Unilateral Neglect Part 1

The following report is included in The Sheriff’s Jeep Log section as background material.

The author drove my pickup into downtown Eugene and parked on 5th with minimal grinding of the clutch. She had decided on her favorite method of securing an appointment: show up with a smile followed by a hook: “Bob has a strange obsession that I created him. Does that put me in some kind of particular danger?” She was ushered in without delay.

First question to exit the psychologist’s mouth: “Are you a relative?”

“Not exactly. We’ve been friends for a number of years. I’m house-sitting while he’s on vacation, but he seems to be sticking around.”

“What makes you believe he thinks you created him?” The psychologist had her own brand of smile, and it intensified on impact with the word you leaving other elements of the sentence in shadows. Already the author was busted. No data to stand on.

“Well, he makes cracks to that effect.”

“For example?”

“Is there a name for his obsession?”

The psychologist whipped out her DSM-IV and laid it in front of the author. “Here’s our catalog. There aren’t many illnesses that don’t show up here.” She stroked the tome fondly: “If I am to wade through this book, I’ll need to know a lot more. Did you create him?”

The author grinned large: “Anything is possible; what’s more, if you follow your question to its logical conclusion, you must surely realize that I created you as well.”

“Only in the mind is everything possible. In the real world, there are rules to live by, gravity for example. We can turn off gravity in our minds. We can imagine balls with wills of their own defying Newton’s laws, but that isn’t real is it—I don’t believe you introduced yourself.”

“Marcia, just Marcia. You’re going to have to trust me on this Bob thing.”

“Trust is not a basis for diagnosis. Maybe you can answer a different question, Marcia.” Her lips closed around the name like a door on a padded cell. “What makes you think you’re in danger?”

“One never knows.”

“True, but you and Bob have been friends for a number of years, or so you said. Has there been a change in your relationship?”

The author had failed to plan out her moves and was forced to jump inelegantly to the real purpose behind her visit. “What is the name of the condition in which a person is unable to perceive the left side of his pancake?”

“Hemispatial neglect, but it doesn’t apply here unless—did Bob receive a blow to the head? He’s much too young for a stroke certainly.”

“He goes through a strange ritual with a knife and a plate of pancakes.”

“Oh?”

“Yes, he bisects the entire stack and then proceeds to rotate the plate, stopping here and there to stare.”

“What worries you most, Marcia, the knife or the pancakes?”

“Would you say, Jocelyn, this ritual is an indication of hemispatial neglect?”

“An accurate bisection would suggest the opposite.”

“Why?”

“A person who suffers from unilateral neglect ignores part of their world.”

“You mean our world don’t you? After all, if they ignore it, it’s no longer part of their reality.”

“Indeed.”

“Is it always the left side that gets ignored as if there were a sinister presence lurking?”

“The neglect is contralesional; however, most of the time only lesions to the right parietal cortex generate the symptoms you’ve described.”

“Does the problem affect vision only?”

“All modalities—auditory, visual, olfactory, tactile, even motor—can be affected. Representational disability usually affects memory as well as dreams. Also, the ipsilesional, non-neglected, side of space may be haunted—hallucinations of course.”

The author was briefly disabled by the barrage of technical terminology and responded with a comment reflective of her own inner state: “Sounds like their reality is way screwed up.”

“It would be more correct to say that the subject’s relationship with reality is altered. We have methods of testing for neglect. Would you like to try one out?”

“Good idea, Jocelyn.” The author handled the psychologist’s name as a possession. The psychologist noticed but hid it so expertly that even the author could not detect the realization. “I could try out the test on Bob.”

The psychologist placed a drawing of a cat and a blank piece of paper in front of the author. The cat faced the viewer in a sitting position. “See if you can copy my cat.”

“I hope you won’t be grading me on accuracy,” she quipped.

“Accuracy is important if I am to assess your attention gradient, Marcia.”

The author took her time finally turning out a hemi-cat looking as if it had been sliced down the middle. The cat was closed on its left side with a vertical line. The psychologist nodded upon receipt and produced a second drawing comprised of multiple objects. The author only copied the objects on the right side of the paper.

“In this last test, I want you to draw a clock from memory. Set the time for 10.”

The author drew the right half of a clock closing it with a straight line on the left side but failed to indicate a time.

Jocelyn nodded significantly, “Yes, you could try these same tests on Bob; however, it would be better if I dropped by and made the assessment myself. When is Bob usually around these days?”

“He’s unpredictable not to mention he would be suspicious.”

“We should coordinate our stories to remove that possibility. If you told him for example that you created me, it would tend to give Bob and I something in common if you see what I mean.”

“Or he might conclude that I was making fun of his obsession. No Jocelyn, it would be better if I tested him myself.”

“Alright, I’ll put you down for an appointment in the morning, let’s say 10. It will be interesting to see what you come up with.”

Marcia Letaw

One Comment

  1. Compelling! One wonders who really has a case of hemilateral neglect.

Leave a Reply