Neurologist and author OLIVER SACKS squeezes an introduction to neurology and details of a case study concerning a right-hemisphere syndrome in ‘The man who mistook his wife for a hat’, an essay published in the London Review of Books on 19 May 1983. The patient is Dr P., a personable and refined elderly musician and educator who routinely fails to recognise the faces of familiar individuals and mistakes inanimate objects, such as water hydrants, for faces. Initially attributing this to deteriorating eyesight, Dr P. eventually seeks neurological help from Sacks. The author candidly and humorously shares his utter bewilderment at his patient’s head-scratchingly bizarre set of symptoms: Dr P. cannot tell his foot and his shoe apart; asked to describe the cover photo of an issue of the National Geographic, he lists features of a landscape which bears no relation to the Sahara dunes depicted; on Sacks’s second visit to Dr P.’s home, the latter begins to extend a greeting hand to the grandfather clock in the living room rather than to the author; he is later unable to identify the emotions of actors in a pointedly dramatic scene of a film playing on television; nor is he able to recognise the faces of loved ones in the pictures lining the walls of his own apartment. Meanwhile, his vision remains mostly intact, his musical prowess undiminished, and his ability to recognise abstract shapes and ‘formal and schematic’ drawings as acute as ever. Perhaps most distressingly for everyone else involved, Dr P. appears completely oblivious to his own predicament. The inscrutability of the patient’s condition, Sacks explains, stems from the fact that it is linked to the right hemisphere of the brain. The right hemisphere lacks the clearly demarcated regions which make left-hemisphere-related diagnostic work a relatively straightforward matter. Indeed, classical neurology (inaugurated in 1861 by French physician PIERRE PAUL BROCA) largely neglected the right hemisphere, in part because the left’s computer-like nature — its main purview being ‘programmes and schematics’ — made it seem exceptionally ‘human’, and so more worthy of medical attention. The long-overdue exploration of right-hemisphere syndromes, says the author, will require a more narrative approach, one in which biographical details and sketches will play a central role — not a trivial challenge for a clinical profession, but a welcome one for a man of Sacks’s literary sensibility and erudition. His 1985 eponymous collection of essays contains an expanded version of this essay as well as a number of other cases approached in the very manner he proposes here.
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