Interview: Oliver Sacks

Dr. Oliver Sacks is a rare bird in the world of medicine: not only is he one the country's top neurologists, but he also has a knack for weaving clinical profiles of his most exceptional patients into lovely, thoughtful books that open up the complex workings of our minds to the peering eyes of layfolk. His charm has much to do with the fact that he's the embodiment of a long-musty archetype of scientist: blustery, with a lisp, brilliant, and eccentric, a member of the American Fern Society, and fascinated with fluorescent minerals.

His latest book, Musicophilia, tackles our intimate mental connection to all things musical, dallying in the experiences of rhythymically-inclined Parkinson's patients and virtuosic amnesiacs, to name a few.

Thanks to the Willamette Week, and as a preface to his Portland lecture next week, I had a chance to chat with Dr. Sacks on the phone -- the result was a sincere, often suprising mish-mash of observations about iPods, pots and pans, and, of course, the fascinatingly complex relationship between our minds and music.

Universe: The New York Times famously called you the "poet laureate of medicine." Are your books science or literature? 
Oliver Sacks: For me, an interest in science is inseparable from an interest in the lives of scientists, and the lives of ideas, as well as in storytelling. In medicine, of course, narratives are essential: the patient tells you what's going on, and you try to match this with stories heard from other patients. I love to give personal accounts, to try and enter people's experiences and describe them, and I don't think there should be a space between literature and the sciences. I think that the sciences should be literate, and that their function is not only exposition, but storytelling. Certainly for myself, science has to be combined with stories -- but also stories have to be combined with science. Although I may tell a story of someone who has musical hallucinations, or cannot tell one tune from another, I also want to know what goes on in their brain, and why this is the case. In a way, these are somewhat like detective stories.

Universe: Do you think that your fascination with music has something to do with the fact that it's a sort of bridge between the arts and the sciences?
Oliver Sacks: I think probably that's one of the things which attracts me to music, yes.

Universe: You often write about aphasic patients, people who can no longer speak. I'm interested in the fact the ability to sing words isn't affected. What is the difference -- isn't speech just a kind of rhythmic sing-song?
Oliver Sacks: A great deal of the brain is involved in the perception and memory of music, much more than is involved with language; as people lose language and become aphasic, they're often able to respond to music and to sing, sometimes even to sing lyrics, to retain language if it's embedded in a song. The brain's ability to hold musical patterns is almost indestructible. It's amazing to see someone with Alzheimer's disease, how music can still be there.

Universe: Is all music the same in this regard? Does some music have less staying power?
Oliver Sacks: I think the music which is called to one, the music which has interested one, I think especially the music which one has been exposed to in one's young years, tends to be the mostly strongly embedded in the brain. If one gets musical hallucinations -- which hopefully, one won't, although they're rather common -- these always tend to be of music which was acquired fairly early in life.

Universe: Does music have some sort of evolutionary advantage for us? How could it come about?
Oliver Sacks: Well, people have different opinions there. Darwin was very interested in music and thought that music preceded speech, that it was part of courtship and wooing. Other people, like Steven Pinker, feel that music is incidental. He speaks of it as "musical cheesecake," as if it's a luxury, or a bonus, or trivial. But it's striking that music is central in every culture to known to us, that we find musical instruments going back to 50,000 BC. You find dance, you find song, the religious use of music, the martial use of music, the social use of music, and bonding with music in every culture.

To claim an independent evolutionary origin from music, you would have to look for some aspect of music which isn't present in speech. The aspect which stands out is rhythm, and the particular fact that we respond to rhythm by keeping in time, by moving our heads. One cannot not respond to music: even if you don't make any external movement, the motor parts of the brain respond to rhythm. This appears spontaneously in every child, but you cannot train a chimpanzee, or a bird, or a whale, or an elephant, to keep synchronized time to a rhythm. This is a specifically human attribute which doesn't have an analogue in speech -- I mean, speech doesn't have the regular pulse of music. So one would suspect that the synchronization with rhythm has evolved independently in human beings, and it's been preserved because it is a reliable evolutionary advantage. For example, bonding, doing things together, and synchronizing social groups. One can only hypothesize, but the rhythmic power of music might be a point at which to start. But of course, we have skeletons, but we don't know what was going on with society and music half a million years ago.

