The limitations of neuroscience
Sacks introduces each section by explaining a different area in which science, often specifically neuroscience, falls short. In “Losses,” the author argues that while neurology is well-versed in left-hemisphere deficits, right-hemisphere deficits are still an uncharted territory. In “Excesses,” he argues that diseases of excess challenge the fundamental character of neurology. “Transports” and “The World of the Simple” both explore territories of the mind that the author says neurology usually neglects entirely. In most of his essays, Sacks casts himself as someone who has less to offer to his patients than one would ideally hope. In “Witty Ticcy Ray,” for example, Ray resents that he has to use Haldol to curb his Tourette’s, saying that the drug has dulled his creativity and vitality. Sacks, in this case, laments the fact that he has to play the role of an arbitrator of society’s expectations, rather than advocate for Ray in the most humanistic terms possible. The stories of Rebecca and Martin A. find Sacks struggling with how best to improve the lives of his patients when his clinical tests only highlight their inadequacies. The book overall is as much about Sacks exploring his own deficits as it is about him exploring the deficits of others.
The right hemisphere
The author continuously circles back to differences between the left and right hemispheres in order to discuss larger themes of judgment, subjectivity, and art. Sacks casts the right hemisphere as the underdog of the brain, writing that scientists have often considered it to be the more “primitive,” unrefined hemisphere that is less inclined to the uniquely human mental processes of written language and high-level schematic organization of sensory data. “The Man Who Mistook His Wife for a Hat,” “The Lost Mariner,” “The President’s Speech,” and “A Matter of Identity” all focus on patients who are experiencing some type of right-hemisphere deficit, whether it’s face-blindness, confabulatory delirium, or tonal agnosia. These conditions are meant to highlight the importance of the right hemisphere in forming coherent and consistent judgments about reality.
Art and Mental Health
The creation and interpretation of art is a common theme when Sacks talks about mental health. Dr. P., for example, has a series of paintings up in his apartment showing his artistic development from a realist painter to an abstractionist. Sacks wonders if this might have to do with the development of Dr. P’s face-blindness, but Mrs. P argues that it was simply a mark of his growth as an artist. The author’s apparent bias towards realism shows through in his later essays, when for example he praises Madeleine J. for creating realistic-looking sculptures, and José for reproducing photographs in a detailed, lifelike manner. Across the book, Sacks emphasizes the ability to create art as a sign of mental health. After all, the author himself is creating artistic renditions of his actual patients.
Subjectivity
The book wrestles with the subjectivity both of Sacks’ patients, who are often trapped in inner-realities that are impossible to understand, and of Sacks himself, who brings his own biases and beliefs to narratives about his patients. A great example of this is John and Michael, the autistic twins who Sacks finds to be grotesque and irritating know-it-alls. Integral to “The Twins” is Sacks’ pent-up jealousy of John and Michael’s inexplicable abilities in mental calculation, and how that envy drives him to understand them on a deeper level than others had ever thought to. As readers, we have to interpret Sacks’ own subjectivity as a narrator in order to understand why he presents his patients the way that he does.
Self-Actualization
Many of Sacks’ patients reach wellness after rewriting their circumstances and becoming self-actualized in their variously crippled mental states. José, a non-verbal autistic man who cannot read or write, finds his purpose through visual art and becomes the hospital’s resident artist. Madeleine J. similarly finds new purpose and vitality as a sculptor, after learning how to use her hands at the age of sixty. But the author also mourns the situations when self-actualization has become seemingly impossible. This is the case with Mr. Thompson, whose Korsakoff’s has made it impossible for him to find a centralized identity for himself. This is similarly the case in “Yes, Father-Sister” and “The Possessed,” which both describe women whose diseases have subsumed their personhood, leaving them either ambivalent towards or totally unaware of the potential of their own humanity.
Coping and Correcting
As neurological disorders are usually irreversible, Sacks’ stories usually describe how he helps his patients cope and correct for their diseases. “Eyes Right!” and “On the Level” are both about the quirky methods two of his subjects use to correct for involuntary behaviors, highlighting the fact that the best correction strategies come from the patients themselves. Similarly, in “Rebecca” and “A Walking Grove,” Martin A. and Rebecca both generate their own best coping strategies, and both are at odds with what the hospital expects that they need. Generally, the author promotes as much collaboration with patients as possible to adjust habits and behaviors, so that patients can retain as much agency as possible as they live with their conditions.
Music
Music is a significant point of emphasis throughout much of the book, often evoked as a sign of a patient’s vitality and harmony with the world. Dr. P.’s relationship with music remains evergreen through the onset and fallout of his neurological disorder, and Sacks remarks how he likes to hum and whistle as he moves about his apartment. Mrs. O’C., Martin A., and Ray among others have important relationships with music as well, which define crucial dimensions of their presence in reality. To Sacks, music is no ordinary pleasure: it is an unspoken language, a rhythm of existence, that organizes reality in a fundamental way.
