Fyodor
Dostoevsky (1821-1881) is among the world’s greatest authors. He is especially
famous for Crime and Punishment, The Idiot,
and The Brothers Karamazov. The central character in The Idiot, Prince Myshkin was beleaguered by epilepsy as was one of
the Karamazov brothers, Smerdyakov.
So, too, was their creator, author Fyodor Dostoevsky.
Dr. Howard Markel recently reviewed
Fyodor Dostoevsky’s life with epilepsy on the PBS NEWS HOUR. His review is
available on-line. 1 Markel noted
that Dostoevsky wrote he
was grateful for his seizure disorder because of the “abnormal tension” the
episodes created in his brain, which allowed him to experience “unbounded joy and
rapture, ecstatic devotion and completest life.” At other times, the author
regretted the disability because he thought it had wreaked havoc with his
memory.
Thoroughly
familiar with epilepsy, Dostoevsky’s descriptions are spot on. For example, the
fictional character Smerdyakov was said to, “…sometimes stop suddenly…and stand
still for ten minutes, lost in thought. Studying his face one would have said
that there was no thought in it…” (page 123). 2 A classical
description that defines a complex partial seizure with post-ictal confusion.
Some of his seizures are followed by headaches, which is a known post-ictal
phenomenon.
Smerdyakov
makes prior plans to kill his father, the loathsome buffoon, Fyodor Karamazov,
whose life is driven by narcissistic greed and lust. Smerdyakov will then blame
the murder on one of his seizures. But, Smerdyakov tells a brother of a
forthcoming seizure to the hour that will occur on a particular day. He is
suspected of feigning some of his seizures, i.e., they are pseudoseizures. And,
indeed, he later admits (page 570) to a brother that he did feign that seizure
and that he consciously did murder Fyodor. 2
Neurologists’
experiences lead us to believe that one-third of seizures in well-documented
epilepsy patients whose seizures have been EEG-verified, are psychogenic or
pseudoseizures, i.e., they are not true seizures. In these situations the
patient is seemingly in the midst of a seizure but the EEG remains normal.
Additionally, the patient can be susceptible to voice communications during the
“seizure.” These pseudoseizures can have psychological causes beyond the
patients’ conscious control; these are termed “conversion-type” seizures. I
describe this phenomenon in greater detail in previous blogs at LanceFogan.com: # 10, September 23,
2011: “Is
It a True Epileptic Seizure or a Faked, Psychogenic Seizure with a
Psychological Cause?” and Blog # 49 August 27, 2014:
“Psychogenic ‘Fake’ Non-Epileptic Seizures.”
In
The Idiot, Prince Myshkin described
after-effects of his seizure―a
description of the classical post-ictal state (page 52): “…after a long series
of fits. I always used to fall into a…torpid condition…and lost my memory
almost entirely…I had no logical power of thought…I remember my melancholy was
intolerable; I felt inclined to cry…” 3
My
blog followers who have epilepsy will be able to identify with these fictional
characters’ epilepsy. I encourage you to explore Dostoevsky’s writings.
Although he created these works over one and a half centuries ago, all of us can relate to his characters’
personalities and motivations. He describes us humans and our natures as we are.
1. Dr. Howard Markel. “For Dostoevsky,
epilepsy was a matter of both life and literature.” PBS News Hour. Health:
Nov 10, 2017 3:05 PM EST.
2. The Brothers
Karamazov by Fyodor Dostoyevsky. A Signet Classic published by the New
American Library: 1957.
3. The
Idiot by Fyodor Dostoyevsky. Everyman’s Library #682 published 1914.
Lance Fogan, M.D. is Clinical Professor of Neurology at the David
Geffen School of Medicine at UCLA. “DINGS” is his first novel. Presented as a medical mystery, it is a mother’s dramatic story that
teaches epilepsy, now available in eBook, audiobook and soft cover editions.
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