Medicine and art

The troll elk and epilepsy

Norwegian
    Trygve Holmøy, Karl Otto Nakken
    See All Articles
    Trygve Holmøy

    trygve.holmoy@medisin.uio.no

    Trygve Holmøy, specialist in neurology, senior consultant at the Department of Neurology, Akershus University Hospital, professor at the Institute of Clinical Medicine, University of Oslo, and a member of the Norwegian Neuro-Literary Club

    The author has completed the ICMJE form and declares no conflicts of interest.

    See All Articles
    Karl Otto Nakken

    Karl Otto Nakken MD, PhD, specialist in neurology and retired senior consultant. He served for many years as the medical director at the Hospital for Epilepsy in Sandvika.

    The author has completed the ICMJE form and declares no conflicts of interest.

    ()

    sporsmal_grey_rgb
    Article

    In older works of fiction, epilepsy is often portrayed through the lens of mysticism, superstition and prejudice. Few Norwegian novels illustrate this better than Trollelgen (the troll elk) (1921) by Mikkjel Fønhus.

    Photo: Jan-Eilert Pedersen
    Photo: Jan-Eilert Pedersen

    Trollelgen (published in English in 1922 with the title The Trail of the Elk) is the fourth and most celebrated novel by Mikkjel Fønhus (1894–1973). It tells the story of Rauten, a mysterious bull elk who appears to be immortal, and Gaupa, a lonely hunter consumed by his relentless pursuit of this troll elk.

    The falling sickness

    The falling sickness

    Early in the novel, we encounter Redalssvenskin, a half-mad old Swede who roams the desolate Redalen valley in search of a long-lost silver treasure. It is well known among the villagers that he suffers from epilepsy, referred to as 'the falling sickness' in the book. At the mountain farms, the herding women have seen him collapse, writhing in convulsions. One summer evening, the renowned hunter Gaupa comes across him digging for the treasure (1):

    'He straightens up; the pick hanging idle in his right hand, and with his left he wipes the sweat from his scalp, leaving streaks of dirt from the digging. His red-bearded face curls into a grimy smile, and his eyes are wide, vacant and confused.

    Then he says,

    "And when I die, I will come back to Redalen, as an animal…"

    Gaupa notes that the Swede is behaving strangely, as if frozen and listening for something unseen. Suddenly, he lets out a piercing scream and falls head first, straight into the hearth.

    Quick as lightning, Gaupa pulls him free. The Swede convulses violently, gripping the pick handle so tightly that it cannot be prised from him. Gaupa manages to place a stick between his teeth to prevent him biting his tongue. He lies there, curling his legs up, as he lets out the occasional guttural groan, foam spilling from his mouth.

    Eventually, the jerking subsides. He drifts into a deep, exhausted sleep, each breath slow and heavy.

    "He'll be fine soon", thinks Gaupa. He has seen people with the falling sickness before and knows that this sleep often signals the end of a seizure.

    But the Swede's slumber continues, and Gaupa notices his breaths grow ever lighter. Leaning in close to listen, he realises that Redalssvenskin is no longer breathing.

    Fønhus provides a hauntingly vivid depiction of a tonic-clonic seizure with focal onset, culminating in sudden, unexpected epilepsy-related death

    Fønhus provides a hauntingly vivid depiction of a tonic-clonic seizure with focal onset, culminating in sudden, unexpected epilepsy-related death. Placing a stick in the mouth of someone experiencing a tonic-clonic seizure to prevent tongue-biting was long considered standard practice, but it is now discouraged as it can obstruct the airway.

    Poet of the wilderness

    Poet of the wilderness

    The Trail of the Elk cemented Mikkjel Fønhus' reputation as a chronicler of the wilderness. The story takes place in the desolate Vidalen valley between Krøderen and Sperillen, renamed Redalen in Fønhus' literary universe. Redalssvenskin is a Swedish lumberjack obsessed with finding the silver treasure that, according to legend, was buried in Vidalen during the Black Death. Sjur Renden, nicknamed Gaupa, is the village's greatest elk hunter, a loner with no close companions other than his hunting dog Bjønn.

