The Man Who Mistook His Wife for a Hat and Other Clinical Tales
Oliver Sacks, 1985
A musician reaches for his wife’s head, taking it for a hat. A sailor is certain it is 1945 and that he is nineteen. The neurologist Oliver Sacks tells the stories of his patients and shows how the brain quietly builds everything we see, feel and remember. And how a person stays themselves when part of that work breaks down.
Who it is for
For anyone curious about how the brain builds the familiar world, and who wants to see a living person behind a diagnosis.
If you lose a leg or an eye, you know it; if you lose your self, you cannot know it, because there is no one left to notice the loss.
A hand reaches for his wife’s head
A musician finishes his appointment with a neurologist and gets ready to leave. He looks for his hat, reaches out his hand to his wife’s head and takes hold of it, as if he means to lift it off and put it on his own head. His wife behaves as if nothing strange has happened. This man is clever, witty, sings beautifully and teaches others to sing, but he has stopped recognizing faces and objects.
This is how the most famous book by Oliver Sacks, a British neurologist who worked for many years in New York, begins. In it Sacks gathered the stories of his patients: people whose brains had lost some ability, gained one in excess, or suddenly transported a person into the past. He did not write case histories so much as stories about people. In his view, to understand a person it is not enough to know the diagnosis. You have to ask what their story is and how they live inside it.
The central idea of the book is both simple and unsettling. What seems natural, whether recognizing a face, sensing your own body or remembering yesterday, is in fact built by the brain, quietly and without a pause. We notice this work only when it breaks. And in almost every one of Sacks’s stories, the person turns out to be larger than their damage: they find a detour, a support, their own way of remaining themselves.
In this book you will meet a musician who holds his world together with a song, a woman who lost the sense of her body, a sailor stuck in 1945, and a drummer whose illness became part of his talent. Each story will show how the thing you use every second without noticing is put together. Let’s begin.
A rose you cannot know by sight
Dr. P., as Sacks calls him, was a singer who taught at a music school. The oddities began unnoticed. He stopped recognizing his pupils by their faces, but as soon as they spoke he knew at once who was standing in front of him. Then he began to pat the street hydrants and the parking meters affectionately, taking them for children’s heads. His eyes were healthy. Something else had broken.
Sacks checked this simply. He handed Dr. P. a glove and asked what it was. The doctor looked it over carefully and described it as a continuous surface folded back on itself, with five protrusions. Perhaps it was some kind of container, he suggested, a purse for coins of five sizes. A child would have recognized the glove in a second. Dr. P. saw every detail but could not assemble them into an object. It was the same with a rose: he called it a curly red form with a straight green appendage. Then he smelled it, and at once brightened, because he recognized the rose.
This is visual agnosia: the eyes see, but the brain does not recognize. Imagine a photograph cut into a hundred pieces. You see each piece clearly, but you cannot put the picture back together. We assume that we simply look and see. In fact, recognizing a face or a glove means grasping the whole and its meaning in an instant, and that work is done by the brain, not the eye.
So how did Dr. P. live? His wife told Sacks that he did everything while singing. He sang when he dressed, when he ate, when he moved from room to room. If the song was interrupted, he lost the thread and stopped, not recognizing even his own clothes. Music held his world together where sight no longer could.
Sacks could not cure him. He offered something else: to make music the center of his whole life. Dr. P. went on teaching until the very end.
What can you take from this? When you are lost in the details of a task, a text or an argument, ask what the whole of it is and what it means. And notice what your life rests on when something goes wrong. For Dr. P. it was a song. Everyone may have a melody of their own that gathers the day together, even when everything else falls apart.
About the author
Oliver Sacks (1933–2015) was a British neurologist who worked for many years in New York and wrote books about unusual cases from his practice. His book “Awakenings” became the basis of a film of the same name.
All books by this author: Oliver Sacks
Terms from the book
- aphasia
- stroke
- Ray
- Jimmy
- neuropsychologist
- Mass
- The New Yorker
- Dr. P.: The patient from the book’s title story, a singer and music teacher. Sacks hid his name behind a letter, as he did with the names of the other patients.
- hydrants: Street standpipes to which firefighters connect hoses to draw water from the city’s water mains.
- Visual agnosia: A condition in which the eyes see, but the brain cannot recognize what is seen: faces, objects or whole scenes. It arises from damage to the visual areas of the brain.
- Christina: Sacks’s patient, a young woman who suddenly lost her sense of where her own body was.
- Proprioception: The sense of the position and movement of one’s own body: the brain receives signals from muscles, tendons and joints and knows where the hands and feet are without help from sight.
- Mrs. S.: Sacks’s patient. After a stroke she stopped perceiving the left half of the world and of her own body.
- Ronald Reagan: A former film actor and President of the United States from 1981 to 1989. Sacks does not name the president, but it is generally assumed that he meant him.
- Emily: Emily D., Sacks’s patient, a former English teacher. Because of a tumor she stopped hearing the expressiveness of voices, although she understood the words perfectly.
- Tourette syndrome: A disorder of the nervous system that usually begins in childhood: a person makes sudden involuntary movements and sounds, called tics.
- Korsakov’s syndrome: A severe memory disorder, most often after years of heavy drinking: a person barely remembers new events and loses part of the past. It is named after the Russian psychiatrist Sergei Korsakov.
- Luria: Alexander Luria (1902–1977), a Soviet psychologist and one of the founders of neuropsychology. Sacks corresponded with him for many years.
All terms
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