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An aphasia case: Patricia


The case of Lilian Kallir: musical alexia
Oliver Sacks Scientist
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In '99 I received a letter from a very eminent pianist, whom I had heard of, and she described how at a concert in 1990, when there was a sudden change of programme to a different Mozart piano concerto, she... she wanted to refresh herself and glance at the score, and she glanced at the score and found it unintelligible. She... she could see that there were the marks of notes, and the clefs, and the ornaments, but she... it didn’t have any meaning for her. She rubbed her eyes, and... and then, since she had a flawless memory, she played it anyhow, but this, her ability to recognise music fluctuated. At the time this happened, I think she may have had a cold, or whatever. It fluctuated, but by '95 she couldn’t read music at all, and had started to have difficulty... and had started to have difficulty reading print.

But she had no difficulty writing, so she wrote me a letter describing this, and wondering... she was puzzled by it. She said, if she went to an ophthalmologist she could clearly see and copy the tiniest letters on the chart, even though she didn’t know what letters they were, but she could describe their shape. So she came to see me. At that time I was working in an epilepsy centre, which my friend Orrin Devinsky was running, but we saw all sorts of patients, epileptic and otherwise.  I spent a lot of time with Lilian Kallir, and so did you, Kate. And I... I really grew to love her. It did not enter my mind at first that I would ever write about her.  I’m not sure, but I don’t think it entered her mind, although she had read some of my work.

And after that first consultation I couldn’t find my reflex hammer. It’s over there, the one with a red handle. And I... I looked everywhere, and then I couldn’t find my medical bag. And then Lilian came back, breathless. She said she had taken my medical bag by mistake, and it was only in the taxi, when she saw the red tip of the reflex hammer that she realised this was the case, and so she said, I was the woman who mistook the doctor’s bag for her own handbag, or something of the sort. She could laugh at herself, which was fortunate, because she was in a... really a grim situation, in which her power to recognise anything visually was eroding. I... I wrote about Lilian, and this was in fact the first case history, I think, I’d written in 10 years or so, perhaps since... since Temple Grandin.

Oliver Sacks (1933-2015) was born in England. Having obtained his medical degree at Oxford University, he moved to the USA. There he worked as a consultant neurologist at Beth Abraham Hospital where in 1966, he encountered a group of survivors of the global sleepy sickness of 1916-1927. Sacks treated these patients with the then-experimental drug L-Dopa producing astounding results which he described in his book Awakenings. Further cases of neurological disorders were described by Sacks with exceptional sympathy in another major book entitled The Man Who Mistook His Wife For A Hat which became an instant best seller on its publication in 1985. His other books drew on his rich experiences as a neurologist gleaned over almost five decades of professional practice. Sacks's work was recognized by prestigious institutions which awarded him numerous honours and prizes. These included the Lewis Thomas Prize given by Rockefeller University, which recognizes the scientist as poet. He was an honorary fellow of both the American Academy of Arts and Letters and the American Academy of Arts and Sciences, and held honorary degrees from many universities, including Oxford, the Karolinska Institute, Georgetown, Bard, Gallaudet, Tufts, and the Catholic University of Peru.

Listeners: Kate Edgar

Kate Edgar, previously Managing Editor at the Summit Books division of Simon and Schuster, began working with Oliver Sacks in 1983. She has served as editor and researcher on all of his books, and has been closely involved with various films and adaptations based on his work. As friend, assistant, and collaborator, she has accompanied Dr Sacks on many adventures around the world, clinical and otherwise.

Tags: Wolfgang Amadeus Mozart, Orrin Devinsky, Lilian Kallir

Duration: 3 minutes, 35 seconds

Date story recorded: September 2011

Date story went live: 02 October 2012