TED2009
Oliver Sacks: What hallucination reveals about our minds
Oliver Sacks: Hvad hallucination afslører om vores sind
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Neurolog og forfatter Oliver Sacks henleder vores opmærksomhed på Charles Bonnetts syndrom -- hvor synshæmmede oplever lysende klare hallucinationer. Han fortæller hjertevarmt og detaljeret om sine patienters oplevelser og leder os igennem biologien bag dette underrapporterede fænomen.
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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Vi ser med øjnene.
00:15
but we see with the brain as well.
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Men vi ser også med hjernen.
00:18
And seeing with the brain is often called imagination.
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Og at se med hjernen bliver ofte kaldt fantasi.
00:22
And we are familiar with the landscapes of our own imagination,
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Og vi kender vores egen fantasis landskaber,
00:27
our inscapes. We've lived with them all our lives.
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vores indskaber. Vi har levet med dem hele livet.
00:31
But there are also hallucinations as well,
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Men der findes også hallucinationer.
00:35
and hallucinations are completely different.
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Og hallucinationer er helt anderledes.
00:38
They don't seem to be of our creation.
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De lader ikke til at være vores værk.
00:40
They don't seem to be under our control.
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De lader ikke til at være under vores kontrol.
00:42
They seem to come from the outside,
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De lader til at komme udefra
00:44
and to mimic perception.
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og [lader til] at efterligne opfattelsen.
00:47
So I am going to be talking about hallucinations,
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Så jeg vil tale om hallucinationer.
00:51
and a particular sort of visual hallucination
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Og en bestemt form for visuel hallucination,
00:55
which I see among my patients.
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som jeg ser blandt mine patienter.
01:00
A few months ago, I got a phone call
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For et par måneder siden modtog jeg et telefonopkald
01:04
from a nursing home where I work.
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fra et plejehjem, hvor jeg arbejder.
01:06
They told me that one of their residents, an old lady in her 90s,
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De fortalte mig, at en af beboerne, en gammel dame i sine 90'ere,
01:11
was seeing things,
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så ting.
01:13
and they wondered if she'd gone bonkers
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Og de tænkte på, om hun var blevet skør.
01:16
or, because she was an old lady,
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Eller, for hun var en gammel dame,
01:18
whether she'd had a stroke, or whether she had Alzheimer's.
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om hun havde haft et slagtilfælde, eller om hun havde Alzheimers.
01:21
And so they asked me if I would come and see Rosalie,
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Og derfor spurgte de mig, om jeg ville komme og se til Rosalie,
01:26
the old lady.
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den gamle dame.
01:28
I went in to see her.
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Jeg tog hen for at se til hende.
01:30
It was evident straight away
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Det var tydeligt med det samme,
01:32
that she was perfectly sane
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at hun var ved sine fulde fem
01:35
and lucid and of good intelligence,
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og klar og godt begavet.
01:38
but she'd been very startled and very bewildered,
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Men hun var blevet meget forskrækket og meget forvirret,
01:42
because she'd been seeing things.
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for hun var begyndt at se ting.
01:45
And she told me --
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Og hun fortalte mig, --
01:48
the nurses hadn't mentioned this --
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sygeplejerskerne havde ikke nævnt dette --
01:50
that she was blind,
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at hun var blind,
01:52
that she had been completely blind from macular degeneration for five years.
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at hun havde været helt blind pga. makulær degeneration i fem år.
01:57
But now, for the last few days, she'd been seeing things.
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Men nu, de seneste par dage var hun begyndt at se ting.
02:00
So I said, "What sort of things?"
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Så jeg sagde, "Hvad slags ting?"
02:03
And she said, "People in Eastern dress,
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Og hun sagde, "Folk i østligt tøj
02:06
in drapes, walking up and down stairs.
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i draperinger, der går op og ned af trapper.
02:10
A man who turns towards me and smiles.
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En mand, der vender sig mod mig og smiler.
02:13
But he has huge teeth on one side of his mouth.
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Men han har enorme tænder i den ene side af munden.
02:17
Animals too.
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Også dyr.
02:19
I see a white building. It's snowing, a soft snow.
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Jeg ser en hvid bygning. Det sner, en blød sne.
02:22
I see this horse with a harness, dragging the snow away.
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Jeg ser den her hest med seletøj, der trækker sneen væk.
02:27
Then, one night, the scene changes.
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Så en nat ændrer scenen sig.
02:31
I see cats and dogs walking towards me.
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Jeg ser katte og hunde gå imod mig.
