Book Blog - The Man Who Mistook His Wife for a Hat

 

The Man Who Mistook His Wife for a Hat and Other Clinical Tales

by Oliver Sacks

Hold on, what was that title!? How could a man think his wife was a hat? 

The title of this book immediately captured my attention. The title alone raised so many questions and I immediately wanted to read more. I was not disappointed, it was a very interesting book, and although I didn't recognize his name at the time, I was already introduced to Oliver Sack's work through interest in the movie Awakenings.

 I decided to take this class because I needed something to do with my time. My children are older and less demanding of my time. Similarly, my career is settled; the corporate ladder long ago climbed and also requiring less of me without business travel resuming for the foreseeable future. I'm too far away from retirement to rest on my laurels, but also utterly bored having worked in the same industry for the last 25 years. I enjoy learning and have a particular fondness for understanding how the mind works and, more specifically, how our behavior is influenced by biology, culture, and development. As an older student, I also have a lot of life experience knowing, working with, living with, and loving people with various psychological challenges and have always sought to learn more to foster and maintain those relationships.

Oliver Sacks was a world-renowned neurologist, writer, and professor of neurology at the NYU School of Medicine. He was known as "The Poet Laureate of Medicine." Although he was a well-known doctor and author previously, his fame skyrocketed after one of his books, Awakenings originally published in 1973, was turned into a feature film in 1990 starring Robin Williams and Robert DeNiro. Oliver Sacks published numerous best selling books, scientific articles and articles for general consumption on a variety of topics. Many of his books are compilations of case studies of patients he saw over his career as a neurologist, as is the case with The Man Who Mistook His Wife for a Hat. A simple Google search will yield a plethora of videos and interviews with Oliver Sacks, and he is very interesting to listen to. I also encourage readers to learn more about Oliver Sacks by listening to the podcast series, Radiant Minds: The World of Oliver Sacks, linked below.

Radiant Minds: The World of Oliver Sacks

First published in 1985, The Man Who Mistook His Wife for a Hat has become a common book in the libraries of neurologists around the world. It is so well known, it has even been turned into an opera. 

Michael Nyman - The Man Who Mistook His Wife for a Hat (1987 TV Opera)

The Man Who Mistook His Wife for a Hat is a collection of case studies of people with cognitive disorders. The eponymous case study tells the story of a man, Dr. P., who suffered from visual agnosia. During the course of one of his visits with Dr. P, he took his wife's head and tried to lift it to put it on his own head as if she were his hat! Dr. P executed daily tasks and taught at a music school, yet could not pick out faces of loved ones or himself in photos. He had learned to look for certain markers or cues then deduce objects or people from those characteristics, however his ability to apply schemas was in tact and allowed him to continue to function.

Throughout the course of this book, Sacks groups his case studies into four parts; Losses, Excesses, Transports, and the World of the Simple. 

Losses

The case studies presented Losses is all about deficits, and the case studies were all about people who had lost or had significantly impaired abilities to interpret things. For example, Dr. P and his visual agnosia; he could examine a glove in his hand and not be able to make the judgement that it was intended for the hand itself. Other case studies with losses included varying forms of agnosia, such as developmental agnosia where the cognition never developed; amnesia, or losses tied to the ability to create or recall memories; proprioception and integration, or our abilities to connect and control parts of our bodies; and more. 

Excesses

In contrast to the loss of abilities, the case studies in the excesses section of the book are focused on too much or "hypers". Case studies in this area include those challenged by conditions such as Tourette's Syndrome, neurosyphillis, Parkinson's Disease, Korsakoff's Syndrome, and more. As the mother of a child affected by Tourette's Syndrome, the case studies Witty Ticcy Ray and The Possessed were of particular interest to me. Sack's speaks to Tourette's in Witty Ticcy Ray as a "disorder of the primal, instinctual bases of behavior" with the excesses in the "very highest parts of the "old brain": the thalamus, hypothalamus, limbic system, and amygdala, the the basic affective and instinctual determinants of personality are lodged." However, he dives deeper into the impact of Tourette's in The Possessed where he digs into the impact of living with Tourette's, "There is a physiological, an existential, almost a theological pressure upon the soul of the Touretter - whether it can be held whole and sovereign, or whether it will be taken over, possessed and dispossessed, by every immediacy and impulse."

Transports

In contract to the clear physical natures associated with conditions of deficits and excesses, in speaking of Transports, Sacks tackles conditions that are not as clearly neurological. He notes that transports are more often referred for psychoanalysis rather than medical doctors. Transports deals with reminiscence and experiential hallucinations that result from abnormal stimulations of the temporal lobes and limbic system. Case studies include reminiscence resulting from strokes, epilepsy, brain tumors, and drug use.

The World of the Simple

In the world of the simple, Sacks assess individuals with intellectual disabilities, however instead of focusing on their defects, Sacks examines their unique and characteristically gentle disposition. "What is this quality of mind, this disposition, which characterizes the simple and gives them their poignant innocence, transparency, completeness and dignity - a quality so distinctive we must speak of the "world" of the simple?" The case study, Rebecca, is a wonderful example of a young woman who in a clinical setting presented with a "mass of handicaps and incapacities," however when in a natural setting was noticeably more communicative and composed. Sacks theorizes that while schematic processing was abysmal with Rebecca, however narrative processing helped Rebecca form thoughts and gave her a "sense of the world" through symbolic imagery and imagination.

Why Should You Read This Book?

This was an incredible book with wide and relevant application to every day life. When we understand more about the brain, we understand more about the people we interact with in life. I found new ways of understanding these neurological conditions that better prepares me to interact and support those I know with these afflictions when I understand the science behind it all. We are more aware than ever of conditions such as Memory Loss, Alzheimer's Disease, Parkinson's Epilepsy, Amnesia, and Tourette's Syndrome. The Man Who Mistook His Wife for a Hat sheds some of the mystery around these conditions, and through his case studies, humanizes them, giving them a face and name beyond their clinical neurology.

References:

Sacks, O (1970,1981,1983,1984,1985) The Man Who Mistook His Wife for a Hat and Other Clinical Tales Vintage Books

The Oliver Sacks Foundation (2022) https://www.oliversacks.com/

Oliver Sacks. (2022, July 15) In Wikipedia. https://en.wikipedia.org/wiki/Oliver_Sacks

Madman Films. (2020, July 22). Oliver Sacks: His Own Life - Official Trailer. YouTube. https://www.youtube.com/watch?v=47ooNWugxRE

MinimalEffort (2019, May 29). Michael Nyman - The Man Who Mistook His Wife for a Hat (1987 TV Opera). YouTube. https://www.youtube.com/watch?v=4r1YpNP0Z9I

Images:

https://www.amazon.com/Man-Who-Mistook-His-Wife/dp/0593466675/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=

https://www.finehomesandliving.com/fashion/women-s-hats-etiquette-fashion-dos-and-don-ts-when-wearing-one/article_c015a144-fa19-52c4-8d6c-4445299edcfb.html

https://www.queensu.ca/artsci_online/sites/default/files/styles/hero_image/public/img/course/psyc221-imagination.jpg?itok=Eh7y5gOK

https://neurosciencenews.com/iq-hyper-brain-body-7720/

https://phys.org/news/2020-07-strategy-therapies-brain.html

https://the-art-of-autism.com/tag/autistic-brain/