Dr. Oliver Sacks

[October 17th, 2007]

Dr. Oliver Sacks is a rare bird in the world of medicine: Not only is he one of the country’s top neurologists, but the British-born doctor also has a knack for weaving his clinical profiles of exceptional patients into lovely, thoughtful books—the most well known being 1985’s The Man Who Mistook His Wife for a Hat and its 1995 follow-up, An Anthropologist on Mars —that open up the complex workings of our noggins to the peering eyes of layfolk. Others may recognize his name in conjunction with the 1990 Oscar-winning film based on his book Awakenings . Sacks’ latest book, Musicophilia: Tales of Music and the Brain , which he’ll talk about this Thursday during his appearance in Portland as part of the Linus Pauling Memorial Lecture Series, tackles our intimate mental connection to all things musical. It dallies in the minds of inspired amnesiacs and melodious Alzheimer’s patients in an effort to explain just what it is about music that can move us so profoundly.

WW: The New York Times called you the “poet laureate of medicine.” Do you consider your books science or literature?
Oliver Sacks: For me, an interest in science is inseparable from an interest in the lives of scientists, the lives of ideas and in storytelling. In medicine, of course, narratives are essential: The patient tells you what’s going on, and you try to match this with stories heard from other patients. I love to give personal accounts, to try and enter people’s experiences and describe them. I don’t think there should be a space between literature and the sciences. I think that the sciences should be literate, and that their function is not only exposition, but storytelling. Certainly for myself, science has to be combined with stories—but also stories have to be combined with science. Although I may tell a story of someone who has musical hallucinations, or cannot tell one tune from another, I also want to know what goes on in their brain, and why this is the case. In a way, these are somewhat like detective stories.

You often write about aphasics, people who can no longer speak, but who can still sing. What’s the difference?
A great deal of the brain is involved in the perception and memory of music, much more than is involved with language; as people lose language and become aphasic, they’re often able to respond to music and to sing, sometimes even to sing lyrics, to retain language if it’s embedded in a song. The brain’s ability to hold musical patterns is almost indestructible. It’s amazing to see someone with Alzheimer’s disease, how music can still be there.

Is all music the same in this regard?
I think the music [that] calls to one, the music [that] has interested one, especially the music [that] one has been exposed to in one’s young years, tends to be the mostly strongly embedded in the brain. If one gets musical hallucinations—which hopefully, one won’t, although they’re rather common—these always tend to be of music [that] was acquired fairly early in life.

Does music present an evolutionary advantage for us?
People have different opinions there. Darwin was very interested in music and thought that music preceded speech, that it was part of courtship and wooing. Other people, like [cognitive scientist] Steven Pinker, feel that music is incidental. He speaks of it as “musical cheesecake,” as if it’s a luxury, or trivial. But it’s striking that music is central in every culture known to us, that we find musical instruments going back to 50000 B.C. You find dance, you find song, the religious use of music, the martial use of music, the social use of music, and bonding with music in every culture. To claim an independent evolutionary origin from music, you’d have to look for some aspect of music which isn’t present in speech. Rhythm, and the particular fact that we respond to rhythm by keeping time, stands out. One cannot not respond to music: Even if you don’t make any external movement, the motor parts of the brain respond to rhythm. This appears spontaneously in every child, but you cannot train a chimpanzee or a bird to keep synchronized time to a rhythm. This is a specifically human attribute which doesn’t have an analogue in speech. So, one would suspect that the synchronization with rhythm has evolved independently in human beings, and it’s been preserved because it’s a reliable evolutionary advantage. For example, bonding, doing things together, and synchronizing social groups. One can only hypothesize, but the rhythmic power of music might be a point at which to start. But of course, we have skeletons, but we don’t know what was going on with society and music half a million years ago.

Are there people with no interest in music?
There are people who don’t recognize musical patterns, can’t clearly tell when one note is higher than another, or can’t recognize any tune. This is fairly rare. Other people can recognize music perfectly well, but it doesn’t get them emotionally.... I have one patient, a very nice, intelligent woman from the Bronx, who has a strange congenital amusia. Even when she was a child—she came from a rather musical family—she just could not distinguish one tune from another. She says she used to be wistful; she would see other people greatly affected by music, but for her it was unintelligible, sometimes excruciating. For her, what people call music was like hearing pots and pans thrown around in the kitchen.

Whoa, are her other senses more developed?
Yeah! Interestingly, this doesn’t affect her perception or appreciation of language. She likes going to the theater, she likes poetry, she likes visual art, and she spent a lifetime trying to enjoy music. When her boyfriends, and then her husband, would take her to concerts, she would dutifully obey. Finally, she read an article which described this condition, and she got investigative. She was told that this was actually a neurological condition, and that if her husband asked her to come to a concert, she should say, “You go, but I’m going to go to a film instead.” She only wishes she’d been given this advice when she was 7, and not 70.

Speaking of music getting us emotionally, why do minor and major chords affect us differently?
Well, it certainly seems to us that things in a minor key are rather sad—the slow movements in Mozart symphonies are most often in a minor key—but this is not always the case. If you go back seven or eight centuries, sometimes you find major keys used for sadness and minor keys for exuberance. So it’s probably a cultural thing. Some things are built-in biologically, though: the perception of octaves, things like that. Sometimes when we listen to music from another culture—Hindu music or Chinese music—we may not know how to respond, emotionally.

I heard growing up that kids who took music lessons ended up being better at mathematics. Is there any truth to that?
Oh, I don’t know, the so-called “Mozart effect” or whatever? Certainly, intensive musical training develops various parts of the brain to deal with music, and there’s probably some bonus effect on other skills.

So it has nothing to do with the underlying structure of music?
No, it doesn’t, and simply listening to music doesn’t do this. I mean, one is speaking of fairly intensive lessons or training...but then again, there are lots of great musicians who are absolute dunces mathematically, and vice-versa. There’s no guarantee here.

What kind of music are you listening to these days?
Well, it sort of depends on my mood. I sometimes like rather rousing music when I wake up, to get me up, and there’s music [that] calms, and music [that] consoles...but since you ask, I happen to have some Brahms concertos here, which for some reason I always seem to be listening to. I don’t use an iPod.

You don’t?
No, I’m actually a little frightened of iPods because I think that not only can you be given music all the while, but you can use it to ward yourself off from your environment. You can have it too loud, I think it can make you functionally deaf. I don’t know how it is in Portland, but New York is full of people who are either on cell phone or iPods—they walk in front of cars, they’re like zombies.

Do you think it’s music or the device that turns them into zombies?
Well, perhaps they go together. There’s the self-contained machine, the cell-phone syndrome, but if music at great intensity is being piped into your head all the while...I think it can be wonderful in a way, but slightly dangerous.