by Oliver Sacks
I was hired a few months ago to write a score for a large string orchestra and several solo instruments, which largely called for semi-dissonant twelve-tone techniques and the use of the full orchestral range…. In short, the most difficult kind of music for me to compose with my cochlear amusia. But I just plunged ahead…I even capably conducted the recording sessions, with my longtime music producer in the recording booth checking for pitch problems, wrong notes, making sure the balance was correct, etc. During the sessions I did have the expected problems accurately hearing some of the high passages, but when they sounded “funny” I knew that my producer was hearing them correctly and checking everything…. Anyway, the score came out wonderfully.
To my disbelief, in the weeks immediately following all this, I started to notice, as I worked at the piano or synthesizer, that my amusia was ameliorating. Not consistently— some days it was worse again, some days better— some tonal areas better than others, then a different set of anomalies the next day, or even next moment!— but generally improving. Sometimes I would check it first thing in the morning, and it was almost normal at first, but within a few seconds it would jump back to the aberrant norm. But then I would try to “correct” it with an effort of will and/or by playing the same note an octave or two lower to help pull it back in to accuracy, and I found I could do this more and more often. This nonlinear but generally improving process has continued now for almost two months.
This improvement seemed to start happening right after I was composing, producing, conducting, and trying to hear— both in my inner and outer ears— harmonically and texturally complex music with an extremely wide tonal range. Perhaps it was like doing extensive musico-neurological calisthenics, and I was gradually strengthening whatever mechanism of will exists in the old gray matter that can be focused on this problem…. It may be worth mentioning that during these last four or five months I’ve been very busy with other musical projects as well…. I first started noticing the distortions after and during a period of relatively little compositional activity; and now they have abated after a period of very intense and varied compositional activity.5
Jacob, of course, is overjoyed at this change, which promises to reopen a once-closing door, expanding his musical life and his enjoyment of music to the full again. And I, as a neurologist, am filled with wonder that the retuning in his musician’s brain has been able to counterbalance the patchy and inconstant output from his aging cochleas, that through intensive musical activity, attention, and will, Jacob’s brain has literally reshaped itself.
11
In Living Stereo: Why We Have Two Ears
In 1996 I began corresponding with a Norwegian physician, Dr. Jorgen Jorgensen, who had written to tell me that his appreciation of music had been altered suddenly and radically when he lost all hearing in the right ear, after removal of an acoustic neuroma in the sensory nerve. “The perception of the specific qualities of music— pitch, timbre— did not change,” he wrote. “However, my emotional reception of music was impaired. It was curiously flat and two-dimensional.” Mahler’s music, in particular, had once had a “shattering” effect on him. But when he went to a concert soon after his surgery and heard Mahler’s Seventh Symphony, it sounded “hopelessly flat and lifeless.”
After six months or more, he began to adapt to this:
I gained a pseudostereo effect, which although it cannot have been as it used to be, gave me ample compensation. The music was not stereo, but it was all the same broad and rich. So, in the opening funeral march of Mahler’s Fifth, after the trumpet announces the gloomy depth of a funeral procession, the full orchestra fortissimo, I was almost lifted out of the chair.
“This may be my own psychological adjustment to the loss,” Dr. Jorgensen added, “[but] our brain is a wonderful instrument. Hearing fibres may have crossed in the corpus callosum to receive input from my functioning left ear…. I also believe my left ear is better than should be expected from a seventy-year-old.”
When we listen to music, as Daniel Levitin has written, “we are actually perceiving multiple attributes or ‘dimensions.’ ” Among these he includes tone, pitch, timbre, loudness, tempo, rhythm, and contour (the overall shape, the up and down of melodies). One speaks of an amusia when the perception of some or all of these qualities is impaired, but Dr. Jorgensen was not amusic in this sense. His perception in the unaffected left ear was normal.
Levitin goes on to speak of two other dimensions. Spatial location, he writes, is “the perception of how distant the source is from us, in combination with how large a room or hall the music is in…it distinguishes the spaciousness of singing in a large concert hall from the sound of singing in your shower.” And reverberation, he writes, “has an underappreciated role in communicating emotion and creating an overall pleasing sound.”
