Hallucinations

Zelda would often see objects duplicated or multiplied, and this might create odd difficulties. “Making dinner and eating was quite difficult,” she said. “I kept seeing several of each piece of food when they didn’t exist. This lasted most of dinner.”⁶ Visual multiplication like this — polyopia — can take even more dramatic form. Once, in a restaurant, Zelda observed a man in a striped shirt paying at the cash register. As she watched, he split into six or seven identical copies of himself, all wearing striped shirts, all making the same gestures — then concertinaed back into a single person. At other times, her polyopia can be quite frightening or dangerous, as when, sitting in the passenger seat of her car, she saw the road ahead of her split into four identical roads. The car seemed to her to proceed up all four roads simultaneously.⁷

Seeing moving pictures even on television may lead to hallucinatory perseverations. Once, watching a television program that showed people descending from a plane, Zelda began to hallucinate minute replicas of the figures, which continued their descent off the screen and down the wooden cabinet of the television console.

Zelda has dozens of these hallucinations or misperceptions every day, and has had them, almost nonstop, for the past six years. And yet she has managed to maintain a very full life, both domestically and professionally — keeping house, entertaining friends, going out with her husband, and completing a new book.

In 2009, one of Zelda’s doctors suggested that she take a medication called quetiapine, which can sometimes diminish the severity of hallucinations. To our amazement and especially hers, she became entirely free from hallucinations for more than two years.

In 2011, however, she had heart surgery, and then, on top of this, she broke a kneecap in a fall. Whether it was due to the anxiety and stress of these medical problems, the unpredictable nature of CBS, or the development of tolerance to her medication, she started to have some hallucinations again. Her hallucinations, though, have taken a somewhat more tolerable form. When she is in the car, she said, “I see things, but not people. I see planted fields, flowering, and many forms of medieval buildings. Frequently I see modern buildings change into more historic looking ones. Every experience brings something different.”

One of her new hallucinations, she said, “is very difficult to describe. It’s a performance! The curtain goes up and ‘performers’ dance out on the stage — but no people. I see black Hebrew letters dressed in ballet dresses of white. They dance to beautiful music, but I don’t know where it comes from. They move the upper parts of the letters like arms and dance on the lower parts so gracefully. They come onstage from right to left.”

While the hallucinations of CBS are usually described as pleasant, friendly, diverting, even inspiring, they may occasionally take on a very different character. This happened to Rosalie when a neighbor of hers in the nursing home, Spike, died. Spike was a whimsical, laughter-loving Irishman, and he and Rosalie, both in their nineties, had been close friends for years. “He knew all the old songs,” Rosalie remarked; they would sing these together and joke and chatter by the hour. When he died suddenly, Rosalie was devastated. She lost her appetite, withdrew from social activities, and spent more time alone in her room. Her hallucinations returned, but instead of the gaily dressed figures she had seen before, she saw five or six tall men standing around her bed, silent and motionless. They were always dressed in dark brown suits and wore dark hats that shadowed their faces. She could not “see” their eyes, but she felt that they were gazing at her — enigmatically, solemnly. She felt that her bed had become a deathbed and that these ominous figures were harbingers of her own death. They seemed overwhelmingly real to her, and although she knew that if she stretched out a hand it would pass right through them, she could not bring herself to do this.

Rosalie continued to have these visions for three weeks, and then she started to emerge from her melancholy. The somber, silent men in brown disappeared, and her hallucinations started taking place chiefly in the dayroom, a place full of music and talk. They would start with a vision of patterns — quadrangles of pink and blue that seemed to cover the floor and then extend up the walls, finally spreading across the ceiling. The colors of these “tiles,” she said, put her in mind of a nursery. And, in accordance with this, she now saw little people a few inches high, like elves or fairies, with little green caps, climbing up the sides of her wheelchair. There were children, too, “picking up pieces of paper from the floor” or climbing hallucinatory stairs in one corner of the room. Rosalie found the children “adorable,” although their activities seemed pointless and, as she put it, “silly.”