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ALPHABETICAL BRAIN™ VOCABULARY
HUMANIST GALAXY
OF SECULAR SCIENCE STARS
OLIVER SACKS
May 18, 2021
MUSICOPHILIA:
Tales of Music and the Brain
by Oliver Sacks
Vintage Books, 2008 (425 pages)
www.oliversacks.com
BOOK OUTLINE
note = Numbers in parentheses refer to pages
Quote = "Our auditory systems, our nervous systems, are indeed exquisitely tuned for music. How much this is due to the intrinsic characteristics of music itself — its complex sonic patterns woven in time, its logic, its momentum, its unbreakable sequences, its insistent rhythms and repetitions, the mysterious way in which it embodies emotion and “willpower” — and how much to special resonances, synchronizations, oscillations, mutual excitations, or feedbacks in the immensely complex, multi-level neural circuitry that underlies musical perception and replay, we do not yet know. But this "wonderful machinery" — perhaps because it is so complex and highly developed — is vulnerable to various distortions, excesses, and breakdowns." (From Preface, xii)
PREFACE (ix-xiv)
"We humans are a musical species no less than a linguistic one. This takes many different forms. All of us (with very few exceptions) can perceive music, perceive tones, timbre, pitch intervals, melodic contours, harmony, and (perhaps most elementally) rhythm. We integrate all of these and ”construct” music in our minds using many different parts of the brain. And to this largely unconscious structural appreciation of music is added an often intense and profound emotional reaction to music." (xi)
"'The inexpressible depth of music,' Schopenhauer wrote, 'so easy to understand and yet so inexplicable, is due to the fact that it reproduces all the emotions of our innermost being but entirely without reality and remote from its pain'... Music expresses only the quintessence of life and of its events, never these themselves." (xi)
"Listening to music is not just auditory and emotional, it is motoric as well: 'We listen to music with our muscles,' as Nietzsche Wrote. We keep time to music, involuntarily, even if we are not consciously attending to it, and our faces and postures mirror the narrative of the melody, and the thoughts and feelings it provokes." (xi)
"Much that occurs during the perception of music can also occur when music is “played in the mind.” The imagining of music, even in relatively nonmusical people, tends to be remarkably faithful not only to the tune and feeling of the original but to 1:5 pitch and tempo. Underlying this is the extraordinary tenacity of musical memory, so that much of what is heard during one’s early years may be “engraved” on the brain for the rest of one’s life. Our auditory systems, our nervous systems, are indeed exquisitely tuned for music.
"How much this is due to the intrinsic characteristics of music itself --- its complex sonic patterns woven in time, its logic, its momentum, its unbreakable sequences, its insistent rhythms and repetitions, the mysterious way in which it embodies emotion and 'willpower' — and how much to special resonances, synchronizations, oscillations, mutual excitations, or feedbacks in the immensely complex, multi-level neural circuitry that underlies musical perception and replay, we do not yet know. But this “wonderful machinery” — perhaps because it is so complex and highly developed — is vulnerable to various distortions, excesses, and breakdowns. The power to perceive (or imagine music) may be impaired with some brain lesions; there are many such forms of 'amusia' [the inability to recognize musical tones or to reproduce them; or tone deafness]. (xi-xii)
"On the other hand, musical imagery may become excessive and uncontrollable, leading to incessant repetition of catchy tunes, or even musical hallucinations. In some people, music can provoke seizures. And there are even special neurological hazards, “disorders of skill,” that may affect professional musicians."
"The normal association of intellectual and emotional may break down in some circumstances, so that one may perceive music accurately, but remain indifferent and unmoved by it or, conversely, be passionately moved, despite being unable to make any “sense” of what one is hearing. Some people — a surprisingly large numbers — “see” color or “taste” or “smell” or “feel” various sensations as they listen to music — though such synesthesia may be accounted a gift more than a symptom. William James referred to our “susceptibility to music,” and while music can affect all of us — calm us, animate us, comfort us, thrill us, or serve to organize and synchronize us at work or play — it may be especially powerful and have great therapeutic potential for patients with a variety of neurological conditions."
