First-time seizures are a common part of neurology practice. Making an accurate and specific diagnosis is achievable by taking an excellent history. Clinicians should keep in mind that seizures are only part of the differential in a patient with a first-time event, with other diagnoses like syncope common as well. This history should focus on what the seizure feels like to the patient and looks like to observers. Two classification systems, the seizure semiology and International League Against Epilepsy (ILAE), exist to make communicating complex information easier. Key semiology history includes the presence or absence of auras, altered awareness, or convulsions. In addition to history, laboratory, EEG, and imaging data can inform to the specific patient diagnosis. If you determine that the patient has had a first-time seizure without a clear epilepsy diagnosis, you can tell them seizure that the recurrence risk is 40%. If you determine the patient has epilepsy, you can tell them that 50% of people are seizure-free with the first medication used. Patients should be reassured that they can live normal lives with most jobs being obtainable and family life being a possibility if the patient so chooses.

There is a profound ambiguity surrounding all elements of CIL, particularly as regards the psychological element of opinio juris. This is further accentuated by the prevailing, in international law, elements of absence, silence or non-action and their often-monolithic interpretation as non-objection or, even, acquiescence. But is this true, according to the rules of informal logic? What is the value of non-doing? Non-acting or abstaining? Non-believing towards the formation of a certain opinio juris? The mainstream interpretation of CIL overlooks the quantifications and varieties of meaning in non-appearances, such as the conceivable neutrality of absence. This has led to persuasive-teleological argumentation, in the sense that the person or agency elaborating on either absence or silence aims at a certain end and is thus characterised by a certain ‘argumentative orientation’ towards a preferred conclusion. In this spirit, the ICJ has developed several techniques of superficial, persuasive argumentation, teleologically governed by the non liquet principle, the containment of international crises and the effective resolution of international disputes. This repositions the whole enquiry to the proper place of informal logic in international legal reasoning. The author suggests that an open-system approach could shed light on these inconsistencies and political manoeuvres.

Chapter 6, ‘Absence of the Other’, points to moments in Schumann where the music is marked by the absence of another’s voice, be it through the Romantic evocation of distant voices in pieces such as the Novelletten’s ‘Stimme aus der Ferne’, or, more troublingly, the loss of voice in songs like ‘Des Sennen Abschied’ and ‘Die Sennin’ – a non-presence often explicitly denoting death, as is the case at the close of Frauenliebe or in the Kerner setting ‘Aus das Trinkglas eines verstorbenen Freundes’. As is found increasingly in Schumann’s later work, the music may pointedly not trace a successful ‘coming to lyricism’: the emergence of an expected lyrical voice is missing. This tendency is epitomised in the genre of melodrama, where music accompanies a declaimed speech that refuses to attain the subjective presence of lyricism, and in pieces such as Manfred.

The absence of lyrical voice in pieces such as Schumann’s Manfred and Ballads for Declamation may point not only to the absence of the other but also to the absence of the subject itself. ‘Absence of the Self’ explores the potential loss of self implied by the absence of lyrical voice, highlighted in the missing silent ‘inner voice’ of the Humoreske, which forms an apt exemplification of later twentieth-century accounts of the illusory, ‘barred’ subject proposed by such thinkers as Lacan, Kristeva, and Žižek, or the empty centre at the heart of the Eichendorff Liederkreis that results from the absence of a unified subject position and any sense of narrative continuity.

Chapter four discusses the Tallinn Manual as a "restatement" of international law. The restatements in the Tallinn Manual were deemed necessary because specific positive law was lacking. Yet, they were also presented as neutral reproductions of rules already in existence. This led me into the recurring topic of this book: the dialectical relation between repetition and something that is absent, unattainable or unspeakable. However, in this chapter, I add another dimension to the analysis of repetition in international law. After all, the restatements occur in a very specific format, the manual. Through a comparison between the Tallinn Manual, consumer manuals and manuals of etiquette, I try to get a better grip on the inherent tensions that come with restatements of international law in the form of a "manual."