02:33
They come to a certain point and then stop.
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De kommer til et bestemt sted og stopper så.
02:36
Then it changes again.
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Så ændrer det sig igen.
02:38
I see a lot of children. They are walking up and down stairs.
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Jeg ser en masse børn. De går op og ned af trapper.
02:41
They wear bright colors, rose and blue,
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De bærer lyse farver, rosa og blå,
02:44
like Eastern dress."
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som østligt tøj."
02:47
Sometimes, she said, before the people come on,
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Nogle gange, sagde hun, før folkene kom på,
02:50
she may hallucinate pink and blue squares on the floor,
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kan hun hallucinere om pink og blå kvadrater på gulvet,
02:54
which seem to go up to the ceiling.
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der lader til at gå op til loftet.
02:57
I said, "Is this like a dream?"
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Jeg sagde, "Er det som en drøm?"
03:01
And she said, "No, it's not like a dream. It's like a movie."
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Og hun sagde, "Nej, det er ikke som en drøm. Det er som en film."
03:04
She said, "It's got color. It's got motion.
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Hun sagde, "Det har farver. Det har bevægelse.
03:07
But it's completely silent, like a silent movie."
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Men det er helt tyst, som en stumfilm."
03:11
And she said that it's a rather boring movie.
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Og hun sagde, at det er en ret kedelig film.
03:13
She said, "All these people with Eastern dress,
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Hun sagde, "Alle disse folk med østligt tøj,
03:16
walking up and down, very repetitive, very limited."
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der går op og ned, meget gentagende, meget begrænset."
03:21
(Laughter)
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(Latter)
03:23
And she has a sense of humor.
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Og hun havde sans for humor.
03:25
She knew it was a hallucination.
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Hun vidste, det var en hallucination.
03:27
But she was frightened. She'd lived 95 years
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Men hun var bange. Hun havde levet i 95 år,
03:29
and she'd never had a hallucination before.
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og hun havde aldrig haft en hallucination før.
03:32
She said that the hallucinations were unrelated
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Hun sagde, at hallucinationerne var uden relation
03:35
to anything she was thinking or feeling or doing,
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til noget som helst hun tænkte eller følte eller gjorde.
03:39
that they seemed to come on by themselves, or disappear.
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At de lod til at komme frem af sig selv, eller forsvinde [af dem selv].
03:43
She had no control over them.
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Hun havde ingen kontrol over dem.
03:45
She said she didn't recognize
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Hun sagde, at hun ikke genkendte
03:47
any of the people or places
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nogen af folkene eller stederne
03:49
in the hallucinations.
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i hallucinationerne.
03:51
And none of the people or the animals,
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Og ingen af folkene eller dyrene,
03:53
well, they all seemed oblivious of her.
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altså, de virkede alle til ikke at ænse hende.
03:57
And she didn't know what was going on.
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Og hun vidste ikke, hvad der foregik.
03:59
She wondered if she was going mad
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Hun spekulerede på, om hun var ved at blive skør
04:01
or losing her mind.
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eller miste forstanden.
04:03
Well, I examined her carefully.
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Nå, jeg undersøgte hende grundigt.
04:05
She was a bright old lady,
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Hun var en kvik gammel dame.
04:07
perfectly sane. She had no medical problems.
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Fuldstændig fornuftig. Hun havde ingen medicinske problemer.
04:11
She wasn't on any medications which could produce hallucinations.
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Hun var ikke på noget medicin, der kunne forårsage hallucinations.
04:15
But she was blind.
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Men hun var blind.
04:17
And I then said to her,
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Og jeg sagde til hende,
04:19
"I think I know what you have."
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"Jeg tror, jeg ved, hvad du har."
04:21
I said, "There is a special form of visual hallucination
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Jeg sagde, "Der er en speciel form for visuel hallucination,
04:25
which may go with deteriorating vision or blindness.
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der kan komme af nedsat syn eller blindhed."
04:29
This was originally described," I said,
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"Dette blev først beskrevet," sagde jeg,
04:32
"right back in the 18th century,
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"tilbage i det 18. århundrede
04:34
by a man called Charles Bonnet.
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af en mand ved navn Charles Bonnet.
04:37
And you have Charles Bonnet syndrome.
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Og du har Charles Bonnets syndrom.
04:40
There is nothing wrong with your brain. There is nothing wrong with your mind.
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Der er intet galt med din hjerne. Der er intet galt med dit sind.
04:42
You have Charles Bonnet syndrome."
