Reviewed in the United States on December 12, 2012
The New York Times has referred to neurologist Oliver Sacks as "the poet laureate of medicine", and his collections of patient case histories are as vast as they are intriguing.
Oliver Sacks, a neurologist and physician from London, England, has practiced medicine for over forty years. He has always held a passionate interest in music, in fact, he claims that "'Music' has always been one of the first things [he looks up] in the index of any new neurology or physiology textbook." In his forty-year practice of medicine, he has come across a number of rare cases, particularly those with a focus on music as an ailment or as a treatment.
Musicophilia covers a variety of musically related topics in neuroscience. Sacks divides these topics into four main parts: First, the often haunting onset of the heightened sensitivity to music, followed by the relation of music to all senses of the body, then the strange presence of music in the lives of patients with mentally crippling disorders, and finally, the incredible impact (or lack thereof) of music in the lives of all people, even those without any kind of condition. Because he has been working with patients who experience auditory phenomena for almost 50 years, Sacks uses each chapter of his book to explain a particular case. Some chapters are filled with examples of patients who suffer or have come to terms with some kind of disorder; others, however, reflect on only one patient, perhaps indicative of the rarities of certain conditions. Most patients experience these conditions around older ages, but still some are born with them. The spectrum of these "musicophilic" or even "musicophobic" conditions is so vast that Sacks has truly pioneered the investigation into this field with his documentation of them.
In Musicophilia, Sacks first recounts his experiences with patients who had, at some point in their lives, suddenly felt the onset of a heightened sensitivity to music. In his very first chapter, "A Bolt from the Blue: Sudden Musicophilia", Sacks tells us of Tony C., a fit forty-two-year-old orthopedic surgeon who was in great health. Tony remembered vividly the moment his onset occurred: He was at a family gathering, and though the weather outside was pleasant, a few storm clouds had accumulated in the distance when he went to make a phone call to his mother. While at the pay phone, he could hear rain amidst the conversation he was having when, upon witnessing a flash come out of the phone, found himself falling backwards to the ground. He had been struck by lightning. Tony even found himself in the middle of an out-of-body experience, believing himself to be dead, but what was even more strange for him was that once he was resuscitated, a short time later he had an insatiable craving for music. Feeling now more alive than ever before, his newly-formed passion for music stole away his every desire. His wife couldn't even bear it, filing for a divorce, but Tony remained indifferent. To this day, Tony still works full-time as an orthopedic surgeon, but his entire being revolves around music.
Though this passion for music may be seen as a blessing, others may see it as a curse. In subsequent chapters of Part I, Sacks tells of patients who, upon hearing a familiar tune, would convulse uncontrollably. Faced with the rare condition of Musicogenic Epilepsy, many of these patients would live in fear of hearing that one familiar tune that set off the attacks, and so Sacks illustrates the need for research in curing that aurally crippling ailment. Sacks also discusses the mechanisms and regions of the brain responsible for musical imagination and continuous playback, as in the case of a catchy tune, until finally, he delves into the rare condition known as Musical Hallucination.
Part II of Musicophilia concerns the vast range of musicality that individuals possess, and Sacks covers topics in Amusia, Absolute Pitch, Dysharmonia, Savant Syndrome, and even Synesthesia. Sacks demonstrates just how fascinating some of these conditions may be in his stories, and in one case of absolute pitch he tells of a former professor of music at Oxford who could even tell what pitch came from the wind blowing or his father blowing his nose.
Sacks moves on from there, illustrating the relationship music has with vital processes such as movement and memory formation. He recounts histories of patients with Tourette's Syndrome, Amnesia, Parkinson's Disease, Phantom Limb Syndrome, and even Musician's Dystonia. All of these patients have suffered through some kind of somatic condition, losing some kind of normal kinesthetic or neural function, yet have used music therapeutically to help at least temporarily overcome their obstacles. Perhaps the most inspiring story comes with Nick van Bloss, an English pianist who had, since age seven, developed a severe form of Tourette's syndrome which created for him a life of ridicule and bullying. It was not until his parents bought a piano that his life became transformed for good. "When I played, my tics almost seemed to disappear. It was like a miracle," he said, and from that he found his passion for a life in music.
Musicophilia closes with Part IV, demonstrating how music is intertwined with emotion and even identity. Sacks states that "music, uniquely among the arts, is both completely abstract and profoundly emotional" (300). In one patient, Harry S., music is the only emotion able to be fully felt after suffering through a brain aneurysm. It is truly amazing to read of the ways music has helped these patients, and even in closing, Sacks shares a truly heartwarming story of how music therapy even brought back certain memories to a person who struggled with dementia.
When I listen to music, I feel wrapped in it entirely. It makes up such a major part of my life, and I know that it impacts so many others in much the same way. Oliver Sacks' Musicophilia demonstrates the countless ways music has helped others in their lives, including adverse conditions such as Savant Syndrome, Amnesia, even Dementia - and for this reason I rate Musicophilia a five out of five stars. It is truly inspiring to hear how many of these patients whom Sacks has interacted with have relied on music in their lives, and uplifting to hear how music has brought back good memories or normal functions in them. In much the same way, it is fascinating to hear of all those who have been tormented by musicogenic epilepsy, or even hallucinations, and I feel that Sacks' patient histories illustrate the need for future research in treating these ailments.
I would, however, make the caveat that Sacks does not write for a scientific audience. I have even searched for his case histories on PubMed, a large database of scientific research studies, and not a single story of his was there. His writing style is not intended for research, as he instead comments on the patient's psychosocial behaviors and lifestyle outside of the normal clinical setting. I have found that he spends almost as much time covering the history and lifestyle of a patient as he does covering the pathology of the specific condition, removing certain physiological or biochemical details but instead adding a poetic, humanistic feel to his tales.
All-in-all, Musicophilia is as eye-opening as it is ear-opening! I would recommend this book to anyone desiring to learn the neurological background to many musical conditions, as Sacks provides the framework in a simple yet humanistic way.