2006 - Vol. 3, Issue 6

Accounts of the sufferings endured by people with epilepsy appear dating back to the Bible and other very early works. These writings reveal the most deeply ingrained negative stereotypes and idealized myths about people with epilepsy. The popular conceptions include the violent, frothing epileptic possessed by the Devil and, conversely, the ethereal visionary. Some writings present people with epilepsy as being intellectually disabled, while others present them as geniuses. Because most people seem to think that it is impossible for citizens with epilepsy to be happy and normal, epilepsy is often linked with suicidality.

Epilepsy and Evil or Violence

Joseph Schneider and Peter Conrad, who wrote a sociological study entitled Having Epilepsy, refer to the gospel of St. Mark 9:14–29 in the Christian Bible. Here, Jesus drives out the unclean spirit from a boy in the throes of a convulsion. The seizure as a sign of possession by the Devil reappears even in modern horror films such as The Exorcist II. The major historian on epilepsy, Oswei Temkin, alludes to Dante's Inferno, where it is implied that there is a place in hell just for people with epilepsy.

Another evil figure with epilepsy emerges in the novel The Brothers Karamazov by Fydor Dostoevsky, who had epilepsy himself. While Dostoevsky frequently included characters with epilepsy in his work, as will be shown in the forthcoming section of this essay, these characters tended to be saintly. Thus, The Brothers Karamazov's evil character with epilepsy, Smerdyakov, is a departure. As a young boy, Smerdyakov was fond of torturing cats and then hanging them. As a grown man, he feigns a seizure and the ensuing sleep to create an alibi for himself and escape prosecution for his murder of the Karamazov patriarch. Smerdyakov gloats when the eldest brother, Dimitri, is accused of the murder. Nonetheless, Smerdyakov himself meets a tragic end and commits suicide.

For the most part epilepsy has been, and still is, linked to violence even when the person with epilepsy is not actually evil. In William Shakespeare's Othello, Iago describes Othello's seizure to Cassio, warning Cassio that if Othello is not left in his lethargic state, he will break out in madness and become violent. Othello's epilepsy, as described by Iago to Cassio, may only have been a lie concocted by Iago: nowhere else in the play is Othello shown or referred to as having epilepsy. However, Othello murders his wife Desdemona in a jealous rage, thus lending credence to Iago's warning.

Nonfiction works also present negative stereotypes of people with epilepsy. Consider the written coverage of Jack Ruby's court trial following the murder of John F. Kennedy's assassin, Lee Harvey Oswald. Ruby's defense attorney alleged that Ruby had shot Oswald during a psychomotor epileptic seizure characterized by purposeless movements such as pacing or running. Ruby's clear motive for the murder led to the failure of his defense. The case received international attention in the press and in books on the subject, such as The Trial of Jack Ruby by John Kaplan and Jon Waltz. Such books and media coverage planted in the public psyche a connection between psychomotor epilepsy and uncontrolled violence.

1972 saw the publication of Michael Crichton's novel The Terminal Man. Assuming the format of a medical case history, the novel relates the story of the violent psychomotor epileptic, Harry Benson, who undergoes stereotactic surgery. The aim of the surgery is to implant in Benson's brain electrodes that would control the violent paroxysms by administering shocks. Benson, however, becomes resistant to the shocks and escapes the hospital to go on a killing rampage. Crichton, known to have graduated from Harvard Medical School, enjoys great credibility. The book became a best seller. Crichton also included an extensive bibliography in which he cited a number of medical articles and books indicating that psychomotor epilepsy is often accompanied by violence and sexual abnormality. After several epilepsy advocacy groups complained, Crichton wrote a postscript to the paperback edition of his novel, acknowledging that most people with psychomotor epilepsy were decent citizens and not subject to acting violent.

The journalist and author Richard Pollak, in his 1984 Atlantic Monthly article, “The Epilepsy Defense,” informs us that between the publication of Crichton's novel and 1984, over twenty criminal defendants mounted some form of an epilepsy defense to evade criminal responsibility. Many of these defenses were bogus. Pollak deems among the most egregious of these the 1977 Torsney case. A police officer by the name of Torsney shot an African-American youth in cold blood and was found not guilty due to his allegedly being in the throes of a psychomotor epileptic seizure. This verdict was handed down despite the fact that no medical evidence existed that he had ever had epilepsy. After a brief period in a mental institution, Torsney was released.

