The Man Who Mistook His Wife for a Hat: And Other Clinical Tales

Oliver Sacks’ The Man Who Mistook His Wife for a Hat is a collection of recounted case histories of patients suffering from a wide variety of neurological disorders. The book is separated into 4 sections: “Losses,” “Excesses,” “Transports,” and “The World of the Simple.” Each section contains a series of case studies having to do with a specific aspect of neurology, which is defined as “the field of science dealing with the nervous system.” The author, Oliver Sacks, is a British Neurologist who earned his medical degree at Oxford University (Queen’s College) and has lived in New York since 1965 as a practicing neurologist. Currently he is a neurology professor at the NYU School of Medicine, continuing his practice in the NYU Comprehensive Epilepsy Center. Throughout the different sections of the novel, Sacks pairs these short-story-like case histories with “normal” language to provide readers with a more comprehensible understanding of the complex workings of varying neurological disorders. Through his poetic storytelling and thorough understanding of neurological disorders and the brain, Sacks brings attention to the ways in which these disorders content that can be accessible to the reader which makes him even more credible. In part one of the book titled “Losses,” Sacks discusses neurological disorders that are considered to be “deficits” in normal neurological functioning. He makes the claim that neurologists have the tendency to label nearly all neurological disorders as deficits. This basically means that the individual has some sort of impairment in performance ranging from loss of vision to loss of memory. Based on what we learned in class about the anatomy of the brain, we know that the areas of the brain specifically being affected in these cases are the occipital lobe and hippocampus. Sacks also brings up how this model of mental illness being a deficit is not entirely accurate because such little research has been done on the right hemisphere of the brain in comparison to the left hemisphere. Another point made is that the affected subjects aren’t given enough credit for their abilities to find ways to compensate for whatever “deficit” they are suffering from. He brings light to such abilities in the case studies provided in this section. In part two of the book titled “Excesses,” Sacks discusses the overabundance of neurological functioning, the contrary to deficits in metal processes. Rather than focusing strictly on the ways this “excess” affects the brain, Sacks displays how an overabundance of function impacts patients’ daily lives. These case studies primarily consist of patients suffering from Tourette’s Syndrome, which as we know from class is due to there being complications with the basal ganglia (controls body movement), as well as there being less white matter in the brains of individuals with this disorder. In part three of the book, titled “Transports,” Sacks discusses cases in which neurological conditions altered patients’ perceptions of reality, in ways that can be deemed imaginative, euphoric, and even “otherworldly.” As it is brought up in the case studies within the section, majority of the cases have to do with seizures disturbing certain regions of the brain. One example given of this was how these women claimed to be hearing loud, beautiful music, when in actuality they were suffering from recurring seizures in the temporal lobe of their brains, which we know to be in control of one’s auditory perception. Lastly, in the final portion of the book titled “The World of the Simple,” Sacks discusses the work he has done with individuals who are mentally challenged in some way. A major theme brought up in the case studies he provides for this section is “concreteness,” which is, in the case of those who are mentally challenged, the way they perceive the world as a collection of material things rather than abstract concepts. He brings light to the true beauty behind such individuals which may seem depressing to one at face value. With this, he ends his book with the stories of individuals who may not perceive the world and its complexities, but how despite this ability to do so, these mentally challenged patients of his have a strong connection with the concrete world in their musical or mathematical gifts, for example, while still having mental deficiencies, showing that they too are simply human. When it comes to the ways in which Sacks creates a book that is accessible and much more credible than others he does this by adding outside sources and making the stories he tells both poetic and understandable. He doesn’t try to make it so that neurological disorders are inaccessible to a wider audience. This book reads in a way that anyone, interested in neuroscience or not, can understand it and want to continue to learn about it. In Chapter 18, “The Dog Beneath the Sun”, Sacks brings up the story of a medical student, age 22, on highs. The way this chapter reads is so that it can be accessed by all, the fact that right off the bat this is a profile on someone that any college student can relate too, especially, makes it even more accessible. Sacks states in one of his footnotes clarifying “a strange nostalgia…” (156) that it is a “a strange emotionalism…reminiscence”. The fact that this footnote creates a sense of understanding beyond what is just written shows that Sacks puts in care to wanting his audience to more deeply understand the subject matter. As the case study continues we learn about the enhancement of smell being affiliated with “paraphilia, fetishism, and allied perversions and regressions.” (158) The reason this part is another solid example of Sacks credibility is because in his footnotes he thing refers to this later being described by A.A Brill in 1932 as a “contrast with the overall brilliance, the redolence, of the smell world…” (158). The truth of the matter is that through the creation of access, which is what Sacks is doing by using such simple terms, neuroscience is becoming accessible and something that anyone can enjoy which, in a way, even furthers his credibility. Knowledge like this should be accessible to all not just those who can afford and education and to study it and Sacks is doing just that. All in all, The Man Who Mistook His Wife for a Hat is Oliver Sacks’ way of creating access for all into the realm of neuroscience. The way this book is broken up into four parts makes it easier to digest and creates for a sense of fluidity that makes the reader continue to wonder about other neurological findings. Lastly, looking back at the ways in which Sacks creates accessibility his clear use of simple yet poetic language makes it so that there is a further want to continue to understand neuroscience as a whole instead of just running away from it. The fact that this is written to be understood makes it so that it is much more enjoyable and more easily digested which is, in many ways, a way of inviting all to enjoy the world of neuroscience not just those who have exclusive access to it.

