The Man Who Mistook His Wife For A Hat: And Other Clinical Tales Summary

Oliver Sacks

The Man Who Mistook His Wife For A Hat: And Other Clinical Tales

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The Man Who Mistook His Wife For A Hat: And Other Clinical Tales Summary

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A groundbreaking work of both clinical and literary import, neurologist Oliver Sacks’ 1985 book of essays, The Man Who Mistook His Wife for a Hat And Other Clinical Tales, comprises 24 case studies that document the process of diagnosing perplexing and unusual neurological afflictions. Ranging from patients suffering from bizarrely altered sensory perception to a set of idiot savant twins, to a World War II Veteran who develops an inability to create new memories and a gentle, old music teacher who quite literally mistakes his wife for his hat, Sacks’ essays explore the farthest reaches of human perception with compassion and warmth, all in language accessible to a general audience.

Divided into four sections, each deals with a specific aspect of brain functioning. Part One deals in Losses, such as being unable to recognize where one’s limbs are in relation to one another, while Part Two focuses on Excesses like tics, jerky involuntary movements (chorea), and Tourette’s Syndrome. Part Three takes on Transports, as when an injury or disease in one part of the brain results in an aberration elsewhere, and Part Four delves into “The World of the Simple,” in which readers are introduced to people with mental handicaps who have surprising abilities. Though indeed clinical in nature, the fact that Sacks chooses to call these case studies “tales” hints at the imaginative and novelistic rendering of his patients’ stories. The Man Who Mistook His Wife for a Hat serves to both clarify and explain some of the more puzzling neurological disorders the author has encountered throughout his practice, while also humanizing and giving voice to his patients’ struggles to cope with the physical and emotional challenges they encounter in their everyday lives.

The essay from which the collection takes its title details the story of Dr. P, an intelligent music teacher suffering from prosopagnosia, or the inability to recognize familiar faces; in his case, he sees faces where none belong, such as in fire hydrants or hats. A type of visual agnosia, which is a disorder in which a person can see, but cannot interpret visual information, these are conditions associated with damage to the parietal lobe. Other patients described by Sacks include those with aphasia, or the inability to comprehend or form speech as a consequence of damage to the language centers of the brain, frequently the result of a stroke.

“The Disembodied Lady” describes the case of a woman who loses her proprioception; that is, her ability to distinguish where her limbs are in space, or whether or not they belong to her in the first place. Perhaps best understood as a sort of inverted phantom limb phenomenon, Sacks’ explanation of the disembodied lady’s experience sheds light on the emotional turbulence a patient feels when part of their body feels alien to them. Eventually, the diagnosis is revealed to be “sensory neuritis, affecting the sensory roots of spinal and cranial nerves throughout the neuraxis,” or the axis of the central nervous system.

At sea in a world with no continuity, Sacks writes about a World War II Navy Veteran in “The Lost Mariner”, a patient named Jimmie G. who cannot form new memories, even of events that took place minutes before. Perpetually stuck in 1945, Jimmie suffers from a rare disorder known as Korsakoff’s Syndrome. Caused by a thiamine or Vitamin B1 deficiency that is often, though not in his case, the result of alcoholism, Sacks’ describes Jimmie G.’s struggle to find happiness and meaning.

“The Twins” is an account of a pair of idiot savant twin brothers who could communicate on a very special frequency despite their mental handicaps. In many ways confined by their cognitive limitations and reliant on others to get through their everyday lives, the brothers are at the same time remarkable for their brilliance with numbers, especially prime numbers. This case study explores elements of the autism spectrum characterized by the twins’ predilection for identifying and dividing prime numbers, as well as their uncanny ability to count large numbers of objects in mere seconds.

In the essay “The Dog Beneath the Skin”, 22-year old medical student “Stephen D.” develops a heightened sense of olfaction in the wake of a night spent dabbling with drugs such as amphetamines, cocaine, and PHP. Sacks later revealed this essay to be an autobiographical piece, as he became less shy in his old age about his frequent experimentation with drugs in pursuit of understanding the human mind. The title of the essay is also a winking nod to the play by the same name, collaboratively written by W.H. Auden and Christopher Isherwood, and a reference to the acute canine sense of smell, apparently lurking just “beneath the skin” for all of us.

The Man Who Mistook His Wife for a Hat is at once a fascinating exploration of rare and unique neurological disorders and afflictions, and a warm-hearted love letter to what makes us human and how we understand the complex inner-workings of the mind. Rich in information and emotion, these essays are substantial and scientifically-sound enough for students of neurology as much as they are for anyone interested in learning more about the human brain.