It is utterly fascinating to know that, as a result of a neurological condition, a man can actually mistake his wife for a hat and not realize it. It is also fascinating to learn that a stroke can leave a person with the inability to see things on one side of the visual field--which is what happened to "Mrs. S." as recalled in the chapter, "Eyes Right!"--and yet not realize that anything is missing. In both cases there was nothing wrong with the patient's eyes; it was the brain's processing of the visual information that had gone haywire.
Neurologist Oliver Sacks, who has a wonderful way with words and a strong desire to understand and appreciate the human being that still exists despite the disorder or neurological damage, treats the reader to these and twenty-two other tales of the bizarre in this very special book. My favorite tale is Chapter 21, "Rebecca," in which Dr. Sacks shows that a person of defective intelligence--a "moron"--is still a person with a sense of beauty and with something to give to the world. Sacks generously (and brilliantly) shows how Rebecca taught him the limitations of a purely clinical approach to diagnosis and treatment. Although the child-like 19-year-old didn't have the intelligence to "find her way around the block" or "open a door with a key," Rebecca had an emotional understanding of life superior to many adults. She loved her grandmother deeply and when she died, Rebecca expressed her feelings to Sacks, "I'm crying for me, not for her...She's gone to her Long Home." She added, poetically, "I'm so cold. It's not outside, it's winter inside. Cold as death...She was a part of me. Part of me died with her" (p. 182). Rebecca goes on to show Dr. Sacks that they pay "far too much attention to the defects of...patients...and far too little to what...[is] intact or preserved" (p. 183). Rebecca was tired of the meaningless classes and workshops and odd jobs. "What I really love...is the theatre," she said. Sacks writes that the theatre "composed her...she became a complete person, poised, fluent, with style, in each role" (p. 185).
Another of my favorite stories is Chapter 23, "The Twins." These two guys, idiots savants, "undersized, with disturbing disproportions in head and hands...monotonous squeaky voices...a very high, degenerative myopia, requiring glasses so thick that their eyes seem distorted" (p. 196) had the very strange ability of being able to factor quickly in their heads large numbers and to recognize primes at a glance. They could also give you almost instantly the day of the week for any day in history. One day a box of matches fell on the floor and "<111,> they both cried simultaneously." And then one said "37" and then the other said "37" and then the first said "37" and stopped. There were indeed 111 matches on the floor (Sacks counted them) and three times the prime number 37 does indeed equal 111! (p. 199). Later he discovered them saying six-figure numbers to one another. One would give a number and the other would receive it "and appreciate...it richly." Sacks discovered that they were tossing out primes to one another just for the sheer joy of doing it.
Another of Sacks's discoveries about his patients is that "music, narrative and drama" are "of the greatest practical and theoretical importance" (p. 185). He demonstrates this again and again here and in his more recent book, An Anthropologist on Mars: Seven Paradoxical Tales (1995), which is also an incredibly fascinating book. (See my review here at Amazon.com.) Many people with neurological disorders or deficiencies become whole when engaged in a process such as story, music or drama. The process seems to give them a structure to follow which, for the time being, overcomes their handicap. This is seen remarkably even in a surgeon with Tourette's syndrome who, while performing surgery, was without tics (as reported in the book mentioned above).
It's clear that one of Sacks's purposes in sharing his experience is to dispel the prejudice against people who are different because of their defects. One can see that respect for others regardless of their limitations is something Sacks incorporates in his practice and his life. It is one of the many virtues of this wonderful book, that in reading it, we too are moved to a greater respect for others, people who really are challenged in ways we "normal" people can only imagine.