Music and Amnesia

There's a really wonderful article by Oliver Sacks in the New Yorker this week, excerpted from his forthcoming Musicophilia. I've got a profile of Sacks in the next issue of Seed (hitting newsstands soon), which was a real thrill to write, since he's always been one of my intellectual heroes. Here's how I describe Clive Wearing, the amnesiac subject of the article, in my profile:

One of the final stories in Musicophilia is that of Clive Wearing, an English musician and musicologist who was struck by a severe brain infection that decimated his memory. As a result, Clive lives inside brief parentheses of time, just a few seconds long. "Desperate to hold on to something," Sacks writes, "Clive started to keep a journal. But his journal entries consisted, essentially, of the statements 'I am awake' or 'I am conscious,' entered again and again every few minutes. He would write: '2:10 pm: this time properly awake...2:14 pm: this time finally awake...2:35 pm: this time completely awake.'"

The only thing that comforts Clive is music. When he is playing the piano, Clive is suddenly "himself again". The Bach Prelude can't recover his past - that is lost forever - but it does allow him to be fully immersed in the present tense. He can share, if only for a moment, the emotions of the melody. The music is a "bridge across the abyss," a temporary relief from the terrifying loneliness of his amnesia.

Also be sure to check out Deborah Wearing's memoir. And there are a bunch of Clive documentaries on You Tube:

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It seems as though the internet is getting smaller. I posted those videos!
PS. Looking forward to your book.

Could you fix that link to the memoir? Right now, it's linked to the Sacks book again. thanks!

what others (and Lehrer) perceive as Sack's connection with the humanity of others, I see as a none too subtle fascination with and display of freaks. Sacks is like the kid at the circus pointing at the Bearded Lady. because he maintains a faux innocence, he gets away with it. but just because you cry along with the freak doesn't mean that your stance is any less inhumane. and just because you don't actually call him or her a freak doesn't mean that that is not your focus. indeed, his fascination with his own incipient blindness is an admission that there is a freak inside of him, inside of all of us. true empathy is not only non-judgmental, it is also non-exploitative.

I've frequently felt, reading Sacks and more generally the literature that deals with brain-damaged patients, that there's some kind of pleasure investigators draw from analysis of their patients. But if you look more closely, you'll see that's not the case.
Their pleasure is simply one of new knowledge, insight, and clarification: the feeling that some previously buried aspect of cognition and/or neural function has been elucidated by the failure of a patient to express some process, or, perhaps more rarely, by a patient's success with it (such as Wearing's increased mnemonic efficacy with music or his wife). I believe William James said something like the hardest phenomena to observe are those that have been present all along. In the pathology of these patients, we see what the absence of a particular anatomical and/or mental process has on how life is lived, how the mind/brain works. It's not dissimilar to quantum physics, in which in order to understand a particle it is smashed into its components; the conditions that caused the particle's breakup and the identities of its components are used to understand the forces that hold particles together and mediate particle-particle interactions. In pathological patients, we see a fragmentation of ("normal") consciousness, which allows us to understand how its components, both physical and psychological, interact to give rise to it.
So don't confuse this thrill of discovery with some kind of mean-spirited curiosity. In fact, the best investigators of brain pathologies, Sacks among them, are probably aided by empathy for their patients. Not only does it facilitate access to the patients--by permitting increased spontaneity and candidness--but in order to truly understand the complex relationships between the patients' deficits and their psyches, empathy might be mandatory. For instance, what's the significance of Clive's stereotyped crossing out of previous entries? This can't be understood from a strictly objective neuroscientific perspective: it's highly unlikely that, for example, Clive's memory loss disinhibited a "consistency engine" in orbitofrontal cortex. The likely explanation is a feeling any of us would have in his situation: the despair, and correspondent desire to correct it, that would arise from seeing but not remembering the same entry repeated over and over, repeatedly crossed out, that contradicted what he was presently writing and feeling. It's probably one of the closest kinds of encounters he has with his illness.
Sacks's mentor, A.R. Luria, urged that this be standard clinical practice, as a part of what he called a "romantic science." Indeed, it's clear in Sacks's work that he feels for, and feels with, his patients. He also spends time and thought discussing the often dreadful institutional conditions the patients suffer through, and how they can be addressed.

and yes, of course, you could bill the above as 'exploitative.' but do cancer patients that willingly take part in studies feel exploited? it seems like more often they're eager to do whatever they can to prevent their illness from striking others.
in luria's (mentioned previously) "the man with a shattered world," the patient actually did most of the writing. although he could only eke out a few sentences, or paragraphs at most, per day he persisted for over three decades. his aim, he said, was to help others, to make sure that they weren't forced to suffer like he was, and to advance knowledge. while your feeling is legitimate, I think you overlook the fact (among others) that this much of this research has direct and beneficial clinical applications.
once, I was in a class that screened video of an autistic child having a fit. a student laughed, and the room turned to ice. the point of this research is, on my final analysis, to REINFORCE the humanity of these patients: despite everything, they still retain basic human qualities, needs, and instincts.