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Oliver Sacks is a psychiatrist and neurologist best known for his collections of case histories from the far borderlands of neurological experience, The Man Who Mistook His Wife for a[…]

Oliver Sacks discusses some bizarre cases from his most recent book “Musicophilia: Tales of Music and the Brain.”

Question: What was the most remarkable experience you had working on the book?

Oliver Sacks: Something I found very remarkable and not easy to imagine, because I was brought up in a sort of fairly musical world, and music is an essential part of my world, was to meet someone, a delightful, intelligent lady who lives in New York who cannot perceive music as such, cannot recognize music.

This was apparent when she was a little girl, when she couldn’t recognize any music. Or when she was asked to sing, she really didn’t know what was meant. And people were puzzled because she wasn’t deaf. She could speak perfectly well and hear their speech and ambient noises, but she seemed to have no idea of what music was about.

And when she was tested at one point, she really couldn’t say whether one note was higher or lower than another note.

She tried to get interested in music. She would go along with boyfriends, now her husband, to concerts and she found the experience somewhere between unintelligible and excruciating.

People often suffer from the feeling that they are unique. And she saw an article some years ago saying that, yes, there’s a thing called congenital amusia, and some researchers in Canada were working on this.  And she got in touch with the people in Canada and they came and visited her, and they tested her, and they were very reassuring.

They told her, first, she is not the only person in the world like this. There are some others, and they’d be happy to introduce her to some fellow amusiacs. They said, second, this was not just bad motivational or neurosis as her family has said. This was a real neurological condition, and a little part of her brain was not that well developed. And they also said to her, you don’t have to go to concerts anymore, and if your husband wants you to go to a concert, you say, “No. You go. I’ll go to a film or something.”

But, this lady, can’t hear tones or semi-tones. She can’t hear the intervals which compose a scale. She has no idea about music.

I spent a lot of time with her. She has a good ear for poetry and for language, but no ear for music. And so, for some reason, that sticks on my mind as very, very fascinating.

I think, in general what especially startled me is have the people talk about musical hallucinations. And a hallucination is not at all like a mental image. It’s very startling. People look around. They listen.

I first heard of this in the 1970’s. It was an old lady in a nursing home, and she described to me how she’d been woken one night by hearing songs sung very, very loudly. And for me, that thought was someone had the radio on loudly, and she was amazed, in fact outraged that someone would have a radio on that loud on the middle of the night when everyone was sleep, although she was rather surprised to find the people were still asleep.

And she went looking for the radio and she couldn’t find it. And then, she’d heard that a filling on a tooth could sometimes pick up radio waves. And then she thought about it more.

These were only songs that she knew, and they kept being repeated again and again, or sometimes just fragments of songs. So there was no commentary. And then she started to realize that the radio was in her head and that she was hallucinating.

And when people hallucinate, it’s very bewildering and rather terrifying.

And what she was describing in her hallucinations were really very early musical memories which were now being somehow regurgitated in her mind.

And I have in fact spoken now to hundreds of people with musical hallucinations, and each time, it startles me as it startled them.

Most of us have never had a hallucination. You have to have had a hallucination to know how startling it is and how you mistake it for an external perception, how you would look around for the source of it. And then you’ll have to realize that some part of your brain and your mind is on automatic and is producing these perceptions.

In general, I think speaking with people with musical hallucinations, which can sometimes be very beautiful and very moving, sometimes rather frightening. One of my patients, for example, started to hallucinate Nazi marching songs which he had heard as a boy growing up in Germany in the 1930s, as a Jewish boy. He was terrified of the Hitlerjugend and their songs, and, fortunately for him, the Nazi marching songs were then replaced by some Tchaikovsky.

I’ve been amazed continually by these people because it shows in a way that everything one has heard, even if one didn’t consciously listen to it, is recorded pretty quickly indelibly in the brain and it can be reproduced. And so, it shows something very remarkable about the brain and also about people’s ability to learn to live with hallucinations.

Recorded on: Sep 4, 2008