Norman M.Weinberger reviews the latest work of Oliver Sacks on music.
A
Music and the brainare both endlessly fascinating subjects, and as a neuroscientist specialisingin auditory learning and memory, I find them especially intriguing. So I hadhigh expectations of Musicophilia, the latest offering from neurologist andprolific author Oliver Sacks. And I confess to feeling a little guiltyreporting that my reactions to the book are mixed.
B
Sacks himself isthe best part of Musicophilia. He richly documents his own life in the book andreveals highly personal experiences. The photograph of him on the cover of thebook which shows him wearing headphones, eyes closed, clearly enchanted as helistens to Alfred 1 Brendel perform Beethoven's Pathitique Sonata--makes apositive impression that is borne out by the contents of the book. Sacks'svoice throughout is steady and erudite but never pontifical. He is neitherself-conscious nor self-promoting.
C
The preface gives agood idea of what the book will deliver. In it Sacks explains that he wants toconvey the insights gleaned from the ^enormous and rapidly growing body of workon the . neural underpinnings of musical perception and imagery, and thecomplex and often bizarre disorders to which these are prone." Healso stresses the importance of Mthe simple art of observation" andMthe richness of the human context.He wants to combine observation and Idescription with the latest in technology,” he says, and to imaginatively enterinto the expe-rience of his patients and subjects. The readercan see that Sacks, who has been practicing neurology for 40 years, istorn between the old-fashionedw path of observation and the new-fangled,high-tech approach: He knows that he needs to take heed of the latter， but hisheart lies with the former.
D
The book consistsmainly of detailed descriptions of cases, most of them involving patients whomSacks has seen in his practice. Brief discussions of contemporaryneuroscientific reports are sprinkled liberally throughout the text. Part I,MHaunted by Music," begins with the strange case of Tony Cicoria, anonmusical, middle-aged surgeon who was consumed by a love of music after beinghit by lightning. He suddenly began to crave listening to piano music， which _ hehad never cared for in the past. He started to play the piano and then tocompose music，1 which arose spontaneously in his mind in a u torrentw of notes. How couldthis happen? Was I the cause psychological? (He had had a near-death experiencewhen the lightning struck him.) Or was it the direct result of a change in theauditory regions of his cerebral cortex? Electro-encephalography (EEG) showedhis brain waves to be normal in the mid-1990s, just after his trauma andsubsequent Mconversionw to music. There are now more sensitive tests, butCicoria has declined to undergo them; he does not want to delve into thecauses of his musicality. What a shame!
E
Part II, “A Rangeof Musicality,” covers a wider variety of topics，butunfortunately，some of the chapters offer little or nothing that is new. For example, chapter13, which is five pages long, merely notes that the blind often have betterhearing than the sighted. The most interesting chapters are those that presentthe strangest cases. Chapter 8 is about “amusia，”an inability to hear sounds as music， and “dysharmonia，”a highlyspecific impairment of the ability to hear harmony, with the ability tounderstand melody left intact. Such specific dissociationsw are foundthroughout the cases Sacks recounts.
F
To Sacks's credit,part III, "Memory, Movement and Music," brings us into theunderappreciated realm of music therapy. Chapter 16 explains how "melodicintonation therapy" is being used to help expressive aphasic patients(those unable to express their thoughts verbaDy following a stroke or othercerebral incident) once again become capable of fluent speech. In chapter 20,Sacks demonstrates the near-miraculous power of music to animate Parkinson’spatients and other people with severe movement disorders, even those who arefrozen into odd postures. Scientists cannot yet explain how music achieves thiseffect.
J
To readers who areunfamiliar with neuroscience and music behavior, Musicophilia may besomething of a revelation. But the book will not satisfy those seeking thecauses and implications of the phenomena Sacks describes. For one thing, Sacksappears to be more at ease dis* cussing patients than discussing experiments.And he tends to be rather uncritical in accepting scientific findings andtheories.
H
It's true that thecauses of music-brain oddities remain poorly understood. However, Sacks couldhave done more to draw out some of the implications of the careful observationsthat he and other neurologists have made and of the treatments that have beensuccessful. For example, he might have noted that the many specificdissociations among components of music comprehension, such as loss of theability to perceive harmony but not melody, indicate that there is no musiccenter in the brain. Because many people who read the book are likely tobelieve in the brain localisation of all mental functions, this was a missededucational opportunity.
I
Another conclusionone could draw is that there seem to be no Mcuresff for neurological problemsinvolving music. A drug can alleviate a symptom in one patient and aggravate itin another, or can have both positive and negative effects in the same patient.Treatments mentioned seem to be almost exclusively antiepileptic medications,which "damp down" the excitability of the brain in general; theireffectiveness varies widely.
J
Finally, in many ofthe cases described here the patient with music-brain symptoms is reported tohave "normal" EEG results. Although Sacks recognises the existence ofnew technologies, among them far more sensitive ways to analyze brain wavesthan the standard neurological EEG test, he does not call for their use. Infact, although he exhibits the greatest compassion for patients, he conveys nosense of urgency about the pursuit of new avenues in the diagnosis andtreatment of music-brain disorders. This absence echoes the book's preface, inwhich Sacks expresses fear that wthe simple art of observation may belost" if we rely too much on new technologies. He does call for bothapproaches, though, and we can only hope that the neurological community willrespond.
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发表于 2019-9-23 09:41:52
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