by Oliver Sacks
There is also an explosion of interest in the neurology of music and all its therapeutic powers in patients with neurological disorders. Anthony Storr, the psychiatrist, has written a beautiful book, Music and the Mind, which touches on every aspect of human response to music. In a chapter entitled “Music and the Brain”, in the forthcoming book Music and Neurologic Rehabilitation, I have focused more narrowly on the possible ways in which music can affect the brain.
Mickey Hart has written about percussion and rhythm in many cultures, in Drumming at the Edge of Magic.
A SURGEON’S LIFE
Gilles de la Tourette’s two-part paper, “Étude sur une affection nerveuse”, was published in 1885, and a partial translation is included, with a commentary, in “Gilles de la Tourette on Tourette Syndrome”, by C.G. Goetz and H.L. Klawans. Meige and Feindel’s great book, Les Tics et leur traitement, was published in 190a and translated by Kinnier Wilson in 1907. This book is remarkable not only for its comprehensiveness, but for its tone-the authors’ respect for their subjects and the real conversations between them and their physicians. It includes a unique, early autobiographical narrative, “Les Confidences d’un ticqueur.”
It is only in the last few years that there have been more accounts from the inside about what it can mean to live with Tourette’s. A series of such inside narratives, edited by Adam Seligman and John Hilkevich, was published as Don’t Think About Monkeys.
I have written a number of papers on Tourette’s: “Witty Ticcy Ray”, originally published in 1981, was republished in The Man Who Mistook His Wife for a Hat, along with “The Possessed.” A general overview of the subject is given in “Neuropsychiatry and Tourette’s”, published in 1989, and more briefly and recently in “Tourette’s Syndrome: A Human Condition.” A particular aspect of Tourette’s that has always fascinated me was presented in “Tourette’s and Creativity”; and research on the speed and accuracy of Tourettic movement, “Movement Perturbations Due to Tics”, appeared in the 1993 Society for Neuroscience Abstracts.
The Tourette Syndrome Association, 42-40 Bell Boulevard, Bay side, NY 11361, first founded in 1971, disseminates information, gives physician referrals, and sponsors research. It can be contacted at (718) 224-2999 or (800) 237-0717 for information on local chapters.
TO SEE AND NOT SEE
The restoration of vision to those blinded early in life, though rare, has been documented with great care since Cheselden’s report in 1728. All known cases up to 1930 are summarized in von Senden’s encyclopedic book, Space and Sight. Many of these are analyzed by Hebb in his Organization of Behaviour and form, along with much other observational and experimental data he provides, crucial evidence that “seeing”—visual perception-must be learned.
The single richest and most detailed case study is that of Richard Gregory and Jean Wallace. This was subsequently reprinted, with further additions, including an exchange of letters with von Senden, in Gregory’s Concepts and Mechanisms of Perception. The philosophical background to the Molyneux question and the impact of the Cheselden case are also well described by Gregory in his article “Recovery from Blindness”, in The Oxford Companion to the Mind.
Alberto Valvo’s deeply pondered cases of patients submitted to a new surgical procedure for corneal reconstruction are described in his Sight Restoration after Long-Term Blindness.
The effects of late blindness-most especially its effects on visual imagery and memory, orientations, and attitudes-have been masterfully described by John Hull in his autobiographical book, Touching the Rock. And the restoration of vision after late blindness is finely described in Second Sight, by Robert Hine.
One of the deepest, widest-ranging explorations of what it may mean in terms of identity to be blind, both to the individual and to those around him, was given by Diderot in his great Letter on the Blind: For the Use of Those Who Can See (he wrote a similar Letter on the Deaf and Dumb: For the Use of Those Who Can Hear and Speak). Von Feuerbach’s account of Kaspar Hauser contains a remarkable description of his profound visual agnosia when first released into the daylight, after being kept in a lightless dungeon since infancy (pp. 64-5).
