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.