Singing in the Key of I
ARIELLE TRAMONTANO
I
n his collection of vignettes, The Man Who Mistook His Wife for a Hat,
Oliver Sacks creates for his readers a dream in which even the most bizarre
experiences make perfect sense: colors become sounds, people become
objects and vice versa, events three decades old happened last week, and emotions flail like the once-familiar limbs that now seem alien, all while some
hauntingly familiar melody plays in the background. But before long, the
music stops. You’re awake and so is your pre-frontal cortex, the nay-sayer of
your brain, there to meet you with groggy eyes and a smug rationale for all
you have just encountered: It wasn’t real. Whereas Sacks’s psychologically
impaired characters are inhabitants, or rather captives, of this dream world,
you are a vacationer, free to return home at any time. Throughout his essays,
Sacks offers rich insights into his clinical experience as a neurologist, telling
and retelling the story of man’s capacity. Sacks wants us to reap the benefits
of this strange and fantastic dream world and learn from the afflicted, whose
voices he orchestrates into a symphony of human identity and potential.
Sacks escorts us into this Shangri-La only to usher us out, but not without introducing us to each member of his wacky cast. In the essay “The Man
Who Mistook his Wife for a Hat,” we meet Dr P., a musician with an uncommon form of visual agnosia who cannot recognize faces and common objects.
In “The Lost Mariner,” Sacks examines Jimmie G., a spirited forty-nine-yearold with Korsakov’s Syndrome who can only recall memories rooted at least
thirty years in the past and easily forgets those immediately formed, due to
“retrograde amnesia.” Another Korsakovian with these symptoms,
Thompson, compensates for his illness through “confabulation,” reinventing
his world by the minute in “A Matter of Identity.” In “Cupid’s Disease,”
eighty-nine-year-old Natasha K. experiences a sudden euphoria after neurosyphilis awakes from a latent period of seventy years, while Christina, “The
Disembodied Lady,” is faced with an even more mystifying condition—lack
of “proprioception,” or a sense of her own body, at the age of twenty-seven.
“The Autist Artist,” José, is a twenty-one-year-old “idiot” who has a remarkMERCER STREET - 53
able ability to draw despite his autism, and “Witty Ticcy Ray” is a twentyfour-year-old who learns that his Tourette’s Syndrome may be the source of
his remarkable percussionist talents. Though severely physiologically imbalanced, these individuals overcome unimaginable odds in their attempts to
find balance and become “centered,” even while their strange perceptions
cause us to designate them as inhabitants of another world.
Woven into Sacks’s case histories are questions of what is at stake for
these patients and also a clear implication: the neurally sound can never fully
understand the experience of the neurally handicapped. Polarizing patient
from reader, Sacks describes devastating disorders and outlandish idiosyncrasies that most readers cannot relate to, such as feeling one’s “body go
blind” (“Disembodied” 47). Still, by honing in on everyday sensibilities, he
invites us to imagine what is going on inside a patient’s mind and what it must
be like to live as they do. Sacks notes that Dr P. “faced [him] with his ears . . .
not with his eyes” (“Hat” 9), and later surmises that “reality . . . might be conveyed by smell, not by sight” (“Hat” 14). He asks sobering questions— “Was
it possible that [Jimmie] had been ‘desouled’ by a disease?” Could a man “isolated in a single moment of being” have a self or existence to speak of? (“Lost”
37). Thompson and Jimmie did not know that they had lost themselves—or
had lost anything, for that matter—while the others fought to regain lost faculties “‘with the tenacity of the damned”’ (“Identity” 115). Which is more tragic? The helpless man who feels the loss of himself or the one who is numb to
this loss, unaware of his existence to begin with? How can we possibly deem
one of these predicaments more favorable than the other? Sacks would probably argue that it could not be done because they are equally tragic.
