Interview: Doctor-writer Oliver Sacks now tunes in to music

John Freeman meets the man who brings back amazing human stories from the dark side of the brain
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The Independent Culture

For a man with music on the brain, Oliver Sacks is strangely unbothered by the sound of jack-hammering. Sitting in his office in Manhattan's West Village, wearing trainers, tracksuit bottoms and a sweater, the 74-year-old neurologist chats for ten minutes before realising the noise juddering up from the road has made it impossible to hear. "Oh dear," Sacks says, running to close the sash. "New York is the noisiest city I have ever lived in," he laments, which sets off a riff on America's sense of pitch and volume. "I hate it when music is forced upon you," he says. "And I'm afraid this will sound anti-American, but Americans do speak louder than most people." He continues: "There's a kind of quacking voice one hears everywhere."

Speaking with Sacks one has to be prepared for such conversational boomerangs. "I love diversions," he admits, and so we take a few moments to exhaust the gamut of irritations before returning to the larger matters at hand in his new book Musicophilia: tales of music and the brain (Picador, £17.99). Street noise and voice modulation are minor quibbles compared to the tintinillations, symphonies, echoes and musical hallucinations Sacks's patients describe rippling through their heads in Musicophilia. Sometimes it comes from above, as with Tony Cicoria, a robust, 42-year-old orthopedic surgeon who is struck by lightning and thereafter obsessed with composing music. "It never runs dry," Cicoria told Sacks about this new music in his head. "If anything, I have to turn it off."

Sacks tells the story of one woman haunted by jags of Christmas carols or old-time songs, others plagued by Jewish tunes from the holidays. "Usually it's just ten or 20 seconds, repeated over and over," Sacks explains. It all sounds comical, until it happens to you. "It's really startling, like it's in the room and over their shoulders, there," he says, darting his head. "If you experienced one, you would know immediately that this was not just a tune in your head."

As in Sacks's previous books, from Awakenings to The Man Who Mistook His Wife for a Hat, he illuminates the way the brain works by examining such disorders. It is his opinion that music, like language, is born in the brain. He calls the facility for listening to and appreciating music – which is best fostered at the youngest ages – musicophilia. "There are about 20 areas of the brain which we know correspond to different parts of listening to or composing music," he says. New technology in brain scanning allows for specialised study of the brain as it hears and plays music.

"My hope is there will be more of this done in the future," Sacks says, "because the potential of what we can learn from it is enormous." This technology doesn't make the facility any less mysterious, however. "Music has no vocabulary, and doesn't mean anything," he points out, "and yet it can inspire the profoundest emotions."

Sacks has been at this kind of work – of being told fantastical stories and listening to paradoxical results – since the beginning of his career as a physician. After studying at Oxford, and interning at the Middlesex Hospital in London, he became a staff neurologist at Beth Abraham Hospital in the Bronx, where he came upon a group of patients suffering from an unusual sleep disorder. He eventually discovered some of them could be "awakened" by giving them the Parkinson's disease drug, L-DOPA. His description of this became the basis of Awakenings, later a movie with Robin Williams. One patient from this time, who awoke wanting to record naughty ballads she heard in 1920s music halls, returns in Musicophilia.

Awakenings was something of a happy story. But many times there is no cure to what Sacks's patients suffer from. He describes a world-renowned psychoanalyst, Leo Rangell, who began having musical hallucinations aged 82 after flying. It never ceased, and Rangell, who took to calling the noise "my little radio", is writing a book on the experience. Darshak Sanghavi, a pediatrician and medical columnist for Slate.com, says, this is a quintessential Sacks story. "Neurology can be frustrating because practitioners have few cures to offer. That's why Sacks is such an interesting thinker and writer," because he "focuses on people's adaptation to their diseases, and finds poetry there."

