The Man Who Mistook His Wife For A Hat

The Man Who Mistook His Wife For A Hat and other clinical tales
by Oliver Sacks
© 1970, 1981, 1983, 1984, 1985 by Oliver Sacks. All rights reserved.
1. Neurology—Anecdotes, facetiae, satire, etc. I. Title.
[RC351.S195 1987]
616.8
86-45686
ISBN 0-06-097079-0

Preface
Part One - LOSSES
1 The Man Who Mistook His Wife for a Hat
2 The Lost Mariner
3 The Disembodied Lady
4 The Man WhoFell out of Bed
5 Hands
6 Phantoms
7 On the Level
8 Eyes Right!
9 The President’s Speech
Part Two - EXCESSES
10 Witty Ticcy Ray
11 Cupid’s Disease
12 A Matter of Identity
13 Yes, Father-Sister
14 The Possessed
Part Three - TRANSPORTS
15 Reminiscence
16 Incontinent Nostalgia
17 A Passage to India
18 The Dog Beneath the Skin
19 Murder
20 The Visions of Hildegard
Part Four - THEWORLD OF THE SIMPLE
21 Rebecca
22 A Walking Grove
23 The Twins
24 The Autist Artist
Bibliography
Chapter References

Preface
The last thing one settles in writing a book,’ Pascal observes, ‘is what one should put in first.’ So,
having written, collected and arranged these strange tales, having selected a title and two epigraphs, I
must now examine what I have done—and why.
The doublenessof the epigraphs, and the contrast between them—indeed, the contrast which Ivy
McKenzie draws between the physician and the naturalist—corresponds to a certain doubleness in me:
that I feel myself a naturalist and a physician both; and that I am equally interested in diseases and
people; perhaps, too, that I am equally, if inadequately, a theorist and dramatist, am equally drawn to thescientific and the romantic, and continually see both in the human condition, not least in that
quintessential human condition of sickness—animals get diseases, but only man falls radically into
sickness.
My work, my life, is all with the sick—but the sick and their sickness drives me to thoughts which,
perhaps, I might otherwise not have. So much so that I am compelled to ask, with Nietzsche: ‘Asfor
sickness: are we not almost tempted to ask whether we could get along without it?’—and to see the
questions it raises as fundamental in nature. Constantly my patients drive me to question, and constantly
my questions drive me to patients—thus in the stories or studies which follow there is a continual
movement from one to the other.
Studies, yes; why stories, or cases? Hippocratesintroduced the historical conception of disease, the
idea that diseases have a course, from their first intimations to their climax or crisis, and thence to their
happy or fatal resolution. Hippocrates thus introduced the case history, a description, or depiction, of the
natural history of disease—precisely expressed by the old word ‘pathology.’ Such histories are a form of
natural history—but theytell us nothing about the individual and his history; they convey nothing of the
person, and the experience of the person, as he faces, and struggles to survive, his disease. There is no
‘subject’ in a narrow case history; modern case histories allude to the subject in a cursory phrase (‘a
trisomic albino female of 21’), which could as well apply to a rat as a human being. To restore the
humansubject at the centre—the suffering, afflicted, fighting, human subject—we must deepen a case
history to a narrative or tale; only then do we have a ‘who’ as well as a ‘what’, a real person, a patient, in
relation to disease—in relation to the physical.
The patient’s essential being is very relevant in the higher reaches of neurology, and in psychology;
for here the patient’s personhood isessentially involved, and the study of disease and of identity cannot
be disjoined. Such disorders, and their depiction and study, indeed entail a new discipline, which we
may call the ‘neurology of identity’, for it deals with the neural foundations of the self, the age-old
problem of mind and brain. It is possible that there must, of necessity, be a gulf, a gulf of category,
between the...