Richard Howard, the poet, was thrown into a delirium for several days following back surgery. The day after the operation, lying in his hospital bed and looking up, he saw small animals all around the edges of the ceiling. They were the size of mice but had heads like those of deer; they were vivid: solid, animal-colored, with the movements of living creatures. “I knew they were real,” he said, and he was astonished when his partner, arriving at the hospital, could not see them. This did not shake Richard’s conviction; he was simply puzzled as to why his partner, an artist, could be so blind (after all, he was the one who was usually so good at seeing things). The thought that he might be hallucinating did not enter Richard’s mind. He found the phenomenon remarkable (“I’m not accustomed to things like a frieze of deer heads on mouse bodies”), but he accepted them as real.

The next day, Richard, who teaches literature at a university, began seeing another remarkable sight, a “pageant of literature.” The physicians, nurses, and hospital staff had dressed up as literary figures from the nineteenth century, and they were rehearsing the pageant. He was very impressed by the quality of their work, although he understood that some other observers were more critical. The “actors” talked freely among themselves, and with Richard. The pageant, he could see, took place on several floors of the hospital simultaneously; the floors seemed transparent to him, so that he could watch all the levels of the performance at once. The rehearsers wanted his opinion, and he told them he thought it very attractively and intelligently done, delightful. Telling me this story six years later, he smiled, saying that even recollecting it was a delight. “It was a very privileged time,” he said.

When real visitors came, the pageant would disappear, and Richard, alert and oriented, chatted with them in his usual way. But as soon as they left, the pageant recommenced. Richard is a man with an acute and critical mind, but his critical faculty, it seems, was in abeyance during his delirium, which lasted for three days, and was perhaps provoked by opiates or other drugs.

Richard is a great admirer of Henry James—and James, as it happens, also had a delirium, a terminal delirium, in December 1915, associated with pneumonia and a high fever. Fred Kaplan describes it in his biography of James:

He had entered another imaginative world, one connected to the beginning of his life as a writer, to the Napoleonic world that had been a lifelong metaphor for the power of art, for the empire of his own creation. He began to dictate notes for a new novel, “fragments of the book he imagines himself to be writing.” As if he were now writing a novel of which his own altered consciousness was the dramatic center, he dictated a vision of himself as Napoleon and his own family as the imperial Bonapartes. . . . William and Alice he grasped with his regent hand, addressing his “dear and most esteemed brother and sister.” To them, to whom he had granted countries, he now gave the responsibility of supervising the detailed plans he had created for “the decoration of certain apartments, here of the Louvre and Tuileries, which you will find addressed in detail to artists and workmen who take them in hand.” . . . He was himself the “imperial eagle.”

Taking down the dictation, Theodora [his secretary] felt it to be almost more than she could bear. “It is a heart-breaking thing to do, though, there is the extraordinary fact that his mind does retain the power to frame perfectly characteristic sentences.”

This was recognized by others too—and it was said that though the master was raving, his style was “pure James” and, indeed, “late James.”

Sometimes withdrawal from drugs or alcohol may cause a delirium dominated by hallucinatory voices and delusions—a delirium which is, in effect, a toxic psychosis, even though the person is not schizophrenic and has never had a psychosis before. Evelyn Waugh provided an extraordinary account of this in his autobiographical novel The Ordeal of Gilbert Pinfold.55 Waugh had been a very heavy drinker for years, and at some point in the 1950s he had added a potent sleeping draft (an elixir of chloral hydrate and bromide) to the alcohol. The draft grew stronger and stronger, as Waugh wrote of his alter ego, Gilbert Pinfold: “He was not scrupulous in measuring the dose. He splashed into the glass as much as his mood suggested and if he took too little and woke in the small hours he would get out of bed and make unsteadily for the bottle and a second swig.”

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