Book Review: The Mind's Eye

Abstract

The Mind's Eye. Oliver Sacks. New York: Vintage Books, Knopf Doubleday, 2011, 288 pages, $15. Oliver Sacks' recent book, The Mind's Eye, is well worth a read. He has created an amalgam of detailed clinical anecdotes that weave a story of the remarkably resilient and flexible capabilities exhibited by the human mind in the face of adversity. He describes how damage to the eye or brain can reveal the nature of brain mechanisms, and he highlights some of the many remarkable strategies that the remaining, intact brain can employ to circumvent damaged areas. Sacks is a master storyteller. He lucidly explains complex science, and describes how this knowledge can be used to help his patients in their day-to-day lives. LOSS OF SPOKEN LANGUAGE AND THE ABILITY TO READ Massive stroke due to hemorrhage into the left side of the brain impairs movement on the other side of the body, and in most people impairs the ability to speak due to aphasia, which is often associated with the ability to read. In some people, however, the capacity to reason linguistically remains intact, as in the remarkable patient, Pat, whom Sacks describes. This ability, combined with the enhanced vibrant and dynamic body language that she developed, enabled her to ultimately communicate with verve and fluency. The idea that a stroke ends a person's inner life was completely rejected by Pat's daughters, who adopted a totally positive approach to her medical condition. Despite the understandable overwhelming nature of her neurological disorder, Pat ultimately conquered over adversity. Using multiple adaptive strategies, she became skilled at understanding and communicating by means of a range of alternative approaches. In particular, she gained an ability to communicate fluently by selecting a succession of singular printed words, which she had become able to read, using a custom-designed lexicon compiled by her daughters. Neurological alexia is an inability to read, due to focal damage to the brain. The case of Howard Engel is described in which a stroke affecting the object- and shape-recognition centers in the left temporal lobe of his brain led to objects such as fruit becoming unidentifiable. This deficit was associated with problems recognizing colors and faces, which can also be affected by damage in the same area of the brain. Engel is portrayed as a Canadian writer known for his Benny Cooperman series of detective novels, so his inability to recognize printed words became a major barrier to his rehabilitation. The paradox of his disorder was that he retained the capacity to write, known as alexia without agraphia. In describing the treatment approach for Engel, Sacks highlights a lecture given by the French neurologist Charcot in 1883, in which he described a patient with the selfsame condition, who relearned how to read, not through vision, but by means of gesticulating the letters in the air. (This has been referred to as pantomiming by Goodale and Milner, in their 2004 book, Sight Unseen.) Engel took this strategy one step further; he instead learned to trace the letters that he was unable to read visually with his tongue on the roof of his mouth as an alternative route to reading! Through persistence and tenacity he has written two more books that draw upon his personal experiences. INABILITY TO RECOGNIZE OBJECTS AND FACES Progressive cortical atrophy affecting the visual brain is a rare, untreatable disorder. When it affected an able and skilled musician, she dealt with her resulting slowly progressive inability to recognize mundane objects by sight (known as object agnosia) in much the same way as someone who is blind adapts to vision loss. The specific colors of kitchen implements aided her in their identification, but the use of colored labels--which could have revealed to others her visual difficulties--was rejected in favor of her own memories regarding where she had placed the objects complemented by their tactile characteristics. …