When Henry Met Karl Artsnight

Your father was a very dominating element in your life.

Do you think that troubled relationship with him has been

a driving force behind what you wrote?

Yeah.

Have you exorcised his ghost?

Yeah, but I have these nightmares that he's still alive

and he's aware of the books.

I have never given an interview while brushing my teeth.

This is an exclusive, I think.

The problem with publishing or writing six books in a series

is that it's published, you know,

different titles in different countries,

so in France book three's out.

In Holland, book six, book five.

Other countries, book one, book two.

It's going all over the place

and I have to go to a country talking about this book

and then move to another country talking about that.

I'm a writer basically because I'm a bit shy,

I'm not good at communicating, I'm not good at talking,

and then I'm thrown into this world where you're supposed to talk

and supposed to be at events and talk about yourself.

I have learned to do that.

If I was on the streets in Norway, Oslo, for instance,

I would be recognised, I guess.

People, you know, people just shout from the other side of the street,

"Great books," or "Keep going," or something.

Knausgaard, of course,

is as close as anybody can come to being a literary superstar.

APPLAUSE

He's written an extraordinary six-volume...sort of semi-fictional

but not fictional autobiography

and it was a huge success, to some extent a huge scandal,

in Norway when it first came out.

Looking for something, looking for something, looking for something,

and I don't know what it is, but then...this came up.

This very confessional thing came up when I wanted to write about

my father's death, which was the thing I wanted to tell,

that story I wanted to tell,

and I was suddenly aware of what I was doing.

He was so extraordinarily honest about himself

and all the traumas and stresses of his youth mainly.

Honesty is a very important surgical quality.

I wrote a book about this.

This kind of honesty is very important in surgery.

Honesty with oneself.

If you're not honest with yourself about mistakes, about problems,

you're not going to make the right decisions.

That's what my book has in common with Karl Ove's work.

They're both books about struggling to be honest with oneself.

The most striking thing about Henry's book was the honesty in it,

how it is to be a surgeon and a surgeon's dilemmas,

and it's also human, you know.

It's taking it down to the real world, so to speak.

Because he liked my book, he wrote to me saying he was interested

in brain surgery and could he come and talk to me about it

and possibly see me operate?

"The silence was total.

"The single focus of attention was a head

"clamped in a vice in the middle of the room."

Karl Ove and I spent a few days together in Albania and he then

wrote a piece about this and his first sight of brain surgery

for the New York Times, accompanied by some extraordinary photographs.

"One doctor looked up from a microscope.

"'Do you want to have a look?' he asked.

"Oh, God.

"I felt as if I were standing on the top of a mountain gazing out

"over a plain covered by long, meandering rivers.

"On the horizon, more mountains rose up.

"Between them there were valleys

"and one of the valleys was covered by an enormous white glacier.

"It was as if I had been transported to another world,

"another part of the universe."

This was the drill in the past

we always used for opening people's skulls.

You make a small cut or a big cut in the scalp

and then you just press and go like that.

It looks...terrible!

Your masterwork, if I can call it that, is called My Struggle.

A struggle is to struggle against something,

to struggle for something.

What were you struggling for?

The thing with the title is it's...

It works on so many levels, you know.

The major struggle in the book is the struggle between my own

self and my surroundings, the social scene.

In all the books, it's about relations with other people,

relations with my father, my brother, my mother.

Problems having no friends, being lonely.

Those kind of things.

So, in a way, the book is a reaction to all the restraints I felt

and all the restrictions I felt,

and, you know, it's to just let all inside of me, which I never

told anyone, never communicated to anyone, just throw it on the page.

It's a way of...this is me.

A lot of your autobiographical book

is about the enormous drives

we have when we're young, particularly sex.

I suspect that's one of the reasons why the book has struck a chord...

Because of the sex?

What I am describing, the sexual drive,

all those kinds of things,

there's no place you can talk about it.

There's no-one you can talk to if you are a young man, 16 years old.

You can't talk to your friends about it, not your parents.

It's like you have it on your own, so the book is about that,

being enclosed in yourself with all these enormously strong feelings,

lusts for other people.

Do you think it's more of a problem for Norwegians

than other people perhaps?

I thought so, yeah, but now the book is translating

and it seems like this is very universal, yeah.

I couldn't reveal this.

Not to anyone.

Not ever, not under any circumstances.

And whenever I thought about it,

which was not seldom, it must have been several times an hour,

I was overcome by a kind of black gloom.

