Musicophilia: Tales of Music and the Brain by Oliver Sacks

The Barnes & Noble Review

When I told my parents that I was pregnant with their first grandchild, my father said, almost sternly, "Well, dear, I do hope you're singing to the baby." I don't know if encouraging an ear for music is an optional stage of fetal development -- it just might be inevitable. The neurologist and essayist Oliver Sacks, in his book of essays entitled Musicophilia, takes on the mysterious internal human drives towards music, often against tough odds. Almost everyone possesses the "neural apparatus" for appreciating music -- Sacks will go on to tell us about some people who, through various neurological accidents, have lost it -- but the sheer human fact of appreciating music at all, he points out, is a very weird thing. "[I]t has no concepts, makes no propositions; it lacks images, symbols, the stuff of language. It has no power of representation. It has no necessary relation to the world."

As a largely internal and nonverbal experience, music can lead to thoughts of solipsism -- perhaps especially in the age of the iPod. What is it other people hear when they listen? And yet we seem to have proof in normal contexts that we are not locked in our own experience of music. We can play and sing and dance in concert with one another, share a smile over a remembered phrase, and so forth. Sacks' job, in his office and this book, is more difficult. He must try "to imagine and enter" into the experiences of people who have had highly anomalous things happen to them.

He considers, for instance, the extreme case of musicophilia -- a sudden onrush of love for, even obsession with, music. Take the orthopedic surgeon who listened, in a casual sort of way, to rock music. Then he was struck by lightning. He survived to find himself consumed with a passion for classical piano music -- he even began to compose it -- that fundamentally altered the course of his life. Synesthesia -- one sense fused to another -- is slightly more common; while some people seem to be born experiencing sound in terms of color, others develop the condition as they age. Still, synesthesia seems to be highly individualized, so that the composer Michael Torke, for example, experiences G Major as bright yellow and D Minor as "like flint, graphite," while for the composer David Caldwell it is the key of B-flat that is "clear and golden." One musician tastes intervals -- minor seconds and major sevenths are sour, a fifth is pure water. The romantic fantasist and composer E.T.A. Hoffmann even describes a character as "a little man in a coat the color of C sharp minor with an E major colored collar." Where in the range of debility and blessing should we put people with Williams syndrome? Their chromosomal glitch debilitates them severely in some areas -- leaving them with an inability to recognize spatial relations, for instance -- and yet grants them extraordinary joy in music.

Hypersensitivity to music can bring with it irritations -- surely we all know the maddening mental repetitions of a jingle or fragmentary snatches from some tune we never liked much to begin with and certainly won't after being possessed by it. Borrowing the German word Ohrwurm, English now has the useful word "earworm" to describe these "cognitively infectious musical agents." Considering the ubiquity of Muzak and iPods, Sacks wonders if such earworms are "to some extent, a modern phenomenon." I suspect he's partly right -- we're all exposed willy-nilly to more music now than ever before -- but English already had its own evocative term for a piece of music that won't let you go: maggot. Plenty of 17th- and 18th-century dance tunes were even called -- whether descriptively or hopefully -- things like "Mr. Isaac's Maggot" (Mr. Isaac was the dancing master to the Stuart court, so a successful maggot could even then bring financial reward).

Worse than temporary earworms and maggots are permanent conditions or alterations such as amusia, in which music makes no sense but sounds discordant, sometimes to the point of nausea. As a lifelong lover of counterpoint, I had never before contemplated the horrifying possibility of having too much of an ear for polyphony. One composer who had been in a coma after a car accident now experiences music as completely discrete lines of sound, "thin, sharp laser beams"; she suffers the agony of life without harmony, without the integrations of disparate voices into a meaningful beauty.

The most painful case to read, I found, is of the English musician Clive Wearing, who more than 20 years ago lost all but the shortest-term memory. Locked outside the flow of time -- like Zeno's stop-motion arrow, never reaching the target -- he has found himself close to despair. But music still possesses the power to tie all his discrete "nows" together, so that, even if only temporarily, he can feel himself move forward through time. His wife, the sole other aspect of his past he remembers, describes him playing: "The momentum of the music carried Clive from bar to bar. Within the structure of the piece, he was held, as if the staves were tramlines and there was only one way to go. He knew exactly where he was because in every phrase there is context implied, by rhythm, key, melody. It was marvelous to be free. When the music stopped Clive fell through to the lost place. But for those moments he was playing he seemed normal."

Tales like this remind us not to underrate the normal. "What then is time? If no one asks me, I know what it is," sighs St. Augustine plaintively. When Augustine tried to figure out this big abstraction, it is partly to music that he turned: "A person singing or listening to a song he knows well undergoes a distension or stretching in feeling because he is partly anticipating words still to come and partly remembering words already sung." God, in Augustine's view, might be the only being who can simultaneously know and experience the totality of time, but music gives us a glimpse of that freedom to feel both the momentary and the eternal.

