The subtitle is "Tales of Music and the Brain", and this is a very accurate description of the book's contents. It's a series of case histories, compiled by a neurologist who is also a lifelong musician. The cases are grouped into well-defined subject areas, some of which are: seizures induced by music; sudden and unexpected musicality; absolute pitch; musical savants; synesthesia; music and blindness; musical hallucintions; and "why we have two ears".
But don't think that this is primarily a medical book. It is, first of all, fascinating and entertaining. One comes to the end of each chapter feeling that one has met some very interesting people. One comes to the end of the book feeling that one has been listening to a highly intelligent and caring person. And, looking back through the table of contents, one realizes that they have learned a great amount about a great many interesting things.
For example, I now know that music therapy is not just a nice way to entertain people who are medically challenged. Music is sometimes the only way to connect with people whose ability to speak, move or understand are compromised. Dr. Sacks introduces us to several patients who seem to have no memory whatsoever - who can't remember what they did a few seconds ago - but who quickly join in the singing of old songs, or play complex scores at the piano. He tells of one woman with Parkinson's disease who had great difficulty walking; her daughter made up a song and put it on a tape recorder hooked on her mother's waistband, which significantly helped her walking.
Music itself is not just a nice-to-have. It connects with ancient parts of the brain which continue functioning, like our lungs and heart, even when we can no longer use our "rational" functions. We know that humans have been making music for more than 40,000 years - which makes the invention of farming about 12,000 years ago seem rather like a new experiment. Our musical wiring seems fundamental to our species.
At an individual level, too, music shapes our brain. If I may quote from the book: "Anatomists today would be hard put to identify the brain of a visual artist, a writer, or a mathematician - but they could recognize the brain of a professional musician without a moment's hesitation". One of the things they would notice is enlargement of the corpus callosum, which connects the left and right halves of the brain. We've all heard about the "creative side" and the "analytical side" of the brain, and it seems these work together better in people who habitually deal with music.
While the "Mozart effect" on young people has probably been overstated, Dr. Sacks relates the findings of one study (using magnetoencephalography, if you'd like to know) which "recorded striking changes in the left hemisphere of children who have had only a single year of violin training, compared to children with no training". The conclusion from this and other research is that "regular exposure to music, and especially active participation in music, may stimulate development of many different areas of the brain ... For the vast majority of students, music can be every bit as important educationally as reading or writing".
Not everyone will become a musician, of course. Most will be spared the pitfalls of devoting a lifetime to performing. One risk is dystonia - known by many as writer's cramp - which can make it physically impossible to perform. Sacks refers to studies by Frank Wilson who looked at "the control systems which would have to underlie the repeated, automatic performance of very fast, intricate sequences of small, precise finger movements ... involving the coordination of many brain structures". Wilson concluded that "the musician in full flight is an operational miracle". When the miracle becomes a problem, interestingly, it's not the muscles which give out; it's the brain. (If only Robert Schumann had known!) One study found that "the mapping of dystonic hands in the sensory cortex was disorganized both functionally and anatomically".
Lest you think that this book is all facts and science, I must tell you that Sacks reserves his final section for considerations of emotion - the thing which most people associate with music. He discusses melancholia, madness, Williams Syndrome (which causes tremendous joy in music-making among people with extremely low intelligence), and even Charles Darwin's surprise at finding himself emotionally moved by music despite his admitted total lack of musicality. Memorable for me is Woody, totally amnesic, vaguely aware of his condition and describing himself as "broken inside", who comes alive joyfully and fully-functionally only when singing with his family.
Thank you, Dr. Sacks.
If I have any quibble, it would be the lack of a simple diagram to help me picture where to find the temporal lobes, the parietal lobes, the amygdala, the visual cortex, and all the other regions of the brain which Dr. Sacks refers to. That is a very small quibble; the geography of the brain is not really important to the book's messages. In fact the inclusion of a diagram might give prospective readers the impression that this is primarily a medical book, rather than a caring view on some important aspects of us humans.