Epilepsy and Saintliness

Despite the stigma of evil or violence that emanates from many works of fiction dealing with epilepsy, there is some association in the public consciousness between epilepsy and saintliness. For instance, there are cultures in contemporary society that see epilepsy as imbuing a person with a benevolent spirit. Anne Fadiman won the National Book Critics Circle Award for her study of a Hmong refugee family in California who regarded the severe seizures of their infant daughter with epilepsy as a mark of some distinction.

Dostoevsky offers the reader a truly saintly protagonist in the person of Prince Myshkin of The Idiot. The villain Rogozhin's attempt to murder Myshkin is aborted by Myshkin's seizure. When the hero discovers Rogozhin's plot, he forgives the man he still considers his friend. The author's depiction of Myshkin's seizures, with their ecstatic auras that precede them, has provided prominent epileptologists such as Henri Gastaut with insight into the complexities of epilepsy. Dostoevsky depicts another saintly character in his novel The Insulted and the Injured. Nellie, an abused waif, is really the abandoned daughter of a prince. Her heart cannot withstand the violence of her seizures and Nellie dies at the conclusion of the novel. On her deathbed, Nellie comforts those around her.

Throughout the ages, saintliness has often been linked with having visions. In William Golding's novel Lord of the Flies, Simon, one of the boys stranded on an island, sees a vision of a beast that speaks to him and warns him that the beast is within the boys. When Simon tells this to the other boys, they beat him to death. Howard Babb, in his text on the novels of William Golding, credits Simon with supernatural insight as well as a kindness and gentleness the other boys do not possess and with being what Golding called a saint.

Neurologists Elizabeth Foote–Smith and Lydia Bayne point out in an article on Joan of Arc, published in the medical journal Epilepsia, that the visions she had may have been ecstatic epileptic auras. The authors liken Joan of Arc to St. Paul and Mohammed, who ostensibly were religious thinkers known to have, or suspected of having, epilepsy. In a scholarly text on Dostoevsky, medical–literary historian James Rice notes that in the 19th Century, delusions of a religious nature were thought to be common among people with epilepsy and that this belief is reflected in some of Dostoevsky's protagonists. In John Osborne's play Luther, Martin Luther is portrayed as a person with epilepsy having visions during his seizures. An example of such a vision occurs in the scene where Luther casts the papal Bull into the fire. This official proclamation by the Pope had been made in response to Luther's revolutionary teachings. When Luther hurls the document into the fire, he begins to shake and then invokes God to speak to him.

Epilepsy and Suicidal Depression

Marsha Norman's Pulitzer Prize–winning play, 'Night, Mother, depicts in ninety searing minutes the reasons for the suicide of a woman with epilepsy. At the beginning of the play, the heroine, a rural Southern woman named Jessie, informs her mother, Thelma, that she will kill herself that evening. Jessie calmly prepares the older woman for life without her. Although Thelma at first violently resists Jessie's decision and begs her to reconsider, at the end the mother lets her daughter commit suicide. During their last conversation, Thelma reveals that Jessie had had petit mal seizures in childhood and had probably inherited them from her father. Neither the father nor the child was ever told of these "spells." It was only after Jessie fell from a horse that the seizures became grand mal. Although the new combination of medications Jessie is taking apparently controls the seizures, Jessie does not change her mind. She tells her mother she could still have a seizure at any time and therefore cannot work. Moreover, the kind of job she could obtain would only make her more miserable. Jessie's husband has abandoned her, and her son is a juvenile delinquent. A sense of incompetence depresses Jessie as much as the seizures. She reminds Thelma that the floorboards creak and it was she, Jessie, who had laid the boards. The abandonment by her husband and the delinquency of her son furnish Jessie with proof that she has no worth. Finally, she confronts Thelma with the fact that her seizures were a source of shame and embarrassment to her mother.

A lesser–known character than Norman's suicidal Jessie is novelist Joanne Greenberg's Minnie Cormer. A male vocational rehabilitation counselor, overwhelmed by cases, is the protagonist in The Monday Voices. Minnie is one of the protagonist's clients. She is an African–American unwed mother with no education and only partially controlled seizures. The counselor dreads telling her how dim her job prospects are but has no choice. As a result, Minnie, who has already attempted suicide, plans a fresh attempt with greater determination for its success.