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Du har Charles Bonnets syndrom."
04:45
And she was very relieved at this,
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Og hun blev meget lettet over at høre,
04:48
that there was nothing seriously the matter,
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at der ikke var noget seriøst i vejen
04:52
and also rather curious.
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og også ret nysgerrig.
04:55
She said, "Who is this Charles Bonnet?"
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Hun sagde, "Hvem er denne Charles Bonnet?"
04:57
She said, "Did he have them himself?"
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Hun sagde, "Havde han dem selv?"
05:00
And she said, "Tell all the nurses
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Og hun sagde, "Sig til alle sygeplejerskerne,
05:03
that I have Charles Bonnet syndrome."
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at jeg har Charles Bonnets syndrom."
05:06
(Laughter)
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(Latter)
05:08
"I'm not crazy. I'm not demented. I have Charles Bonnet syndrome."
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"Jeg er ikke gal. Jeg er ikke dement. Jeg har Charles Bonnets syndrom."
05:12
Well, so I did tell the nurses.
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Nå, så jeg fortalte sygeplejerskerne det.
05:14
Now this, for me, is a common situation.
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Nå for mig er dette en normal situation.
05:17
I work in old-age homes, largely.
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Jeg arbejder hovedsagligt på plejehjem,
05:19
I see a lot of elderly people
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og jeg ser en masse ældre mennesker,
05:21
who are hearing impaired or visually impaired.
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der er hørehæmmede eller synshæmmede.
05:25
About 10 percent of the hearing impaired people
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Omkring 10 procent af de hørehæmmede
05:27
get musical hallucinations.
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får musiske hallucinationer.
05:30
And about 10 percent of the visually impaired people
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Og omkring 10 procent af de synshæmmede
05:33
get visual hallucinations.
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får visuelle hallucinationer.
05:35
You don't have to be completely blind,
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Du behøver ikke være helt blind,
05:37
only sufficiently impaired.
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kun tilstrækkeligt hæmmet.
05:39
Now with the original description in the 18th century,
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Nå hvad angår den originale beskrivelse i det 18. århundrede,
05:43
Charles Bonnet did not have them.
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havde Charles Bonnet dem ikke selv.
05:45
His grandfather had these hallucinations.
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Hans bedstefar havde disse hallucinationer.
05:48
His grandfather was a magistrate, an elderly man.
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Hans bedstefar var underretsdommer, en ældre mand.
05:51
He'd had cataract surgery.
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Han var blevet opereret for grå stær.
05:54
His vision was pretty poor.
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Hans syn var ret dårligt.
05:56
And in 1759, he described to his grandson
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Og i 1759 beskrev han for sit barnebarn
06:01
various things he was seeing.
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forskellige ting, han så.
06:03
The first thing he said was he saw
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Det første, han sagde, var, at han så
06:05
a handkerchief in midair.
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et lommetørklæde frit i luften.
06:07
It was a large blue handkerchief
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Det var et stort, blåt lommetørklæde
06:09
with four orange circles.
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med fire orange cirkler.
06:11
And he knew it was a hallucination.
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Og han vidste, det var en hallucination.
06:14
You don't have handkerchiefs in midair.
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Man har ikke lommetørklæder frit i luften.
06:16
And then he saw a big wheel in midair.
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Og så så han et stort hjul frit i luften.
06:20
But sometimes he wasn't sure whether he was hallucinating or not,
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Men nogle gange var han ikke sikker på, om han hallucinerede eller ej.
06:25
because the hallucinations would fit
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For hallucinationerne ville passe
06:27
in the context of the visions.
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ind i sammenhængen af syn.
06:29
So on one occasion, when his granddaughters were visiting them,
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Så ved én lejlighed, da hans børnebørn besøgte dem,
06:32
he said, "And who are these handsome young men with you?"
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sagde han, "Og hvem er så disse nydelige unge mænd, I har med?"
06:37
And they said, "Alas, Grandpapa, there are no handsome young men."
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Og de sagde, "Ak, Bedstefar, der er ingen nydelige unge mænd."
06:41
And then the handsome young men disappeared.
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Og så forsvandt de nydelige unge mænd.
06:45
It's typical of these hallucinations
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Det er typisk for disse hallucinationer,
06:48
that they may come in a flash and disappear in a flash.
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at de kan komme i et glimt og forsvinde i et glimt.
06:51
They don't usually fade in and out.
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De toner som regel ikke ind og ud.
06:53
They are rather sudden, and they change suddenly.
