The Man Who Mistook His Wife for a Hat

by Oliver Sacks

Rating: ★★★

This was one I expected to enjoy an awful lot more. Strange neurology and psychology is something that always interests me, and as a collection of neurology cases, this sounded ideal. And, to be sure, the cases discussed were unusual and thought-provoking examples of a range of neurological disorders, roughly categorised by the manner in which they present.

The problem I have with the book stems from how Sacks chooses to write up these case reports. First of all, everything is too tidy. Sacks admits he alters some names and circumstances in the case details, to preserve the anonymity of the patients, and so far as that is fine, but the scenes that Sacks presents in these reports ring terribly false. If you take him at his word, patients walk into his office with a complaint, and Sacks pronounces what is wrong with about a minute's thought, usually in some charming dialogue that leads them or him to 'get it'. I'm not saying Sacks made these cases up, it's just that his editorial choice is to omit or smooth over almost all of the reality of clinical practice, thus depriving me of something I would've found very interesting.

Similarly, Sacks mostly avoids talking about neurology. This is quite annoying in a book about neurology. He will describe some symptoms, and usually apply a name for the condition, but it is quite rare that Sacks actually explains what he believes is going on with the wiring of his patients' brains. The dearth of detail here is treated by the application of repeated salulatory references to the 'greats' of neurology, most notably Luria, and a great deal of time spent on Sacks waxing philosophical about what moral lesson might be learnt from the fable he presents.

It is this last that really rubs me the wrong way. Sacks does not present a properly coherent theory, with nearly every case using a different and non-interlocking metaphorical language. His efforts smack, not of the precision of a brain scientist, but of the airy 'reaching beyond' of a spiritualist. He constantly tries to reference the soul, the importance of music, and the 'value' of debilitating mental disorders. He seems disappointed when one of his patients explains that she does indeed want to be cured of her auditory hallucinations, as he finds it fascinating and somehow meaningful, while she just finds it annoying.

Read it for the interesting case stories in neurological disorder, but be prepared to be disappointed -- both with what is there that is unwanted, and what is absent that is wanted.