Exhibit A for “Peter Pan syndrome”

Reader critic blacks out during Verdi's Otello

The publicity department of the Opera had as usual placed me exactly in the middle of one of those immensely broad rows uninterrupted by aisles, so that the project of rising and stumbling out of the theater seemed fraught with difficulty and embarrassment.
  • The publicity department of the Opera had as usual placed me exactly in the middle of one of those immensely broad rows uninterrupted by aisles, so that the project of rising and stumbling out of the theater seemed fraught with difficulty and embarrassment.
  • Image by David Diaz

In the second act of Verdi's Otello, the malevolent Iago begins to weave the net of jealousy and deception in which he will capture the soul of his noble, passionate, gullible general. He insinuates that the Moor's young wife, Desdemona, is involved with Otello's lieutenant, Cassio. From this point on, every innocent act or statement by Desdemona to Cassio serves only to confirm Otello's growing conviction that his wife has been unfaithful. The opera commences its ineluctable drive toward its tragic outcome: murder, suicide, the destruction of a happy marriage, the disastrous conclusion of a glorious career.

When the San Diego Opera put on the first performance of their recent production of Otello, many members of the audience were conscious of a second level of dramatic action. The lead tenor, Giuseppe Giacomini, had been ailing with a respiratory infection, and although he had heroically determined to sing that Saturday night, no one could be certain whether he would get through the role. Would we witness another tragedy of a sort different from that intended by Shakespeare, Boito (the librettist), and Verdi?

But while all this was going on, no one but me knew that a third drama was taking place in the Civic Theatre and that it too was potentially tragic. No one knew it because the setting of that drama was the interior of my own skull. The critic, by the nature of his profession, stands outside of drama, observing, analyzing, empathizing, but not taking part. In this instance, both Otello's actions and Giacomini's had assume for me the status of plays within a play, subordinate dramas reflecting a more important drama: silently, relentlessly, unobserved by the audience intent on the state, something monstrous was happening to me.

To make this interior drama intelligible, I must go back a bit in time and supply some necessary background information, of the sort one might find in program notes outlining the antecedents of a complicated plot. Two weeks before that evening, I had returned home after a long and rewarding day (writing, teaching, an invigorating run on the beach, a fascinating evening seminar on the unconscious) and had climbed into bed with the latest copy of the British journal Gramophone, to do some light reading before going to sleep. I read on for a while, feeling comfortable, mildly interested, and generally soothed, until in the middle of a review of Nielsen's Inextinguishable Symphony (a work that asserts the power of the life force over nihilism and despair) I found myself reading the same sentence over and over again, without quite registering what the writer was trying to say. This happens not infrequently when one is tired or distracted, so I concentrated my attention and reread the sentence slowly and carefully. What I read was something like this: "The opening has an imposing immediately further repetition as it does from impeccable." Gramophone is excellently edited and proofread, so that such a sentence seemed to indicate some terrible breakdown in the journal's usual procedures. I tried it again: "The opghni hms in rbposbni dmmlately gruhtre...." This was no good; what was happening? I screwed up my eyes and focused with the most intense sharpness on one of the words. But by this time, I could not even perceive the little black strokes on the page as letters representing sounds; they looked like arbitrary marks meaning nothing at all.

Laying the journal down, I considered the situation and evaluated it as highly undesirable. Evidently the wise thing to do would be to get help. The telephone is next to my bed. I lifted the receiver with the intention of calling B., a close friend who lives about a mile away down the coast. But in spite of the fact that I ordinarily know his number by heart, I found that at that moment I could not remember it. Indeed, I could not even remember his name. With the receiver suspended in my hand, I tried to think of someone else to call, but I could not remember the name of a single person I knew. After pondering a moment or two, I decided to look in my address book, expecting that the names there would jog my unaccountably recalcitrant memory. I soon was reminded that I was no longer able to read; all the names and phone numbers appeared as mere gibberish.

