William Bates was born in 1860 and earned considerable distinction as a medical researcher (he first identified what would be later known as adrenaline) and as a noted ophthalmologist with a fashionable New York practice. By 1902, he was already well-known in his profession.
And then he disappeared...
When last seen, he had just finished a pleasant note to his wife who was visiting her mother in another town and he made arrangements to send her some books. When the janitor in the building where they had been living contacted Mrs. Bates and told her that her husband had not returned to their apartment for days, she hurried back to New York to search for her husband. It would take many weeks but she eventually tracked him down to a hospital in London, England where he was working as an assistant. He had apparently been brought there as an amnesia patient some time before. When Mrs. Bates reached London, she found her husband in a nervous, agitated state and still unable to remember recent events. She took him to the Savoy Hotel where he rested for two days before disappearing a second time. She never saw him again. Despite an extensive search, she died before he was rediscovered by accident in 1910. A colleague apparently found him practicing as an oculist in North Dakota under a different name and convinced him to resume his old life and practice in New York. He later remarried, published his most famous work, Perfect Sight Without Glasses in 1920, and died in 1931.
While the formal diagnosis of dissociative fugue was never made in Dr. Bates' lifetime (his obituary listed him as suffering from aphasia), it seems to fit the known facts of the case. The DSM IV classifies it as a dissociative disorder and lists the diagnostic criteria as:
- sudden, unexpected travel away from home or one's customary place of work, with inability to recall one's past,
- confusion about personal identity, or the assumption of a new identity, or
- significant distress or impairment.
Differential diagnosis can be critical as other medical conditions such as dementia or head trauma can mimic certain aspects of fugue. An estimated 0.2 percent of the population are believed to experience fugue although traumatic life experiences may increase the likelihood of occurrence. Most fugues can last for hours or days and often resolve on their own or can be successfully treated through psychotherapy. While memories predating the fugue episode can be recovered through treatment, what happened during the fugue episode itself is usually lost. More extreme cases in which the fugue sufferer can live for years under a different identity are considerably rarer.
It is likely that many fugue episodes go unreported due to feelings of embarrassment or worry about the resulting stigma. Agatha Christie's famous disappearance in 1926 may well have been a fugue episode although she went to her grave without ever revealing the truth of what happened. As to whether other famous disappearances can be linked to dissociative fugue, who can say? In any event, dissociative fugue provides a graphic example of the fluid nature of memory and how easily something as basic as personal identity can be lost.