Musicophilia: Tales of Music and the Brain

As Sacks points out, the ability to sense the auditory world is widely taken for granted, but many people are born with or acquire various forms of amusia, or deafness to some element of music, such as tone deafness or rhythm deafness. Rhythm deafness is also partially cultural, as infants learn to process rhythms of their own culture. Tone deafness has varying levels, and most people with tone deafness can still appreciate music, but there are rare occurrences in which a person has absolutely no sense for tones at all. Acquired amusia is the sudden and often temporary onset of tone deafness and can occur as the result of a stroke or seemingly for no reason at all. Such an experience happened to Sacks twice: He reports suddenly hearing Chopin’s music as an irritating banging—but only for a few minutes. Sacks worked with one patient, D. L., who throughout her entire life was unable to perceive pitch and tone in music. To her, it all sounded like meaningless noise. Despite this, she was able to perceive and use speech without issue, which is common for people with “complete congenital amusia” (110). Sacks’s own experience and the experience of D. L. suggest a deafness to timbre as well as tone. Neurologically, people with impairments in their ability to perceive melodies reflect this in the right hemisphere, while those who cannot perceive rhythm reflect this in a wide array of brain areas.

Amusia takes many forms: Some patients are unable to perceive melody as a composite form but maintain perception of pitch and tone, while others are unable to associate emotion with music. Sacks received a letter from a composer named Rachael who lost her ability to perceive harmony after an injury to her head and spine. Instead, she heard each instrument on its own, and these sounds did not coalesce as they once did. Her ability to perceive pitch also disintegrated, and she lost hearing in her right hear. Rachael also developed simultagnosia, in which sounds and sights in her daily environment were perceived as isolated from one another. In time, her ability to perceive harmony returned to an extent, but only with immense effort and for short periods. As Sacks wrote the book, she was working on her first composition in over a decade: a re-imagining of her last work before everything changed. She hoped the new composition would represent her time in a coma, the long period of adjustment and coming back to herself afterward, and how she had learned to accept a fragmented auditory world.

Absolute pitch is the ability to detect any heard or imagined note down to its exact pitch. Sacks refers to a man named Sir Frederick Ouseley, a professor at Oxford who could detect the tone of any sound, musical or otherwise, and another man who knew the pitch of his tinnitus. This ability is often compared to seeing colors distinctly, as those with absolute pitch hear each note uniquely and distinctly. Having absolute pitch can be beneficial, but can also be an irritation, as those who have it find out-of-tune instruments abrasive to the ear. They may also find it difficult to transpose a piece into a different key, as each key, to them, is totally separate from the next. Sacks notes that absolute pitch is in no way essential to the production or appreciation of music. The rarity of absolute pitch intrigues him, as there is no clear explanation for the fact that some people have it while most do not. He describes a letter from a woman with absolute pitch who struggles to understand how others require visual information or of a continuum of notes in order to identify them.

According to studies by Diana Deutsch and her team (2006), certain languages like Mandarin and Vietnamese encourage the development of absolute pitch through their use of extremely subtle variations in tones to denote different words or connotations. Furthermore, the earlier children begin musical training, the more likely they are to develop absolute pitch, and it is theorized that most children have the potential to do so. A study by Gottfried Schlaug et al. (1995) used MRI imaging to determine neurological differences in those with absolute pitch and found that they have “exaggerated asymmetry between the volumes of the right and left planum temporale” (137). Anthropologist and linguistic historian Steven Mithen theorizes that absolute pitch was a necessary part of human and language evolution and that peoples of the distant past may have used a hybrid of musical and gestural forms to communicate.