These impairments of language were familiar to me from the condition of a friend's elderly father and from Arthur Kopit's play Wings. I supposed I must be having a stroke. However, I could not retrieve the word "stroke" — or, for that matter, any word at all. I was now thinking (so far as I could perceive it) without words. My thought processes seemed inordinately slow, as though, having been deprived of my usual swift medium of thinking, I had to make do with something heavier, more unwieldy, more primitive. But the thoughts themselves, sluggish as they were, seemed cogent. "If I can't phone B.," I thought (except that I thought it without the use of language), "I can get up....drive to this house....I know where he lives...." But if my reading ability and my memory were so terribly impaired, I thought, I might also discover that I had forgotten how to drive or that I could not distinguish between a red light and a green one. The safest thing to do, I wordlessly concluded, was to stay where I was and do nothing until either my consciousness (and perhaps my life) was snuffed out altogether or I regained enough of my faculties to take some useful action. So I lay there and waited.

After a while, I noticed that things were starting to change — fortunately in the direction of recovery. I still could not remember B.'s name, but his phone number came back to me. I called him. The moment I heard his voice, I remembered his first name — though not the last one. I searched for words to describe my condition and managed to dredge up a simple vocabulary and to use it in short sentences. As we talked, and with occasional promptings from him, I recovered more and more of my memory. Soon I was thinking and speaking normally; a glance at the discarded Gramophone proved I could once again read. The entire episode, as I found out by consulting the bedside clock, had occupied twenty minutes.

Curiously, I had not experienced the least panic during those eventful twenty minutes. I had certainly not enjoyed them, but — in a perverse way quite characteristic of me — I had found the succession of symptoms extraordinarily interesting to observe, particularly the progressive deterioration, stage by stage, of my reading ability. This emotional coolness in the face of an experience so uncanny and threatening (for how could someone like me get along in life if unable to read?) struck me as the most peculiar — and the most interesting — symptom of all. But if I was not panicked, I was not exactly indifferent to what had happened, and the first thing the next morning, I phoned the UCSD Medical Center, diagnosed myself as having had a "stroke-like" attack, and was put in contact with Dr. R., a neurologist specializing in strokes.

Dr. R., a man of rigorous intellect, plunged energetically into the challenge posed by my syndrome. He conducted a thorough examination of my reflexes, coordination, memory, and reasoning powers, instructing an attentive medical student as he did so, with daunting rapid-fire disquisitions on the numerous sectors of the brain that can be damaged and so give rise to neurological symptoms. All these tests ("Follow my finger," "Press against my hand") produced negative results, indicating that my attack — whatever it had been, had not left any obvious permanent effects.

Nevertheless, my adventure of the night before had not been a dream, and it was necessary to find out what had caused it. Although he would have to investigate more thoroughly to make sure, Dr. R. considered me too young and in too good physical condition for it to be likely that I had had a stroke, an assessment that I took as a deserved commendation. I am enough of a Californian to feel a rather pompous pride in my fitness, as though being healthy were a moral act. This is an inheritance from the self-righteous advisers of the ailing Job, who explain to the confused sufferer that virtue is rewarded by prosperity and health, whereas illness is a punishment for wickedness. Confident of having done my best to behave correctly in all circumstances, I have always taken my lifelong freedom from disease as a divine endorsement of my rectitude, to the point where, deep down, I do not even believe I am going to die. I'd rather be surfing, as we say in the Southland.

This same attitude colored my reaction to Dr. R's alternative diagnoses. I silently rejected each of the other possible causes of the Gramophone episode as he reeled them off: brain tumor (too much like a movie), cardiac arrhythmia (in someone who jogs fifty miles a week?), a low-grade spinal meningitis (in someone who never gets an infection?), migraine (in someone who never gets a headache?), AIDS (come on!). Not blessed with my intuitive certainties, the neurologist ordered an exhaustive series of diagnostic tests, to which I was subjected for the next two weeks. I had undergone most of the tests, all of which were to confirm my utter sinlessness (that is, my state of perfect health), when the opening night of Otello rolled round and I nonchalantly took my seat in the Civic Theatre. In the first act, I duly noted that the tenor, Giacomini, was having some vocal trouble but was gallantly pressing on; that his Desdemona, the Hungarian soprano Ilona Tokody, had a luscious voice; and that the Iago was a forceful actor with coarse singing mannerisms — and in my mind I began tentatively assembling these perceptions into the sentences for my review. A few moments into act two, as Iago was soliloquizing on his faith in a cruel God and a meaningless, purely material universe, I thought I would take a look at the English supertitles that were being flashed on a screen above the proscenium. I know Italian — and Otello — well, and most of the singers were enunciating clearly, so that I had no difficulty in following the words being sung, but it seemed part of my critical duties to check the supertitles and see whether they were giving the audience an accurate and stylistically suitable translation of the text. Much to my surprise, I soon realized that the words coursing serenely across the screen did not make any sense. Something must have gone wrong with the projector — or with the translator, for surely this was not English at all; had Hungarian supertitles been inadvertently substituted, perhaps because of the presence of Miss Tokody?

