, she would see cartoons.
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I sobretot veia dibuixos animats.
09:20
These cartoons would be transparent
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Eren dibuixos transparents
09:25
and would cover half the visual field, like a screen.
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que li cobrien mig camp visual, com una pantalla.
09:28
And especially she saw cartoons of Kermit the Frog.
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Especialment veia la granota Gustau.
09:34
(Laughter)
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(Rialles)
09:35
Now, I don't watch Sesame Street,
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Jo no veig Barri Sèsam,
09:38
but she made a point of saying,
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però ella insistia molt,
09:41
"Why Kermit?" She said, "Kermit the Frog means nothing to me.
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"Per què la granota Gustau, que no significa res per a mi?
09:45
You know, I was wondering about Freudian determinants.
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Pensava en els determinants freudians.
09:48
Why Kermit?
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Per què en Gustau?
09:50
Kermit the Frog means nothing to me."
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La granota Gustau no significa res per a mi."
09:52
She didn't mind the cartoons too much.
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No li importava veure dibuixos,
09:54
But what did disturb her was she got very persistent
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el que l'amoïnava era veure
09:58
images or hallucinations of faces
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imatges persistents o al·lucinacions de cares
10:01
and as with Rosalie, the faces were often deformed,
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i, com la Rosalie, sovint eren cares deformades,
10:04
with very large teeth or very large eyes.
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amb les dents o els ulls molt grossos.
10:08
And these frightened her.
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Això li feia por.
10:11
Well, what is going on with these people?
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Bé, doncs què els passa a aquestes persones?
10:15
As a physician, I have to try and define what's going on,
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Com a metge, he d'intentar definir el que passa,
10:18
and to reassure people,
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i tranquil·litzar la gent.
10:20
especially to reassure them that they're not going insane.
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Sobretot explicar-los que no s'estan tornant bojos.
10:24
Something like 10 percent, as I said,
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Aproximadament un 10%, com us deia,
10:27
of visually impaired people get these.
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de les persones amb ceguesa parcial tenen aquestes al·lucinacions.
10:30
But no more than one percent of the people acknowledge them,
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Però menys d'un 1% ho reconeixen.
10:34
because they are afraid they will be seen as insane or something.
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Perquè tenen por de ser considerats bojos, i tal.
10:37
And if they do mention them to their own doctors
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I si ho expliquen al seu metge
10:39
they may be misdiagnosed.
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els pot diagnosticar malament.
10:42
In particular, the notion is that if you see
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Concretament, la idea és que si veus
10:44
things or hear things, you're going mad,
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coses o sents coses, t'estàs tornant boig.
10:47
but the psychotic hallucinations are quite different.
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Però les al·lucinacions psicòtiques són força diferents.
10:50
Psychotic hallucinations, whether they are visual or vocal,
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Les al·lucinacions psicòtiques, ja siguin visions o sons,
10:53
they address you. They accuse you.
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se t'adrecen. T'acusen.
10:55
They seduce you. They humiliate you.
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Et sedueixen. T'humilien.
10:57
They jeer at you.
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Se'n riuen de tu.
11:00
You interact with them.
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Hi interactues.
11:02
There is none of this quality of being addressed
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Aquesta mena d'interpel·lacions no es donen
11:05
with these Charles Bonnet hallucinations.
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en les al·lucinacions de Charles Bonnet
11:08
There is a film. You're seeing a film which has nothing to do with you,
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És una pel·lícula. Veus una pel·lícula que no té res a veure amb tu.
11:12
or that's how people think about it.
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Almenys així és com ho veu la gent.
11:15
There is also a rare thing called temporal lobe epilepsy,
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També hi ha una raresa que es diu epilèpsia del lòbul temporal.
11:19
and sometimes, if one has this,
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De vegades, si la pateixes,
11:22
one may feel oneself transported back
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et sents com si et portessin enrere
11:24
to a time and place in the past.
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cap a un temps i un lloc del passat.
11:27
You're at a particular road junction.
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Estàs en una cruïlla de camins.
11:29
You smell chestnuts roasting.
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Sents olor de nous torrades.
11:31
You hear the traffic. All the senses are involved.
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Sents el trànsit. Tots els sentits hi participen.
11:34
And you're waiting for your girl.
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Estàs esperant la teva xicota.
11:36
And it's that Tuesday evening back in 1982.
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I és aquell dimarts al vespre de 1982.
11:40
And the temporal lobe hallucinations
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Les al·lucinacions de lòbul temporal
11:42
are all-sense hallucinations,
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són al·lucinacions multisensorials,
11:44
full of feeling, full of familiarity,
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plenes de sensacions, de familiaritat,
11:47
located in space and time,
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situades en l'espai i el temps,
11:49
coherent, dramatic.
