The Man Who Mistook His Wife For a Hat (no spam please)

frogus · Post by **frogus** » Tue Mar 19, 2002 2:21 pm

Has anyone read 'The Man Who Mistook His Wife For a Hat' by Oliver Sacks?
If not, then it is a book of interesting and occasionally amusing cases that Dr Oliver Sacks has come across in his carreer as a neurologist/neuropsychologist.

Anyway, this thread is for discussion and anecdotes of intersting neurological disorders and bizarre excesses heard of by you lot, specifically relating to the so-called 'Idiot Savants', people with autism who can 'access' the obscure reaches of their brains which most of us have to 'chunk', 'group' and ignore the actions of, enabling them super-human feats of mathematic or musical ability.

frogus · Post by **frogus** » Tue Mar 19, 2002 2:47 pm

here's one to kick off with (lifted out of TMWMHWFaH):

The Twins:

The Twins, who were then 26 years old, had been in institutions since the age of 7, variously diagnosed as autistic, psychotic or severely retarded...They are, indeed, unprepossesing at first encounter- a soert of grotesque Tweedledum and Tweedledee, indistuinguishable, mirror images, identical in face, in body movements, in personality, in mind, identical too in their stigmata of brain and tissue damage. They are undersized, with disturbing disproportions in head ad hands, high-arched palates, high arched feet, monotonous squeaky voices, a variety of peculiar tics and mannerisms, and a very high, degenerative myopia requiring glasses so thick that their eyes seem distroted, givbing them the appearence of absurd little proffesors, peering and pointing, with a misplaced, obsessed and absurd concerntration...The twins say 'Give us a date- any time in the last or next forty thousand years.' You give them a date, and, almost instantly, they tell you what day of the week it would be. 'Another date!' they cry...Their memory for digits is remarkable- and possibly unlimited. They will repeat a number of three digits, of thirty digits, of three hundred digits with equal ease. This too has been attributed to a 'method'...when one comes to test their ability to calculate-the typical forte of arithmetical prodigys and 'mental calculators' -they do astonishingly badly, as badly as their IGs of 60 might lead one to think...soemthing mysterious, though commonplace, is operating here. The mysterious human ability to form unconscious algorithms on the basis of examples...They can tell one the weather, the events, of any day of their own lives...Give them a date, and their eyes roll for a moment, and then fixate, and in a flat, monotonous voice they tell you of the weather, the bare political events that they would have heard of, and the events of their own lives-the last often including the painful or poignant anguish of childhood, the contempt, the mortifications, the jeers they endured...A box of matches on their table fell, and discharged its contents on the floor: '111' they both cried symoultaniously; and then, in a murmur, John said '37'. Michael repeated this, John said it a third time and stopped. I counted the matches, it took me soem time, and there were 111. 'How did you count the matches so quickly?' I asked. 'We didn't count,' they said 'We saw the 111.'

Obsidian · Post by **Obsidian** » Tue Mar 19, 2002 4:57 pm

It leads one to wonder, if those abilities are only reachable through a trade off of the average persons skills and abilities.
Or perhaps it is possible to somehow connect yourself to the nether reaches of your brain and gain these abilities.
Has there ever been an example of a person who has been able to do this AND live a relatively normal happy life?

C Elegans · Post by **C Elegans** » Wed Mar 20, 2002 6:04 am

@Frogus: Of course I've read dr Sachs books, if you like this kind of case descriptions, I also recommed you to read A Luria and VS Ramachandran. Luria's "The mind of a mnemonist" and "The man with a shattered world" are case histories of patients with unusual conditions. Ramachandran has written about epilepsia and stroke patients with very unusual symtoms, much like Sachs patients.

Originally posted by Obsidian
It leads one to wonder, if those abilities are only reachable through a trade off of the average persons skills and abilities.
Or perhaps it is possible to somehow connect yourself to the nether reaches of your brain and gain these abilities.
Has there ever been an example of a person who has been able to do this AND live a relatively normal happy life?

Unfortunately, "idiot savants" are very, very rare, most people with these disorders don't at all become very talented in one special field like dr Sachs patients. The twins Frogus describe is a unique case, they have an autism diagnosis IIRC, and autism in most cases make people generally less able to process complex information.

It is generally thought that those few who have these talents (often music or math skills) have them because of a tradeoff.

fable · Post by **fable** » Wed Mar 20, 2002 8:35 am

Originally posted by C Elegans
@Frogus: Of course I've read dr Sachs books, if you like this kind of case descriptions...