I looked about me in the audience to see how others were reacting to this absurd mishap, but they all seemed quite oblivious to it, although I could see the eyes of those nearby regularly lifting to consult the translation. And then my concern with Otello's gullibility, Giacomini's flu, and the projectionist's incompetence vanished; all I could think about was the fact that my disconcerting experience of two weeks before was repeating itself, and with even more bizarre features. I was now in the absolutely dumbfounding condition of listening with flawless comprehension to the Italian words of the singers, while at the same time being unable to understand printed words in my native tongue. This could mean nothing other than the irreversible disintegration of my brain.

The earlier attack had found me calm and observant. Now the moment for terror had arrived. I broke out, all over my body, in a cold sweat, a physical experience whose impact is thoroughly incommensurable with the routine melodrama suggested by that old but irreplaceable cliche. My thoughts were dire.

I am of the belief that the body and soul are distinct entities. The body is the prison-house of the soul, as the neo-Platonist puts it, or the body is the soul's vehicle and servant, as it seems to the more eupeptic among us — but certainly the independent current of the self flows on, assessing its circumstances and opportunities and following its own incorporeal scenario, no matter what may be happening to the knees, the lungs, the liver, or even the heart. The distinction between the soul and the brain is not so easy to feel confident about, especially when the brain is not functioning with its usual unobtrusive efficiency. If I am disabled so that I cannot walk, I am still myself, whole and possessed of a firmly shaped identity. But what will happen to the "I" if my ability to think breaks down, if my memory goes, if the mental functions that are also — theoretically — my soul's servants refuse to do their jobs? Will there remain any master in the house? And if the self ceases to have any way of manifesting itself and knowing itself, then Othello's occupation is really gone. These were the dismal speculations that, at a far more rudimentary level of articulation, accompanied and gave a particularly terrifying acridity to my cold sweat.

The publicity department of the Opera had as usual placed me exactly in the middle of one of those immensely broad rows uninterrupted by aisles, so that the project of rising and stumbling out of the theater seemed fraught with difficulty and embarrassment. What if my control of my legs were in the same state of debility as command of English? In any case, I am one of those people who cannot be impelled to cause any kind of disturbance during a theatrical performance unless what is involved is unmistakably a matter of life and death. Although the notion that this condition might be threatening me with imminent death had reduced me to a state of paralytic dread, still I couldn't be sure I was going to die. So I sat there, slumped in my seat, exuding a steady stream of icy drops, while Iago spun his wicked web, Desdemona displayed her naive innocence, and Otello became more insanely suspicious and enraged.

Twenty minutes later, this extremely taut and driving operatic act was over, and the frenzied intensity of my own secret drama was also diminishing. I found no difficulty in standing and shuffling out with the rest of the intermission crowd. But I knew that I had to get to a doctor as soon as possible. By good fortune I bumped into B., strolling outside for a breath of air. I could not recall the words for doctor, hospital, attack, or help — not to speak of alexia (inability to read) or aphasia (inability to use language) — but with great effort, I succeeded in forming the sentence, "I'm in trouble." Soon we were on our way in B.'s car to the emergency room.

By the time we arrived, I had regained my faculties sufficiently to feel guilty about having dragged B. away from the opera, and I found I could express this feeling in intelligible language. "How is the opera going to end?" asked B., who never loses his sense of humor. "Tragically, of course," I replied, gratified not to have to search for the word. "In that case, I can skip it," B. remarked slyly as we drove up to the emergency entrance. At the time this seemed a purely facetious remark, but I was later to recognize a remarkable profundity in it.

