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2 of 2 people found the following review helpful
5.0 out of 5 stars Science, literature and personal confessional, 23 Nov. 2012
This review is from: Hallucinations (Paperback)
Sacks is pushing eighty so you might think he would be going off the boil, but I was gripped by this latest book.

He begins with accounts of visions experienced by 10-20% of those with sight loss from macular degeneration, as the brain works to fill in the missing bits, wonderfully illustrated from his own experiences working in a nursing home as well as with the experiences of friends and those who have written to him. He ends the book with an account of religious visions and phantom amputated limbs. In between, he illustrates his story not just with the hallucinations of others, but with his own vivid stories from a period in mid life when he experimented too much with mind-bending drugs. So the objective scientist goes in to the confessional.

He takes in a wide sweep along the way - visual, auditory and smell hallucinations; migraine; epilepsy; nightmares and illusions on the edge of sleep; the effect of strokes; out of body experiences; delirium and drugs; and the side effects of some drugs used for treating Parkinson's. On the way, he records historical speculation that Joan of Arc's visions were the result of epilepsy. He links Dostoyevsky's evolution from realism to mysticism to his experience of epilepsy.

As previously, many of Sacks' accounts are from early medical observations - for instance the treatment of religious experience and out of body experiences by nineteenth century scientists. But he combines this with the learning from this century and its use of the MRI scan and brain surgery to see what is going on objectively in the brain at the point where the patient is subjectively experiencing visions. I was most struck by the comment that there is a reason why the mind cannot distinguish hallucination from reality - hallucinating an object activates the same part of the brain as seeing an object, imagination activates an entirely different part of the brain. He is fascinating in mapping the differences between hallucinations and dreams and imagination - the hallucinations do a different job. His approach normalises the experience of visions and hallucinations - using the weight of evidence on the frequency of hallucinations in some circumstances to tackle head on the idea that you have to be schizophrenic or seriously mad to hear voices or see things that aren't there.

He is also often funny. He recounts an experiment in 1973 where pseudo patients who were sane turned up to doctors with only one symptom - that they heard voices. They were all immediately admitted to psychiatric hospitals, hospitalised for up to two months and prescribed anti-psychotic medicines. None of the pseudo patients were identified by the staff as pseudo. The real patients, however, were more observant - "You're not crazy" said one, "You're a journalist or a professor."
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