NeurologyOliver Sacks is a music lover, a superb physician and a confabulator with a gift for turning truculent medical material into illuminating narratives that describe the impact of complex neurological conditions and their treatment on the lives of patients. His most loved works are probably The Man Who Mistook His Wife for a Hat and Awakenings (which was also an Oscar-nominated film).
In his new publication, a book he's probably always wanted to write, Sacks submits music and how the brain does music to his careful scrutiny, thus bringing together his aesthetic obsession, his clinical work and his literary practice. The result is a rich and informative account that offers an explanation of music as a cultural and neurological event, that offers insight into conditions with a musical dimension (everything from Tourette's to Williams Syndrome) and that argues persuasively for the integration of music into the care of patients with chronic conditions. The science is fiendish but Sacks has a knack for explaining complex phenomena: all the content here is within the grasp of any layman. Finally, Musicophilia contains, which is Sacks's trademark, some of the most extraordinary case histories I've ever read.
Consider this for instance: Tony Cicoria was a well-regarded orthopedic surgeon of 42, who hadn't touched a piano since childhood, when he was struck by lightning in 1994. A few weeks later he returned to work having experienced nothing worse than temporary memory loss, and that he thought, was the end of the matter. It wasn't.
A few days later he was suddenly filled with an insatiable hunger for music, in particular, for Chopin's music. From that moment on, he devoted every free moment he had to it, first listening to Chopin, next learning the piano so he could play Chopin (within six years he was performing in public) and finally learning to compose.
So what was the neural basis of Cicoria's sudden musicophilia? As far as Sacks was aware "the startling emergence or release of musical talent and passion was typically associated with patients with degeneration of the front parts of the brain, so-called frontotemporal dementia, but clearly that was not the case with Dr Cicoria, who remained articulate and highly competent in every way" after he was struck by lightning. Sacks invited Dr Cicoria to have an MRI scan which would reveal how the lightning had changed the structure of his brain, because clearly the structure had changed, but the patient declined, saying his musicophilia was a gift, probably from God, and one into which he was not inclined to pry.
Sacks opens Musicophilia with the Cicoria case. He does because it's such a good story and he wants to lure us on. But Sachs is also a writer and nothing writers do is innocent. He has another agenda: we are increasingly suspicious of medical arrogance but with this story he knows he can undermine the veracity of that prejudice.
Another of his ploys to win sympathy is that he puts himself into his own book as a patient, thereby signalling he's on the same level as the reader. The events in question occurred in 1974. First, Sacks had two episodes of acquired amusia during which Chopin pieces lost "their pitch and their character and were reduced, within a couple of minutes, to a sort of toneless banging . . . as if [ they] were being played with a hammer on a metal sheet".
Then, on a mountain in Norway, Sacks fell and tore the quadriceps tendon off his left leg. He had surgery and bed rest throughout which his hurt leg felt as if it was no longer part of his body. His only solace was a cassette player with a single cassette, Mendelssohn's Violin Concerto in E minor, to which Sacks listened incessantly.
After 15 days, Sacks was told to walk but he found he had lost the "automaticity of walking completely". Then, the Mendelssohn, unbidden, welled up in his head, and next thing he started to walk, his automaticity miraculously restored.
NOW SACKS'S MOST determined detractors, (usually other medics), who've always argued that his clinical probity is called in question by his wily and seductive prose and his devious authorial ways, they won't like the way he undermines resistance and enhances the appeal of his book with tricks like this. This is envy of course and, as we know, any individual (like him) who excels in more than one field is always hated. It goes with the turf. Myself, I am of completely the opposite opinion to the Sacks haters. I admire the cunning way he identifies those objections a reader might have and then seeks to dissolve them, and I admire the chutzpah with which he carries off the enterprise of getting us to love him, too.
Now, as well as being a charmer, Sacks is also a communicator with a unique ability to tell us about our ills (or the ills of others which could be ours) but in such a way that we are left feeling not worse but better. The brain, as he demonstrates here, is not only an extraordinary organ, but an amazingly resilient one too. Besides filling us with wonder, his other mission is to banish ignorance. Given the enormous reservoir of social antagonism to handicap he has his work cut out for him. But the book is so well written, so interesting and so engaging I'd hazard its chances of doing some good as pretty high. Sacks also makes the case, definitively in my opinion, for mandatory music tuition in all schools and mandatory music therapy for all dementia sufferers. It is to be hoped that those in power who order these matters might pay attention.
Carlo Gébler is a novelist. He teaches at Queen's University Belfast on the creative writing MA and at HMP Maghaberry, where he is writer-in-residence
Musicophilia: Tales of Music and the Brain By Oliver Sacks Picador, 381pps. £17.99