"Such people may respond powerfully and specifically to music (and, sometimes, to little else], Some of these patients have widespread cortical problems, whether from strokes or Alzheimer’s or other causes of dementia; others have specific cortical syndromes — loss of language or movement functions, amnesias, or =xii-xiii= Frontal-lobe syndromes. Some are retarded, some autistic; others have subcortical syndromes such as parkinsonism or other movement disorders. All of these conditions and many others can potentially respond to music and music therapy."
"For me, the first incitement to think and write about music came in 1966, when I saw the profound effects of music on deeply parkinsonian patients I later wrote about in the book, Awakenings. And since then, in more ways than I could possibly imagine, I have found music continually forcing itself on my attention, showing me its effects on almost every aspect of brain function --- and life."
"Music has always been one of the first things I look up in the index of any new neurology or physiology textbook. But I could find scarcely any mention of the subject until the 1977 publication of Macdonald Critchley and R. A. Henson's book Music and the Brain, with its wealth of historical and clinical examples."
"Perhaps one reason for the scarcity of musical case histories is that physicians rarely ask their patients about mishaps of musical perception (whereas a linguistic problem, say, will immediately come to light). Another reason for this neglect is that neurologists like to explain, to find putative mechanisms, as well as to describe — and there was virtually no neuroscience of music prior to the 1980s."
This has all changed in the last two decades with new technologies that allow us to see the living brain as people listen to, imagine, and even compose music. There is now an enormous and rapidly growing body of work on the neural underpinnings of musical perception and imagery, and the complex and often bizarre disorders to which these are prone. These new insights of neuroscience are exciting beyond measure, but there is always a certain danger that the simple art of observation may be (xiii-)
PART 1 — HAUNTED BY MUSIC (1-86)
1) A BOLT FROM THE BLUE — Sudden Musicophilia (3-17)
2) A STRANGELY FAMILIAR PEELING — Musical Seizures (18-22)
3) FEAR OF MUSIC — Musicogenic Epilepsy (23-29)
4) MUSIC ON THE BRAIN — Imagery and Imagination (30-40)
5) BRAINWORMS, STICKY MUSIC, AND CATCHY TUNES (41-)
note = Carol King quote (41)
6) MUSICAL HALLUCINATIONS (49-86)
PART 2 — A RANGE OI MUSICALITY (87-183)
7) SENSE AND SENSIBILITY — A Range of Musicality (89-97)
8) THINGS FALL APART — Amusia and Dysharmonia (98-119)
9) PAPA BLOWS HIS NOSE IN G — Absolute Pitch (120-130)
10) PITCH IMPERFECT — Cochlear Amusia (131-142)
11) IN LIVING STEREO — Why We Have Two Ears (143-150)
12) TWO THOUSAND OPERAS — Musical Savants (151-159)
13) AN AUDITORY WORLD — Music and Blindness (160-164)
14) THE KEY OF CLEAR GREEN — Synesthesia and Music (165-183)
PART 3 — MEMORY, MOVEMENT AND MUSIC (185-275)
15) IN THE MOMENT — Music and Amnesia (187-213)
note = Quote by T. S. Elliot (187)
16) SPEECH AND SONG — Aphasia and Music Therapy (214-223)
17) ACCIDENTAL DAVENING — Dyskinesia and Cantillation (224-225)
18) COME TOGETHER — Music and Tourette’s Syndrome (226-232)
19) KEEPING TIME— Rhythm and Movement (233-247)
20) KINETIC MELODY — Parkinson’s Disease and Music Therapy (248-258)
21) PHANTOM FINGERS — The Case of the One-Armed Pianist (259-263)
22) ATHLETES OF THE SMALL MUSCLES — Musician’s Dystonia (264-275)
PART 4 — EMOTION, IDENTITY, AND MUSIC (277-347)
23) AWAKE AND ASLEEP — Musical Dreams (279-284)
24) SEDUCTION AND INDIFFERENCE (285-294)
25) LAMENTATIONS — Music and Depression (295-301)
26) THE CASE OF HARRY S. — Music and Emotion (302-304)
27) IRREPRESSIBLE — Music and the Temporal Lobes (305-316)
28) A HYPERMUSICAL SPECIES — Williams Syndrome (317-334)
29) MUSIC AND IDENTITY — Dementia and Music Therapy (335-347)
