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Part 4, Chapter 23
Themes
Key
LitCharts assigns a color and icon to each theme in The Man Who Mistook His Wife for a Hat, which you can use to track the themes throughout the work.
Neurology
Conceptions of Mental Illness
The Neurological Community
Equalization and Adaptation
Illness as a Gift
Summary
Analysis
Once, Oliver Sacks ran tests on a twenty-one year-old man named José, who was said to be “hopelessly retarded.” Over the objections of his attendants, Sacks encouraged José to draw a picture of his pocket watch, which José proceeded to do. Sacks was struck by José’s attention to detail, and his confidence as a drawer. He left the test, sure that José was a special case.
Sacks builds on some of the ideas he brought up in the previous chapter, particularly the way that society marginalizes mentally disabled people who may in fact have wonderful gifts. Before Sacks met him, José had been dismissed as “hopeless”; however, Sacks discovered José’s artistic talents.
Themes
Shortly after his first visit with José, Sacks met with José again and asked him to copy a picture of people canoeing on a lake. Without hesitation, José proceeded to draw a remarkable facsimile of the picture. Indeed, the drawing was more than just a copy of the original—in some ways, Sacks thought, José had improved on the original picture, giving the two tiny figures more of a sense of drama and aliveness than they’d had originally. José drew more pictures for Sacks, and Sacks came to realize that José had a great creative gift and a wonderful sense of humor. José’s case is especially interesting, Sacks argues, because traditional accounts of “idiot savants”—patients who have severe intellectual problems, but who excel at certain intellectual tasks—focus on tasks that are mostly mathematical or mechanical; for example, patients who have incredible talent for calculating large numbers.
As with Martin A. and the twins, José’s talents go far beyond robotic mimicry; indeed, Sacks gives us no reason to think that José’s talents are in any way inferior to those of an artistically gifted person with a “normal” intelligence. It’s a sign of the strong dehumanizing stigma often associated with mentally disabled people that the few such people who do attract attention for their mental abilities usually excel in mathematics and similar fields—whereas Sacks shows that at least some mentally disabled people, like José, excel at art, a field that’s often associated with emotional maturity and insight.
Themes
After conducting more research, Sacks learned that José had suffered from temporal lobe seizures since the age of eight, and as a child had had an abnormal amount of spinal fluid in his body, leading doctors to diagnose him as autistic. Doctors had argued that José’s medical condition “interfered” with his mental faculties. José’s parents had pulled him out of school at an early age, and since then he was isolated from most other people. Sacks wasn’t able to get much information about José between the ages of eight and twenty, but he speculates that José enjoyed drawing because art represented a way for him to connect with the outside world. José was taken to the hospital because of a supposed “violent fit”—possibly epileptic—during which he smashed many objects, and endangered people around him. During José’s time in the hospital, he was heavily medicated; the drugs gave him a modicum of control over his seizures, giving him more time to draw.
At the time when Sacks was writing this article, autism was a little-understood condition, even in the medical community (and even today, people have lots of misconceptions about autism). As was the case with Sacks’s work with Tourette’s Syndrome, Sacks’s writing on autism was instrumental in raising awareness of the condition, both among other doctors and in the general public. José’s talent for art reiterates one of Sacks’s key points: people of all kinds, including and (perhaps) especially neurodivergent people, turn to art to find happiness, peace, and meaning in their lives.
Themes
The third time Sacks saw José, he asked José to draw more pictures. José drew a picture of a little fish and a big fish, which, Sacks felt, seemed to symbolize José and himself. When Sacks gave José a picture of a wintry nature scene, José drew Sacks a lush spring scene.
Notice that Sacks doesn’t explicitly say who the big fish is—Sacks himself or José—perhaps suggesting the way that Sacks sees himself as both a mentor and a student of highly gifted patients like José. Sacks continues to be awed by José’s artistic ability—not just his abilities to copy pictures, but to imbue his drawings with his own unique style.
Themes
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During later visits, Sacks got José to talk to him. His utterances were often unintelligible, but Sacks found it significant that José was making any sound at all—in the past, he’d been mute at almost all times. He wondered if José’s struggle to speak might be a manifestation of his general struggle for self-expression, in which drawing was critical.
Sacks interprets José’s behavior as a sign of his emotional development—showing that José really is trying to communicate and connect with other people and with the external world, contrary to what his other doctors have claimed.
Themes
The last time Sacks met with José, José drew a garden scene—instead of modeling the scene off of a picture, he drew from life, studying the small garden in his hospital. Sacks found the drawing beautiful. He notes that, for autistic patients like José, the concrete and the particular are far more interesting than the abstract. José is a great artist because he naturally understands the concrete, real world. And yet José’s artistry arises from the fact that he is, in many ways, cut off from the world—or at least, cut off from the rest of human society. José suffers from a form of autism that set in fairly late in his life. Perhaps the lateness of José’s autism explains why he was more accessible and communicative than other autistic patients with whom Sacks has met.
As with the other patients in this quarter of the book, José’s connection to the concrete, material world gives him tremendous gifts, which he uses to draw beautiful pictures. Although José is, in many ways, cut off from the rest of the world, Sacks suggests that he uses art to form connections with external objects and places, such as the garden in his hospital. Sacks’s additional hypotheses about José aren’t intended to be the last word on the matter; rather, they emphasize the need for further autism research.
Themes
Sacks poses a challenging question: is there anywhere in the modern world for people like José, other than a hospital? Couldn't José become a great illustrator of plants or anatomical texts? Couldn’t he become a useful assistant on scientific expeditions? Couldn’t he become a great illustrator of children’s books? Sadly, it’s unlikely that José will do any of these things—unless someone very patient works with him. In all likelihood, he’ll spend a “useless, fruitless life, as so many other autistic people do, overlooked, unconsidered, in the back ward of a state hospital.”
As in the previous chapter, Sacks implicitly criticizes society for too hastily concluding that people like José are “useless” and depriving them of their dignity by sending them into hospitals and clinics. One senses Sacks’s bitterness in the final sentence: society is being pointlessly cruel to people like José who, have profound gifts to offer.
Themes
In the Postscript, Sacks discusses a letter he received from Doctor C. C. Park about some of the defining qualities of autistic people’s drawings—in particular, a knack for “rendering the object as perceived,” and for reducing subjects to their simplest, most stereotyped form. Park also discusses Japanese educators who’ve found ways of teaching talented autistic patients to become accomplished, mature painters and sculptors without interfering with their style. To conclude, Sacks cites the final words of the letter: “The teacher should love the beautiful, honest retarded person, and live with a purified, retarded world.”
Sacks’s final Postscript is particularly important because it suggests that the medical community, and, by extension, society in general, is making some progress in respecting the talent and dignity of autistic people, and finding ways to nurture autistic people’s abilities instead of ignoring them. While Sacks isn’t trying to idealize the life of an autistic person—or of any other neurodivergent person—he’s used his book to argue for a more nuanced, respectful understanding of so-called abnormal people. In the thirty years since Sacks’s book, society has certainly become more accepting of autistic people, although there’s still a lot to work to be done before their abilities are accepted and celebrated without the stigma of mental illness.
Themes
