Earlier this year, at the age of 82, Oliver Sacks passed away. Along with Lewis Thomas (and, arguably, Benjamin Spock) he broke down the doors between the high priesthood of medicine and the poor supplicants who require medical help.
Sacks was a neurologist whose notoriety grew over the last 4 decades or so as he published case studies of his most interesting patients. If the old saw is that medicine is as much an art as a science, Sacks did his best to live up to that. His writing was never fussy and while he never avoided using medical terminology he did his best to render it in context so you learned what he meant.
Even if you don’t recognize his name, you might still know who he is, especially if you saw ‘Awakenings‘. In that 1990 film, based on Sacks’ 1973 book about his pioneering work on L-dopa, Sacks was played by Robin Williams. His key patient was played by Robert DeNiro.
Sacks published frequently and I most often encountered him in the pages of The New Yorker. As with John McPhee, if you missed something and waited long enough it was sure to show up between stiffer covers eventually. As a result with the exception of the present volume, my bookshelves are marked by a distinct absence of Sacks (as opposed to Thomas and McPhee).
So why buy an Oliver Sacks book at all? One word: music. I listen all day and I can read about it on into the night. I like to say I can remember every string of notes I’ve ever heard; I just can’t wring them out of any musical instrument. As for lyrics, well, I can find a lyrical reference for almost anything.
Sacks, I think, would recognize the symptoms.
And yet that’s not really what this volume is about. It opens with a tale, collected and previously read elsewhere, of a man who, struck by lightning, develops a sudden musical acuity. I’d tell you that this mystery is solved, but it isn’t. That’s for the good because medicine is a work in progress and life needs a few mysteries. At least for me.
And they abound in these tellings. Like synesthesia. I’d read about this confounding of the senses before and even had some inkling that many musicians have it. I looked like a world-class know-it-all, though, when a colleague started talking about her ASD-nephew who is a musical prodigy. He ‘sees’ tones as colors which is a classic example of the phenomenon.
Then there are ear worms, or brainworms as Sacks has them. I don’t think I’ve encountered anyone who hasn’t, at one time or another, gotten some bit of a song stuck in their head all day. Sometimes I find it happens simply by hearing the name of a song. In those cases it seems like the more annoying the song the more likely it is to be triggered by a non-auditory stimulus.
It turns out that brain worms have all sorts of odd attributes. For one, they can be stimulated by certain drugs. I’d like a list of those if only to keep from hearing Barry Manilow singing ‘Copacabana‘ endlessly.
For another they are unlike other sensory phenomena. Sacks catalogs a number of these–seeing EEGs everywhere after hours of intently studying them, feeling the boat rock hours after disembarking, astronauts needing to regain their ‘earth legs’–and attributes them to sensory overload. That annoying song playing in the back of your head? That’s a “…perceptual construction, created much higher in the brain.” (p. 51) Who knew?
Or how about dystonia? There’s a nifty word for you. What it refers to is a neurological problem that is too often misdiagnosed and addressed as an orthopedic/surgical problem. We’ve all heard about the man with a hammer and that’s as good a definition as any for these medical mechanics. Show them a problem and the recommended treatment will no doubt include scalpels, sutures and suites (of the operating kind).
So imagine you’re a musician, a talented professional who has spent years honing technique and practicing until muscle memory allows you to concentrate on the things that make your playing art. And imagine that one of your playing hands freezes up. I wouldn’t be surprised if you panicked. I wouldn’t be surprised if you went to the orthopedist–hands are full of bones after all.
And yet what’s really going on is that your brain and muscles are no longer in sync. Your muscles, tendons and bones haven’t failed, your brain has. The risk is that you elect for surgery and wind up with needlessly compromised performance.
It’s all endless fascinating because, unlike, say, birds or whales, humans don’t need music to communicate. There’s just something that happens with most people that makes the combination of rhythm and melody–with or without words–far more powerful than other combinations.
The downside risk of a book such as this is always that something you love will be exposed. What if music is a trick the mind plays on itself? Or what if it’s an example of mental imbalance? Or what if it’s something even worse? You don’t run that risk here. Sacks, I think, loved music as much as anyone could.
He does leave one area unexplored, one that has left me astounded whenever I’ve encountered it. And it’s those poor souls who don’t react to music. They’ve told me it’s background or something they just don’t get. They don’t understand what the fuss is all about.
To which I say that not understanding why it works as it does is at least half the fun.