The emotional response to music, it would seem, is widespread and probably not only cortical but subcortical, so that even in a diffuse cortical disease like Alzheimer’s, music can still be perceived, enjoyed, and responded to. One does not need to have any formal knowledge music --- nor, indeed, to be particularly “musical” --- to enjoy music and to respond to it at the deepest levels. Music is part of being human, and there is no human culture in which it is not only developed and esteemed. Its very ubiquity may cause it to trivialized in daily life: we switch on a radio, switch it off, a tune, tap our feet, find the words of an old song going enough our minds, and think nothing of it. But to those who are t in dementia, the situation is different. Music is no luxury to them, but a necessity, and can have a power beyond anything else to restore them to themselves, and to others, at least for a awhile. (346-347)
ACKNOWLEDGMENTS (349-352)
BIBLIOGRAPHY (353-367)
INDEX (369-381)
AUTHOR NOTES, SUMMARY,
AND BOOK DESCRIPTION
AUTHOR NOTES = Oliver Sacks was born in London, England on July 9, 1933. He received a medical degree from Queen's College, Oxford University and performed his internship at Middlesex Hospital in London and Mount Zion Hospital in San Francisco. He completed his residency at UCLA. And he received the Hawthornden Prize, a Polk Award and a Guggenheim fellowship. In 1965, he became a clinical neurologist to the Little Sisters of the Poor and Beth Abraham Hospital. His work in a Bronx charity hospital led him to write the book Awakenings in 1973. The book inspired a play by Harold Pinter and became a film starring Robert De Niro and Robin Williams. His other works included An Anthropologist on Mars, The Mind's Eye, The Man Who Mistook His Wife for a Hat, Uncle Tungsten, Musicophilia, A Leg to Stand On, On the Move: A Life, and Gratitude.
In 2007, he ended his 42-year relationship with the Albert Einstein College of Medicine to accept an interdisciplinary teaching position at Columbia. In 2012, he returned to the New York University School of Medicine as a professor of neurology. He died of cancer on August 30, 2015 at the age of 82. -- Bowker Author Biography.
SUMMARY = Oliver Sacks explores the place music occupies in the brain and how it affects the human condition.
BOOK DESCRIPTION = With the same trademark compassion and erudition he brought to The Man Who Mistook His Wife for a Hat, Sacks explores the place music occupies in the brain and how it affects the human condition. In this book, he shows us a variety of what he calls "musical misalignments." Among them: a man struck by lightning who suddenly desires to become a pianist at the age of forty-two; an entire group of children with Williams syndrome, who are hyper-musical from birth; people with "amusia," to whom a symphony sounds like the clattering of pots and pans; and a man whose memory spans only seven seconds --- for everything but music. Sacks describes how music can animate people with Parkinson's disease who cannot otherwise move, give words to stroke patients who cannot otherwise speak, and calm and organize people who are deeply disoriented by Alzheimer's or schizophrenia.
EDITORIAL BOOK REVIEWS
PUBLISHER'S WEEKLY REVIEW = Sacks is an unparalleled chronicler of modern medicine, and fans of his work will find much to enjoy when he turns his prodigious talent for observation to music and its relationship to the brain. The subtitle aptly frames the book as a series of medical case studies-some in-depth, some abruptly short. The tales themselves range from the relatively mundane (a song that gets stuck on a continuing loop in one's mind) through the uncommon (Tourette's or Parkinson's patients whose symptoms are calmed by particular kinds of music) to the outright startling (a man struck by lightning subsequently developed a newfound passion and talent for the concert piano).
In this latest collection, Sacks introduces new and fascinating characters, while also touching on the role of music in some of his classic cases (the man who mistook his wife for a hat makes a brief appearance). Though at times the narrative meanders, drawing connections through juxtaposition while leaving broader theories to be inferred by the reader, the result is greater than the sum of its parts. This book leaves one a little more attuned to the remarkable complexity of human beings, and a bit more conscious of the role of music in our lives.
