July 16, 2009


I left college brimming with evolutionary biology and philosophy and thought I was headed toward psychiatry. Then I read The Man Who Mistook His Wife For A Hat. In that book Dr. Sacks explores the more interesting and outer reaches of neurology through a series of vignettes. In The Anthropologist on Mars his powers are most on display as he describes seven cases in greater detail.

For Musicophilia he took a different approach. There are still the brief case histories, but they are woven into music-themed chapters. Instead of cases standing alone, they are used to illustrate different music-related neurologic disorders. The story about the amnestic musician, first printed in the New Yorker, is an exception: his story is more developed and better reading. In some ways the organization of the book seemed to make sense, but sometimes the links were tenuous, the concatenation of music-related neurology derailing into anecdote. In the two books I mentioned above, the cases stood alone, but here the organizing principle, music, makes the cases seem haphazard, an atonal symphony.

In popularizing neurology, Sacks has succeeded. His contribution to the field largely stops there. His brand of descriptive neurology, at its most developed in Awakenings, has given way to a more scientifically rigorous discipline. There is still room for phenomenology in neurology, but new insights and effective treatments are achieved in the laboratory and in clinical trials. However, in medicine hard science will always have to give way to the individual and more broadly, the social context of disease. Sacks excels in recognizing the individual; he looks beyond the neurologic disease. For this reason, there will always be a place for him in neurology.

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