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De er ret pludselige. Og de ændrer sig pludseligt.
06:56
Charles Lullin, the grandfather,
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Charles Lullin, bedstefaren,
06:59
saw hundreds of different figures,
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så hundredvis af forskellige figurer,
07:02
different landscapes of all sorts.
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forskellige landskaber af alle slags.
07:04
On one occasion, he saw a man in a bathrobe smoking a pipe,
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Ved én lejlighed så han en mand i badekåbe, der røg pibe,
07:08
and realized it was himself.
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og indså, det var ham selv.
07:11
That was the only figure he recognized.
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Det var den eneste figur, han genkendte.
07:14
On one occasion when he was walking in the streets of Paris,
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Ved én lejlighed, da han gik i Paris' gader,
07:18
he saw -- this was real -- a scaffolding.
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så han -- dette var ægte -- et stillads.
07:21
But when he got back home, he saw a miniature of the scaffolding
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Men da han kom hjem, så han en miniatureudgave af stilladset
07:24
six inches high, on his study table.
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seks tommer højt på sit skrivebord.
07:28
This repetition of perception
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Denne gentagelse af sansning
07:31
is sometimes called palinopsia.
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kaldes nogle gange palinopsia.
07:33
With him and with Rosalie,
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For ham, og for Rosalie,
07:38
what seems to be going on --
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hvad der lader til at foregå --
07:40
and Rosalie said, "What's going on?" --
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og Rosalie sagde, "Hvad foregår der?" --
07:42
and I said that as you lose vision,
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og jeg sagde, at som du mister synet,
07:45
as the visual parts of the brain are no longer getting any input,
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når de visuelle dele af hjernen ikke længere modtager noget,
07:48
they become hyperactive and excitable,
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bliver de hyperaktive og pirrelige.
07:51
and they start to fire spontaneously.
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Og de begynder at affyre spontant.
07:53
And you start to see things.
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Og man begynder at se ting.
07:56
The things you see can be very complicated indeed.
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Tingene, man ser, kan i den grad være meget komplicerede.
07:59
With another patient of mine,
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For en anden af mine patienter,
08:03
who, also had some vision,
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der [ligesom Charles Lullin stadig] havde noget af synet,
08:05
the vision she had could be disturbing.
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kunne synes hun havde være forstyrrende.
08:09
On one occasion, she said she saw
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Ved én lejlighed sagde hun, hun så
08:12
a man in a striped shirt in a restaurant.
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en mand i en stribet trøje i en restaurant.
08:15
And he turned around. And then
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Og han vendte rundt. Og så
08:17
he divided into six figures in striped shirts,
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delte han sig i seks identiske skikkelser i stribede trøjer,
08:20
who started walking towards her.
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der begyndte at gå imod hende.
08:23
And then the six figures came together again, like a concertina.
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Og så blev de seks skikkelser sat sammen igen, som en concertina.
08:26
Once, when she was driving,
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Engang, imens hun kørte,
08:28
or rather, her husband was driving,
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eller rettere, hendes mand kørte,
08:30
the road divided into four
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delte vejen sig i fire.
08:32
and she felt herself going simultaneously up four roads.
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Og hun følte sig selv køre op ad fire veje på én gang.
08:36
She had very mobile hallucinations as well.
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Hun havde også meget mobile hallucinationer.
08:41
A lot of them had to do with a car.
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Mange af dem havde noget at gøre med en bil.
08:44
Sometimes she would see a teenage boy
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Nogle gange så hun en teenagedreng
08:46
sitting on the hood of the car.
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sidde på bilens kølerhjelm.
08:49
He was very tenacious and he moved rather gracefully
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Han var meget vedholdende og han bevægede sig ret yndefuldt,
08:51
when the car turned.
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når bilen drejede.
08:53
And then when they came to a stop,
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Og så, når de holdt stille,
08:56
the boy would do a sudden vertical takeoff, 100 foot in the air,
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ville drengen pludseligt sætte lodret af, 30 meter op i luften,
08:59
and then disappear.
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og så forsvinde.
09:02
Another patient of mine had a different sort of hallucination.
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En anden af mine patienter havde en anden form for hallucination.
09:07
This was a woman who didn't have trouble with her eyes,
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Dette var en kvinde, der ikke havde problemer med øjnene,
09:10
but the visual parts of her brain,
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men med de visuelle dele af sin hjerne.
09:12
a little tumor in the occipital cortex.
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En lille svulst i nakkelappen.
09:15
And, above all, she would see cartoons.
