by Oliver Sacks
Listening to Picker’s music, watching him play or compose, I have the feeling that he has a special brain, a musician’s brain, very different from my own. It is a brain that works differently and has connections, whole fields of activity that mine lacks. It is difficult to know how much such differences may be “congenital,” as Picker puts it, and how much they are the result of training— a tricky question, since Picker, like many musicians, began intensive musical training in early childhood.
With the development of brain imaging in the 1990s, it became possible to actually visualize the brains of musicians and to compare them with those of nonmusicians. Using MRI morphometry, Gottfried Schlaug at Harvard and his colleagues made careful comparisons of the sizes of various brain structures. In 1995, they published a paper showing that the corpus callosum, the great commissure that connects the two hemispheres of the brain, is enlarged in professional musicians and that a part of the auditory cortex, the planum temporale, has an asymmetric enlargement in musicians with absolute pitch. Schlaug et al. went on to show increased volumes of gray matter in motor, auditory, and visuospatial areas of the cortex, as well as in the cerebellum.2 Anatomists today would be hard put to identify the brain of a visual artist, a writer, or a mathematician— but they could recognize the brain of a professional musician without a moment’s hesitation.
How much, Schlaug wondered, are these differences a reflection of innate predisposition and how much an effect of early musical training? One does not, of course, know what distinguishes the brains of musically gifted four-year-olds before they start musical training, but the effects of such training, Schlaug and his colleagues showed, are very great: the anatomical changes they observed with musicians’ brains were strongly correlated with the age at which musical training began and with the intensity of practice and rehearsal.
Alvaro Pascual-Leone at Harvard has shown how rapidly the brain responds to musical training. Using five-finger piano exercises as a training test, he has demonstrated that the motor cortex can show changes within minutes of practicing such sequences. Measurements of regional blood flow in different parts of the brain, moreover, have shown increased activity in the basal ganglia and the cerebellum, as well as various areas of the cerebral cortex— not only with physical practice, but with mental practice alone.
There is clearly a wide range of musical talent, but there is much to suggest there is an innate musicality in virtually everyone. This has been shown most clearly by the use of the Suzuki method to train young children, entirely by ear and by imitation, to play the violin. Virtually all hearing children respond to such training.3
It has been said that even a brief exposure to classical music can stimulate or enhance mathematical, verbal, and visuospatial abilities in children— the so-called Mozart effect. This has been disputed by Schellenberg and others, but what is beyond dispute is the effect of intensive early musical training on the young, plastic brain. Takako Fujioka and her colleagues, using magnetoencephalography to examine auditory evoked potentials in the brain, have recorded striking changes in the left hemisphere of children who have had only a single year of violin training, compared to children with no training.4
Can musical competence be seen as a universal human potential in the same way as linguistic competence? There is exposure to language in every household, and virtually all children develop linguistic competence (in a Chomskian sense) by the age of four or five.5 This may not be the case with regard to music, since some households may be almost devoid of music, and musical potential, like other potentials, needs stimulation to develop fully. In the absence of encouragement or stimulation, musical talents may not develop. But while there is a fairly well-defined critical period for language acquisition in the first years of life, this is less so for music. To be languageless at the age of six or seven is a catastrophe (it is only likely to occur in the case of deaf children given no effective access to either Sign or speech), but to be music-less at the same age does not necessarily predict a music-less future. My friend Gerry Marks grew up with very little exposure to music. His parents never went to concerts and rarely listened to music on the radio; there were no instruments or books on music in the house. Gerry was puzzled when classmates talked about music, and he wondered why they were so interested in it. “I had a tin ear,” he recalled. “I could not sing a tune, I could not tell if others sang in tune, and I could not distinguish one note from another.” A precocious child, Gerry was passionate about astronomy, and he seemed all set for a life of science— without music.
But when he was fourteen, he became fascinated by acoustics, especially the physics of vibrating strings. He read about this and did experiments in the school lab, but, increasingly, craved a stringed instrument for himself. His parents gave him a guitar for his fifteenth birthday, and he soon taught himself to play. The sounds of the guitar and the feeling of plucked strings excited him, and he learned rapidly— by the time he was seventeen, he came in third in a contest for “the most musical” in his senior class in high school. (His high-school friend Stephen Jay Gould, musical from infancy, came in second.) Gerry went on to major in music at college, where he supported himself by teaching guitar and banjo. A passion for music has been central to his life ever since.
Nevertheless, there are limits imposed by nature. Having absolute pitch, for example, is highly dependent on early musical training, but such training cannot, by itself, guarantee absolute pitch. Nor, as Cordelia shows, can the presence of absolute pitch guarantee that there will be other, higher musical gifts. Cordelia’s planum temporale was no doubt well developed, but perhaps she was a bit lacking in prefrontal cortex, in judgment. George, on the other hand, while doubtless well endowed in those areas of the brain involved in emotional reaction to music, may have been lacking in other areas.
