Summary
In “The Man Who Fell Out of Bed” the author describes an encounter he had with an unnamed patient many years ago when Sacks was a medical student. The patient tells Sacks that he had woken up from a nap and, to his surprise and horror, found “someone’s leg” with him in his bed. Although the leg was attached to him, he was convinced that, as a prank, somebody left the leg in the bed for him to find. Disgusted, he’d thrown the leg out of bed, which brought the rest of his body to the floor. Sacks asks the man where his leg is, if this isn’t it. He shakes his head and says “I have no idea. It’s disappeared. It’s gone. It’s nowhere to be found” (57). In the postscript to this story, Sacks includes a short letter he received from the eminent neurologist Michael Kremer, who says he once had a patient with the exact same issue.
Madeleine J., the subject of “Hands,” is a congenitally blind 60-year-old woman with cerebral palsy. Her family had supported her in every way since infancy. Although she is exceptionally intelligent and well-read, Madeleine tells Sacks that she never learned to read braille; everything had always been read to her. She says that she can’t do anything with her hands at all. “[u]seless godforsaken lumps of dough–they don’t even feel part of me” (59). This initially confuses Sacks, who after running several tests can’t identify any deficit in Madeleine’s sensory capacities. He wonders if she doesn’t feel any connection with her hands simply because, over sixty years, she has never had the need to use them. In Madeleine’s first ever “manual act,” she takes hold of and eats a bagel without assistance from her nurses. With a new hunger for tactile sensation, she rapidly begins to explore objects in her environment, including Sacks’ face.
Within a year, Madeleine takes to sculpting, creating “simple but recognizable” figures with a “remarkably expressive energy” (63). Sacks praises her astonishing and unexpected artistic sensibility, marveling at how one’s basic powers of perception can be developed so many decades after infancy. In the postscript, the author mentions a patient named Simon K., who comes to Sacks with the exact same problem. Although Simon is not as naturally gifted as Madeleine, after a year of learning to use his hands, he becomes an adept carpenter.
“Phantoms” is, for the most part, an explanatory essay, using a series of anecdotal stories to illustrate what neurological phantoms are and how they are experienced by amputees. An unnamed man is plagued for forty years by the sense that his amputated index finger is rigidly extended at all times. After developing severe sensory diabetic neuropathy, he loses all feeling in his hands and in turn the phantom finger disappears. A second patient under Sacks’ care has to slap his thigh-stump every morning several times in order to “wake up” his phantom leg. Without his phantom, he is unable to use his prosthetic leg to walk. A third patient, Charles D., has to look at the position of his feet on the floor in order to remain balanced. Due to a sensory delirium in his dorsal root, Charles experiences rapidly fluctuating proprioceptive illusions that make the floor pitch, jerk and tilt “like a ship in heavy seas” (68). A fourth man tells Sacks that on occasion his phantom-foot “hurts like hell -- and the toes curl up, or go into spasm” (69). These pains only occur when the man has taken his prosthetic leg off for the night. When the prosthetic is on, his phantom gives him the sense that his leg is still there, allowing him to walk with ease.
Analysis
These three short essays each present a different angle for Sacks to discuss how the boundaries of the self are invented and manipulated by the brain. The story of the man who “loses” his leg while taking a nap illustrates that the brain is constantly constructing its sense of what “belongs” to us–where our personhood begins and ends. Further, Madeleine’s development shows that the boundaries of the self are not only invented by the brain, but also that they constitute a learned behavior that can change over time. And finally, the anecdotes in “Phantoms” illustrate that the brain’s sense of self can even extend past the boundaries of the physical body. In this three-part illustration, Sacks in effect deconstructs the notion of the self as a concrete reality.
The way the author chooses to word Madeleine's gripe with her hands–as “useless lumps of dough”–cleverly foreshadows her future development as an artist. A lump of dough, after all, is an object that by definition has not yet reached its final form. This image presented at the beginning of the story comes to symbolize the hands that Madeleine “sculpts” into existence, as it were. Curiously, Sacks also specifies that the first object Madeleine manipulates by herself is a bagel–an object that was also once a lump of dough. By weaving this symbolic thread throughout the story, Sacks is perhaps implying that Madeleine unconsciously knew her potential all along.
