Literature Annotations


Sacks, Oliver
The Man Who Mistook His Wife for a Hat


Genre Collection (Case Studies) (233 pp.)
KeywordsArt of Medicine, Body Self-Image, Communication, Dementia, Disability, Doctor-Patient Relationship, Empathy, Human Worth, Institutionalization, Medical Testing, Memory, Mental Illness, Mental Retardation, Narrative as Method, Patient Experience, Prayer as Medicine
Summary

This is a collection of two dozen case studies, written for non-medical readers, of patients with right-brain disorders. The chapters are divided into four groups: "Losses," dealing with loss of memory, cognition, and proprioceptive sense; "Excesses," with tics and other cases of overabundance; "Transports," with seizures and various "dreamy states," and "The World of the Simple," concerning mental retardation. In every case, Sacks focuses on the interior or existential world of the patient as the foundation of diagnosis and treatment. Sacks argues that this approach is appropriate for the right hemisphere, which compared to the left is less dedicated to specific skills and more dedicated to a "neurology of identity."

Sacks openly proposes these studies as a corrective to the field of neurology, which has tended to focus on the left hemisphere and therefore, he argues, has wound up treating patients solely in terms of specific deficits, often to their detriment. In "the higher reaches of neurology," and in psychology, Sacks argues, disease and identity must be studied together, and thus he recommends that neurologists "restore the human subject at the centre" of the case study. Sacks warmly recommends music, story-telling, and prayer as therapies that work by ignoring physiological defects and speaking to the patient's spirit or soul.

Commentary

This book became immediately famous when it was published because, along with many physicians, lay readers found the individual case studies extraordinarily interesting. Partly it was the lure of the mentally exotic, which clearly attracts Sacks himself (and which has brought some criticism of his writing as exploitative). Then there was the appealing image of Sacks as a deeply empathetic physician who actively pondered the inner experience of his patients and chose treatments to benefit the whole person. Finally, there was the richness of Sacks's intellect, with his references to the history of neurology and to philosophy, psychology, and the arts, and his speculations about the relations between physiology and personal identity.

Sacks is not always easy to read, but the effort is worth it. These case studies are exercises in humane medicine and literary portrayal, and they make a persuasive and moving argument for the therapeutic value of incorporating "illness" (the patient's perspective) along with "disease" (the doctor's) in diagnosis and treatment. The Man Who Mistook His Wife for a Hat is a contemporary classic in the medical humanities, as memorable as its title and the tragic condition of the man who made that mistake.

PublisherSimon & Schuster: Summit Books
Edition1985
Place PublishedNew York
MiscellaneousSee annotations in this database of several individual case studies from this volume: The Autist Artist, The Man Who Mistook His Wife for a Hat, Rebecca, and Witty Ticcy Ray.
Annotated by Woodcock, John A.
Date of Entry 04/28/05
Last Revised 05/09/05