The Many Mysteries of Human Consciousness: A Guest Post by Karen Thompson Walker

Karen Thompson Walker (The Age of Miracles) is back with a mesmerizing story about motherhood, memory and complicated family ties, based on case notes from neurologist Oliver Sacks. Read on for an exclusive essay from Karen on writing The Strange Case of Jane O.

The first scene of The Strange Case of Jane O. came to me in an unexpected flash, when I was supposed to be working on something else. In that scene, a woman shows up at a psychiatrist’s office, but she won’t explain what’s wrong or why she made the appointment. All she’ll say is this: “Something strange happened to me.” After a few minutes, the woman abruptly ends the appointment, leaving the psychiatrist puzzled and concerned.

New ideas for novels don’t come to me often, and they always feel surprising, but my source was obvious this time. On the day that I wrote that scene, I had been revisiting the work of the neurologist and writer Oliver Sacks.

In books like The Man Who Mistook his Wife for a Hat, Sacks wrote deeply empathetic case histories of real people living with rare and extraordinary brain disorders. He wrote about patients who were unable to form new memories and were thus trapped in a perpetual present, and others who could make instant computer-like calculations but struggled with simpler tasks. One man became convinced that his own leg was someone else’s. Another hallucinated music. Sacks beautifully illuminated the ways that these people’s unusual brains profoundly altered their experience of everyday reality.

My novel began with this question: what if a doctor like Oliver Sacks were to encounter a patient whose psychological symptoms were so extraordinary that they defied all known explanation? What if the patient’s experiences seemed, in some sense, impossible?

That woman from the opening scene eventually became Jane O., a new mother who is struck by a series of blackouts, hallucinations of the dead, and an inexplicable fear.

At first, I thought the whole book would function as a kind of fictional case history, told entirely from the psychiatrist’s point of view. But I soon realized that Jane needed her own voice in the novel, and so the story is told in alternating points of view, as Jane and her psychiatrist struggle to understand her escalating symptoms—and their eerie implications.

To write this book, I read deeply about the practice of psychotherapy, as well as memory, amnesia, dissociative fugue, and the many mysteries of human consciousness.

In a stroke of serendipity, I also wrote major sections of this book inside an actual therapist’s office, surrounded by the classic props: a couch, a box of tissues, and two editions of the DSM. (When the pandemic forced therapy online and my first-grader out of school, I needed a place to work, and a therapist friend had an office that was going unused.)

Later, when I asked a psychiatrist to factcheck the book, she seemed to find the reading experience a little uncanny because, she said, it was undetectable to her that the psychiatrist’s sections were not written by an actual psychiatrist.

Of course, it was only an impersonation. I’m an actor playing a part, this time surrounded by a realistic stage set. But what strange work this is, the act of writing fiction, this elaborate form of pretend.

It makes me think again about Oliver Sacks, the way his books remind us that we all conceive of reality in our own unique and surprising ways.