Review of Sacks The Man Who Confused His Wife with a Hat

Book Review: The Man Who Mistook His Wife for a Hat

As an adolescent, I read very frequently. I usually had a stack of three or four books on my headboard and I am sure that all the nights I stayed up with my reading lamp on cost my parents a small fortune in electricity bills.

Sadly, once I entered college I read for fun less and less. Spending time with friends and working two or three jobs took up a lot of time. Reading literature by Stephen Krashen or Juan Rulfo meant less time and energy for books by S.E. Hinton or Phillip Pullman. That’s not to say I did not enjoy the former, but it is to say I missed the latter.

Therefore in the year 2016, I made it a goal to read 12 books for fun. I’m ready to tell you know about Book 1: The Man Who Mistook His Wife for a Hat by Dr. Oliver Sacks.

I’m currently only 1/4 of the way through the book, so I’ll be updating this post as I go….

Overview & Why I Think an SLP Would Enjoy This Book

The book is a series of case histories, essays, or vignettes (depending on which term you prefer) based on real patients that Dr. Sacks saw and worked with during his career. Theses are cases of people living with the most extraordinary neurological conditions. The book is divided into 24 essays (each about 12 pages long) which is further divided into 4 thematic sections:

(click each link to jump to that section of the review)

I. Losses

II. Excesses

III. Transports

IV. The World of the Simple

As a lay person, I was at first hesitant to pick up a book written by a neurologist. I thought it was about impersonal accounts or scientific descriptions that were beyond me (aka I thought it would be boring). I was quite happy to be wrong.

This is a book about humans and their experiences. 

I value Dr. Sacks’ sympathetic recounting of these people’s conditions and struggles. In the helping professions, it is critical that we never forget the humanity of the people we work with. When I was training to become a teacher, I interviewed my high school Spanish teacher Mrs. West (la Señora Oeste) about her long career as an educator. At the end of the conversation, she shared her best advice for future teachers which I’m reminded of as I reflect on Dr. Sacks’ book. She said, “Each and every student in your classroom needs to know that you see them and that you’re not looking past them. Don’t concentrate just on your bright students or your problem students. Recognize their existence everyday.” Based on the deeply human telling of these stories I think that Dr. Sacks knew that same thing Mrs. West told me.
I found this description on Dr. Sacks’ website, and I thought it perfectly represents the book. So, I’ve pasted it for you here:

If inconceivably strange, these brilliant tales remain, in Dr. Sacks’s splendid and sympathetic telling, deeply human. They are studies of life struggling against incredible adversity, and they enable us to enter the world of the neurologically impaired, to imagine with our hearts what it must be to live and feel as they do.

In brief, this book is a refreshing way to look at some of the people that an SLP might serve.
As I recently finished a class on the anatomy of Speech and Language, I found Dr. Sacks’ (simplified) explanations of the science behind some of these conditions accessible. Reading the case studies is a neat way to reinforce and enrich what I studied in class, especially the unit on neuroanatomy. 

Section I – Losses:

These 9 fascinating stories account for nearly half of the books length, and deal (as you would imagine). with losses. What you might not imagine is the types of losses dealt with. Dr. Sacks uses evocative language to tell stories of men and women who have lost access to various abilities that the rest of us take for granted.

I’m not sure the word abilities is entirely precise, because you read about things like the loss of the recognition of one’s own appendages like The Man Who Fell Out of Bed. This poor soul wakes up in the middle of the night and feels what he thinks is a severed human leg in his bed with him. He reacts by pushing it out of bed to find that his entire body tumbles out of bed with the leg. To his shock he discovers the leg is attached to his body. This sounds like something out of a horror movie (and I can imagine it felt that way to the patient), but the leg was the man’s own leg – somehow his brain has simply lost track of it.

The story at the close of this section might be of particular interest to Speech Language Pathologists. Entitled, The President’s Speech this vignette discusses the aphasia ward at the residence where Dr. Sacks worked. He describes the reasons for which aphasiacs, despite not being able to understand words themselves, can often understand perfectly what is being said to them. At one point he says that one cannot lie to an aphasiac and continues, “he cannot grasp your words, and so cannot be deceived by them: but what he grasps he grasps with infallible precision namely the expression that goes with the words…which can never be simulated or faked, as words alone can…”

These first nine case-histories had me devouring the book. The carpe-diem was probably not an intended theme of the doctor’s book, I have found myself reflecting on the need to focus on the important things in life because one’s health doesn’t last forever. 

Section II – Excesses:

I was quite excited upon reading the introduction to this section of the book. I’ve thought before about what Dr. Sack’s proposes at the onset: What of the opposite of deficit of function? Does there exist an excess or superabundance of function?

He goes onto explain that traditionally neurology has no concept of this. Either a system functions or it does not. I’m no neurologist, so who am I to disagree?

However, the little I know about autism for example is that we consider it on a spectrum. The restricted behavior, limited communication abilities, and impaired social abilities are all “deficits”, no? So with social ability for example, we’re comparing its “impaired” capacity to people who have full social abilities: understanding of body language, ability to sense and understand shifts in tone of voice or pitch, recognizing sarcasm, etc.

