Once upon a time, there was a man named Dr. P, a singer and music teacher. He was alive, a real person—not a character in a story. In the years leading up to his death in 1983, he became unable to make sense of the things he saw with his eyes. An eye doctor told him his vision was fine but that he should see a neurologist. Thus did Dr. P come to encounter Dr. Oliver Sacks, who would tell the story of Dr. P in The Man Who Mistook His Wife for a Hat. Over the course of two visits, Sacks determined that Dr. P could make sense of visual input only if it were abstract or schematic—such as the face cards of a deck of cards or a set of Platonic solids that Sacks carried in his neurological kit—or by focusing on small details—recognizing a photograph of Albert Einstein by his hair and mustache, recognizing his brother because of his square jaw and large teeth. It became clear to Sacks from his time with Dr. P and his wife, Mrs. P, that the couple had developed ways of making music stand in for the sense-making work that our visual cognition does for most of us: when he sang a dressing song or an eating song, Dr. P knew what he was doing and could move through the necessary actions of his day . . . but if he were interrupted in the song, he would lose the thread of what he was doing. At the end of their second meeting, Dr. Sacks’s only prescription for Dr. P was more music: “You are a wonderful musician, and music is your life. What I would prescribe, in a case such as yours, is a life which consists entirely of music. Music has been the centre, now make it the whole, of your life” (Sacks, 18).
Dr. P was alive, a real person—not a character in a story. Had Sacks published a case history in a neurological journal, he would never have become a character. But Sacks was interested in story: “we must deepen a case history to a narrative or tale; only then do we have a ‘who’ as well as a ‘what’, a real person, a patient in relation to disease—in relation to the physical” (Sacks, viii). And so Dr. P became a character.
How we treat characters isn’t so different from how we treat other people—we project our own wishes, aversions, and interpretations onto our fellow humans as readily as we do onto Anna Karenina. But a character, fixed, written, doesn’t push back the way a living person does. And a character, fixed, yet endlessly encounterable and reproducible, can become meaningful for the projections of those living in later times.
For Sacks, the story of Dr. P was a story about right-brain dysfunction—one of his audiences in the book was his fellow neurologists, because the field had persistently shown more interest in the syndromes that developed from left-brain lesions in patients: “The left hemisphere, like a computer tacked onto the basic creatural brain, is designed for programs and schematics; and classical neurology was more concerned with schematics” (Sacks, 4). More attention to the right brain is necessary, he argues, because of what right-brain neurological syndromes can teach us about more fundamental questions of identity and cognition: “it is the right hemisphere which controls the crucial powers of recognizing reality which every living creature must have in order to survive . . . . for the physical foundations of the persona, the self, are here revealed for our study” (Sacks, 4-5).
When composer Michael Nyman read Sacks’s book, he immediately began work to adapt the narrative into an opera. For Nyman, who thinks musically, the composition process involved the creation of “a self-supporting, self-referential musical structure on the narrative. . . . The musical process had to relate not simply to the gradual accumulation of diagnostic evidence but also to the precise perceptual problems that visual agnosia presented to Dr. P” (from the liner notes to the 1990 CBS recording). Put simply, Nyman’s music for the opera uses the songs of Robert Schumann, deconstructed, to create a schematic musical scaffold for the action, just as Dr. P’s “eating songs, dressing songs, bathing songs” structured his days (Sacks, 17). Snippets of these melodies appear, reworked and repurposed, throughout the opera, and the centerpiece of the work is Dr. P singing Schumann’s “Ich grolle nicht,” which demonstrates how perfectly whole and sound Dr. P’s musical intelligence and ability remain.
But librettist Christopher Rawlence also read the story and also had the chance to impose his own readings and interpretations onto the characters. He gained deeper insight into Mrs. P through a four-hour visit he made with Oliver Sacks to visit Dr. P’s widow in New York City. When asked for permission to create an opera, “she was unhappy at the prospect of a musical (as she saw it) making light of the ordeal he had been through” (liner notes). Through that meeting, Rawlence came to perceive more keenly in how many ways Mrs. P’s love had enabled Dr. P to survive and to create and sustain “body music” to replace his lost “body image” (Sacks, 18). Rawlence’s addition to the story was to deepen the role of Mrs. P, who, by the end of their meeting, agreed to let the project proceed because of her belief in “die heilige Kunst”—the communion that had sustained her husband until Alzheimer’s ended his life (liner notes).
