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What is an intellectual disorder? Why did psychologist Oliver Sacks find intellectual disorders especially interesting to study? What did he learn about concrete and abstract thought?
In his book The Man Who Mistook His Wife for a Hat, Oliver Sacks explains that working with intellectually disabled patients was special to him. He was interested in the differences between concrete and abstract thought and trying to help intellectually disabled patients live lives rich with creativity and joy.
Here are a couple of Oliver Sacks’ stories about his experiences working with patients with intellectual disorders.
Oliver Sacks on Intellectual Disorders
Sacks believed that there was something profoundly moving about working with patients with intellectual disorders. Much of this had to do with the distinctions between abstract and concrete thought. Broadly speaking, abstract thought deals with the world of ideas and concepts that don’t “exist” in the physical world.
The Opera Aficionado
One of Sacks’ patients with an intellectual disorder was Martin, a 61-year-old who came to live at the facility Sacks operated. Martin suffered from Parkinson’s disease and had been severely brain-damaged by meningitis as an infant. His disabilities prevented him from holding down a job or taking care of himself.
But Martin had a gift for music. Specifically, he possessed an exceptional musical memory and knew the music from over 2,000 operas, as well as all the other details of each production—the roles, who had sung the leads, and where they’d been performed anywhere in the world. This love of music was an inheritance from his late father, who had been a singer with New York’s Metropolitan Opera. Father and son had bonded over opera and it remained Martin’s passion and guiding light.
When he first came to live at the facility, Martin could often be irritable and unsociable, given to childlike fits of temper that made him unpopular with staff and patients alike. He later confided to Sacks that he missed being able to sing. He had sung in a choir every Sunday with his beloved father, he explained until the latter passed away. Music was what sustained him.
Seeing that Martin was being denied his crucial creative outlet, Sacks arranged to have him resume his singing at churches and cathedrals across New York City, where he soon became valued for his encyclopedic musical knowledge.
Martin was utterly transformed when he sang. Gone was the childish and often spiteful person Sacks had come to know at the facility—in these moments, Martin was a complete person, fully at peace. In working with him, Sacks saw that Martin’s musical knowledge was no mere knack or trick of rote memory. Instead, he had a deep and sincere musical intelligence, one that could grasp the rich subtleties of a composer like Bach and appreciate the complexity and structure of the music.
Communication Through Drawing
The last Sacks patient whose story we’ll explore is Jose. Jose was a young man in his early 20s who, at age eight, had suffered a severe case of encephalitis. The illness wreaked havoc on Jose’s neurological functioning. He became prone to frequent and violent seizures and was no longer able to communicate verbally—symptoms that doctors would later use to diagnose Jose with autism.
His parents, fearful that he would suffer a seizure in public and become injured, began keeping him in the cellar of their home. For 15 years, Jose was deprived of nearly all links to the outside world. After a particularly violent seizure, Jose’s parents finally took him to the hospital, where he was able to get the treatment he needed. EEG scans confirmed that Jose was experiencing severe temporal lobe disorders on both his left and right sides.
The hospital staff discovered that Jose had a remarkable talent for drawing. Indeed, Jose’s sketches were his only mode of self-expression, deprived as he was of other means of communication. His excellent performance in visual and spatial tasks seemed to compensate for verbal skills deficits.
The first time Sacks met Jose, he was thoroughly impressed by the young man’s success in drawing a watch in great detail. At their next meeting, Jose was able to reproduce a landscape scene on a magazine cover. In fact, Jose’s copy surpassed the original in many ways—he imbued the scene with mood, feeling, and character that had been lacking in the original. Subsequent drawings from Jose hinted at an interior life rich with creativity, emotion, and a sophisticated appreciation for aesthetics.
Jose’s artistic works demonstrated his entirely concrete and particular mind. They evinced no understanding of general categories or fixed forms and were free of ambiguity. Sacks saw that a talented artist like Jose had the potential to lead a rich and fulfilling life, perhaps as an illustrator. But he lamented the short-sightedness of the mental health system of which Jose was a part. Nurturing his prodigious talents would require the patience that the other doctors around him lacked.
His gifts were too often written off by the hospital staff as being merely tricks of a human Xerox machine, rather than the artistic fruits of a sensitive and delicate soul. Sacks lamented that Jose’s talents were likely to be wasted, his potential remaining forever untapped.
Sacks’ work with his patients shows the pitfalls of traditional thinking about neurological disorders. As we’ve seen, people suffering from these conditions can lead rich lives filled with joy and creativity. Studying disorders of the human brain, ironically, can give us insight into just how powerful it is and how it is the source of so much of our humanity.
It is incumbent on the neurological profession to expand its view of neurological disorders and of the people who are afflicted by them. There is enormous untapped potential and capacity for them to lead meaningful and productive lives. But first, we must abandon the idea that such individuals are irreparably damaged or abnormal. But perhaps their “normal” isn’t deviant or wrong, but merely different than our own. Rather than attempting to cure or alter it, we should open ourselves up to the possibilities that the study of their unique brains can reveal to us. In recognizing their humanity, we come to recognize our own.
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Here's what you'll find in our full The Man Who Mistook His Wife for a Hat summary:
- Neurologist Oliver Sacks' case studies on patients with neurological impairments
- The remarkable complexity of the human brain and its extraordinary capacity to adapt
- How Sacks' work with his patients shows the pitfalls of traditional thinking about neurological disorders