Neurologist's Oeuvre Offers an Appealing

March 3, 2002

Oliver Sacks

Book Review
Gilbert Strang

I had the chance in November to hear Oliver Sacks speak about (and read from) his new book, Uncle Tungsten. It is not a mathematics book. This one is about his childhood love of chemistry---especially the metallic elements. Sacks himself is a neurologist, and I am writing here about six of his books because I think many mathematicians would enjoy them. (They are quite varied; I will tell you a little about my favorites.) You shouldn't miss the work of this remarkable man.

On the other hand, you may feel better off not knowing about all the things that can go wrong with your nerves and brain. I haven't read Migraine and I don't want to.

Sacks speaks in such a gentle and unassuming way, not all-knowing, that you like him at once. His writing is full of intelligent observations about strange neurological conditions---really strange, as in The Man Who Mistook His Wife for a Hat. In the title story, the patient sees but cannot assimilate. A rose becomes a convoluted red form with a linear green attachment. And the hat: "He took hold of his wife's head, tried to put it on. . . . His wife looked as if she was used to such things." And there was another patient, who particularly needed a visual marker to identify his wife---"a conspicuous article of clothing, such as a large hat."

The story of Rebecca, later in that book, struck me most forcefully. She was clumsy, all-of-a-fumble, defeated by the simplest ideas. "No more classes, no workshops, they do nothing to bring me together." What worked in the end was drama, and dancing. The power to perform was present. The music and the play "organized her." How natural that is, if you think about it.

After reading about these patients, I am amazed that our minds work at all. Awakenings is the book that brought Sacks his widest audience, because it became a full-scale film. It describes the astonishing effects (good and bad) of the dopamine medication L-DOPA, now a standard treatment for Parkinson's disease. The patients had been caught by the sleeping sickness epidemic of 1918, and no one imagined 40 years later that they would recover. L-DOPA had them awake in a week, but it led to incredible behaviors. Nothing is simple in the world of neurology.

One instance of a compulsion (no doubt shared by some readers of this review) is the "arithmomania" of Miriam H., whose story appears in Awakenings. She felt compelled to count and compute. "I asked her to start taking 7's from 100 . . . and I heard a wild clattering of the EEG recording pens. When she reached 2, she thought this absurd." The subtractions continued at top speed, to -600. When Sacks came to look at the EEG, he saw 100 spikes in the occupital (visual) areas. They were "the sort of spikes one sees in fits."

I first heard Sacks speak about his 1996 book, The Island of the Colorblind. In 1775 a typhoon killed nearly everyone on the tiny Pacific atoll of Pingelap; as the population recovered, inbreeding produced rare genetic traits (recessive ones). When Sacks visited the island, he found that 57 of the 700 islanders had achromatopsia (total colorblindness). The worst part of the disease is extreme sensitivity to light; the only good part is exceptional night vision.

Colorblindness comes into An Anthropologist on Mars too, in the story of a New York artist who had a traffic accident. Afterward, he was unable to see colors. (At night, though, he could see a worm wriggling a block away.) The devastation of the first months, the gradual learning of a new artistic style without colors, the point when he rejected a last desperate idea for a cure---this story and so many others are full of courage and tragedy and humanity. One looks at people with new respect.

I had the same response to Newton's Madness and Toscanini's Fumble, two books by Harold Klawans that Mike Artin lent me. There is science in these stories (Bernoulli's law explains the drop in blood pressure that Toscanini experienced while conducting). There are nice moments too: Dostoevsky's epileptic seizures were terrible, but the aura in the first moments was something he treasured: "You can't imagine the happiness which we epileptics feel during the second before our fit." All of these books are somehow light reading but very thought-provoking.

This review was originally intended to concentrate on Uncle Tungsten. I am an inveterate reader of autobiographies. It is wonderful to live someone else's life, telescoped into a few days of reading. (Right now I am hiking through Asia in a book called After You, Marco Polo, which in spite of the title is good. The previous borrower at Wellesley College returned it in 1982. . . . By chance, the longest part takes place in Afghanistan, so Mazar-i-Sharif is a place I know well!) I am not much of a popular science reader, but I was sure I would love Uncle Tungsten. Fortunately, others have.