These themes have not only been the subject of philosophical discussions and case reports, but of fiction and dramatic reconstruction, ever since Diderot’s imagination of Nicholas Saunderson’s deathbed. In 1909 the novelist Wilkie Collins based a novel, Poor Miss Finch, on such a subject, and the theme is also central in Gide’s early novel La Symphonie pastorale. A more recent treatment is a brilliant reconstruction by Brian O’Doherty, The Strange Case of Mademoiselle P., very closely based on Mesmer’s original 1779 account. In Brian Friel’s 1994 play, Molly Sweeney, the central character is, like Virgil, blind from early life with retinal damage and cataracts, and, following the removal of the cataracts in middle life, is plunged into a state of agnosic confusion and ambivalence, which is resolved only by a final reversion to blindness.
THE LANDSCAPE OF HIS DREAMS
The original report on Franco Magnani, written by Michael Pearce and illustrated with reproductions of Franco’s paintings and Susan Schwartzen-berg’s photographs in linked pairs, is found in the Exploratorium Quarterly for Summer 1988.
Esther Salaman’s A Collection of Moments provides a beautiful literary and psychological study of “involuntary memories” as they occurred in Proust, Dostoevsky, and other writers. An excerpt from this, and the greater part of Schachtel’s paper on memory and childhood amnesia, Stromeyer’s classic account of an Eidetiker, a segment of Luria’s Mind of a Mnemonist, and much else, are to be found in an invaluable sourcebook, Ulrich Neisser’s Memory Observed.
Frederic Bartlett’s classic book, Remembering, brings together his experiments showing the constructive, imaginative quality of memory.
The eruption of “experiential” memories during seizures (and their elicitation by direct stimulation of the brain at surgery) is described in almost novelistic detail by Wilder Penfield (and his colleague Perot) in a book-length article, “The Brain’s Record of Visual and Auditory Experience”, in Brain. This same volume of the journal also contains a striking account of Dostoevsky’s epilepsy, by Alajouanine. A readable and accessible description of TLE and Dostoevsky syndrome, both in relation to ordinary people and to celebrated artists and thinkers, is given in Eve LaPlante’s Seized: Temporal Lobe Epilepsy as a Medical, Historical, and Artistic Phenomenon.
A good historical discussion and acute psychoanalytic consideration of nostalgia is given by David Werman in “Normal and Pathological Nostalgia.”
PRODIGIES
Darold Treffert’s Extraordinary People is an excellent introduction to the subject of idiot savants, drawing as it does equally on historical accounts (from Séguin, Down, Tredgold, and others) and Treffert’s own clinical experience.
In a more academic vein, The Exceptional Brain, edited by Loraine Obler and Deborah Fein, brings together a great range of research regarding human talents in general, and savant talents in particular.
Steven Smith’s book, The Great Mental Calculators, is the fullest source of observations on calculating talent as it occurs in normal as well as retarded and autistic people.
A particular favorite of mine, never noted by current writers, is F.W. H. Myers’s Human Personality. Myers himself was a genius, and this shows in every sentence of his great (though often absurd) two-volume book. The chapter on “Genius” is a penetrating and prescient account of computing talents in relation to the cognitive unconscious.
Though Loma Selfe’s Nadia: A Case of Extraordinary Drawing Ability in an Autistic Child is, sadly, out of print, Howard Gardner’s Art, Mind, and Brain contains an important essay on Nadia, which was to some extent the starting point of his subsequent, widely ramifying studies on intelligence and creativity. A particularly thoughtful review of Nadia is provided by Clara Claiborne Park, in which she compares Nadia’s work with that of her daughter, Jessy, and other autistic artists.
The most detailed cognitive in
vestigation of a musical savant, Eddie, is given by Leon K. Miller in his book Musical Savants.
The extensive investigations of Beate Hermelin and her colleagues (including Neil O’Connor and Linda Pring) are mostly available as individual papers, which include detailed studies of Stephen Wiltshire and other savants. An early paper by O’Connor and Hermelin, “Visual and Graphic Abilities of the Idiot Savant Artist”, reproduces and discusses some of Stephen’s early work.
