“‘Who in the world am I?’ Ah, that’s the great puzzle!” says Lewis Carroll’s Alice after experiencing a sudden, disorienting growth spurt.

AliceAlice during a growth spurt. (Illustration by John Tenniel, 1865.)

While she meditates on this philosophical conundrum, her body changes again. The girl shrinks. I have asked myself the same question many times, often in relation to the perceptual alterations, peculiar feelings, and exquisite sensitivities of the migraine state. Who in the world am I? Am “I” merely malfunctioning brain meat? In “The Astonishing Hypothesis” Francis Crick (famous for his discovery of the DNA double helix with James Watson) wrote, “You, your joys and your sorrows, your memories and ambitions, your sense of personal identity and free will, are, in fact, no more than the behavior of a vast assembly of nerve cells and their associated molecules.” Mind is matter, Crick argued. All of human life can be reduced to neurons.

There is a migraine aura phenomenon named after Charles Lutwidge Dodgson’s (Lewis Caroll’s) story of myriad transformations: Alice in Wonderland syndrome. The afflicted person perceives herself, or parts of herself, ballooning or diminishing in size. The neurological terms for the peculiar sensations of growing and shrinking are macroscopy and microscopy. Dodgson was a migraineur. He was also known to take laudanum. It seems more than possible that he had experienced at least some of the somatic oddities that he visited upon his young heroine.

These experiences are not unique to migraine. They are also seen in people who have suffered neurological damage. In “The Man with a Shattered World,” A. R. Luria, the Russian neurologist, recorded the case of a patient, Zazetsky, who suffered a terrible head injury during World War II. “Sometimes,” Zazetsky wrote, “when I’m sitting down I suddenly feel as though my head is the size of a table — every bit as big — while my hands, feet, and torso become very small.” Body-image is a complex, fragile phenomenon. The changes in the nervous system wrought by an oncoming headache, the lesions caused by a stroke or a bullet, can affect the brain’s internal corporeal map, and we metamorphose.

Is “Alice in Wonderland” a pathological product, the result of a single man’s “nerve cells and associated molecules” run amock? The tendency to reduce artistic, religious, or philosophical achievements to bodily ailment was aptly named by William James in “The Varieties of Religious Experience.” “Medical materialism,” he wrote, “finishes up Saint Paul by calling his vision on the road to Damascus a discharging lesion of the occipital cortex, he being an epileptic. It snuffs out Saint Teresa as an hysteric, Saint Francis of Assisi as a hereditary degenerate.” And, I might add, Lewis Carroll as an addict or migraineur.

We continue to live in a world of medical materialism. People pay thousands of dollars to get a peek at their genetic map, hoping to ward off disease early. They rush to embrace the latest, often contradictory, news on longevity. One study reports it’s good to be chubby. Another insists that when underfed, our close relatives chimpanzees live longer, and we would do well to follow suit. Republicans and Democrats are subject to brain scans to see what neural networks are affected when they think about politics. The media announces that researchers have found the “God spot” in the brain. Before the genome was decoded and scientists discovered that human beings have only a few more genes than fruit flies, there were innumerable articles in the popular press speculating that a gene would be found for alcoholism, obsessive-compulsive disorder, an affection for purple ties — in short, for everything.

It is human to clutch at simple answers and shunt aside ambiguous, shifting realities. The fact that genes are expressed through environment, that however vital they may be in determining vulnerability to an illness, they cannot predict it, except in rare cases, such as Huntington’s disease; that the brain is not a static but a plastic organ, which forms itself long after birth through our interactions with others; that any passionate feeling, whether it’s about politics or tuna fish, will appear on scans as activated emotional circuits in the brain; that scientific studies on weight and longevity tell us mostly about correlations, not causes; that the feelings evoked by the so-called “God spot” may be interpreted by the person having them as religious or as something entirely different — all this is forgotten or misunderstood.

The man who gave us “Alice in Wonderland” suffered from migraine. He was also a mathematician, a clergyman, a photographer, and a wit. He was self conscious about a stammer and may have had sexual proclivities for young girls. It is impossible to know exactly what role migraine played in his creative work. My own experience of the illness — scotomas, euphorias, odd feelings of being pulled upward, Lilliputian hallucination — figure in the story of myself, a story that in the end can’t be divided into nature or nurture. Migraine runs in families, so I probably have a hereditary predisposition to headaches, but the way the illness developed, and its subsequent meaning for me are dependent on countless factors, both internal and external, many of which I will never penetrate. Who in the world am I? is an unsolved question, but we do have some pieces to the puzzle.

Alice growingIllustration by John Tenniel, 1865. Images courtesy of Lenny’s Alice in Wonderland Site.

As Freud argued over a century ago, most of what our brains do is unconscious, beneath or beyond our understanding. No one disputes this anymore. The human infant is born immature, and in the first six years of its life, the front part of its brain (the prefrontal cortex) develops enormously. It develops through experience and continues to do so, although not as dramatically. Our early life, much of which never becomes part of our conscious memory because it’s lost to infantile amnesia (our brains cannot consolidate conscious memories until later), is nevertheless vital to who we become.

A child who has good parental care — is stimulated, talked to, held, whose needs are answered — is materially affected by that contact, as is, conversely, the child who suffers shocks and deprivations. What happens to you is decisive in determining which neural networks are activated and kept. Since we are born with far too many neurons, the ones that aren’t used are “pruned”; they wither away. This explains why so-called “wild children” are unable to acquire anything but the most primitive form of language. It’s too late. It also demonstrates how nurture becomes nature and to make simple distinctions between them is absurd. A baby with a hypersensitive genetic makeup that predisposes him to anxiety can end up as a reasonably calm adult if he grows up in a soothing environment.

So Crick was technically right. What seem to be the ineffable riches of human mental life do depend on “an assembly of nerve cells.” And yet, Crick’s reductionism does not provide an adequate answer to Alice’s question. It’s rather like saying that Vermeer’s “Girl (or Woman or Maidservant) Pouring Milk” is a canvas with paint on it or that Alice herself is words on a page. These are facts, but they don’t explain my subjective experience of either of them or what the two girls mean to me. Science proceeds by testing and retesting its findings. It relies on many peoples’ work, not just a few. Its “objectivity” rests upon consensus, the shared presuppositions, principles, and methods from which it arrives at its “truths,” truths, which are then modified or even revolutionized over time.

We are all prisoners of our mortal minds and bodies, vulnerable to various kinds of perceptual transfigurations. At the same time, as embodied beings we live in a world that we explore, absorb, and remember — partially, of course. We can only find the out there through the in here. And yet, what the philosopher Sir Karl Popper called World 3, the knowledge we have inherited — the science, the philosophy, and the art — stored in our libraries and museums, the words, images, and music produced by people now dead, becomes part of us and may take on profound significance in our everyday lives. Our thinking, feeling minds are made not only by our genes, but through our language and culture.

I have been fond of Lewis Carroll’s Alice since childhood. She may have started out as words on a page, but now she inhabits my inner life. (One could also say her story has been consolidated in my memory through important work done by my hippocampus.) It is possible that my headache episodes have made me particularly sympathetic to the girl’s adventures and her metaphysical riddle, but I am hardly alone in my affection. I dare say countless people have lifted her from World 3, a kind of Wonderland in itself, and taken her into their own internal landscapes where she continues to grow and shrink and muse over who in the world she is.