The cochlea is a spiral-shaped cavity in the ear, which is filled with fluid and contains the organ of Corti—whose 3,000 hair cells receive auditory vibrations and communicate them to the auditory cortex. Recent research has shown that the cochlea not only sends signals but also receives them from the auditory cortex, which can temporarily tune the cochlea to amplify and focus on particular sounds. This is useful, for example, when a person must focus on a conversation in a loud space, or when a musician must distinguish various tones and instruments in a piece. In the early 2000s, Sacks worked with a patient named Jacob L., a musician with increasing difficulty accurately perceiving tones in higher octaves. What Sacks found particularly noteworthy about Jacob’s experience was the fact that the distortions he heard were not necessarily in any particular order. Jason felt that the death of single hair cells, which he believed to each be responsible for perceiving a specific tone or set of tones, was the cause of his acquired problem. Sacks notes that the cochlea has been compared to a string instrument, “differentially tuned to the frequency of notes” (144) and each hair to a string. Jacob adapted by playing in lower octaves and then transferring that music into higher octaves, but still found it difficult to play the music anywhere outside his mind without it sounding wrong. He also found he could to some extent will his mind to hear the correct tone, but he compared this compensatory method more to an illusion than a true auditory experience. In a letter a year later, Jacob wrote to Sacks with a newspaper article confirming his and Sacks’s suspicions: A loss of pitch perception is likely a common symptom of hearing loss, but one rarely discussed by musicians and rarely noticed by non-musicians. He seemed comforted to know that he was not alone in his condition. Jacob continued working to strengthen his hearing to its original state, refusing to give up. Soon, Sacks received another letter from Jacob, who was excited to report that his ability to perceive higher tones was slowly returning. He found it to be a non-linear process but noted that being presented with the opportunity to write the score for a large orchestra gave him the drive he needed to push his auditory system back in the other direction. Largely through sheer will, Jacob managed to reshape his own brain to perceive missing tones again despite the loss of some cochlear function.

There is a noteworthy connection between emotional responses to auditory stimuli and the ability to hear in stereo. Sacks describes his correspondence with Dr. Jorgen Jorgensen, who lost hearing in his right ear following an operation. Jorgensen retained his ability to perceive all the subtleties of music, but the lack of stereo hearing deprived the music of any emotional impact. Similarly, when a person loses vision in one eye, they sometimes report feeling an emotional disconnect from what they see. The ability to perceive sounds in stereo allows people to perceive distance, echo, and the spaciousness of sound. Dr. Jorgensen explained in a letter that, like Jason, he was able to adapt to his acquired disability by willing himself to perceive something that his ears physically could not. Since vision and hearing are closely connected, Sacks theorizes that Dr. Jorgensen’s adaptation may be due in part to an unconscious visual processing of the location of instruments and size and shape of the theater. Another man named Howard wrote to Sacks after experiencing hearing loss in his right ear. Howard was able to use visual cues as well as tactile cues like the vibrations of a subwoofer to perceive the stereophonic sounds that he thought he had lost.

Sacks discusses the neurology behind the existence of savants—people who demonstrate extraordinary musical abilities in conjunction with significant deficits in other areas. He opens with the case of Martin, who had severe intellectual and physical deficits as a result of childhood meningitis. Along with these new disabilities came an extraordinary talent for music, and he became able to reproduce complex melodies after a single listening. Martin was also partially blind, which Sacks theorizes may have had something to do with his increased auditory capacities. Most savants, Sacks notes, have autism, and approximately 10% of people with autism have savant-like abilities. Auditory and visual savants seem to share a great deal in common, as visual savants also often possess the ability to reproduce scenes in stunning detail after a single viewing. Savant syndrome is classified as a heightened ability in the absence or lack of other basic abilities, which could be the result of a compensatory response by the right hemisphere when the left hemisphere is damaged. This “anomalous right-hemisphere dominance” (167) means that the brain can adapt to use the right hemisphere for functions generally performed by the left. Some neuroscientists theorize that everyone is born with savant abilities, but that a significant change is usually required for these to be realized; others believe that some people are born with these abilities waiting to be unlocked and others simply are not. However, the fact that savant abilities often become pronounced after a stroke, seizure, or similar event leads Sacks to wonder whether these abilities are in fact within everyone.

