The Man Who Mistook His Wife for a Hat

Neuroscience is a study of the brain’s biology, schematics, operations, and functions. Practitioners in the field combine medical knowledge with knowledge of psychology to understand how the brain affects a person’s ability to move, think, feel, and function. Although human beings have always speculated on issues of human behavior and how the mind and body work together, the field of neuroscience could not emerge as a separate field until technology allowed the study and understanding of neurons. There is some question as to whether neuroscience is strictly a science of biology or of psychology. In The Man Who Mistook His Wife for a Hat, Sacks draws heavily on both philosophical inquiry and medical knowledge to create a more holistic view of neuroscience as he refines the lens through which he views his more unusual patients.

Some might say neuroscience began in Ancient Greek times when philosophers questioned the location of “the seat of intelligence.” Hippocrates believed human reason resided in the brain, while Aristotle believed it resided in the heart. Galen believed that the physical structure of the brain affects the way a person behaves, a theory that is the basis for modern neuroscience. However, the Ancient Greeks were hindered because dissecting human brains was forbidden by law until 300 BCE.

In the 8th century, Persian Muslim physician Ali ibn Sahl Rabban al-Tabari wrote what is considered to be the first medical encyclopedia (entitled Firdous al-Hikmah). He drew from the influence of Hippocrates, Galen, and other physicians. He opened one of the first known psychology wards, where he treated and documented cases of brain damage and neurological conditions. He integrated views on medicine with views on psychology to assess, treat, and document his findings.

In the 17^th century, French philosopher René Descartes proposed “mind-body dualism.” His thesis maintains that there is a divide between the body and the mind, and because of this distinction, the two entities should be studied separately. Sacks notes that this divide still occurs today and has shaped methods of treating neurological conditions. He calls it a “bodiless psychology and a soulless neurology” (48), which he states began at the turn of the century. In reality, its roots stretch back farther.

Between the 1940s and 1970s, technologies like the microscope made it possible for scientists and doctors to look at the brain more closely. This, in turn, allowed for a better understanding of how neurons work. A. R. Luria, who studied neurological damage during World War II, is considered “the father of modern neuropsychology.” With encouragement through his correspondence with Luria, Sacks integrated principles of psychology and medicine to view his patients as whole people, not as mere medical conditions. As Sacks writes, his “simple” patients were some of the dearest in the world to him, and he believed that man has not only a brain but also a sense of emotional coherence, morality, and community.

In the 1960s and 1970s, a new field of psychology emerged, dubbed “humanistic psychology” by its founders. German neurologist Kurt Goldstein, one of the precursors to this movement, posited the term “self-actualization,” the belief that human beings have an innate tendency to grow toward their highest potential. This influenced American psychologists Abraham Maslow and Carl Rogers to develop theories of human development and the ideal relationship between doctor and patient. As Sacks notes in Chapter 21, it became fashionable to refer to patients as “clients.” This change in terminology hinges on the belief that there should be less of a hierarchy between doctor and patient, and patients should be viewed as capable of collaborating with doctors in their own mental health treatment. Although Sacks does not prefer this terminology, he otherwise displays views that align with principles of humanistic psychology.

Sacks’s respect for his patients’ uniqueness, and his view that some unusual conditions come with benefits, has led him to be regarded as a “champion for neurodiversity.” Neurodiversity is a term that originated in the late 1990s and describes conditions previously referred to as “disorders.” The term “disorder” suggests that a neurodivergent mind is “defunct” or “abnormal.” Neurodiversity instead offers that a person with a neurodivergent mind is simply different when compared to a person with a neurotypical mind. Those who embrace neurodiversity, like Sacks, also recognize that people with neurodivergent minds may have unique mental strengths.