Another important point that The Man Who Mistook His Wife for a Hat makes about neurological disorders is that not all disorders are uniformly “bad.” To classify something as an illness—much like conceiving of a mental illness as a deficit (see “Conceptions of Mental Illness” theme)—is not itself a scientific procedure, but rather an arbitrary decision. Notions of what is and isn’t bad or normal are subject to cultural forces, and therefore change over time (to cite one notorious example, the medical community classified homosexuality as a disease until the 1970s). Throughout his book, Sacks questions and complicates the very definition of the word “illness,” suggesting that some so-called mental illnesses could be construed as valuable gifts, rather than conditions to be abhorred. (For the sake of convenience, Sacks uses the words “illness,” “disability,” and “disorder” throughout the book, although he seems to disagree with the purely negative stigma they imply.)
In several of the case studies in The Man Who Mistook His Wife for a Hat, patients “suffer” from diseases that not only don’t cause them significant problems, but which seem to enhance their lives in surprising ways. Particularly in Part Three of the book, Sacks shows how so-called neurological disorders can provide patients with a new sense of enlightenment, inspiration, or euphoria. Sacks brings up two famous historical figures, Dmitry Shostakovich and Hildegard of Bingen, who, in all probability, had neurological conditions that allowed them to experience vivid hallucinations, triggered by seizures in the temporal lobes of the brain. In the strictest sense, Shostakovich and Hildegard probably had mental illnesses, but their illnesses seem to have helped them find enlightenment and inspiration far more than they impaired their lives. Too often, the medical community ignores the talents of mentally disabled people or acknowledges these talents in only the narrowest sense, treating them as mere party tricks, instead of signs of sophisticated, mature cognitive ability.
Although mental disorders could sometimes be conceptualized as an across-the-board benefit, Sacks discusses other, more ambiguous cases, in which the neurological disorder could be construed as having some positive and some negative effects, almost as if the mind compensates for certain deficits. Particularly in Part Four of the book, Sacks shows how mental disabilities, such as intellectual impairment, sometimes coincide with prodigious gifts in another mental departments. In one case study, we meet a man named Martin A., who, despite—or, quite possibly, because of—his intellectual impairment, has become a leading expert on the music of Johann Sebastian Bach. In another case study, Sacks describes an intellectually disabled woman named Rebecca who possesses a tremendous talent for poetic imagery. Although most medical researchers interpret such patients’ mental gifts as existing independent of their intellectual impairment, Sacks hypothesizes that their gifts are, in fact, a product of intellectual impairment. Perhaps, in being incapable of abstract, categorical thought, a mentally disabled person can focus on the concrete and the particular, and attain powers of concentration or attention that the average person could never hope for.
Sacks stresses that he’s not trying to fetishize mental illness, and readily acknowledges that, in many, many cases—perhaps the majority—mental illness is a tragic phenomenon that causes the patient distress and pain. Nevertheless, he argues, society, and even the medical community, is too hasty in stigmatizing mental abnormalities as “illnesses.” Some mental abnormalities have benefits as well as drawbacks, others could even be considered special gifts, and—perhaps most importantly—all should be treated as a mark of the individual’s humanity.
Illness as a Gift ThemeTracker
Illness as a Gift Quotes in The Man Who Mistook his Wife for a Hat
Here then was the paradox of the President's speech. We normals—aided, doubtless, by our wish to be fooled, were indeed well and truly fooled (‘Populus vult decipi, ergo decipiatur’). And so cunningly was deceptive word-use combined with deceptive tone, that only the brain-damaged remained intact, undeceived.
As this pattern became clear to him, and after discussing it with me, Ray made a momentous decision: he would take Haldol ‘dutifully’ throughout the working week, but would take himself off it, and ‘let fly’, at weekends. This he has done for the past three years. So now there are two Rays—on and off Haldol. There is the sober citizen, the calm deliberator, from Monday to Friday; and there is ‘witty ticcy Ray’, frivolous, frenetic, inspired, at week- ends.
All the transports described in this section do have more or less clear organic determinants (though it was not evident to begin with, but required careful investigation to bring out). This does not detract in the least from their psychological or spiritual significance.
Another week passed, and now Bhagawhandi no longer responded to external stimuli, but seemed wholly enveloped in a world of her own, and, though her eyes were closed, her face still bore its faint, happy smile. ‘She's on the return journey,’ the staff said. ‘She'll soon be there.’ Three days later she died—or should we say she ‘arrived’, having completed her passage to India?
Invested with this sense of ecstasy, burning with profound theophorous and philosophical significance, Hildegard’s visions were instrumental in directing her towards a life of holiness and mysticism. They provide a unique example of the manner in which a physiological event, banal, hateful or meaningless to the vast majority of people, can become, in a privileged consciousness, the substrate of a supreme ecstatic inspiration.
But of much greater interest, much more human, much more moving, much more ‘real’—yet scarcely even recognized in scientific studies of the simple (though immediately seen by sympathetic parents and teachers)—is the proper use and development of the concrete.
The concrete, equally, may become a vehicle of mystery, beauty and depth, a path into the emotions, the imagination, the spirit.
‘I’m like a sort of living carpet. I need a pattern, a design, like you have on that carpet. I come apart, I unravel, unless there's a design.’
One speaks of ‘idiot savants’ as if they had an odd ‘knack’ or talent of a mechanical sort, with no real intelligence or understanding. This, indeed, was what I first thought with Martin—and continued to think until I brought in the Magnificat. Only then did it finally become clear to me that Martin could grasp the full complexity of such a work, and that it was not just a knack, or a remarkable rote memory at work, but a genuine and powerful musical intelligence.
This is the positive side—but there is a negative side too (not mentioned in their charts, because it was never recognized in the first place). Deprived of their numerical ‘communion’ with each other, and of time and opportunity for any ‘contemplation’ or ‘communion’ at all—they are always being hurried and jostled from one job to another—they seem to have lost their strange numerical power, and with this the chief joy and sense of their lives. But this is considered a small price to pay, no doubt, for their having become quasi-independent and ‘socially acceptable’.
Could he, with his fine eye, and great love of plants, make illustrations for botanical works or herbals? Be an illustrator for zoology or anatomy texts? (See the drawing overleaf he made for me when I showed him a textbook illustration of the layered tissue called ‘ciliated epithelium’.) Could he accompany scientific expeditions, and make drawings (he paints and makes models with equal facility) of rare species? […] He could do all of these—but, alas, he will do none, unless someone very understanding, and with opportunities and means, can guide and employ him. For, as the stars stand, he will probably do nothing, and spend a useless, fruitless life, as so many other autistic people do, overlooked, unconsidered, in the back ward of a state hospital.