But Sacks then debunks notions of tragedy—or, rather, universalizes
them—by guiding us to a place where we can find the characters as likable as
he does. The symptoms and conditions his patients cope with force us to ask
probing, fundamental questions about ourselves. Once we can get past the
extraordinary nature of the cases—which, for Sacks, is the norm of clinical
experience—we can finally begin to understand what makes the problem of
the afflicted patient the problem of any suburban housewife, heir to the
throne of England, or college student—the universal problem of the self.
Through the stories of his patients, Sacks shows us the frightening
fragility of identity. With the laceration of a single nerve, an entire past can
be lost—but can a self be lost as well? In contemplating his patients’ curious
conditions, Sacks draws on artistic and scientific authorities to get readers
thinking about the often underestimated importance of memory and how
questions of identity can be addressed through the context of the impaired.
54 - MERCER STREET
Borrowing the words of Luis Buñuel, the father of cinematic surrealism,
Sacks reminds us that “life without memory is no life at all. . . . Without it, we
are nothing.” In response to this sobering view, Sacks then inquires, “What
sort of self can be preserved in a man who has lost the greater part of his
memory?” (“Lost” 23). Sacks identifies Jimmie as being rooted only in the
distant past, “stuck in a constantly changing, meaningless moment” (29). For
this severe and seemingly hopeless case, Sacks elicits the advice of his contemporary, the famous Soviet developmental and neuropsychologist
Alexander Luria, who concluded that in neuropsychology “there is little or
nothing you can do, but in the realm of the Individual, there may be much
you can do” (34). Luria states that man is more than memory alone—he is his
feelings, sensibilities, will and moral being. It is primarily in this “realm” that
Sacks works to develop treatments. It is here where humans can let their creativity play in a sort of dream world, and the possibilities are vast. In other
words, for Jimmie, that “constantly changing” moment is all but “meaningless.” But Sacks purports that it comes to define him, moment by moment.
Sacks uses the stories of people for whom a stable sense of self may not
be possible because of their perceptual aberrations. By exposing us to the
fragility of the human brain, he asks a pivotal question: Has evolution separated us from ourselves? Sacks implies that when we cease to use the more evolved,
judgmental parts of our brains, as most of his characters have, a sort of primitive, naïve and uninhibited self emerges. In the same way a child grows and
learns to be more self-conscious, restricting himself in preparation for adulthood, humans have evolved throughout history—and continue to evolve—
adapting to changes, moving further away from the primal, the pure, the
unrepressed. Sacks explicitly states that by means of disease and perceptual
regression, Dr P. gained “an almost Picasso-like power to see” as an artist; he
extracted benefit from illness—but where does that leave us? (“Hat” 18). This
essay, among others, reveals that Sacks is riveted by, concerned with, perhaps
even disturbed by our evolutionary progression, and the possibility that it may
be anything but progression.
Sacks places before us yet another dilemma: What constitutes a perceptual
“gain”? As Sacks strolls past Dr P.’s artworks, he notices that they become less
realistic and detailed as time progresses, more abstract and chaotic with each
step he takes. When he relates this observation to the patient’s wife, she contends that it is “artistic development,” advancing into the abstract rather than
regressing because of pathological progression (“Hat” 17). The simple
exchange of words between Sacks and Dr P.’s wife leads him to establish his
initial postulation of “a collusion between the powers of pathology and creMERCER STREET - 55
ation” (“Hat” 18). Dr P. didn’t just shift, he progressed when he gained the
abstract. Sacks also recognizes the weird nature of this connection in the disinhibition of Natasha, who claimed she “wasn’t fully alive until the wrigglies
got [her]” (“Cupid” 103). “What a paradox, what a cruelty, what an irony,
there is here,” Sacks declares, “that inner life and imagination may lie dull and
dormant unless released, awakened by an intoxication or disease!” (“Cupid”
107). He juxtaposes the familiar with the abstract and the restricted with the
unbound to prove, perhaps, that when a person loses something, that loss
yields a new opportunity; an aberration may open the door to a new skill or
new lease on life.