That's precisely the reason I read the first chapter of the work in question, and put it down a number of years ago. It's sort of a sensationalistic anecdotal account of an involved, serious subject, which I personally find frustrating--kind of like being shown a feast, and while being allowed to consume only a weight-watcher's diet tin.

frogus · Post by **frogus** » Wed Mar 20, 2002 10:27 am

sorry fable I didn't get that simile...what's the feast reprsenting?

anyway...I don't understand why one can only have access to this data in a tradeoff for some other faculty. It seems to be the case that (of course) people see everything in their lives, but do not need to remember nearly all of it, so it is forgotten...but how can data get out of the brain? Of course it stays in there, (and the same goes for the 'artistic' and 'musically gifted' 'idiot savants': of course we all hear every note, but do not need to consciously realise what it is) but repressed, which is why one sometimes has vivid deja vu and sudden recolection of things from long ago. But what I don't understand is how the brain makes the 'cut off point'. Is it really the case that we can only 'deal with' a certain ammount of information or we would not be able to think about it properly? Does the conscious brain have a 'capacity', which cannot be exceded? or is it more as if we could use and process more information, but do not need to?

a fascinating thing I saw on television [which is more than likely completely made up] was experiments carried out in Australia, in which magnetic charges were used to stimulate the areas of peoples brains found active in 'idiot savants' but dormant in normal people. The results were that about 70% of the cases gained remarkable skills in art and music never had before. So could it be that nature has just thought that we don't really need to know about everything that our senses have ever perceived, but we could if we needed to? what would this mean for policework etc?

fable · Post by **fable** » Wed Mar 20, 2002 11:43 am

Originally posted by frogus
sorry fable I didn't get that simile...what's the feast reprsenting?

The science at the heart of the matter.

C Elegans · Post by **C Elegans** » Wed Mar 20, 2002 6:42 pm

Originally posted by fable
That's precisely the reason I read the first chapter of the work in question, and put it down a number of years ago. It's sort of a sensationalistic anecdotal account of an involved, serious subject, which I personally find frustrating--kind of like being shown a feast, and while being allowed to consume only a weight-watcher's diet tin.

Yes, and this is what many professional has criticised Sacks for as well. Many people feel that he is making a freak-show out of serious diseases that often caused death and much suffering to the patients and their families. Also, he has been critised for exaggregating certain aspects and "romanticising" the patients. Many of the cases described in "The man who mistook his wife for a hat" are well known cases that many researchers have documented, and when you read other people's descriptions of the same cases, a different picture appears than the one dr Sacks is painting.

I don't know dr Sack's personally, but I really believe he meant the best when he wrote the books. I think he wanted to focus on the extraordinary while at the same time point out the humanistic aspect of the conditions he describes. I also think he wanted people to be fascinated and interested in the mysteries of the human brain.

I have a mixed feeling towards this kind of case descriptions. One on hand, I agree with the critisism of Sacks, especially since I have read much about his cases from other writers. It is certainly true that Sacks picks out only part of the truth about these patients. On the other hand, I've actually met several students who first started to get interested in neurology/neuropsychology/neuropsychiatry when they read Sacks, Luria or Ramachandran - and to me, it's worth a lot when I see young people get inspired to make an effort for brain research. We need a lot of people! There is still no cure for most severe diseases that affect the central nervous system

Of the three, I prefer Alexander Lurias work because he has written two monographies about 2 patients. You really learn to know these patients much deeper than in Sacks and Ramachandras brief descriptions.

C Elegans · Post by **C Elegans** » Wed Mar 20, 2002 7:00 pm

Originally posted by frogus
anyway...I don't understand why one can only have access to this data in a tradeoff for some other faculty.

It is believed that "idiot savants" or, as this subgroup are called nowadays, "autistic savants" get their special abilities both due to a difference in nerve impulse pattern and due to learning. The abnormal pattern of nerve impulse propagation, both causes impairment in some areas, and extreme abilities in other areas. Look at the talents autistic savants typically have - calender calculations, drawing with photographic skill, playing music - it's all to a large exent based on memorizing complex patterns. Then, remember that obsessive-compulsive behaviour is actually part of the diagnosis criteria - people with autism are known for repeating and repeating the same things over and over endlessly. It is much easier to be extremly good at one thing if you spend all your time, energy and focus on this sole thing. So the learning component is actually believed to be a large part of their skills.

It seems to be the case that (of course) people see everything in their lives, but do not need to remember nearly all of it, so it is forgotten...but how can data get out of the brain? Of course it stays in there, (and the same goes for the 'artistic' and 'musically gifted' 'idiot savants': of course we all hear every note, but do not need to consciously realise what it is) but repressed, which is why one sometimes has vivid deja vu and sudden recolection of things from long ago. But what I don't understand is how the brain makes the 'cut off point'. Is it really the case that we can only 'deal with' a certain ammount of information or we would not be able to think about it properly? Does the conscious brain have a 'capacity', which cannot be exceded? or is it more as if we could use and process more information, but do not need to?

