Friday, March 20, 2009

Musicophilia - A Review

Sacks, Oliver. Musicophilia: Tales of Music and the Brain. New York and Toronto: Alfred A. Knopf, 2007. xiv + 381 pages. Acknowledgments. Bibliography. Index.

Oliver Sacks is a neurologist who has published many essays on his speciality. A number of these have been collected into books. I read and enjoyed The Man Who Mistook His Wife for His Hat some time ago. Musicophilia pulls together a number of essays with a common, rather broad theme: how the brain affects our hearing and enjoyment of music, and vice versa. It should be noted that Sacks doesn’t deal much in the normal brain, but rather with cases of abnormalities due to disease, trauma, genetic accident, or aging. These cases can be very useful at illuminating normal brain function by showing exactly what happens when something goes wrong.

So, what Sacks provides are case studies of patients with particular problems. Despite the almost mind-numbing number and variety of these cases, Sacks never loses his compassion for these people and their families. This books leaves one with the impression of a kind man who is often frustrated by his inability to help people. His joy at the occasions on which he is able to help, through music therapy or other means, is apparent.

The first story in the book is that of Tony Cicoria, a surgeon who was struck by lightning and acquired an “insatiable desire to listen to piano music.” Cicoria started listening to lots of recorded piano music, then he took up the piano after a hiatus of 30 years. While he has continued to practice as a surgeon, he has become a very accomplished pianist, as indicated by a public performance of Chopin’s B-flat Minor Scherzo, together with a piece of Cicoria’s own composition.

Clive Wearing suffered a herpes encephalitis that left him with a memory span measurable in seconds. This case, with some others Sacks mentions, brings up the very interesting distinction between “episodic” memory and “semantic” memory. Clive can carry on a conversation, or at least appear to do so, because he has in his semantic memory a little repertoire of conversation pieces. But he can remember nothing that happened five minutes ago, and has, in fact, the impression of constantly awaking from a state of unconsciousness.

Like several other people here, Clive remembers quite a bit of music. There is one case of a woman who practiced for days to sing at an event at her hospital, and when led up to sing commented that she wished she’d had some notice. She remembered the song perfectly, but she had no memory of the practice sessions, or even that she had been told of the event in advance.

All this with semantic memory reminds me of something I was told when learning French at the Foreign Service Institute: Learning to speak a language is a physical, not an intellectual, exercise. One can’t think about speaking and carry on a normal conversation. Rather, like a game of catch, a conversation is a series of transactions in which one party “tosses” something, and the other has to “catch” it and return it. This answers for me the question of how people can lose their memories almost completely, through Alzheimer’s or other diseases, strokes, or accidents, and yet they can still speak. I suppose that if I reach the point at which I am unable to recognize my children, I’ll still respond “Good morning, and how are you?” when they say “Hi, Dad.” And, in fact, if they were to say “Bonjour,” I’ll probably answer, “Bonjour.”

Another very interesting article has to do with Williams Syndrome, of which I had not heard until I read this book. Williams Syndrome was identified in the 1960s, and its possessors have, like those with Down Syndrome, a particular look. They also have IQ scores in the 40s and 50s, and their brains are about 20% smaller than those of the average person. Despite this, they are capable of learning complex musical arrangements, and they are eager to perform. One Williams Syndrome person, with an IQ of about 49, is a professional singer of opera and art songs. They are articulate and social, but their spatial relationships and drawing abilities are deficient.

Sacks is a good writer, and these are entertaining, sometimes fascinating stories. He seldom attempts to draw conclusions in the higher realms of epistemology or philosophy. About as far as he goes is to state that every mental condition he’s ever seen has a physical source. But that is very important for those concerned with dualism, the mind-body question, and questions of consciousness. Sacks provides me with many, many instances of how the brain not only provides a general substratum for mental processes, but how relatively minor, and very specific changes to the brain are followed by similarly specific changes to knowledge, skills, attitudes, memory, and perceptions.

(Note: I previously published this review on my Knight's Castle blog. I think Musicophilia has some rather interesting implications for the more philosophical bent of Cafe Third Edition.)

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Sunday, January 13, 2008

The Man Who Mistook His Wife for a Hat

It is Sunday, January 13, 2008, the 13th day of the year. A bit earlier today, I posted my fifth reading list, the one for May 2007. If I say so myself, it was an interesting selection of books that I finished last May, and those of you interested in history, the Middle East, naval warfare (both historical and fictional), how Hitler consolidated his power in Germany, or the Sicilian Defense will all find material of some value. Because of the particularly philosophical interest of one of the books I read that month, I have decided to post on it here, and to expand upon the brief remarks I posted on Knight's Castle.

Sachs, Oliver. The Man Who Mistook His Wife for a Hat. 1987. x + 243 pages. Begun 12 May 2007, finished 16 May 2007. Short, quick, fascinating, The Man Who Mistook His Wife for a Hat, by the author of Awakenings (movie version starring Robin Williams and Robert DeNiro), is about memory, consciousness, and how the brain actually functions. From my point of view, this book, along with several of the works of Daniel Dennett, does much to support the view that the “mind” is a product of the manner in which the brain functions, rather than an autonomous organ.

Oliver Sachs is a medical doctor and has studied people with a variety of mental disorders. This book consists of a number of essays which are case studies of such mishaps to the brain as Asberger's Syndrome, Korsakov's Syndrome, migraine, epilepsy, and traumatic brain injuries. The title story is about a man who ceased to be able to recognize people by the gestalt of facial features which identify them for most of us. He could only recognize his friends, students, wife, by assigning each person a theme song, or melody, by which he could distinguish her.

Some of these stories reminded me of the works of R. D. Laing, which I read years ago. I tend to agree that Freudian psychotherapy was, and is, unscientific, and it is unknown how it works, to the degree that it works at all. Still, Laing made one very good discovery based upon his confidence in Freudian method. Laing treated young people for reported mental illnesses, such as schizophrenia, and he cured them by the Freudian method. As a reminder, the Freudian theory is that early events, buried in the mind, cause disturbances in one's behavior later on. If one can discover (literally) and resolve these traumas and conflicts, one effects a cure. There is no way in which these problems of early childhood could recur. Why, therefore, did Laing find young people returning to his clinic?

The answer, put simply, was that people are not treated for what is inside their minds. They are treated when their behavior becomes a problem for themselves or others. In many cases, parents were having their children committed because they found the child's behavior intolerable, even though many of us would find nothing out of the ordinary in the particular behavior. That is, the child is being treated for the parent's neuroses. (See James Thurber's wonderful short story of "The Unicorn in the Garden" for a fictional account of such a situation.)

Similarly, Sachs finds that, in many cases, it isn't the illness or trauma that causes problems - some people enjoy the mental brilliance that comes with Tourette's Syndrome, and stop taking their meds on weekends. Hildegarde of Bingen wrote music and made fantastic drawings of her holy visions, which are characteristic of drawing of epileptics. Most of us think of these drawings as symptoms; Hildegarde thought she was privileged to see angels. It's all in the interpretation.

The intimate connection between the brain's functioning and changes in the way peoples ideas, moods, and behavior exhibit themselves, indicates to me that Daniel Dennett is correct. We don't have a little mental driver - the soul, mind, anima, psyche, who is watching the actions of the brain and steering things. Descartes' dualism was incorrect. At the same time, some of these events are so far out of the conscious control of the subjects, that it is easy to understand why they find it difficult to accept that there is only one, integral, mind-body unit at work.

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