Oliver Sacks Pp[1]

Oliver Sacks

The Man who Mistook his Wife for a Hat and The Disembodied Lady

by Suzanne Mc Mahon, Marianne Murphy, Megan McDonnell and Liam Murphy.

The Man who Mistook his Wife for a Hat

Introduction The perception of size and shapes of objects is

part of daily life for all of us.

 We need a good sense of perception to be able

to cross the road safely , pay for things in shops and even recognize our friends and family.

 Perception is recognizing key features in

objects and managing this information in our brain.....For example:

trouble recognizing what this is... •It’s height and width

•It’s curved contours •The size and style of the text on the label

drive recognize this road sign by: Its hexagonal shape

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Its infamous red and white colour

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And again the size and style of its text

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If you couldn’t perceive this as a sign to stop , you would be a danger to yourself and others...

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• Corporations rely on peoples perception to create recognizable brands and trade marks. •

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• Product designers bear peoples perceptions in mind when designing products and packaging. • They try and create a perceptual illusion that their product is

So far, I hope I have outlined the

importance of a good sense of perception in day to day life.

 For most of us, the part of our brains

which deals with perception works fine.

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For most of us, the ability to perceive

depths, shapes and size is taken for granted...

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Unfortunately… Dr. P had true problems with perception.  He was a skilled teacher, painter and

musician.

 His visual-agnosia affected him in everyday

situations such as dressing himself, working on his art and recognizing his wife and the students he taught. •

And so,Megan will now go on to explain in

greater detail his particular agnosia;

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Explanation

Agnosia

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Dr. P's suffered

mainly from prosopagnosia, also known as "face blindness". Although he was unable to recognise faces mainly, he also from a more general agnosia, confusing things like his own foot for his shoe.

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Memory Loss D r. P a lso se e m e d to sh o w sig n s o f d a m a g e in

th e le ft h e m isp h e re o f h is b ra in . H e w a s a ske d to w a lk d o w n a fa m ilia r stre e t fro m th e so u th e n tra n ce a n d ta ke n o te o f th e b u ild in g s h e sa w . W h e n q u e stio n e d , h e w a s a b le to re m e m b e r th e b u ild in g s o n h is rig h t b u t n o n e o n th e le ft. H e re p e a te d th is e xe rcise , b u t e n te re d th e stre e t fro m th e n o rth e rn e n tra n ce th is tim e , a n d stra n g e ly , D r. P co u ld re m e m b e r th e b u ild in g s o n th e rig h t h a n d sid e , w h ich h e h a d p re vio u sly " fo rg o tte n " . •

Aphasia As Dr. P was a musician and a teacher it

was very important to him to be able to understand the written language, especially in the case of music scores. However, Sacks states that the score for "Dichterliebe", Dr. P's favourite piece of music was kept in his living room, but he could no longer play it as he lost his ability to read music. •

Gnosis

Finally, Sacks mentions gnosis a lot when

speaking of Dr. P. It is defined as "the knowledge of spiritual matters" or a "mystical knowledge". Dr. P experiences an attitude change as his agnosia becomes more prominent. Sacks describes him as "computer-like", and states that he can no longer have "personal reactions" to everyday occurrences. Whether or not this constitutes being "mystical" or not is open to interpretation!

Speculation Dr. P didn't realise the extent to which

his visual capabilities had diminished. Dr. Sacks pondered whether it was sadder to have this condition and be aware of the loss, or not to realise there was anything gone at all...

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Blind? One could speculate that perhaps Dr. Ps visual

deficit led him to believe that others shared his strange visual perception, yet his was just a bit out of focus. In other words, did he believe he had a type of “short-sightedness” and just needed some sort of adjustment (like some people need glasses) to regain his faculties?   •

One could possibly presume this because

of Dr. P’s blatant lack of understanding that there was anything majorly wrong. Of course from the outside looking in there was something terribly amiss.

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Autism

Another speculation one could make, or even a

comparison, is Dr. P’s attitude to faces being similar (albeit much more extreme) to some forms of autism. One symptom of autism or Aspergers syndrome is the inability to recognise human emotion or expressions, particularly in the face (a kind of empathetic agnosia). One could be led to consider this possibility because although Dr. P’s eyes showed up healthy in the tests, his great downfall was relating what he saw to his brain properly; that is, a complete lack of existential perception in relation to

Conclusion In co n clu sio n , w e se e th a t so m e o n e w ith a

p e rce p tu a l d e ficie n cy , su ch a s visu a la g n o sia o r m o re sp e cifica lly p ro so p a g n o sia , vie w s th e w o rld d iffe re n tly th a n u s.

  N o - o n e , a n d n o th in g , w a s fa m ilia r to D r. P. H e live d h is life su rro u n d e d b y fa ce le ss p e o p le , u n a b le to d e cip h e r e ve n a sin g le exp re ssio n . •

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H e fa ile d to re co g n ise e ve n su ch a co m m o n o b je ct

a s a g lo ve . D r. P co n stru e d th e w o rld a s w o u ld a co m p u te r - id e n tifyin g ke y fe a tu re s b u t fa ilin g to se e th e re a lity a s a w h o le . 

