Dr. Joseph Babinski, a French neurologist, introduced a new term in the medical lexicon in 1914.
It’s derived from Greek and translates to “without disease knowledge.”
He noticed something strange about the patients he was seeing. They were hemiplegic, i.e. completely paralyzed on the left side of their body, but were unaware of it or in complete denial.
It was as if the part of their brain that’s supposed to talk to the body about illnesses was asleep, or destroyed.
Since Babinski introduced the neologism, it’s been the focus of hundreds of scientific papers. Now, anosognosia is closely related to all sorts of degenerative diseases including Alzheimer’s, Parkinson’s, Schizophrenia, and Dementia.
People who suffer from it don’t know that they’re suffering from it.
In Babinski’s patients with hemiplegia, the patients outright denied their paralysis because the mental representation of their left side of the body was absent. In their mind, they only have (and have always had) one side to their body: the right side.
Our Metaphorical Anosognosia
I was having lunch with someone — we’ll call him K — one Friday afternoon.
K was introduced to me through a mutual connection.
He was a 25-year-old engineer working at Google. In between bites of roti and daal, he was telling me about his daily routine: Wake up at 7:30 AM, get ready and get to work by 9 AM, code for a few hours, take a break to have lunch at the Google cafeteria, continue working until 5 PM, take a quick caffeine boost, workout at the in-house gym at Google, have dinner again at the Google cafeteria, get home at 8 PM, watch television, and go to sleep. Rise and repeat all over again.
I listened quietly, and asked, “Sounds like a nice routine. Do you plan on working there for a few more years?”
He thought for a moment and responded, “Yeah. I am aiming to get promoted in the next 2 years. After that, I might move to another company.” He paused and said, “Mostly a startup.”
I prodded, curious, “So, is the eventual goal to build a company?”
“No no. The eventual goal is to make enough money so I never have to work again, and can travel wherever I want to.”
“Ah, that’s great. When do you think you’ll reach that? In another 5 or 10 years?”
He responded, nonchalantly, “No, in 25 years.”
I tried my best to hide my shock. I don’t think I did a very good job.
“25 years? But… why though? You could take a sabbatical to travel next year if you wanted to. Is there a specific financial goal you’re planning to hit?”
He said, still nonchalantly, “Hmm, I haven’t really thought about a financial goal. I just thought it would take me 25 years to accumulate enough to never have to work again.”
I couldn’t help but ask, “Do you not enjoy your work? I’m curious why you said that again.”
“I mean, I like it. But what gives me happiness is lying on a beach without having to worry about anything. I spent a month in Hawaii last year. And I felt the happiest when I was on the beach not having to worry about work.”
“Would you not feel bored after a while though?”
“Maybe. But I want to work when I want to work. I want that agency.”
The conversation went on for another 15 minutes. Eventually, both of us felt it was time to call it a day. I departed and took a walk to play back the dialogue between us.
25 years? Why does he think he needs to wait 25 years? He can quit or take a sabbatical now if he wanted to.
Is fear stopping him? Or losing a sense of comfort?
Whatever it is, I hope he does it sooner.
While you and I may not have a degenerative disease or lesions in our brain causing us to overlook paralysis, we too are metaphorically anosognosic.
We don’t know that we have agency… until we do.
Its presence is little noted, but its absence causes great distress. — Sundus
Agency is the sense of having control over one’s actions and consequences.
The keywords in the above sentence are “the sense of.” Agency does not equate to free will. Regardless of whether you have free will or not (which is a debate best shelved for another book), you can have agency by believing that you have control over your actions (and consequences). You don’t wait for conditions to be just perfect to get what you want. And you don’t believe that life just happens to you as you sit in the backseat of the car. No. You’re the one driving it.
I remember a few moments in my life when I felt agency flow through my bloodstream.
One such moment happened on my third night in New York as a graduate student at Columbia University, I stayed back late at the university to work on an assignment. As I finished my work and looked up, the clock struck 4 AM. Gosh. I hurried up, stuffed my belongings into a small bag, and began walking home, which was only two blocks away, fortunately. But between those two blocks I realized that, for the first time in my life, I am able to walk home at 4 AM without fear, guilt, or nervous excitement.
The university where I pursued my undergrad had a curfew, only for women. We couldn’t walk outside the four walls of our hostel after 9 PM on a weekday, or 9:30 PM on a weekend. Things weren’t much different when I was home with my parents. I had to give an elaborate reason if I were to stay out anywhere after 9 PM, with my parents checking on me. So my experiences of walking on the streets after 9 PM stemmed out of either a rebellious attitude to resist rules or an adventurous attitude to experience something novel. It never felt like I had agency. I was simply peeking into the window of what it could feel like.
So walking home at 4 AM on my third night in a new country where walking that late felt like just another aspect of life (and even a little mundane) was… freeing. It filled me with a sense of agency, which until that moment, was alien to me. It was a feeling I didn’t know I could experience, even though I was always capable of it. In a way, like the person K, I was metaphorically anosognosic too.
Since then, I’ve experienced agency many more times: posting my first YouTube video, publishing my first book, launching my course, moving states within the U.S., a spontaneous trip to Hawaii, and quitting my job. In all those instances, I felt like it was me in control of my life. Nobody forced me to do these things. I did it of my own volition. I was driving the car (even if I didn’t know how to at times).
But even now, I can’t say I have complete agency over my life because it’s simply impossible. There will always be things that are out of my control. A nuclear war; the pandemic; a loved one passing away. So having agency also means accepting that fact, and knowing the difference between what is and isn’t under your control.
And knowing that difference is a lifelong learning process.