BOOKLIST REVIEW = Music seems to be meaningless, and our love of it inexplicable, but neurologist Sacks, one of the foremost physician-essayists of the day, charmingly argues that music is essential to being human in ways that have only begun to be understood. In many different circumstances, music may arise involuntarily within a person, as attested to by Sacks' initial presentation of cases of sudden intense affinity for music and development of musical skills, of so-called brain worms or tunes that automatically repeat within the mind, and of musical seizures and hallucinations. Despite the range of individual experience of music, from amusia, or incomprehension of melody and/or rhythm and/or harmony, to absolute ( perfect ) pitch to synesthesia (e.g., seeing the colors of tones), it seems from the clinical literature that anyone could have a sudden loss or gain in musicality. Indeed, the seeming universality of musical mental imaging, even in the utterly deaf, has encouraged the therapeutic use of music to treat an ever-increasing number of illnesses, including the results of severe brain damage, congenital retardative conditions, and such degenerative neuropathies as parkinsonism and Alzheimer's. Sacks' reporting on all of this makes for quite an omnium-gatherum on the main contention that, in essence, musicality is humanity. His customary erudition and fellow-feeling ensure that, no matter how clinical the discussion becomes, it remains, like the music of Mozart, accessible and congenial. – Ray Olson.
CHOICE REVIEW = Avid readers of Sacks's other work such as the books --- The Man Who Mistook His Wife for a Hat (1985) and Awakenings (1972) --- will be impressed by this treatment of the neurology of music. Those in the fields of psychology and physiology have written books about music's effect on the brain, but none of those works is as readable, and few are as insightful, as this one. Sacks (Columbia Univ. Medical Center) argues that human neurology is designed for music in the same way it is designed for language. Until quite recently, scientists learned about the normal human brain primarily by studying brains gone awry. Sacks acknowledges that technological innovations will reveal much about the brain, but he believes that case histories are equally legitimate sources of information. The case histories included here include a man who could remember nothing but music for more than seconds, a man struck by lightning who took up the piano, and a woman plagued by musical hallucinations. Sacks also includes general examinations of intriguing topics --- absolute pitch, synaesthesia, amusia, music "stuck" in one's head. But the book's best quality is Sacks's clear, probing, yet compassionate writing. He demonstrates how understanding human engagement with music can help one understand the meaning of being human. Summing Up: Essential. All readers, all levels. M. Neil Augustana College (IL)
LIBRARY JOURNAL REVIEW = Everyone's favorite neurologist considers how music affects us.
EXCERPT
A BOLT FROM THE BLUE --- SUDDEN MUSICOPHILIA
Tony Cicoria was forty-two, very fit and robust, a former college football player who had become a well-regarded orthopedic surgeon in a small city in upstate New York. He was at a lakeside pavilion for a family gathering one fall afternoon. It was pleasant and breezy, but he noticed a few storm clouds in the distance; it looked like rain. He went to a pay phone outside the pavilion to make a quick call to his mother (this was in 1994, before the age of cell phones). He still remembers every single second of what happened next: "I was talking to my mother on the phone. There was a little bit of rain, thunder in the distance. My mother hung up. The phone was a foot away from where I was standing when I got struck. I remember a flash of light coming out of the phone. It hit me in the face. Next thing I remember, I was flying backwards." Then — he seemed to hesitate before telling me this — "I was flying forwards. Bewildered. I looked around. I saw my own body on the ground. I said to myself, 'Oh shit, I'm dead.'
I saw people converging on the body. I saw a woman --- she had been standing waiting to use the phone right behind me --- position herself over my body, give it CPR... I floated up the stairs--my consciousness came with me. I saw my kids, had the realization that they would be okay. Then I was surrounded by a bluish-white light... an enormous feeling of well-being and peace. The highest and lowest points of my life raced by me. No emotion associated with these... pure thought, pure ecstasy. I had the perception of accelerating, being drawn up. .. there was speed and direction. Then, as I was saying to myself, 'This is the most glorious feeling I have ever had' --- SLAM! I was back." Dr. Cicoria knew he was back in his own body because he had pain — pain from the burns on his face and his left foot, where the electrical charge had entered and exited his body --- and, he realized, "only bodies have pain." He wanted to go back, he wanted to tell the woman to stop giving him CPR, to let him go; but it was too late — he was firmly back among the living.
