Emile Belcourt: tenor; Dr. S, The Neurologist
Sarah Leonard: Soprano, Mrs. P
Frederick Westcott: Baritone, Dr. P
Alexander Balanescu:first violin
Jonathan Carney: second violin
Kate Musker: viola
Moray Welsh: first cello
Anthony Hinnigan: second cello
Helen Tunstall: harp
Michael Nyman: piano
The synopsis by Christopher Lawrence.
The neurologist Dr. S sets the scene: he seeks a neurology that places the humanity of his patients at the centre instead of defining them in terms of their deficits. Traditional case studies convey nothing of the person, and the experience of the person, as he struggles to survive disease. By deepening the case study into a narrative or tale we find a ‘who’ as well as a ‘what’, real people whose essential being is very relevant in the higher reaches of neurology.
Dr. P, a professional singer, and his wife, Mrs. P, arrive at the neurologist’s clinic. Dr. P has been referred by an ophtalmologist because of certain silly visual mistakes he has been making, like confusing parking meters for people. It’s probably all a joke, Mrs. P thinks. There’s really nothing the matter. The neurologist can’t find much wrong either, but does notice Dr. P’s strange way of looking at him. As they are leaving, Dr. P reaches for his hat, but mistakes the shape of his wife for the hatstand, reaching instead for her head. The neurologist sees that there is indeed something wrong and resolves that next time he will see Dr. P in his home, away from the cold abstraction of the clinic.
The neurologist visits Dr. P in his home. They discover a mutual lobe for Schumann. Mrs. P acompanies her husband as he sings ‘Ich grolle nicht’. The delighted neurologist joins in. He notes that Dr. P can no longer read music, but that he has a perfect ear -his musical brain is intact.
The neurologist gives Dr. P a series of simple visual tests. He asks him to identify a sequence of platonic solids, playing cards and caricatures which he takes from his case. He notes that Dr. P can identify abstract patterns and shapes. But when it comes to showing Dr. P photographs, of his own family and even himself, it’s apparent that altogether he can see, he cannot recognise even the most familiar faces.
Mrs. P admits to herself the serious nature of her husband’s condition. While arranging a bunch of roses that the neurologist has brought her, she sees her husband as Blake’s ‘Sick Rose’ -a dying man. The neurologist offers Dr. P one of the roses. He cannot tell what it is until he smells it. A glove is equally confusing.
The neurologist plays a game of chess with Dr. P, who, playing mentally, beats him soundly. The neurologist concludes that P’s visual is impaired. This is confirmed when Dr. P describes walking down a local street in detail, although he omits desrcibing things to his left.
The apartment is full of Dr. P’s paintings. The neurologist thinks he can detect in them a movement from the more naturalistic earlier work to later abstraction which parallels the progress of dr. P’s illness. This makes Mrs. P very cross. She is astounded that the neurologist can’t se the artistic development in her husband’s work and angrily calls him a philistine.
As the neurologist and Mrs. P wrangle over the painting, Dr. P is tucking into afternoon tea, humming to himself as he munches his way through the spread of cakes and sandwhiches. When Mrs.P shouts ‘Philistine!’ at the neurolgist, Dr. P freezes, shocked into silence byt the sudden exclamation.
This incident is the key to the neurologist’s diagnosis. It turns out that Dr. P has a profound visual agnosia which prevents him from relating the parts of anything he sees to a coherent whole. Unable to maje any cognitive visual judgement, the musician in Dr. P employs an inner soundtrack -hummed tunes of his favourite Schumann- to help him coordinate simple everyday visual tasks. In this he is helped by his wife, who lays everything out -clothes, washing things, food- in a pattern they both know. This way they get by, but if interrupted by a sudden intrusion like ‘Philistine!’, Dr. P’s world falls apart and comes to a complete stop. It’s also clear that Mrs. P’s love is crucial for her husband’s compromised wellbeing. Dr. P asks the neurologist what he should do. The neurologist can offer no solution other than that he continue to give his shattered visual world coherence with music, building on what has been at the centre of his life.
The neurologist sums up the case. With this affirmation of the substitution of the musical for the visual, Dr. P continued teaching for some years, living a full life instead of merely deteriorating in the shadow of his ‘deficits’.
The entire libretto is available as text only.
My first reading of the title text of The Man who Mistook his Wife for a Hat, soon after the book was published in Britain in November 1985, curiously mirrored the way its central character, Dr. P, viewed the world: I scanned it, skipped from page to page, incident to incident, fascinated by the details, but seeing the whole. These details, however, inescapably formed themselves into a new picture: an opera. Compositional challenges and solutions instantly emerged -as much from Sack’s layout of the case study as from ist subject. (My initial enthusiasm was not allowed to wane through the normal delays of opera funding and scheduling: the project was immediately accepted for production by Michael Morris at the Institute of Contemporary Arts (ICA) in London, and Channel 4 TV soon became involved with a film version directed by Christopher Rawlence and produced by Debra Hauer for the newly formed ICA TV. Rawlence, Morris and I began a treatment of Sack’s text, and Jock Scott’s designs had a formative influence on the shape of the work. Rawlence’s libretto explored areas only hinted at by Sacks, much to the enrichment of the work and to Dr. Sack’s satisfaction. From conception to first performance in October 1986 was less than a year.) What primarily interested me was that Sacks does not describe Dr. P’s neurological problem, but rather takes the reader through his own step by step discovery of the patient’s condition: narrative as process, demanding a parallel musical process. The text contains very little dierct portrayal of Dr. P’s daily experience of visual agnosia but instead reveals his affliction through a series of diagnostic tests conducted in two sessions -the first in Dr. Sack’s consulting room, the second at the home of Dr. and Mrs. P. Each test presents a new piece of diagnostic evidence and, in the opera, would be treated as an individual narrative event: each of these self-contained musical events would then be linked together into a large-scale sequential narrative -a number opera with a difference. My first preparatory step had been to carve up the case study into the Greeting Event, Shoe Event, Rose Event, etc., rather like Fluxus Events.