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"Awakenings," and the power of music

Oliver Sacks

[From 2008.] Reading Oliver Sacks’s Awakenings, which is about his experiences with post-encephalitic, Parkinsonian patients. It’s a good book, full of good thoughts and superb writing. Sacks emphasizes, as against his colleagues, that Parkinson’s disease is an existential rather than a purely neurological illness. It affects the whole being and not just the body; it is holistic and should be treated holistically. The doctor should adopt a sympathetic, imaginative, therapeutic approach to it—to understand how it is experienced—rather than a mechanical, external, ‘objective,’ ‘neuroscientific’ approach, which won’t be as fruitful. (If the patient, for example, is immersed in a warm and loving environment, his symptoms will be less severe than otherwise.) Sacks even suggests that Parkinson’s has features in common with a neurosis or psychosis. He strikes me as the R. D. Laing of Parkinson’s disease (though without Laing’s intuitive genius).

Our health, diseases, and reactions cannot be understood in vitro, in themselves; they can only be understood with reference to us, as expressions of our nature, our living, our being-here (da-sein) in the world. Yet modern medicine, increasingly, dismisses our existence, either reducing us to identical replicas reacting to fixed ‘stimuli’ in equally fixed ways, or seeing our diseases as purely alien and bad, without organic relation to the person who is ill… It is salutary to remember Pasteur’s death-bed words: ‘Bernard is right: the pathogen is nothing; the terrain is everything.’ Diseases have a character of their own, but they also partake of our character; we have a character of our own, but we also partake of the world’s character: character is monadic or microcosmic, worlds within worlds within worlds, worlds which express worlds. The disease-the man-the world go together, and cannot be considered separately as things-in-themselves.

Words of wisdom, Eastern wisdom and Marxist wisdom, holistic wisdom.

I’m surprised that Awakenings was actually published, since it would seem to fall in the crack between pop culture and academia. (Sacks’s colleagues didn’t like it, ignored it because its philosophy was utterly foreign to theirs and its style was too literary.)

Here’s a footnote that reminds me of Carl Jung: “Instinctively and intuitively all patients [and all people!] use certain metaphors again and again. Thus, there are the universal images of rising and falling, which come naturally and automatically to every patient: one ascends to health and happiness and grace, and one descends to depths of sickness and misery… Another universal metaphor is that of light and darkness: one emerges from the darkness and dimness of disease, into the clear light of health.” Jung would add to this last an array of other images, like the mandala. What explains their recurrence throughout history, in the most varied of cultures? “Archetypes” in the human mind? (Or is that hypothesis little more than a confession of ignorance, a sophisticated expression of “It’s a mystery!”?) Jung didn’t plumb the depths. Profound lessons are hidden in the recurrence, the resonance, of particular images.