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Og først og fremmest så hun tegneserier.
09:20
These cartoons would be transparent
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Disse tegneserier var gennemsigtige
09:25
and would cover half the visual field, like a screen.
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og dækkede halvdelen af det synlige felt, som en skærm.
09:28
And especially she saw cartoons of Kermit the Frog.
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Og hun så især tegneserier med Kermit.
09:34
(Laughter)
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(Latter)
09:35
Now, I don't watch Sesame Street,
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Nu ser jeg godt nok ikke Sesame Street.
09:38
but she made a point of saying,
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Men hun havde en pointe i at sige,
09:41
"Why Kermit?" She said, "Kermit the Frog means nothing to me.
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"Hvorfor Kermit?" Hun sagde, "Kermit betyder intet for mig.
09:45
You know, I was wondering about Freudian determinants.
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Du ved, jeg tænkte på freudianske determinanter.
09:48
Why Kermit?
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Hvorfor Kermit?
09:50
Kermit the Frog means nothing to me."
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Kermit betyder intet for mig."
09:52
She didn't mind the cartoons too much.
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Hun havde ikke så meget imod tegneserierne.
09:54
But what did disturb her was she got very persistent
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Men hvad der forstyrrede hende, var at hun havde meget vedvarende
09:58
images or hallucinations of faces
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billeder eller hallucinationer af ansigter
10:01
and as with Rosalie, the faces were often deformed,
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og som for Rosalie, var ansigterne ofte deforme
10:04
with very large teeth or very large eyes.
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med meget store tænder eller meget store øjne.
10:08
And these frightened her.
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Og disse skræmte hende.
10:11
Well, what is going on with these people?
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Nå, hvad sker der for disse mennesker?
10:15
As a physician, I have to try and define what's going on,
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Som læge, er jeg nødt til at forsøge at definere, hvad der sker,
10:18
and to reassure people,
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og forsikre folk.
10:20
especially to reassure them that they're not going insane.
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Især forsikre dem om, at de ikke er ved at blive sindssyge.
10:24
Something like 10 percent, as I said,
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Omkring 10 procent, som jeg sagde,
10:27
of visually impaired people get these.
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af synshæmmede får disse.
10:30
But no more than one percent of the people acknowledge them,
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Men ikke mere end en procent af menneskerne vedkender sig dem.
10:34
because they are afraid they will be seen as insane or something.
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Fordi de er bange for, at de vil blive anset for gale eller sådan noget.
10:37
And if they do mention them to their own doctors
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Og hvis de nævner dem for deres egne læger,
10:39
they may be misdiagnosed.
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kan de blive fejldiagnosticerede.
10:42
In particular, the notion is that if you see
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Især er opfattelsen, at hvis du ser
10:44
things or hear things, you're going mad,
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ting eller hører ting, er du ved at blive gal.
10:47
but the psychotic hallucinations are quite different.
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Men de psykotiske hallucinationer er meget forskellige.
10:50
Psychotic hallucinations, whether they are visual or vocal,
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Psykotiske hallucinationer, uanset om de er visuelle eller stemmer,
10:53
they address you. They accuse you.
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de henvender sig til dig. De anklager dig.
10:55
They seduce you. They humiliate you.
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De forfører dig. De ydmyger dig.
10:57
They jeer at you.
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De håner dig.
11:00
You interact with them.
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Du interagerer med dem.
11:02
There is none of this quality of being addressed
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Der er intet af denne bliven tiltalt
11:05
with these Charles Bonnet hallucinations.
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ved disse Charles Bonnet-hallucinationer.
11:08
There is a film. You're seeing a film which has nothing to do with you,
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Der er en film. Du ser en film, der intet har med dig at gøre.
11:12
or that's how people think about it.
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Eller det er sådan folk opfatter det.
11:15
There is also a rare thing called temporal lobe epilepsy,
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Der er også en sjælden ting kaldet temporallapsepilepsi.
11:19
and sometimes, if one has this,
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Og somme tider, hvis man har dette,
11:22
one may feel oneself transported back
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kan man føle sig ført tilbage
11:24
to a time and place in the past.
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til en tid og et sted i fortiden.
11:27
You're at a particular road junction.
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Man er ved en bestemt vejtilslutning.
11:29
You smell chestnuts roasting.
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Man kan lugte ristede kastanjer.
11:31
You hear the traffic. All the senses are involved.
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Man kan høre trafikken. Alle sanser er involverede.
11:34
And you're waiting for your girl.
