The Man Who Mistook His Wife for a Hat

Sacks, Oliver

Primary Category: Literature / Nonfiction

Genre: Case Study

Annotated by:
Fefferman, Stanley
  • Date of entry: Feb-06-2002


P., a music teacher, whose associates have questioned his perception, is referred by his ophthalmologist to the neurologist Oliver Sacks. During the first office visit, Sacks notices that P. faces him with his ears, not his eyes. His gaze seems unnatural, darting and fixating on the doctor's features one at a time. At the end of the interview, at which his wife is present, P. appears to grasp his wife's head and try to lift it off and put it on his own head. "He had . . . mistaken his wife for a hat!" She gave no sign that anything odd had happened.

During the second interview, at P.'s home, P. is unable to recognize the rose in Sacks' lapel, describing it as "a convoluted red form with a linear green attachment." He is encouraged to speculate on what it might be, and guesses it could be a flower. When he smells it, he comes to life and knows it. The wife explains that P. functions by making little songs about what he is doing--dressing, washing or eating. If the song is interrupted he simply stops, till he finds in his sensorium a clue on how to proceed.

This cantatory method of compensating allows P. to function undetected in his professional and personal life. He remains unaware that he has a problem. Sacks chooses not to disturb his ignorant bliss with a diagnosis. Though his disease (never diagnosed but hypothesized as a tumor or degeneration of the visual cortex) advances, P. lives and works in apparent normalcy to the end of his days.


P.'s ability to compensate for failing neurological function, and to do so unconsciously, speaks of the awesome capacity we have to heal the rifts that appear between us and our reality due to physical accident. That P. is a cultivated man, immersed in love--of music--which wins him the devotion of wife and students and colleagues, gives a kind of eccentric Belvederian charm to the story. His dependence on song and scent to orient himself to the richness of the world around him shows the living and loving aspect of his humanity.

P.'s deficiency in the visual realm Sacks characterizes as a loss of feeling and judgment around visual data which reduces the concrete, the real, the personal, to mechanical abstractions. Visually, P. functions like a computer. Sacks makes the analogy between P.'s visual agnosia and the current state of cognitive neurology and psychology, which sees the brain as a computer and fails to see what is concrete and real about people. Sacks the clinician avoids this want of feeling when he withholds a diagnosis of the deficiency. Instead he prescribes more music to strengthen P.'s inner music without which his life would come to a stop.

Primary Source

The Man Who Mistook His Wife for a Hat and Other Clinical Tales


Simon & Schuster: Summit

Place Published

New York



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