Why then can’t we imagine there is an “upper end” of the spectrum that also passes beyond what is considered “average” or “normal.” Couldn’t there be a person who is hyper sensitive to social cues, body language, and other pragmatics? There is probably a perfectly scientific explanation as to why this is not possible…

Anyways…all of this is to say I was very excited to read this section.

These stories were fascinating and engaging just like the others, but they failed to excite my pensivity on the topic of “excess” like I had hoped they would.

My favorite chapter from the section was: “A Matter of Identity” (12) It was about a man with Korsekov’s syndrome (which I confess I know nothing about other than what I’ve read from this book and gleaned from Wikipedia) but it seems the man has lost his sense of identity. I don’t dare try to explain it better than Dr. Sacks himself, so I’ve taken a few quotes:

“[The patient] remembered nothing for more than a few seconds. He was continually disoriented. Abysses of amnesia continually opened beneath him…” Sacks goes on to describe how this man was constantly making up stories to fill in his missing identity. The stories were usually funny, but also nonstop. Whenever he was in a social setting, the man felt the need to be emitting a constant stream of “confabulated” narrative.

Dr. Sacks explains why the man is desperately creating these stories:

We have, each of us, a life-story, an inner narrative—whose continuity, whose sense, is our lives. It might be said that each of us constructs and lives, a ‘narrative’, and that this narrative is us, our identities.

If we wish to know about a man, we ask ‘what is his story—his real, inmost story?’—for each of us is a biography, a story. Each of us is a singular narrative, which is constructed, continually, unconsciously, by, through, and in us—through our perceptions, our feelings, our thoughts, our actions; and, not least, our discourse, our spoken narrations. Biologically, physiologically, we are not so different from each other; historically, as narratives—we are each of us unique.

Sacks description of the self is a look at one of the great mysteries of psychology, philosophy, neurology, religion, or any other study of man. What is the self? We will likely never fully understand it, but we know, as Dr. Sack’s states that, “To be ourselves we must have ourselves—possess, if need be re- possess, our life-stories. We must ‘recollect’ ourselves, recollect the inner drama, the narrative, of ourselves. A man needs such a narrative, a continuous inner narrative, to maintain his identity, his self.” By contrast we can see that this man in the vignette does not have himself and thus is not himself.

Apart from the look at self, or perhaps related to it, were two stories of patients with Tourette syndrome. One was mild and the other quite severe. I doubt SLP’s work with Tourette patients, but there might be some connection. I found the second story to be truly terrifying in its description of how the syndrome enslaves and overwhelms its victims. In fact, Sacks titled the chapter, The Possessed.

Overall, I found this section of the book to be much more thought provoking on a purely philosophical level. If you read the book, treat this section like a piece of cheesecake. It is rich and full of flavor so you must savor it. If you consume it too quickly, you’ll be over saturated and unable to appreciate it.  

Section III – Transports

I wasn’t entirely sure what to expect here. Honestly, I found Dr. Sacks’ introduction to the section a bit cryptic…. so I just dove right in. As usual, I wasn’t disappointed.

The section opens with a story of “Mrs. O’C” who begins hearing music in the middle of the night. Eventually, she finds her way to Dr. Sacks and they determine that she had suffered a minor stroke which affected her temporal lobe causing seizures. Somehow, these seizures cause her to here Irish lullabies which through investigation they come to learn were songs Mrs. O’C’s mother had sung to her as a child. This was actually how I was introduced to Dr. Sacks – through this episode of RadioLab which features him in the second half.

Other sections tell about a young girl dying from a brain tumor being transported back to her childhood home in India or about the visions of Hildegard of Bingen, a nun and mystic who lived at the beginning of the first millennium.  

Section IV – The World of the Simple

This final section of the book was probably one of the most inspiring and one I might be tempted to recommend to anyone wishing to work with mentally handicapped people (including SLP’s!). Dr. Sacks’ narration really got back to an appreciate to the beautiful humanity of each of his patients that I enjoyed from the beginning.

Dr. Sacks’ was a practicing doctor several decades ago, and so I should remember that there is probably more complete and contemporary research on many of the things he talks about. Even if the science isn’t up-to-date (and I don’t know if it is or not) the messages about remember the humanity of the people we work with is clear.


It was heartrending to read Dr. Sack’s descriptions of some patients who had always been seen and defined by their “deficits” or “inabilities” instead of by the things they are good at. And he goes on to describe many things that many of his patients (though handicapped in someways) were good at.


I can’t go into the details of each chapter (I have to leave the best for you to read on your own!) but I can say that this section and these four stories reached my heart. They augmented my understanding of the mentally handicapped and encouraged me to look at their abilities and gifts before anything else.

If you’re looking to order a copy, here is my affiliate link to Amazon for The Man Who Mistook His for a Hat


To wrap this up, please share with me what books you’re reading! I’m always looking for something interesting to accompany my coffee and my imagination 🙂


Cover Image "open-book" designed

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