In some instances, the people Sacks speaks to would rather not have a "cure". Certain brain injuries or conditions feel like inspiration. Sacks recalls the man who had an inoperable tumour which, as it pressed down on a part of his brain, caused seizures accompanied with music. The people who suffer from Williams syndrome – symptoms of which include facial deformations and very low IQ – also have a fantastic sense for music, without which their life might be less meaningful.

In order to get these stories, Sacks keeps up an impressive pace. On the day we speak, he arose at 4:30am to go for a swim, spoke with a few patients uptown, and then travelled downtown to his office, where between 10 and 11 he answered the 50 or so emails he receives daily. "I usually respond at once, and if we correspond more than that then I ask them to call me." Sacks is serious about this correspondence as it provides him with the stories which give his books their palpable human ballast. "My favourite page in the book is this," he says, opening to the acknowledgements, where the names of more than 150 people who shared their stories with him appear.

As Sacks tells this story, it becomes clear the most used part of his office is his swivel chair, which neatly charts his mood and interest level. When answering a question about himself, he turns slightly away, but when provided a story, an anecdote or something tangible, he pivots and leans forward, his great, bearded head and crinkled eyes suddenly animate and listening.

"I think what Sacks does in a genuine way, is he befriends these people," says Harvard University medical professor Jerome Groopman, the New Yorker's medical correspondent. "It's almost like he is filling the physician's ancient role, which is mixed with that of a clergyman. He is present... in a way that allows them to tell their story in some way, to almost confess."

Sacks says he does very little talking during interviews, a habit hard to break. He keeps his personal anecdotes to a minimum, as if he has more than exhausted his revelations in Uncle Tungsten: his 2001 memoir about growing up in wartime England, saved from bombing raids when he was sent to a boarding school where he and his brother were beaten horribly. Music, he says now, was "the only good thing about the time I spent there". This morning, he woke to Schubert's Sixth Symphony on his clock radio, "which made me think of mama," he says with a slight smile.

Through this self-effacement, Sacks provides an important model, since in America his largest audience has been aspiring doctors who read his books and learn compassion through readerly osmosis. "Oliver Sacks has consistently illuminated the human sides of doctoring, and of patients' lives," says Dr Robert Klitzman, a colleague and physician at Columbia University. "He has inspired an entire generation of medical students, pre-med students, young – as well as seasoned – doctors, and patients and their families."

Sacks is acutely aware of the burden that this reverence places upon him. "One always has to be careful not to exploit," he says, before explaining how he goes to great lengths to include the people he speaks to in his books. Much of his current correspondence has to do with responses to Musicophilia, for which he is already compiling an expanded paperback edition. "You can't squeeze everything in," he laments.

But you can fit in a lot. In spite of the arthritis which means he now writes with oversized pens, Sacks's front office is packed with folders for future projects. He is tremendously curious about creativity, and why some seem to have more than others, as well as visual phenomena. In recent years, Sacks has lost part of his depth perception, which means: "I see... in two dimensions right now". He shakes his head, as if baffled. Then, after a shadow passes over his face, he scurries to fetch a piece of metal the shape of a cylinder. "Hold this," he says, dropping a piece of tungsten into my hands. It is surprisingly heavy and miraculously still, almost like the weight of the world. "Amazing, isn't it?" he asks, beaming again.

Biography: Oliver Sacks

Born in 1933, educated at Oxford University and the Middlesex Hospital, Dr Oliver Sacks first worked at the Middlesex and in Birmingham. He has practised as a neurologist in New York since 1965, from 1966 as a consultant at Beth Abraham Hospital, Bronx. After 1975, he was also a professor of neurology at the Albert Einstein College of Medicine. His first general book was Awakenings (1973), filmed with Robin Williams. It was followed by A Leg to Stand On, The Man who Mistook his Wife for a Hat, Seeing Voices, An Anthropologist on Mars and, in 2001, a memoir, Uncle Tungsten. His new book Musicophilia is published by Picador. His dozens of honours range from the Hawthornden Prize for literature to the American Neurological Association's Special Presidential Award.

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