The examples of George and Cordelia introduce a theme that will be echoed and explored in many of the clinical case histories that follow: that what one calls musicality comprises a great range of skills and receptivities, from the most elementary perceptions of pitch and tempo to the highest aspects of musical intelligence and sensibility, and that, in principle, all of these are dissociable one from another. All of us, indeed, are stronger in some aspects of musicality, weaker in others, and so have some kinship to both Cordelia and George.
8
Things Fall Apart: Amusia and Dysharmonia
We take our senses for granted. We feel we are given the visual world, for example, complete with depth, color, movement, form, and meaning all perfectly matched and synchronous. Given this seeming unity, it may not occur to us that there are many different elements composing a single visual scene, and that all of these have to be separately analyzed and then put together. This composite nature of visual perception may be more apparent to an artist or a photographer; or it may become apparent when, due to some damage or failure of development, one element or another is defective or lost. The perception of color has its own neural basis, and so, too, have the perception of depth, motion, form, and so on. But even if all of these preliminary perceptions are working, there may be difficulty synthesizing them into a visual scene or object with meaning. Someone with such a higher-order defect here— a visual agnosia, for example— may be able to copy a picture or paint a scene so that others can recognize it, but they themselves cannot.
It is similar with hearing and with the special complexities of music. There are many elements involved, all concerned with the perception, decoding, and synthesis of sound and time, and thus there are many forms of amusia— A. L. Benton (in his chapter on the amusias in Critchley and Henson’s Music and the Brain) distinguishes “receptive” from “interpretive” or “performance” amusia, and identifies more than a dozen varieties.
There are forms of rhythm deafness, slight or profound, congenital or acquired. Che Guevara was famously rhythm-deaf; he might be seen dancing a mambo while the orchestra was playing a tango (he also had considerable tone deafness). But, especially after a left
-hemisphere stroke, one can develop profound forms of rhythm deafness without tone deafness (just as, after some right-hemisphere strokes, a patient may develop tone deafness without rhythm deafness). In general, though, forms of rhythm deafness are rarely total, because rhythm is represented widely in the brain.
There are also cultural forms of rhythm deafness. Thus, as Erin Hannon and Sandra Trehub have reported, infants at six months can readily detect all rhythmic variations, but by twelve months their range has narrowed, albeit sharpened. They can now more easily detect the types of rhythms to which they have previously been exposed; they learn and internalize a set of rhythms for their culture. Adults find it harder still to perceive “foreign” rhythmic distinctions.
Having been raised on Western classical music, I have no difficulty with its relatively simple rhythms and time signatures, but I get confused by the more complex rhythms of tangos or mambos— to say nothing of the syncopations and polyrhythms of jazz or African music. Culture and exposure determine some of one’s tonal sensitivities as well. Thus someone like myself may find the diatonic scale more “natural” and more orienting than the twenty-two-note scales of Hindu music. But there does not seem to be any innate neurological preference for particular types of music, any more than there are for particular languages. The only indispensable elements of music are discrete tones and rhythmic organization.
Many of us are unable to sing or whistle in tune, though usually we are very conscious of this— we do not have an “amusia.” But true tone deafness is present in perhaps five percent of the population, and people with such an amusia can veer off key without realizing it, or be unable to recognize off-key singing by others.
Sometimes tone deafness can be quite gross. I used to attend a small temple that employed a cantor who could hit jarringly wrong notes, sometimes a third of an octave away from where he should have been. He particularly fancied himself as a cantillator, and would embark on elaborate tonal excursions of a sort that require a very good ear, but he would get completely lost in these. When I complained discreetly to the rabbi one day about the cantor’s singing, I was told that he was a man of exemplary piety, and that he did his best. I said I had no doubt of this, but that one could not have a tone-deaf cantor; this was, to anyone musical, akin to having a clumsy surgeon.1
Those with gross tone deafness can still enjoy music and enjoy singing. Amusia in its absolute sense— total amusia— is another matter, for here tones are not recognized as tones, and music, therefore, is not experienced as music.
Some of the classic cases in the neurological literature describe this. Henri Hécaen and Martin L. Albert noted that for such people, “melodies lose their musical quality, and may acquire a non-musical, disagreeable character.” They described one man, a former singer, who “complained of hearing ‘a screeching car’ whenever he heard music.”
I found these descriptions almost unimaginable, until I experienced amusia myself on two occasions, both in 1974. On the first, I was driving along the Bronx River Parkway, listening to a Chopin ballade on the radio, when a strange alteration of the music occurred. The beautiful piano tones started to lose their pitch and their character and were reduced, within a couple of minutes, to a sort of toneless banging with an unpleasant metallic reverberation, as if the ballade were being played with a hammer on sheet metal. Though I had lost all sense of melody, I had no impairment of rhythmic sense and I could still recognize the ballade by its rhythmic structure. A few minutes later, just as the piece was ending, normal tonality returned. Greatly puzzled by all this, when I got home I phoned the radio station and asked them if this had been some sort of experiment or joke. They said no, of course not, and suggested that I get my radio checked.
