Oliver Sacks on the soundtrack of our lives

Some people start hearing music when they recline, writes author/neurologist Oliver Sacks. Others react to cerebral aneurysms or malformations, aging, injury, illness or hearing loss with similar "musical hallucinations." His own mother, when still a practicing surgeon at 75, began hearing patriotic German songs one night, perhaps caused by blood pressure medication or a small, otherwise asymptomatic stroke. One patient, a composer, said he had "an iPod in his head," Sacks writes in his new book, "Musicophilia: Tales of Music and the Brain" (Knopf, 367 pp., $26).

Many others (including Sacks himself) note music triggered by radio or TV theme music, pop tunes or advertising jingles, those annoyingly catchy ditties meant to stick in our minds, burrowing like "earworms" or "brainworms." Whatever the reasons, Sacks observes, "It really is a very odd business that all of us, to varying degrees, have music in our heads."

Author of nine previous books focusing primarily on the brain and its amazing capacities, deficits and methods of coping, Sacks once again examines the many mysteries of a fascinating subject, turning it this way and that like a partially-solved Rubik's cube.

Why, he wonders, do some people associate certain colors or tastes with specific notes? Why do larger proportions of people who speak Asian languages or who became blind at a young age have absolute pitch? (Absolute pitch is, among other things, the ability to identify or sing a note with no frame of reference). Why don't we all have absolute pitch? Why do certain brain lesions leave some persons utterly indifferent to music? Yet for others — those with Tourette's syndrome or autism, for example, with Parkinson's disease or after "sleeping sickness" that left victims in a "frozen state" for years — music temporarily frees them from their conditions' constraints. Will the day come when the brain's instructions to a phantom limb could allow an amputee's prosthetic hand to play piano?

Virtually everyone, Sacks writes, has "innate musicality," even though there is clearly a wide range of talent. And in fact, modern imaging technology lets researchers compare the sizes of various brain structures of musicians with nonmusicians. "Anatomists today," he states, "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."

Like his previous books, "Musicophilia" combines case histories with Sacks' observations and speculations. He is sometimes his own patient, as when he ponders how music allowed him to emerge from a time of bereavement.

In another instance following a serious climbing accident, "a sort of marching or rowing song" enabled him to struggle off the mountain, then months later, to learn to walk again when aided by the rhythm and melody of the Mendelssohn violin concerto. He finds others inspired by musical rhythm, too: a woman with a complex hip fracture whose apparently paralyzed and useless left leg nevertheless began to tap a toe to Irish jigs; a cyclist who clocked his personal best time when he listened to operatic overtures.

Just how music becomes a "key to ... transformation" in so many cases is still being studied. But music therapies, it's now understood, must be tailored to different disorders. For instance, some music triggers tics in people with Tourette's, while jazz and rock may mask and channel energy. A drumming group cannot only bring calm and focus, but also provide musical and social bonding.

Sacks' tales of musicophilia, loving music, work their way beyond passionate personal appreciation of music toward potential uses with neurological conditions. "This might seem a very tall order," he remarks when discussing music therapy to help people with dementia, but "... music of the right kind can serve to orient and anchor a patient when almost nothing else can." The same, his excellent book shows, might be said for each of us, that music — like love — works its own unique magic.