book lover, professional writer & blogger
In his enlightening and accessible book The Man Who mistook His Wife For A Hat, Oliver Sacks describes how Chinese neurologist Dr. Dajue Wang suggested Shostakovich had a neurological ‘secret’: the creative effect of the “presence of a metallic splinter, a mobile shell-fragment, in his brain.” Apparently, he was “reluctant to have it removed.” Legend has it that the artefact, this neurological impostor located in the temporal horn of his left ventricle, assisted him during musical composition. It only worked when he tilted his head in a certain direction allowing the shell-fragment to press on his temporal lobe. At that moment, Shostakovich supposedly enjoyed a cacophony of inspiring musical hallucinations. If our tale is true, Shostakovich was lucky.
As Sacks carefully points out, not everyone’s temporal lobe productions are as wanted or appreciated. To many sufferers, the sudden unstoppable ‘appearance’ of music in their mind is overwhelming, disorienting, deafening – even devastating. The benefits of being impaired neurologically are more often mixed inextricably and cruelly with the resulting losses. He says, touchingly, of one patient, notably a former doctor of medicine: “By and large, he recognised nobody: neither his family; nor his colleagues; nor his pupils; nor himself.”
In his quest to offer a new perspective on his subject, Sacks begins to explore what he refers to as “living neurology” – the evaluation and understanding of the entire being, always looking to bridge the gap between scientific principle and patient experience. Gradually, and with sensitivity, he demonstrates links between unexpected elements, showing us that neurology, physiology and psychology are not separate sciences but important facets of the whole patient; the whole person. To treat those aspects in isolation is not to be a neurologist at all. His description of “life’s repertoire” is compelling. In unaffected people, he explains the repertoire is the source of memory and imagination ranging from simple motor movements to the most complex creative thoughts – like the imaginary worlds and landscapes of fiction. However, in some patients, these powerful inner imaginative worlds are either in the process of being lost or are already lost.
Perhaps most successfully, Sacks challenges our understanding of the day-to-day effects of neurological ‘defects’ and of the concept of ‘defect’ itself. For many years, neurology saw only deficit, loss or impairment of function but this book illustrates how such misconceptions need to change and, to some extent, have changed. To blend two of Sack’s most terrific arguments: “Disease is never mere loss [ . . . ] there is often a struggle, and sometimes, even more interestingly, a collusion, between the powers of pathology and creation.”
In scientific research terms,The Man Who mistook His Wife For A Hat cannot be considered recent yet, in lots of ways, it challenges current perceptions and stands the test of time.
To conclude, I want to mention ‘Mrs. O’C’, a patient with epilepsy and childhood amnesia. Sacks offers a particularly poignant picture of her and the story quickly became a highlight of the book. By taking us on a journey into her “cerebral mishap”, he discovers a deep, emotional nostalgia associated with her seizures which, ironically, allows her to rediscover huge chunks of early memory. Mrs. O’C refused available treatment. Her seizures were the only way she could visit her “ long-forgotten home” and be “in the arms of her mother” as a child once more. By telling her story, Sacks teaches us that the so-called “chasm” between brilliant science and human experience can – in unexpected ways – be bridged.