In the emergency room, I was greeted by Dr. M., who, as I rapidly recalled, had at one time been a student of mine in a course on Russian poetry. He had gone on from quiet brilliance about Pushkin to a medical degree, and now he was looking at his former teacher with the mixture of shrewdness and compassion I was to encounter in every member of the medical staff. I was busily reading signs on the wall in order to prove to myself that I had recovered from my fit; I felt ready to go home. But Dr. M., having heard a description of the symptoms that might well be ascribed to a stroke, was urgent in persuading me to stay there under observation in case the condition should repeat itself in a more pernicious form. He brought me to the intensive care unit, where, however, I immediately found the atmosphere of crisis and suffering unendurable, informing the doctor that rather than stay all night among that pain and fear, I would go and sleep in my own bed, even if it meant certain death. The thought no doubt occurred to Dr. M. that a judgment of this sort might be the result of some brain damage I had just suffered; although had he known me better, he would have recognized such willful irrationality as a normal trait of my character, not to be excused by organic pathology. In any case, he found me a room on the neurology floor, where nurses and doctors would know how to deal with any recurrence of my illness, and there, after further neurological tests of the now-familiar type — "Follow my finger," "Who is president of the United States" (possibly a trick question) — I was permitted to go to sleep.

The following morning I was examined by the chief neurologist on the floor, Dr. W.; a neurology resident, Dr. K.; my friend Dr. M.; and various medical students attached to the day's rounds. Once again the various somber hypotheses were considered. The symptoms remained ambiguous, Dr. W., pointed out; but the immediate danger was still the possibility that I had had a stroke and might have another. Like Dr. R. two weeks before, he seemed skeptical about this possibility, but he was not about to take chances with my life; he ordered an intravenous administration of a blood-thinning agent, to lessen the likelihood that a blood clot might form somewhere in my body and travel to the arteries of the brain.

In the meantime I had procured pen and paper and was busy writing my article on the first one-and-one quarter acts of Otello. My current troubles had given me a somewhat altered perspective on the opera and the performance. My heart went out to Giacomini, carrying on in spite of his sickness; I was myself going through the same sort of thing, and for the first time in my heretofore blessedly healthy life, I was learning how much courage it takes to put aside one's worries about one's own welfare and to concentrate on getting on with one's work. My heart always goes out to Otello, noble, foolish, and victimized; but now, more than ever before, I was conscious of the terrible inevitability of the tragic story. All its elements — Otello's character, Iago's destructiveness, Desdemona's beauty, Cassio's simplicity, the time, the place, the racial difference, the misplaced handkerchief — worked together to imprison the hero in a fate from which he could not escape. Doom was certain; the freedom to avoid the catastrophe through reason or restraint was absent; Otello was helpless before the demons of his destiny, just as I felt myself to be, lying in a hospital bed, gripped by a mysterious and perhaps life-threatening ailment, unable to do anything about it but wait for it to proceed according to its own iron laws.

Busily constructing my sentences and struggling to keep my attention focused on compassion for Otello rather than pity for myself, I became aware that something was wrong with the yellow, lined pad I was writing on. It had become covered with an annoying flickering, as though a shower of infinitesimal fireflies was sweeping across it. My prose remained intelligible, but that rolling scintillation had fallen between me and it like a veil. A rather officious nurse at my bedside had for the last few minutes been occupied with preparing the intravenous apparatus. "I'm having an attack," I told her. "You'd better call for a doctor." "I'm almost finished here," she muttered distractedly fiddling with the needle, the tube, and the suspended plastic bag of blood-thinner. "You don't get the point," I persisted, becoming more agitated as the interference with my vision grew more intense. "Something terrible is happening to my brain."

She got the point. Almost immediately Dr. K. was there, soon to be joined by Dr. M. and Dr. W. I described my symptoms, which were distinctly different from those of the previous attacks. The scintillation had now receded, to be replaced by a strange emptiness in the middle of my visual field. When I looked at Dr. K.'s eyes, his nose, mouth, and chin disappeared, their absence (which was not a darkness or a hole but an absolute nothingness) surrounded by a jagged outline that made the poor man's face look like one of Picasso's early experiments with analytical cubism. This lasted for a few minutes, with the zigzag of nothingness gradually migrating downward and toward the left. The effect was becoming less pronounced when I perceived that the fingers of my left hand had gone numb. "Can you move them?" asked the doctor, alert to every change in my condition. I found I could; it was only sensation that was gone, and even now the numbness was being replaced by a peculiar tingling. Meanwhile, the left corner of my mouth had gone numb.

