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Reading Oliver Sacks The Man Who Mistook His Wife for a Hat and other clinical tales I was overwhelmed at the idea of the perception-of-self illustrated through these stories. Starting from a neurological point of view one is confronted with extraordinary conditions that express the complexity we possess.

It is tempting to reduce the complexities of existence to a purely mechanistic understanding, a biology book or chemistry text, more often than not will contain such an account. Observational views of reactions and regrowth, taking for granted the fact that they organize and behave as they do simply bypassing the question of overall organizational direction that takes place in complex systems.

Sacks presents the story of a man Jimmie who had seemingly lost his ability to retain new memories past a certain age. He lived as if he were perpetually twenty-four years old (though nearly twice that age at the time of the story) and as one can imagine the continual shock of unfamiliarity and uncertainty can be disastrous to being human. Sacks questions this purely mechanical view of being and goes on to deliver a volume of parables that shed some light on the matter.

“Hume wrote, ‘that we are nothing but a bundle or collection of different sensations, which succeed each other with an inconceivable rapidity, and are in a perpetual flux and movement.’ In some sense, he has been reduced to a ‘Humean’ Being–I could not help thinking how fascinated Hume would have been at seeing Jimmie his own philosophical ‘chimera’ incarnate, a gruesome reduction of a man to mere disconnected, incoherent flux and change.” (Sacks 30)

Sacks quickly returns to defining and describing neurological control systems, however one is unable to help but think of the implications these stories have against a purely mechanistic view. In the first few stories one is introduced to the system of proprioception, it gives us the ability to “feel our bodies as proper to us, as our property, as our own.” (Sacks 43) It is one of three main systems that give us a sense of the body, the other two being vision and the vestibular system or balance organs.

The story is given of a woman who due to a toxic shock was left without her proprioceptive system shows just how crucial this is to our perception of self and how easily we take it for granted, perhaps never even considered. The woman, Chris, was forced to rely upon her optical system to monitor and watch her body, but it was as if it were not her own. The stories that follow go on to illustrate different sense perceptions related to proprioception but in smaller increments.

Phantom limbs, many have heard of, give the sense that one possesses a limb where it had been removed. One man… “whenever he moved his hand toward his face–for example to eat or scratch his nose–he was afraid that his phantom finger would poke his eye out. (He knew this to be impossible, but the feeling was irresistible.)” (Sacks 67). This ‘irresistible’ feeling is enough to make one marvel at the complexity of neurology yet Sacks continues to provide even more intriguing thoughts.

“All amputees, and all who work with them, know that a phantom limb is essential if an artificial limb is to be used . . . One such patient, under my care, describes how he must ‘wake-up’ his phantom in the mornings. First he flexes his thigh-stump towards him, and then he slaps it sharply–’like a baby’s bottom’–several times. On the fifth or sixth slap the phantom suddenly shoots forth, rekindled, fulgurated, by the peripheral stimulus. Only then can he put on his prosthesis and walk.” (Sacks 69)

What exactly is proprioception and what else does it control? Where do the original spatial concepts come from? Are they passed on in ones DNA? Is it proprioception that drives embryonic growth, healing, regrowth, cell differentiation? How does the nervous system interact with  this overall control system? Why is it that without this system some may intellectually know but still lack the ability to compensate for a deficit? Like the woman with hemi-inattention.

“Sometimes, she will put on lipstick, and make up the right half of her face leaving the left half completely neglected: it is almost impossible to treat those things, because attention cannot be drawn to them [...] and she has no conception that they are wrong. She knows it intellectually, and can understand, and laugh; But it is impossible for her to know it directly.” (Sacks 77)

Do things such as faith, belief, and meditation enact these spatial controls in our minds thus driving and catlyzing things such as healing or positive feedback loops? The implications are intriguing.

The last section of the book is the ‘world of the simple’ where Sacks gives new perspective to individuals that are often overlooked and written off as simply mentally handicapped. His sensitive observations of one girl revealed how her sense of self of self-perception though handicapped in a traditional sense was instead expressed in a ‘narrative’ organization of the world. In fact she seemed to excel in her grasp of narrative as it connected her whole world. Other similar patients showed tendencies toward musical and narrative understandings of reality.

When one looks are the power of metaphore it becomes obvious how essential stories are to the basis of linguistics, morality, biology, religion, just to name a few. Sacks points out the common mistake of giving narrative and metaphore such little importance when approaching the mentally handicapped. This makes one consider how it may be lacking in their own personal life even though we may excell in other ’intellectual’ modes. Overall this well written volume causes one to reconsider the importance and function of healthy self perception. Most importantly it leads ones mind toward more questions. {tb}