Friday, October 16, 2015

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

Musicophilia: Tales of Music and the Brain

Author: Oliver Sacks
Publisher: Knopf Doubleday Publishing Group
Date of Publication: September 23, 2008
Pages: 425

     Oliver Sacks died this past August at the age of 80.  He was a professor of Neurology at New York University and is best known for his essays and books related to many of the fascinating clinical problems he observed during his long career.  His 1973 book Awakenings, an auto-biographical look at post-encephalitic patients becoming "unlocked" after doses of L-Dopa, was developed into an Oscar-nominated movie starring Robin Williams and Robert De Niro.  Musicophilia was originally released in 2007.  In this intriguing book Oliver Sacks explores music as part of disease processes and, further, as part of treatments for other disorders.  

     The book opens with a case study of an orthopedic surgeon struck by lightning who became obsessed with piano music and learning to play the piano.  This physician "once an easy-going, genial family man, almost indifferent to music - was inspired, even possessed, by music, and scarcely had time for anything else."  He eventually loses his family and job because of his obsession.

     Many more case studies follow, including patients with musical seizures, musical savants, stroke and dementia patients.  The sections on patients with profound neurological deficits who maintain their ability to play and appreciate music are fascinating.  The author tells all of these stories with grace and style, managing to entertain as well as educate the reader.  Much of the current understanding of complex neurologic syndromes comes from modern functional brain imaging.  These techniques have been used to map the brain and define which areas of the brain are responsible for musical ability, learning and appreciation.  This data is included in the discussions of the disorders.

    Sacks deftly explains the rationale for music therapy, explaining how the astute therapist can manipulate functioning areas of the brain.  Music therapy can be used in motor disorders such as Parkinson's disease to reduce uncontrollable movement and can also be used in dementia patients to calm and ease the distress which many of them suffer.  The author states:

"As music seems to resist or survive the distortion of dreams or of Parkinsonism, or the losses of amnesia or Alzheimer's, so it may resist the distortions of psychosis and be able to penetrate the deepest states of melancholia or madness, sometimes when nothing else can."

     I can truthfully say that I remember very little neuro-anatomy or physiology from medical school.  Also, much has changed in the decades since I last was exposed to any of this.  This book helps explain many very complex medical issues and engenders a true appreciation of the complexity of neurologic and psychiatric conditions.  The role which music can play in the pathophysiology of disease as well as in the treatment plan for many disorders was a revelation to me.  Musicophilia is packed with compelling information and was a joy to read.

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