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The Man Who Mistook His Wife for a Hat: And Other Clinical Tales

The Man Who Mistook His Wife for a Hat: And Other Clinical Tales

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Rating: 5 stars
Summary: Wow!
Review: "The Man Who Mistook His Wife for a Hat" (A mouthful!) is a series of essays that will undoubtedly prove helpful to future neurologists witnessing some novel cases in their practice. It is a collection of intriguing and mind-provoking stories of the mind. Some of the "tales" actually made me apprehensive of my future and my occasional case of mild amnesia. You'll fine these cases interesting even if you've never read anything on neurology, or if you know little of brain anatomy and physiology. It's a great book. Actually, it's splendid!

I particularly found the story of "Jimmie" very interesting and touching at the same time (Chapter 2). Indeed, there is more to a human being than just memory. There is also "feeling, will, sensibility, moral being," and other intangibles. ALL of the stories were really just fascinating. Dr. Sacks also writes in a beautiful, easy, and almost poetic style - which makes the book a relatively fast read.

People have likened the brain to a computer at times, but after reading the book, you begin to realize that the central nervous system is really much more complex and complicated than a mere computer. Dr. Sacks does away with all the scientific and medical jargon that often complicates comprehension. This is why this book is not only readable, but also enjoyable. Once I read the first case, I was hooked! I couldn't put the book down. All the cases are like a puzzle - a fascinating labyrinth. I was happy to discover "proprioception" and many other things that were not part of my knowledge before. Some of the cases might even tear you eyes, or enchant you. Some are downright risible!

There is not a single story in this book that didn't make me say "wow!" I applaud Dr. Sacks. It's a job well done.


Rating: 5 stars
Summary: Compassion and hope for those in neuronal hell
Review: A surgeon with Turrette's Syndrome. A man whose recent memory is obliterated every five minutes. A man who ceases to recognize objects in their completeness -- faces, gloves, his wife -- but only by adding up the sum of their parts. A man who no longer sees his leg as part of his own body, and is found on the floor after throwing this "foreign" object out of bed. Oliver Sacks uses each of these stories to illustrate the way our brains operate by means of studying those who have lost mental functioning due to accident or disease.

Sacks' stories are often poignant, and are portraits not only of the abstract workings of the mind, but of the people who must bear these disabilities. What is it like to live as a person whose last remembered self image is decades old? What happens when he looks into a mirror and sees himself as a wrinkled grayhair? Can such a person, with no ability to see life as a developing continuity, be said to have a soul? Does nature provide compensations? Or is life an existential nightmare ended only by merciful death?

Sacks has a gift for making extraordinary internal realities accessible to the non-technician. His deep humanity and compassion, evident on every page, help the reader share and care for individuals with deficits I pray never to experience.

Rating: 5 stars
Summary: A Neurologist with Great Humanity.
Review: Considering my stereotyped image of a neurologist, i.e., having that strict 'scientific' view of the human being (the mind/brain having solely mechanical processes, devoid of 'soul'; a noticeable unawareness or avoidance of a human's actual 'being', that purely 'clinical' approach to the patient as mere 'subject') was exploded in a thousand pieces after reading this special book. Sacks' general humanity in general and particularly for his patients glimmered bright from every page. As a doctor, researcher and therapist in this field, he communicates quite freely and clearly as to his personal views on his profession and where he would like it to go:

"The patient's essential being is very relevant in the higher reaches of neurology, and in psychology; for here the patient's personhood is essentially involved, and the study of disease and the identity cannot be disjoined. Such disorders, and their depiction and study, indeed entail a new discipline, which we may call the 'neurology of identity', for it deals with the neural foundations of the self, the age-old problem of mind and brain.' (X)