The 1945 monograph on a savant subject, L., “A Case of ‘Idiot Savant’: An Experimental Study of Personality Organization”, by Martin Scheerer, Eva Rothmann, and Kurt Goldstein, raises fundamental questions unanswered (and often unasked) today. It is, to my mind, the deepest and most searching analysis ever made of the savant (and autistic) mind. L. is clearly autistic, though this term is not used, because the original version of the paper appeared in 1941, before Kanner’s description of autism. In their later, fuller 1945 paper, Goldstein et al. compare their formulations with Kanner’s.
Merlin Donald’s book, Origins of the Modern Mind, in which he speculates on the mimetic powers of primitive man, opens vast historical vistas and is one of the most powerfully argued and imaginative reconstructions I have seen of our past (and perhaps future) mental evolution. Jerome Bruner has explored the development of thinking in the child for many years; a very clear account of the “enactive” stage is given in Studies in Cognitive Growth.
A fascinating and richly illustrated study of a gifted, retarded octogenarian artist is John MacGregor’s Dwight Macintosh: The Boy Whom Time Forgot.
I have written three other case histories of savant syndrome, all published in The Man Who Mistook His Wife for a Hat: “The Autist Artist”, “The Twins”, and “A Walking Grove.”
Finally, and most importantly, there are Stephen’s own books: Drawings, Cities, Floating Cities, and Stephen Wiltshire’s American Dream. (Unfortunately, only Floating Cities is currently in print in the United States.)
See the suggested readings for “An Anthropologist on Mars” for more books on autism, and for autism associations.
AN ANTHROPOLOGIST ON MARS
The delineation of autism as a medical condition goes back to the pioneer papers of Kanner, Asperger, and Goldstein in the 1940s; while it was psychiatrically defined (with misleading suggestions of parental etiology) by Bruno Bettelheim in the 1950s (and later in The Empty Fortress), and finally established as a biological condition in the 1960s (when Bernard Rimland’s Infantile Autism was published), autism was not fully portrayed as a human condition until biographical and finally autobiographical narratives began to appear.
One of the first (and still the best) of these is The Siege: The First Eight Years of an Autistic Child, by Clara Claiborne Park. Mira Rothenberg’s Children with Emerald Eyes is a collection of portraits-at once clinical, analytic, empathetic, and poetic-of a dozen children among the hundreds in her pioneering Blueberry Treatment Centers. Charles Hart, in Without Reason, provides a remarkable account of his experience of having first an older brother, then a son, with autism. Jane Taylor McDonnell’s beautifully written News from the Border contains an afterword by her autistic son, Paul.
There has indeed been an explosion of books written about and by autistic people since 1990 (many centering on the complex questions of facilitated communication), and it is difficult to mention any of these without appearing to ignore others. But in terms of its forthrightness, its vigor, its fullness and insight (to say nothing of its priority-for it was the book that gave direct, personal access to an autistic world for the first time), there is nothing to match Temple Grandin’s own book, Emergence: Labeled Autistic.
Uta Frith’s Autism: Explaining the Enigma is a very clear and balanced account, though oriented perhaps too exclusively in a “theory of mind” direction. Autism and Asperger Syndrome, edited by Frith, contains a number of important articles, including clinical accounts by Christopher Gillberg, Digby Tantam, and Margaret Dewey. It also contains an essay on the autobiographical writings of Asperger adults, including Temple, by Francesca Happé; and the first English translation of Asperger’s original 1994 paper, appended to a searching essay by Frith on his contributions. Asperger was, in a sense, “discovered” by Lorna Wing, and her essay comparing his approach and insights with Kanner’s also appears in this volume.
The Autism Society of America has chapters throughout the United States and in Puerto Rico. The national headquarters can be contacted at 7910 Woodmont Avenue, Suite 650, Bethesda, MD 20814, telephone (301) 565-0433 or (800) 328-8476. In England, the National Autistic Society is located in 276 Willesden Lane, London NWi 5RB, telephone (081) 451-1114. More Able Autistic People (MAAP), Box 524, Crown Point, IN 46307, publishes a newsletter on higher-functioning people with autism. The Autism Society of Canada is at 129 Yorkville Avenue, Suite 202, Toronto, Ontario M5R 1C4, telephone (416) 922-0302.
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