The Man Who Mistook His Wife for a Hat and Other Clinical Tales

Book, 1985

Premise - A collection of clinical case studies during the 20th century from famous neurologist Oliver Sacks. Each case study presents a different odd neurological condition, many of which are understandable and definable to us now, but were undiscovered territory in the 20th century. Still other cases, perhaps the more exceptional ones, may continue to be a mystery to the world of neurology.

Review - Academically coming from a clinical psychology background, I have of course heard of this book and had wanted to read it for some time. Psychology was a very different field at the time that this was written, so most references outside of neurology are to psychiatry, and quite Freudian in approach. However, historically it is such an important piece of work.

The cases were collected over the course of decades. By the time the book was being published, in the 1980s, Dr. Sacks often added postscripts that described what he had learned in the years since, or other similarly odd cases that had arisen. But at the time he initially wrote down each case, it was the first time he had come across someone with that particular condition. Disorders like prosopagnosia, in which one can't recognize faces, has a name and is taught in psychology classes today, but I can't imagine how weird that must have been to discover.

So, as I mentioned prosopagnosia, there are certain case studies like that where I went, "Aha! I can tell what's going on." Yet there were still others that seemed so bizarre I had never heard of anything like it, and do not know if others exist with this condition today. And maybe that's not due to their rarity but to my focus on psychology and not neurology. I had never even heard the term proprioception before, a sort of sixth sense that tells you where your body parts are in relation to your body, so to imagine someone who lacked all proprioception was almost incomprehensible to me. I found it so overwhelmingly fascinating.

I think what can make readers love or hate this book is how it aged. It was written at a time in which evidence-based science was... there... but not clinical research psychology did not really exist the way we think of it today. Therefore, a lot of what Dr. Sacks says isn't based in evidence, but rather critical theory. What I love about psychology historically is that before we had an empirical understanding of the various phenomena, we just pulled from all sorts of other approaches - philosophy, literature, etc. I mean, think of Freud. None of what he was saying was necessarily accurate but it was pulled from literary theory. Luckily, I love literature, and studied it in addition to psychology. I studied literary theory, and therefore had a better basic understanding of the way in which Dr. Sacks approached his medical cases. The best way to describe psychotic symptoms was through, for example, a Dionysian lens, in which people were so possessed by music and the Gods that they became manic or otherwise exhibited bizarre behavior. Of course, Dr. Sacks didn't believe these people were possessed by Dionysus, but it's a good way to allude to what he was trying to describe, from a theoretical standpoint. However, he did make reference to a number of philosophers as well. I don't have a philosophical background so much of those references likely went right over my head. It did make me want to read more philosophy, however,

So while I enjoyed this eclectic understanding of behavior that pulled from art, science, and even religion, perhaps many others would not. An easy way of putting it is that the content is outdated. Much of the terminology is outdated as well, as we would not use words like "retarded" today, but rather "intellectual disability." This can be uncomfortable at times, but Dr. Sacks does not mean them in a degrading way. The accepted medical terminology was just different. The other somewhat uncomfortable piece was religion. Dr. Sacks brings up the question with many of his patients of whether or not they have a soul. He didn't always mean this in the, "Can they go to heaven?" sense, but rather a more earthly soul, as in "Do they have a true, conscious identity?" It's a spiritual question I can get behind so long as it doesn't cross over into direct religion.

The last thing I would like to say about this book is how much it simultaneously terrified me, and made me grateful for life. Neurological problems are clearly organic and medical, but they have so much interference with aspects of ourselves we would consider non-organic, like our souls and our minds. I felt so happy to have a body that I felt connected to and could control, but I'm terrified for a day where that may not be the case. (89/100)

Quote - “If we wish to know about a man, we ask 'what is his story--his real, inmost story?'--for each of us is a biography, a story. Each of us is a singular narrative, which is constructed, continually, unconsciously, by, through, and in us--through our perceptions, our feelings, our thoughts, our actions; and, not least, our discourse, our spoken narrations. Biologically, physiologically, we are not so different from each other; historically, as narratives--we are each of us unique.”

“Perhaps there is a philosophical as well as a clinical lesson here: that in Korsakov’s, or dementia, or other such catastrophes, however great the organic damage and Humean dissolution, there remains the undiminished possibility of reintegration by art, by communion, by touching the human spirit: and this can be preserved in what seems at first a hopeless state of neurological devastation.”

“Empirical science, empiricism, takes no account of the soul, no account of what constitutes and determines personal being.”


What to look out for - I think as I had mentioned, the most fascinating case to me was the one where the woman had lost all proprioception and literally couldn't tell where her body parts were as she was using them. So bizarre.

If you liked this book, I recommend 50 First Dates ahahahaha the besttt

Written by Oliver Sacks
Published by Summit Books