Another of Rawlence’s additions picked up on the “Zen-like paradoxes and jests” that Dr. P was known for. For Rawlence, “what interested me were the questions of how and when a person becomes conscious of a disease that is eroding his consciousness, and the point at which that person is no longer neurologically capable of knowing that something is wrong. Zen koans address themselves to the paradoxes of consciousness” (liner notes). The libretto includes several references to Zen koans; of these Buddhist allusions, the most significant to me is the quotation from the Heart Sutra [http://path.homestead.com/heartsutra.html]: “Form is emptiness, / Emptiness form” . . . because here we arrive at a whole new frame for the experience of meaninglessness, which pushes me to interpret Dr. P’s struggle allegorically. I have loved this opera since 1990, but like all of us, I have a mental storehouse full of things I love that I nevertheless don’t often revisit . . . but lately I’ve been listening to this opera a lot. It moves me in a way that it didn’t 20 or 25 years ago, and I think that’s because this moment—personally and professionally for me, nationally for us—represents an unusual degree of challenge to the ongoing project of pushing back against the sense of meaninglessness.
Rawlence’s decision to emphasize the Buddhist concept of the non-existence of the self as a discrete entity is legitimate, the more so since neuropsychological research since this piece was created in the 1980s has provided empirical support for the hypothesis that the individuals’ felt sense of a unitary self is a convenient fiction imposed by the brain (see, for example, Klein and Gangi’s 2010 review article). But the pathos of the story of Dr. P and Mrs. P lends an emotional weight to the concepts explored, concepts that could be discussed purely rationally in, for example, a neurological or psychological research article. With story, as Sacks recognized, we have emotion linked to concept in ways that become unpredictable, depending on who experiences the artwork, and when.
Commenting on the opera, Sacks writes “Dr. P and his wife both have elements of the heroic, but the real hero in ‘The Hat’ is surely music—the power of music to organise and integrate, to knit or reknit a shattered world into sense” (liner notes). For Sacks, for Nyman, for Rawlence, in the 1980s, Dr. P is a sort of tragic hero. For me in 2019, though, Rawlence’s allusion to the Heart Sutra opens the narrative to allegorical interpretation, and such allegoresis can take the interpreter in directions never intended by the original storytellers.
For me, Dr. P becomes not just a tragic character but another Sisyphus, specifically Albert Camus’s own reappropriation of the Sisyphus myth, and Camus’s lyrical definition of absurdity maps literally to Dr. P’s experience of visual agnosia—all the usual visual input but with no ability for the mind to process the information into a world of real and meaningful objects:
A world that can be explained even with bad reasons is a familiar world. But, on the other hand, in a universe suddenly divested of illusions and lights, man feels an alien, a stranger. His exile is without remedy since he is deprived of the memory of a lost home or the hope of a promised land. This divorce between man and his life, the actor and his setting, is properly the feeling of absurdity. (Camus)
For Camus, Sisyphus is “the absurd hero,” and his heroism derives from his consciousness of the absurdity and meaninglessness of his eternal task: “If this myth is tragic, that is because its hero is conscious. Where would his torture be, indeed, if at every step the hope of succeeding upheld him?” But Dr. P pushes back against the waves of meaninglessness surrounding him not with scorn, not with consciousness, but with dressing songs, bathing songs, eating songs. Mrs. P conspires with him to fight meaninglessness: she lays out his things, in order—clothes, shaving tools, food—and I imagine her setting him on the right path by leading him in song, singing alone until he takes up the melody, takes it into his body to animate him toward the next daily stone to be pushed up the hill. If we have to live in an absurd world, we would likely all prefer to see ourselves as Camus’s Sisyphus—lip curled in scorn, flexing our massive muscles and then pushing our shoulder against the boulder to get it started on its ten thousandth ascent.
And maybe it’s like that on some days. But some days the fight against absurdity is not heroic but is itself absurd: we grab hold of each other and create the songs together that will lead us to continue striving, not striving to push a boulder but just to keep believing in things and acting based on beliefs, instead of giving in to nihilism and cynicism. “The final therapy, as Freud said, is work and love” (Sacks, 164).