Current Books

Rapturous Lightning

by Colleen Foy Sterling, MD

Musicophilia, by Oliver Sacks, MD, 400 pages, Knopf, $26.

Dr. Oliver Sacks has been writing about the wonderful world of neurology for many years. Before I went into medicine, I enjoyed one of his early books, The Man Who Mistook His Wife for a Hat. The title alone tickled me, and I still enjoy seeing the book on my bookshelf. So when I opened his latest creation, Musicophilia, I settled in for an enjoyable performance. What I found was more like an invitation to an intimate conversation with a sage and experienced colleague in the medical arts.

Dr. Sacks is wise. Born in 1933, he originally trained at Queen’s College, Oxford. After internships in medicine and neurology in England, he moved to the United States for further training at Mt. Zion Hospital in San Francisco. He eventually abandoned our coast for New York City, where he has practiced and taught neurology for the last 40 years.

In the first chapter of Musicophilia, “A Bolt from the Blue,” Sacks playfully muses about the lucky people who are suddenly overcome with musical passion. Most impressive is the case of an orthopedic surgeon who is struck by lightning and reborn, via this near-death experience, with an all-consuming “craving for piano music.” The craving starts with simply buying CDs by the pianist Vladimir Ashkenazy; it ends with the orthopedist’s new ability to hear and learn by ear almost any classical music he wants. I tried to replicate this effect by setting my Internet radio to Chopin, Janácek and Mendelssohn. Suddenly workmates were stopping by and inquiring as to the source of my inspirational soundtrack. I even started playing music in my exam rooms. The patient response was overwhelmingly positive.

Sacks loves to relate anecdotes about life-altering experiences, and these made me realize how blocked our brains are from taking in new things, new ways of seeing, of hearing. Daily we work with patients who feel it is “too late to change their ways, too late to modify a life-long habit, too late to pick up a new skill or to recover from a neurologic event.” As Sacks observes, the acquisition of a sudden passion, “a rapture,” could make anyone want to be struck by lightning.

The benefit of reading Sacks’s work, rather than inviting him over for an afternoon of conversation, was that I could put the book down, savor passages, and let them sink in. I also could leaf through some of the more tedious sections and move on to the next. “A Strangely Familiar Feeling,” “Musical Seizures” and “Fear of Music: Musicogenic Epilepsy” are the obvious result of years of collecting correspondence and case reports (from his own mother, his practice and historical sources) of epileptic phenomena manifesting in any form related to music. Epilepsy is one of Sacks’s clinical specialties, and perhaps this collection of cases was originally even the inspiration for the book. The material was fascinating and familiar from my own practice, and informational as well—but not as fun, and disappointingly less inspiring of fantasy than the initial flourish at the book’s onset.

One need not despair, however. Musicophilia is rich in melodic prose and a joy to read. In the book, medicine and science harmonize with thought-provoking human stories, many of which involve the human brain’s co-evolution with musical creation and appreciation. Sacks describes how scientists have used PET scans and MRI morphometry to study the role of music vis-à-vis the development, differentiation and destruction of the mind. He notes, “Anatomists today would be hard put to identify the brain of a visual artist, a writer, or a mathematician—but they could recognize the brain of a professional musician without a moment’s hesitation.” Even 10 minutes of musical training a day has a direct effect on our brains.

Musicophilia will reawaken and rekindle an appreciation for the ways in which music floods and flows through our brains. The implications for patient care and symptom interpretation are many. Hope springs forth, and it is mind-bending to contemplate the possible role of music for rehabilitation, recovery and remodeling of behaviors in ourselves and in our patients.
As a musician, physician and philosopher, Sacks has written a book that stimulates and reinvigorates how we see our patients and their potential for life, change and growth.

Dr. Foy Sterling, a family physician at Kaiser Santa Rosa, serves on the SCMA Editorial Board.