While all this was happening, I noticed an inexplicable reaction on the part of the doctors. The rapid appearance of one frightening symptom after another, and their incontinent migration across my eyes and around my body, had convinced me I was in the middle of the most horrible crisis, that my condition had (so to speak) come to a head, that my brain was undergoing total dissolution, and that — Otello's words in the final act of the opera leaped into my strangely lucid mind — "Ecco la fine del mio cammin" ("Here is the end of my journey."). As my symptoms multiplied and I moved inexorably toward what I thought was my doom, the doctors, however, who had in their previous examinations regarded me with a sober concern I had interpreted as a restrained pessimism, seemed to become more and more cheerful; they glanced at each other with debonair insouciance, and I had a sudden premonition that they were going to join hands and perform the perky dance of the young swan maidens from Tchaikovsky's Swan Lake. No perception could have offered more incontrovertible proof that my brain was melting, thawing, and dissolving into a dew, for it was impossible that I could actually be seeing that.

Yet the relaxation and optimism I saw on the doctors' faces was real. The fit had passed; the symptoms, after having traveled all over me, had crawled off into oblivion; the entire episode — like the earlier ones — had occupied little more than a quarter of an hour; and the doctors were making a confident diagnosis. There were a few more tests to be carried out, just for the sake of absolute certainty, but Dr. W. now felt sufficiently sure that it was not a stroke I had been suffering from to tell the nurse that the intravenous blood-thinner would not be necessary. "But I've gotten it ready!" she protested with some indignation. "Nevertheless, it won't be needed," he repeated, with a slight smile at her persistent earnestness. He knew that her patient, unlike so many others on the neurology floor, was no longer an object of deep medical (or compassionate) concern. This was only a case of migraine.

Up to this point my medical adventures had had something of the form of drama; the exposition of an initial situation, the establishment of a conflict, the setting into motion of a plot, the rising to a crisis. Now the equivalent of an intermission took place. Mystery, drama, and the tumult of intense emotions — these gave way to a period of learning and reflection, as I began to find out what an extraordinarily strange affliction migraine is. My knowledge of this condition, like that of most people, had been limited. I had thought of it in terms of the "typical" migraine symptoms: the agonizing head pain, the pallor, the prostration, the desperate escape from light and noise to the isolation of a dark, silent room. I was soon learning that this is by no means all migraine entails, that in fact the most curious features of the malady are of quite a different sort. The widespread but hidden society of migraine sufferers in the world shares not only the terrible headaches but also an astonishingly broad range of bizarre distortions in perception and sensation. These surrealistic sensory disturbances are classified as migraine "aura," and although they are ordinarily preliminary to a severe headache, they may occasionally be experience alone, as in my case. The alexia and aphasia of my attack at home and at the opera were relatively rare manifestations of migraine aura and could have been signs of much graver conditions. But the attack in the hospital exhibited the most common symptoms of migraine aura. With this evidence, the doctors could make sense of all the other, more ambiguous symptoms. That was why they had cheered up so while observing my attack.

An even more important reason for their good spirits (and mine, once they had explained things to me) was that migraine is not a serious condition — at least not as compared to a stroke or brain tumor. It is caused by spasm-like contractions and dilations of the cerebral blood vessels. The spasms themselves, in people predisposed (often by heredity) to migraine, can be brought on by practically anything: food allergies, flickering lights, excessive sunshine, alcohol, emotional stress, the cessation of emotional stress, too little sleep, too much sleep, Italian opera.... Yet these transient attacks do not result in the death of tissue (as in a stroke) or in any permanent damage to one's ability to think, perceive, or act. The weirdness of the migraine aura, when one is ignorant of how trivial the condition really is, can make it a source of uncanny terror, as the visual world is rent apart and invisible demons seem to take possession of one's body. But the demons of the aura, however capricious, cause no pain and pose no threat to sanity or life. If migraine aura (I do not speak about the headache) are to be construed as a punishment from moral obliquity, then the sin must be a mere peccadillo and the punisher a whimsical jokester, rather than the "Dio crudel" of Iago's nihilistic credo.