This book is a collection of twenty-four cases, clinical tales about people who, in some cases, have been struck with terrible brain related illnesses during the prime of their lives. The physical, emotional and very foundations of how they function and view the world, has been drastically altered. In the case of 'The Man Who Mistook His Wife for a Hat', Dr. P., a musician of distinction, teacher and accomplished painter, developed a type of visual agnosia or prosopagnosia, where he could not recognize faces and came to see things, people and objects as something else. His entire perceptions of the world had totally changed. One aspect of this particular story that was interesting was Dr. P's paintings, which Sacks observed hanging on the wall of his home. In the beginning the paintings depicted a 'realist' style, almost mirror representations; as the years went by, each painting became more impressionistic, ending in the most recent work being entirely abstract. Sacks made a comment about this fact to the Dr.'s wife, who believed that his artistic style simply matured over the years. However Sacks saw the paintings as representing the progressive nature of the man's condition. I found this case to be at once bizarre, interesting and sad.

Most if not all of the cases in this book are bizarre, interesting and sad, but Dr. Sacks conveys a deep humanity, a scientific concern and a real hope that the profession will find more effective ways in dealing with the brain. He believes the profession should re-think their approaches; perhaps ask different questions, however, most importantly, not forget that, as physicians, they're not dealing with just 'clinical subjects', but human beings with identity. In other words, to truly understand the brain/ mind relation, the essential being, science and the humanities must join forces. One can see from this wonderful book, that Oliver Sacks has already attempted to do just this, with varying degrees of success.

This is a book that drastically changed my views on a lot of things, not least the utter vastness of the mind, and how easily we can lose what we take for granted everyday.

Rating: 5 stars
Summary: A must for anyone who is human
Review: For those who don't know, Oliver Sacks is a world-famous neurologist, treating patients where the problem is (at least believed) to be caused by a physical aspect of brain function. He has also written a host of popular books based on his case studies. This is probably the most famous one.

This book deals with patients who are suffering from various forms of diseases which impact their living and thinking selves so dramatically that the core of the book seems to be coming to terms with what these states of mind could mean. There's the man who's lost all the intuition related to vision - he can recognise abstract shapes but not faces or commonplace objects. There's the man suffering from Tourette's who's become so used to the disease's influence on his personality that the downer drugs have given him a loss of identity. There's the man who has absolutely no short term memory and is thus forced into a farcical and tragical string of endless flights of fance to make things fit into his worldview.

The book is divided into 4 sections - the first dealing with a loss of some part of cognition, the second with some excesses of cognition (and yes this may seem odd but read the essays!), the third with visions in patients and the fourth with the "simple" - people with a low IQ.

Sacks is very interested in imagining what it must be like to live like a certain patient - although at times it's quite impossible. It is here that his humanity and empathy comes through. The book is critical of the impersonal and clinical nature of traditional neurology - Sacks is much more human-oriented.

The uncertainty of the various selves paraded in the book leads him to explore many philosophical aspects of what a "self" is and what parts are essential. The surprising (to people new to this area) thing is that in so many of the patients with severe problems (complete amnesia, an IQ of 60, autism) - the external characteristics of the mind are shattered but there remains somewhat of an introspective, emotional, conscious self. It is in highlighting this that the book is at it's most human.

This is a must read as it will enhance your knowledge of some of the more "self"-debilitating illnesses, challenge your own sense of self and humanity and in many occasions will move you to an extent that few scientific books do. And through it all will be clear the magical, still-mystical-despite-scientific-advances and elusive essence of humanity that gives life wonder.

Rating: 5 stars
Summary: A great read for any person interested in the human mind
Review: I love this book. I first read it as an undegraduate English major, and it fascinated me with its accounts of people with various neurological deficits and excesses. Non-medical professionals will have no trouble appreciating Sacks' writing, which is clear and free of complicated medical jargon. I have revisited this book since graduating from medical school and I continue to find it fascinating and the writing itself a delight, as Sacks is a writer with a strong, clear "voice."

For me, the book stimulated much thought on the nature of the human mind, and the concept of the Self that we all carry. It's one of my all-tme favorite books, one I would recommend to readers who enjoy literature and works of philosophy as well as medicine.