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coherents, dramàtiques.
11:51
The Charles Bonnet ones are quite different.
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Les de Charles Bonnet són bastant diferents.
11:54
So in the Charles Bonnet hallucinations,
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Amb les al·lucinacions de Charles Bonnet,
11:58
you have all sorts of levels,
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hi ha tota mena de nivells,
12:00
from the geometrical hallucinations --
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des d'al·lucinacions geomètriques,
12:02
the pink and blue squares the woman had --
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com els quadres roses i blaus de la senyora,
12:05
up to quite elaborate hallucinations
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fins a al·lucinacions força elaborades
12:09
with figures and especially faces.
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amb figures i sobretot cares.
12:12
Faces, and sometimes deformed faces,
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Cares, de vegades cares deformades,
12:15
are the single commonest thing
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són el comú denominador més habitual
12:18
in these hallucinations.
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d'aquestes al·lucinacions.
12:20
And one of the second commonest is cartoons.
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I una altra cosa habitual són els dibuixos.
12:23
So, what is going on?
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Així doncs, què passa?
12:26
Fascinatingly, in the last few years,
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És fascinant com, en els darrers anys,
12:28
it's been possible to do functional brain imagery,
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s'han pogut fer escàners cerebrals funcionals,
12:32
to do fMRI on people as they are hallucinating.
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fer una ressonància magnètica funcional quan la persona està al·lucinant.
12:36
And in fact, to find that different parts
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I realment veure quines parts
12:40
of the visual brain are activated
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del cervell visual s'activen
12:43
as they are hallucinating.
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durant l'al·lucinació.
12:45
When people have these simple geometrical hallucinations,
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Quan la gent té al·lucinacions geomètriques simples,
12:48
the primary visual cortex is activated.
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s'activa el còrtex visual primari.
12:52
This is the part of the brain which perceives edges and patterns.
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És la part del cervell que percep siluetes i formes.
12:55
You don't form images with your primary visual cortex.
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No es formen imatges amb el còrtex visual primari
12:59
When images are formed,
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Quan les imatges es formen,
13:02
a higher part of the visual cortex
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una part superior del còrtex visual
13:04
is involved in the temporal lobe.
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intervé en el lòbul temporal.
13:06
And in particular, one area of the temporal lobe
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Concretament, una zona del lòbul temporal
13:11
is called the fusiform gyrus.
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que es diu gir fusiforme.
13:13
And it's known that if people have damage in the fusiform gyrus,
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Se sap que les persones amb lesions al gir fusiforme
13:17
they maybe lose the ability to recognize faces.
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poden perdre la capacitat de reconèixer cares.
13:21
But if there is an abnormal activity in the fusiform gyrus,
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Però si hi ha activitat anormal al gir fusiforme,
13:25
they may hallucinate faces,
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pot ser que al·lucinin cares.
13:27
and this is exactly what you find in some of these people.
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I això és exactament el que els passa a aquestes persones.
13:30
There is an area in the anterior part of this gyrus
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Hi ha una zona a la part anterior del gir
13:34
where teeth and eyes are represented,
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on es representen les dents i els ulls.
13:39
and that part of the gyrus is activated
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I aquesta part del gir s'activa
13:42
when people get the deformed hallucinations.
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quan els pacients tenen les al·lucinacions deformes.
13:46
There is another part of the brain
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Hi ha una altra part del cervell
13:48
which is especially activated
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que està especialment activada
13:50
when one sees cartoons.
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quan veiem dibuixos animats.
13:52
It's activated when one recognizes cartoons,
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S'activa quan reconeixem els dibuixos,
13:55
when one draws cartoons, and when one hallucinates them.
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quan dibuixem, i quan els al·lucinem.
13:59
It's very interesting that that should be specific.
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Es molt interessant que tot sigui tan específic.
14:02
There are other parts of the brain which are specifically involved
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Hi ha altres parts del cervell que estan implicades específicament
14:05
with the recognition and hallucination
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en el reconeixement i l'al·lucinació
14:07
of buildings and landscapes.
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d'edificis i paisatges.
14:10
Around 1970, it was found that there were not only parts of the brain,
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Cap al 1970 es va descobrir que no només són parts concretes del cervell,
14:13
but particular cells.
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sinó cèl·lules concretes.
14:15
"Face cells" were discovered around 1970.
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Les "cèl·lules facials" es van descobrir cap al 1970.
14:20
And now we know that there are hundreds of other
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Ara sabem que hi ha centenars d'altres
14:22
sorts of cells,
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tipus de cèl·lules.
