Review | Musicophilia: Tales of Music and the Brain, by Oliver Sacks

Musicophilia: Tales of Music and the Brain, by Oliver Sacks. New York: Vintage Books, 2008. [450p. ISBN: 9781400033539, $26.00 (hardcover).]

The neurologist Oliver Sacks must be one of the few authors reviewed in musicological journals to have been portrayed in a Hollywood film. But then Sacks, who was played by Robin Williams (under the name Malcolm Sayer) in the 1990 film Awakenings, has achieved a degree of public attention that music scholars with aspirations to be public intellectuals can only dream of. In a series of books since the 1970s, he has more or less invented a new literary subgenre — neurological anecdotes as a branch of belles lettres. A Professor of Clinical Neurology and Psychiatry at Columbia University in New York, where he moved from London in 1965, Sacks’ bestsellers such as MigraineAn Anthropologist on Mars, and The Man who Mistook his Wife for a Hat have given a general audience insight into a wide range of neurological conditions such as Tourettes, aphasia, and amnesia in a way that has illuminated the physiological basis of human consciousness and behavior. His most recent book, MusicophiliaTales of Music and the Brain, is in a format familiar to readers of Sacks’ work, mixing as it does humane observation of patients with up-to-date neurological diagnosis and explanations of brain function, this time with cases all related to music.

The book opens in dramatic fashion with the alarming and fascinating case of Tony Cicoria, who was struck by lightning while using a public payphone in 1994. When he recovered, Cicoria, who had never had any particular interest in music beforehand, became obsessed with Chopin. He took up piano lessons and now composes in a Chopinesque manner. In other cases Sacks looks at music as the cause rather than the symptom of crises. Drawing on the work of the neurologist Macdonald Critchley, whose studies of music and the brain stretched over half a century, and patients of his own, Sacks discusses music as a cause of seizures, of what Critchley termed musicogenic epilepsy.

Another fascinating section deals with the subject of musical hallucinations, something that is much more common than might be supposed. Richard Wagner claimed that the prelude to Das Rheingold came to him as a hallucination, and Sacks himself had a similar experience when he heard Mahler’s Kindertotenlieder, despite loathing the composer. Sacks, who described a related case in The Man who Mistook his Wife for a Hat, in which a patient heard the songs of her Irish childhood playing inside her head decades later, also gives examples here of deaf patients who have musical hallucinations. He shows how these cases, combined with state-of-the-art neuro-imaging technology, might illuminate what we mean by hearing “music in the head.”

The neurological basis of musicality and perfect pitch is the common theme in a number of chapters that look at musical savants and people with Williams’ syndrome, a genetic condition that causes low IQ and a very specific facial appearance which is often combined with high levels of sociability and musical ability. At the opposite end of the spectrum, Sacks examines various forms of amusia (lack of musicality), rhythm, and tone deafness when people are unable to make sense of one or more aspect of music. Responses to this can range from Nabakov’s knowing indifference to heartbreak for musicians robbed of music. If these conditions are based on missing some form of sense for music, then the phenomenon of synaesthesia is connected to having an extra one that associates different kinds of sensory information, music, and color, for instance. Estimates vary to the number of people who experience synaesthesia, and it is certainly rare, but the examples presented here are a good introduction for anyone who thinks it merely a literary conceit.

In various forms, music therapy is a major theme in Musicophilia. His interest in neurology and music, he says, goes back to his experience seeing the effect of music on Parkinson’s patients awoken by the drug L-Dopa at the Beth Abraham hospital in 1966, the period of his life shown in Awakenings. Patients with aphasia (the inability to speak due to problems in the brain, which is often the result of a stroke) could not speak, but could sing, showing that speech and music involve different parts of the brain (coincidentally, there is evidence that swearing is also based on a separate part of the brain from speech). Sacks also gives examples of music’s role in controlling movement, including cases of people with Tourette’s syndrome (subject to involuntary movements, twitching, and swearing) for whom drum circles and playing the piano gave them a way of controlling their symptoms. Similarly, in a previous book, A Leg to Stand On, which Sacks wrote after injuring a leg, music helped him “remember” how to walk.

Musicophilia has appeared at a time when music and neurology seems to be a hot topic in publishing, with books like Daniel Levitin’s This Is Your Brain on Music on the bestseller lists. Indeed, the field of neuroaesthetics seems to be flavor of the month in the humanities at the moment. A. S. Byatt’s article “Observe the Neurones” (TLS, September 22, 2006) is perhaps the most prominent example of this vogue. Although advances in neurology nowadays are rapid and exciting, one fears that this is likely to be a short-lived fad, as the science’s inability to answer the big questions in aesthetics inevitably leads to disappointment.Sacks draws on some of the exciting work being done in the booming academic field of music neurology, in particular Alvero Pascual-Leone’s research on changes in the brain caused by musical training and Isabelle Peretz’s onamusia, but he does not get carried away with the power of neurology to explain aesthetic phenomena. His approach, combining intense interest in developments in neurology with a determination that “the richness of the human context” should not be ignored, offers an enlightening way of thinking about the brain and music. These sober and elegant studies in music and the mind provide a more solid basis for bridging the gap between C. P. Snow’s cultures.


James Kennaway is a Wellcome Research Fellow in the History of Medicine at the University of Durham, UK. He is writing a book on Pathological Music, which is on the history of the idea that music can over-stimulate the nerves and make listeners sick, hysterical, and even kill them. He completed a PhD in Musicology at UCLA in 2004, following an MMus from King’s College, London and a BA from the London School of Economics. Before starting at Durham, he worked at Stanford University, the University of Vienna, and the Viadrina University in Frankfurt-an-der-Oder, Germany.