Nobody knows, but the current consensus is that there is a limit for how much information the brain can store. A memory is not an abstract thing, it is formed by neurochemical events at intracellular level as well as changes in the communication pattern between the neurons (brain cells). Are you familiar with the term Long Term Potentiation? This is believed to be a crucial mechanism for how memories are stored in our brains, and in brief, it's a long term, permanent change that occurs in the cells and their firing patterns when new things are learned. So every time you learn something, a new pattern occurs in your brain, and since the number of neurons is limited, there must also be a limit for how much information the neurons can store.

a fascinating thing I saw on television [which is more than likely completely made up] was experiments carried out in Australia, in which magnetic charges were used to stimulate the areas of peoples brains found active in 'idiot savants' but dormant in normal people. The results were that about 70% of the cases gained remarkable skills in art and music never had before. So could it be that nature has just thought that we don't really need to know about everything that our senses have ever perceived, but we could if we needed to? what would this mean for policework etc?

Like you, I think this was made up or hugely exaggregated - I searched in the scientific databases for anything like this, and found nothing that was even remotely similar. Besides, there are no parts of a healthy human brain that lies dormant, and this is one the most common "urban legends" that brain research has been trying to fight against for some 50 years now.

fable · Post by **fable** » Wed Mar 20, 2002 10:14 pm

Look at the talents autistic savants typically have - calender calculations, drawing with photographic skill, playing music - it's all to a large exent based on memorizing complex patterns.

Just in case anybody thinks, "Playing music is an art," under autistic hands, it isn't. I've heard a few instances of music performed by autistic children while managing public radio stations; usually, somebody trying to peddle a recording to make money off the poor subject and their family. In no case could it be truly called music-making. There was no sense of phrasing or dynamics, no understanding of the music. It was simply note repetition.

C Elegans · Post by **C Elegans** » Wed Mar 20, 2002 10:41 pm

Originally posted by fable
Just in case anybody thinks, "Playing music is an art," under autistic hands, it isn't.

Yes, good that you pointed this out Fable, it's unfortunately very much so. Just like with drawing and painting, which has this "photographic" quality.

I once had a patient, who we later gave the diagnosis "atypical autism", atypical because he had unusally much psychotic symtoms. (Slight psychotic symtoms are usual, but this guy had periods of very severe paranoia). My patients was a very sweet and lovely guy, and as all autistic people, he had a lot of cognitive problems like memory and attention. However, he played the guitarr very well, he practised for at least 6 hours every day, the same tones over and over again. He had been doing this for years, and he listened only to one artist, who he copied into the tiniest little detail. This, is very characteristic for people with autism.

VoodooDali · Post by **VoodooDali** » Wed Mar 20, 2002 11:07 pm

Originally posted by frogus
But what I don't understand is how the brain makes the 'cut off point'. Is it really the case that we can only 'deal with' a certain ammount of information or we would not be able to think about it properly? Does the conscious brain have a 'capacity', which cannot be exceded? or is it more as if we could use and process more information, but do not need to?

a fascinating thing I saw on television [which is more than likely completely made up] was experiments carried out in Australia, in which magnetic charges were used to stimulate the areas of peoples brains found active in 'idiot savants' but dormant in normal people. The results were that about 70% of the cases gained remarkable skills in art and music never had before. So could it be that nature has just thought that we don't really need to know about everything that our senses have ever perceived, but we could if we needed to? what would this mean for policework etc?

I agree with what CE said about this. I used to be a therapist mainly for schizophrenics. I think schizophrenics are a good example of what goes wrong when people are overloaded with information. One of the theories of what happens in schizophrenia is that they are flooded with information, and a thought disorder results from the inability of the brain to process so much information at once. (You can sort of induce this state if you take LSD). This is a rather simplistic explanation, but the theory is that when your senses perceive something, it gets sent to the hypothalamus of your brain. The hypothalamus is like a telephone operator who decides whether the call is important enough to get relayed to another part of the brain, and which part that should be. In schizophrenics, the telephone operator is sometimes letting in too much information and thus telling the brain that it is vital (when it's not), and often sending the information to the wrong area of the brain to process. So, I think schizophrenics show that the brain cannot handle too much information at once. It's an excellent parallel processor, but there is a limit to how much can be processed. If overwhelmed, it will come to some very bizarre conclusions about what all this information means. I'm trying to think of an example. Lets say that you are schizophrenic and you walk into a room. Everyone hears you walk in and they look up at you for a moment. The ordinary brain will decide this is not even worth thinking about. The schizophrenic brain will decide that this is important, and that all these people are thinking about you, probably thinking bad things, maybe they're in on it together, some kind of conspiracy, or maybe they can hear your thoughts (thought projection) etc. etc. (paranoia) Or you walk into a building, and the building number is 12, and you were born on the 12th, therefore this must mean that you were meant to walk into this building, etc. (ideas of reference) Or you look at a woman and think, I'd really like to get into her pants, but this thought is sent to the auditory section of your brain and instead of being recognized as a thought, it is heard as an actual voice telling you that you had sex with that woman. (auditory hallucinations) We all have some of these feelings sometimes, it's just that schizophrenics experience them constantly, and it informs all their decisions.

