Footnote of the Month: August 2010

Bravo to the Mark Morris Dance Group for their pioneering program bringing music, and dance, to people with Parkinson’s disease.  Dr. Sacks first saw the power of music in his Awakenings patients, survivors of the encephalitis lethargica epidemic who had an extremely severe form of parkinsonism which left them motionless, like human statues.

The power of music to integrate and cure, to liberate the parkinsonian and give him freedom while it lasts . . . is quite fundamental, and seen in every patient. This was shown beautifully, and discussed with great insight, by Edith T., a former music teacher. She said she had become “graceless” with the onset of parkinsonism, that her movements had become “wooden, mechanical—like a robot or doll,” that she had lost her former “naturalness” and “musicalness” of movement, that—in a word—she had been “unmusicked.” Fortunately, she added, the disease was “accompanied by its own cure.”

I raised an eyebrow. “Music,” she explained. “As I am unmusicked, I must be remusicked.” Often, she said, she would find herself “frozen,” utterly motionless, deprived of the power, the impulse, the thought, of any motion; she felt at such times “like a still photo, a frozen frame” . . . without substance or life. In this state, this statelessness, this timeless irreality, she would remain, motionless-helpless, until music came: “Songs, tunes I knew from years ago, catchy tunes, rhythmic tunes, the sort I loved to dance to.”

With this sudden imagining of music . . . the power of motion, action, would suddenly return, [along with a] sense of . . . restored personality and reality. Now, as Edith T. put it, she could “dance out of the frame,” the flat frozen visualness in which she was trapped, and move freely and gracefully: “It was like suddenly remembering myself, my own living tune.” But then, just as suddenly, the inner music would cease, and with this all motion and actuality would vanish, and she would fall instantly, once again, into a parkinsonian abyss.

Equally striking, and analogous, was the power of touch. At times when there was no music to come to her aid, and she would be frozen absolutely motionless in the corridor, the simplest human contact could come to the rescue. One had only to take her hand, or touch her in the lightest possible way, for her to “awaken”; one had only to walk with her and she could walk perfectly, not imitating or echoing one, but in her own way. But the moment one stopped, she would stop too.

From Awakenings, Vintage paperback edition, p. 60.

Footnote of the Month: July 2010

People with alexia can see perfectly well, but their brains lose the ability to decipher words and letters. Howard Engel, the Canadian novelist known for his Benny Cooperman series of detective novels, put it this way:

The July 31, 2001, Globe and Mail looked the way it always did in its make-up, pictures, assorted headlines and smaller captions. The only difference was that I could no longer read what they said. The letters, I could tell, were the familiar twenty-six I had grown up with. Only now, when I brought them into focus, they looked like Cyrillic one moment and Korean the next. Was this a Serbo-Croatian version of the Globe, made for export? . . . Was I the victim of a practical joke? . . . I have friends who are capable of such things. . . . I wondered what I might do to them that would improve on this piece of foolery. Then, I considered the alternative possibility. I checked the Globe’s inside pages . . . I checked the want ads and the comics. I couldn’t read them either. . . .

Panic should have hit me like the proverbial ton of bricks. But instead I was suffused with a reasonable, business-as-usual calm. “Since this isn’t somebody’s idea of a joke, then, it follows, I have suffered a stroke.”

from The Mind’s Eye, chapter 3.

Footnote of the Month: June 2010

“Stereo Sue,” a chapter in The Mind’s Eye, is about Sue Barry, a neurobiologist who suddenly acquires stereopsis, and true three-dimensional vision, in her fifties.  After a lifetime of inferring depth by other monocular cues such as perspective and motion parallax, Sue is stunned by the beauty of her new sense of 3-D space and depth. While most of the the chapter is about Sue’s experiences, Dr. Sacks also points out how stereo vision is important for animals:

Stereopsis, as a biological strategy, is crucial to a diverse array of animals. Predators, in general, have forward-facing eyes, with much overlap of the two visual fields and, presumably, stereoscopic vision; prey animals, by contrast, tend to have eyes at the sides of their heads, which gives them panoramic vision, helping them spot danger even if it comes from behind. An astonishing strategy is found in cuttlefish, whose wide-set eyes normally permit a large degree of panoramic vision but can be rotated forward by a special muscular mechanism when the animal is about to attack, giving it the binocular vision it needs for shooting out its tentacles with deadly aim.