Vigor and wellness via disease and illness: Sacks pauses to meditate on
this peculiar notion, which seems to resonate throughout his clinical experience. This schism of lifestyle—simply going through the motions as opposed
to realizing and releasing “inner life”—reveals Sacks’s fundamental assumption that most of us, though healthy and capable, keep true vitality at a distance. Most of us unwittingly limit ourselves, shunning the spontaneity and
impulsiveness his patients demonstrate as “abnormal.” Perhaps Sacks would
view these characteristics, in accordance with the orchestra analogy, as the
improvised solo of a trumpet player—unrestricted and of-the-moment. He
wants us to learn how to harness this boundless energy rather than dismiss it.
By exposing us to the fascinating feats of his patients, Sacks asks us to
turn a clinical eye on ourselves, self-diagnosing the ailments that bar us from
reaching maximum potential, or at least trying to. He urges his readers to liberate themselves, to lose stringent self-control and allow individuality to blossom:
Complementary to any purely medicinal, or medical, approach there must
also be an ‘existential’ approach: in particular, a sensitive understanding of
action, art and play as being in essence healthy and free, and thus antagonistic to crude drives and impulsions, to ‘the blind force of the subcortex’
from which these patients suffer. The motionless Parkinsonian can sing
and dance, and when he does so is completely free from his Parkinsonism;
and when the galvanized Touretter sings, plays or acts, he in turn is completely liberated from his Tourette’s. Here the ‘I’ vanquishes and reigns
over the ‘It.’ (“Ray” 96)
Sacks seems to entreat clinicians to be dynamic in their work, but he also
entreats us to acknowledge the universal struggle between It and I. Through
the use of existential vocabulary, pronouns like “I” and “It,” Sacks is trying to
reach his readers on a personal level, invoking individual sentiments. At any
given time, an “I” has some version of an “It” to overcome, even if it may not
56 - MERCER STREET
be a disorder caused by a lesion of the frontal lobe of the brain. Following this
logic, Sacks endeavors to strike some balance, equilibrium, harmony, between
the disease-stricken and the healthy. Once these patients become active and
perform, they can suppress the compulsions they are usually prone to, defying their own predicaments. Sacks places his characters in a separate world
only to have them escape it. They are “organically” impaired, meaning inherently affected, finding ways to happiness on their own. We, bound up in nonorganic systems, lack such power of individuality. In other words, he forces us
to reconsider who is sick and who is healthy.
While Sacks certainly makes it clear that science can be used to treat the
It we face, he believes only the creativity of doing what we love can treat the
I. Identity is ultimately in our hands—we have the power to orchestrate it.
When Jimmie is praying in the chapel, Sacks describes him as “wholly held,
absorbed, by a feeling,” no longer at the mercy of a fallible delicate mechanism, his body (“Lost” 37). Art was José’s only connection to the outside
world and perhaps it is our connection to the inside world, Luria’s “realm of
the Individual,” which Sacks encourages us to explore. He employs musical
diction throughout his work, perhaps to lend more weight to the notion that
creativity is integral to human experience. He equates adverbs like “melodiously” with others like “swiftly, fluently, [and] unthinkingly,” while the
process of eating a meal is “an edible song of food” (“Hat” 16). Dr P. could
not get himself dressed in the morning, let alone recognize his own body, if
his thread of song was interrupted; Sacks highlights this oddity to universalize it, showing that artistic creativity is crucial to the functioning of our lives.
His profound admiration for his patients and their unique gifts culminates
when he attributes a high level of value to them, maintaining that “Dr P. was
a musician of distinction” rather than a hopeless man who would mistake his
own wife for headgear (“Hat” 8). Sacks even comes to correlate creativity
with treatment, declaring that “I would prescribe . . . a life that consists entirely of music” (“Hat” 18).
