This week we heard the incredible report from Germany of the world’s first double arm transplant; a man who had lost both his arms years ago has been given new arms which came from a young man who died shortly before the surgery. Much has been said about the possibility of rejection of the new arms, and the crucial problem of blood flow. But there is another problem: the man’s brain has to learn to recognise that the new arms are actually his arms. This may involve many months (if not years) of physiotherapy before the recipient will actually be able to move the arms. However, physiotherapy might not be enough; for those arms to become more than just two lumps of living flesh, perhaps music will be needed.
It reminds me of an extraordinary little book by Oliver Sacks called A Leg to Stand On. Sacks is a prominent neurologist who has written some incredible books such as The Man Who Mistook His Wife for a Hat, Awakenings, and An Anthropologist on Mars where he writes about neurological case studies. But in this particular book (written in the 1980s), Sacks himself becomes the humble patient. In 1974, Oliver Sacks had a serious accident, rupturing the main tendon of his left leg. He underwent an operation to repair the leg, but was left with absolutely no feeling in the limb. But it was worse; he had the feeling of the leg’s extinction – that the leg was not his own leg – it was just an object dissociated from his body. It seems that since the leg was inactivated for a significant amount of time, it had lost its place in the brain’s sensory cortex. Its place was quickly taken over by mappings of the rest of the body so that Sacks’ body map which is represented in the cortex had no place for the leg; the brain’s body map represented a one-legged man. This is very interesting; body-image is not fixed in the brain, but is something that adapts itself all the time to experience. So Sacks had no conscious access to his leg so, the left leg he saw before him did not belong to him.
It is not possible for any spontaneous revival of a part of the cortical body map that has vanished to occur; there needs to be creation of a new organization, and this can only be achieved by new experiences, new stimuli and actions. This was a particularly distressing time for Oliver Sacks; he had effectively lost his leg, and it seemed that no amount of physiotherapy could reunite him with his leg. During one of his physiotherapy sessions, he even resorted to a convoluted type of 'walking', where he would calculate each step fully in advance (with reference to visual landmarks such as furniture and walls), and then make an appropriate flexion-movement of the hip. This ridiculous manner of locomotion was a completely conscious process, but the walking that we take for granted is automatic and unconscious. However, the first signs that the leg’s return was imminent came when he heard a familiar musical piece in his mind – a piece he had been repeatedly listening to the day before. Here is how Sacks described the experience:
"And suddenly – into the silence, the silent twittering of motionless frozen images – came music, glorious music. Mendelssohn, fortissimo! Life, intoxicating movement! And, as suddenly, without thinking, without intending whatever, I found myself walking, easily, with the music. And, as suddenly, in the moment that this inner music started, the Mendelssohn which had been summoned and hallucinated by my soul, and in the very moment that my 'motor' music, my kinetic melody, my walking came back – in this self-same moment the leg came back. Suddenly, with no warning, no transition whatever, the leg felt alive, and real, and mine, its moment of actualisation precisely consonant with the spontaneous quickening, walking and music. ... I believed in my leg, I knew how to walk ...
... It was as if I suddenly remembered how to walk – indeed, 'not as if'. I remembered how to walk. All of a sudden I remembered walking’s natural, unconscious rhythm and melody; it came to me.
... I was doing it perfectly and easily, with no conscious counting or calculation whatever, but simply giving myself to the activity’s own tempo, pulsion and rhythm."
But then music in his mind died, and it resulted in a relapse:
"... I had a sudden and unexpected relapse – suddenly forgot my kinetic melody, forgot how to walk. In this moment, as suddenly as if the needle had been lifted from a record, the inner playing of Mendelssohn stopped, and in the instant it stopped, my walking stopped too. Suddenly the leg ceased to be stable and real and reverted to its cinematic delirium, its awful wild jumping of shapes, sizes, frames."
"And in that moment, when the body became action, the leg, the flesh became quick and alive, the flesh became music, incarnate solid music. All of me, body and soul, became music in that moment."
This is an application of music therapy. Music is a mysterious thing. Not all of us can play a musical instrument or carry a tune (I can do neither of these things), but we spend a lot of our time enjoying music; it can alter our moods, it bonds groups of people together, and it can release tension. It varies between cultures and historical periods, but every culture has it – just like language. Is music hard-wired in our brains? Noam Chomsky taught us that all the world’s languages are based on a universal grammar module that is hard-wired in the brain; is there a “music module” hard-wired in every brain? According to musicologists like Fred Lerdahl and Heinrich Schenker, this is most probably the case. For our brains to have evolved something as complex as a universal music module means that it must have some survival value (just like language) – it’s not just there for our enjoyment and amusement. Maybe each of us carries our song within us – a "kinetic melody", a rhythm of life. I’ll stop typing and just sit back and listen to that classical guitar CD playing in the background of my lounge-room ... how about you?
