The Man Who Mistook His Wife for a Hat

Oliver Sacks was a British neurologist and a best-selling writer of non-fiction. Born in London in 1933, he spent most of his career in the US, where he treated a group of people who had been catatonic since the 1920s after contracting encephalitis lethargica or ‘sleeping sickness’. Sacks published his experiences in the book Awakenings (1973), which became a film starring Robert De Niro and Robin Williams. In 1985, Sacks published an even more acclaimed work: The Man Who Mistook His Wife for a Hat relates a series of fascinating neurological case studies of patients with remarkable poignance and humanity.

HUMANITY

On his journey into the terra incognita of the human brain, Sacks brings together science, history, medical knowledge and the arts. He focuses on the lives of the individual patients and describes how they adapt to their conditions. The title story discusses the strange case of Dr. P., a musician with visual agnosia, who is unable to identify human faces or everyday objects. Indeed, he often confuses the two.

“He also appeared to have decided that the examination was over, and started to look around for his hat. He reached out his hand, and took hold of his wife’s head, tried to lift it off, to put it on. He had apparently mistaken his wife for a hat! His wife looked as if she was used to such things.”

“Evidentemente convinto che la visita fosse finita, si guardò intorno alla ricerca del cappello. Allungò la mano e afferrò la testa di sua moglie, cercò di sollevarla, di calzarla in capo. Aveva scambiato la moglie per un cappello! La donna reagì come se fosse abituata a cose del genere.”

MAKING SENSE

Sacks also describes patients with excessive brain function. One named William Thomson has Korsakov’s syndrome, which badly affects his memory. Thomson misidentifies the people he meets in a plausible if sometimes comic way. This is simply his damaged brain seeking to make sense of the world.

“He remembered nothing for more than a few seconds. He was continually disoriented. Abysses of amnesia continually opened up beneath him, but he would bridge them, nimbly, by fluent confabulations and fictions of all kinds. For him, they were not fictions, but how he suddenly saw, or interpreted, the world.”

”Non ricordava nulla per più di qualche secondo. Era costantemente disorientato, costantemente sull’orlo di abissi di amnesia che però scavalcava agilmente lanciandosi in chiacchierate e fantasie di ogni sorta. Ma per lui non erano fantasie, bensì il modo in cui all’improvviso vedeva o interpretava il mondo.”

DREAMING

Memory is also an issue for Mrs. O’C., an elderly care home resident. She is transported back to her past in Ireland by a stroke, which causes lucid dreams, complete with a traditional Irish music soundtrack. When she awakens, these vivid childhood memories persist.

“Mrs. O’C. had no conscious memory of the first five years of her life — no memory of her mother, of Ireland, of ‘home’. She had always felt this as a keen and painful sadness... Now, with her dream [...] she recaptured a crucial sense of her forgotten, lost childhood [...] It was, as she said, like the opening of a door – a door which had been stubbornly closed all her life.”

”La signora O’C. non aveva alcun ricordo cosciente dei primi cinque anni di vita – nessun ricordo della madre, dell’Irlanda, di «casa sua». Questa mancanza, o dimenticanza, dei primi e più preziosi anni della vita la sentiva con un senso di acuta e dolorosa tristezza [...] Ora, con il suo sogno e con il lungo «stato di sogno» che seguiva, ritrovava il senso della propria infanzia dimenticata, perduta. La sensazione provata non era solo un «piacere ictale», era una felicità trepida, profonda, fortissima. Era come aprire una porta [...] una porta rimasta ostinatamente chiusa per tutta la sua vita.”

AUTISM

In the final section, Sacks describes people for whom the door to everyday life is permanently closed. Twenty-one-year-old José is severely autistic, suffers seizures and cannot speak or read. But when Sacks gives him a pen, José draws beautifully and with obvious pleasure. Art connects him to the outside world. Sacks challenges society to do better with the talents autistic people possess.

“Isolated islands of proficiency’ and ‘splinter skills’ are spoken of in the literature. No allowance is made for an individual, let alone creative, personality.

What, then, was José, I had to ask myself. What sort of being? What went on inside him? How had he arrived at the state he was in? And what state was it – and might anything be done?”

“La letteratura parla di «isole di abilità» e di «capacità isolate». Non lascia alcuno spazio alla possibilità di una personalità individuale, o tanto meno creativa.

Che cosa era dunque José? dovetti chiedermi. Che specie di essere? Che cosa succedeva dentro di lui? Come era arrivato allo stato in cui si trovava? E di che stato si trattava? Era possibile fare qualcosa?”

SINGULAR VOICE

Dr. Sacks died in 2015, and he is still remembered as a compassionate, questioning and singular voice in the world of science. He recognised its connection with the arts, an idea that has gained considerable traction since. Many of Sacks’ works were adapted for stage or screen. In 1986, the composer Michael Nyman adapted The Man Who Mistook His Wife For a Hat into a critically-acclaimed opera.