The Man Who Mistook His Wife For A Hat : And Other Clinical Tales

Rating:
Summary: A series of twenty-four intriguing neurological case studies
Review: Oliver Sacks' book, The Man Who Mistook His Wife for a Hat, is a delightful conglomeration of twenty-four different case studies concerning neurological conditions. Oliver Sacks, who is a clinical neurologist, as well as a professor, at the Albert Einstein School of Medicine, tells of unique disorders that have afflicted his patients. One such case study that Dr. Sacks name that book after, dealt with a gentleman who suddenly was unable to recognized a number of usually familiar objects including: a glove, his shoe, characters of television, his own foot, and even his wife whom he astonishingly mistakes for a hat. It is the bizarre tales like this that really envelopes the reader into each and every case study. This book is ideal for anyone interested in neurology or is looking for an intriguing, thought provoking book.

Rating:
Summary: Truly incredible tales; 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:
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.

Rating:
Summary: It will change the way you think of the concept of "self".
Review: I first picked up this book about five years ago when browsing in the Science section of a local bookstore. I was taken by the strangeness of the title. Later, I got ahold of the Audio version of the book, which my wife and I played during a long vacation drive.

The book consists of a collection of reasonably short clinicial stories of some of the patients that Dr. Sacks has come across in his work as a Neurologist. Sound dry? I assure you, it is not.

With facination, and great humanity, Sacks recounts the stories of people, who, because of one deficit (injury or progressive malady) or another have had their personalites, perceptions, or senses profoundly altered. Taken one at a time, the stories are quirky, yet compassionate, illustrations of the symptoms of various neurological maladies and the people who struggle with them. There's the story of the patient who suffers from an inability to conceive of his own legs as part of his own body. There's the sad and lonely tale of a man who us unable to form long term memories and lives in a constantly shifting world that is perpetually only a few minutes old. There's a recounting of the visions of the ancient Saint Hildegard, whose migrane headaches appeared to her to be visions of heaven.

Taken together, one gets a awe inspring sense of how who and what we are is controlled by the processes of the brain and also a sense that there are certain universal human prepensities- such as the struggle for "wholeness" or a desire for the sublime.

This is one of my favorite books. I frequently loan one of my two copies to friends. I highly recommend the somewhat abridged Audio version as well, as Dr. Sacks voice adds a layer of facination to the tales.

Rating:
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:
Summary: Excellent book of case studies on the diseases of the mind
Review: This is a layman's journey into the case studies of nureological problems. The book is written in a clear style that makes each case a story rather than a statistic. If you've ever wondered about diseases of the mind, this is the book for you.

It's not really a good book to read before bed as some of these people have problems that could make one want to stay up and talk about it with someone else.

Rating:
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:
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:
Summary: Hang on to your right hemisphere!
Review: This is one of the most entertaining and thought provoking books I've read in a while. Oliver Sacks has done a marvelous job of illustrating just how mysterious and tenuous our perception of the world is by relating stories about patients who have suffered some kind of injury to the right hemisphere of their brains. Why the "right" hemisphere? As Sacks explains, the left hemisphere has a fairly comprehensible role; it seems to follow rules. When it does not function appropriately, the consequences are reasonably predictable. "Indeed, the entire history of neurology and neuropsychology can be seen as a history of the investigation of the left hemisphere."

In contrast, the right hemisphere has been something of an enigma, and is consequently called the 'minor' hemisphere. But, "it is the right hemisphere which controls the crucial powers of recognizing reality which every living creature must have in order to survive." For example, the right hemisphere is responsible for "proprioception", which allows us to feel our bodies as "proper to us"; that they belong to us. This is so basic that it is difficult to even imagine what it would be like to have impaired proprioception. Sacks is keenly aware of this challenge; in a sense, the entire book is an attempt to give us a glimpse into such an incomprehensible world.

Sacks quotes Wittgenstein:, "The aspects of things that are most important for us are hidden because of their simplicity and familiarity. (One is unable to notice something because it is always before one's eyes.)" Those things that are most basic, most obvious, have a deeply mysterious foundation in the brain. One can begin to appreciate this when one considers those unfortunate individuals who have lost some of these basic perceptions due to injury or illness. As Sacks points out in the introduction, "It is not only difficult, it is impossible, for patients with certain right-hemisphere syndromes to know their own problems... And it is singularly difficult, even for the most sensitive observer, to picture the inner state, the 'situation', of such patients, for this is almost unimaginably remote from anything he himself has ever known."

Sacks presents detailed and compassionate accounts of numerous patients whose worlds are indeed unimaginably remote from our own. He tells us of patients who have difficulty distinguishing between people and inanimate objects, those who have perfect "vision" yet cannot discern the purpose of an object without tactile feedback, those who fail to recognize their own limbs as belonging to them, and those who have lost fundamental spatial concepts, such as the distinction between left and right. One of the most intriguing cases that Sacks presents is that of a woman who had "totally lost the idea of 'left', both with regard to the world and her own body," a condition known as hemi-inattention. To this woman, everything in her left visual field simply ceased to exist, in analogy to the way each of us fills the blind spots in our visual field. This unfortunate woman would eat half her lunch (that on the right side of her tray) and was incapable of turning to the left (since left did not exist) to discover what remained. In time, she learned to turn herself around, always to the right, until she found the rest of her lunch.

This book is not only engrossing, it is challenging; it forces one to acknowledge that what we take as so plainly obvious about the world is intimately tied to basic brain function. Oliver Sacks demonstrates beautifully that the brain is still deeply mysterious, particularly in how it creates our sense of reality. There are profound implications here for those interested in psychology and philosophy. It's a great read.

Rating:
Summary: Great Book
Review: This was required reading for my undergraduate course in neurobiology. There's no need to have any understanding of neurobiology in order to understand this book. It provides an interesting and entertaining view into how our brains control our basic sensory systems. Particularly interesting is the woman who lost, what I call, her "sixth sense" proprioception. I would highly recommend this book to anyone looking for a good quick read.