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carefully studying his face in the mirror he slowly began to recognise it, but "not in a flash" as in the past-he relied on the hair and facial outline, and on two small moles on his left cheek.'
       In general he could not recognise objects 'at a glance', but would have to seek out, and guess from, one or two features- occasionally his guesses were absurdly wrong. In particular, the authors note, there was difficulty with the animate.
       On the other hand, simple schematic objects-scissors, watch, key, etc.-presented no difficulties. Macrae and Trolle also note that: 'His topographical memory was strange: the seeming paradox existed that he could find his way from home to hospital and around the hospital, but yet could not name streets en route [unlike Dr P., he also had some aphasia] or appear to visualize the topography.'
       It was also evident that visual memories of people, even from long before the accident, were severely impaired-there was memory of conduct, or perhaps a mannerism, but not of visual appearance or face. Similarly, it appeared, when he was questioned closely, that he no longer had visual images in his dreams. Thus, as with Dr P., it was not just visual perception, but visual imagination and memory, the fundamental powers of visual representation, which were essentially damaged in this patient-at least those powers insofar as they pertained to the personal, the familiar, the concrete.
       A final, humorous point. Where Dr P. might mistake his wife for a hat, Macrae's patient, also unable to recognise his wife, needed her to identify herself by a visual marker, by '. . . a conspicuous article of clothing, such as a large hat'.
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       The Lost Mariner*
       You have to begin to lose your memory, if only in bits and pieces, to realise that memory is what makes our lives. Life without memory is no life at all . . . Our memory is our coherence, our reason, our feeling, even our action. Without it, we are nothing … (I can only wait for the final amnesia, the one that can erase an entire life, as it did my mother's . . .)
       –Luis Bunuel
       This moving and frightening segment in Bunuel's recently translated memoirs raises fundamental questions-clinical, practical, existential, philosophical: what sort of a life (if any), what sort of a world, what sort of a self, can be preserved in a man who has lost the greater part of his memory and, with this, his past, and his moorings in time?
       It immediately made me think of a patient of mine in whom these questions are precisely exemplified: charming, intelligent, memoryless Jimmie G., who was admitted to our Home for the
       *After writing and publishing this history I embarked with Dr Elkhonon Goldberg- a pupil of Luria and editor of the original (Russian) edition of The Neuropsychology of Memory -on a close and systematic neuropsychological study of this patient. Dr Goldberg has presented some of the preliminary findings at conferences, and we hope in due course to publish a full account.
       A deeply moving and extraordinary film about a patient with a profound amnesia (Prisoner of Consciousness), made by Dr Jonathan Miller, has just been shown in England (September 1986). A film has also been made (by Hilary Lawson) with a prosopagnosic patient (with many similarities to Dr P.). Such films are crucial to assist the imagination: 'What can be shown cannot be said.'
       Aged near New York City early in 1975, with a cryptic transfer note saying, 'Helpless, demented, confused and disoriented.'
       Jimmie was a fine-looking man, with a curly bush of grey hair, a healthy and handsome forty-nine-year-old. He was cheerful, friendly, and warm.
       'Hiya, Doc!' he said. 'Nice morning! Do I take this chair here?' He was a genial soul, very ready to talk and to answer any questions I asked him. He told me his name and birth date, and the name of the little town in Connecticut where he was born. He described it in