Universe: What is your opinion of people who claim to have no interest in music? Do they have some kind of developmental problem?
Oliver Sacks: Well, some of them, and perhaps they have different bases. There are some people who don't appear to recognize musical patterns, who can't clearly tell when one note is higher than another, who can't recognize any tune -- this is fairly rare, in that degree. Other people can recognize music perfectly well, but it doesn't get them emotionally. Obviously, people vary a good deal here, but if someone is not affected that much by music, well, then they can live a perfectly full life with other things.

You know, I have one patient, a very nice, intelligent woman from the Bronx, who has a strange congenital amusia. Even when she was a child -- she came from a rather musical family -- she just could not distinguish one tune from another. She says that she used to be wistful; she would see that other people were greatly affected by music, but for her it was unintelligible, sometimes excruciating. For her, what people call music was like hearing pots and pans thrown around in the kitchen.

Universe: Whoa, are her other senses more developed?
Oliver Sacks: Yeah! Interestingly, this doesn't affect her perception or appreciation of language. She likes going to the theater, she likes poetry, she likes visual art, and she spent a lifetime trying to enjoy music. When her boyfriends, and then her husband, would take her to concerts, she would dutifully obey. Finally, she read an article which described this condition, and she got investigative. She was told that this was actually a neurological condition, and that if her husband asked her to come to a concert, she should say, "You go, but I'm going to go to a film instead." She only wishes she'd been given this advice when she was seven, and not seventy.

Universe: Speaking of music getting us emotionally, why do minor and major chords affect us so differently? Is it a biological thing or a cultural construct?
Oliver Sacks: Well, it certainly seems to us that things in a minor key are rather sad -- the slow movements in Mozart symphonies and Mozart concertias are most often in a minor key, and are sad -- but this is not always the case. If you go back seven or eight centuries, sometimes you find that major keys are used for sadness and minor keys for exuberance. So it's probably a cultural thing. Some things are built in biologically, though: the perception of octaves, things like that, and obviously music which is fast may be seen as animated, and music which is slow has a funereal quality. Sometimes when if we listen to music from another culture -- Hindu music or Chinese music -- we may not know how to respond, emotionally.

Universe: I heard growing up that kids who took music lessons ended up being better at mathematics. Is there any truth to that?
Oliver Sacks: Oh, I don't know, the so-called "Mozart effect" or whatever? Certainly, intensive musical training develops various parts of the brain to deal with music, and there's probably some bonus effect on other skills.

Universe: So it has nothing to do with the underlying structure of music?
Oliver Sacks: No, it doesn't, and simply listening to music doesn't do this. I mean, one is speaking of fairly intensive lessons or training...but then again, there are lots of great musicians who are absolute dunces mathematically, and vice-versa. There's no guarantee here.

Universe: What kind of music are you listening to these days?
Oliver Sacks: Well, it sort of depends on my mood. I sometimes like rather rousing music when I wake up, to get me up, and there's music which calms, and music which consoles...but since you ask, I happen to have here, let me look at the tape, I have some Brahms concertos here, which for some reason I always seem to be listening to. I don't use an iPod.

Universe: You don't?
Oliver Sacks: No, I'm actually a little frightened of iPods because I think that not only can you be given music all the while, but you can use it to ward yourself of from your environment. You can have it too loud, I think it can make you functionally deaf. I don't know how it is in Portland, but New York is full of people who are either on cell phone or iPods -- they walk in front of cars, and they're sort of like zombies.

Universe: Do you think it's music or the device which turns them into zombies?
Oliver Sacks: Well, perhaps they go together. There's the self-contained machine, the cell phone syndrome, but if music at great intensity is being piped into your head all the while...I think it can be wonderful in a way, but slightly dangerous.