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This book by Oliver Sacks (a noted neurologist) outlines several cases he saw where damage to the brain led to 'losses' or 'excesses'. An extremely good read, especially considering that until medical imaging (MRI, PET) became possible the brain could only really be studied by seeing what happened when it was damaged. In the book (which is a collection of case studies) he touches on proprioception, autism and Tourette's syndrome amongst others.

The Man Who Mistook His Wife for a Hat by Oliver Sacks. Summit Books, Simon & Schuster, Inc., 1985. ISBN 0-671-55471-9.

Highly recommended.

A good, weird, non-fiction book about neurology. This is Oliver Sacks' best known work, and for good reason.

The title describes an actual case. A man came to consult with Dr. Sacks because he seemed to be confusing people and objects. The man did not feel that it was a problem, but his friends and wife had convinced him otherwise. It turned out that while his vision was fine he had damage to his right hemisphere that prevented him from processing this information correctly. He had no problems with abstract forms, and could describe objects in great detail, but couldn't make the connection of the description with the function of an item with anything more than vague approximations. He could not distinguish his foot from a shoe, or his wife's head from his hat.

This is only one of many cases found in the book, many of them odder. It's worth reading just so you can hear about The Weirdness That Is Humanity. But even better, many of the losses and gains of his patients are things we have, but are not aware of. Knowledge we don't develop, and senses we don't realize we have. You may hear a lot about this book in philosophy classes, as it points out the holes in our knowledge of epistemology and questions our brain's ability to form an objective view of reality.

There are cases of people losing all sight, being completely blind, failing to even recognize the meaning of the words 'seeing' and 'light' -- and not realizing that they had lost any capacity. A part of the world lost, with no feeling of loss. People who failed to recognize that a limb was connected to their body -- despite the fact that they had had their leg since they were a baby, and it was firmly attached to their body. It was simply undeniable to them that this limb was an alien object. There are also cases of savants, people with odd types of memory loss, and who have visions, and many other quirks.

This book isn't particularly technical, although it is sometimes rather dry. The author sometime goes off into philosophical rambling on 'what it means to be human' or some such. But it is well worth reading, and not boring once you actually get into it. It's also sliced into bite-sized pieces, so if you decide you don't like the first couple of cases, you can just quit. You have nothing to lose. Your local library has a copy -- give it a try. Neurology is more interesting than you think.

The Man Who Mistook his Wife for a Hat was written by Oliver Sacks, a neurologist noted for his work with Alzheimer's disease, schizophrenia, retardation and autism. He has written eight other books, the best known of which is Awakenings which was adapted into a movie starring Robin Williams.

Dr. Sacks divides the book into several vignettes about different patients he treated in his years at the Albert Einstein College of Medicine. The patient who he refers to as Dr. P, an accomplished musician and teacher, had a serious neurological disorder. It started out looking like Alzheimer's as he became unable to recognize the faces of his students. As the disease progressed, he sometimes mistook fire hydrants and parking meters for people and stopped to talk with them. When Dr. Sacks examined Dr. P for the first time, he found his reflexes slightly abnormal on the left side. After scratching the sole of his left foot to test his reflexes, he instructed Dr. P to put his shoe back on. He couldn't do it, because he could recognize neither his foot nor his shoe. When the examination was over, Dr. P reached over to put his hat on, but instead of a hat, he tried to lift off his wife's head.

Dr. Sacks visited Dr. P at home to see how he functioned in a familiar environment. Dr. P could identify shapes and cartoons, but he couldn't recognize people on television or photographs of family. Dr. Sacks took a rose out of his lapel and asked Dr. P to identify it. He could not name it, but he was able to describe its dimensions, shape and color. However, when he smelled it, he immediately knew it was a rose. From this, Dr. Sacks determined that the problem was in his parietal and occipital lobes where visual processing occurs. He had become completely unable to visualize, even internally. When asked to close his eyes and describe a familiar market square, he correctly described everything on the right side, but nothing on the left. When asked about Anna Karenina, he could recount plots, but omitted any mention of visual characteristics.

Dr. P functioned on a daily basis by using his musical talents. He sang to himself to keep his focus. He sang eating songs, dressing songs and bathing songs, but if he was interrupted he just stopped. He didn't know his clothes or his own body.

At the time, Dr. Sacks thought his patient had a tumor or degenerative process in the visual parts of his brain. At the time of his writing he was not aware of the studies on visual agnosia, which comes from the Greek word meaning "lack of knowledge". It describes the inability to recognize objects using a given sense, in Dr. P's case, his sight. Patients with object agnosia usually have sustained damage to their occipital lobe or inferotemporal cortex, located at the back of the cerebral hemisphere where you receive and process visual information. Damage here can blind a person even though the eyes may be perfectly healthy.

Dr. Sacks' final recommendation to Dr. P was to continue making music and live his life as normally as he could. Dr. P continued to teach at a university and played music (and did a lot of singing) until his death.

Dr. Sacks describes many other unusual instances of neurological disorders in his book, which, without his study in the field, might have been incorrectly categorized as schizophrenia or Alzheimer's.

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