Summary
The book turns now from the quantitative topics of losses and excesses to a more qualitative side of neurological disorder. Transports—what the 19th-century neurologist Hughlings Jackson calls “reminiscence”—are the portals created by the brain that take us to vividly realized memories, dreams, and other worlds. Neurologists usually don’t see patients because of transports, in part because there is a sense that using neuroscience to account for brilliant visions and memories would cheapen their experience. Sacks argues on the contrary that medicine is not in the business of valuing or devaluing. Mystic dreams and otherworldly visions are no less spiritually or psychologically significant because they can be explained by science; there is no reason for magic not to coexist with science. Sacks borrows a phrase from Charles Sherrington (an English neurophysiologist), calling the brain an “enchanted loom,” which may “weave a magic carpet to transport us” (131).
The section’s first story “Reminiscence” follows two women who both begin to experience vivid, uncontrollable musical hallucinations. 88 years old, Mrs. O’C wakes from a dream about her childhood in Ireland and finds that the music she heard in the dream is still playing loud and clear in her ears, almost deafeningly loud. After visiting an otologist and a psychiatrist, she comes to Dr. Sacks for help. Mrs. O’C is overall in excellent health, and she isn’t taking any medication. Wondering if the music might have been caused by a stroke, Sacks orders EEG scans of her temporal lobes. The scans confirm that Mrs. O’C’s temporal lobes are having small seizures causing auditory hallucinations. After three months, the music gradually dies down. However, Mrs. O’C tells Dr. Sacks that she misses hearing the songs. Having come to the United States at a young age, Mrs. O’C has almost no conscious memories of her life in Ireland. Mrs. O’C says that “It was like being given back a forgotten bit of my childhood again. And some of the songs were really lovely” (134). When given the option, Mrs. O’C asks not to be put on anticonvulsants.
Mrs. O’M is a partially deaf woman in her eighties who comes to Dr. Sacks because of the music in her head. She also sometimes hears ringing, hissing, rumbling, and several voices talking at once in the distance. Mrs. O’M hears three different hymns: “Easter Parade,” “Glory, Glory, Hallelujah,” and “Good Night, Sweet Jesus.” These tunes had begun to play over four years ago, and they’d grown to be quite annoying. “It was like some crazy neighbour continually putting on the same record,” she tells Dr. Sacks (135). The songs come on loudly and suddenly, drowning out the voices of people around her. She reports that the music is most vivid when she wakes up in the morning, and that it’s least likely to occur when she is emotionally, intellectually, or visually occupied. Just as in the case of Mrs. O’C, EGG scans of Mrs. O’M’s temporal lobes registered “strikingly high voltage and excitability” (136). Her hallucinations go away as soon as Dr. Sacks puts Mrs. O’M on anticonvulsants. Unlike Mrs. O’C, she is nothing but glad to be rid of the music.
Although prevailing neurological studies on this topic hold that there is no reason or significance behind the experience of one particular hallucination over another, Sacks wonders if there might be more to it than that. Mrs. O’C.’s seizures turned out to be integral to her experience of her forgotten homeland, and Mrs. O’M recalls that before she began having hallucinations, she used to hum the songs that now deafen her. “This suggests,” Sacks writes, “that they were already unconsciously ‘selected’ -- a selection which was then seized on by a supervening organic pathology. Sacks shows Mrs. O’M a New York Times article about Dmitri Shostakovich, a Russian composer who is supposedly able to hear vivid music when he leans his head to the side. This is allegedly due to a metallic splinter in Shostakovich’s brain, which presses against his temporal lobe when he moves his head. Although the composer’s hallucinations have a use, Mrs. O’M says that her songs do not. She finds no emotional connection to them either; they are only tiresome. In the postscript, Sacks writes that we should think about reminiscence as the brain’s involuntary playing of the “score or script” that has been iconographically inscribed in our neural pathways. “This is the final form of the brain’s record, even though the preliminary form may be computational or programmatic. The final form of cerebral representation must be, or allow, ‘art’–the artful scenery and melody of experience and action” (148).
Analysis
Sacks maintains an even balance between the thoughtful, rational discourse of neuroscience and encroaching images of the fantastic, interdimensional, and even psychedelic. Re-establishing a dichotomy that was laid out in the first introduction, he writes that there are two “universes” of discourse, one physical and the other phenomenal. The former is the objective universe, and the latter is a universe of the immediate senses that make up subjective reality–an individual, ineffable experience of being alive. Sacks frequently employs the idea of separate “worlds” to describe his patients’ inner-experiences, as if to commune with their subjective realities would be akin to intergalactic space travel. He also uses the sci-fi-esque term “portals” to describe epileptic states. In sum, these images are meant to mark a transition from the first half of the book’s objective, physiologically based perspective on disorder, to a qualitative, phenomenological, fantastical perspective.
Mrs. O’C and Mrs. O’M represent two opposing perspectives on the value of reminiscent events. Mrs. O’C has no existing memories of living in Ireland, and no tangible connections to the country now. Her auditory hallucinations could have easily become a terrible, useless annoyance to her, as they did with Mrs. O’M. However, unlike Mrs. O’M, Mrs. O’C has made a conscious connection between these Irish jigs and her forgotten memories of home. In other words, the seizures in Mrs. O’C.’s temporal lobes have become portals into her memory, where otherwise they would simply be random, annoying bursts of music. Sacks tries to help Mrs. O’M see that with a more positive perspective, her hallucinations might come of use to her, but she refuses to acknowledge that the songs in her head -- all of them hymns -- have any meaningful connection to her. Both Mrs. O’C and Mrs. O’M are perfectly correct in their valuations, and Sacks is able to treat them both according to their needs. But by the end of the story, it is clear that Mrs. O’C gets something that Mrs. O’M does not: a sense of awe and gratitude for her brain, which has inexplicably given her a portal into her early childhood. By countering these two similar patients, the author demonstrates that the value of transports is itself a subjective choice, and most importantly, a matter of imagination.