In works like Awakenings and The Man Who Mistook His Wife for a Hat, Oliver Sacks has proven to be beautifully tuned to both the calibrations of the brain and the appearances -- sometimes mere traces -- of personality in the cases brought before his clinical attention. That is, while he is obviously fascinated by the mechanics -- the physical causes behind why someone is experiencing life differently -- he doesn't reduce the people before him to bundles of medical happenstance but always also seeks the particularities of that self. Many of the lives in Sacks' book are so distorted by severe neurological traumas that it would be easy to classify them as monstrous mistakes of nature from which a human -- all-too-human -- reaction is to avert our eyes with a shudder. We would be wrong. That arch-antisentimentalist Nietzsche asserted, "Without music, life would be a mistake." Sacks, equally unsentimental, amends Nietzsche. Conceiving of life without music is, at some fundamental level, a human impossibility. --Alexandra Mullen

Alexandra Mullen left a life as an academic in Victorian literature to return to her roots as a general reader. She now writes for The Hudson Review (where she is also an Advisory Editor), The New Criterion, and The Wall Street Journal.

From the Publisher

Revised and Expanded

With the same trademark compassion and erudition he brought to The Man Who Mistook His Wife for a Hat, Oliver Sacks explores the place music occupies in the brain and how it affects the human condition. In Musicophilia, he shows us a variety of what he calls “musical misalignments.” Among them: a man struck by lightning who suddenly desires to become a pianist at the age of forty-two; an entire group of children with Williams syndrome, who are hypermusical from birth; people with “amusia,” to whom a symphony sounds like the clattering of pots and pans; and a man whose memory spans only seven seconds-for everything but music.

Illuminating, inspiring, and utterly unforgettable, Musicophilia is Oliver Sacks' latest masterpiece.

The Washington Post - Peter D. Kramer

What makes Musicophilia cohere is Sacks himself. He is the book's moral argument. Curious, cultured, caring, in his person Sacks justifies the medical profession and, one is tempted to say, the human race. Nothing is alien to him. If he has been saved by music, he also has been briefly afflicted by amusia, an inability to hear music as music, rather than "toneless banging." In his daily consciousness, Sacks embraces music at an extraordinary level. He writes in passing, "I have lately been enjoying mental replays of Beethoven's Third and Fourth Piano Concertos, as recorded by Leon Fleisher in the 1960s. These 'replays' tend to last ten or fifteen minutes and to consist of entire movements." Sacks is, in short, the ideal exponent of the view that responsiveness to music is intrinsic to our makeup. He is also the ideal guide to the territory he covers. Musicophilia allows readers to join Sacks where he is most alive, amid melodies and with his patients.

The New York Times - Michiko Kakutani

Dr. Sacks writes not just as a doctor and a scientist but also as a humanist with a philosophical and literary bent, and he's able in these pages to convey both the fathomless mysteries of the human brain and the equally profound mysteries of music…

The New York Times Book Review - Anthony Gottlieb

Freud, despite being both Viennese and a medical man, said he was almost incapable of obtaining any pleasure from music: "Some rationalistic, or perhaps analytic, turn of mind in me rebels against being moved by a thing without knowing why I am thus affected and what it is that affects me." In the end, Sacks's catalog of oddities sheds little systematic light on the mystery of music. He cannot be blamed for this—the science of music is still in its early days. Readers will probably be grateful that Sacks, unlike Freud, is happy to revel in phenomena that he cannot yet explain.

Publishers Weekly

Sacks is an unparalleled chronicler of modern medicine, and fans of his work will find much to enjoy when he turns his prodigious talent for observation to music and its relationship to the brain. The subtitle aptly frames the book as a series of medical case studies-some in-depth, some abruptly short. The tales themselves range from the relatively mundane (a song that gets stuck on a continuing loop in one's mind) through the uncommon (Tourette's or Parkinson's patients whose symptoms are calmed by particular kinds of music) to the outright startling (a man struck by lightning subsequently developed a newfound passion and talent for the concert piano). In this latest collection, Sacks introduces new and fascinating characters, while also touching on the role of music in some of his classic cases (the man who mistook his wife for a hat makes a brief appearance). Though at times the narrative meanders, drawing connections through juxtaposition while leaving broader theories to be inferred by the reader, the result is greater than the sum of its parts. This book leaves one a little more attuned to the remarkable complexity of human beings, and a bit more conscious of the role of music in our lives. (Oct.)

Kirkus Reviews

The gentle doctor turns his pen to another set of mental anomalies that can be viewed as either affliction or gift. If we could prescribe what our physicians would be like, a good number of us would probably choose somebody like Sacks (Uncle Tungsten: Memories of a Chemical Boyhood, 2001, etc.). Learned, endlessly inquisitive and seemingly possessed of a bottomless store of human compassion, the neurologist's authorial personality both reassures and arouses curiosity. Here, Sacks tackles the whole spectrum of the human body's experience of music by studying it from the aesthetic as well as medical viewpoint. Fantastical case studies include a young boy assaulted by musical hallucinations who would shout "Take it out of my head! Take it away!" when music only he could hear became unbearably loud. Less frightening are stories about people like Martin, a severely disabled man who committed some 2,000 operas to memory, or ruminations on the linkage between perfect pitch and language: Young children learning music are vastly more likely to have perfect pitch if they speak Mandarin than almost any other language. A gadfly and storyteller as well as a scientist, the author can't resist a good yarn even when it's not likely to be true, such as the anecdote about Shostakovich claiming that he heard beautiful new melodies every time he tilted his head to one side, due to a piece of German shrapnel lodged in his brain. Sacks is as good a guide to this mysterious and barely understood world as one could ask for, mixing serious case studies with personal takes on music and what its ultimate uses could possibly be. As the book wears on, however, his loose approach makes some later chapters more workthan they should be. Pleasantly rollicking, but with a definite hint that the grand old man is taking it easy. First printing of 100,000

