This is one of the two dozen studies of patients with right-brain disorders that make up Sacks's volume The Man Who Mistook His Wife for a Hat. The nineteen-year-old Rebecca has significant physical and mental defects (her IQ is 60 at best), and by conventional neurological standards she is severely impaired, but Sacks discovers that she has moments of being quite in touch and "together" (her word).

The essay tells of Sacks's discovery of Rebecca's poetic expression and spiritual qualities, and of her self-awareness, in planes unknown to standard neurological and psychiatric categories. Sacks is broadly critical of psychological and neurological testing as constituting a "defectology" that is blind to important human qualities. He warmly recommends music and story-telling, both as modes of understanding and also as narrative therapies that work by ignoring the defects and speaking to the soul.


Rebecca nicely represents Sacks's intriguing and provocative book, which he wrote partly in the hope of reforming the field of neurology. Sacks presents Rebecca's case as a classic example of the failure of a system that reduces patients to what is wrong with them, what is perhaps tearing them apart, and ignores whatever might help them hold themselves together. Rebecca says it beautifully in a moment of metaphoric insight: "I'm sort of a living carpet. I need a pattern, a design, like you have on that carpet. I come apart, I unravel, unless there's a design."

Primary Source

The Man Who Mistook His Wife for a Hat


Summit Books

Place Published

New York



Page Count