The Man who Mistook his Wife for a Hat
As a child, I watched Alfred Hitchcock Theater, The Twilight Zone and other science fiction or horror shows. Often times the storyline was based on a victim's mental problems or their skewed perception of the world. Looking back, I remember the fascination I felt when watching one specific episode of the Twillight Zone. In this particular episode, a man turned into a zombie by some type of poison. Essentially he was still alive, but he was dead to the world. In the end he was embalmed while he was completely conscious yet could not say anything to prevent it. Like this incident, every episode captivated me but when it was over I could sleep easy because there was no possibility of any of it happening. Oliver Sacks disrupts my childhood understanding of what is plausible and what is not in the real world. In his Book, The Man Who mistook his Wife for a Hat, Sacks compiles a group of stories that appeal to the curiosity and compassion of a young boy through his close look at human experiences in the eyes of science, medicine and new technology.
The chapters discussing 'Losses'; and 'Transports'; sparked my interest the most. The first story that caught my attention was about the sixty year old Madeline J. who was suffers from being 'congenitally blind'; and has 'cerebral palsy';(Sack 59). She was a very bright and intelligent woman that gained all her knowledge and learning from listening to books and from talking to people. She had never learned Braille because her hands were 'Useless godforsaken lumps of dough…'; Through simple tests, Sacks discovered that her hand recognized light touches, pain, and temperature. All basic sensations and perceptions were in tact. However, when objects were placed in her hands, she could not identify them. She did not try to search and explore the object; 'there were no active 'interogatory' movements of here hands. Sacks concluded that her hands were fine functionally; she did not know they were there. Madeline had to discover her hands and make the neural connection before she would be able to use them (Sacks 59-61).
In an effort to get Madeline to use her hands, he asked her nurses to put her food slightly out of reach and leave the room on occasions. Sacks hope that due to the hunger, she would reach out for the food and use her hands. One day 'impatient and hungry'; she grabbed a bagel, fed herself and began her life as a 'motor individual';. As time past, Madeline found delight in her new world of shapes. This interest led to an unknown talent to sculpt. She was known as the 'Blind Sculptress of St. Benedict's.
Madeline suffered from Cerebral Palsy a disease that causes rigid, convulsive muscles in the legs and arms. Children with the disease often have a difficult time crawling, walking and grasping objects. As time passes they do not get any better. Formerly, it was called Little's Disease in 1860 by the English surgeon William Little, today it is known as Spastic Diplegia, a category of Cerebral Palsy (Introduction). Today medications, surgery and braces help children with Cerebral Palsy improve nerve and muscle coordination, treat related medical problems and correct abnormalities (Introduction).
Sacks discussed the ideas behind the phantom limb and how they affected many peoples live. The most interesting story was about a sailor that accidentally cut off his index finger. For forty years he thought he would poke himself in the eye whenever he moved his hand to his face. One day he lost the feeling in his entire hand including his phantom finger and his problem was cured (Sacks 66-67). Up to 70 percent of amputees confirmed that they still feel or still thought a missing limb was there. They often feel that they can reach out and grab something. Some won't sleep in a certain way because they feel the missing limb between them and the mattress. The sensations felt stem from the activity of the sensory axons of the missing limb (Carlson 196). Neuromas are formed at the ends of proximal portions when the connection between the proximal and distal portions are cut and the bond is not reformed. R. Melzak suggests that the phantom limb occurs because of the organization of the parietal cortex. This is the part of the brain that deals with body awareness(Carlson 196).
The last story was about Bhagawhandi P., a 19 year old Indian girl that suffered from a malignant brain tumor for more than 12 years. She lived life as a normal young adult though she knew she had a living time bomb in her head. As the years passed the tumor worsened to point that it could no longer be removed. She had to go through surgery to help in the decompression of her head to allow the tumor to keep growing. At first she began to suffer from 'grand mal convulsions.'; They began to resemble more of a 'dream'; state where she would not loose consciousness but began to reminiscence about her life. When asked if the memories bothered her she responded 'I like these dreams ;#8211; they take me back home.'; (Sacks 154)
Sacks didn't understand the origin of these dreams or conclude why they were happening. As the sickness worsened, Bhagawhandi began to sit quietly with a smile. She was fully conscious of the world, and when asked a question, she would quickly respond. As the weeks passed, the dreams came more frequent and grew deeper. Sacks commented that he thought she was in another world and did not want to interrupt her. Once he asked, 'Bhagawhandi, what is happening?'; 'I am dying,'; she answered. 'I am going home. I am going back where I came from – you might call it may return. Eventually she would not respond to people asking questions. She often sat with her eyes closed with a face of happiness and bliss. Three days later she died and returned home.
Sack does not give any explanation about what Bhagawhandi may have suffered from. I take this last story to explore what I think may have been wrong. From the story, I felt she suffered from a Dysembryoplasic Neuroepithelial Tumor (Case). DNT usually occurs in the patients first 20 years of life. They are often found in the temporal or frontal lobes. Bhagawhandi's tumor was found in the frontal lobe. DNT have many intracortical nodules that vary in size. Its cells resemble 'well-differentiated oligodendroglioma';. However the cells are often found in clusters and other intricate shapes. Because of the tumor the 'adjacent cerebral cortex often exhibits cortical dysphasia with disturbed lamination and disarray in architecture (Final).
Oliver Sacks does an excellent job of writing about that appeals to all walks of life and a diverse set of cultures. He translates topics that would take a doctorate degree to understand and presents it in a way that is entertaining and a joy to read. In the story of the blind sculptress he gives us hope, feeds our curiosity with the phantom finger, and finally touches our heart in our trip with the Indian girl back home.
Carlson, Neil R. Foundations of Physiological Psychology. Allyn and Bacon. London. 1999.
'Case Eight - Dysembryoplastic Neuroepithelial Tumor';. http://www.uhrad.com/mriarc/mri008.htm
'Introduction to Cerebral Palsy';. http://www.islandnet.com/aclemens/intro2.htm
Sacks, Oliver. The Man who Mistook his Wife for a Hat. Touchstone Book. New York. 1985.