author : Oliver Sacks

The brain's perception of the body: Sacks breaks his leg, and his brain 'loses' it.

Various strange brain problems

The horrors of unnaturally forcing deaf people to learn speech, depriving them of the rich language and culture of signing

• sign language

More case studies of people with strange brain problems. I can almost feel parts of my brain looking suspiciously at other parts as I read these. Fascinating, but not at all morbid: Sacks sees these people as people, not as cases.

[mental disorders] may force the nervous system into making other paths and ways, force on it an unexpected growth and evolution.

• The Case of the Colour-blind Painter: being able to perceive and distinguish wavelengths is not the same as being able to perceive colour
• The Last Hippie: amnesia forces Greg to live in the 60's; a large brain tumour destroyed his ability to remember new events
• A Surgeon's Life: Dr Carl Bennett combines Tourette's syndrome with a surgical practice
• To See and Not See: why restoring sight to the early-blind can sometimes destroy their lives; how the brain has to learn to see
• The Landscape of His Dreams: compulsive memories of childhood
• Prodigies: idiots savants and autism; Stephen Wiltshire's amazing drawings
• An Anthropologist on Mars: autism has not stopped Temple Grandin from gaining a Ph.D. and running a successful business

This is a book in two parts, about strange medical conditions on isolated Pacific Islands. The first is a high incidence of total colour blindness (achromatopsia, locally called maskun) on Pingelap and Pohnpei (which is accompanied by extreme light sensitiveness and poor visual acuity, since the sufferers have only rods, and no cones, in their retinas), the second a high incidence of lytico-bodig, a neurological disorder similar to Creutzfeld-Jacob and Parkinson's disease, on Guam (which may, or may not, be caused by eating cycad flour). Sacks tells the tale of his visits to both places: the first in an attempt to understand what it might be like to live in a colour-free world, the second because the Guam disease has similarities with his own work as described in Awakenings.

The strange diseases aren't described in their usual detail: this is more a travelogue than a medical investigation. But Sacks' deep humanity, his care for the person rather than mere interest in their condition, comes through yet again. As does his dismay at the appalling devastation of island paradises, for such important reasons as American military bases and Japanese golf courses. And the story of how one of the team, a Norwegian achromatope, was sent to a school for the blind, where he was punished for using his sight to read Braille, and was blindfolded, simply beggars belief.

Here Sacks investigates our many and varied responses to music, from absolute (or perfect) pitch, musical hallucinations, via musical synaesthesia, to complete amusia, and then to the varied uses of music therapy for treating other problems. Music seems to occupy its own special part of the brain, not that closely associated with, for example, speech, and to be deeply important to us in surprising ways.

He points out how much our musical environment has changed over the last century: music is now essentially omnipresent. This may account for a seeming increase in so-called "earworms" -- those irritating fragments of songs and jingles that get stuck in your head for simply ages -- since jingles especially are designed to be catchy.

However, it is difficult to know if these actually are on the increase: what is clear from this book is how many people live with unreported conditions, because they assume (often rightly!) that nothing can be done, or because they think they are "normal", or they are worried that they are not normal.

Sacks starts, in his familiar case study style, with a tour of people suddenly infected with musicophilia, or musical seizures, or musical hallucinations, maybe caused by a problem like a stroke, or simply by ageing and deterioration of hearing. He moves into "natural" musical conditions, from absolute pitch to amusia, and musical savants. (This has one of the best descriptions, for me, of the quality of perception of absolute pitch that I have seen.) Then he describes the interaction of music and other problems, such as amnesia (where, despite almost total amnesia and inability to lay down new memories, musical performance may not be affected), aphasia (speech loss, that may sometimes be alleviated through musical therapy), Tourette's syndrome, Parkinson's disease (where almost completely frozen patients may be able to walk, dance or sing to the right kind of music), depression (which may be alleviated by the right kind of music), and dementia. This part is fascinating: it shows how differently music is handled by our brains from other forms of sound, and how valuable music therapy can be (not just playing any old music, but the right kind of music for each particular condition).

There is also a fascinating chapter on Williams Syndrome: I have encountered this before in readings on language, because these people are severely retarded in certain areas, but are very loquacious with large vocabularies. It turns out that many are also very musically gifted. In fact, one of the things this chapter does is provide yet more evidence that the notion of IQ is severely skewed: many of these people are described as having IQs in the 60s, yet are clearly above average in certain forms of intelligence.

The book does suffer slightly from feeling rushed; there are several places where an anecdote or explanation is repeated, in different words, a few paragraphs on. (I am assuming that this is the result of lacking a final editorial polish, rather than being some subtle musical "theme and variation" stylistic trick.) One stylistic feature that I do approve of the fact the book has footnotes, rather than endnotes (no constant flipping back and forth, just a quick eye-flick downwards).

This is a fascinating book: it shows how subtle and sophisticated is our interaction with music. And, as ever, Sacks' deep humanity and regard for his patients comes shining through.