Sacks wrote about the people who lack some functions of the brain and how they are affected or injured. For example, aphemia, aphonia, alexia, apraxia, amnesia, ataxia, aphasia, and agnosia. ‘The man who mistook his wife for a hat’, Dr. P had problems with visual images. He was unable to recognize objects around him, even his wife, shoes, feet, face and other objects. One day he grabbed the head of his wife to put it as a hat on his head because he thought that his wife’s head was his hat. He had a great musical intelligence. He was able to do various activities if he was singing, but he could forget everything and stop doing his activities when interrupted.
Dr. P was a music teacher, his perception was questioned. His ophthalmologist referred him to a neurologist, Oliver Sacks. On the first visit, Sacks noticed that P faced him with the ears and not the eyes. The gaze was unnatural, fixating, and darting on the features of the doctor, one at a time. At the end of the visit, P appeared to grasp his wife’s head trying to lift it. He mistook the head for a hat. She didn’t show any sign that something was wrong.
During the second visit, at his home, P was not able to recognize the rose that was on Sacks lapel. He described it as red form convoluted with a green attachment. Sacks encouraged him to think of what it was, and he guessed it could be the flower. He knew it well after smelling. His wife explained that P functioned by making songs about what he did, like dressing, eating, or washing. If he was interrupted, he could stop until he finds a clue on how to continue in his sensorium (Graham, 2015).
The use of music allowed P to function well in his personal and professional life. He remained unaware of his problem. Sacks chose not to disrupt P’s ignorant bliss using a diagnosis. His condition only hypothesized as degeneration or tumor of the visual cortex, he was not diagnosed. The condition advanced, but he lived and worked in normalcy to the end of his life.
P had the ability to compensate for the neurological function failure; he speaks of the capacity that people have to heal the defects that occur between them and reality because of physical injury. P was immersed in the love of music which enabled him to win the devotion of his colleagues, students, and his wife. His dependence on music and smell to orient himself to the richness of the world around him displays the loving and living aspect of humanity (Bernstein et al., 2018).
The deficiency of the visual realm is characterized as the loss of judgment and feeling around the visual data which lowers the concrete, real, mechanical, and personal abstractions. P functioned like a computer visually. Sacks made an analogy between his agnosia and the state of cognitive psychology and neurology. The analogy saw his brain as a computer and did not see anything real and concrete about people. The neurologist avoided the want of feeling when he withheld the diagnosis of the condition. He instead encouraged more music to strengthen the inner music of P without which he could not do any meaningful activity. He was unable to see faces but recognized people by their voices. P also saw faces where there were none.
The condition is also known as face blindness. The condition allows an individual to see but cannot assemble the holistic pictures. He confused the sensory data easily. It may be difficult to understand how P saw objects and yet did not understand when he saw a face. The difference between sensation and perception should be remembered to understand. P seemed to be fine but the perception was impaired in a way that could not complete the final stage and translate the collected data into real objects. The fact that he has a problem with the concept of left suggested that there was a problem in the right part of his brain.
Sacks learnt that P was a talented artist. He had paintings that were finely painted and detailed. His work became less realistic as he grew older. The paintings showed the development of his agnosia over time. The sense of concrete visual world disappeared slowly.
His condition could not have been learnt if he did not develop diabetes and his eyes were examined. The lingual and verbal realm was not affected, because he had fluent conversations. The problem lied in the brain, in the secondary visual cortex.
Visual agnosia is divided into two; associative and apperceptive agnosia. Appercetive is a condition in the visual process at higher levels than the vision of the eyes. The condition may make it difficult to recognize an object because the person is not able to see the object clearly regardless the fact that the eye vision is intact. The condition also makes it hard to recognize shapes and copy letters or drawings. Associative agnosia is the condition which an individual is not able to relate a percept with the meaning. This may lead to difficulty in recognizing various objects. It is different from apperceptive agnosia in that the general perception at higher levels is better for the associative agnosics. In associative condition, the shape perception is better; they can copy an image but cannot tell what the image is. Those suffering from associative agnosis cannot be able to name objects that they perceive visually but can match them perfectly but not according to function.
Diagnoses
It was difficult to ascertain the condition of P. He displayed the associative and apperceptive agnosia consistently. P’s condition can be characterized as a loss of judgment and feeling near visual data which reduces the real, concrete, personal, or mechanical abstractions. Most mistakes were from the incorrect judgment of the visual data. He worked as an innovative computer. He had a varying degree of different conditions and sub-types. He was suffering from prosopagnosia but had the ability to recognize an individual by their voices.
Two parts of the brain are used to symbolize the difference between the interests of Sacks and the interests of neuroscience. A symbolic framework was created where the work of Sacks was right-brained and neuroscience was left-brained. The framework is just used to tell the story of P. The aim of neuroscience is to distinguish the detailed schematics of the brain and connecting words to various defects and conditions. Quantitative testing to find diagnoses is also used. The aim of Sacks was to explain and make sense of the reality that the patients undergo to understand the neurological disorder (Hughes, 2015).
Sacks is an inactive player in P’s story. Even though Mr. and Mrs. P visited Sacks’ clinic, he did not offer them and concrete help. He may have played down his knowledge so as to show the disarray between the condition of P and neuroscience. Sacks wrote that neurology and psychology talk of everything but never talk about judgment.
The case study rests on a triangular relationship between reality, the observer, and the subject. When the subject mistook his wife for a hat, the reality is broken between the wife and P and conflict is created, turning the scenario into a meaning tale. There is a broken relationship between neuroscience, the observer, and the goals of scientific studies.
Conclusion
Though observation and reflection, the readers see how P used music to do various activities. He could only do tasks like dressing and eating while singing. P was a painting and music teacher. He never lost his judgment. As sacks observed his paintings, he found out that they changed over time. The earlier works were natural and realistic; with vivid atmosphere and mood but later they became less concrete, less vivid, and less realistic and more abstract. P never lost his creativity throughout his life in his condition. He still made paintings, but they changed much. After losing his judgment, he changed too and became more abstract in his life.
References
Bernstein, D.A., Pooley, J.A., Cohen, L., Gouldthorp, B., Provost, S., " Cranney, J. (2018). Psychology:
Australian and New Zealand edition. (2nd ed.). South Melbourne, Vic: Cengage Learning Australia. ISBN: 9780170386302
Graham, G. (2015). "Behaviorism", The Stanford Encyclopedia of Philosophy. Edward N. Zalta (ed.), URL = http://plato.stanford.edu/archives/spr2015/entries/behaviorism/
Renee Kohler-Ryan, ‘Human Persons’, An Introduction to Philosophy and Theology within Catholic Liberal Education (McGraw-Hill, 2015)
Hughes, T. (2015). The Man Who Mistook His Wife for a Hat. Practical neurology, 15(2), 155.