It grieves me to admit that I even skipped pages. My lack of interest in chemistry developed at an early age. The New York Times of December 4 had a beautiful interview with the author, and I hope you will read it---it does justice to the feel and smell and fantastic colors of metals and rare earths. Even I could appreciate the pleasure that Sacks found, at age 12, when he first met Mendeleev's periodic table. He already knew and loved individual elements. Here was the pattern.

At that point the book got better for me. The periodic table was a fantastic achievement. The ultimate explanation needed Niels Bohr and nuclear physics---the understanding that the number of electrons, not the atomic weight, determined an element's position in the table. I liked best the part about spectroscopy, when Kirkhhoff and Bunsen and Fraunhofer saw dark-line spectra from the sun and bright-line spectra from flames; they matched them up to learn what the sun is made of. Sacks still carries a pocket spectroscope to analyze lights in New York City.

Thinking about links to mathematics, what are the "SIAM problems" that come from computational chemistry? One is minimizing the Gibbs free energy---nonlinear optimization in many, many variables (as in protein folding). The neatest example might be Herbert Hauptman's Nobel Prize algorithm, which computes the phases from the magnitudes of a Fourier transform. I ran across a lowpass filter (sgolay in MATLAB) that preserves spectral lines and seems to be practically unknown outside spectroscopy. It is based on least squares, and my project this month is to figure out how it works.

While skipping pages in the early part of Uncle Tungsten, I wondered whether a chemist would like A Beautiful Mind---Sylvia Nasar's biography of John Nash. (Jim Case's review of the movie of the same title, which is not very faithful to the book or Nash's life, can be found in this issue.) Then some incomplete train of thought led me to ask whether reviewers of popular science books might be overly kind. Maybe they skip pages and feel guilty too. You don't have to admit that you failed to finish A Brief History of Time and Godel, Escher, Bach. Both were way up on the best-seller lists, but they seemed impenetrable to me.

I learn more about science from authors like Sacks and Klawans, and Seeing Voices is the book by Sacks that I most want to call to your attention. In it he gives a little history (just amazing) of the years when the deaf developed sign language, and the years when it was essentially forbidden. And the language is described in such lyrical (also mathematical) terms: "We see in Sign at every level a linguistic use of space. What looks so simple consists of innumerable spatial patterns, nested three-dimensionally in each other."

William Stokoe, an earlier author, remarked that speech has one dimension (time), writing has two, models have three, but only signed languages have four (space-time). His 1960 paper was the first scientific analysis of Sign---which "the deaf feel as a most intimate part of their world, something that may be taken from them at any time." I had totally ignored this world, even while a signer was translating my lectures for a deaf student.

A key time was the early 1800s, when Thomas Gallaudet encountered Laurent Clerc teaching in the Institute of Deaf-Mutes in Paris. ("Mutes" are silent not because they are unable to speak but because they do not know how.) Clerc sailed to the U.S. with Gallaudet to open the Hartford Asylum, which transformed the education of the deaf. This was the golden period, and its greatest success was Gallaudet College in Washington---chartered by Congress in 1864 and led for fifty years by Thomas Gallaudet's son Edward.

It is heartbreaking that the tide soon turned against the use of Sign. Alexander Graham Bell (like Edward Gallaudet) had a deaf mother. Well-meaning but ferocious and intransigent, Bell and others insisted that the deaf must learn to speak. Sign was out; lip-reading was required. The deaf paid an intolerable price: a dramatic deterioration in education and function. One asks how this could have continued for eighty years. If we are true to what we see in the world, we know such things can happen. But not forever.

Recent years have seen a revival of Sign and even, in 1988, a small revolution. In the search for Gallaudet's next president, the trustees chose the hearing candidate, "for the sake of the students." Wrong! What a scene that produced---silent crowds seeing passionate protest speeches, applauding wildly, all in Sign. Success brought a deaf president and a new dignity to those students. The writing of Oliver Sacks brings a dignity to all of us.

Gilbert Strang, a former president of SIAM (1999-2000), is a professor of mathematics at MIT.

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