Oliver Sacks was a neurologist who wrote several different best-sellers that delved into further understanding the capacity of the human brain. He wrote his best-sellers using his collection of cases of patients who suffered from different neurological conditions. Among one of his best sellers is the book The Man Who Mistook His Wife for a Hat and Other Clinical Tales where he compiled several of his most interesting clinical tales using his former patients that suffered from a variety of different neurological disorders. In his book, he divided the cases into four different categories; loses, excesses, transports, and simple. This review will further analyze the title of the book, the different neurological disorders that are divided into the four different categories which will then be reviewed categorially by analyzing the ways in which neuroscience is present in the book. For starters, the book title The Man Who Mistook His Wife for a Hat and Other Clinical Tales is extremely fitting because it conveys the essence of the book. The title allows for some curiosity on the reader’s behalf which entices them to read the book because they want to know what kind of neurological disorder prevents the patient from recognizing faces and mistaking their wife for a hat. Dr. Sacks quickly introduces us to the patient responsible of the title of the book during the first chapter. I think it’s fitting that Dr. Sacks chose Dr. P as his first patient as his book title because it sets the precedent to the rest patients in his collection of clinical tails. By introducing the person responsible for the title of the book in the first chapter, it doesn’t leave the reader wondering which patient mistook their wife for a hat. On the contrary, it helps set the tone for the rest of the clinical tales which shows stories about neurological disorders just as wild as Dr. P’s case. For the most part, the book was very well written and easy to understand. Since the book was divided into four different categories, it allowed for the book to be extremely organized because the cases either fell into a losses, excesses, transports and simple categories. The first part of the book is losses, where Dr. Sacks describes neurological disorders that have a certain kind of loss in their neurological functions. An example of a loss would be visual agnosia which in the case of Dr. P, it took away his ability to distinguish faces. Although Dr. P was unable to distinguish faces, he still found a way to continue his everyday life with minimal interruption by using the help of music to guide him in his life. Neuroscience is presented in Dr. P’s case excessively. Because Dr. P’s has the inability to recognize faces, it means that his thinking is more abstract and mechanical. Dr. P’s thinking is more computer like because his brain is classifying and categorizing the faces he sees. Dr. P’s case is a prime example of why it’s important for not only the brain to classify and categorize things, but also having continual judging and feeling. If any of these elements are missing in the human brain, people become computer like, just as Dr. P. When people suffer from visual agnosia, just as Dr. P, their life becomes entirely abstract and computational. Dr. Sacks claim regarding that such disorder makes patients computer-like is accurate and valid because after making that claim, he follows up with the reader by showing another brief case of visual agnosia which allows the readers to compare the two patients and understand how complex visual agnosia is. The second part of the book is excesses, where Dr. Sacks describes neurological disorders that have a superabundance’s of functions. An example of an excess would be Tourette’s syndrome which is when a person has an excess amount of nervous system energy which transpires into production of strange motions and notions such as tics, compulsions, and etc. In the case of Witty Ticcy Ray his Tourette’s was extremely debilitating because his tics were uncontrollable and unorthodox. It wasn’t until Witty Ticcy Ray got started on a new medication called Haldol which allowed him to live his life with minimal interruption with his illness by finding the proper dosage that worked for him. Neuroscience is presented in the case of Witty Ticcy Ray in several different ways. For starters, Dr. Sacks starts out by explaining that Tourette’s patients have disturbances in the instinctual bases of behavior in the brain. Such areas affected are the thalamus, hypothalamus, limbic system and amygdala which is where all the determinants for personality are located at. The presentation of neuroscience in the case of Witty Ticcy Ray makes sense with my understanding of neuroscience because it helped me understand how Tourette’s Syndrome works due to the fact that the areas affected are the areas that control personality which in turn with Tourette’s is expressed through different kind of ticks. Additionally, the treatment for Witty Ticcy Ray’s Tourette’s was a medication called Haldol. Haldol helped control his ticks and helped him assimilate into everyday life. Haldol works by helping to restore the balance of certain natural substances in the brain such as neurotransmitters. Dr. Sacks claims of Haldol working on Witty Ticcy Ray’s Tourette’s demonstrates a further understanding of neuroscience. The only thing I would have liked to see from Dr. Sacks argument about Haldol, would have been to have been provided with an elaborate