Looking over the other reviews, one sees a lot of 4 and 5 star reviews, with the occasional "I hated it" review. For exmaple, one reader cited what she called Sacks' "horribly cruel and unempathetic tone." I didn't detect such a tone in Sacks' writing, and I'm surprised that anyone did. (He does refer to persons with mental retardation as "retardates," which was then the accepted, medical, "politically-correct" term for such individuals. One era's PC term is the next era's faux pas, and I suspect instances of this phenomenon account for some of the negative reviews.) I guess it is a matter of perception, and depends upon your own experiences, etc. Some people have very definite ideas about how medical cases should be discussed; this book did not offend any of my ideas on that subject. I highly recommend it.

Rating: 5 stars
Summary: Truly incredible tales and a great read
Review: It is utterly fascinating to know that, as a result of a neurological condition, a man can actually mistake his wife for a hat and not realize it. It is also fascinating to learn that a stroke can leave a person with the inability to see things on one side of the visual field--which is what happened to "Mrs. S." as recalled in the chapter, "Eyes Right!"--and yet not realize that anything is missing. In both cases there was nothing wrong with the patient's eyes; it was the brain's processing of the visual information that had gone haywire.

Neurologist Oliver Sacks, who has a wonderful way with words and a strong desire to understand and appreciate the human being that still exists despite the disorder or neurological damage, treats the reader to these and twenty-two other tales of the bizarre in this very special book. My favorite tale is Chapter 21, "Rebecca," in which Dr. Sacks shows that a person of defective intelligence--a "moron"--is still a person with a sense of beauty and with something to give to the world. Sacks generously (and brilliantly) shows how Rebecca taught him the limitations of a purely clinical approach to diagnosis and treatment. Although the child-like 19-year-old didn't have the intelligence to "find her way around the block" or "open a door with a key," Rebecca had an emotional understanding of life superior to many adults. She loved her grandmother deeply and when she died, Rebecca expressed her feelings to Sacks, "I'm crying for me, not for her...She's gone to her Long Home." She added, poetically, "I'm so cold. It's not outside, it's winter inside. Cold as death...She was a part of me. Part of me died with her" (p. 182). Rebecca goes on to show Dr. Sacks that they pay "far too much attention to the defects of...patients...and far too little to what...[is] intact or preserved" (p. 183). Rebecca was tired of the meaningless classes and workshops and odd jobs. "What I really love...is the theatre," she said. Sacks writes that the theatre "composed her...she became a complete person, poised, fluent, with style, in each role" (p. 185).

Another of my favorite stories is Chapter 23, "The Twins." These two guys, idiots savants, "undersized, with disturbing disproportions in head and hands...monotonous squeaky voices...a very high, degenerative myopia, requiring glasses so thick that their eyes seem distorted" (p. 196) had the very strange ability of being able to factor quickly in their heads large numbers and to recognize primes at a glance. They could also give you almost instantly the day of the week for any day in history. One day a box of matches fell on the floor and "<111,> they both cried simultaneously." And then one said "37" and then the other said "37" and then the first said "37" and stopped. There were indeed 111 matches on the floor (Sacks counted them) and three times the prime number 37 does indeed equal 111! (p. 199). Later he discovered them saying six-figure numbers to one another. One would give a number and the other would receive it "and appreciate...it richly." Sacks discovered that they were tossing out primes to one another just for the sheer joy of doing it.

Another of Sacks's discoveries about his patients is that "music, narrative and drama" are "of the greatest practical and theoretical importance" (p. 185). He demonstrates this again and again here and in his more recent book, An Anthropologist on Mars: Seven Paradoxical Tales (1995), which is also an incredibly fascinating book. (See my review here at Amazon.com.) Many people with neurological disorders or deficiencies become whole when engaged in a process such as story, music or drama. The process seems to give them a structure to follow which, for the time being, overcomes their handicap. This is seen remarkably even in a surgeon with Tourette's syndrome who, while performing surgery, was without tics (as reported in the book mentioned above).