The power of music to integrate and cure, to liberate the Parkinsonian and give him freedom while it lasts, is quite fundamental, and seen in every patient. This was shown beautifully by Edith T., a former music teacher. She said that she had become ‘graceless’ with the onset of Parkinsonism, that her movements had become ‘wooden, mechanical—like a robot or doll,’ that she had lost her former ‘naturalness’ and ‘musicalness’ of movement, that—in a word—she had been ‘unmusicked.’ Fortunately, she added, the disease was ‘accompanied by its own cure.’ I raised an eyebrow: ‘Music,’ she said, ‘as I am unmusicked, I must be remusicked.’ Often, she said, she would find herself ‘frozen,’ utterly motionless, deprived of the power, the impulse, the thought, of any motion; she felt at such times ‘like a still photo, a frozen frame’—a mere optical flat, without substance or life. In this state, this statelessness, this timeless irreality, she would remain, motionless-helpless, until music came: ‘Songs, tunes I knew from years ago, catchy tunes, rhythmic tunes, the sort I loved to dance to.’
With this sudden imagining of music, this coming of spontaneous inner music, the power of motion, action, would suddenly return, and the sense of substance and restored personality and reality… [She could] move freely and gracefully… But then, just as suddenly, the inner music would cease, and with this all motion and activity would vanish, and she would fall instantly, once again, into a Parkinsonian abyss.
Equally striking, and analogous, was the power of touch. At times when there was no music to come to her aid, and she would be frozen absolutely motionless in the corridor, the simplest human contact could come to the rescue. One had only to take her hand, or touch her in the lightest possible way, for her to ‘awaken’; one had only to walk with her and she could walk perfectly, not imitating or echoing one, but in her own way. But the moment one stopped she would stop too.
…‘I can do nothing alone,’ she said. ‘I can do anything with—with music or people to help me. I cannot initiate, but I can fully share. You “normals,” you are full of “go,” and when you are with me I can partake of all this. The moment you go away I am nothing again.’
Kant speaks of music as ‘the quickening art,’ and for Edith T. this is literally, vitally, true. Music serves to arouse her own quickness, her living-and-moving identity and will… Rhythmic impetus has to be present [in the music], but has to be ‘embedded’ in melody. Raw or overpowering rhythm, which cannot be so embedded, causes a pathological jerking; it coerces instead of freeing the patient, and thus has an anti-musical effect. Shapeless crooning (‘slush,’ Miss D. calls this), without sufficient rhythmic/motor power, fails to move her—either emotionally or motorically—at all. One is reminded here of Nietzsche’s definitions regarding the pathology of music: here he sees, first and foremost, ‘degeneration of the sense of rhythm.’ ‘Degenerate’ music sickens and forces, ‘healthy’ music heals and frees. This was precisely Miss D.’s experience; she could never abide ‘banging’ or ‘slush,’ and required a firm but ‘shapely’ music.
Would any music, then, provided it was firm and shapely, serve to get Frances D. going in the right way? By no means. The only music which affected her in the right way was music she could enjoy; only music which moved her ‘soul’ had this power to move her body…

Elsewhere he writes more about Edith: “‘When you walk with me,’ she said, ‘I feel in myself your own power of walking. I partake of the power and freedom you have. I share your walking powers, your perceptions, your feelings, your existence. Without even knowing it, you make me a great gift.’ This patient felt this experience as very similar to, if not identical with, her experiences with music: ‘I partake of other people, as I partake of the music. Whether it is others, in their own natural movement, or the movement of music itself, the feeling of movement, of living movement, is communicated to me. And not just movement, but existence itself.’ This patient is surely describing something transcendent, which goes far beyond any ‘contactual reflexes.’ We see that the contactual is essentially musical—as the musical is essentially contactual. One must be ‘touched’ before one can move. This patient, whether speaking of others or music, is speaking of just this, the mysterious ‘touch,’ the contact, of two existences. She is describing, in a word, the sense of communion.”

Remember when I wrote about music’s being like an “other,” or a being with whom one can interact conversationally?[1] (It is both the being and the conversation.) This must be why it is able to assuage loneliness. In listening to Chopin’s nocturnes, the lonely person is engaging with a sympathetic spirit, thereby having his loneliness soothed.

[1] Here's the passage of my journal I was referring to: "You probably think that music is for me only a very pretty garnish on life, a way to escape from boredom or occupy my mind with something else when I’m lonely. But you’re not quite right. In despairing moments like this one right now, when I’m thinking lovingly of the long knife in the kitchen drawer, music is literally my companion, someone who whispers to me as the tenderest of lovers. This is, indeed, the secret to my lifelong musical love-affair. It is as if a living being with violin-strings for vocal cords is talking to me, comforting me and telling me I am not alone. —There is no hyperbole here, no poetic license. I am just reporting my experience, my experience of the Adagio from Schubert’s String Quartet in C, D. 956. My 'girlfriend' is talking to me through my headphones and I’m passively letting her caress away my sadness. Music is not only a stream of sounds for me; it is the speech of a person who communicates by externalizing emotions, directly expressing them, in Rousseauian fashion. Music is my ideal other, or the speech of my ideal other. When I’m lonely there is someone to sympathize with me, and when I’m happy I have someone to laugh with. That is the secret (or one of the secrets) of music’s power, of its uniqueness among art forms."


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