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Music's Unanswered Questions

October 23, 2007

Neurologist Oliver Sacks, who wrote The Man Who Mistook His Wife for a Hat, is an M.D. and plays a Bechstein. His newest book, Musicophilia, will be published this month by Random House.
The impact of music on the human brain, Sacks writes, cannot be overstated. It's as important as language. "I'm impressed that a huge amount of the brain is involved in aspects of music,” he said recently from New York. “Keeping time to the music is a purely human thing. No animal can do this. It's curious that music can affect us so deeply without any representation that's external."

Until 1995, what patients said was only anecdotal. There was no way of recording how music affected various parts of the brain, and adverse reactions to music were thought, like adverse reactions to scripts, to be matters of behavior, rather than neurology. Today, though, "we can examine people, as well," and record and measure changes in the brain. The research, he says, is just beginning. The goal: "If we understand music, we'll understand how the brain works."

Sacks' first encounter with music's impact on behavior, some 40 years ago, was described in his 1973 book Awakenings. In a hospital he encountered post-Parkinson's patients, “frozen” and physically unable to move. Working with a music therapist, he found that the patients could "be got going by music,'' he says. Music added a rhythmic flow to their lives, unfroze their bodies, released them from their corporeal prisons.

The same thing happened to patients in the throes of autism, stroke, and Alzheimer's. Music could become an organizing principle, adding order and lucidity to disrupted lives. "Seeing the therapeutic possibilities of music started me off," he says. And it also triggered the riddle that continues to propel his work today: "How can music suggest so much, induce moods of every sort? We just don't know how it works. It's the language of the heart."

In 1990, Awakenings became a movie starring Robert De Niro as a patient and Robin Williams as Sacks. "I was impressed by the amount of work De Niro did,” Sacks says. “He spent 48 hours with patients, nonstop." For the most part, Sacks found Awakenings accurate and moving. He disliked "one or two additions of love and violence," which at one point caused him to walk off the set. "You have to dissociate yourself. I returned after a few days and sat quietly."
Hearing Things
Sacks hears from people like the woman who e-mailed him recently saying that since she had suffered a brain injury, music no longer sequences for her. "It's a form of amusia, because certain parts of the brain are affected,” he says. “It was described 150 years ago. But it's not well-known that it's her brain, and not just her mind. I get requests to see people with musical hallucinations, who quite suddenly hear music so vividly and loudly that they think it may be coming from outside them. They think it's from an external source.'' When he wrote about it 40 years ago "in my 'hat' book," he says, Dear Abby picked it up for her column and readers started writing to her, "outing themselves" about their musical hallucinations.

Actually, says Sacks, such phenomena are quite common. They are the most common mental short circuit, occurring in 2 percent of the population, far more frequently than hearing voices or being psychotic. "There is the need to advise such people," as well as their doctors. Hence Musicophilia.

The book takes its place on a growing shelf that also includes Daniel Levitin's Your Brain on Music. "We read each other's manuscripts," says Sacks, describing Levitin as a friend. Levitin's a researcher, whereas Sacks describes himself as "a practicing physician who sees people with problems."

The problems that involve music, amazing to a layperson, are confounding to the sufferers. One man who as a small boy escaped Nazi Germany before World War II years later began hearing Nazi marching songs. "Usually it's more benign, but it's maddening, repetitive, uncontrollable," Sacks says. "It's as if a bit of one's brain is on strike.'' Sometimes it's just part of a melody, and people are irritated by not hearing the whole piece. "If only it would complete itself," Sacks quotes a patient as saying.

One of his patients heard the same four bars over and over, 24 hours a day, "a hallucinatory form of an ear worm. One woman told me her refrigerator played Haydn. Another would hear music with the sound of a lawn mower." One correspondent experienced epileptic seizures when listening to modern, dissonant music, which unfortunately was the type of music her husband favored.
A Bolt From the Blue
Sacks, 73, describes himself as "an indifferent pianist" who hopes to find the time to resume piano lessons soon. "I like my classical music from Monteverdi to Stravinsky, and a few of the neoclassical composers." Of later work, he says, "I'm not as sensitive to other types of music. My father” — like his mother, a physician; the Bechstein had been his — "was much more musical and more open than I."

Musicophilia takes its title from a chapter that appeared recently in The New Yorker. In 1994 an orthopedic surgeon, Tony Ciccoria, was struck by lightning while making a call from a pay phone during a storm. He had had only the barest childhood contact with classical music. Now he developed a mania, taking piano lessons, buying CDs, and attending performances, finally giving a concert. Music became the most important thing in his life. A near-fatal motorcycle accident a few years ago, involving head trauma, did nothing to change his obsession.

Although Ciccoria was not a particularly religious man, even before the lightning strike he had a belief in reincarnation, and he felt that he had been chosen for this new obsession. When Sacks suggested that today, with all the new insights into the workings of the brain, perhaps it would be worthwhile to investigate how all of this had come to pass, Ciccoria responded that "perhaps it was best to let things be," Sacks writes. "His was a lucky strike, and the music, however it had come, was a blessing, a grace — not to be questioned."

Janice Berman was an editor and senior writer at New York Newsday. She is a former editor in chief of Dance Magazine.