A few weeks later I had a similar episode while playing a Chopin mazurka on my piano. There was again a profound loss of tone, and the music seemed to decompose into a disconcerting racket, along with an unpleasant metallic reverberation. But this time it was accompanied by a brilliant, scintillating zigzag expanding in half of my visual field— I had often experienced such zigzags during attacks of migraine. Now, it was evident, I was experiencing an amusia as part of a migraine aura. Still, when I went downstairs and spoke to my landlord, I found that my voice and his voice sounded perfectly normal. It was only music, and not speech or sound in general, that was so strangely affected.2
My experience, like most of those described in the neurological literature, was of an acquired amusia— one that I found startling and frightening but also fascinating. Were there, I wondered, people with congenital amusia of an equally extreme degree? I was startled to find the following passage in Nabokov’s autobiography, Speak, Memory:
Music, I regret to say, affects me merely as an arbitrary succession of more or less irritating sounds…. The concert piano and all wind instruments bore me in small doses and flay me in larger ones.
I do not know what to make of this, for Nabokov is such a jester, such an ironist, that one is never sure whether to take him seriously. But it is conceivable, at least, that in the Pandora’s box of his multitudinous gifts there was, along with these, perhaps, a profound amusia.
I had met the French neurologist François Lhermitte, who once told me that when he heard music, he could say only that it was “The Marseillaise” or that it was not— his ability to recognize melodies stopped there.3 He did not seem distressed by this, nor had he ever had the impulse to investigate its neural basis— it was simply the way he was, and had always been. I should have asked him how he recognized “The Marseillaise”: Was it by its rhythm or the sound of a particular instrument? By the behavior or attention of other people around him? And what did it actually sound like to him? I wondered when and how he had discovered his amusia, and what effect, if any, it had had on his life. But we had only a few minutes together, and conversation veered to other topics. I would not meet another person with complete congenital amusia for another twenty years, and only then through the kindness of my colleague Isabelle Peretz, a pioneer in the study of neuroscience and music.
In late 2006, Peretz introduced me to D.L., an intelligent, young-looking seventy-six-year-old woman who has never “heard” music, though she seems to hear, recognize, remember, and enjoy other sounds and speech without difficulty. Mrs. L. recollected that when she was in kindergarten, children were asked to sing their names, as in “My name is Mary Adams.” She could not do this and did not know what was meant by “singing” nor could she perceive what the other children were doing. In second or third grade, she said, there was a music-appreciation class in which five pieces, including the William Tell Overture, were played. “I could never tell which piece was being played,” she said. When her father heard of this, he got a Victrola and records of the five pieces. “He played them again and again,” she said, “but it didn’t help.” He also got her a little toy piano or xylophone that could be played by numbers, and she learned in this way to play “Mary Had a Little Lamb” and “Frère Jacques”— while having no sense that she was producing anything but “noise.” If others played these songs, she could not tell whether they made mistakes, but if she herself made a mistake, she would feel this, she said, “in my fingers— not by hearing.”
She came from a very musical family— everyone played an instrument— and her mother would always ask her, “Why don’t you like music the way the other girls do?” A family friend who was a learning specialist tested her with pitches. D.L. was asked to stand up if a note was higher than another, or to sit down if it was lower. But this too failed: “I could not tell if one note was higher than the other,” she said.
D.L. was told as a little girl that her voice was monotonous when she recited poetry, and one teacher set herself to tutor her in inflections and intonations, to read dramatically. This, apparently, was successful, for I could not detect anything abnormal in her speech. Indeed, she now spoke warmly of Byron and Sir Walter Scott, and when I asked her to, she recited “The Lay of the Last Minstrel” with express
ion and feeling. She enjoyed poetry readings and going to the theater. She had no difficulty recognizing people’s voices, nor did she have difficulty recognizing all sorts of sounds around her: water running, wind blowing, cars hooting, dogs barking.4
D.L. loved tap dancing as a girl, was very good at it, and could tap-dance on skates. She said she was “a street kid,” and liked to perform with other kids on the street. She seemed, therefore, to have a good sense of rhythm in her body (and now likes rhythmic aerobics), but if there was a musical accompaniment, this would throw her off and interfere with her dancing. When I tapped a simple rhythm with my pencil, like the opening of Beethoven’s Fifth or a bit of Morse code, Mrs. L. could easily imitate it. But if the rhythm was embedded in a complex melody, she had much more trouble, and the rhythm tended to be lost in the overall noisy confusion she heard.
During junior high school, D.L. developed a liking for war songs (this was in the mid-1940s). “I recognized them because of their words,” she said. “Anything with words is okay.” Her father, newly encouraged, bought records of war songs, but, she remembered, “if an orchestra was in the background it drove me crazy, like sounds coming from all different directions, overwhelming noise.”
