The Joplin Globe, Joplin, MO

March 13, 2011

Linda Cannon, book review: Doctor’s latest book covers his own problems

By Linda Cannon
Globe Columnist

JOPLIN, Mo. — It’s been about 25 years since I read “The Man Who Mistook His Wife for a Hat,” by Oliver Sacks, and I’ve read everything he’s written since.

Most are probably familiar with him through the 1990 movie version of “Awakenings,” starring Robin Williams. As is often the case, I’ve read the book but haven’t seen the movie. I can wholeheartedly recommend any and all of Sacks’ books, though, including his latest, “The Mind’s Eye.”

This one is a lot more personal than his others, dealing as it largely does with the brain/eye connection. Not to give too much away, but Sacks has been dealing with his own visual problems since December 2005. He devotes 66 pages to his own experience in the sixth chapter, “Persistence of Vision: A Journal,” but the other six chapters are all about patients with neurological problems.

The first chapter centers on a woman in her 60s, a well-known pianist who suddenly found herself unable to read sheet music after a lifetime of playing. This “alexia” (inability to read) progressed over a few years to an inability to read words, name objects and recognize faces.

As time wore on, she became less and less able to recognize objects, even familiar ones in her own home. If anything was not in its expected place, it might as well have been entirely absent.

Her ability to recognize things on sight continued to diminish, but she could often immediately recognize objects once she touched them and had no reduction in her ability to recognize people by their voices. She developed amazing coping skills that helped her live a more or less normal life for several years, but at last report she was heavily reliant on her husband -- even in their own home.

The second chapter concerns a very determined (not to mention willful and stubborn) woman who suffered a major stroke and lost nearly all her language skills. She had always been very verbal, and her aphasia was a terrible blow to her and her family.

Over time, she learned to cope very well with the use of a word book. Her ability to understand others was still quite impaired, but a therapist had put together a “word book” with sections for objects, people, events, emotions, etc. with which she was able to convey basic information.

Music therapy was also helpful, because singing uses different pathways in the brain, and that allowed her (following a session of singing) some short periods of time in which she could speak in a singsong fashion.

Her greatest talent, however, turned out to be her ability to mime or gesture to convey her thoughts and feelings. While words literally failed her, she was able to communicate through gesture.

I wondered while reading about her aphasia if sign language might not be useful in such cases, given the difference in the neural pathways used by the visual language from the written, but Sacks was silent on the issue.

“A Man of Letters” concerns alexia, the inability to recognize the written word. In this case, the patient had a stroke (undiagnosed for a few days) and found that his newspaper seemed to be written in Cyrillic or Korean or other symbologies he was not familiar with.

After finally going to the hospital a few days later, it was confirmed that he had indeed had a stroke and had been rendered incapable of recognizing the written word.

The brain being such a peculiar organ, he turned out to have alexia sine agraphia -- the inability to recognize language but the ability to write it. So, he could write and his writing was normal and recognizable to others, but still looked like foreign symbols to him.

Space prohibits me from saying much else, but there are other chapters about “face blindness,” stereo vision and different ways people cope with blindness.

If any of this whets your appetite to find out more about the strange and wonderful thing that is the human brain, you can check out any of the six Sacks titles on the subject at the library, including this one in text or audiobook.