Man Who MIstook His Wife for a Hat Read Free Page B

listening rather than looking out. 'Traffic,' he said, 'street sounds, distant trains- they make a sort of symphony, do they not? You know Honegger's Pacific 234?'
       What a lovely man, I thought to myself. How can there be anything seriously the matter? Would he permit me to examine him?
       'Yes, of course, Dr Sacks.'
       I stilled my disquiet, his perhaps, too, in the soothing routine of a neurological exam-muscle strength, coordination, reflexes, tone. … It was while examining his reflexes-a trifle abnormal on the left side-that the first bizarre experience occurred. I had
       taken off his left shoe and scratched the sole of his foot with a key-a frivolous-seeming but essential test of a reflex-and then, excusing myself to screw my ophthalmoscope together, left him to put on the shoe himself. To my surprise, a minute later, he had not done this.
       'Can I help?' I asked.
       'Help what? Help whom?'
       'Help you put on your shoe.'
       'Ach,' he said, 'I had forgotten the shoe,' adding, sotto voce, 'The shoe? The shoe?' He seemed baffled.
       'Your shoe,' I repeated. 'Perhaps you'd put it on.'
       He continued to look downwards, though not at the shoe, with an intense but misplaced concentration. Finally his gaze settled on his foot: 'That is my shoe, yes?'
       Did I mis-hear? Did he mis-see?
       'My eyes,' he explained, and put a hand to his foot. 'This is my shoe, no?'
       'No, it is not. That is your foot. There is your shoe.'
       'Ah! I thought that was my foot.'
       Was he joking? Was he mad? Was he blind? If this was one of his 'strange mistakes', it was the strangest mistake I had ever come across.
       I helped him on with his shoe (his foot), to avoid further complication. Dr P. himself seemed untroubled, indifferent, maybe amused. I resumed my examination. His visual acuity was good: he had no difficulty seeing a pin on the floor, though sometimes he missed it if it was placed to his left.
       He saw all right, but what did he see? I opened out a copy of the National Geographic Magazine and asked him to describe some pictures in it.
       His responses here were very curious. His eyes would dart from one thing to another, picking up tiny features, individual features, as they had done with my face. A striking brightness, a colour, a shape would arrest his attention and elicit comment-but in no case did he get the scene-as-a-whole. He failed to see the whole, seeing only details, which he spotted like blips on a radar screen. He never entered into relation with the picture as a whole-never
       faced, so to speak, its physiognomy. He had no sense whatever of a landscape or scene.
       I showed him the cover, an unbroken expanse of Sahara dunes.
       'What do you see here?' I asked.
       'I see a river,' he said. 'And a little guest-house with its terrace on the water. People are dining out on the terrace. I see coloured parasols here and there.' He was looking, if it was 'looking', right off the cover into mid-air and confabulating nonexistent features, as if the absence of features in the actual picture had driven him to imagine the river and the terrace and the coloured parasols.
       I must have looked aghast, but he seemed to think he had done rather well. There was a hint of a smile on his face. He also appeared to have decided that the examination was over and started to look around for his hat. He reached out his hand and took hold of his wife's head, tried to lift it off, to put it on. He had apparently mistaken his wife for a hat! His wife looked as if she was used to such things.
       I could make no sense of what had occurred in terms of conventional neurology (or neuropsychology). In some ways he seemed perfectly preserved, and in others absolutely, incomprehensibly devastated. How could he, on the one hand, mistake his wife for a hat and, on the other, function, as apparently he still did, as a teacher at the Music School?
       I had