Oliver Sacks

The Man who Mistook

his Wife for a Hat
and
The Disembodied Lady
by Suzanne Mc Mahon, Marianne Murphy,
Megan McDonnell and Liam Murphy.
The Man who Mistook his
Wife for a Hat
 Introduction
The perception of size and shapes of objects is
part of daily life for all of us.

We need a good sense of perception to be able
to cross the road safely , pay for things in
shops and even recognize our friends and
family.

Perception is recognizing key features in
objects and managing this information in our
brain.....For example:
trouble recognizing
what this is...

•It’s height and width

•It’s curved contours

•The size and style of the

text on the label
 drive recognize this
road sign by:
Its hexagonal shape
•

Its infamous red and white

•

colour
•

And again the size and style

•

of its text
•

If you couldn’t perceive this

•

as a sign to stop , you

would be a danger to
yourself and others...
 • Corporations rely
on peoples
perception to create
recognizable brands
and trade marks.
•
• Product designers
bear peoples
perceptions in
mind when designing
products and
packaging.
•
• They try and
create a perceptual
illusion that
their product is
So far, I hope I have outlined the
importance of a good sense of
perception in day to day life.

For most of us, the part of our brains
which deals with perception works
fine.
•

For most of us, the ability to perceive

depths, shapes and size is taken for
granted...

Unfortunately…
Dr. P had true problems with perception.

He was a skilled teacher, painter and
musician.

His visual-agnosia affected him in everyday
situations such as dressing himself,
working on his art and recognizing his wife
and the students he taught.
•

And so,Megan will now go on to explain in

greater detail his particular agnosia;
•
Explanation
• Agnosia
Dr. P's suffered
mainly from
prosopagnosia, also
known as "face
blindness". Although
he was unable to
recognise faces
mainly, he also
from a more general
agnosia, confusing
things like his own
foot for his shoe.
•
Memory Loss
D r. P a lso se e m e d to sh o w sig n s o f d a m a g e in
th e le ft h e m isp h e re o f h is b ra in .
H e w a s a ske d to w a lk d o w n a fa m ilia r stre e t
fro m th e so u th e n tra n ce a n d ta ke n o te o f th e
b u ild in g s h e sa w .
W h e n q u e stio n e d , h e w a s a b le to re m e m b e r
th e b u ild in g s o n h is rig h t b u t n o n e o n th e le ft.
H e re p e a te d th is e xe rcise , b u t e n te re d th e
stre e t fro m th e n o rth e rn e n tra n ce th is tim e ,
a n d stra n g e ly , D r. P co u ld re m e m b e r th e
b u ild in g s o n th e rig h t h a n d sid e , w h ich h e
h a d p re vio u sly " fo rg o tte n " .
•
Aphasia
As Dr. P was a musician and a teacher it
was very important to him to be able to
understand the written language,
especially in the case of music scores.
However, Sacks states that the score for
"Dichterliebe", Dr. P's favourite piece
of music was kept in his living room,
but he could no longer play it as he
lost his ability to read music.
•
Gnosis
Finally, Sacks mentions gnosis a lot when
speaking of Dr. P. It is defined as "the
knowledge of spiritual matters" or a
"mystical knowledge".
Dr. P experiences an attitude change as
his agnosia becomes more prominent.
Sacks describes him as "computer-like",
and states that he can no longer have
"personal reactions" to everyday
occurrences.
Whether or not this constitutes being
"mystical" or not is open to
interpretation!
Speculation
Dr. P didn't realise the extent to which
his visual capabilities had diminished.
Dr. Sacks pondered whether it was sadder
to have this condition and be aware of
the loss, or not to realise there was
anything gone at all...
•


•
Blind?
One could speculate that perhaps Dr. Ps visual
deficit led him to believe that others shared his
strange visual perception, yet his was just a bit
out of focus.
In other words, did he believe he had a type of
“short-sightedness” and just needed some sort of
adjustment (like some people need glasses) to
regain his faculties?


•
One could possibly presume this because
of Dr. P’s blatant lack of understanding
that there was anything majorly wrong.
Of course from the outside looking in
there was something terribly amiss.

 Autism
Another speculation one could make, or even a
comparison, is Dr. P’s attitude to faces
being similar (albeit much more extreme) to
some forms of autism.
One symptom of autism or Aspergers syndrome
is the inability to recognise human emotion
or expressions, particularly in the face (a
kind of empathetic agnosia).
One could be led to consider this
possibility because although Dr. P’s eyes
showed up healthy in the tests, his great
downfall was relating what he saw to his
brain properly; that is, a complete lack of
existential perception in relation to
 Conclusion
In co n clu sio n , w e se e th a t so m e o n e w ith a
p e rce p tu a l d e ficie n cy , su ch a s visu a la g n o sia o r
m o re sp e cifica lly p ro so p a g n o sia , vie w s th e w o rld
d iffe re n tly th a n u s.
 
•

N o - o n e , a n d n o th in g , w a s fa m ilia r to D r. P. H e live d
h is life su rro u n d e d b y fa ce le ss p e o p le , u n a b le to
d e cip h e r e ve n a sin g le exp re ssio n .
•

H e fa ile d to re co g n ise e ve n su ch a co m m o n o b je ct
a s a g lo ve . D r. P co n stru e d th e w o rld a s w o u ld a
co m p u te r - id e n tifyin g ke y fe a tu re s b u t fa ilin g to
se e th e re a lity a s a w h o le .