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Og man venter på sin pige.
11:36
And it's that Tuesday evening back in 1982.
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Og det er den tirsdag aften tilbage i 1982.
11:40
And the temporal lobe hallucinations
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Og tindingelaphallucinationerne
11:42
are all-sense hallucinations,
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er alle mange-sansende hallucinationer
11:44
full of feeling, full of familiarity,
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fyldt med følelse, fyldt med genkendelighed,
11:47
located in space and time,
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placerede i rum og tid,
11:49
coherent, dramatic.
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sammenhængende, dramatiske.
11:51
The Charles Bonnet ones are quite different.
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Charles Bonnet hallucinationerne er helt anderledes.
11:54
So in the Charles Bonnet hallucinations,
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Så i Charles Bonnet hallucinationer
11:58
you have all sorts of levels,
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har man alle mulige niveauer
12:00
from the geometrical hallucinations --
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fra de geometriske hallucinationer,
12:02
the pink and blue squares the woman had --
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de pink og blå kvadrater, kvinden så,
12:05
up to quite elaborate hallucinations
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op til de ret detaljerede hallucinationer
12:09
with figures and especially faces.
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med figurer og især ansigter.
12:12
Faces, and sometimes deformed faces,
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Ansigter, og nogle gange deforme ansigter,
12:15
are the single commonest thing
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er den allermest almindelige ting
12:18
in these hallucinations.
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i disse hallucinationer.
12:20
And one of the second commonest is cartoons.
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Og en af de næst-mest normale er tegneserier.
12:23
So, what is going on?
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Så, hvad sker der?
12:26
Fascinatingly, in the last few years,
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Fascinerende nok i de sidste par år
12:28
it's been possible to do functional brain imagery,
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har det været muligt at skabe funktionelle hjernebilleder,
12:32
to do fMRI on people as they are hallucinating.
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at lave fMRI på folk, mens de hallucinerer.
12:36
And in fact, to find that different parts
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Og faktisk at finde ud af, at forskellige dele
12:40
of the visual brain are activated
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af den visuelle hjerne aktiveres,
12:43
as they are hallucinating.
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mens de hallucinerer.
12:45
When people have these simple geometrical hallucinations,
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Når folk har disse simple geometriske hallucinationer,
12:48
the primary visual cortex is activated.
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aktiveres den primære visuelle hjernebark.
12:52
This is the part of the brain which perceives edges and patterns.
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Dette er den del af hjernen, der opfatter kanter og mønstre.
12:55
You don't form images with your primary visual cortex.
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Man skaber ikke billeder med sin primære visuelle hjernebark.
12:59
When images are formed,
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Når billeder skabes,
13:02
a higher part of the visual cortex
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er en højere del af den visuelle hjernebark
13:04
is involved in the temporal lobe.
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involveret i tindingelappen.
13:06
And in particular, one area of the temporal lobe
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Og især ét af områderne i tindingelappen
13:11
is called the fusiform gyrus.
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hedder den tenformede gyrus.
13:13
And it's known that if people have damage in the fusiform gyrus,
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Og det er kendt, at hvis folk har skader i den tenformede gyrus,
13:17
they maybe lose the ability to recognize faces.
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mister de måske evnen til at genkende ansigter.
13:21
But if there is an abnormal activity in the fusiform gyrus,
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Men hvis der er en abnorm aktivitet i den tenformede gyrus,
13:25
they may hallucinate faces,
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kan de få ansigtshallucinationer.
13:27
and this is exactly what you find in some of these people.
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Og dette er præcis, hvad man finder hos nogle af disse folk.
13:30
There is an area in the anterior part of this gyrus
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Der er et område i den forreste del af denne gyrus,
13:34
where teeth and eyes are represented,
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hvor tænder og øjne repræsenteres.
13:39
and that part of the gyrus is activated
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Og denne del af gyrussen aktiveres,
13:42
when people get the deformed hallucinations.
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når folk får de deforme hallucinationer.
13:46
There is another part of the brain
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Der er en anden del af hjernen,
13:48
which is especially activated
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som især aktiveres,
13:50
when one sees cartoons.
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når man ser tegneserier.
13:52
It's activated when one recognizes cartoons,
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Den aktiveres, når man genkender tegneserier,
13:55
when one draws cartoons, and when one hallucinates them.
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når man tegner tegneserier, og når man hallucinerer om dem.
13:59
It's very interesting that that should be specific.
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Det er meget interessant, at dette skulle være specifikt.
