The Man who Mistook his Wife for a Hat: A Book Review

The more unusual neurological problems we've discussed in class this semester- complete loss of proprioception, phantom limbs, "unilateral neglect" (inability to perceive objects on either the right or the left)- are certainly interesting to consider in theory. In practice, however, it's hard to imagine how someone with one of these problems would function and perceive the world. Because their situations are "abnormal," deviations from typical neurological wiring, they can be very difficult for a "normal" person to grasp intuitively- unless they have a human example to connect the disorder to.

Enter Oliver Sacks' The Man who Mistook his Wife for a Hat. Sacks, a well-known neurologist, presents several of his more memorable cases, including Christina, a woman with no proprioception, "Witty Ticcy Ray", who has severe Tourette's Syndrome, and Rebecca, a cognitively impaired woman with a gift for language and theater. Sacks strives, when applicable, to emphasize the unique skills these people gain from their disabilities, rather than their limitations. Ray, for instance, was "a weekend jazz drummer of real virtuosity, famous for his sudden and wild extemporizations, which would arise from a tic or a compulsive hitting of a drum and would instantly be made the nucleus of a wild and wonderful improvisation" (97). However, his constant tics also made it difficult for him to keep a job, and also caused some tensions in his marriage. After several months of intensive meetings, Sacks convinced him to try Haldol, an anti-psychotic drug which suppresses tics. Ray recognized that the drug improved his work and marriage considerably, but missed the wild creativity that came with Tourette's; in the end, he compromised by taking Haldol during the week but not on weekends, allowing himself a designated time to be his former, frenetic self. Sacks admits that this is a "strange situation" but does not pass judgment on Ray for not choosing to remain "normal" at all times-one of the book's great strengths.

Sacks is also very sympathetic to Christina, noting that others often misunderstand those who are "disabled, but with the nature of [their] disabilities unclear" (51). As we discussed in class, most people don't even think of proprioception as a separate sense; it feels like an entirely innate, integrated part of us. Losing this sense, then, is especially devastating, since we are so unaware of its existence. Christina describes her experience as feeling constantly "pithed" or "disembodied," raising interesting questions about the role of proprioception in creating the self. Along with proprioception, Sacks claims, Christina has lost her sense of "corporeal identity" (52) as well; just as we discussed, this sense is extraordinarily powerful and extraordinarily underrated.

In the case of Rebecca, however, Sacks falters. Her case falls in a section of the book called "The World of the Simple," which is already indicates certain preconceptions about cognitively impaired people. With cases like Rebecca, Sacks tries to show that seemingly "simple" people can have extraordinary skills, that we view them as stupid or impaired largely because of intelligence tests designed to highlight deficits, rather than unique abilities. But he still begins the chapter by highlighting all the things is unable to do (move smoothly, make change, open a door with a key) and, even after one of his more charitable moments, calls her an "idiot Ecclesiastes" (180). For a man so intent on pointing out the unique abilities and realities of disabled people, the use of this degrading term,and the initial focus on the things Rebecca cannot do, is jarring. Why not start by describing her strengths and abilities, present her view of the world as different instead of "simple" and impaired? The other chapters about cognitively impaired people have similarly flawed descriptions. Sacks wonders how Martin, a "simpleton," could possibly appreciate the technical complexity of Bach's choral music; Michael and John, autistic twins with an extraordinary ability to calculate future dates and large prime numbers, have a memory that is seemingly limitless but still "childlike and commonplace" (199). And so on and so forth.

For this reason, I can't wholeheartedly recommend The Man Who Mistook his Wife for a Hat, interesting as it is. It sums up many of the concepts we discussed in class (like the importance of proprioception) beautifully, but gives others (like the realities of "simple" people) an overly simplistic treatment. Maybe that's why the book's subtitle is "and Other Clinical Tales;" Sacks excels at describing the medical symptoms and problems his patients might face, their difficulties in being perceived as "normal," but is sometimes less successful at describing the lives behind the symptoms without resorting to stereotype.

Works Cited

Sacks, Oliver. The Man Who Mistook His Wife for a Hat: and Other Clinical Tales New York: Simon and Schuster, 1985.