Musicophilia: Tales of Music and the Brain

Amnesia is a term classically used to refer to any type of memory loss, whether temporary or permanent. Stereotypical depictions involve a person forgetting where they were or what they did, but amnesia can also take a more permanent form as a result of a brain injury or infection. This was the case for Clive Wearing, whose brain infection left him unable to remember most of his life and interests. Clive did not forget how to play or enjoy music, however, and Clive’s story speaks to the power of music to maintain itself in the mind. Amnesia is an extremely debilitating state of being, as it often renders the person unable to care for themselves or navigate daily life without support.

Encephalitis is the term used to refer to brain inflammation/swelling as a response to infection. Since encephalitis often affects most or all of the brain, it can have a wide variety of side effects such as seizures, memory loss, constant confusion, and horrible headaches. Clive Wearing experienced encephalitis as the result of a brain infection and was thereafter left in an amnesic state. Despite the permeation of encephalitis across the brain areas, music seems to survive the damage that this condition causes. Sacks reasons that this is due music’s ability to unite disparate areas of the brain.

Epilepsy is a neurological condition whose primary symptom is frequent seizures. Seizures can be mental, physical, or both, and can come in the form of zoning out, jerking bodily movements, or even hearing music. The basal ganglia is thought to be responsible for the majority of physical seizures, as it is the house of motor control in the body. When it enters an over-excited state, it sends too many impulses, leading to a seizure. Frontotemporal epilepsy is another form of epilepsy which results in a disconnect from reality, a frozen state, or sudden auditory or visual hallucinations. In relation to music, Sacks notes that epilepsy can both cause and be caused by music; he has worked with patients who experienced seizures when exposed to certain music, and others who heard music in their heads when a seizure happened.

Musicality describes the entirety of human beings’ ability to create, perceive, and appreciate music. Musicality varies widely from person to person and from culture to culture. Musicality includes perception of pitch, tone, timbre, and tempo. It also includes emotional appreciation of music, understanding how to use music to relate to others, and the ability to compose and conduct music. What Sacks finds most intriguing about musicality is that no musical skill depends on another; someone may have absolute pitch but no composing ability. Someone else may not understand the emotion of music but may have an innate grasp of compositional theory. Musicality is not only cultural and personal, but also neurological—dependent on the structures of the brain.

Musical hallucinations are musical perceptions originating inside the brain, rather than in the outside world. Musical hallucinations may be memories of songs a person knows, or they may be entirely new compositions. Interestingly, when a person hallucinates known music, it is usually true to the original to a startling degree. Many composers have hallucinated music which they then turn into a beautiful piece. Musical hallucinations may happen to anyone at any time, but they are most common in people who experience damage to their hearing. Sheryl C. was a patient of Sacks’s who gradually experienced more and more musical hallucinations as her hearing loss progressed. She would wake up to the sound of clanking, and later to the sounds of an orchestra playing familiar tunes. Images of Sheryl’s brain showed that the same areas active when actually listening to music (temporal lobe, frontal lobe, basal ganglia, auditory cortex) were also active during her hallucinations. Eventually, Sheryl learned to accept her musical hallucinations as part of her life.

Musical imagery is the ability of most humans to imagine music in their mind. People may intentionally imagine music to pass the time or to simply enjoy it, or they may be met with an earworm—a song that plays over and over in the mind without any conscious volition. Many composers also rely on musical imagery to compose while they are not at their instruments. Musical imagery speaks to the innateness of music in humans, as it seems as though music is always with us even when we do not ask for it.

Musicophilia is Sacks’s term for the innate, universal, and passionate connection humans have with music. Music has been a part of human culture, Sacks notes, since possibly even before language has. It is the primary mode of expression and one which is almost universally understood, except by those with amusia. Human beings are constantly listening to and creating music, and when they are not, it follows them anyway in the form of earworms and musical hallucinations. Humans’ connection with music is personal, culture, and neurological.

Parkinson’s disease is a neurological movement disorder that affects a person’s ability to control their muscle movements. It is a progressive disease that can result in either constant movement or a catatonic (frozen) state. In his work with people with Parkinson’s disease, Sacks observed that many people who normally could not move at all could move to music. He also found that people with excessive movement problems were able to slow down and harness some control over their muscles when listening to rhythmic music. The effects of music on Parkinson’s speaks to music’s power to heal and inspire resilience.

Synesthesia is a neurological difference which results in the combining of various senses. For instance, a person may see color as they hear various notes, or experience smells in response to numbers. Synesthesia is thought to be something all humans are born with, as infants distinguish much less between the senses and rely more on a complete understanding and picture of their surroundings. As people develop, their brain prunes away unneeded connections, such as those between the visual and auditory cortex. For some people, however, this pruning never takes place, and they are left with synesthesia. Synesthesia is not a debilitating condition; in fact, people who have it either do not even realize they have it, think nothing of it, or in some cases even rely on it for their art. This was the case for Patrick Ehlen, who felt that his ability to see colors in musical notes was essential to his composing.

Tourette’s syndrome is a neurological condition resulting in uncontrollable tics (movements or sounds). Similar to epilepsy, Tourette’s is related to the functioning of the basal ganglia, which controls motor function. When this part of the brain becomes overactive, it can result in an unignorable urge to twitch, clap, blink, make noise, or any other wide variety of responses. Like those with Parkinson’s, people with Tourette’s respond positively to music. Sacks recalls one man named John S. who was unable to control his tics except when he was listening to music; however, if the music was too heavy or rhythmic, it had the opposite effect, making his ticcing worse.