(reynaudc)

Oliver Sacks, British neurologist who has practised in the USA for the past 50 years has acquired a great notoriety as a prominent author especially thanks to his book Awakenings published in 1973 which was later made into the Oscar-nominated movie Awakenings by the same name and his book The Man Who Mistook His Wife for a Hat, and Other Clinical Tales. Sacks draws from his experiences as a neurologist to present a unique and insightful look into consciousness, the human mind and brain.

 

The Man Who Mistook His Wife for a Hat, and Other Clinical Tales is a collection of 24 essays relating the cases of patients presenting bizarre and even bewildering neurological conditions. The essays are divided into 4 categories:

  • Losses which presents among others the case of an amnesiac sailor, a “bodiless” woman (who’s lost her sense of proprioception) and the case of Dr. P who can’t recognize objects;
  • Excesses presents the cases where the brain is subject to too much activity as in the cases of Tourette’s syndrome;
  • Transports describes the worlds of visions and hallucinations, in which Sacks includes a personal experience of feeling like a dog whilst under the influence of amphetamines and LSD;
  • The world of the simple presents the cases of people affected by mental retardation but yet enjoy a rich and full life.

 

“Street neurologist with a sense of wonder”: interview with Sandee Brawarsky, the Lancet, 1997

In this interview Sacks is asked about how he came to the USA and how he started writing. When asked how he is seen by other neurologists he is often categorized as “a spokesman” or a sell out to “pop neurology”. It is probably his own view of himself that describes him best. He would like “to be seen as a sort of explorer, driven by, and trying to share, a strong sense of wonder.” a description which seems appropriate and well-fitting upon reading his work. Every case in the book presents a neurological condition whose implications the average reader could never have imagined and makes us wonder at the complexity of the human mind and brain.

The interview also raises the question of Dr Sacks’ motivation as a doctor, and his certain guilt in regards to writing about his patients. Does he now practice for the sake of some kind of voyeuristic desire to write his next book or for the patient’s best interest? This is a question often raised when doctors relate their experiences through art.

The Man Who Mistook his Wife for a Hat

The first case in the book is the case of Dr P. a music professor who seems completely unable to recognize objects. He is unable to recognize his students faces but able to see these same faces in water-hydrants and other inanimate objects. Upon developing diabetes and seeing an ophthalmologist he is referred to Dr Sacks. Immediately Dr Sacks is aware that something is not quite right but is unable to determine what it is. It is only upon conducting a routine neurological examination that he starts to grasp what is going wrong. Dr P. is unable to put back his shoe believing that his foot is his shoe. The situation becomes all the more bizarre when Dr P. leaves; he mistakes his wife for his hat and tries to put her on his head. The puzzlement of the narrator is made evident and is easily shared with the reader.

The next day Dr Sacks visits Dr P. at his home and performs a few tests, he first asks him to describe a rose and then a glove. Although Dr P. knows very well what these are, and is perfectly able to describe them he is unable to label them rose and glove. Sacks doesn’t describe the disease with any scientific terminology at any stage during the essay and yet through these two tests he cleverly presents it and reveals to the reader what the problem is. However the simplicity of the situation make us wonder whether or not Sacks has not used some artistic licence in presenting this condition to us in such a neat and effective way.

Other elements hint at the truthfulness of his account (or rather lack of) especially at the beginning when presenting Dr P. “Had he not always had a quirky sense of humour, and been given to Zen-like paradoxes and jests?”.  It is difficult to imagine any doctor knowing his patient so well after only two consultations. Although it seems Sacks may have used some artistic licence (or has an outstanding memory) these anecdotes and details make us relate all the more to the patient.

The essay ends with a somewhat tragic revelation on how the disease has progressed throughout the years when Dr Sacks looks at Dr P.’s paintings. “This wall of paintings was a tragic pathological exhibit, which belonged to neurology, not art.” (Which seems like a strange comment given that many great artists presented some kind of neurological condition or substance abuse which helped them produce their art).

 

I really enjoyed this book as it was easy to read, not burdened with complex scientific explanations and offered interesting insights into the complexity of the human mind whilst making every case more about the patient and his response to the disease rather than about the disease alone.

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