14:02
There are other parts of the brain which are specifically involved
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Der er andre dele af hjernen, som er specifikt involveret
14:05
with the recognition and hallucination
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med genkendelsen af og hallucination om
14:07
of buildings and landscapes.
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bygninger og landskaber.
14:10
Around 1970, it was found that there were not only parts of the brain,
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Omkring 1970 fandt man ud af, at der ikke kun var specielle dele af hjernen [involverede],
14:13
but particular cells.
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men specielle celler.
14:15
"Face cells" were discovered around 1970.
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"Ansigtsceller" blev opdaget omkring 1970.
14:20
And now we know that there are hundreds of other
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Og nu ved vi, at der er hundredvis af andre
14:22
sorts of cells,
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slags celler,
14:24
which can be very, very specific.
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der kan være meget meget specifikke.
14:26
So you may not only have
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Så man kan ikke bare have
14:28
"car" cells,
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"bil"-celler,
14:30
you may have "Aston Martin" cells.
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man kan have "Aston Martin"-celler.
14:33
(Laughter)
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(Latter)
14:35
I saw an Aston Martin this morning.
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Jeg så en Aston Martin i morges.
14:37
I had to bring it in.
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Jeg var nødt til at have den med.
14:39
And now it's in there somewhere.
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Og nu er den derinde et sted.
14:42
(Laughter)
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(Latter)
14:45
Now, at this level, in what's called the inferotemporal cortex,
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Nå, på dette niveau i det, der kaldes den inferotemporale hjernebark,
14:49
there are only visual images,
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er der kun visuelle billeder,
14:52
or figments or fragments.
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eller hjernespind eller brudstykker.
14:55
It's only at higher levels
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Det er først på højere niveauer,
14:58
that the other senses join in
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at de andre sanser kommer med,
15:00
and there are connections with memory and emotion.
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og der er forbindelser med hukommelse og følelse.
15:02
And in the Charles Bonnet syndrome,
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Og med Charles Bonnets syndrom
15:05
you don't go to those higher levels.
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kommer man ikke op på disse højere niveauer.
15:07
You're in these levels of inferior visual cortex
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Man er på disse niveauer af lavere visuel hjernebark,
15:10
where you have thousands and tens of thousands
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hvor man har tusindvis og titusindvis
15:12
and millions of images,
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og millioner af billeder,
15:15
or figments, or fragmentary figments,
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eller hjernespind, eller brudstykker af billeder,
15:17
all neurally encoded
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alle kodet i nerver
15:19
in particular cells or small clusters of cells.
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især celler eller små bunker af celler.
15:23
Normally these are all part of
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Normalt er alle disse del af
15:26
the integrated stream of perception, or imagination,
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den integrerede strøm af opfattelse eller fantasi.
15:30
and one is not conscious of them.
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Og man er dem ikke bevidst.
15:33
It is only if one is visually impaired or blind
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Det er kun, hvis man er synshæmmet eller blind,
15:37
that the process is interrupted.
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at processen afbrydes.
15:39
And instead of getting normal perception,
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Og i stedet for at få normal opfattelse,
15:42
you're getting an anarchic,
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får man en anarkisk,
15:44
convulsive stimulation, or release,
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krampagtig stimulans eller frigivelse
15:47
of all of these visual cells
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af alle disse visuelle celler
15:49
in the inferotemporal cortex.
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i den inferotemporale hjernebark.
15:51
So, suddenly you see a face. Suddenly you see a car.
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Så pludselig ser man et ansigt. Pludselig ser man en bil.
15:54
Suddenly this, and suddenly that.
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Pludselig dit og pludselig dat.
15:57
The mind does its best to organize
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Sindet gør sit bedste for at organisere
15:59
and to give some sort of coherence to this,
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og give en form for sammenhæng i dette.
16:02
but not terribly successfully.
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Men ikke med stor succes.
16:04
When these were first described,
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Da disse først blev beskrevet,
16:06
it was thought that they could be interpreted like dreams.
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troede man, at de kunne fortolkes som drømme.
16:10
But in fact people say,
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Men faktisk siger folk,
16:12
"I don't recognize the people. I can't form any associations."
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"Jeg genkender ikke de folk. Jeg får ingen associationer."
16:15
"Kermit means nothing to me."
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"Kermit betyder intet for mig."
16:18
You don't get anywhere thinking of them as dreams.
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Man kommer ingen vegne ved at tænke på dem som drømme.
16:23
Well, I've more or less said what I wanted.
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Nå, jeg har mere eller mindre sagt, hvad jeg ville.