After a minute or two, when he could speak, he said, "It's okay — I'm a doctor!" The woman (she turned out to be an intensive-care-unit nurse) replied, "A few minutes ago, you were not!" The police came and wanted to call an ambulance, but Cicoria refused, delirious. They took him home instead ("it seemed to take hours"), where he called his own doctor, a cardiologist. The cardiologist, when he saw him, thought Cicoria must have had a brief cardiac arrest, but could find nothing amiss with examination or EKG. "With these things, you're alive or dead," the cardiologist remarked. He did not feel that Dr.Cicoria would suffer any further consequences of this bizarre accident. Cicoria also consulted a neurologist — he was feeling sluggish (most unusual for him) and having some difficulties with his memory. He found himself forgetting the names of people he knew well. He was examined neurologically, had an EEG and an MRI. Again, nothing seemed amiss. A couple of weeks later, when his energy returned, Dr. Cicoria went back to work. There were still some lingering memory problems--he occasionally forgot the names of rare diseases or surgical procedures--but all his surgical skills were unimpaired. In another two weeks, his memory problems disappeared, and that, he thought, was the end of the matter. What then happened still fills Cicoria with amazement, even now, a dozen years later. Life had returned to normal, seemingly, when "suddenly, over two or three days, there was this insatiable desire to listen to piano music."
This was completely out of keeping with anything in his past. He had had a few piano lessons as a boy, he said, "but no real interest." He did not have a piano in his house. What music he did listen to tended to be rock music. With this sudden onset of craving for piano music, he began to buy recordings and became especially enamored of a Vladimir Ashkenazy recording of Chopin favorites--the Military Polonaise, the Winter Wind Étude, the Black Key Étude, the A-flat Polonaise, the B-flat Minor Scherzo. "I loved them all," Tony said. "I had the desire to play them. I ordered all the sheet music. At this point, one of our babysitters asked if she could store her piano in our house--so now, just when I craved one, a piano arrived, a nice little upright. It suited me fine. I could hardly read the music, could barely play, but I started to teach myself." It had been more than thirty years since the few piano lessons of his boyhood, and his fingers seemed stiff and awkward. And then, on the heels of this sudden desire for piano music, Cicoria started to hear music in his head. "The first time," he said, "it was in a dream. I was in a tux, onstage; I was playing something I had written. I woke up, startled, and the music was still in my head. I jumped out of bed, started trying to write down as much of it as I could remember. But I hardly knew how to notate what I heard." This was not too successful--he had never tried to write or notate music before.
But whenever he sat down at the piano to work on the Chopin, his own music "would come and take me over. It had a very powerful presence." I was not quite sure what to make of this peremptory music, which would intrude almost irresistibly and overwhelm him. Was he having musical hallucinations? No, Dr. Cicoria said, they were not hallucinations — "inspiration" was a more apt word. The music was there, deep inside him — or somewhere — and all he had to do was let it come to him. "It's like a frequency, a radio band. If I open myself up, it comes. I want to say, 'It comes from heaven,' as Mozart said." His music is ceaseless. "It never runs dry," he continued. "If anything, I have to turn it off." Now he had to wrestle not just with learning to play the Chopin, but to give form to the music continually running in his head, to try it out on the piano, to get it on manuscript paper. "It was a terrible struggle," he said. "I would get up at four in the morning and play till I went to work, and when I got home from work I was at the piano all evening. My wife was not really pleased. I was possessed." In the third month after being struck by lightning, then, Cicoria — once an easygoing, genial family man, almost indifferent to music — was inspired, even possessed, by music, and scarcely had time for anything else. It began to dawn on him that perhaps he had been "saved" for a special reason. "I came to think," he said, "that the only reason I had been allowed to survive was the music." I asked him whether he had been a religious man before the lightning. He had been raised Catholic, he said, but had never been particularly observant; he had some "unorthodox" beliefs, too, such as in reincarnation. He himself, he grew to think, had had a sort of reincarnation, had been transformed and given a special gift, a mission, to "tune in" to the music that he called, half metaphorically, "the music from heaven."
