A. R. Luria and the Art of Clinical Biography

^A. R. Luria and the Art of Clinical Biography* Anne Hunsaker Hawkins In 1928, Sir Harold Nicolson made the pessimistic prediction that "the scientific interest in biography is hostile to, and will in the end prove destructive of, the literary interest." He explained his gloomy prognosis by pointing out that scientific biography "will insist not only on the facts, but on all the facts" whereas literary biography "demands a partial or artificial representation of facts." He concluded, "I foresee, therefore, a divergence between the two interests."1 Nicolson's statement seems to me to have come true in a way that he could not have foreseen. On the one hand, we have our case histories, compiled by physicians and psychologists, stored in the files of hospitals and clinicians, and read, if ever, by other medical and psychological scientists . And on the other hand, we have our literary biographies, written by literati and intended for the non-scientific public. It is unfortunate that the methodological expertise of the scientist and the nurtured humanism of the literary craftsman should be so rigorously separated. But in fact this is so. Few researchers or clinicians would want to compromise their objectivity (an objectivity that is, paradoxically, both an assumption and a goal) by introducing literary dimensions of form and style and submitting to a humanist concern with the subjective experience of the patient. And literary critics, for their part, have complied by treating case histories and the like as "non-literature." But the scientific and the humanistic ought not to be reified as separate entities; rather, these terms refer to different attitudes, attitudes toward human experience that should be complementary. This complementarity between the scientific and the humanistic is also true of their representative genres of life-writing, case history and literary biography. I " The study of which this essay is a part has been supported by an American Council of Learned Societies grant. 1 am also indebted to Dr. Oliver Sacks s Awakenings, fully cited later, which inspired me to begin this study; also to his article, "The Mind of A. R. Luria," in The Listener, 28 June 1973, pp. 870-73, and to remarks made during a personal interview on 2 JuJy 1980. Literature and Medicine 5 (1986) 01-15 C 1986 by The Johns Hopkins University Press CLINICAL BIOGRAPHY shall argue here that case history and biography are indeed quite closely related. Both involve a good measure of authorial interpretation (and an inevitable subjectivity) in that facts are selected and arranged with the aim of achieving coherence and intelligibility. Both employ a methodology which is pictorial and historiographie. Finally, both are "contextual" narratives : they seek to understand an individual human being in the context of some other reality — in case history the internal reality of anatomy and physiology, in biography the external reality of family influence, cultural trends, and historical events. As an illustration of these claims, one might imagine a narrative that combined the approaches of both genres — one that would give expression to scientific reality by resorting to devices of literary form. An attempt at such a syndiesis can be found in the extended case histories of the great Russian psychologist and physician A. R. Luria. Luria, writes his American colleague, the neurologist and author Oliver Sacks, "almost alone among contemporary physicians, has preserved or revived the almost forgotten art of clinical biography. His great case histories combine an extraordinary accuracy and wealth of detail with the ease and sensibility and style of a novel."21 shall adopt this term, "clinical biography," to refer to narratives like Luria's that combine scientific and humanistic attitudes, blending the aims of case history with the methodology of literary biography. The degree to which Luria has, in fact, succeeded in achieving this synthesis is a matter of personal opinion; what concerns us here is the attempt to do so, and the model created in that attempt. I Before discussing Luria's clinical biographies, let us look more closely at some of the differences and similarities between case history and literary biography. Initially, the two genres appear to differ greatly in subject matter . Biography concerns the life of an individual, but case history...