A gloom of hopelessness, sometimes only fleetingly,

like a cloud drifting past the sun.

Sometimes for longer periods,

and whatever form the hopelessness took, I could not surmount it.

There was so much doubt and torment associated with it.

This refers to being a virgin at the age of 18.

When you were writing it,

my impression was almost an act of suicidal catharsis, so to speak.

Were you aware of the fact

it might actually strike a chord with so many people?

No, I had no idea.

It was the exact opposite experience I had, that this is only about me,

very private and without any interest for other people.

That was what I wrote.

And yet you still wrote it, though,

and you presumably wanted an audience for it?

Yeah, yeah, I'm a novelist and I publish novels

and I would publish it, you know.

I would be happy.

In surgery we have what are called morbidity and mortality meetings

where we're supposed to sit down together in the surgical department

and discuss our mistakes and what went wrong

and how we can do better next time.

As a writer, is there any equivalent? Do you read the reviews?

No, it's like I have to...all the mistakes I have to bury behind me.

I never reread what I've been writing. I never read reviews.

I can't stand it.

The only way of critical...like this is with my editor, you know.

You said that you'd seen it as a slightly Faustian bargain.

You lost your soul.

-You alienated and pissed off quite a few members of your family.

-Yeah.

Maybe the pain you caused some people, it's not life or death.

It's not that critical.

But do you think in retrospect you could have been a bit more tactful?

Do you have any regrets about some of the things you said?

Could you have still carried out this act of suicidal catharsis

without hurting some people in the process?

-No, you can't.

-Or is the pain an inevitable necessary part?

You can't tell a story about your life without involving other people

and the whole idea was I should tell the way it was for me

and be as honest as I could.

So that was impossible to avoid.

Why do you write?

Have you got any answer to that?

-It is very personal.

-Yeah, yeah.

It is good.

It feels almost like a repair shop or something for my mental health.

That suggests you've got to have a wound to heal in the first place.

Yeah, I think so,

but I guess the same thing would apply to you, wouldn't it?

Oh, very much so in my case.

There are very many different reasons why different people

become doctors, but, in my case,

I was trying to heal myself by healing others.

"Did I really look straight into it?

"I felt a sudden sharp pang of guilt."

I watched you operate and it looked like it was a completely

different state of mind that you almost entered and got into.

Completely. It is a complete addiction.

You're living entirely in the present.

I was once in a casino watching people betting on a roulette wheel,

watching the ball bouncing round the wheel.

It was the same complete intense concentration.

The future and the past kind of disappeared.

Although you're anxious,

you've very keen to win something or not to lose in the future.

It's similar to that, and I think most surgeons would say the same.

Of course, lots of doctors don't want to do surgery

because they're not risk-seekers.

I saw no brain surgery as a medical student and then, by chance,

I saw an aneurysm operation

and I knew immediately this is what I wanted to do.

It was love at first sight.

There was a series on American TV in the 1960s called Ben Casey.

Although the doctors and nurses were all incredibly good-looking,

they gave not a bad idea of what neurosurgery was really like.

How do you like that?

Aneurysm.

Cerebral aneurysms are very small,

usually less than a centimetre in size,

blowouts on the blood vessels at the base of the brain.

Door is open. We're going in now.

You have to stalk this aneurysm.

At any moment it might blow up, and if the aneurysm bursts

usually the patient dies.

That's it.

We found it.

It's like bomb-disposal work for cowards

cos all surgeons are cowards to the extent

they take risks on behalf of their patients.

I see surgery as a blood sport.

So, although one becomes a surgeon to stimulate yourself

and excite yourself, it is all premised for most of us

on some degree of care for patients.

With your experiences, is it possible to be, you know,

a neurosurgeon without being on the A-list,

or without everything ending in materialism, ending in...

Well, I think my answer to that is very simple.

Saying that everything we think and feel is a physical phenomenon,

-it upgrades matter into something we don't understand.

-Yeah.

-It doesn't downgrade thought or feeling.

-Yeah.

There's a common misconception that neuroscientists - and brain surgery

is a very crude, lowest form of neuroscience -

that we understand great truths about human nature.

We don't, at all.

Looking at the brain,

as you know, looking at the brain as a physical entity,

it just fills you with an enormous sense of wonder and awe,

I think, but it doesn't actually answer any questions

about what is meaningful in human life whatsoever.

I started this book when I was 40

and, at that time, my father had left the family,

started to drink, remarried,

and in the end became an alcoholic and died.