Indeed, one inevitable consequence of a diagnosis of migraine, as I already noticed in the attitudes of the doctors, hospital staff, and all my friends who had eased my hospital stay with their generous visits and loving attention, is that no one, with the kindest will in the world, seems to be able to take this ailment seriously. When they all feared that I might be on the doorstep of death, they had treated me as someone infinitely precious and important. Now that the door had been opened, to reveal nothing worse than migraine, everyone suddenly remembered that he had other pressing business. My moment in the limelight of heartfelt sympathy was over.

I would be dishonest if I denied that this universal reaction of indifference produced a certain letdown. I am not much given to seeking pity, but on the rare occasions when it comes, I apparently enjoy it as much as any kid allowed to stay home from school because of a tummy-ache and coddled by relatives speaking in hushed tones. Nevertheless, the loss of all those regressive pleasures was far outweighed by my joy at reclaiming — and being reclaimed by — life. Having for several days hung suspended outside the world's vital activities, not sure of whether I had a future or not, I now was ecstatic that I could plunge immediately back into the hurly-burly of hoping, wanting, doing, and enjoying. And one of the first things I thought of was going back to Otello to complete the experience that had been aborted by my mysterious ailment. So it was that a week later I returned to the Civic Theatre for the final performance of the opera — as well as (after the relatively placid interregnum of learning to understand my condition) for the last act of the personal drama I have been describing.

Act one of Otello, at this Sunday matinee, went splendidly. Giacomini had recovered his voice, and the entire cast was singing with the extra confidence that comes after several performances before audiences. When act two began, I felt some apprehension. Would Giacomini make? Would I make it? In fact, the tenor did well, and so did I, for having learned that nobody cares about migraine sufferers, I had simply made a resolution never to have a migraine aura again, and I am a great believer in the power of the human will (though I took care to keep my eyes away from the supertitles). The only one who was doing poorly was Otello. He let himself be manipulated by Iago's machinations, he saw treachery in Desdemona where there was none, he gave way to his violent passions, and at the end of the act, he allied himself — folly of follies! — with the man who had set out to destroy him. I have seen Verdi's Otello countless times, as well as the Shakespeare play it follows so closely, and I am used to the spirit of tragedy as we experience it in this sort of theater; fate, doom, pity fear, the acceptance of that relentless process in the tragic universe that drives conflict-laden situations on to the most catastrophic outcome possible. It is a great form, tragedy, and corresponds to an underlying truth in the universe. But at that Sunday afternoon performance of Otello, I no longer felt willing to accept the tragic view of life as the only truth — or even as the deepest truth.

The week before, no one in the audience had known that I was sitting there watching my own presumably tragic destiny unfold before me; as Iago was stripping Otello of his reason, so migraine had seemed to be stripping me of mine. How no one could know that in the privacy of my mind, I was exerting the most stupendous force to make this performance of the Verdi opera move in a direction more consonant with human desire. I hurtled every erg of my mental energy at the stage to make Otello see the light, to make Emilia reveal where she got the handkerchief, to make Desdemona show some intelligence and spunk, to defeat Iago, to save Otello's grandeur and Desdemona's life. There are few things in the musical theater greater than the last act of Otello, where the tragic hero kills his wife and then himself. But I would have gladly renounced every bar of that glorious music if the alienated couple could have been reconciled, and if Otello's final words could have been not "Pria d'ucciderti sposa ti baciai" ("I kiss'd thee ere I killed thee") but the Italian equivalent of "Then there is mirth in heaven/When earthly things made even/Atone together" (perhaps "Tutto nel moudo é burla"). Surely the austere tragic muse, so certain of her final triumph in every story, can once in a while be persuaded to yield the victory to her comic sister! Does she not do so in Shakespeare's The Winter's Tale, which begins as a tragedy and ends as a comedy? And had she not shown graciousness in my personal tale, which was now coming to its happy conclusion?

As everyone who was at that Sunday performance can testify, I did not succeed in influencing the events of the stage. Otello suffocated Desdemona, as always, plunged the dagger into his breast, and died upon a kiss. But since the world has been given back to me for a time, there will presumably be many other performances of Otello to be seen, and I intend to keep on trying. One day the tenor playing Otello is going to be very surprised at what he finds himself doing and singing in that last act. It will, admittedly, not be easy to get the comic muse to prevail in this opera, just as she has an uphill battle on the neurology floors of hospitals. But, as I mentioned before, I am a great believer in the power of the human will.

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