    Mikkjel Fønhus. Photo: Aschehoug's photo archive
    Mikkjel Fønhus. Photo: Aschehoug's photo archive

    Gaupa may also have had a form of epilepsy:

    'At the left corner of his mouth, he has occasional twitching of the skin; these twitches appeared when he was a young man, and now he no longer notices them, but they are always there, whether he is asleep or awake.'

    This description suggests that the movements may have been caused by hemifacial spasm or epilepsia partialis continua (Kojevnikov's syndrome), possibly due to cortical dysplasia or another stable lesion near the central sulcus (2).

    The spring after Redalssvenskin's death, Gaupa shoots a cow elk in Redalen that had calved that very night. The eyes of the newborn calf unsettle the seasoned hunter. He does not see them as empty or soulless like those of other newborn animals, but as watchful, human-like eyes staring at him:

    'Gaupa holds the elk calf in both hands. He feels the blood coursing through its fragile body; under the animal's belly he sees that it is a male calf. And he also sees the face of Rèdalssvenskin, hears the piercing scream at the very moment of the seizure, watches the mouth open, and hears the final, spasmodic cry: animal, animal…' (1)

    The calf grows up to become the legendary Rauten – Trollelgen himself – the largest and mightiest bull elk anyone has ever known. The hunt for Rauten becomes Gaupa's obsession, and ultimately his undoing. Meanwhile, the idea emerges that Redalssvenskin has come back to Redalen in the form of Rauten.

    Like Fønhus' earlier novels Skoggangsmand (1917), Der vildmarken suser (1919) and Det skriker fra Kverrviljuvet (1920), The Trail of the Elk celebrates the vitality of wild animals, the wilderness and the hunter (3). An undercurrent of unsentimental yet sensitive nature poetry permeates his work, shifting fluidly between animals' and humans' perspectives on landscapes and events (4). However, The Trail of the Elk differs from Fønhus' other books in the mystique created by Gaupa's belief in reincarnation. It is this journey of the soul that transforms Rauten into a troll elk. Rauten embodies not only the strength, instincts and rut of a wild animal, but also something distinctly human. At least, that is how Gaupa sees things – and through his eyes, the reader sees them as well.

    Resounding success

    Resounding success

    Trollelgen by Mikkjel Fønhus (1921). Cover of the 2012 reissue. Photo: Aschehoug's photo archive
    Trollelgen by Mikkjel Fønhus (1921). Cover of the 2012 reissue. Photo: Aschehoug's photo archive

    The Trail of the Elk received glowing reviews and is regarded by many as the best of Fønhus' many novels. In a memorial tribute to Mikkjel Fønhus, fellow author Knut Hauge wrote 'It is a masterpiece in both form and lyricism, a stroke of genius in a moment of inspiration... A writer cannot be expected to produce such a work more than once in a lifetime' (5).

    The feature film Trollelgen, which premiered on Boxing Day in 1927, also received excellent reviews and was a box office success in both Norway and Sweden (6). In the film, however, the ill-fated Redalssvenskin and his epilepsy are replaced by a romantic subplot, and much of the story is drawn from Fønhus' debut novel Skoggangsmand. Despite huge audiences, the film, with a staggering production value of NOK 100,000, ultimately made a loss (6).

    Trollelgen and Germany

    Trollelgen and Germany

    The Trail of the Elk was translated into multiple languages. Nowhere did the mystical qualities of nature resonate with readers and critics as strongly as in Germany, where Der Troll-Elch was published in 1926 (3). Both Deutsche Allgemeine Zeitung and Die Welt am Montag compared Fønhus to Hamsun and The Trail of the Elk to Pan (3):

    'In both works, nature becomes a breathing, living being, imbued with its own spirit. One senses a fraternal closeness to all that exists, to all living things. But while Hamsun's stance is essentially sentimental – a "back-to-nature" attitude – Fønhus' original, observant approach is borne out of a closer, more immediate connection.' (7).

