We learned about the upside-down world from the hit Stranger Things series, in which reality on the other side of the world is portrayed differently, with monsters and storms. But an upside-down planet, with the sky instead of the ground and the clouds like carpets, Patient M knew in the last century and his story, which El Pais told on the occasion of the publication of a new article in Neurology journal The study of the strange case still represents a valuable clue in the never-completed study of how the human brain works.
The story of patient M
Patient M was 25 years old in 1938 when he was shot in the head in combat in the Spanish Civil War. Two weeks later, the Republican soldier regained consciousness and miraculously required no special surgery or treatment. But the man had undergone a shocking change: he saw the world upside down. Realizing that it was the doctor who was following him, Justo Gonzalo. The bullet, believed to have been fired by Franco supporters, had partially damaged the cerebral cortex in the left parieto-occipital area. Doctor and patient survived the war and continued to see each other for 50 years until Dr. Gonzalo died in 1986.
The strange symptoms
Over the years, the doctor has described the bizarre symptoms of this patient who became a friend. The soldier saw everything tripled and perceived the colors “detached” from the objects as if they were a separate thing, distinct and separate from the object itself. The objects were then colored predominantly green. But the strangest thing of all is that when the war veteran was not exposed to any special stimuli and was resting, he saw everything as if it were upside down. He had a kind of reverse vision: he could read letters and numbers both in the normal position and in the upside down position, which meant that the position was identical in both cases. His auditory and tactile perceptions were also reversed, so that sound and touch appeared on the opposite side in his mind. Gonzalo wrote in his notes that his patient saw men working upside down on scaffolding.
The brain and its adaptability
At the time, most neurologists believed that the brain was made up of very different regions, separated by sharp boundaries, with very precise functions. Justo Gonzalo, in his book Cerebral Dynamics, was observing the aftermath of the soldier’s injury and hypothesized that the brain is not divided into distinct regions, but is interconnected with surprising adaptability. The researcher had hypothesized that the effect of a cortical lesion depends on its size and location: size affects the intensity of the disorder, while location affects the type of disorder. Deepening his studies, he proposed the theory of brain dynamics, or, in simple terms, that brain functions are distributed in gradients with gradual transitions.
The reconstruction of the daughter
Years later, Gonzalo’s daughter Isabel Gonzalo, physicist and professor emeritus at the Complutense University of Madrid, who had known patient M all her life during her family visits, dusted off her father’s archives, boxes containing hundreds of documents and photos, with the aim of reconstruction of the case with the help of neuropsychologist Alberto García Molina. The result of this trip down memory lane is the new work recently published in the journal Neurology. “My father admired him because he was a very brilliant person who could take care of himself and work in the fields,” Isabel Gonzalo recalls. Although wounded in the war, Patient M never received a pension, but tended to minimize his ailments, which he had struggled with throughout his life. His identity was never revealed.
What does the history of neurology tell us?
The history of neurology tells of many tragic experiments in nature. Like that of Phineas Gage, an American railroad captain who survived an iron bar rammed into his brain on September 13, 1848. The previously quiet man became aggressive and vulgar. World-renowned neurologist Oliver Sacks collects some interesting clinical cases that happened to him throughout his career in his famous book, The Man Who Mistook His Wife for a Hat. Such as the story of Jimmie, who lost his ability to memorize at age 19 and was stuck in 1945; or dr P, the musician who mistook fire hydrants for children and addressed doorknobs as if they were people. He once mistook his wife’s head for a hat and grabbed her to put it on his head. Another lesser-known Indian neurologist, perhaps because of his unpronounceable name, Vilayanur Subramanian Ramachandran, has also reported numerous patient stories in his book The Man Who Thought He Was Dead. The neuroscientist tells us the stories of Francesca, Susan and Mirabelle, who, quite literally, see sounds and hear colors due to synesthesia that “mixes” sensations, perceptions and emotions. Nora, on the other hand, after suffering a stroke, denied the apparent infirmity of young Ali, an epileptic who really thought he was dead. More recently, a young American girl has anterogada amnesia: After a head injury, her memory is stuck on October 12, 2017. The girl cannot remember anything for more than 12 hours and always lives in the present.