In a ward of a hospital, Sacks listened to the patients laughing at the television. The president of the United States was speaking, and Sacks wondered what his voice sounded like to the patients.
When Sacks published this book, the president was Ronald Reagan—a man who some (including, it would seem, Sacks) didn’t always trust or respect.
Even patients who have global aphasia—the inability to understand words—are capable of understanding ordinary conversations, because when people speak naturally, they can pick up on non-verbal cues. However, aphasia patients couldn’t understand anything spoken by an affectless voice. Aphasia patients are, in short, living proof that speech doesn't consist of words alone, but rather of utterances delivered with inflection and emotions. Aphasia patients become highly attuned to the nuances of speech. As a result, when they listen to the president’s televised speech, the words ring false.
Understanding speech, Sacks suggests, isn’t a purely left-brained activity; in order to understand the nuances of human communication, one must not only understand the explicit meaning of words, but also the inflections and other nuances of language. Therefore, patients who lack the ability to understand words can still communicate insofar as they become especially attuned to the nuances of speech.
There are also patients who have a condition called tonal agnosia, which is the reverse of global aphasia—these patients can understand words, but not different tones and inflections. One such patient, Emily D., couldn’t understand if a voice sounded happy or angry—however, she trained herself to pay attention to people’s facial cues, compensating for her condition. While watching the president speak, Emily said, “He is not cogent … He does not speak good prose.” Many ordinary people, Sacks notes, were taken in by the president’s speech—“only the brain-damaged remained … undeceived.”
This passage is one of the first in which Sacks suggests that, at times, patients with so-called neurological disorders may actually be better off than “normal” people. Agnosia and aphasia give the patients in the hospital a special insight into political language, so that they can see the underlying crudity and cheap emotional manipulation of Reagan’s rhetoric. Since Sacks seems to dislike Reagan, he also seems to respect his patients’ ability to see through Reagan’s charming façade.