Product Details

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• Reading Group Guide
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Table of Contents

Reading Group Guide

1. In the preface Sacks presents differing views on the origins and evolution of the music instinct [p. x]. On first reading, which explanation is the most persuasive? Did the book change or confirm your opinion?

2. Discuss the style and structure of Musicophilia. How does Sacks blend personal anecdotes, case histories, theories, and empirical research into an engaging narrative? How does he bring out the humanity of the patients he describes? What do the explanations of complex brain functions add to the portraits of each individual?

3. Tony Cicoria “grew to think [that he] . . . had been transformed and given a special gift, a mission, to 'tune in' to the music that he called, half metaphorically, 'the music from heaven'”[p. 7]. Is art by its very nature a “spiritual” endeavor? Does Sacks's conclusion that “even the most exalted states of mind, the most astounding transformations, must have some physical basis or at least some physiological correlate in neural activity” [p. 12] belittle the value of artistic expression?

4. In chapter four (Music on the Brain: Imagery and Imagination) and chapter five (Brainworms, Sticky Music, and Catchy Tunes), Sacks explores normal musical imagery, which almost everyone experiences, and the pathological version, when “music repeats itself incessantly, sometimes maddeningly, for days on end” [p. 44]. Do his explanations of the psychological and neurological components of these phenomena support his suggestion that people are more susceptible to brainworms today because of the pervasiveness of music in our lives [p. 53]? Does Anthony Storr's theory that even unwanted music has apositive effect [p. 42] mitigate Sacks's darker outlook?

5. The stories of musical hallucinations demonstrate the disruptive power of music [pp. 54-92]. Using these stories as a starting point, discuss the distinction between the “brain” and the “mind.” What accounts for the different ways people react to involuntary mental intrusions? What do the various coping mechanisms people employ reveal about biological determination and the exercise of choice and free will?

6. “Musicality comprises a great range of skills and receptivities, from the most elementary perceptions of pitch and tempo to the highest aspects of musical intelligence and sensibility…” [p. 104]. What do Sacks's descriptions of extreme conditions like amusia and disharmonia show about the many factors—neurological, cultural, and experiential—that shape an individual's response to music?

7. Sacks also introduces people who represent the “highest aspects of musical intelligence and sensibility.” What insights do these examples of extraordinary or unusual gifts offer into average musical sensibilities? What do his examinations of absolute pitch and synesthesia, as well as his stories about musical savants and the high level of musicality among blind people, reveal about the brain's innate strengths and weaknesses?

8. The story of Clive Wearing is one of the most memorable tales in Musicophilia. While it illustrates the persistence of musical memory with clarity and precision, it is much more than a well-written “case history.” How does Sacks capture the emotional impact of Wearing's devastating amnesia without descending into melodrama or sentimentality? What details help create a sense of Wearing as a distinct and sympathetic individual? What is the significance of Deborah's description of Clive's “at-homeness in music” and their continuing love for one another [p. 228]?

9. Music therapy is used to treat conditions ranging from Parkinson's and other movement disorders to Alzheimer's and other forms of dementia. In what ways does music therapy represent the perfect intersection of scientific knowledge and deep-seated personality traits like intuition, creativity, and compassion?

10. The relationship between music and universal human activities is a central theme in Musicophilia. Sacks writes, for instance, “The embedding of words, skills, or sequences in melody and meter is uniquely human. The usefulness of such an ability to recall large amounts of information, particularly in preliterate culture, is surely one reason why musical abilities have flourished in our species” [p. 260]. Drawing on the stories and studies presented in Musicophilia and on your own experiences, discuss the roles music plays in human society. Talk about its importance in creating a sense of community, evoking spiritual or religious feelings, and stimulating sexual desire, for example.

11. In a review for The New York Review of Books [March 6, 2008] Colin McGinn noted “Sacks generally confines himself to classical music, saying little specifically about jazz and rock music.” How do the emotional, psychological, and physical reactions to popular music differ from those elicited by classical music? Do you think a familiarity with or preference for certain kinds of music might influence a reader's reaction to Musicophilia?

12. What does Musicophilia show about science's ability to resolve intriguing quirks and mysteries? What do the new technology Sacks describes portend for future discoveries about how the brain works?

13. Does Musicophilia offer a new way of understanding what makes us human? Which facts, theories, or speculations did you find particularly compelling?

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