Like the Pinker and Wilson volumes I’ve covered here recently, this is another classic nonfiction book, one I first read years ago without taking notes (maybe before I began taking notes on my reading). So I skimmed through it again last week to capture essential points. This won’t be a detailed summary/review, like I did for those other two.
Subtitled: “and Other Clinical Tales.” (First published 1985 by Summit Books. Edition shown is trade paperback reprint, Perennial Library, 1987. x + 243pp, including 10pp chapter-by-chapter bibliographic notes.)
Sacks, who died in 2015, was a clinical neurologist who specialized in neurological disorders. He was famous for this book, with its intriguing title, and for previous book Awakenings, which was made into a movie in 1990 starring Robin Williams and Robert DeNiro. He wrote numerous other books too, including one about music. (Also, he was a burly guy with a huge beard, a bodybuilder, and gay, though he was celibate for 40 years.)
The gist of this book is that various neurological disorders are associated with specific parts of the brain. That is, in the 1960s and ’70s, recourse to demons or souls had long been abandoned. He recounts actual patients he treated or interviewed. He does not always diagnose; in many cases he speculates, or simply considers social consequences of living with particular disorders, which may or may not even be disadvantages or disabilities. (In this reprint edition Sacks adds postscripts to most of his chapters, concerning cases similar to the ones he discusses that came to his attention after the book’s initial publication.)
Not a complete summary, just some key points and items:
- The book consists of 24 essays, some quite short, in about 230 pages of text. They’re divided into four sections: “Losses,” concerning what are called “deficits” in neurology; “Excesses,” the opposite of deficits; “Transports,” cases of altered perceptions; and “The World of the Simple,” i.e. about retardates in Sacks’ terminology.
- The famous title essay is about a musician who has trouble recognizing faces, who sometimes perceives faces that aren’t there, and who, searching for his hat as he prepares to leave, grasps his wife’s head instead. He’s an excellent singer, despite his issues. He seems to live in a world of lifeless abstractions, but doesn’t realize he’s lost anything. The author recommends not worrying, and living his life for his music. (Quote below shows Sacks’ way of thinking.)
- Another curious case: a man who loses his memory of everything after 1945. In the present, he can barely remember anything for more than two minutes. In what sense is he a person, with a [metaphorical] “soul,” Sacks wonders. Sounds like a science-fictional scenario.
- Another curious case: Patients in an aphasia ward laugh at the President’s speech [apparently Reagan’s’] without understanding what he’s saying, but responding to his “feeling-tone.”
- “Excess” cases include those about Tourette’s syndrome, Cupid’s Disease [syphilis], Korsakov’s; with mentions of Borges’ story “Funes the Memorious”.
- “Transport” cases include one about a woman who hears music in her head, the same few songs, over and over, for years; with a reference to Wells’ story “The Door in the Wall.”
There are several cases I was especially struck by.
- Chapter 18, “The Dog Beneath the Skin.” About a medical student (and drug user) who, after dreaming one night of being a dog, wakes with an enhanced sense of color, and smell, experienced along with a sense of nostalgia, or déjà vu. His heightened senses last three weeks, and then stop.
Here what strikes me about this — whatever is happening in this guy’s brain, how can he have an enhanced sense of smell, like a dog’s, unless his sensory apparatus is as capable as a dog’s? One possibility: he’s merely imagining what it would be like to smell like a dog, and reporting that. (How is Sacks to know?) Another more intriguing possibility: perhaps humans have retained the sensory apparatus from ancient mammalian ancestors we share with the dogs, and unlike the canines have suppressed or ignored them, as human evolution found better things for the brain to do than to smell the world. This suggests science fictional scenarios! Are there dormant parts of the brain that might be reactivated…?
- Chapter 20, “The Visions of Hildegard,” with focus on Hildegard, whose visions the author concludes were due to migraines. Of course she saw them as visions from God. (All such ‘visions’ can be regarded as neurological issues, of course.)
In the section “The World of the Simple”:
- Chapter 21, “Rebecca,” a 19-year-old but like a child, unable to dress herself. She likes stories but can’t read. She uses narrative to make sense of the world. After her grandfather dies, she joins a theater group, and does well
- Chapter 23, “The Twins”, who lived in a state mental hospital. They were able to name the day of the week for any date in the past or future, and repeat numbers of many digits — but can’t do the simplest calculations. They sit together, playing a game by exchanging six digit numbers — that are primes. This case is notable because these twins were moderately famous, well known on radio and TV, and apparently used by Robert Silverberg to model an idiot-savant in the early pages of his novel Thorns.
- Chapter 24, “The Autist Artist,” the last chapter, is notable for revealing attitudes about autistic people at the time. This subject, 21-year-old, can draw subjects very well, but not much else. Author gradually draws him to the outdoors, which opens him up. He has no interest in the abstract, author concludes, only the concrete. Author speculates about how such people might function in society — but his identification of autism with only the very extreme cases has become obsolete in our own era of think along a ‘spectrum’ of autism.
- (The author’s later 1995 book An Anthropologist on Mars deals with similar cases, fewer and at greater length, one involving Temple Grandin. So presumably his attitudes about autism developed.)
Here’s the quote I mentioned above, from page 20:
Of course, the brain is a machine and a computer–everything ins classical neurology is correct. But our mental processes, which constitute our being and life, are not just abstract and mechanical, but personal, as well–and, as such, involve not just classifying and categorizing, but continual judging and feeling also. If this is missing, we become computer-like, as Dr P. was. And, by the same token, if we delete feeling and judging, the personal, from the cognitive sciences, we reduce them to something as defective as Dr P.–and we reduce our apprehension of the concrete and the real.
Final thoughts:
Some of these examples recall my notion that if we want to understand how aliens might think, just look to varieties of human beings whom we think are ‘defective’ in some way, but who are actually just different, and more innately talented in other ways… The whole autistic ‘spectrum’ is just that – a spectrum, not an on/off setting. We’ve come to understand in recent decades the concept of “neuro-divergence,” which means there are varieties of human intelligence. Or another way of thinking about it: the aliens are already here….
