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  SPIEGEL Interview with Neurologist Oliver Sacks: 'I Think of Us as a Musical Species'

SPIEGEL Interview with Neurologist Oliver Sacks 'I Think of Us as a Musical Species'

Part 2: The Musical Brain

SPIEGEL: If you look at the brain of a musician and compare it to a brain of a not-so-musical person, what do you see?

Sacks: The differences can be very, very striking. The neurologist Gottfried Schlaug in Boston has been making these comparisons for several years using MRIs in the brain and measuring carefully the size or thickness of gray matter. He has found many different things. The corpus callosum between the hemispheres, for example, tends to be larger in musicians. Auditory areas are often larger, too, but so are motor areas, and there may be enlargement of gray matter in the cerebellum -- to the extent that you can even see it with your bare eyes.

SPIEGEL: Can differences like that reveal whether someone is a born or a trained musician?

Sacks: This is not always easy to say because gifted musicians are likely to be highly trained and training early. But one can demonstrate that some of these changes happen with training. So the power of music and the plasticity of the brain go together very strikingly, especially in young people.

SPIEGEL: In rare cases, people can suddenly lose their sense of music. Did you encounter any of those cases?

Sacks: Oh yes. Since there are particular parts of the brain associated with particular aspects of music, they can be damaged through an accident, a stroke or a tumor. I have some patients who have experienced this. Incidentally, the sense of music might get lost, but it might also get enhanced.

SPIEGEL: As happened to Tony, who was struck by lighting?

Sacks: Yes. I once had a patient, a woman, who had a tumor in her right temporal lobe, and when that was removed, she found herself much more musical.

SPIEGEL: Was she happy about that?

Sacks: She seemed to enjoy it a great deal. In any case, it was much more pleasant than something that happened to me many years ago, when I lost my sense of music for a short time after a migraine attack.

SPIEGEL: So you don't need to have a tumor or a stroke for that to happen, then?

Sacks: Not at all. Usually with migraines one has visual disturbances of one sort or another, but I had a musical disturbance. I had been listening to a piece in the car, a Chopin ballad, and it seemed to lose all its tone, and finally it became a sort of flat banging of a rather metallic sort, although the rhythm was preserved. I was very puzzled about it, and then it came back after about 10 minutes. And I phoned the radio station and said, "What happened? Was that a joke? Was that an experiment?" They said, "You'd better check your car radio." But it happened again when I was at home and not listening to the radio.

SPIEGEL: Have you ever had a musical hallucination?

Sacks: No. But for people who do have them, it can be very startling. You look around. You're puzzled. You wonder if other people are hearing it. You look to see: Is the radio on? Is there a band outside? There's an overwhelming feeling of an external source. It may also be very loud, too, physically loud. You may actually be deafened by a hallucination.

SPIEGEL: Can these hallucinations be connected to deafness or hearing loss?

Sacks: In some cases, yes. It seems that the brain always has to be active, and if the auditory parts of the brain are not getting sufficient input, then they may start to create hallucinatory sounds on their own. Although it is curious that they do not usually create noises or voices; they create music.

SPIEGEL: What kind of music?

Sacks: It could be anything: sometimes hymns, sometimes popular tunes, and often melodies that were in the culture during one's childhood. Occasionally, it can be rather frightening, as it was with one patient I describe, who heard Nazi marching songs which terrified him because he was a Jewish boy growing up in Hamburg in the 1930s. Fortunately, that was then replaced by Tchaikovsky.

SPIEGEL: How do you treat patients with music hallucinations?

Sacks: I may suggest some further tests, but basically I think my role is a reassuring one, to say: You're not crazy, and there is no similarity between this and hearing voices, like psychotic schizophrenic voices. Sometimes very small doses of tranquilizers or anticonvulsants can be useful. They just generally dampen the excitability a bit.

SPIEGEL: You quote the German Romantic writer Novalis, who wrote that every disease is a musical problem and every cure is a musical solution. Can music be a cure?

Sacks: Absolutely, and in many different ways. It was this which attracted my attention as a physician some 40 years ago with the patients I describe in my book "Awakenings." These were people suffering from very severe Parkinson's, who were often

completely motionless. They couldn't initiate movement by themselves, but music liberated them. They could dance, they could sing, they could do completely normal things. The rhythm of music is very, very important for people with Parkinson's, and this may go back to what we were saying before about this human proclivity to move with rhythm -- even if you have Parkinson's. But it's also very important with other sorts of patients, such as patients with Tourette's syndrome. Music helps them bring their impulses and tics under control. There is even a whole percussion orchestra made up exclusively of Tourette's patients.

SPIEGEL: Music even appears to have a positive effect on people suffering from Alzheimer's.

Sacks: Right. Even when other powers have been lost and people may not even be able to understand language, they will nearly always recognize and respond to familiar tunes. And not only that. The tunes may carry them back and may give them memory of scenes and emotions otherwise unavailable for them.

SPIEGEL: So does this mean that music is their only connection to the outside world?

Sacks: I would actually say their only connection to the inner world.

SPIEGEL: You say that people shouldn't read while listening to music because music challenges your brain all the time. What do you think when you see people running all over the place with iPods?

Sacks: I want to kill them.

SPIEGEL: Why?

Sacks: Not long ago, I was on my bicycle, when I saw a woman with earphones on, who was obviously thinking of crossing the bicycle path. I rang my bell; she didn't hear it. I have a police whistle; she didn't hear it. Then she jumped in front of me, and I had to jam on the brakes. I went over the handlebars and got quite injured. So, although I think it is wonderful to have the whole world of music available in something that small and to have it conveyed with such fidelity almost straight into the brain, I think the technology is also a danger.

SPIEGEL: Are you not over-dramatizing a little?

Sacks: Don't you think one has to be careful about walking around in the real world functionally deaf? My neighborhood, Greenwich Village, used to be nicer. There used to be more street life. People used to speak to one another. And now it is as if they're all hallucinating. They're all speaking to invisible presences on cell phones, listening to invisible music.

SPIEGEL: But can't invisible music make us happy, too?

Sacks: Music originally had a social function. You were in church, in a concert hall, a marching band; you were dancing. I'm concerned that music could be too separated from its roots and just become a pleasure-giving experience, like a drug.

SPIEGEL: Doctor Sacks, thank you for this interview.

Interview conducted by Samiha Shafy and Jörg Blech.

Oliver Sack's "Musicophilia: Tales of Music and the Brain" will be published in German in June.