While evil/violent and saintly characters are, for the most part, one–dimensional and unrealistic representations of people with epilepsy, depictions of suicidal or depressed characters with epilepsy reflect reality for at least part of the population of people with epilepsy. Among this population, depression is a common experience, and the incidence of suicide among people with epilepsy is significantly higher than it is in the general population. In fact, many anti–convulsant drugs have depression as a side effect. Thus, fiction that links epilepsy with depression does not mythologize epilepsy, as do the previously discussed types of portrayals.

Epilepsy and Normalcy

A discussion of well-adjusted, happy, and/or "normal" characters with epilepsy is appropriate for this final segment because there is a growing trend to show persons with epilepsy in a much more realistic, multi–dimensional fashion. These characters interact with their environment. They are imperfect and navigate their world at times with joy, at times with anger, as everyone does. Thus, such protagonists with epilepsy are increasingly accessible to readers.

Disappearing Acts by best–selling author Terry McMillan is a novel with two narrators, Zora and Franklin, who have a troubled love affair. Zora is a self–confident and attractive music teacher/singer who happens to have had epilepsy since childhood. At one point in the novel Zora has a seizure and is mortified. Franklin cannot understand her shame. "All you got is epilepsy, right?  .  .  ." He says, "Well, having it ain't the end of the world, is it?"

Later, Zora tells her best friend, Portia, that Franklin has witnessed her having a seizure, but Portia reassures Zora that she's a good catch and dismisses the epilepsy, saying, "[S]o you have a little seizure every four years. Gain a few too many pounds once in a while. Big deal."

In this literary work, epilepsy is a non–issue. It never has an impact on the development of the plot, and it never detracts from or adds to Zora as a professional or as a person. Disappearing Acts is about a professional African–American woman in a relationship with a workingclass African–American man. It is not a novel about epilepsy. This is what makes it such a positive literary development.

Another important work is by an author who has epilepsy, Richard Pollak. Pollak, however, is far more than a voice on epilepsy. Primarily a journalist, Pollak wrote Up Against Apartheid: The Role and Plight of the Press in South Africa; The Creation of Dr. B.: a Biography of Bruno Bettelheim; and Columbo Bay, his latest work, which is a nonfiction account of Pollak's voyage on a container ship the week following 9/11. In fact, Pollak has published only two works dealing with epilepsy in the last thirty years: one article, "The Epilepsy Defense," and one novel, The Episode.

In The Episode, Pollak's protagonist, Daniel Cooper, is a journalist who is attractive, self–confident, humorous, and caring. He is a talented pianist and a jogger. He also has epilepsy, but he has not had a seizure for well over ten years. During a sudden seizure in the presence of his new girlfriend, a murder occurs. Daniel is known to have had an adversarial relationship with the victim, a businessman engaged in corrupt real estate ventures. Therefore, Daniel is the prime suspect. He was in a seizure and post–seizure state during the murder and has no recall and thus no alibi. Assuming the role of a detective, Daniel solves the murder.

What is most salient is the fact that Daniel is portrayed as very human, with weaknesses and foibles along with his strengths. He can be irritable and prone to petty temper as well as loving and funny. When the book came out in 1986, newspaper critics, including one at The New York Times Book Review, noted that the novel dispels many myths about epilepsy and that Daniel emerges as very normal and even bland. Like Zora in Disappearing Acts, Daniel does the best that can be done for epilepsy: he makes it a minor matter or even a non–issue.

More Recent Works on Epilepsy

Since I did my research for the essay above, new fiction on epilepsy has been written. Among the English–language works are Ana Castillo's So Far from God (1994), Daniel Chavarria's The Eye of Cybele (2002), Susan Hawthorne's The Falling Woman (1992), Thom Jones's The Pugilist at Rest (1991; epilepsy figures in five of eleven stories), and Amos Oz's To Know a Woman (1992).

A version of this essay, entitled "Images of Epilepsy in Literature," appeared in the medical journal Epilepsia, November/December 1991, as suggested course material for a disability studies or literature program.