Free Musicophilia: Tales of Music and the Brain by Oliver W. Sacks Page A

immediately requested a tape recorder, and in the course of a few days she recorded innumerable salacious songs from her youth in the music halls of the 1920s. No one was more astonished by this than Rose herself. “It’s amazing,” she said. “I can’t understand it. I haven’t heard or thought of these things for more than forty years. I never knew I still had them. But now they keep running through my mind.” Rose was in a neurologically excited state at this time, and when the L-dopa dosage was reduced she instantly “forgot” all these early musical memories and was never again able to recall a single line of the songs she had recorded.
    Neither Rose nor my mother had used the term “hallucination.” Perhaps they realized, straightaway, that there was no external source for their music; perhaps their experiences were not so much hallucinatory as a very vivid and forced musical imagery, unprecedented and astonishing to them. And their experiences were, in any case, transient.
    Some years later, I wrote about two of my nursing home patients, Mrs. O’C. and Mrs. O’M., who had very striking musical hallucinations. 5 Mrs. O’M. would “hear” three songs in rapid succession: “Easter Parade,” “The Battle Hymn of the Republic,” and “Good Night, Sweet Jesus.”
    “I came to hate them,” she said. “It was like some crazy neighbor continually putting on the same record.”
    Mrs. O’C., mildly deaf at eighty-eight, dreamt of Irish songs one night and woke to find the songs still playing, so loud and clear she thought that a radio had been left on. Virtually continuous for seventy-two hours, the songs then became fainter and more broken up. They ceased entirely after a few weeks.
    My account of Mrs. O’C. and Mrs. O’M., when it was published in 1985, seemed to have a wide resonance, and a number of people, after reading it, wrote in to the widely syndicated newspaper column “Dear Abby,” to report that they, too, had experienced such hallucinations. “Abby” in turn asked me to comment on the condition in her column. I did this in 1986, stressing the benign, nonpsychotic nature of such hallucinations— and was surprised by the volume of mail that soon flooded in. Scores of people wrote to me, many of them giving very detailed accounts of their own musical hallucinations. This sudden influx of reports made me think that the experience must be much more common than I had thought— or than the medical profession had recognized. In the twenty years since, I have continued to receive frequent letters on the subject, and to see this condition in a number of my own patients.
    As early as 1894, W. S. Colman, a physician, published his observations on “Hallucinations in the Sane, Associated with Local Organic Disease of the Sensory Organs, Etc.” in the British Medical Journal. But notwithstanding this and other sporadic reports, musical hallucinations were considered to be very rare, and there was scarcely any systematic attention to them in the medical literature until 1975 or so. 6
    Wilder Penfield and his colleagues at the Montreal Neurological Institute had written famously in the 1950s and early ’60s of “experiential seizures,” in which patients with temporal lobe epilepsy might hear old songs or tunes from the past (though here the songs were paroxysmal, not continuous, and were often accompanied by visual or other hallucinations). Many neurologists of my generation were strongly influenced by Penfield’s reports, and when I wrote about Mrs. O’C. and Mrs. O’M., I attributed their phantom music to some sort of seizure activity.
    But by 1986, the torrent of letters I received showed me that temporal lobe epilepsy was only one of many possible causes of musical hallucination and, indeed, a very rare one.

    T HERE ARE MANY different factors that may predispose one to musical hallucinations, but their phenomena are remarkably unvarying. Whether the provocative factors are peripheral