The man who mistook his wife for a hat

• Oliver sacks

If a man has lost a leg or an eye, he knows he has lost a leg or an eye; but if he has lost a self—himself—he cannot know it because he is no longer there to know it. Dr Oliver Sacks recounts the stories of patients struggling to adapt to often bizarre worlds of neurological disorder. Here are people who can no longer recognize everyday objects or those they love; who are stricken with violent tics or shout involuntary obscenities; who have been dismissed as autistic or retarded, yet are gifted with uncanny artistic or mathematical talents. If inconceivably strange, these brilliant tales illuminate what it means to be human.

These studies deal with the most extraordinary mental conditions, often arising from damage to the brain, from the title case where a man in complete charge of his faculties is unable to identify the purpose of any object (thus his mistaking his wife for a hat) to individuals who, again otherwise wholly reasonable, will deny ownership of one of their limbs.

This is not presented as a freak show. Each person is shown as an individual demanding our respect and sympathy. The over-arching message is how little we understand ourselves and how both revealing and bizarre it is when the machinery of the mind breaks down.

A non-fiction book where the author, a neurologist and a gifted writer, has presented some fascinating case studies about his patients with unique afflictions.

The book has been divided into four parts, wherein each section contains case studies about a particular category of neurological afflictions.

Medical case studies are written in a dry, clinical language where the patient is dehumanized and reduced to a cursory phrase. In the preface, the author says, “Such [medical case] histories are a form of natural history – but they tell us nothing about the individual and his history; they convey nothing of the person, and the experience of the person, as he faces, and struggles to survive, his disease.” Thus, the author has attempted to “deepen the case history to a narrative or tale”, and I liked the way he has talked about his patients with warmth, sympathy and respect.

The narratives are often enriched with quotes, theories and experiences of other doctors, some of whom were stalwarts in their fields. There is a reference to Anton Chekhov as well.

I believe most of us understand what a magnificent and complex entity the human brain is. The book reinforced the fact that how fragile it can be – a little bit of damage. It can turn a person’s life upside down and make it difficult or impossible for the individual to do some essential functions that are so mundane that we do not even think about them.

In the book’s pages, I came across afflictions I would not have imagined possible even in my weirdest dreams. A gifted music teacher suffering from “visual agnosia” had indeed mistaken his wife’s hand for a hat and provided the title of the book; a woman would learn to use her hands at the age of 60 and prove herself to be a gifted sculptor; a man had the problem of leaning like the Tower of Pisa without his knowledge and would come up with his novel solution, and the list goes on. In some cases, the patients would learn to cope, but they would not be so lucky in others.
What a coincidence that I had just read Forrest Gump, the story of a fictional “idiot savant”, before coming across real-life idiot savants in the pages of this book.

One particular comment by the author – “The power of music, narrative and drama is of the greatest practical and theoretical importance”, pleasantly surprised me. I would not have expected this from a doctor, but maybe I should not have been surprised because the author did show his preference for a humane (for the lack of a better word) treatment of the patients.