This chapter examines military attitudes toward “emotional injuries” resulting from the end of romantic relationships. Evaluations of why some men “cracked” evolved substantially from World War I to the present. Often, however, psychiatrists attributed servicemen’s maladies to deficient female love: whether that of mothers or romantic partners. In Vietnam, psychiatrists construed romantic rejection as a “narcissistic injury”: a blow to the ego that led men to decompensate in various ways. Alcoholism, going AWOL, self-harm, and violence directed toward others were all associated with Dear John letters. The chapter considers how the military medical and legal establishments adjudicated unlawful acts perpetrated by servicemen whose intimate relationships had recently been severed by letter. It focuses on two court-martial cases: a Korean War POW who briefly rejected repatriation to the United States in 1953, citing a Dear John as his motive for defection, and a Marine Corps private court-martialled in 1969 for killing four Vietnamese peasants. In the latter case, military lawyers deemed the defendant to have been temporarily insane after his fiancée sent him a Dear John.

This chapter shows that marks of punctuation are continuous with the much larger forms of punctuation that interrupt human experiences in time and space, especially ‘larger relations of voice and body, space and absence’. The chapter shows that punctuation has ‘reciprocal and reflexive relationships’ with what it punctuates while at the same time punctuation marks can work ‘as reminders of and reflections on vocal and bodily presence’.

This chapter explores the portrayal of Chicago in the fiction of Saul Bellow, examining the conflict between materialism and visionary idealism that lies at the heart of his work. Starting from the stereotypical characterization of Chicago as the home of brute matter, cynical pragmatism, and the mass production of commodities and physical things, the chapter traces Bellow’s autobiographical search for hidden spiritual truths, connecting this to the Jewish notion of being exiled in a foreign land, vestiges of the soul or the spirit disguised among the quotidian ugliness of industrial America. This conflict between things and ideas, matter and spirit, morality and “the hustle” of economic life, draws on both the conflicts of Bellow’s early life and the wider patterns of Jewish immigration and assimilation. Chicago appears in Bellow’s work as both an overwhelming physical presence and a metaphysical absence, linked to the emptiness of the prairies and haunted by the Jewish-Russian past of Bellow’s family. These contradictions and paradoxes are traced through a close reading of Bellow’s short fiction, as well as his major novels The Adventures of Augie March, Herzog, and Humboldt’s Gift.

This chapter explores Elena Ferrante’s use of Virgil’s Dido as a model for Elena and Lila, the two protagonists of the Neapolitan Novels, through the lens of absence. Not only is Ferrante able to conjure and comment on the Aeneid’s treatment of one of its most divisive characters following the classical rules of intertextual engagement with the ghosts of masterpieces past; she ends up changing the whole game. By teasing narrative material out of Virgil’s silences in Dido’s story-arch, Ferrante centres and requalifies the very reason of Dido’s undoing – the trauma which stems from the loss of love – as the generative force behind both Elena’s and her own literary output. However, by making Lila’s invisible writing and her subsequent disappearance into the beating heart of Elena’s writing, Ferrante uses Virgil as her Muse to stage a woman-centred takeover of literary greatness. Elena’s anxieties over how much of Lila’s life she has truly cannibalized, and her responsibility in Lila’s disappearance, not only take Virgil to task for hiding his Muse, but suggest an alternative model of criticism; moving beyond the postmodern view of the absent author and his unaccountability by giving agency back to the Muse.

Soon after the eruption of Vesuvius in 79 CE, Pompeii seemed to have vanished. The buried city maintained a presence in the region’s collective memory primarily as an overwhelming absence, repressed even in the near-contemporary poetry that ruminated on its demise. In such texts, the name of Pompeii is conspicuous by its absence, and the shock over the swallowing up of this solid ancestral ground is keenly felt. This chapter argues that Martial, Statius, and others initiate the trope of Pompeii as an absent presence that continues to characterize our responses to the site today, even in the face of the apparently abundant materiality of the site. By following Pompeii’s disappearing act from these Latin authors through a variety of more recent engagements with the city – from the subterranean journey to the site in Jacopo Sannazaro’s Arcadia (1504), to the sci-fi dislocation of the city in Amelie Nothomb’s novella, Péplum (1996), and the recent video installation Soleil Noir (2014), in which Pompeii becomes a post-human landscape – we can observe Pompeii’s importance as a locus for understanding the absences that permeate Roman culture, and our modern receptions of it.

