“If you’re in your house, why are there elevators there?”

I’m fascinated by how we make and hold beliefs, often in the light on contrary evidence. You see how easy it is for us to have false belief in many patients with brain injury. Many have false beliefs and explain away contradictory evidence effortlessly, which is called confabulation.

This is one of my favourite examples of confabulation, heard by neuroscientist Michael Gazzaniga (from Gazzaniga 2000):

In one patient I had, the patient was a woman who, although she was being examined in my office at New York Hospital, claimed we were in her home in Freeport, Maine. The standard interpretation of this syndrome is that she made a duplicate copy of a place (or person) and insisted that there are two.

This woman was intelligent; before the interview she was biding her time reading the New York Times. I started with the ‘So, where are you?’ question. ‘I am in Freeport, Maine. I know you don’t believe it. Dr Posner told me this morning when he came to see me that I was in Memorial Sloan-Kettering Hospital and that when the residents come on rounds to say that to them. Well, that is fine, but I know I am in my house on Main Street in Freeport, Maine!’ I asked, ‘Well, if you are in Freeport and in your house, how come there are elevators outside the door here?’ The grand lady peered at me and calmly responded,

‘Doctor, do you know how much it cost me to have those put in?

Gazzaniga goes on to explain the reason for this woman’s false belief, due in part to a lesion in her brain:

Because of her lesion the part of the brain that represents locality is overactive and sending out an erroneous message about her location. The interpreter is only as good as the information it receives, and in this instance it is getting a wacky piece of information.

It’s easy to think of this as just an amusing story of someone with brain injury. I think we all have the same mechanisms in our brain that are making sense of the world as best they can. We can all have beliefs that make perfect sense to us, but seem bizarre to outside observers.

Reference

Gazzaniga MS. 2000. Cerebral specialization and interhemispheric communication: Does the corpus callosum enable the human condition? Brain 123(7): 1293-1326. http://dx.doi.org/10.1093/brain/123.7.1293

Photo by Boston Public Library on Flickr; used under a Creative Commons license.