His visual agnosiaaffected his visual memory and
imagination as well, particularly on the left-
hand side, and he was even unable to dream
pictorially.
•  
Dr. P got through daily tasks with the help of
music, which was at the core of his life. He
made everything a song and was able to manage a
task if it flowed well. This was said to be his
“body-music.” For example: Dr. P would sing
whilst dressing but if there was an
interruption he would lose the thread,
recognising neither his clothes nor his own
body.

Thus, Dr. Sacks advised Dr. P to make music his
It was thought that Dr. P suffered from either
a massive tumour or a degenerative process
in the visual parts of his brain.
• 
Prosopagnosia can also be caused by a defect
in a developing foetus. Though, owing to
circumstances beyond Sacks’ control, he was
unable to follow this case further and
ascertain the actual disease pathology.
• 

Despite this , Dr . P taught music until

the last days of his life .
http://www.youtube.com/watch?v=vwCrxomPbtY
The Disembodied Lady
 Introduction
Christina was a 27 year old woman, with
an active and healthy life, two children
and gallstones when Dr. Sacks met her.
She was due to have her gallbladder
removed when suddenly, 3 days before her
operation, Christina had a vivid dream.
In the dream she felt unsteady on her
feet, was continuously dropping things
was “swaying wildly”.
A psychiatrist was called and put
Christina’s dream down to nothing more
than pre- operative anxiety.
The next day however, Christina’s dream became
reality.
The psychiatrist was again called, but put
Christina’s condition down to nothing more
than “pre-operative hysteria”.
Christina could not stand unless she looked
directly at her feet. When she tried to feel
herself her hands would overshoot wildly and
miss; she could barely even sit up by herself.
She told Dr. Sacks that she felt “weird –
disembodied”.
Dr Sacks was taken aback by this strange
statement and decided to investigate further,
despite the psychiatrist's diagnosis.
•
Explanation
Christina suffered from a lack of
Proprioception, the lack of a sense of oneself
and the location of ones limbs.

This important sense works alongside balance
organs in the ear and a good sense of vision.

When Proprioception is lost, one has to learn to
use these other senses to be able to move
and speak.
•
Physiological reasons:
•

• A spinal tap removed from Christina revealed:


A sensory neuritis.

This is an inflammation of nerves fibres in the
brain.

In the case of Christina, the nerve fibres which
affect proprioception became inflamed.
•
Physiological reasons
Sacks explains that this was a rare case as it
was a purely sensory neuritus.

It affected “the sensory roots of spinal and
cranial nerves throughout the
neuraxis.”(Sacks,1985)

This was what caused Christinas loss of feeling
all over her body.

Speculation
As we know Christina was suffering from
proprioception, the loss of sense of oneself.

It’s interesting to consider how this came about,
not just physiologically speaking, but also
mentally.

Although we know that the damage was caused by
acute polyneuritis or sensory neuritis (the
sensory roots of her spinal and cranial nerves
were affected throughout the neuarxis) there was
the confounding dream she had before her
operation.
•
Speculation
She was put on a antibiotic for microbial
prophylaxis (to prevent her getting sick from
microbes that could get into her system during
the operation).

Could this medicine have caused the bizarre dream
that rendered her terrified?
•

“She was swaying wildly, in her dream, very

unsteady on her feet, could hardly feel the
ground beneath her, could hardly feel anything in
her hands, found them flailing to and fro, kept
dropping whatever she picked up”(Sacks, 1985).
•
Speculation

It may be that, subconsciously, she was much
more afraid of the impending operation than she
appeared and the stress could have manifested
itself in this dream.
•

But how did her body have this foresight? After all,
what she dreamed about is exactly what
happened. Was there a different state of mind at
work here?
Did her body know there was severe damage done
even though Christina herself was unaware of it?
Was the dream trying to warn her?
Conclusion
In conclusion, we see how the loss of a sense that
one typically doesn’t take into account can
seriously alter a person’s way of life.
• 
Christina is one such person who fully realises the
value of proprioception. Her loss of this sense
making her feel alienated from her own body.
• 

This case shows us the importance of

proprioception in our lives. Without it we would
be blind to ourselves, unable to tell what our
body is doing - not feeling it at all.

Conclusion
Though Christina was able to get her life back,
she still felt that her “body is blind and
deaf to itself… it has no sense of
itself.”(Sacks,1985)

Christina, after extensive rehabilitation
therapy, was able to again learn how to walk,
eat, sit, etc…, though all this was achieved
through constant vigilance.
•  
She lacked any natural posture, whether it was
of body, voice or face. All movements, tone of
voice and facial expressions were artificial.
Conclusion
Although Christina was the first person to be
diagnosed with proprioception, many cases
were discovered soon after. These cases were
caused by the overuse of Vitamin B6
(pyridoxine).
•  
Christina had no hope of recovery and was
destined to live her life seemingly ‘bodiless’,
however these other cases may have
improved if the use of Vitamin B6 was
stopped.

Any Questions