The Man Who Mistook His Wife For a Hat by Oliver Sacks

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Reviewed by Simon 

It has been thirty years since Oliver Sacks’ most famous book, The Man Who Mistook His Wife For a Hat, was published and, while it does not need rediscovering, having never gone out of print (and selling over a million copies), the momentous anniversary seems a good time to celebrate this astonishing work.

It was not Sacks’ first book; that was Migraine in 1970. Nor was it the first to bring Sacks fame (that came with Awakenings in 1973, later a film starring Robin Williams and Robert De Niro), but it is perhaps the best introduction to the world which Sacks observes and the way in which he writes about his experiences. It also demonstrates what makes Sacks such a gift to scientific writing and (at the risk of sounding saccharine) the world.

The Man Who Mistook His Wife For a Hat is rather a sensationalist title, and sounds a bit like a crime novel, but it refers to one of the patients whom Sacks treated; Dr. P had visual agnosia – that is, he was no longer able to recognise objects despite being able to understand the shape, colour, and texture of them. His attempt to describe a glove, when handed to him, is “a continuous surface, infolded on itself. It appears to have five outpouchings, if that is the word.” And he mistakes his wife’s head for his hat.

It is difficult to write about the cases in Sacks’ book without sounding like somebody insensitively wandering through a Victorian freak show. There is undeniably a fascination to such unlikely neurological impairments as somebody who can only see the right half of anything and can’t compute the concept of ‘left’; to somebody losing their memory; to autistic twins who can barely communicate but can instantly find the prime factors of piles of matches. I’d be lying if I denied that I read Sacks’ work to marvel at the ways in which the brain works – or, rather, sometimes doesn’t work – and the bizarre manifestations of these disorders. But what Sacks has created is something far superior to a point-and-stare situation.

He has been attacked for an inhumanity in writing about his patients (without revealing their identities, of course), but he is probably the most humane writer I have ever read. Here, for instance, is how he introduces the chapter on the man who mistook his wife for a hat:

Dr. P was a musician of distinction, well known for many years as a singer, and then, at the local School of Music, as a teacher. It was here, in relation to his students, that certain strange problems were first observed. Sometimes a student would present himself, and Dr P. would not recognise him; or, specifically, would not recognise his face. The moment the student spoke, he would be recognised by his voice.

Rather than starting an account by announcing that he treated a patient with visual agnosia, Sacks starts by placing him in the context of his life. He picks out, first, the quality which most characterised Dr. P before he became ill; the quality by which he would most want to be remembered. Sacks’ patients are always, first and foremost, people to him – and thus to his readers. This humanity makes The Man Who Mistook His Wife For a Hat pop neuropsychology rather than a scientific textbook, but that is all to the good, in my opinion.

Time and again, Sacks writes about his admiration for stoical people undergoing extraordinary circumstances. One of the patients experiences a damaged sense of proprioception (that is, the sense of the position of parts of the body in relation to other, neighbouring parts of the body). He cannot walk upright, but always feels that he is – and, from his own initiative, invents the integration of a spirit level into his glasses, that he can use to maintain his balance. Sacks writes about his ingenuity with genuine respect that doesn’t feel at all patronising. I don’t think Sacks could patronise if he tried.

There are twenty-four different essays in this collection, divided quite approximately into ‘losses’, ‘excesses’, ‘transports’, and ‘the world of the simple’. Sometimes these links work, and sometimes they feel rather too vague – and, indeed, there isn’t really a strong thread of continuity through the book, except for the continuity of Sacks’ approach and tone. It doesn’t much matter (except for when it comes to trying to discuss the book as a single entity), but it does rather stand out among his catalogue of books which otherwise tackle one thing – hallucinations, migraines, colour blindness, deafness, and so forth. Almost all of the illnesses addressed in The Man Who Mistook His Wife For a Hat are far rarer than those on that list (there would scarcely be enough material for a whole book on, say, people who can’t see the left half of objects), but occasionally he does talk about much commoner phenomena, such as Tourette’s.

Thirty years on, many of Sacks’ conclusions and investigations may be scientifically behind the times – I wouldn’t know – but what is timeless is the way in which he writes about them. Whether or not you think neuroscience is a topic you’re interested in, if you find people fascinating, and value kindness, then you will find much to marvel at and appreciate in The Man Who Mistook His Wife for a Hat.

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Simon Thomas is one of the editors of Shiny New Books.

Oliver Sacks, The Man Who Mistook His Wife for a Hat (London: Picador, 2015). 978-1447275404, 272pp., paperback.

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