It is easy to forget that the sciences and the arts are often seen as binary
forces when reading Sacks’s works. He considers the two disciplines allies,
praising Luria by claiming that in his accounts, “science became poetry”
(“Lost” 31). William Howarth, writer of environmental literature and history, explores this implicit concern in his article, “Oliver Sacks: The Ecology of
Writing Science.” Howarth describes Sacks as torn between art and science
and between being the clinician who is “gentle and loving toward patients”
and the one who is “fiercely critical of mechanical, assembly-line medicine
that fails to grasp their plight” (109). While this claim may very well be true,
MERCER STREET - 57
perhaps Sacks is thinking along the lines of another strain of dialectics when
he learns from his patients and searches for the center, the balance between
health and sickness, practiced prudence and blind spontaneity. Perhaps the
first hint of his predisposition towards the latter is to be found in the unconventional language of his case studies, which Howarth identifies as “not . . .
statistical, but intensely subjective or metaphorical,” due to “his emphatic
power to imagine or picture [his patient’s] inner life” (109). Sacks succeeds in
his attempts to lead his readers through the extraordinary dream world, his
patient’s mind, suspending clinical convention to allow us to see.
To grant us access to this new world, Sacks abandons the standards of
clinical reporting: “no ‘orthodox’ presentation . . . could have conveyed the
historical reality of the experience” (108). Howarth brings to light the “historical paradox” the patients expressed through their distortions of history,
which caused Sacks to shift his accounts from the empirical to the narrative.
Just as Dr. P.’s artwork shifted from detailed to abstract, Dr. Sacks’s writing
creatively shifts from a detailed clinical report to an abstract compilation of
clinical musings. He throws himself willingly into a world of “otherness,” not
just to entertain us with tales of the bizarre idiosyncrasies of disabled characters, but to condone their asymmetries as sources of the self—a notion that
evolutionary theory denies. Howarth is fascinated with Sacks’s significant use
of the word “present” (109). This word, while certainly prevalent in Sacks’s
style of clinical recording, strikes me as more of a medium, a “center,” as Sacks
might label it—the midpoint of history between past and future, and perhaps
the only chance we have to truly feel alive.
Perhaps we are all a little off-center, unusual, handicapped. “And as for
sickness? Are we not almost tempted to ask whether we could get along
without it?” Nietzsche inquires (6), but Sacks is by no means suggesting that
it is humanly possible to maintain the balance between vitality and disease—
he is, rather, demonstrating that creativity is the vehicle by which his
patients have fled the damning persistence of their disabilities (“Ray” 101).
In trying to find this center, we become who we are through our sensibilities, will, and affective being. To borrow the words of Luria, this self-awareness can only happen in “the realm of the Individual,” the dream in which
there are no limits, reason is absent, and the absurd is valued beyond measure—the world of the arts. Sacks would probably contend that each of us is,
in the words of Sir Isaac Newton, a mere “boy playing on the seashore . . .
whilst the great ocean of truth lay all undiscovered before [him]” (407).
Sacks is beckoning us to take a dip—not ensuring that this endeavor will
place us at the “center,” but promising that the pursuit of balance will bring
us closer to ourselves.
58 - MERCER STREET
WORKS CITED
Brewster, Sir David. Memoirs of the Life, Writings and Discoveries of Sir Isaac
Newton. 1855. Vol. 2. New York: Adamant, 2005. Print.
Howarth, William. “Oliver Sacks: The Ecology of Writing Science.” Modern
Language Studies. 20. 4. Literature and Science (Autumn, 1990): 103-120.
JSTOR. Web. 25 Nov. 2008.
Nietzsche, Friedrich. Preface to the Second Edition. The Gay Science. By
Nietzsche. Trans. Josefine Nauckhoff. Ed. Bernard Arthur Owen
Williams. Cambridge UP, 2001. 3-10. Print.
Sacks, Oliver. The Man Who Mistook His Wife for a Hat. New York:
Touchstone, 1998. Print.
“The Autist Artist.” 214-33.
“Cupid’s Disease.” 102-07.
“The Disembodied Lady.” 43-54.
“The Lost Mariner.” 23-42.
“The Man Who Mistook His Wife for a Hat.” 8-22.
“A Matter of Identity.” 108-15.
“Witty Ticcy Ray.” 92-101.
MERCER STREET - 59
60 - MERCER STREET