Character Analysis: The Man Who Mistook His Wife For A Hat

Dr.P was a singer and teacher at the Local School of Music, who was full of life and joy. Although he seemed physically and mentally great, he had a problem within inside his brain. He could not recognize detailed things like faces because he had multiple types of agnosia that made his representation, imagery and reality disappear. Even though he often made mistakes with distinguishing an inanimate object to a human being, he was able to live life to his happiness through music.

In “The Man who Mistook his Wife for a Hat,” Dr.P experienced two of the three types of visual agnosia. He experienced apperceptieve and prosopagnosia. Apperceptieve agnosia is the inability to see in general, which is usually caused by damages to the visual

cortex. Patients with this type of agnosia may only be able to distinguish things by piecing or combining aspects of the whole together. Sacks tried to understand Dr.P’s disorder by handing him a National Geographic Magazine, and asked him to describe the pictures. “ His responses here were very curious. His eyes would dart from one thing to another, picking up tiny features, individual features, as they had done with my face. A striking brightness, a color, a shape would arrest his attention and elicit comment--but in no case did he get the scene-as-a-whole,” (Sacks 13). In this instance, seeing color, movement, and sharpness is evident. Prosopagnosia is face blindness, which is the inability to recognize faces, even if you know them quite dearly. In most instances, a face might not be recognized as a face. People are either recognized by their voice or a specific characteristic. This is caused by lesions. The disorder can also occur if there has been no brain damage. Mr.P was diagnosed by both types of agnosia, so how did he manage to live an average life?
Mr.P couldn't distinct students from their faces, yet he could recognize their voices and movements.

Often, he patted water hydrants and parking meters, and is appalled when the furnitures doesn’t reply to him as he makes a conversation. Although Dr.P physically and mentally felt great, he went to his eye doctor who recommended him to Mr.Sacks. During his appointment with Oliver Sacks, he was able to distinguish abstract objects. However, as the objects became more complexed, he began to guess. Sacks was shocked to find Dr.P facing him with his right ear, rather than his eyes. Not only that, but Dr.P had also mistook his wife for his hat and his foot for his shoe. Sacks wanted to understand more about his case and went to his house a few days later. He came upon Dr.P’s artwork, which was placed in chronological order. There was a massive difference between his art work then and now. Before it was, “naturalistic and realistic, with vivid mood and atmosphere, but finely detailed and concrete. Then, years later, they became less vivid, less concrete, less realistic and naturalistic, but far more abstract, even geometric and cubist,” (Sacks 17). Sacks was curious on how Dr.P was able to function in life, so he asked his wife. “I put his usual clothes out, in all the usual places, and he dresses without difficulty, singing to himself,” (Mrs.P 17). Music centered all around Mr.P’s life, which made him able to live an average life. Although his disease became worse

throughout the years, Dr.P was able to live his life with something he loves, music.
Dr.P’s case is an excellent example of agnosia that Oliver Sacks uncovered throughout his personal experiences with his patients.

Agnosia is a rare disorder that revolves around the inability to recognize things, things differ from what type of agnosia is in question. Agnosia derived from the Greek word “agnosia.” The translated meaning is ignorance or without knowledge. On the norm, agnosia affects one single information pathway in the brain. The two most common forms of agnosia are visual and auditory. The senses themselves are still intact and there is no loss of memory. Intact, in this case, means that they are still there. Even though many have suffered from visual agnosia like Dr.P, they would still be able to use their eyesight. However, it would not be as accurate as an average person. These type of patients would usually attempt to pick up an object. Once the object is in their hands, they would use their sense of touch, or their tactile information pathway, to distinguish what the object truly is. The main cause for agnosia, is brain damage. This damage affects certain pathways. The pathways in the brain connects primary sensory processing areas to areas that store information and knowledge. Lesions, or damage in tissues or organs, in the parietal and temporal lobes is also served to cause agnosia. Lesions could be caused by strokes, head traumas, or encephalitis. Any additional conditions that can damage the brain may also be a result in agnosia. Examples of

these conditions may include dementia, carbon monoxide poisoning, or anoxia (an absence of oxygen).
A CT or MRI is most likely used to figure out the exact cause of a patient. These scans could help distinguish a lesion, which could also detect a future degenerative disorder. After getting some sort of imaging done, bedside and neuropsychological testing may be performed on the patient. Neuropsychological testing helps to identify subtle agnosias. Patients would be asked to identify objects by sight, touch, or another sense. The primary reason for physical examination is to identify any deficits in senses or in the ability to communicate that may intervene with testing for agnosia.
Since many agnosia patients are not aware of their disorder, treatment could be difficult. If the patient experienced very deep lesions, their motivation levels would not be as strong. Before beginning treatment, the clinician would have to increase recognition of the disorder for the patient. A common way to do so would be to show a stimulus in the impaired area. After repeating this strategy multiple times, the patient would eventually become aware of the disability. Once this happens, the problem should be broken down into small components so that it is easier for the patient to understand the situation. Once these steps are accomplished, the clinician focuses on a compensatory treatment so that the patient can return to living an average life.