It was precisely these qualities that Dr. Jorgensen missed when he lost the ability to hear in stereo. When he went to a concert, he found that it lacked spaciousness, voluminousness, richness, resonance— and this rendered the music “flat and lifeless.”
I was struck here by the analogy to the experience of those who lose the use of one eye, and with this their ability to see depth stereoscopically.1 The resonances of losing stereoscopy can be unexpectedly far-reaching, causing not only a problem in judging depth and distance, but a “flattening” of the whole visual world, a flattening that is both perceptual and emotional. People in this situation speak of feeling “disconnected,” of a difficulty in relating themselves not only spatially but emotionally to what they are seeing. The return of binocular vision, if this occurs, can thus give great pleasure and relief, as the world once again seems visually and emotionally rich. Yet even if there is no restoration of binocular vision, there may be a slow change, an adaptation analogous to what Dr. Jorgensen described— the development of a pseudostereo effect.
It is important to emphasize the word “pseudostereo.” Genuine stereo perception, either visual or auditory, depends on the brain’s ability to infer depth and distance (and such qualities as rotundity, spaciousness, and voluminousness) from the disparities between what is transmitted by the two individual eyes or ears— a spatial disparity in the case of the eyes, a temporal disparity in the case of the ears. Tiny differences are involved here, spatial disparities of a few arc seconds with vision, or of microseconds with hearing. This allows some animals, especially nocturnal predators like owls, to construct a veritable sound map of the environment. We humans are not up to this standard, but we nevertheless use binaural disparities, no less than visual cues, for orienting ourselves, for judging or forming impressions of what lies around us. It is stereophony that allows concertgoers to enjoy the full complexity and acoustic splendor of an orchestra or a choir performing in a concert hall designed to make listening as rich, subtle, and three-dimensional as possible— an experience we try to re-create, as best we can, with two earphones, or stereo speakers, or surround sound. We tend to take our stereo world for granted, and it requires a mishap like Dr. Jorgensen’s to bring home, starkly and suddenly, the huge but often overlooked importance of having two ears.
No genuine stereo perception is possible if one has lost an eye or an ear. But as Dr. Jorgensen observed, a remarkable degree of adjustment or adaptation can occur, and this depends on a variety of factors. One of these is the increased ability to make judgments using one eye or ear, a heightened use of monocular or monaural cues. Monocular cues include perspective, occlusion, and motion parallax (the shifting appearance of the visual world as we move through it), and monaural cues are perhaps analogous to these, though there are also special mechanisms peculiar to hearing. The diffusion of sound with distance can be perceived monoaurally as well as binaurally, and the shape of the external ear, the pinna, provides valuable cues about both the direction and the asymmetries of sound reaching it.
If one has lost stereoscopy or stereophony, one must, in effect, recalibrate one’s environment, one’s spatial world— and movement here is
especially important, even relatively small but very informative movements of the head. Edward O. Wilson describes in his autobiography, Naturalist, how he lost an eye in childhood but nonetheless is able to judge distances and depths with great accuracy. When I met him I was struck by a curious nodding of the head, and took this to be a habit or a tic. But he said it was nothing of the sort— it was a strategy designed to give his remaining eye alternating perspectives (such as normally the two eyes would receive), and this, he felt, combined with his memories of true stereopsis, could give him a sort of simulacrum of stereo vision. He said that he adopted these head movements after observing similar movements in animals (like birds and reptiles, for instance) whose visual fields have very little overlap. Dr. Jorgensen did not mention any comparable head movements in himself— they would not be too popular in a concert hall— but such movements might well help one construct a richer, more diverse soundscape.
There are other cues that stem from the complex nature of sounds and the vicissitudes of sound waves as they bounce off objects and surfaces around one. Such reverberation can provide an enormous amount of information even to a single ear, and this, as Daniel Levitin has remarked, has an essential role in communicating emotion and pleasure. It is for this reason that acoustical engineering is a major science and art. If a concert hall or lecture hall is badly designed, sounds may be “killed,” voices and music seem “dead.” Through centuries of experience, the builders of churches and auditoriums have become remarkably adept at making their buildings sing.