His visual agnosiaaffected his visual memory and

imagination as well, particularly on the lefthand side, and he was even unable to dream pictorially.

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Dr. P got through daily tasks with the help of

music, which was at the core of his life. He made everything a song and was able to manage a task if it flowed well. This was said to be his “body-music.” For example: Dr. P would sing whilst dressing but if there was an interruption he would lose the thread, recognising neither his clothes nor his own body.

 Thus, Dr. Sacks advised Dr. P to make music his

It was thought that Dr. P suffered from either

a massive tumour or a degenerative process in the visual parts of his brain.

  Prosopagnosia can also be caused by a defect in a developing foetus. Though, owing to circumstances beyond Sacks’ control, he was unable to follow this case further and ascertain the actual disease pathology. •  Despite this , Dr . P taught music until the last days of his life . http://www.youtube.com/watch?v=vwCrxomPbtY •

The Disembodied Lady

Introduction

Christina was a 27 year old woman, with

an active and healthy life, two children and gallstones when Dr. Sacks met her. She was due to have her gallbladder removed when suddenly, 3 days before her operation, Christina had a vivid dream. In the dream she felt unsteady on her feet, was continuously dropping things was “swaying wildly”. A psychiatrist was called and put Christina’s dream down to nothing more than pre- operative anxiety.

The next day however, Christina’s dream became

reality. The psychiatrist was again called, but put Christina’s condition down to nothing more than “pre-operative hysteria”. Christina could not stand unless she looked directly at her feet. When she tried to feel herself her hands would overshoot wildly and miss; she could barely even sit up by herself. She told Dr. Sacks that she felt “weird – disembodied”. Dr Sacks was taken aback by this strange statement and decided to investigate further, despite the psychiatrist's diagnosis. •

Explanation Christina suffered from a lack of

Proprioception, the lack of a sense of oneself and the location of ones limbs.  This important sense works alongside balance

organs in the ear and a good sense of vision.

 When Proprioception is lost, one has to learn to

use these other senses to be able to move and speak.

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Physiological reasons:

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A spinal tap removed from Christina revealed:

 A sensory neuritis.  This is an inflammation of nerves fibres in the

brain.

 In the case of Christina, the nerve fibres which

affect proprioception became inflamed.

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Physiological reasons Sacks explains that this was a rare case as it

was a purely sensory neuritus.  It affected “the sensory roots of spinal and

cranial nerves throughout the neuraxis.”(Sacks,1985)  This was what caused Christinas loss of feeling

all over her body.

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Speculation As we know Christina was suffering from

proprioception, the loss of sense of oneself.

 It’s interesting to consider how this came about, not just physiologically speaking, but also mentally.  Although we know that the damage was caused by acute polyneuritis or sensory neuritis (the sensory roots of her spinal and cranial nerves were affected throughout the neuarxis) there was the confounding dream she had before her operation. •

Speculation She was put on a antibiotic for microbial

prophylaxis (to prevent her getting sick from microbes that could get into her system during the operation).

 Could this medicine have caused the bizarre dream that rendered her terrified? •

“She was swaying wildly, in her dream, very

unsteady on her feet, could hardly feel the ground beneath her, could hardly feel anything in her hands, found them flailing to and fro, kept dropping whatever she picked up”(Sacks, 1985).

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Speculation  It may be that, subconsciously, she was much

more afraid of the impending operation than she appeared and the stress could have manifested itself in this dream. •

But how did her body have this foresight? After all,

what she dreamed about is exactly what happened. Was there a different state of mind at work here? Did her body know there was severe damage done even though Christina herself was unaware of it? Was the dream trying to warn her?

Conclusion In conclusion, we see how the loss of a sense that

one typically doesn’t take into account can seriously alter a person’s way of life.

  Christina is one such person who fully realises the value of proprioception. Her loss of this sense making her feel alienated from her own body. •  This case shows us the importance of proprioception in our lives. Without it we would be blind to ourselves, unable to tell what our body is doing - not feeling it at all.  •

Conclusion Though Christina was able to get her life back,

she still felt that her “body is blind and deaf to itself… it has no sense of itself.”(Sacks,1985)

 Christina, after extensive rehabilitation

therapy, was able to again learn how to walk, eat, sit, etc…, though all this was achieved through constant vigilance.

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She lacked any natural posture, whether it was

of body, voice or face. All movements, tone of voice and facial expressions were artificial.

Conclusion Although Christina was the first person to be

diagnosed with proprioception, many cases were discovered soon after. These cases were caused by the overuse of Vitamin B6 (pyridoxine). •

 

Christina had no hope of recovery and was

destined to live her life seemingly ‘bodiless’, however these other cases may have improved if the use of Vitamin B6 was stopped.

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Any Questions