In primates like ourselves, forward-facing eyes have other functions. The huge, close-set eyes of lemurs serve to clarify the complexity of dark, dense close-up foliage, which, if the head is kept still, is almost impossible to sort out without stereoscopic vision—and in a jungle full of illusion and deceit, stereopsis is indispensable in breaking camouflage. On the more exuberant side, aerial acrobats like gibbons might find it very difficult to swing from branch to branch without the special powers conferred by stereoscopy. A one-eyed gibbon might not fare too well—and the same might be true of a one-eyed lemur or cuttlefish.

From The Mind’s Eye, Chapter 5.

Footnote of the Month: May 2010

Writing, a cultural tool, has evolved to make use of the inferotemporal neurons’ preference for certain shapes. “Letter shape,” as Stanislas Dehaene writes, “is not an arbitrary cultural choice”—it is dictated by our neural proclivities.

The earliest written languages used pictorial or iconic symbols, which became increasingly abstract and simplified. There were thousands of distinct hieroglyphs in Egypt and tens of thousands of ideograms in classical Chinese; reading (and writing) such a language demands a great deal of training and, presumably, the dedication of a larger portion of the visual cortex. This, Dehaene suggests, may be why most human languages have tended to favor alphabetic systems.

And yet there may be certain powers, certain qualities peculiar to ideograms. Jorge Luis Borges, who was well versed in Japanese poetry, spoke of the multiple connotations of kanji ideograms in an interview:

“The Japanese have achieved a wise ambiguity in their poetry. And that, I believe, is because of their particular form of writing itself, because of the possibilities that their ideograms present. Each one, according to its features, can have several connotations. Take, for example, the word ‘gold.’ This word represents or suggests autumn, the color of leaves, or the sunset because of its yellow color.”

From The Mind’s Eye, Chapter 4.

Footnote of the Month: April 2010

We often talk about which sense we would choose to lose, if we had to give one up. But sometimes, the borderline between senses is not so clear.  Dr. Sacks explored this theme in Seeing Voices, and he will return to it in his forthcoming book, The Mind’s Eye.

There is, of course, a “consensus” of the senses—objects are heard, seen, felt, smelt, all at once, simultaneously; their sound, sight, smell, feel all go together. This correspondence is established by experience and association. This is not, normally, something we are conscious of, although we would be very startled if something didn’t sound like it looked—if one of our senses gave a discrepant impression. But we may be made conscious, very suddenly and startlingly, of the senses’ correspondence, if we are suddenly deprived of a sense, or gain one. Thus David Wright “heard” speech, the moment he was deafened; an anosmic patient of mine “smelt” flowers, whenever he saw them (Sacks, 1985); and a patient described by Richard Gregory (in “Recovery from early blindness: a case study,” reprinted in Gregory, 1974) could at once read the time on a clock when he was given his sight (he had been blind from birth) by an eye operation: before that he had been used to feeling the hands of a watch with its watch-glass removed, but could make an instant “transmodal” transfer of this knowledge from the tactile to the visual, as soon as he was able to see.

From Seeing Voices, Vintage paperback edition, p. 133.

Footnote of the Month: March 2010

Last week, production started on a new feature film directed by Jim Kohlberg and based on Dr. Sacks’s essay “The Last Hippie,” in An Anthropologist on Mars.