14:24
which can be very, very specific.
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que poden arribar a ser molt i molt específiques.
14:26
So you may not only have
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Pot ser que tinguem no tan sols
14:28
"car" cells,
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cèl·lules "de cotxes",
14:30
you may have "Aston Martin" cells.
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sinó cèl·lules "d'Aston Martin".
14:33
(Laughter)
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(Rialles)
14:35
I saw an Aston Martin this morning.
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He vist un Aston Martin aquest matí.
14:37
I had to bring it in.
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N'havia de parlar.
14:39
And now it's in there somewhere.
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I ara el tinc per aquí dins.
14:42
(Laughter)
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(Rialles)
14:45
Now, at this level, in what's called the inferotemporal cortex,
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Ara, en aquest nivell, en l'anomenat còrtex temporal inferior,
14:49
there are only visual images,
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només hi ha imatges visuals
14:52
or figments or fragments.
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o imaginacions o fragments.
14:55
It's only at higher levels
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És només en els nivells superiors
14:58
that the other senses join in
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que entren en joc els altres sentits
15:00
and there are connections with memory and emotion.
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i hi ha connexions amb la memòria i les emocions.
15:02
And in the Charles Bonnet syndrome,
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En la síndrome de Charles Bonnet
15:05
you don't go to those higher levels.
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no s'entra en els nivells superiors.
15:07
You're in these levels of inferior visual cortex
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Estàs en aquests nivells del còrtex visual inferior
15:10
where you have thousands and tens of thousands
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on hi ha milers i desenes de milers
15:12
and millions of images,
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i milions d'imatges,
15:15
or figments, or fragmentary figments,
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o d'imaginacions, o fragments d'imaginacions,
15:17
all neurally encoded
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totes codificades neurològicament,
15:19
in particular cells or small clusters of cells.
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en cèl·lules concretes o agrupacions de cèl·lules.
15:23
Normally these are all part of
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Normalment són totes part
15:26
the integrated stream of perception, or imagination,
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del flux integrat de percepció, o imaginació.
15:30
and one is not conscious of them.
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I no en som conscients.
15:33
It is only if one is visually impaired or blind
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Només si un té disminunció visual, o ceguesa,
15:37
that the process is interrupted.
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s'interromp el procés.
15:39
And instead of getting normal perception,
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I en lloc de tenir percepció normal,
15:42
you're getting an anarchic,
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tenim estímuls anàrquics,
15:44
convulsive stimulation, or release,
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convulsius, o emissions,
15:47
of all of these visual cells
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de totes aquestes cèl·lules visuals
15:49
in the inferotemporal cortex.
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del còrtex temporal inferior.
15:51
So, suddenly you see a face. Suddenly you see a car.
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I de sobte, veus una cara. De sobte veus un cotxe.
15:54
Suddenly this, and suddenly that.
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De sobte això, i de sobte allò altre.
15:57
The mind does its best to organize
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La ment fa el que pot per ordenar
15:59
and to give some sort of coherence to this,
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i donar alguna coherència a tot plegat.
16:02
but not terribly successfully.
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Però no se'n surt gaire.
16:04
When these were first described,
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Quan es va descriure per primer cop,
16:06
it was thought that they could be interpreted like dreams.
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es creia que es podien interpretar com a somnis.
16:10
But in fact people say,
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Però de fet la gent diu:
16:12
"I don't recognize the people. I can't form any associations."
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"No reconec les persones. No formo cap associació".
16:15
"Kermit means nothing to me."
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"La granota Gustau no significa res per a mi."
16:18
You don't get anywhere thinking of them as dreams.
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No anem enlloc si suposem que són com somnis.
16:23
Well, I've more or less said what I wanted.
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Bé, he dit més o menys el que volia dir.
16:28
I think I just want to recapitulate
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Només em falta recapitular
16:31
and say this is common.
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i dir que això és habitual.
16:33
Think of the number of blind people.
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Penseu en el nombre de persones cegues.
16:35
There must be hundreds of thousands of blind people
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Hi deu haver centenars de milers de persones cegues
16:37
who have these hallucinations,
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amb aquestes al·lucinacions,
16:39
but are too scared to mention them.
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però tenen massa por per parlar-ne.
16:41
So this sort of thing needs to be brought into
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Són coses que s'han de fer saber
16:44
notice, for patients, for doctors, for the public.
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als pacients, als metges, al gran públic.
16:50
Finally, I think they are
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Per acabar, crec que són
16:52
infinitely interesting and valuable,
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infinitament interessants, i valuoses,
16:55
for giving one some insight as to how the brain works.
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perquè ens aporten detalls de com funciona el cervell.