    Nowhere did the mystical qualities of nature resonate with readers and critics as strongly as in Germany

    Although several of Fønhus' books sold reasonably well in Germany before World War II, none could match Der Troll Elch. By 1940, 409,000 copies had been printed in German (8). Not even Knut Hamsun achieved such a high readership in Germany. Only Trygve Gulbranssen's Und ewig singen die Wälder sold more copies (8). Gulbranssen's trilogy exalts the unspoiled, pre-industrial human in harmony with nature, much as Fønhus does in The Trail of the Elk. Der Troll-Elch's initial success can be attributed to its use as a promotional gift by the Nazi-controlled book club Büchergilde Gutenberg Berlin. During the war, the Wehrmacht printed an additional 15,000 copies for distribution among soldiers on the frontline (3).

    Nazi marzipan elk

    Nazi marzipan elk

    Mikkjel Fønhus was a harsh critic of socialism and the labour movement. In 1927, his motion of no confidence forced Arnulf Øverland to resign as head of the Norwegian Authors' Union after participating in the tenth-anniversary celebrations of the Soviet Union (3). At the invitation of the Nazi-affiliated Nordische Gesellschaft, Fønhus visited the controversial writers' exchange in Travemünde in 1937. He encouraged his close friend Tarjei Vesaas to do the same: 'You'll see it is a very different Germany from the one Dagbladet falsely depicts – deliberate and consistent lies' (9). As late as October 1938, Fønhus reluctantly went on a lecture tour in Germany arranged by the Nordische Gesellschaft (3). There is, however, no evidence that he was a Nazi sympathiser. When Germany invaded Norway, he reacted with disgust and did not collaborate with the occupying forces. Ironically, shortly before hostilities broke out, a German admirer had sent him a beautiful 'troll elk' made from marzipan. Fønhus buried it as deep as he could when German troops reached his home village (10).

    It is perhaps not difficult to understand that Fønhus' nature romanticism and his celebration of the solitary hunter's affinity with the wild Nordic landscape appealed to German National Socialists. What is more striking, however, is that they were captivated by a story in which epilepsy plays such a prominent role. People with epilepsy were, in their eyes, a burden on society. The Nazi's so-called 'euthanasia programme' was launched with the aim of killing people with epilepsy, among others (11). Although epilepsy is only mentioned in a few pages of The Trail of the Elk, Redalssvenskin's dramatic death, not to mention his reincarnation, is a central element of the book, and is precisely what makes Rauten a troll elk.

    It is striking that German National Socialists were captivated by a story in which epilepsy plays such a prominent role. People with epilepsy were, in their eyes, a burden on society

    Part of the explanation may lie in the rather disparaging description of Redalssvenskin: a gullible simpleton obsessed with an ancient legend, if not outright ostracised, at least living on the margins of society; someone that no one missed or mourned.

    Stigma and superstition

    Stigma and superstition

    Around 1920, epilepsy in Norway was widely regarded as a mental illness. In his 1923 textbook on neurology, Søren Bloch Laache (1854–1941) described epilepsy as one of the most severe types of neurosis. Treatment options at the time were extremely limited, and for many years, bromide salts – administered in an aqueous solution or baked into bread – remained the only available therapy. By the mid-1920s, it became increasingly common to combine potassium bromide with phenobarbital, which had been shown as early as 1912 to have anticonvulsant properties (12).

    The story of Redalssvenskin's reincarnation in Rauten is part of a literary tradition that conveys stigma, superstition and prejudice towards people with epilepsy (13). It is no coincidence that Fønhus allows Redalssvenskin to die from the condition. In antiquity, epilepsy was known as morbus sacer, the sacred disease: a term reflecting the enduring myth that seizures were a divine or demonic punishment for past sins. There is a distinctly demonic quality to Rauten; Redalssvenskin's wayward soul appears to possess him like an evil spirit. This portrayal is explicitly articulated in a contemporary study of Fønhus' work:

    'The ancient pagan motif emerges as a guiding theme: humanity's pursuit of evil spirits that bring misfortune. There is a profound meaning underlying the story of Gaupa the forest wanderer and Bjønn … Their struggle against the evil spirit, the long-dead scoundrel Rèdalssvenskin' (14).

