Book Review: Oliver Sacks’ “Musicophilia: Tales of Music and the Brain” – by Don Alhambra

musicNeurologist Oliver Sacks is well known for his ability to write about case histories in his own compelling lyrical style. Probably his most famous work is his 1989 book The Man Who Mistook His Wife for a Hat, a fascinating and seminal exploration of the weird world of neurology. Drawing on his clinical experience with neurological patients, Sacks’ vivid descriptions of his patients’ behaviour and the realities behind the mask of ‘brain damage’ that society places on these people are fascinating and strangely humbling. It’s the kind of book you come away from and think: wow, the brain really is awe-inspiring, and incredibly mysterious.

There is no shortage of either awe or mystery in his latest book, Musicophilia. Subtitled ‘Tales of Music and the Brain’, Sacks makes a concerted attempt to understand another great mystery of humanity: why in the world do we like music so much? The book is wide-ranging and deals in part with the stories of neurological patients familiar from The Man Who Mistook His Wife for a Hat. For example: the patient in the title role of that book, a keen musician with neurological stroke damage, could only live a seemingly normal life when accompanied by music. Sacks comes back to this theme continually, noting that for many patients seemingly lost in their own worlds, music can be a real way for them to communicate and get back some of what they have lost.

Sacks notes that music therapy in particular, though largely ignored in clinical rehabilitation programmes, can be of great help to those patients who do not respond to other treatments. For example, Parkinson’s patients who are ‘frozen’ and unable to initiate movements can be trained to use a rhythmic beat to help them to walk and therefore regain much of their lost freedom. Music therapy is also known to be effective with certain aphasic patients (i.e. those who have lost the power of speech).

Other chapters focus on such topics as musical hallucinations (see this thread on the Heathen Hub), which while initially interesting and exciting to experience can soon become frightening and irritating. I was struck by how suddenly these disorders can strike, which brings home just how fragile our poor brains are, and how complex they have to be to go wrong in such interesting ways! Sacks also investigates such seemingly prosaic topics as earworms, tunes that get stuck in the head; literal bolts from the blue, such as the man who became a keen musician after being struck by lightning, despite having little interest in music prior to this; and the fascinating and almost alien abilities of autistic musical savants.

Musicians are known to have different-sized brain structures to non-musicians, so is it the experience of playing music from childhood that leads to these changes due to the plasticity of the brain? Or is it that people born with brains specialised for music tend to grow up to become musicians? The answer, surprisingly, is not as simple as one might think. Certain people have greater aptitude for music than others, and there are deficits (atonia and tone deafness, for example) that render either the appreciation or production of music impossible.

Most strongly of all, Sacks challenges the infamous pronouncement by Stephen Pinker that music is merely “auditory cheesecake” that piggybacks on the highly evolved linguistic capabilities of the human brain. Pinker’s thesis is that musical ability is not evolutionarily important. Not so, Sacks argues: music is bound up with the operation of the human brain, and is one of the things that separates us from other animals. No other animal shows such affinity, such natural rhythm and such appreciation of music as we humans. There must be some evolutionary reason why our brains impose patterns on our sensory experience, and an inherent sense of rhythm is one of the things that results from this. For example, we hear clocks going tick-tock, tick-tock even though the sound of both the tick and the tock is the same. It is as though we unconsciously impose a ‘beat’ on the world.

With so much of human experience seemingly dependent on the production and appreciation of music, perhaps that is what makes us truly human. Musicophilia is an excellent book, and I highly recommend it for not only musicians and neuroscientists but non-specialists as well.

Don Alhambra is a Research Fellow in Neuroscience at the University of Birmingham, UK. He can be found mainly at the Heathen Hangout and the Heathen Hub.

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