So we were thinking back to Awakenings, which includes an appendix called “Awakenings on Stage and Screen” about the many dramatic adaptations that book has inspired, including a play by Harold Pinter.  Dr. Sacks worked closely with Robert De Niro and Robin Williams as they were researching their roles for the 1990 feature film “Awakenings.” Here is what he had to say about Robin Williams:

We had spent a few minutes in a very disturbed geriatric ward, where several of the patients were shouting and talking bizarrely, at one point at least six of them together. Later, as we all drove away, Robin suddenly exploded with an incredible playback of the ward, imitating everyone’s voice and style to perfection. It was incredible to hear this: I felt that he must have taken in everything which went on, all the different voices and conversations together, and held them in his mind with total recall – and now he was reproducing them, or, almost, being possessed by them. This instant power of apprehension and playback, a power for which “mimicry” is too feeble a word (for they were funny imitations, feeling ones, and full of creativity), was developed to an enormous degree in Robin. It constituted, I came to think, the first step in his actorial investigation; the one which provided an intense and minute sensory and motor corporeal image, which he could then scan internally and analyse, and then finally imbue with himself, deepen, subjectivise.

I was soon to find this in regard to myself. After our first meeting, Robin “had,” or mirrored, some of my mannerisms, my postures, my gait, my speech; all sorts of things of which I had been hitherto unconscious. It was uncanny, and disconcerting at first, to see myself in this living mirror. We would talk – and the way we stood, and our cadences, our gestures, were the same: it was like suddenly acquiring an identical twin. But then this too-explicit mimesis gave way to a much profounder, much more subjectivised, actor’s portrait of me – or rather of a being half-Robin, half-me, one created by his imagination and feelings, no less than by his observation of me; and finally, to a new character, neither Robin nor me, but one with a life and personality of its own.

From Awakenings, Vintage paperback edition, pp. 376-7.

Footnote of the Month: February 2010

An Anthropologist on Mars takes its title from a comment Temple Grandin once made to Dr. Sacks: that, for someone with autism or Asperger’s syndrome, trying to figure out subtle human emotions is like being . . . an anthropologist on Mars.

Temple’s life is the subject of a stunning new film starring Claire Danes, Julia Ormond, and David Strathairn.  It debuts this Saturday, February 6th, at 8 pm, on HBO.

February’s Footnote of the Month talks about high-functioning autistic people, and originally appeared in An Anthropologist on Mars.

Many high-functioning autistic people describe a great fondness for, almost an addiction to, alternative worlds, imaginary worlds such as those of C.S. Lewis and Tolkien, or worlds they imagine themselves. Both the B.’s and their older son have spent years constructing an imaginary world with its own landscapes and geography (endlessly mapped and drawn), its own languages, currencies, laws and customs—a world in which fantasy and rigidity play equal parts. Thus days might be spent computing the total grain production or silver reserves in Leutheria, or designing a new flag, or calculating the complex factors determining the value of a thog—this occupies hours of the B.’s leisure time at home together, Mrs. B. providing the science and technology; Mr. B. the politics, languages, social customs; and their son the natural features of the often-warring countries.

From An Anthropologist on Mars, Vintage paperback edition, p. 276.

Footnote of the Month: January 2010

Why don’t we all have savant talents? In Musicophilia, Dr. Sacks discusses the experimental use of transcranial magnetic stimulation to temporarily inhibit certain brain functions in order to heighten others. He includes a footnote on his own experiences:

Something perhaps analogous happened to me in 1965, when, like a certain number of medical students and residents at the time, I was taking massive doses of amphetamines. For a period of two weeks, I found myself in possession of a number of extraordinary skills I normally lacked. (I published an account of this, “The Dog Beneath the Skin,” which focused on the heightening of smell, in The Man Who Mistook His Wife for a Hat.)

I could not only recognize everyone I knew by smell, but could hold very accurate and stable visual images in my mind and trace them on paper, as with a camera lucida. My powers of musical memory and transcription were greatly increased, and I could replay complex melodies on my piano after a single hearing. My enjoyment of these newfound powers and the world of greatly heightened sensation that went with them was mitigated, however, by finding that my abstract thinking was extremely compromised. When, decades later, I read of Bruce Miller’s patients and of Allan Snyder’s experiments, I wondered whether the amphetamines might have caused a transient temporal lobe disinhibition and a release of “savant” powers.

(from Musicophilia, Vintage paperback edition, p. 169)