explanation in the ways in which Haldol helps the neurotransmitters restore chemical balances in the brain. The third part of the book is transports, where Dr. Sacks describes neurological disorders of patients that suffer from altered perceptions which allows them to transport back to a moment in their past by reminiscing without notice. An example of transports which in the case of Mrs. O’C was caused by temporal lobe seizures due to a stroke the right temporal lobe. In the case of Mrs. O’C she was hearing Irish music in her head which filled her with personal feelings of her past which allowed her in a way to transport back to her childhood. Mrs. O’C Irish music in her head was resolved on its own with time but it shows how some neurological conditions are able to transport patients back to forgotten memories. Neuroscience is presented in the case of Mrs. O’C in various ways. For starters, it shows the impact of a stroke in the brain and because of the location of the stroke occurred in the right temporal lobe, it allowed for temporal lobe seizures to occur which was the reasoning behind hearing music and transporting to earlier memories. The presentation makes sense with my current understanding of neuroscience because from what I’ve learned in class it was that the temporal lobe is involved in primary auditory perception, such as hearing, and holds the primary auditory cortex. When Mrs. O’C had right temporal lobe seizures, it makes sense that she would hear music in her head. Dr. Sacks also followed up his claim by providing evidence of a test he ran on Mrs. O’C where he electrically stimulated the right temporal lobe and caused her to hear music. Which further proved his claim regarding the temporal lobe seizures and their impact on the human brain. The fourth part of the book is simple, where Dr. Sacks introduces several different patients who are considered “simple” because they suffer from different forms of mental retardation. Although Dr. Sacks labels these patients as “simple” they completely outgrow that label because Dr. Sacks brings out their personal strengths in each of their case and shows how these patients are able to thrive despite their neurological limitations. Neuroscience is presented in this final section by Dr. Sacks providing different case studies of patients who all live a simple and innocent lives due to their mental retardation. Although, their world might be simple; that doesn’t mean that their brain doesn’t work. Dr. Sacks did well presenting different patients which helped me understand the different ways that neuroscience works in the world of simple. The last case study of the section of simple shows the story of an Autistic boy named Jose who is referred to as “The Autistic Artist.” Although he was mentally retarded and unable to speak, that did not make him an imbecile because when asked to draw pictures, he drew those same pictures differently and amazingly. The argument that Dr. Sacks makes regarding the different skills of many different individuals with mental retardation and what they can achieve despite their limitations is backed up correctly and well explained by providing different examples of all the different patients. Altogether, Dr. Sacks collection of various different clinical tales makes for an interesting yet informative neuroscience read. Dr. Sacks effectively examines the personal side of neurosis by making his book an easy read by incorporating empathy with clinical jargon. Dividing the book into four separate parts allows for the reader to get an understanding of how different neurological diseases come in all shapes and sizes. Dr. Sacks effectively explains the concepts of losses in neuroscience, the concept of excesses, the concept of transports and the world of simple. All the different patients that were included in the different sections made it easier to understand the different neurological diseases being explained because it allowed the reader to see different examples of how neuroscience plays a giant role in our everyday lives.

Such an interesting read for people interested in neurology or the quirks of the human body!

A great mixture of bite size case histories that never the less somehow inform each other, all told with a humanistic and engaging tone. Just enough technical language mixed with amazing insights into how our minds are and what it all could mean.

Very interesting cases, but Sacks’ excessive use of em dashes was distracting. The book could have been much shorter without the redundant over-descriptions of how strange the case is or how the patient must feel—sometimes going on for two pages after the conclusion.

Boken är på engelska och skriven av en neurolog.Kan vara svårt för en svensk att förstå alla medicinska termer på engelska.

The Man Who Mistook His Wife for a Hat" is a captivating and thought-provoking book by neurologist Oliver Sacks. Through a series of fascinating case studies, Sacks delves into the intricacies of the human mind and the bewildering world of neurological disorders. Each story unveils the profound impact of these conditions on the affected individuals' lives, challenging our perception of identity, reality, and consciousness. With empathy and insight, Sacks explores the resilience of the human spirit in the face of extraordinary challenges, leaving readers with a deeper understanding of the complexities that make us human. A mesmerizing exploration of the human brain's mysteries.