The book The Man Who Mistook His Wife For A Hat by Oliver Sacks is a fascinating series of essays about various neurological deficiencies and disorders. It is an older book, originally written in 1985. The edition I read was published in 1998. However, it did not seem to be updated with newer terminology which makes me think that there was not much revision done in the later editions and printings.
Each story in the book is an essay about various brain processing problems, many of which were bizarre and new to me. I am not a neurologist nor have I ever read anything about neurology. The brain can do some amazing things, as was demonstrated in the book. For example, one of the stories is about a man who gained canine-like olfactory sensitivity. He was able to process smells in a way that was not unpleasant, yet smells were much stronger in his mind. After he returned to normal he commented that he looks back with fondness to the time when he could recognize people and things by their smell.
The essay from which the title of the book comes is The Man Who Mistook His Wife For A Hat. It is a story of a man who had visual agnosia. This mean that he was able to see objects with perfect clarity, but was not able to process them for what they were. He was known to pat and talk to fire hydrants as if he were talking to children in the street. He could recognize pictures of his brother, not because he knew the face, but because his brother had an odd looking tooth. He was not able to process faces as a whole, but a distinguishing feature would help him know who certain people were.
The stories in the book are riveting and fascinating. However, I think the nature of the vocabulary of neurology made it sometimes difficult to stay awake when reading the book late at night. It is not poorly written, but because there is so much explanation needed for the non-neurologist, I would not consider it light reading. Dr. Sacks does a splendid job of making the book understandable for those who may not be familiar with the field.
The book is broken into four sections: Losses, Excesses, Transports and The World of the Simple. Each of the four sections deals with case studies of people who experienced traits fitting into these categories. Some were caused by trauma or disease while others were born with their condition. There are 24 essays in all.
The Man Who Mistook His Wife For A Hat: Losses
The title essay is in the first section. There are similar stories of people who lose an ability because of different injuries or disease. One essay is about a lady who lost the ability to sense her body parts in relation to one another. It was like her head was completely intact and functioning normally, but stuck on a body that was not hers. One blind lady learns to use her hands for the first time after she is 60 years old.
The Man Who Mistook His Wife For A Hat: Excesses
Section two is about excesses in desires and abilities. The most interesting story to me in this section is about an elderly lady who was 90 years old at the time the book was written who had heightened energy and sexual cravings that started a couple of years before. It was caused by neuro-syphilis. She had contracted syphilis 70 years previously, but the disease remained dormant and did not affect her mentally until all those years later. She wanted to be treated because she knew it was a disease, but she did not want to lose the effects of what it was doing to her body. It turned out that even though Dr. Sacks was able to treat the disease and kill it, the damage to her brain or nervous system had already been done. He was not able to reverse the way it was affecting her. She continued to have the energy that the disease brought on, but no longer had the disease itself.
A couple of essays are dedicated to Tourette's syndrome. One of the Tourette's stories was about a man who was calmed by medication during the week when he had to interact with others, but benefited from the excessive energy and free thinking as a musician on the weekends.
The Man Who Mistook His Wife For A Hat: Transports
There were some very strange stories in this third section. Many had to do with dreams and remembrances. A couple of the people profiled would hear music as if it were coming from a source outside of themselves (radio, TV), yet no one else could hear the music. Sometimes it was so loud inside their heads that they were not able to hear others speaking around them. It turned out that they were having seizures which caused them to remember music and places from their childhood that had long been forgotten.
A disturbing essay about a man who killed his girlfriend while on PCP is in this section of the book. The man had absolutely no recollection of the event. No amount of hypnosis or therapy could reveal to him what he had done. After several years in a psychiatric hospital, he gained some freedom to go out in society. As a result of a biking accident he received a head injury. When he awoke in the hospital he had regained complete and graphic recall of the events from when he murdered his girlfriend. Initially those were the only memories he had, but over time he was able to learn to suppress them enough to function once again. The story is fascinating in and of itself, but what I found most interesting is the fact that many head injuries cause us to lose information. He was able to gain information through the traumatic accident.
Each of the stories in this section seemed to have a similar theme. It is as if there is something that can be switched on and off in our brains to give us more or less functionality than previously was possible. A clear example of that is the story mentioned above about the medical student who gained a canine-like sensitivity to smell. The ability is apparently there within the brain, but for some reason we don't have access to it.
The Man Who Mistook His Wife For A Hat: The World of the Simple
As someone who has worked with mentally retarded people, this was a very enjoyable section of the book. I would like to read more essays like these. Dr. Sacks profiles various people who are retarded either physically or mentally in some way, yet have extraordinary abilities in other areas. He talks about a couple of idiot-savants who were mathematical genius twins, but only in certain types of numbers. They love to "play" with prime numbers.
One young lady in this section, Rebecca, has trouble understanding spacial relationships. It could take her hours to put on gloves or socks. Yet she had an uncanny ability with music, dance, poetry and prose. She could describe things in metaphor in incredible ways. She ultimately was pointed to a theater group where she learned to dance and act. Within the theater she was as normal as anyone else. Life was scripted and musical.
A 60 year old man was profiled in this section who had no social graces, but had an uncanny ability to remember music. He had encyclopedic knowledge of thousands of operas. While he had trouble holding down menial jobs because of inability to pay attention and focus, he came to life when anyone had questions about music.
It took me a while to read through The Man Who Mistook His Wife For A Hat. As I said, it is not an easy read. But if you are at all interested in brain or neurological disorders, you will enjoy this book. There are many more stories than I mentioned. Dr. Sacks has written a few books since then. I have not read any of them, but I am very interested in seeing what his other books are like.