This essay formulates a critical response to scholars’ Freudian-Lacanian understanding of Ovidian desire in terms of frustration, futility, absence and lack. It focuses on the Remedia Amoris, a poem it takes as paradigmatic and culminatory in Ovid’s elegiac project, and attempts to give an account of what is meaningful and productive about the rhythmic process of Ovidian amor in and of itself, through the lens of Jean-Luc Nancy’s recent book on jouissance (Coming, 2017). The Remedia, it argues, performs absence not as tragic loss but as an undoing-remaking that continually regenerates desire and teaches investment in the pleasure of process. The second half of the essay explores how the poem’s temporal instabilities and dislocated subject positions produce a series of imagined inter-relations and ‘elsewheres’ that move readers away from Lacanian desire as continually projected into an ungraspable future, and into the experience of jouissance in the elegiac present.

What should we make of the glaring absence of the emperor Nero from Seneca’s Epistulae morales – not mentioned once in 124, often lengthy, letters, written by a man who had been for many years one of his closest associates? Although Seneca does sometimes allude to the question of how frank advice may be offered to the powerful, the letters barely touch on imperial politics, beyond advising their addressee that he would be better off withdrawing from the public sphere. Yet if Nero is not present explicitly, there are a number of respects in which Nero’s domination of others as well as his failure to exercise control over himself are constructed as implicit and potent anti-models in the letters. When Seneca reflects on the dynamics of vice in its more florid and imaginative forms (the examples analyzed here are letters 90 and 114), his terms frequently resonate quite specifically with ancient accounts of Neronian Rome (notably those of Tacitus and Suetonius) and other works of Neronian literature (particularly Petronius and Persius). As it turns out, highly refined vices even play a notable role in Seneca’s model of the development of philosophy.

Silence permeates intimate spaces and intimate relationships. Such intimate silences shape social action, which can establish and maintain fundamental inequalities. The unsaid can be difficult to identify, especially in such contexts. However, by showing how we “tiptoe” around particular topics, a convincing case for the unsaid can be made. Using two case studies, we show how triangulation can be used to make the unsaid noticeable. The first case study is situated in post-apartheid South African paid domestic labor, where dyadic research was used to reveal silences around the topics of black sexuality, male visitors, and employer monitoring. These silences work to maintain privileged white control over intimate black activities. The second case study occurs in the undocumented student movement in the United States, where a comparison between public utterances and individual interviews revealed an absence of talk around intimate partner violence within the public discourses of undocumented students. This absence works to keep inequalities around ongoing domestic violence among undocumented immigrants invisible and unaddressed. In both cases, it was only through multimethod research that the absences and dissonances across the data sets were noticed, allowing for new understandings of the issues and their fundamental inequalities.

This chapter recommends that we study silence not merely as the absence of speech but also as the presence of non-speech, thereby featuring discursive absences as manifestations of active avoidance. By highlighting hesitations, the use of euphemisms, the use of effectively elusive generics, and the lexical gaps surrounding default assumptions we habitually take for granted, it offers an introduction to the sociological study of absence.

We open the book by showing – briefly, by a consideration of the South African Truth and Reconciliation Commission – how our social worlds are structured around silences and absences; and how even the process of unsilencing can lay down new absences. We explain why qualitative research in the social and human sciences has often neglected studying silences as it focused on the presences in talk, discourse, and interaction. We then provide a quick roadmap of the silence literature that has begun to gain momentum as part of what we cal, “a turn to silence.” Finally, we outline the perspectives and objectives of this book, arguing that qualitative studies are well suited to explore the unsaid, which we conceptualized as a slippery and multilayered form of social action. The chapter provides an overview of the collection and introduces the two broad questions answered by each of its contributors, namely: (1) “What is unsaid?” – focusing attention on methods, practices, and perspectives for identifying absence, and (2) “What is the unsaid doing (here)?” – focusing attention on the ideological significance of absence.