This came, often, in "an absolute torrent" of notes with no breaks, no rests, between them, and he would have to give it shape and form. (As he said this, I thought of Caedmon, the seventh-century Anglo-Saxon poet, an illiterate goatherd who, it was said, had received the "art of song" in a dream one night, and spent the rest of his life praising God and creation in hymns and poems.) Cicoria continued to work on his piano playing and his compositions. He got books on notation, and soon realized that he needed a music teacher. He would travel to concerts by his favorite performers but had nothing to do with musical friends in his own town or musical activities there. This was a solitary pursuit, between himself and his muse. I asked whether he had experienced other changes since the lightning strike --- a new appreciation of art, perhaps, different taste in reading, new beliefs? Cicoria said he had become "very spiritual" since his near-death experience. He had started to read every book he could find about near-death experiences and about lightning strikes. And he had got "a whole library on Tesla," as well as anything on the terrible and beautiful power of high-voltage electricity. He felt he could sometimes see "auras" of light or energy around people's bodies — he had never seen this before the lightning bolt. Some years passed, and Cicoria's new life, his inspiration, never deserted him for a moment. He continued to work full-time as a surgeon, but his heart and mind now centered on music. He got divorced in 2004, and the same year had a fearful motorcycle accident. He had no memory of this, but his Harley was struck by another vehicle, and he was found in a ditch, unconscious and badly injured, with broken bones, a ruptured spleen, a perforated lung, cardiac contusions, and, despite his helmet, head injuries. In spite of all this, he made a complete recovery and was back at work in two months. Neither the accident nor his head injury nor his divorce seemed to have made any difference to his passion for playing and composing music.
I have never met another person with a story like Tony Cicoria's, but I have occasionally had patients with a similar sudden onset of musical or artistic interests — including Salimah M., a research chemist. In her early forties, Salimah started to have brief periods, lasting a minute or less, in which she would get "a strange feeling" — sometimes a sense that she was on a beach that she had once known, while at the same time being perfectly conscious of her current surroundings and able to continue a conversation, or drive a car, or do whatever she had been doing. Occasionally these episodes were accompanied by a "sour taste" in the mouth. She noticed these strange occurrences, but did not think of them as having any neurological significance. It was only when she had a grand mal seizure in the summer of 2003 that she went to a neurologist and was given brain scans, which revealed a large tumor in her right temporal lobe. This had been the cause of her strange episodes, which were now realized to be temporal lobe seizures. The tumor, her doctors felt, was malignant (though it was probably an oligodendroglioma, of relatively low malignancy) and needed to be removed.
Salimah wondered if she had been given a death sentence and was fearful of the operation and its possible consequences; she and her husband had been told that there might be some "personality changes" following it. But in the event, the surgery went well, most of the tumor was removed, and after a period of convalescence, Salimah was able to return to her work as a chemist. She had been a fairly reserved woman before the surgery, who would occasionally be annoyed or preoccupied by small things like dust or untidiness; her husband said she was sometimes "obsessive" about jobs that needed to be done around the house. But now, after the surgery, Salimah seemed unperturbed by such domestic matters. She had become, in the idiosyncratic words of her husband (English was not their first language), "a happy cat." She was, he declared, "a joyologist."
Salimah's new cheerfulness was apparent at work. She had worked in the same laboratory for 15 years and had always been admired for her intelligence and dedication. But now, while losing none of this professional competence, she seemed a much warmer person, keenly sympathetic and interested in the lives and feelings of her co-workers. Where before, in a colleague's words, she had been "much more into herself," she now became the confidante and social center of the entire lab. At home, too, she shed some of her Marie Curie-like, work-oriented personality. She permitted herself time off from her thinking, her equations, and became more interested in going to movies or parties, living it up a bit. And a new love, a new passion, entered her life. She had been "vaguely musical," in her own words, as a girl, had played the piano a little, but music had never played any great part in her life. Now it was different. She longed to hear music, to go to concerts, to listen to classical music on the radio or on CDs. She could be moved to rapture or tears by music which had carried "no special feeling" for her before. She became "addicted" to her car radio, which she would listen to while driving to work. A colleague who happened to pass her on the road to the lab said that the music on her radio was "incredibly loud" --- he could hear it a quarter of a mile away. Salimah, in her convertible, was "entertaining the whole freeway."
Like Tony Cicoria, Salimah showed a drastic transformation from being only vaguely interested in music to being passionately excited by music and in continual need of it. And with both of them, there were other, more general changes, too --- a surge of emotionality, as if emotions of every sort were being stimulated or released. In Salimah's words, "What happened after the surgery --- I felt reborn. That changed my outlook on life and made me appreciate every minute of it!"
REMEMBER ALWAYS:
You Are Your Adaptable Memory!
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