Dr. Jorgensen says that he believes his good ear is “better than should be expected from a seventy-year-old.” One’s ear, one’s cochlea, cannot improve as one gets older, but as Jacob L. clearly demonstrated, the brain itself can improve its ability to make use of whatever auditory information it has. This is the power of cerebral plasticity. Whether or not “hearing fibres may have crossed in the corpus callosum” to the other ear, as Jorgensen suggests, is questionable— but there most assuredly have been significant changes in his brain as he has adapted to life with one ear. New connections must have been made, new areas recruited (and a sufficiently subtle brain-imaging technique might be able to demonstrate such changes). It seems probable, too— for vision and hearing normally complement each other and tend to compensate for each other if one is impaired— that Dr. Jorgensen, consciously or unconsciously, is using vision and visual data to map the position of instruments in the orchestra and the dimensions, spaciousness, and contours of the concert hall, as a way of reinforcing a sense of auditory space.
Perception is never purely in the present— it has to draw on experience of the past; this is why Gerald M. Edelman speaks of “the remembered present.” We all have detailed memories of how things have previously looked and sounded, and these memories are recalled and admixed with every new perception. Such perceptions must be especially powerful in a strongly musical person, a habitual concertgoer like Dr. Jorgensen, and imagery is surely recruited to complement one’s perceptions, especially if perceptual input is limited. “Every act of perception,” Edelman writes, “is to some degree an act of creation, and every act of memory is to some degree an act of imagination.” In this way the brain’s experience and knowledge are called upon, as well as its adaptability and resilience. What is remarkable in Dr. Jorgensen’s case, at least, is that, after such a severe loss, with no possibility of function being restored in the ordinary sense, there has nonetheless been a significant reconstruction of function, so that much of what seemed irretrievably lost is now available to him again. Though it took some months, he has, against all expectation, been able to recover in large measure what was most important to him: the richness, the resonance, and the emotional power of music.
* * *
DR. JORGENSEN’S ACCOUNT was the first I had received of the effects of sudden deafness on one side, but since he wrote to me, I have found that his experience is far from unusual. One friend of mine, Howard Brandston, related to me how, twenty years ago, he had an attack of sudden vertigo, followed by an almost complete loss of hearing in his right ear. “I could still hear sounds on that side,” he said, “but could not unscramble words or distinguish tonal differences.” He continued:
The following week I had concert tickets but the musical performance sounded flat, lifeless, and without the harmonious quality I loved. Yes, I could recognize the music, but instead of the uplifting emotional experience I was anticipating, I became so depressed that tears came to my eyes.
There were other problems, too. Howard was an avid hunter, and on his first deer-hunting trip after his hearing loss, he found that his ability to locate sounds was severely undermined:
Standing absolutely still, I could hear the scurry of the chipmunk, the foraging of the squirrel, but the ability I formerly had to pinpoint the location of these sounds was now lost to me. I began to realize that if I wished to be a successful hunter, I would have to learn to compensate for the sensory handicap.
After several months, Howard discovered many ways to compensate for his hearing loss on one side. He would alternate between analyzing a scene visually and auditorily, trying to meld the two perceptual inputs. “After a while,” he said, “I no longer had to close my eyes if I kept scanning the scene by moving my head in a side-to-side motion, with a very slight up-and-down wave motion. After quite a while I began to feel comfortable enough to go dangerous game hunting again. Now I was searching for sounds that were familiar to me.”2
In a concert hall, Howard learned to turn his head slightly, “as if I was looking at the instruments that would be playing at that moment— to the left for the violins and slightly to the right for the bass and percussion.” The sense of touch, as well as that of sight, was crucial in helping him reconstruct a sense of musical space. He experimented with his stereo’s subwoofer, which, he said, “made me most aware of the tactile physical nature of the sounds I was listening to.” In his trophy room, which he had designed to be a perfect listening environment for his high-end stereo, he would use the power of the subwoofer to help him “round up” memories and images of sound and space. Perhaps all of us, unconsciously, use visual and tactile cues along with auditory ones to create the fullness of musical perception. With these and doubtless many other accommodations, both conscious and unconscious, Howard now gets a pseudostereo effect, as Dr. Jorgensen does, and he enjoys music once again.