I was 40 then and I realised maybe it was the same feeling I had

because I wanted to leave the family and I wanted to...

not to start to drink, but I have this self-destructive thing.

When I could identify that in him, I started to, you know...

..understand him, and understanding is somehow forgiving, I think.

Your father was obviously a very dominating element in your life...

-Yeah.

-..in a very disturbing sort of way.

Do you think that troubled relationship with him

was very much a driving force behind what you wrote?

Yeah, I think so.

-Have you exorcised his ghost...

-Yeah, I have.

-..completely?

I have completely, yeah.

But it's a strange thing with parents or with fathers

that they are almost like inhuman.

When you grow up they are...like a god or something.

Did you ever worry you might become an alcoholic yourself?

You said you had a rather awkward relationship with booze

when you were younger.

It clearly was a major escape.

I'm a very addictive person.

I can get addicted to anything,

but I know of it, so I try to avoid it.

"I had experienced black-outs like this,

"after which I had remembered only fragments of what I have done.

"Ever since I first started drinking.

"That was the summer I finished the ninth class at the Norway Cup,

"when I just laughed and laughed.

"A momentous experience.

"Being drunk took me to places where I was free

"and did what I wanted while it raised me aloft

"and rendered everything around me wonderful.

"Only recalling bits and pieces afterwards,

"isolated scenes brightly illuminated against a wall

"of darkness from which I emerged and disappeared back into,

"was the norm."

I work so much and it's the same mechanism.

It's an addiction.

It's a way of escaping, you know.

I guess you know what it is to work a lot.

It's like a gyroscope.

-If I stop spinning very fast, I'm worried I will fall over.

-Yeah.

-My book is based completely upon memory...

-Yes.

..which feels like it's visual.

It feels like it's stored somewhere.

When I'm writing about childhood,

it's like an inner world is opening up and it's huge.

Image after image, feeling after feeling, emotion after emotion.

Round about here on the inside are two small areas the size of almonds

called the amygdala, which are very, very tied up with emotion and fear.

This area here, the hippocampal gyrus, is involved in memory.

A bit like the recording heads on a tape recorder.

So the magnetic tape is still there

and maybe you can play it back.

Where memories are stored,

if you put somebody in a functional brain scanner, bits of the

brain light up which show crudely which bits of the brain are working.

Do you think the brain is developing still?

I mean, like it's changing in an evolutionary way?

It must be, but we don't know the timescale.

Each of us in our head, our own being, our own consciousness,

is actually a greater mystery than the Big Bang and the cosmos

and the universe, cos we understand more

actually about the universe than we do about our very own consciousness.

When I started off writing I had a certain sense of meaninglessness,

which I shouldn't have, because then I had three children

and I did what I wanted to do and I was in a good place in life,

but I still felt meaningless and grey.

That's one of the major death sentences,

not to appreciate life.

So writing is a way of trying to kind of re-establish meaning,

and in that area, it's death,

because when you are around death everything is loaded with meaning,

and then it's falling in love, where everything is meaningful.

It's strange, isn't it,

when one's in love everything seems to fit together

into one unitary whole.

It's a sort of madness in a way, isn't it?

Yeah, and I noticed you writing about love in your book.

You said normally love is full of vanity and narcissism

but then there was love for your mother when she died, which wasn't.

And it's true, it is.

The intensity of life is much stronger

and it's the same in art.

That's the strangest thing.

If you see a Dutch painting from the 17th century,

a glass of water and an apple, really it's nothing, because a glass

of water and an apple is nothing, but then it's like it's almost...

It's this inner light, sort of thing.

Yeah, and it lifts you up and it feels very, very meaningful.

I think at one point in your book you refer to...

-I think it's probably Rembrandt's last self-portrait.

-Yeah.

How do you see your writing and relationship to that painting?

The strange thing is that, you know, my book is a huge self-portrait

but it never occurred to me that there was any reason

that I wrote about Rembrandt.

I didn't think about self-portraits at all.

The thing was, I've seen that picture in London.

Every time I'm in London I go and see it

because it's such an amazing picture of...

It's like you can see his soul.

I'm so...in presence of someone...

It's dead, it's canvas, there's nothing there,

but that was just a mystery to me

and that was why I was writing about it.

Where is the meaning? Where does it come from?

That's, you know, continuously questioned in the books,

that rhythm, looking for meaning, you know.

That's completely freaking me out.

LAUGHTER

I have been very interested in identity and personality

and the feeling of being one,

which you almost always have.