    At the end of the 19th century, the Italian doctor and criminologist Cesare Lombroso (1835–1909) argued that criminality, genius and epilepsy shared a common pathogenesis, and that criminal behaviour was an epileptic equivalent (15). Émile Zola (1840–1902) was influenced by Lombroso, particularly in his depiction of the murderous Jacques Lantier in La Bête Humaine (The Beast Within). Other writers have also historically been interpreted as portraying characters with epilepsy as villains, including William Shakespeare (1564–1616) in Othello and Charles Dickens (1812–1870) in Oliver Twist (13). Fønhus, however, did not follow this approach, despite the impression given by his first biography (14). Although he allowed Redalssvenskin to return as a sinister spirit in the form of Rauten, he never portrayed him as a villain in life; he is presented as innocent and naive, rather than malevolent or criminal.

    Not just tall tales

    Not just tall tales

    Almost all of Fønhus' books are based on oral accounts of real events that he gathered. 'A book does not contain as many tall tales as many people think. Most of the action in my books is not made up. It is about things that actually happened, though I have adapted them. Almost all of my writing draws on reality. I might alter it slightly, but…' (16).

    The character Gaupa is modelled on the well-known game hunters Per Maribo from Strømsoddbygda, a forested village in eastern Norway, and Elling Jallen Tørrisdokken from Gol, a small town in southern Norway (1, 4). The character Redalssvenskin is inspired by a Swedish soldier who, like many others, worked in logging in the forested valley of Vidalen during the 1870s and 1880s (17). He is said to have searched in vain for the legendary silver treasure for many years, but he did not have epilepsy, nor did he die in Vidalen (17).

    Where did Fønhus find inspiration for his vivid depiction of epilepsy? He was well read and one of the first Norwegian writers to acquaint himself with Sigmund Freud's work, as early as 1920 (3). He may have read about epileptic seizures, but his portrayal of Redalssvenskin's death reads more like an eyewitness account. We have found no evidence that any of Fønhus' relatives or acquaintances had epilepsy. The closest connection is that his uncle at Nordre Fønhus died of tetanus in early winter 1921 – with The Trail of the Elk appearing in print that autumn. According to oral family accounts, he endured grotesque convulsions at his farm for several days before he died (Arne Erik Fønhus, personal communication). It is likely that Mikkjel witnessed this. These powerful impressions may have found their way into the book he was writing.

    He may have read about epileptic seizures, but his portrayal of Redalssvenskin's death reads more like an eyewitness account

    We will probably never know why Mikkjel Fønhus wrote about epilepsy in the way he did, or why a National Socialist book club chose to celebrate this particular book. We must content ourselves with wondering at, and revelling in, his lush and poetic renderings of Norwegian nature and the sense of connection it evokes.

    When, in 1972, the chair of the Norwegian Authors' Union, Ebba Haslund, congratulated Mikkjel Fønhus on the print run of that year's book, Villmarksoteren, reaching 20,000, Fønhus replied (14):

    'It's not that I write so well. It's just that I write about things that are considered modern today.'

    Fønhus was likely referring to the preservation of untouched nature, a concern that may still be considered modern. His depiction of epilepsy, however, certainly is not.

    Comments  ( 0 )
    Dette kommentarfeltet modereres, men kommentarer blir ikke redaksjonelt behandlet ut over å sikre at de følger retningslinjer for vårt kommentarfelt.
    Skriv Kommentar
    Published: 3 November 2025
    Tidsskr Nor Legeforen 3 November 2025 Vol. 145.
    doi:
    10.4045/tidsskr.25.0397
    Received 16.6.2025, first revision submitted 9.7.2025, accepted 18.8.2025.
    Copyright: ©️️ Tidsskriftet 2026
    PlumX
    Published: 3 November 2025
    Tidsskr Nor Legeforen 2025 Vol. 145.
    doi: 10.4045/tidsskr.25.0397
    Received 16.6.2025, first revision submitted 9.7.2025, accepted 18.8.2025.
    Copyright:
    ©️️ Tidsskriftet 2026
    Plum Print visual indicator of research metrics PlumX Metrics
    PDF
    Print
    Reply to article

    Recent Articles

    Nyeste ledige stillinger fra legejobber.no

    Se alle stillinger

    Motta vårt nyhetsbrev! Hold deg oppdatert om ny forskning og medisinske nyheter.

    Meld deg på