frogus · Post by **frogus** » Thu Mar 21, 2002 10:23 am

ahhh..this is all fascinating. CE and Fable yes, I strongly dissaprove of Sacks' work being taken as science. It is certainly perverse to present all of his cases in such a charming way, so rosey and as if nothing is really 'wrong', it is just 'quaint'. I also am frustrated fable that I didn't really learn anything useful in the course of the book...but it did lead me to think about things more I experience more seriously, trying to realise why things happen. It is bad that people still think that we just see things, just understand them, and are just able to act appropritly on the basis of that information. It seems we live in a far reaching scientific civilisation, but we are only just beggining to reach into ourselves. This book helped me do that, so some good has come of it. [it also let me enjoy The Matrix

] It encourages the attitude (despite it's 'romanticism') that nothing happens by coincedence, which is IMHO the only attitude which has ever got anyone anywhere.

I have been told to read The Selfish Gene so I'm off to do that now.

C Elegans · Post by **C Elegans** » Thu Mar 21, 2002 9:13 pm

Originally posted by frogus
it did lead me to think about things more I experience more seriously, trying to realise why things happen. It is bad that people still think that we just see things, just understand them, and are just able to act appropritly on the basis of that information. It seems we live in a far reaching scientific civilisation, but we are only just beggining to reach into ourselves. This book helped me do that, so some good has come of it. [it also let me enjoy The Matrix ] It encourages the attitude (despite it's 'romanticism') that nothing happens by coincedence, which is IMHO the only attitude which has ever got anyone anywhere.

I have been told to read The Selfish Gene so I'm off to do that now.

I think it's good that Sack's book made you reflect over the process of consciousness and awareness, and the complexity is our perception and cognition. When I first read Sack's and Luria (100 years ago

) I remember I was struck by how our consciousness is split in so many part, not at all the unit we perceive it as ourselves. Sure it's a "freak-show", but reading about people who only percept half of the world and half of their bodies, people who don't percept their own body as belonging to them, people with a memory span of 30 secs...You realize that the sense of the self as an integrated unit is almost an illusion, an illusion that are held together by complex brain process we have only just began to understand.

The human brain is sometimes called "the last frontier". It is true we know very little about ourselves.

The Selfish Gene is a nice book, it was ages ago I read it, but since there are so few good popular science writers there, I absolutely recommend it. Dawkins is a good writer. I can also recommend James Watson's autobiography "The double helix", of course about his and sir Francis Cricks remarkable discovery.

frogus · Post by **frogus** » Fri Mar 22, 2002 4:29 pm

I remember I was struck by how our consciousness is split in so many part, not at all the unit we perceive it as ourselves. Sure it's a "freak-show", but reading about people who only percept half of the world and half of their bodies, people who don't percept their own body as belonging to them, people with a memory span of 30 secs...You realize that the sense of the self as an integrated unit is almost an illusion, an illusion that are held together by complex brain process we have only just began to understand.

that's exactly what I was trying to say.

...I'll get back to you on tSG

C Elegans · Post by **C Elegans** » Fri Mar 22, 2002 11:44 pm

Originally posted by frogus
that's exactly what I was trying to say. ...I'll get back to you on tSG

Good!

Let's hope you like TSG. If you feel like thinking more about the concept of consciousness and it's parts, I recommend the currently most influcential thinker in the field of consciousness, the neurologist Antonio Damasio. He has written several books suitable for the interested non-scientist, this one is already a classic:

Damasio, A. R. (1994). Descartes' error: Emotion, reason, and the human brain. New York, NY, Grosset/Putnam.

In Descartes' error, Damasio describes the modern neuroscience perspective as well as the concept of consciousness and the mind during the history of philosophy, so you should find it worth reading, I think

@Fable if you read this: could be something for you as well if you haven't already read it, I recall you are interested in consciousness issues (who isn't

- it's one of the great questions mankind has yet to find an answer to).