Have you ever had a tune ‘embed’ itself in your brain and refuse to leave? I had this nightmarish experience during a written examination (thankfully not an important one) in my 2nd MBBS. I’d love to tell you it was an excerpt from a Mahler symphony or a Beethoven sonata, but it was in fact “Frankie (Do You Remember Me)” by Sister Sledge.

The early 1980s were a technological revolution for me. From listening to spool tapes, LPs and 45s in a designated part of the house, we had made the switch to a much more portable cassette player, and around 1984 I had been presented with a stereo Walkman, which was the height of portability then, and über ‘cool’. I must have been listening to a tape which included “Frankie” while studying for my microbiology test, and its peppy beat and lyrics ‘grabbed’ me.

brain worms

When we got the paper, it was, if I remember right, an essay question on some micro-organism, Staphyloccocus aureus or Klebsiella. But each time I tried to recall what I knew about it, the song would start to ‘play’ in my head, and I just couldn’t ‘switch’ it off. This had never ever happened to me before, and it really scared me. I remember looking helplessly about as everyone else scribbled away, while I tried in vain to get the music to stop. The lyrics seemed to taunt me: “Do you Remember?” But I just couldn’t remember anything I’d studied. It put me off listening to anything ‘catchy’ while studying, at least for a long while, until I lapsed back into it.

I was reminded of this while re-reading ‘Musicophilia’ by the famous neurologist and author Oliver Sacks (1933-2015), in the wake of his death last month. It is a fascinating work, and my first introduction to his brilliant writing. I had browsed through his other books in bookshops but bought this one, perhaps because it brought music and medicine together so wonderfully, two disciplines that are also important to me.

musicophilia_cover

The subject of “Brainworms, Sticky Music, and Catchy Tunes” like the one (“Frankie”) that caught me so suddenly and dramatically has a whole chapter devoted to it in Sacks’ book, in its first part “Haunted by Music”.

Other portions of the book also resonated within my experience, if not first-hand, then through those of people I knew. The experiences of some of Sacks’ patients after a stroke reminded me of Vere da Silva, easily the most accomplished violinist, conductor and consummate musician in my extended family. I remember how after his first stroke, when classical music (which he had obviously loved so much) was played, he would indicate that it be switched off. At that time, I had felt that perhaps the music was a bitter reminder of what he was (temporarily, thankfully) unable to do due to the hemi-paresis. But perhaps there was also a sensory aspect to the cerebral insult, in that he might have been for a while unable to process the auditory signals as music. As I said, he mercifully regained these faculties with time.

Sacks’ case histories often read stranger than fiction: a surgeon struck by lightning in a phone booth survives this near-death experience only to develop a curious, out-of-nowhere, out-of-character craving for learning the piano, and piano music; “musical hallucinations” in a whole host of subjects; a musical savant with a ‘phonographic’ memory for melodies of hundreds of operas in their entirety, which includes individual instrumental and vocal parts; and so on. The book pulls you in despite the verbose footnotes, often peppered with medical jargon.

There is also a sobering cautionary note regarding the harmful effects of loud music: “Unlike the eye, the organ of Corti is well protected from accidental injury; it is lodged deep in the head, encased in the petrous bone, the densest in the body….But, protected as it is from gross injuries, the organ of Corti, with its delicate hair cells, is highly vulnerable in other ways –vulnerable, as a start, to loud noise. Every ambulance siren or garbage truck exacts a cost, to say nothing of airplanes, rock concerts, blaring iPods, and the like.”

I was recently saddened to hear of the deafness acquired by a dear friend, musician and music-lover, who in his youth would listen to music through earplug-shaped speakers, in retrospect, at a dangerously high volume. He is now unable to hear sounds within a specific frequency range in one ear. That is to say, he is able to “hear”, but what he experiences is a distortion of the actual sound. The damage, sadly, is irreversible. This is why I feel so concerned about increasing noise pollution in our everyday lives; we are all, whether we realise it or not, growing progressively, inexorably and irreversibly deaf.

Sacks has written other best-selling books, mostly also collections of case studies of people with neurological disorders. They have esoteric titles: ‘The Man who Mistook His Wife for a Hat’; ‘A Leg to Stand On’; ‘An Anthropologist on Mars’.

The New York Times called him the ‘poet laureate of contemporary medicine’. Atul Gawande, another wonderful writer of medical case studies and the ethical, moral and philosophical dilemmas presented in active medical practice, freely acknowledges his debt to Sacks. I love his work too. In his tribute to Sacks in the September 2015 issue of The New Yorker, Gawande writes: “No-one taught me more about how to be a doctor than Oliver Sacks”; high praise indeed, as both Gawande’s parents were doctors. Gawande goes on to laud Sacks’ “inquisitiveness and observational power” and the manner in which “he captured both the medical and the human drama of illness, and the task of the clinician observing it.”

Critics have, in a parody of one of his book titles, called Sacks “the man who mistook his patients for a literary career”, and termed his work a “high-brow freak show”. Sacks responded to criticism: “I would hope that a reading of what I write shows respect and appreciation, not any wish to expose or exhibit for the thrill…” This is how it comes across to most of us, and how he will be remembered.

(An edited version of this article was published on 20 September 2015 in my weekend column ‘On the Upbeat’ in the Panorama section of the Navhind Times Goa India)

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