16:28
I think I just want to recapitulate
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Jeg tror, jeg bare vil sammenfatte
16:31
and say this is common.
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og sige, at det her er normalt.
16:33
Think of the number of blind people.
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Tænk på antallet af blinde
16:35
There must be hundreds of thousands of blind people
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Der må være hundredtusindvis af blinde,
16:37
who have these hallucinations,
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der har disse hallucinationer,
16:39
but are too scared to mention them.
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men er for bange til at nævne dem.
16:41
So this sort of thing needs to be brought into
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Så denne slags ting bør gøres opmærksom på
16:44
notice, for patients, for doctors, for the public.
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for patienter, for læger, for offentligheden.
16:50
Finally, I think they are
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Endelig synes jeg, de er
16:52
infinitely interesting and valuable,
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uendeligt interessante og værdifulde
16:55
for giving one some insight as to how the brain works.
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til at give en noget indsigt i, hvordan hjernen virker.
16:59
Charles Bonnet said, 250 years ago --
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Charles Bonnet sagde for 250 år siden --
17:02
he wondered how, thinking these hallucinations,
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han spekulerede på hvordan, imens han tænkte på disse hallucinationer,
17:06
how, as he put it, the theater of the mind
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hvordan, som han sagde det, sindets teater
17:09
could be generated by the machinery of the brain.
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kunne skabes af hjernens maskineri.
17:12
Now, 250 years later,
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Nu, 250 år senere,
17:15
I think we're beginning to glimpse how this is done.
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tror jeg vi begynder at se et glimt af, hvordan dette gøres.
17:18
Thanks very much.
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Mange tak.
17:20
(Applause)
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(Bifald)
17:23
Chris Anderson: That was superb. Thank you so much.
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Chris Anderson: Det var superbt. Mange gange tak.
17:26
You speak about these things with so much insight
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Du taler om disse ting med så stor indsigt
17:28
and empathy for your patients.
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og empati for dine patienter.
17:31
Have you yourself experienced any of the syndromes you write about?
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Har du selv oplevet nogen af syndromerne, du skriver om?
17:36
Oliver Sacks: I was afraid you'd ask that.
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Oliver Sacks: Jeg frygtede, du ville spørge om det.
17:38
(Laughter)
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(Latter)
17:39
Well, yeah, a lot of them.
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Altså, jah, mange af dem.
17:42
And actually I'm a little visually impaired myself.
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Og faktisk er jeg en smule synshæmmet selv.
17:45
I'm blind in one eye, and not terribly good in the other.
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Jeg er blind på det ene øje, og det andet er ikke frygteligt godt.
17:48
And I see the geometrical hallucinations.
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Og jeg ser de geometriske hallucinationer.
17:52
But they stop there.
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Men de stopper der.
17:54
CA: And they don't disturb you?
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C.A.: Og de forstyrrer dig ikke?
17:56
Because you understand what's doing it, it doesn't make you worried?
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Fordi du forstår, hvad der forårsager det. Det gør dig ikke bekymret?
17:58
OS: Well they don't disturb me any more than my tinnitus,
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O.S.: Altså de forstyrrer mig ikke mere end min tinnitus.
18:02
which I ignore.
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Som jeg ignorerer.
18:05
They occasionally interest me,
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De interesserer mig til tider.
18:07
and I have many pictures of them in my notebooks.
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Og jeg har mange billeder af dem i mine notesbøger.
18:10
I've gone and had an fMRI myself,
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Jeg har selv fået en FMRI
18:13
to see how my visual cortex is taking over.
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for at se, hvordan min visuelle hjernebark tager over.
18:16
And when I see all these hexagons
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Og når jeg ser alle disse hexagoner
18:20
and complex things, which I also have,
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og komplekse ting, som jeg også ser
18:22
in visual migraine,
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under visuel migræne,
18:24
I wonder whether everyone sees things like this,
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tænker jeg på, hvorvidt alle ser sådanne ting,
18:26
and whether things like cave art or ornamental art
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og hvorvidt ting som hulekunst eller ornamentkunst
18:29
may have been derived from them a bit.
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kan være afledt af dem en smule.
18:32
CA: That was an utterly, utterly fascinating talk.
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C.A.: Det var en yderst fascinerede snak.
18:34
Thank you so much for sharing.
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Mange gange tak for at dele den.
18:36
OS: Thank you. Thank you.
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O.S.: Tak. Tak.
18:38
(Applause)
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(Bifald)
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