Wednesday, April 1, 2015

The Man Who Mistook His Wife for a Hat

            Let’s get some nonfiction into the mix, shall we? Oliver Sacks’ The Man Who Mistook His Wife for a Hat* is not all about one man who thought his wife resembled a fedora (although that sounds like literary gold). Rather, it is a collection of case histories that Sacks, an esteemed neurologist, has recorded over his fifty-plus year practice. It is split into four parts: Losses, Excesses, Transports, and The World of the Simple. The first two sections are concerned with so-called “deficits” or hyperactivity. The “transport” chapter deals with atypical stimulation of specific brain regions that leads to perceptual hallucinations. The final portion refers to the “mentally defective” (patients with low IQs, autism, etc.).

            Sacks is interested in the human condition as a whole; a diseased person cannot be so easily parsed that their identity is unaffected by their illness. That is not to say that one becomes an entirely different person as a result of their diagnosis. Simply, identity and illness meet, interact, and transform each other. He emphasizes that there is a person beyond the disease and that treating that person entails much more than just addressing the physical.

Consequently, he has a real problem with a purely rigid, systematic approach to medicine. He maintains, “Empirical science, empiricism, takes no account of the soul, no account of what constitutes and determines personal being. Perhaps there is a philosophical as well as a clinic lesson here: that in Korsakov’s, or dementia, or other such catastrophes, however great the organic damage and Humean dissolution, there remains the undiminished possibility of reintegration by art, by communion, by touching the human spirit: and this can be preserved in what seems at first a hopeless state of neurological devastation” (Sacks, 39).

            It’s a beautiful thing—he really believes in his patients. He fights for them to gain control of their symptoms AND grapple with the psychological side effects. Many of the cases demonstrate a triumph of will, as the patients turn inwards to find creative ways to cope with their physical limitations. Several patients teem with innovation. For example, Mr. MacGregor creates a custom pair of glasses with a level (like one used in carpentry) extended from the rims to help him walk straight, whereas beforehand he unknowingly strutted with a noticeable tilt (Sacks, 75). Here is where identity and illness converge, as patients strive to assert themselves in the midst of their condition. “He may be faced, from early childhood, with extraordinary barriers to individuation, to becoming a real person. The miracle is that, in most cases, he succeeds—for the powers of survival, of the will to survive, and to survive as a unique inalienable individual, are, absolutely the strongest in our being: stronger than any impulses, stronger than disease. Health, health militant, is usually the victor” (Sacks, 125). One cannot help but think that his own words are applicable to his current plight, as he recently announced that he has terminal cancer (My Own Life).

            As a whole, this book surprised me with its brooding, existential undertone. Some patients suffer from diseases afflicting their memory capabilities, so Dr. Sacks makes some unscientific inquiries as to the relationship between memory and soul, i.e. how one’s personality might be affected by the lack of a continuous stream of memories. What remains of a person who has lost some (or even all) sense of reality? At one point, he asks the nuns at his hospital if it was “possible that [the patient] had really been ‘desouled’ by a disease” (Sacks, 37). Talk philosophy to me, Dr. Sacks.

            Furthermore, he encourages us not to look at illness and wellness in such a binary framework. He encounters numerous paradoxical situations in which some patients find that their so-called “illness” actually provides them with a benefit… so much so that they do not wish to be treated. Could an illness have a healing power? Intrigued? *You’ll just have to read for yourself*

            I find it quite remarkable that he is so bent on restructuring the medical perspective so that patients might fully flourish. Still, this book confuses me a little. Perhaps I’m breathing words into Dr. Sacks that aren’t true, but I feel as though at its core, this book is meant to be accessible to the layman; yet, he is still an erudite professor…and it shows. There is nothing wrong with sounding scholarly as a scholar, but I think that it complicates the voice of his book. I wonder if the formality of his writing interferes with his ability to paint his patients as truly human. And isn’t that his whole point? He cries out for medicine that incorporates meaning—a flexible practice that acknowledges the existential—but crams his book with a pretentious air and jargon that distracts the reader from envisioning the patient in this holistic way. As a result, I think I like him very much as a person and a doctor—not necessarily a writer. As an aside, he is allegedly celibate, which is funny insofar as Dr. Sacks isn’t getting any in the sack.
That being said, the cases he presents are wildly entertaining. One man literally tries to pick up his wife’s head, confusing it with his hat due to his visual agnosia (Sacks, 11). A medical student gets amped up on a bunch of drugs (cocaine, PCP, amphetamines) and then is left with an outrageously keen olfactory system for weeks (Sacks, 156). If this makes you want to do PCP, check out what happened to Big Lurch. In a later chapter, autistic twins each shout the number of matches that fall out of a box the instant it hits the floor—111 matches (Sacks, 199). The book is abound with truly fantastical stories though some are communicated too obliquely; thus, my review balances out at a cool 3 out of 5 camel humps.  

*Sacks, Oliver. The Man Who Mistook His Wife for a Hat. New York: Touchstone, 1998. Print.

*Sacks, Oliver. “My Own Life: Oliver Sacks on Learning He Has Terminal Cancer.” The New York Times. 19 Feb. 2015. Web. 1 April 2015.

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