When Sacks was a child, his family employed a piano tuner who was blind, and for a long time Sacks assumed all piano tuners were blind. He notes that many of his patients and correspondents have been blind or partially blind while also possessing striking musical sensitivity. Historically, folk music players in Gaelic culture were frequently blind, and in modern times, one can consider famous artists like Stevie Wonder and Ray Charles. Children who are born blind or become blind very early in life often incline toward music to “create a rich world of touch and sound” (173). Adam Ockelford, a prolific researcher and educator for children with visual impairments, performed a study in which he compared children with a rare visual impairment called septo-optic dysplasia to children with normal sight. He found that the majority of the students who had visual impairments were far more interested in and dependent upon music. Only children with total blindness were observed to have savant abilities in relation to music. In a separate study, Ockelford found that a disproportionate number of children with blindness also had absolute pitch. Sacks notes that “a third or more of the human cortex” (175) relates to vision, and because of this, when vision is lost, the brain must reorganize itself in drastic ways. This can occur whether a person becomes blind as a child or late in life. To end the chapter, Sacks makes mention of Jacques Lusseyran, a French Revolutionist, writer, and musician who became blind at age seven and who found that music profoundly changed his quality of life thereafter.

Music and color have been metaphorically associated throughout human history, but some people experience a literal combining of senses, known as synesthesia. This can come in a variety of forms, but Sacks focuses on those who experience synesthesia in relation to music. They may hear music and experience taste, or specific smells, or even see color. In the late 1800s, Francis Galton (a eugenicist) observed various forms of synesthesia and determined that it was not a mental association so much as an automatic and physiological process. In his years working with patients, Sacks has found that most people with synesthesia don’t consider it a condition that requires treatment, and many don’t even bring it up with their doctors; indeed, most synesthetes interpret it as the norm until they learn otherwise. One of Sacks’s patients suffered a brain injury that rendered him colorblind. He was a painter and synesthete, and after his injury, was no longer able to see color with music as he once had. Talking to this patient convinced Sacks that synesthesia is a physiological phenomenon. A prolific composer named Michael Torke has remarked that, for him, living without synesthesia would be like a type of blindness. He has absolute pitch in addition to synesthesia, and he feels the two go hand in hand. Torke and others like him also report seeing colors in their minds that they do not perceive in the real world. The colors associated with each key seem to have no pattern but have remained the same for Torke’s entire life. Another composer, David Caldwell, has color associations that are completely different from Torke’s. His synesthesia works in the other direction as well, so that he starts to hear music when he sees specific colors. Like Torke, Caldwell does not know where his associations come from or whether they have any meaning. Unlike Torke, Caldwell sees colors for more than just keys, associating them with most parts of music. David’s synesthesia guides his composition and carries emotional associations, but for Michael, it is just a fixed part of his perception. For some synesthetes, music can also be associated with taste. One synesthete named Christine Leahy has a particularly unique association involving letter-color associations that bleed over into music; for instance, seeing the letter D as green means she also sees green when she hears the note of D. For a psychologist named Patrick Ehlen, colors and shapes are associated with all types of sounds, not just music. He feels that synesthesia enriches his life: It led him to pursue psychology, and the music he composes on the side is equally made better and even possible by his synesthesia.

Synesthesia has sometimes been seen as belonging to the realm of art and poetry rather than science. In the 1980s, however, Richard Cytowic conducted neuroscientific studies confirming that when synesthetes reported, for example, seeing colors in response to sound, their visual processing centers were indeed being activated. It has long been assumed that synesthesia is quite rare, but that is being called into question as recent studies show that synesthesia in subtler forms is fairly common. Synesthetic brains show higher numbers of connections between various brain areas, which could be due to the way pruning seems to slowly separate the senses as humans develop. When a person becomes blind, they may develop synesthesia as a compensatory response. When developed later in life, it is often experienced as more of an intrusive and negative experience than when someone is born with it and just assumes it as a natural part of themselves.