 n 
		articulate, liberally educated neurologist at the University of 
		Edinburgh, Adam Zeman has written columns for The Times of London and is 
		an occasional commentator for the BBC and the co-author of a book on 
		ethical problems in neurology. His new book covers many aspects of 
		consciousness for general readers. His treatment of the disorders of 
		knowledge is superb. If you were intrigued with ''The Man Who Mistook 
		His Wife for a Hat,'' you'll appreciate the buildup to what Oliver Sacks 
		described in that work. Zeman's much more subtle examples give you some 
		appreciation for how seeing and describing can become disconnected from 
		recognition and other forms of knowledge.
n 
		articulate, liberally educated neurologist at the University of 
		Edinburgh, Adam Zeman has written columns for The Times of London and is 
		an occasional commentator for the BBC and the co-author of a book on 
		ethical problems in neurology. His new book covers many aspects of 
		consciousness for general readers. His treatment of the disorders of 
		knowledge is superb. If you were intrigued with ''The Man Who Mistook 
		His Wife for a Hat,'' you'll appreciate the buildup to what Oliver Sacks 
		described in that work. Zeman's much more subtle examples give you some 
		appreciation for how seeing and describing can become disconnected from 
		recognition and other forms of knowledge. 
		There have been a number of fine books on consciousness in the last 
		dozen years, starting with Daniel Dennett's ''Consciousness Explained,'' 
		which was written from the standpoint of a philosopher well versed in 
		cognitive sciences and evolution. I am also fond of ''The Feeling of 
		What Happens,'' by Antonio Damasio. Like Zeman, Damasio is a neurologist 
		steeped in both literature and philosophy. But Zeman's ''Consciousness'' 
		is the broader book, the one that could be used in an undergraduate 
		humanities or psychology course to fill in the neuroscience background 
		for readers coming to it for the first time. Indeed, Zeman first 
		introduces his subject and then spends a hundred pages on neurobiology 
		and human evolution before returning to consciousness. Readers impatient 
		for consciousness per se can skim these chapters without losing the 
		thread, though they are relatively painless introductions to what 
		consciousness is built atop of. 
		Consciousness implies both awake and aware. ''Sleep, like 
		wakefulness, is organized from the brainstem,'' Zeman writes. ''It has a 
		hidden structure of its own: in the course of the night we cycle 
		repeatedly from light sleep to deep, from deep to dreaming sleep. The 
		brainstem continues to generate these rhythms after the destruction of 
		the hemispheres, as, for example, in the 'vegetative state.' By 
		contrast, death of the brainstem is almost always followed, within hours 
		or days, by death, pure and simple.'' The nerves controlling the entire 
		body pass through the brainstem, and some brainstem strokes injure these 
		connections while leaving the patient surprisingly alert and aware. ''In 
		these circumstances awareness may survive while almost all means of 
		expressing it are lost, an unhappy state of affairs known as the 
		'locked-in syndrome.' Sufferers from this disorder usually retain the 
		ability to make voluntary up and down movements of their eyes, and can 
		use these to communicate.'' He adds that we can't deny ''the disturbing 
		possibility'' that this disorder may affect more people than we can now 
		properly recognize as being afflicted by it. 
		A couple of chapters after I read this, my 91-year-old mother 
		suffered a similar brainstem stroke. There were periods when she could 
		communicate only by moving her eyes and eyelids. Because she was 
		sometimes able to get a few words out, it was obvious she was tracking 
		what we said and was thinking ahead as usual; her consciousness was 
		trapped in a body that would no longer obey her. We knew her wishes 
		about such situations quite well, her sister having lingered five years 
		in a similar state, but my mother was still competent to make her own 
		decision if we could frame it for her limited ability to communicate. So 
		her doctor told her that her situation was unlikely to improve, that we 
		proposed doing nothing except comfort drugs and that she probably would 
		die within a few days. Was that what she preferred? We thought she would 
		have to communicate by blinking her eyelids. But she burst forth with 
		her longest utterance since her stroke: ''You're the best doctor I ever 
		had.'' Those turned out to be her last words. She died two days later.
