Musicophilia by Oliver Sacks

Musicophilia is a medical short-story book brimming with anecdotes about people’s musical afflictions and talents—their amusias, dysharmonias, dystimbrias, and synesthesias. It suggests a carnival of freakish specimens with perfect pitch and musical hallucinations. But for author Oliver Sacks, those abnormalities are only a way of getting at what’s profoundly normal—our love of music, our “musicophilia.” Sacks focuses on cases of extreme musical ability and disability in order to demonstrate that humans “are a musical species no less than a linguistic one.” Tone deafness is the exception that proves the rule.

Sacks is a seventy-four-year-old practicing neurologist and nine-time author known primarily for his 1973 book Awakenings—a chronicle of his experience at a Bronx hospital treating survivors of encephalitic lethargica, or “sleeping sickness.” (A successful 1990 film adaption of the book starred Robert De Niro as Sacks.) Sacks is a doctor, not a sociologist or professional musician, so it’s no surprise that he views the universal appeal of music chiefly as a neurological phenomenon, what Sacks describes as music’s “extraordinary neural robustness.” Unlike language or motor function, musical appreciation isn’t centrally located within any region of the brain. Dancing to James Brown or humming along to Samuel Barber’s Adagio for Strings relies on a number of brain functions without depending solely on any. We listen with all of ourselves—even, as Nietzche wrote, “with our muscles.” Music is inextricable from our identity. Even amid the ravages of Alzheimer’s or Parkinson’s, music remains instinctive.

These are noble (if not particularly revolutionary) theories. The idea that music is the sine qua non of the human experience and that we can see this played out in the machinations of the mind is a beautiful marriage of philosophy and neurology. But Sacks does not do it justice. Musicophilia reads like a survey of illness rather than a storyof illness. The subjects—many of whom, being patients of Sacks and other physicians, are largely unidentified—appear rather like anonymous septuagenarians floating in a sea of musical anomalies. There’s Sheryl C., whose musical hallucinations wake her up in the middle of the night with a racket of “trolley cars [and] bells clanging” that only she can hear; there’s Jacob L., a composer whose upper-range hearing loss causes him to hear certain high notes distinctly sharp or flat; there’s a nameless musician whose synesthesia allows her to instantly associate any musical interval with a taste (minor thirds are “salty,” a fifth is like “pure water”). By the time you’ve figured out what musician’s dystonia means, Sacks has already moved on to the next exhibit. Rarely does he find the time for more depth or the patient willing to supply the material to construct it.

A notable exception is Clive Wearing, a British musicologist who contracted a brain infection in 1985 that erased twenty years of memories and left him unable to retain new ones for more than a few seconds. (Wearing’s story appeared in a recent issue of The New Yorker.)  The extent of Wearing’s terrifying “lostness”—a life where no moment logically follows from its parent—is illustrated by the journals he kept immediately after recovering from his infection. Page after painful page contains contradictory existential assertions: “this time properly awake,” followed five minutes later by “this time finally awake,” followed again by “… I awoke for the first time, despite my previous claims.” Wearing lived in the moment, and nowhere else.

Today, Wearing finds his way forward by relying on two guideposts—his wife Deborah and his piano. While his brain infection decimated Wearing’s “episodic memory,” his “procedural memory” remained largely intact. Wearing can’t remember what he eats each morning, but he can brush his teeth with no problem. The former requires the retention of a unique event, an episode, while the later is simply a matter of recalling how something is done, the procedure for applying toothpaste to brush and brush to teeth. As he and Deborah have happily discovered, music is primarily a function of procedural memory: Wearing can still read music, play the piano, and sing along with his wife. These abilities rely on “larger and more primitive” structures intersecting throughout the brain (music’s “neural robustness”)—structures left largely untouched by Wearing’s infection. One doesn’t remember how to play Chopin—one simply plays him. Musical performance is, as Sacks describes it, “entirely in the present.”


At the piano, Wearing finds himself. Music—that most human of activities—reanimates his identity, gives it substance and texture. In a text scarred by dry prose, Wearing elicits some rare emotion from Sacks:

And yet one has only to see him at the keyboard or with Deborah to feel that, at such times, he is himself again and wholly alive. It is not the remembrance of things past, the “once” that Clive yearns for, or can ever achieve. It is the claiming, the filling, of the present, the now, and this is only possible when he is totally immersed in the successive moments of an act. It is the “now” that bridges the abyss.

For a book so committed to music’s universality, it is troubling that Sacks remains so committed to a narrow definition of his beloved muse. In Musicophilia, “music” is simply read as “classical music.” Like Wearing, Sacks’ characters are generally middle-aged and older, and many of them are composers or performers of Bach, Beethoven, and Schubert. Sacks is content to ignore the great swath of humanity animated by jazz or blues, rock or pop, Indonesian gamelan or West African kora. His bias alienates readers who would otherwise warm to his quirky characters.

When Sacks does venture beyond the cushy comfort of dead Europeans, he seems hopelessly out of touch. At a 1991 Grateful Dead concert in the company of a patient suffering from a brain tumor that left him largely unresponsive to music, Sacks suddenly finds himself, like his friend, “unable to remain a detached observer.” “I realized that I, too, was moving, stamping, clapping with the music,” he writes, “and soon lost all my usual diffidence and inhibition and joined the crowd in communal dancing.” Such stodginess hurts Sacks’ credibility. One can only assume that an author with a more diverse iTunes library could have written a book with more humanity and humor.

In the preface, Sacks worries whether the latest advances in medical technology—advances that have allowed neuroscientists to observe the brain in the act of listening to or composing music—may discount “the richness of the human context.” Musicophilia is partly an attempt to balance the scales, to give flesh and blood to super-rare neurological disorders and the wonky medical-speak used to describe them. Music is that humanizing force—we all respond to it, and with music therapy it can make us healthier.

But Sacks’s celebration of sound suffers from too many characters and too little depth. Sacks is so busy naming musical oddities that he forgets to tell us what they look, feel, and sound like. Casting a wide net is not, in fact, the best way to illustrate music’s ubiquitous power. It’s by focusing in and diving deep that we appreciate music’s eerie sway, that we see lives made livable—that we see ourselves.