A Journey Round My Skull (New York Review Books)

By Frigyes Karinthy

There's a timely relevance to Hungarian writer Frigyes Karinthy's 1939 memoir A Journey Round My Skull. TV's medical mysteries have become our classical drama, their sequence of gore, gadgetry, and unconcealed patient disregard recalling Aristotelian unities. In Round My Skull, that aesthetic is turned on its head, the story unfolding entirely from the patient's perspective and fully absent of present-day medical technology.

Karinthy, one of Hungary's leading 20th-century writers, was a mainstay of Budapest's interbellum café society. It's there he encounters his earliest sensations of all not being well: "The mirror opposite me seemed to move.... I was conscious of something I had never known before, or rather I missed something I had been accustomed to since I was first conscious of being alive." After a surprisingly cursory examination, a physician diagnoses Karinthy with "nicotine poisoning."

In the introduction to this volume, Oliver Sacks sees in this scene the archetypal physician at his trade: "not listening, not examining, being opinionated, jumping to conclusions—all are as ubiquitous, and dangerous, now as they were then." Perhaps so, but an equivalent problem is Karinthy's familiarity with his examiners. One physician even inquires after Karinthy's absence at a rehearsal the previous day, an intimacy that might have marred the data-taking that should lead to prompt diagnosis.

After a series of inconclusive medical opinions, Karinthy resolves to self-diagnose his bouts of dizziness, failing eyesight, retching, and phantom auditory sensations. His encounter with a terminal brain-tumor patient at a lunatic asylum suggests the source of his ailment. That event leads to an appointment with an eye specialist, in those days particularly relied upon for understanding brain abnormalities by identifying increased brain pressure.

The self-diagnosis confirmed by evidence of swollen optic discs, Karinthy is transported to Stockholm and into the hands of a neurosurgeon. The violence of essentially non-anesthetized trepanning, followed by the out-of-body experience neurosurgery can inspire, are reason alone to read this book. However, it's the insights encountered in the narrative that finds Karinthy there, strapped face down "as if bound to the guillotine," that most resonate after the last page.