It's clear that one of Sacks's purposes in sharing his experience is to dispel the prejudice against people who are different because of their defects. One can see that respect for others regardless of their limitations is something Sacks incorporates in his practice and his life. It is one of the many virtues of this wonderful book, that in reading it, we too are moved to a greater respect for others, people who really are challenged in ways we "normal" people can only imagine.

Rating: 3 stars
Summary: A little book about a big subject.
Review: Oliver Sacks is a Clinical Professor of Neurology, and many of his patients have had brain disorders that have manifested themselves in bizarre and often surprising ways.This book is a collection of stories about some of these patients and the profound effect the brain disorders have had on their lifes, and ways of thinking.The stories are in turn traumatic,funny,sad,and often unbelievable,more suited to sci-fi than a medical journal.The chapters are an easy read for your average layman but the postscripts that follow these chapters are full of medical jargon that only medical students or doctors can appreciate.

This book made me think about the grey matter between my ears in a different light, and also of how little we know about this complex organ that makes us what we are.The only downside to this book was the author's theological ramblings.

Rating: 5 stars
Summary: A quiet gem of a book
Review: Oliver Sacks takes us on a visit to various patients with a broad array of neurological diseases. His prose breathes quiet dignity into the actions of even the most bizarre behaviors. From Tourette's syndrome sufferers to those who have lost great chunks of their memory and past, he is unfailingly optimistic and, yes, kind. He almost forces one to abandon harsh judgments about the quality of life of these people and to look at and think about the pleasures and contributions they make.

I think the most touching chapter is when he delineates the lives and problems of those with what is loosely termed limited or drastically small mental abilities. He makes you stop and wonder if, indeed, their lives are not only valuable but also pleasurable and worthwhile.

A very thought provoking book.


Rating: 5 stars
Summary: An Enriching Experience
Review: This book is incredibly well written and easy to follow along with being very informative in a compassionate manner.
The format is logical and keeps the reader interested. There are four parts: the first Losses, the second Excesses, the third Transports and the fourth the World of the Simple. Each section contains stories of Dr. Sacks' clients that broaden the understanding, appreciation and knowledge of our senses.
Oliver Sacks wonderfully touches the emotional core of the reader with his clients' stories. This book opens the door to a subject not often publicized. All of Dr. Sacks' patients have one thing in common-each has lost or never had a particular sense which disables him from functioning in what we consider normal reality. This book illustrates the struggles and worries of these patients and the doctors who treat them.
Not only does Dr. Sacks create vivid images of the patients' "deficits", but he conveys the second problem of treating a psychological disorder. After a "dysfunction" is identified and a treatment determined, the patient and the doctor must decide whether or not to proceed. Often this "dysfunction" is not a disturbance to the patient . If the treatment will completely free him of it, the patient feels as though a part of him is lost and might not want the treatment at all.
Reading this book is an enriching experience and gives great perspective of both the clients of the psychological world and those who treat them. Oliver Sacks obviously cares for each of his patients. And if nothing else, this book will make your heart smile.

Rating: 5 stars
Summary: Fascinating Food for Thought
Review: This is a book where every twenty minutes or so you will find yourself pausing and looking up just to think about what you just read. It's a book that I think just about anybody would enjoy. It's never boring because Sacks has a great talent for taking complex medical issues and bringing them down to earth in a way that a layperson can understand without struggling.

Also, the book is laid out in vignettes so that just at the point one might find themselves getting bored, he moves on to a new neurological dysfunction. It sounds terrible to say, but in a way, this book is really just a very sophisticated freak-show. But Sacks is no P.T. Barnum. Sacks portrays these anecdotes with great humanity. His thoughts on the subjects of these stories, the disorders and their sufferers, border on the spiritual in magnitude. He explores these issues with such a great awe and respect for the mysteries of physical life, that it feels as if one is walking along with him as tour guide on a journey through the stars.

Just a terrific read and a book that feels great to have on your shelf.


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