12
Two Thousand Operas: Musical Savants
The first adult musical savant I met was a retarded man who had been admitted to a nursing home where I worked.1 Martin had been normal at birth, but at the age of three he contracted meningitis, which caused seizures and a spastic weakness of his limbs and voice. It also affected his intelligence and personality, so that he became impulsive, “odd,” and unable to keep up with his classmates at school. But along with these problems, he developed curious powers: he became fascinated by music, would listen to it intently, and would then sing the melodies he had heard or play them on the piano, as best he could with his spastic limbs and voice. He was greatly encouraged in this by his father, who was a professional opera singer.
Along with his musical abilities, Martin also developed a prodigious rote memory. Once he was fitted with glasses for the very severe visual problems he had been born with, he became an avid reader, retaining (though often not understanding) everything he read. And this, like his musical memory, was auditory— whatever he read he heard in his mind’s ear, sometimes in his father’s voice. As some people may be said to have a photographic memory, Martin had a phonographic one.
Though solitary in his habits, Martin was able to live independently and to do simple, unskilled work. His only pleasure, seemingly, was to sing in church choirs; he could not be a solo singer with his hoarse, spastic voice. But by the time he was sixty-one, his increasing physical disabilities (arthritis and heart disease among them) brought him to the nursing home.
When I met him in 1984, he told me that he knew more than tw
o thousand operas, as well as the Messiah, the Christmas Oratorio, and all of Bach’s cantatas. I brought along scores of some of these, and tested him as best I could; I found I was unable to fault him. And it was not just the melodies that he remembered. He had learned, from listening to performances, what every instrument played, what every voice sang. When I played him a piece by Debussy that he had never heard, he was able to repeat it, almost flawlessly, on the piano. He then transposed it into different keys and extemporized on it a little, in a Debussyan way. He could grasp the rules and the conventions of any music he heard, even if it was unfamiliar or not to his taste. This was musicianship of a high order, in a man who was otherwise so mentally impoverished.
What was the origin of Martin’s musical powers? He had an intensely musical father, and musical ability is often inherited, as with the seven generations of the Bach family. He was born into and grew up in a musical household. Was this enough, or did his auditory and potentially musical powers also gain strength from the poorness of his vision? (Darold Treffert, in his remarkable book on savantism, Extraordinary People, notes that more than a third of all musical savants are blind or have very poor vision.) Martin was born with very severe visual problems, but this was not recognized and corrected until he was almost three, so in these early years he must have been nearly blind and dependent on hearing to orient him and make sense of the world. Or was it the meningitis, which, while stripping him of some of his cortical controls and higher powers, also stimulated or released previously unsuspected savant powers?
The term “idiot savant” was introduced in 1887 by Langdon Down, a London physician, in reference to “feebleminded” children who had special and sometimes remarkable “faculties.” Among these were exceptional powers of calculation, drawing, mechanical aptitude, and, above all, of remembering, playing, and sometimes composing music. The case of Blind Tom, an American slave who exhibited prodigious musical powers from an early age, attracted worldwide attention in the 1860s.2 Musicality is indeed the most common and perhaps the most dramatic form of savant talent, for it readily comes to public notice and commands attention. Darold Treffert devoted a large part of Extraordinary People to musical savants, and Leon K. Miller wrote an entire book about a single musical savant, Eddie.3 Detailed studies of savant talents and especially of musical savant skills have been carried out by Beate Hermelin and others in London, and these confirm that such skills depend on the recognition (which may be implicit and unconscious) of essential musical structures and rules, as is the case with normal musical skills. The anomaly is not in the skill itself, but in its isolation— its unusual and sometimes prodigious development in a mind that may otherwise be markedly underdeveloped in verbal and abstract thought.