		
		Consciousness is, however, more than just the minimum requirements of 
		awake and focused. Zeman explains that ''sensation becomes conscious 
		only when it undergoes some further process -- when it encounters past 
		associations, or is used to govern future action, or becomes the object 
		of reflection or is felt to impact upon the self.'' There is an 
		''important link between consciousness and volition. . . . Willed or 
		voluntary acts are those with aims of which we are conscious and are -- 
		usually -- prepared to acknowledge.'' Consciousness, he concludes, 
		''bridges perception and action, the events we perceive and the ones we 
		bring about.'' 
		But consciousness is fragile, and ''however magical it may be, it is 
		a physical affair: mundane requirements for oxygen and glucose, 
		electrical equilibrium, clean blood and adequate sleep must be met in 
		the brain -- or consciousness fails. . . . However coherent our 
		experience and behavior may appear, they are prone to fragment under 
		stress. . . . Faints, fits and intoxication all reveal that perception, 
		memory, movement and speech are separable capacities.'' He adds: ''It 
		may be arrogant to deny that consciousness can ever slip its moorings in 
		the brain -- after all, much of the world's population believes firmly 
		that it can -- but the evidence in favor of this happening is tenuous at 
		best.'' 
		Though the book's subtitle proclaims it a ''user's guide,'' the 
		phrase is not easy to find in these pages, making one suspect it was 
		tacked on by the publisher to make the book sound approachable and 
		instructive -- which, fortunately, it is. However, it is not tuned in to 
		two important issues that one would expect to find in a user's guide.
		
		The first concerns how aspects of consciousness develop in childhood. 
		As a child, you eventually come to realize that someone else may not 
		know what you know. This much is covered well. But such structured 
		thinking begins as a 2-year-old makes the transition from two-word 
		utterances to speaking long sentences that cannot be understood without 
		some structuring principles. They are usually called grammar or syntax, 
		and we use them to create past and future tenses and to nest phrases 
		inside clauses and vice versa. Children understand structured sentences 
		long before they can produce them -- if they can hear long sentences or 
		watch them being signed. Certainly, one of life's major tragedies occurs 
		when a child is not recognized as being deaf until well after the major 
		windows of opportunity for soft-wiring the brain in early childhood have 
		closed (much of structuring is not hard-wired instinct). We know how 
		essential this tune-up period is for normal adult consciousness from the 
		short-sentence, present-tense-only adult abilities of deaf children of 
		hearing parents who failed to provide an environment during preschool 
		years that was adequately rich in sign language. (Deaf children of 
		signing deaf parents do fine.) 
		That suggests that a child born both deaf and blind has little 
		opportunity to soft-wire a brain capable of structured consciousness. 
		But what about Helen Keller and what Zeman calls ''her rich inner 
		life?'' Zeman, alas, makes the usual mistake of describing her as ''born 
		blind and deaf,'' when in fact she probably had 19 months of normal 
		exposure to language before being stricken by meningitis (by 18 months, 
		some children start to express structured sentences, showing that they 
		had been understanding them even earlier). So she probably soft-wired 
		her brain for structured stuff like syntax before losing sight and 
		sound. 
		A user's guide also needs something about how we create a plan or 
		utterance of high quality -- something better than our dreams, where we 
		see cognitive processes freewheeling without much quality control. They 
		provide us with a nightly experience of people, places and occasions 
		that do not fit together. Fortunately our movement command centers are 
		inhibited during most dreams, so we don't get into trouble acting on 
		nonsense. Awake, we are always searching for coherence, trying to shape 
		combinations that ''hang together'' well enough to act on. When our 
		quality control fails and incoherence is the best thing our 
		consciousness has available during waking hours, it tends to be called 
		hallucination, delusion or dementia. 
		A great deal of our consciousness -- indeed, our intelligence -- 
		involves guessing well, as we try to make a coherent story out of 
		fragments. Zeman lumps this under a search for meaning, but his 
		description is memorable: ''Eye and brain run ahead of the evidence, 
		making the most of inadequate information -- and, unusually, get the 
		answer wrong. . . . Our knowledge of the world pervades perception: we 
		are always seeking after meaning. Try not deciphering a road sign, or 
		erasing the face of the man in the moon. What we see resonates in the 
		memory of what we have seen; new experience always percolates through 
		old, leaving a hint of its flavor as it passes. We live, in this sense, 
		in a 'remembered present.' ''