Mind over matter
The following is an extract from a handwritten letter that Oliver Sacks received in Janurary 1999:
Dear Dr. Sacks,
My (very unusual) problem, in one sentence, and in non-medical terms, is: I can’t read… I cannot read words… I would be every so happy and grateful if you could find the time to see me.
One would be forgiven for thinking this was some kind of practical joke, or one of those tests of gullibility. After all, it is inconceivable that someone could use a colon in completely the right context and spell the word ‘sincerely’ but not be able to read even the simplest of words. (From personal experience, there are many people around who can read a book at the speed of light but are unable of using a colon correctly in a sentence.)
This letter, however, is genuine — and is just one of the seemingly unbelievable cases that Sacks discusses in his book The Mind’s Eye. From the bestselling author of The Man who mistook his Wife for a Hat, this book is another collection of fascinating case studies encountered by Dr Sacks during his time as a physician.
Neurology is an incredibly complex branch of medicine as there is still so little that we know about the human brain. This can make diagnosis very challenging. Lilian’s condition is known as pure Alexia — the inability to recognise text. In the chapter ‘Sight Reading’, Sacks explains how this progressed onto what is known as ‘visual agnosia’ — the inability to recognise visual objects (in Lilian’s case, she had specific difficulty naming images in photos). However, despite mistaking an umbrella for a snake, being unable to either recognise a sofa or locate a plate of biscotti that had been moved a couple of inches across the table, she was able to play a Haydn Quartet she had heard two years before (although she did have difficulty locating the piano).
Additionally, Sacks provides some neuroanatomical information to accompany his stories (although he goes into far less detail than Ramachandran’s The Tell Tale Brain). In the case of Lilian, he refers to MRI scans that show shrinkage in the occipital and occipitotemporal cortex (the visual area of the brain). But, despite the odd intelligent-sounding anatomical term, the book is accessible to all and is surprisingly gripping.
Sacks approaches reporting such case histories as a writer of fiction would go about writing and compiling a collection of short stories. He maintains a sense of mystery throughout each case study, building up a clear picture of the patient, their history, their condition, with the clarity and attention to detail of a clinical report, but with the engaging language and sophisticated writing style of an experienced storyteller.
In true storyteller fashion, Sacks introduces an interesting twist to the tale when he gives readers a glimpse into his own psychiatric history. In the chapter ‘Face- Blind’, he reveals that he himself suffers from propagnosia — difficulty in recognising faces. He presents this in a rather light-hearted manner:
My problem with recognizing faces extends…also to myself….[One time] I turned to the restaurant window and began grooming my beard…I realised that what I had taken to be my reflection was not grooming himself but looking at me oddly. There was in fact a grey-bearded man on the other side of the window, who must have been wondering why I was preening myself in front of him.
Throughout his book, Sacks tells amusing anecdotes alongside far more serious (and sometimes devastating) examples of individuals suffering from neurological conditions. Also in the chapter ‘Face-Blind’, Sacks describes Capgras Syndrome, a condition in which an individual will inexplicably lose all emotional attachment to a family member, to the extent that they become convinced that their spouse, parent, or even child, is an impostor.
In conclusion, Sacks’ remarkable ability to tell the story of an individual’s struggle with a poorly understood neurological condition in as few as 21 pages is what makes him truly unique both as a physician and as a writer.