16:59
Charles Bonnet said, 250 years ago --
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Charles Bonnet va dir, fa 250 anys --
17:02
he wondered how, thinking these hallucinations,
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pensava en aquestes al·lucinacions i es preguntava
17:06
how, as he put it, the theater of the mind
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com, segons ell, el teatre de la ment
17:09
could be generated by the machinery of the brain.
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podia ser generat per la maquinària del cervell.
17:12
Now, 250 years later,
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Ara, 250 anys més tard
17:15
I think we're beginning to glimpse how this is done.
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crec que en comencem a albirar el funcionament.
17:18
Thanks very much.
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Moltes gràcies.
17:20
(Applause)
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(Aplaudiments)
17:23
Chris Anderson: That was superb. Thank you so much.
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Chris Anderson: Ha estat magnífic. Moltes gràcies.
17:26
You speak about these things with so much insight
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Ens parla d'aquestes coses amb tanta saviesa
17:28
and empathy for your patients.
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i empatia pels seus pacients.
17:31
Have you yourself experienced any of the syndromes you write about?
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Ha experimentat alguna de les síndromes de què escriu?
17:36
Oliver Sacks: I was afraid you'd ask that.
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Oliver Sacks: Em temia que m'ho preguntaries.
17:38
(Laughter)
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(Rialles)
17:39
Well, yeah, a lot of them.
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Bé, sí, molts.
17:42
And actually I'm a little visually impaired myself.
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I de fet tinc una mica de disminució visual.
17:45
I'm blind in one eye, and not terribly good in the other.
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Sóc cec d'un ull, i no hi veig massa amb l'altre.
17:48
And I see the geometrical hallucinations.
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I tinc les al·lucinacions geomètriques.
17:52
But they stop there.
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Però això i prou.
17:54
CA: And they don't disturb you?
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C.A.: I no l'inquieten?
17:56
Because you understand what's doing it, it doesn't make you worried?
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Perquè entén d'on surten. No es preocupa?
17:58
OS: Well they don't disturb me any more than my tinnitus,
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O.S.: No em molesten pas més que els acúfens.
18:02
which I ignore.
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No en faig cas.
18:05
They occasionally interest me,
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De tant en tant m'interessen.
18:07
and I have many pictures of them in my notebooks.
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En tinc ple de dibuixos als meus quaderns.
18:10
I've gone and had an fMRI myself,
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He anat a fer-me una ressonància
18:13
to see how my visual cortex is taking over.
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per veure com el meu còrtex visual s'obre pas.
18:16
And when I see all these hexagons
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I quan veig els hexàgons
18:20
and complex things, which I also have,
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i coses complexes, que també tinc,
18:22
in visual migraine,
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en migranyes oftàlmiques,
18:24
I wonder whether everyone sees things like this,
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em pregunto si tothom ho veu igual,
18:26
and whether things like cave art or ornamental art
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i si certes coses com l'art rupestre, o l'art ornamental
18:29
may have been derived from them a bit.
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poden haver derivat una mica d'aquí.
18:32
CA: That was an utterly, utterly fascinating talk.
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C.A.: Ha estat una xerrada realment fascinant.
18:34
Thank you so much for sharing.
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Moltes gràcies per compartir-ho amb nosaltres.
18:36
OS: Thank you. Thank you.
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O.S.: Gràcies. Gràcies.
18:38
(Applause)
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(Aplaudiments)
ABOUT THE SPEAKER
Oliver Sacks - Neurological anthropologistSince "Awakenings" stormed the bestseller lists (and the silver screen), Oliver Sacks has become an unlikely household name, single-handedly inventing the genre of neurological anthropology.
Why you should listen
Oliver Sacks was a ground-breaking neurologist -- and a gifted storyteller who enriched our knowledge of the infinite variations of human psychology. After his pioneering work with “sleepy sickness” patients (who were in fact survivors of an early-20th-century pandemic), Sacks went on to study the connections between music and the brain, as well as disorders such as Tourette's syndrome, Parkinson's disease, and many other little-understood disorders that often count Sacks as one of their first chroniclers.
Sacks was well known as a writer of such best-selling case histories as Hallucinations, The Man Who Mistook His Wife for a Hat, An Anthropologist on Mars, and his memoir of his early work, Awakenings, all of which have breathed new life into the dusty 19th-century tradition of the clinical anecdote. Sacks' writing, compassion and wide-ranging knowledge catapults the genre into the 21st century and brings the far frontiers of neurological experience into the view of millions of readers worldwide. Sacks died at age 82 in August 2015.
Read TED's long, wonderful Q&A with Oliver Sacks >>
Oliver Sacks | Speaker | TED.com