Fyodor M. Dostoyevsky
In the transition from the 18th to the 19th century the modern novel was born. Romanticism was replaced by realism and later by naturalism. Literary focus is increasingly turned inward to human nature and the subconscious mind
(8). It is at the beginning of this wave that the great Russian novelist Fyodor M. Dostoyevsky starts to write (Figure 2). He suffered from epilepsy, and his struggle with the disease came to set its mark on his entire literary production. The kind of epilepsy that afflicted Dostoyevsky is a matter for debate. He was never diagnosed during his lifetime, and the diagnosis is based on his diaries and novels, as well as statements from general practitioners who examined him (9).
Figure 2 Fyodor M. Dostoyevsky (1821–81) suffered from epilepsy and the disease was a topic in many of his books. Portrait by Vasily Perov, 1872. Wikipedia Commons
Most reports conclude that Dostoyevsky must have suffered from temporal-lobe epilepsy
(10, 11). It is claimed that features such as his gambling mania, hyperreligiosity, depressive tendencies and hypergraphia can be explained by this disease. Others believe that he suffered from epilepsy of a primary, generalised type (12), while the Norwegian neurologist Halfdan Kierulf points to the likelihood that Dostoyevsky suffered from meningoencephalitis caused by secondary-stage syphilis (13). In any case, it seems certain that the author suffered from what has later been referred to as 'Dostoyevsky epilepsy', partial seizures represented by brief ecstasy. There was prolonged disagreement as to whether such seizures actually existed, until an Italian neurologist succeeded in capturing one during an EEG scan (14). This finding has later been confirmed, including by Norwegian researchers (15).
The main character of the novel
The Idiot (1868), Prince Myshkin, suffers from precisely such ecstatic seizures. The prince returns to Russia after a stay in a rehabilitation facility in Switzerland where attempts have been made to cure him of his epilepsy or 'idiocy', with little success. He is a naive character – well-intentioned and benevolent – who encounters a cynical Russian bourgeoisie. Things do not turn out well. The object of his affection is murdered by a jealous rival and the prince returns to Switzerland in a worsened condition.
This Christ-like main character contrasts strongly with another of Dostoyevsky's main characters who also suffers from epilepsy, Smerdyakov in
The Brothers Karamazov (1880). Smerdyakov bears many similarities to Monks in Dickens' novel. He is the result of his father's rape of a mentally retarded prostitute. He is introverted and hostile, and he also kills his father, who is keeping him as a servant. Smerdyakov conceals the murder by simulating an epileptic seizure and pretending to be in the post-ictal phase. He finally confesses to the crime and commits suicide.
One can safely say that Dostoyevsky's descriptions of people with epilepsy are extremely diverse. He both demonises and glamorises their character, perhaps as a result of his own ambiguous relationship to his disease. Interestingly, this ambivalent image remains consistent with antique notions of the disease, which alternate between divinity and possession. World literature from the late 19th century includes only a few protagonists who merely
have epilepsy and are not merely 'epileptics', with all the prejudice and characteristics inherent in that name.