Even if you're very drunk or whatever, it's still you.

But then I have experienced, like...

I've had one or two hangovers where I felt I was split in half actually.

-Yeah.

-You probably know the feeling better than I do.

Yeah, but then I see people with psychosis, bipolar.

My wife is bipolar and she can change personality, like completely.

Then, if there's a psychosis, it's like there is no self any more.

It's all in bits and pieces, so what do you think, what is the self?

-Well, many...

-Is it a way of organising?

..many cognitive scientists,

as psychologists call themselves nowadays, say self is an illusion.

Not a delusion, but it's not what we think it is.

Somehow everything is interconnected to produce

an illusion of our being an organised self.

The best analogy I think for psychosis is it's like dreaming.

Yeah.

When we dream, we move around

and it's in a completely irrational, unpredictable way.

There's some evidence people, when they're in a psychotic state,

are thinking in that sort of way.

Yeah.

Coming back to your life, if I may, the old business about, you know,

mental health is linked to art and creativity

and things like that, do you see that with her?

-Her disorder is tied up with her creativity as a writer?

-Yeah, it is.

It's much more, you know...

It's not like...

It is very problematic for her to have that condition.

It's very, very hard and very difficult

and it's not comforting to be able to write brilliantly,

but it is connected to it somehow, I'm sure.

And presumably it just speeds up out of control and the mania is fun

-to begin with, but then it becomes very frightening and chaotic?

-Yeah.

When I watched you operate and you have people dying on you

on the table, if you think there is anything after life...

No, there's nothing. It seems...

You can't prove it either way,

but it seems deeply improbable to me,

and the reason for that is not so much the fact of death,

but the fact of brain damage,

in particular damage to the front part of the brain,

which is where all our social behaviour and our sensitivity

to others is to be found,

and if you see people, particularly talk to the family,

if people have had a head injury

and suffered damage to the frontal lobe, they're not the people

they were and they're almost always changed for the worse.

So if what we think of the true self, the moral being,

the social being is so damaged by physical damage to the brain,

it seems everything else follows on from that,

that, you know, we are our brains.

But if something happens with the brain

and the person changed personality,

will that person be aware?

-No, they're often not, and that's what's so disturbing about it.

-Yes.

-You have to talk to the family...

-Yeah.

..and often the family is reluctant to talk to you about it cos

it's often deeply embarrassing.

People often become disinhibited.

They lose normal social restraint

and therefore doctors are often blind to all these terrible effects.

My favourite surgical quotation is by the French surgeon Rene Leriche,

who said all surgeons carry within themselves an inner cemetery.

It's a place we all have to go to full of bitterness

and regret, where we have to think about our mistakes.

In reality, of course, I've helped and saved thousands of people,

but I find I tend to remember more the mistakes and the disasters.

It is, in fact, very important, cos in many ways the most

important surgical quality is an honesty with oneself,

that one recognises the difference between bad luck

and something one could and should have done differently.

I suppose that's what my book has in common with Karl Ove's work.

They're both books about struggling to be honest with oneself,

although in very different areas of life.

If I go out at night in a pub or something,

then all kinds of stuff can happen, so I don't do that.

People can be very angry, for instance.

Someone was taking a picture of his kids and,

"How could you do that to your own kids? How could you do that?

"This is my kids. I would never have done that. How could you do that?"

He was, of course, drunk, but still, where does the aggression come from?

I don't know.

HE CHUCKLES

This is...

I have the same drum kit at home.

When you grow up in a small part of Norway, music is the sound of

the world, and you know there is a world outside that's bigger.

The only way I had to get into a band

was to try to learn to play the drums.

I'm not a natural drummer so it's hours of practising

and basically no results.

I can do that.

But I can't really play the guitar either, you know.

Do you want me to sing too?

Haven't seen one of those things for years.

-Would you listen to music when writing?

-Yeah, I do all the time.

I remember when this one came out, Motorhead's Ace Of Spades.

MOTORHEAD PLAYS

I was 11 when it came out and I played it nonstop. I love it.

I'm trying to find some music I might have operated to,

but, at the moment, I can't find any.

Mmm, no.

Kate Bush. I play Kate Bush occasionally in operations.

MUSIC: Babooshka by Kate Bush

# Babooshka

# Babooshka

# All yours, Babooshka, Babooshka

# Babooshka-ya-ya

# All yours, Babooshka, Babooshka

# Babooshka-ya-ya. #