The Topic: Confabulation
The Guest: V.S. Ramachandran
As a motto for the sapient, “cogito ergo sum” is pretty fantastic. Every time I’m reminded of it, a twinge of pride flows through my veins. It makes me want to stand up straight and pronounce proudly to my cat, “I think, therefore I am,” and then take his blank stare and plaintive meow as confirmation of my vitality. To be human is to know you exist. It is to know you are, and to know you are you.
It’s fitting that Jules Cotard, a man who was a close friend of the philosopher Auguste Comte, would find a way to dull the edge of Descartes’ famous proclamation. In an era preceding automobiles and airplanes, Cotard transferred his interest in the philosophy of being into the medicine of being – neurology – and after serving as a military surgeon in 1870, Cotard joined a clinic that did what it could with the knowledge of the day. Cotard and others at the clinic treated those with what one lecturer at the time called “madness in all its forms.”
Cotard was one of the pioneers of neuroscience, connecting behavior to the physical locations in the brain. As he progressed in his career he became particularly interested in patients who exhibited aphasia, or difficulties with language. He would follow those patients past death to the autopsy table in search of the cause of their maladies, and he encouraged other doctors to do the same. Considering his background in philosophy, it must have been astonishing when he found a patient devoid of a sense of self. In 1880, Cotard introduced a newly identified medical condition to the world. He called it “delire des negations,” or negation delirium. Essentially, he had discovered a condition in which a person thought, “I think, therefore I’m not.”