In 1980, a sixty-year-old blind woman with cerebral palsy named Madeline J. was admitted to Saint Benedict’s Hospital in New York. Madeline was intelligent, and had read a huge number of books with other people’s help. Madeline explained to Sacks that she couldn’t do anything whatsoever with her hands, and compared them to “godforsaken lumps of dough.” Sacks found Madeline’s explanation strange, since usually cerebral palsy doesn’t affect the hands. Furthermore, although Madeline’s hands were mildly spastic, they weren’t useless, as she claimed. Sacks then researched cases of patients who couldn’t use their hands. In one case, hundreds of soldiers reported their hands feeling “foreign” and “lifeless.” However, the soldiers could remember a time when they used their hands normally—Madeline, on the other hand, had never used her hands normally.
In addition to suffering from cerebral palsy, Madeline seems to suffer from a neurological affliction that creates the illusion that she has no control over her hands (even though, scientifically speaking, her brain’s control over her hands is perfectly normal). Notice how Sacks initially tries to understand Madeline’s unusual condition by comparing it with the existing scholarship on the matter—like a good neurologist, Sacks understands the importance of compiling research and situating individual patients in a broader medical narrative.
Sacks tried to push Madeline J. to use her hands to feed herself by serving her food without utensils. Eventually, Madeline began using her hands to eat bagels. Afterwards, she began to take an interest in feeling different objects with her hands. Madeline also began sculpting in her spare time. Amazingly, control of one’s hands—a mental function that most people learn when they’re babies—eluded Madeline for the first sixty years of her life. More amazingly still, she learned how to control her hands after sixty years.
When he realizes that Madeline’s situation is unprecedented in medical literature, Sacks tries to treat Madeline’s impairment by training her to use her hands. That Sacks succeeds in doing so suggests that humans are hard-wired for motor control over their own hands, even if, in some rare cases, this ability can lie dormant for many decades.
In the Postscript, Sacks notes that Madeline J.’s case wasn’t unique—another patient, named Simon K., had a similar lack of control over his hands, and, with help, learned how to use his hands normally. Sacks also notes that sometimes patients lose their ability to use their hands and feet normally, and sometimes suddenly regain the ability.
Since studying Madeline, Sacks has learned that there are, in fact, other similar cases of people losing and regaining control over their hands. By treating Madeline, however, Sacks advances the medical scholarship on the subject and proves that this neurological impairment can be treated.