Weird Brains

Reading a book by Oliver Sacks, MD: The Man Who Mistook His Wife for a Hat. Kindle version. Can’t say I like the prose style, but the case histories of his patients with severe neurological disorders, especially the symptoms they present with, are fascinating.

One in particular involved a patient who was blind. But there was nothing wrong this patient’s eyes or any part of the visual transduction system, the system that converts images to electrical signals and sends them to the brain. All of that was perfectly intact in this patient. Instead, this patient had a large lesion in a specific part of her brain that normally resolves these signals (occipital lobe), and consequently she literally could not “see” anything.

In another example, the basis of the book title, Dr. Sack’s was examining a man — a talented musician, teacher, and otherwise “normal” — who had slowly lost his ability to recognize faces (a disorder known as prosopagnosia). This was followed by him seeing faces everywhere, in places where there were no faces (on an umbrella for instance), and eventually he started showing symptoms of more general agnosia, the inability to recognize common objects. At one point during the exam this man had removed his shoe for some test Dr. Sacks wanted to perform. When Dr. Sacks told the man he could put his shoe back on, instead of reaching for his shoe the man grabbed his foot and seemed perplexed when he couldn’t put his own foot on his foot. Shortly after that when the exam was over, and the man and his wife (also in the exam room) were getting ready to leave, the man searched the room for his hat and mistook his wife’s head for his hat — he literally grabbed her head and tried to lift it off her body and put it on his head! What I found fascinating was that in spite of his mental deficit this man was otherwise normal. He was an accomplished music teacher at the local university, a job he kept because he was good at it, not out of any sense of charity. Dr. Sacks wondered how this man could be independent in his daily life — eating, bathing, dressing, etc.. His wife’s reply was that so long as he did these things while singing (apparently he sang songs while doing almost everything), he was fine, but the second he stopped signing, even lightly, his activity came to a full stop; he’d become completely bewildered because suddenly he could no longer recognize anything, even his own clothes.

Now, there were certain times during my misdirected youth — close your eyes Mom — when I saw things that weren’t really there, but I have never, ever mistook Happy Wife’s head for a hat.