Here to take note

For nearly 40 years, neurologist Oliver Sacks has changed the way we view human experience by popularizing brain science through accounts of real-life cases in such books as “The Man Who Mistook His Wife for a Hat” and “Awakenings.” The latter -- about his treatment of long-comatose patients brought back to consciousness -- inspired both Harold Pinter’s play “A Kind of Alaska” and the 1990 film “Awakenings,” starring Robin Williams and Robert De Niro.

But in Sacks’ 10th book, “Musicophilia: Tales of Music and the Brain” (Alfred A. Knopf), the stories turn personal as he filters medicine through his lifelong passion for music -- both as a listener and as an accomplished amateur pianist.

“Musicophilia” -- literally “love of music” -- opens sensationally, with a 42-year-old physician shocked into musicianship by a bolt of lightning. At first only grateful to be alive, the subject feels a growing obsession with classical piano music, an art that had never interested him. Learning to play well in midlife, he chooses not to question his surprise gift with medical examination.

Many of Sacks’ stories concern less dramatic subjects, however. Some are about musicians who literally “see” Gershwin’s “Rhapsody in Blue” -- in blue -- or Mahler’s “Kindertotenlieder” in deep burgundy. Others experience an “amusia” so severe that even nursery tunes sound cacophonous to them. A symptom common to nearly everyone involves jingles, songs and tunes you just can’t get out of your head.

Throughout, the book portrays music as a universal force transcending language, culture and even devotion. The result is a grab bag of inspiration and hope but also of devastating loss. In parts, music haunts performers whose gifts have disappeared. But music also performs miracles of communication for autistic children, stroke victims, Alzheimer’s patients and others.

Speaking via telephone recently from his Greenwich Village office, Sacks, now 74, recalled playing chamber music with his siblings and parents -- both physicians -- in their prewar London home. Today, he said, that spirit lives on in him: He plays his father’s grand piano regularly.

How did your interest in musical neuroscience start?

I first heard about the phenomenon from nurses at Beth Abraham Hospital in 1966, who had observed patients I wrote about in “Awakenings.” On weekends, there was singing in religious services -- and these people who’d been frozen for many years seemed liberated by the music and could move, sing and even dance. I couldn’t explain it at the time but began understanding the intimate connection between the auditory cortex and motor systems. As humans, we always respond to a musical beat. At a Grateful Dead concert -- although it’s not entirely my sort of thing -- I simply couldn’t stop myself from moving with the music.

Why do so many blind performers like Stevie Wonder, Ray Charles and Art Tatum seem to have unusual musical talent?

Many people who are born blind or lose their sight during formative years become dependent on their hearing. I met a blind musician in London who had severe autism with rocking but could repeat pieces after a single hearing. It’s fascinating to note that one-third of savants -- subjects with very low IQ with extraordinary skill in calculations, visual art or music -- are born sight-impaired. About half have absolute pitch -- the ability to identify notes plucked from the air. That’s quite amazing, as it’s found in only one in 10,000 of the normal population.

Can adults develop absolute pitch?

Do you have absolute pitch? Would you want it? I keep my father’s 1894 Bechstein piano tuned one-third tone flat, to preserve the original strings -- that could drive someone with absolute pitch absolutely mad. The ability may be less rare than you think; some believe it gets “pruned out” over time. There’s research being done with TMS -- Transcranial Magnetic Stimulation -- exploring whether savant talents and absolute pitch might have been suppressed in many of our brains.

What is Transcranial Magnetic Stimulation?

TMS is an experimental technique that inhibits certain physiological brain functions. Back when I was writing about patients with cerebral colorblindness, my colleagues said they could “blast” me -- but warned I might not come out of it. Now I’m working at Columbia University near a department that’s using it to treat depression and other conditions; it shows promise and much less danger than before. Recently, I submitted myself to TMS in the laboratory of Allan Snyder, an Australian neuroscientist, hoping to release my own savant abilities of one sort or another, including absolute pitch. I stopped after 10 minutes when my head and face started to ache, and I feared for my old brain. There was no improvement, I’m afraid.

You wrote about Gordon, an Australian violinist who couldn’t silence his musical hallucinations -- a private soundtrack blasting even as he slept or performed a different work, in an unrelated key and rhythm.

I’m very amazed at Gordon’s ability to concentrate, but when I mentioned this to another patient, a cellist, he said, “Oh, that’s nothing, we can all do that!” You tell me of Broadway musicians who read and play simultaneously, and I am intrigued by that as well, as I keep a notebook on the piano and jot down notes with my right hand while improvising harmonies autonomously with the left.

Do you keep a piano in your office?

It’s in my apartment in the building next door -- and I almost never play music for patients or anyone else. One time I did, though. I was working on a ward with very autistic and disturbed youngsters who could make no contact except nonverbally, with music. I was so impressed by the result that I took my own piano, an old secondhand Kimball, and gave it to the ward. Unfortunately, few physicians who treat patients with musical problems and phenomena keep a piano or music in the office.

Do patients ever see positive aspects to these neuromusical conditions?

People have said I romanticize things and put too benign a face on them, and I wouldn’t underplay the symptoms of, say, Tourette’s syndrome for a moment. It’s often intrusive, annoying, frustrating and sometimes tormenting -- but still can have potentially positive aspects. The distinguished composer Tobias Picker, who has Tourette’s, says he harnesses that energy for his composing, and his body often stops ticcing even while studying a musical score. I make analogies between tics and hallucinations -- on the whole when they first occur, musical hallucinations are not fun. They’re frightening, intrusive and bewildering, but a lot of people come to terms with them, and some even mildly enjoy them -- I can think of an account of one elderly poet with many poems stimulated by visual hallucinations.

Have you experienced any of these musical phenomena yourself?

Well, 1974 was a peculiar year. One night, while [I was] listening to Chopin on the car radio, the piano tones lost their pitch and were reduced to what sounded like toneless banging on sheet metal. After a few minutes, the tonality returned, but the same amusia occurred on another day, evidently part of a migraine. Later, when recovering from an injury in the hospital, I continually played a tape of the Mendelssohn Violin Concerto. I was awoken one morning by it, thinking nurses had switched on the tape -- but my musical memory is not good enough to evoke a whole orchestra, and upon surfacing, I found the tape wasn’t on at all. The most common musical hallucinations occur in the borderlines of sleep; one is in a quasi-hallucinogenic state anyhow. Clearly, unconscious memory is much wider than what hits people with musical hallucinations.

Has the iPod changed the way we process music?

I think of the iPod as a sort of IV of music. It’s good at home, but on the street it’s dangerously strong and intense and bypasses all the usual mechanisms. I’m frightened of the engrossing ability of music, to the extent people can walk in front of cars while listening. I also dislike forced music, which in New York means you can’t go into any cafe or gym or mall without Muzak-like sound imposed on you, and it is often very loud. This dissociates music from context as a communal act -- it’s no longer in church or a concert hall or singing with others.

In “Musicophilia,” you tell stories of atheists or agnostics who find spiritual release through music. What could account for this?

I just ran into that in Amsterdam. In a synagogue and the Jewish museum; the singing induced a peculiar mood both nostalgic and mystical that I couldn’t resist. Music, voice and auditory stimuli are functionally more closely linked to memory and emotion than visual phenomena, therefore they hold an ability to transport one into realms of emotion and memory. Maybe that music doesn’t represent objects and scenes, but states of mind are difficult to objectify. I recently heard an amazing production of Bach’s St. Matthew Passion at the Brooklyn Academy. Many people were moved to tears and ecstasy, and I’ve never experienced it so intensely.