Thursday, May 19

AK Benjamin’s The Case for Love Review: Inside the Minds of the Seriously Ill | Autobiography and memoirs

TO A couple of years ago, neuropsychologist AK Benjamin (a pseudonym) published an unclassifiable memoir and case study titled Don’t let me get mad. It was based on his experience dealing with patients with severe brain disabilities and psychiatric conditions, and on his own struggle to find meaning and purpose as a recovering alcoholic and drug addict.

The writing was both powerfully precise and yet eerily elusive, as if the more carefully the author tried to represent a neurological reality, the more he was forced to question its metaphysical basis. The same tension is repeated in his new book, The case of love: my adventures in other minds.

That “Adventures” can be taken as dryly ironic or a deceptive attempt to add a more commercial action note to an almost claustrophobic cerebral work. Other minds are once again those radically damaged or transformed by disease and misfortune.

The book begins with “Bella,” a jubilant woman who suffers a catastrophic stroke when she dives into the swimming pool of her new home in Albania. She was brought back to a neurointensive care unit in England, she is completely paralyzed, apparently in a coma. She has “lost everything under her eyes,” as you hear, or Benjamin imagines her hearing, says a doctor, but her brain, in a sense, still works.

In what sense? There is nothing you can do to convey understanding or appreciation of the outside world. To a bystander, she is a breathing corpse, and even her oxygen intake is dependent on a machine. But in an act of bravery of imagination, empathy, or, as the book suggests, love, Benjamin evokes an inner perception, a consciousness locked deep within the dying body.

It is a nightmare scenario treated with a Kafka-like appreciation of random displacement, “like being trapped in surgical anesthesia where I felt everything, worse, where I felt nothing but imagined everything that did not feel with phantom acuity.”

Medical efforts to keep her alive are like a sinister mechanized conspiracy and yet she is alive, blessed and cursed with distorted emotions, thoughts and perceptions, a “trail of individuality rather than the thing itself.”

Is this literary revival really an act of love or an act of therapeutic helplessness or even existential despair? It’s a question Benjamin seems to challenge the reader to ask, when he’s not dealing with it himself.

Not for him the voice of the impartial and scrupulously scientific narrator. The patients whose trauma he enters are not so much fascinating cases, the kind explored in a gender-defining way by Oliver Sacks, as neurological injustices that demand our reluctant attention. They are also philosophical mysteries, emissaries of altered states of consciousness whose unspoken message is that all this, the entire rich panoply of what we consider reality, is infinitely and relentlessly fragile.

The reality itself, even with a healthy brain, can also be quite difficult to bear. Certainly Benjamin seems to struggle with the conventions of the good life, detailing between case studies and imaginations of his own family crises and romantic detours. He told me in an interview that “there are aspects of being alive that have been extremely difficult for me”, and in these pages there is no impression that a new facility has been installed.

In any case, his writings about himself are wrapped in more ontological doubts than the sections devoted to his patients. He questions his motives for working with deeply disabled people, wondering if it was just a means of resolving his inner turmoil, as if it was only in the outer manifestation of the trauma of others that he could find respite from his own.

He also questions his role as a writer, how he turns himself into a character who, in his own way, is as imprisoned and alienated from himself as the Beauty he imagines imprisoned within herself.

While his unwillingness to fall into the role of superior and knowledgeable storyteller is admirable, Benjamin can at times seem trapped in a circular self-questioning, leaving the reader yearning for a solid touchstone of ‘reality’, something beyond multi-layered self-criticism. and the terrible arbitrariness of neurological malfunction. He is aware of this too, engaging in a defensive dialogue with a friend who cautions against abstraction. But that awareness does not deny the problem.

Benjamin writes beautifully and with exceptional vision, a tormented soul who knows the truth of the worst torments. In a poignant epilogue, he describes with masterful control the moments leading up to Bella’s fateful plunge into the pool, her intimate feelings, and her tiny distractions, summoning a fully realized adult woman with a complex past and future plans. A stunning writing and expression of love, it could also show the novelist waiting to get out of the hard and inflexible facts of life.

The case of love: my adventures in other minds by AK Benjamin is published by Vintage (£ 16.99). To support the guardian Y Observer order your copy at Shipping charges may apply

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