Neurologist Oliver Sacks Writes About Patients With Unusual Conditions

This is SCIENCE IN THE NEWS in VOA Special English. I'm Barbara Klein. And I'm Bob Doughty. This week, we tell about the doctor and writer Oliver Sacks. He has spent most of his adult life treating patients in New York City. He also teaches neurology and psychiatry at Colombia University.

But Doctor Sacks is most famous for his books about people with disorders of the brain and nervous system. The stories he writes explore the science of the brain and the way it works. But they also tell a very human story about the experiences of real people struggling to live with unusual conditions.

Imagine a person who has no memory of the past twenty years of his life and still thinks he is a young man. The patient suffers from Korsakov's syndrome, a brain disorder that leads to memory loss. He remains trapped in a distant past because his memory of recent activities only lasts a few minutes.

Or imagine a man who learns to control the repeated movements and shouts that are signs of Tourette's syndrome. His doctor gives him medicine to take during the week to control the disorder. But on the weekends, the man decides to enjoy the signs of Tourette's because they are a part of his identity and personality.

These are examples of stories about patients as described in Oliver Sacks' book, "The Man Who Mistook His Wife for a Hat." Published in nineteen eighty-five, the book became a huge success.

Doctor Sacks' earlier book, "Awakenings," told about his work with post-encephalitic patients at a hospital in New York City. Signs of this sickness include loss of speech and movement. In the nineteen sixties, Doctor Sacks gave the then-new drug L-Dopa to the patients. The drug gave them an explosive and sudden awakening to a temporary experience of active life.

When Oliver Sacks began treating patients, a traditional case history might be a detailed scientific description of a person's disorder. Doctor Sacks has expanded what he calls mechanical neurology to include the effects of the disorder on a patient's identity and personality.

In most cases, there is nothing Doctor Sacks can do to heal his patients. His aim is to help them find a way to live with and accept their conditions as well as is possible.

His stories describe a patient's disorders in detail. But more importantly, the stories express the patient's humanity as he or she struggles to survive in a world that has been changed by sickness.

Oliver Sacks was born in nineteen thirty-three in Britain to a family of doctors and scientists. His mother and father were doctors. His grandfather was an inventor. Doctor Sacks wrote a book, "Uncle Tungsten," about his uncle -- a scientist who made light bulbs with pieces of tungsten wire.

As a child, Oliver had a deep love of chemistry. His childhood heroes included the British chemist Humphry Davy and the French chemist Marie Curie. Oliver's questioning mind later led him to study medicine and neurology. Oliver Sacks moved to the United States in the early nineteen-sixties.

One expert who had a great influence on Doctor Sacks' work was the Soviet neuropsychologist Alexander Luria. Doctor Luria believed that the study of the brain and nervous system could not just be about facts and information. He urged neurologists to have a more "personalistic" method that included an understanding of the patient's self and identity. He also believed that patients could be taught to adapt, or get used to, their conditions as fully as possible even if they remained sick. Shortly before he died, Alexander Luria urged Oliver Sacks to combine scientific investigation with literary observation.

Oliver Sack's story "To See and Not See" gives a good example of his writing. This story is one of several in "An Anthropologist on Mars," a work published in nineteen ninety-five. It tells about Virgil, a fifty-year old man who had been blind since he was a child. Doctors believed that his blindness resulted from a genetic condition.

Virgil visits a doctor who believes he may not be permanently blind. The doctor successfully operates on one eye. But after the eye heals, Virgil has trouble seeing and understanding the light and images moving in front of him.

Doctor Sacks explains that people with eyesight have spent a lifetime learning how to see. So, they know how to judge distance and depth. He says they understand new experiences and sights based on similar, past experiences.

Virgil had an active, but partly damaged retina and optic nerve. Yet his brain did not know how to deal with the information coming from these areas of the eye.

As a blind man, Virgil had a rich life. He could enjoy great freedom because of his excellent sense of touch, hearing, and smell. But with sight, he was unable to understand the visual world around him.

Doctor Sacks explains that the brain's cortex in people like Virgil who become blind adapts to its new situation. By regaining sight, Virgil's nervous system had to undo its specialized adaptations.

Doctor Sacks also noted that such a big change made Virgil more fearful about his condition. The story Doctor Sacks tells is medically descriptive and informative. But it also remains personal and respectful of Virgil's special situation.

Doctor Sacks has written books on many subjects. In "Migraine", he explores severe head pain to further understand the way neurons in the brain operate.

In "The Island of the Colorblind," Doctor Sacks writes about a community living on an island in the Pacific Ocean. These islanders all suffer from colorblindness. They describe their world to Doctor Sacks in terms of lightness, darkness, and pattern.

In "Oaxaca Journal," Doctor Sacks explores his interest in pteridology, or the study of ferns. Ferns are some of the oldest plants on earth. They have not changed much over millions of years. In this book, he explores the ferns native to Oaxaca, Mexico and the cultural history of the area.

In his latest book, "Musicophilia," Oliver Sacks describes the effect music has on the brain by studying the experiences of many people with unusual conditions.

OLIVER SACKS:

" 'Musicophilia' means love of music. And this is a very general word. But I think this is almost universal among people. And the width of the title has really allowed me to embrace dozens and dozens of different musical experiences and sensations."

Music is an interesting subject for neurologists because many parts of the brain work together to listen to and make music. Music activates even more areas of the brain than language. And, music is very powerful. Even people with severe brain damage can still react to and even find healing in music.

For some people, music can actually change the structure of the brain. Researchers have found that an area of the brain called the corpus callosum is enlarged in professional musicians.

Another part of the brain is enlarged in musicians with absolute pitch. A person with absolute pitch can identify or recreate a musical note without the help of a musical instrument. Researchers also believe that the younger a musician begins training, the greater the changes in his or her brain.

One part of the book "Musicophilia" is about people with synesthesia.

OLIVER SACKS:

"The word 'synesthesia' has been around for a century, a little bit more. It was introduced in the eighteen nineties for people who would perhaps see colors when they heard music. Or in whom generally, one sensation would give rise to another sensation."

For example, one person Doctor Sacks writes about is a musician who experiences color with every musical note. The note G minor is a yellowish color, while D major is blue. Another person with synesthesia sees colors, shapes, and light when she listens to music.

Modern brain imaging has helped medical experts understand conditions like synesthesia. Brain images show that synesthetes have activity both in the area of the brain that sees and in another area that reacts to music.

OLIVER SACKS:

"I think of the book as sort of a treasury of stories and information which other people and in particular neuroscientists and others will be able to use and make sense of. But also, it's a fun book."

After the publication of "Musicophilia", Doctor Sacks received hundreds of messages from people with examples of the conditions he described.

A second version of the book includes information about their cases. Doctor Sacks has once again provided his readers with a rich exploration of the complex workings of the human mind.

This SCIENCE IN THE NEWS was written by Dana Demange, who was also our producer. I'm Barbara Klein. And I'm Bob Doughty. Listen again next week for more news about science, in Special English, on the Voice of America.