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The human mind is made up of many complicated and fragile processes.

One small
change can throw off an entire system and can take someone from being perfectly functional one
day to being unable to perform basic tasks the next. But not every change is all bad, and it is easy
to overlook the functions that still exist and the ones that have even been enhanced. Assuming
that any divergence from normal brain activity is completely negative, overlooks the bigger
picture of brain activity and does a patient a disservice. Research, tests, and perceptions about
cognitive issues focus too much on the negatives rather than the positives, pointing out what a
patient lacks rather than what is left intact.
Just because someone is lacking in one cognitive area doesn’t mean that he or she has no
cognitive ability. Oliver Sacks makes this point on page 40 of The Man Who Mistook His Wife
for a Hat when he says, “a man does not consist of memory alone. He has feeling, will,
sensibility, moral being.” He is pointing out that there are many components to someone’s
cognitive well-being and although a deficit in one component can impact the person’s cognitive
function to the extent that it is hard to recognize the other components, that doesn’t mean that
they aren’t still sufficient. He gives an example on page 81, while talking about Mrs. S, a patient
who is unable to see things on her left side but has “perfectly preserved intelligence and humour”
and has “worked out strategies for dealing with her imperception.” Because of the assets she still
has left, intelligence and humor, she is able to find ways to compensate for what’s lacking. By
focusing on the positives, what is still there, patients can make up for what they’re missing.

Doctors are missing opportunities to help their patients when they only look at what has been
In fact, the defects can also bring benefits to the patients. For example, Mrs. O’C is
unable to remember her childhood until she begins having musical seizures, during which she
hears music from her childhood in her head, which brings back other memories. Clearly,
something is wrong, and she can’t live the rest of her life hearing music the way she does during
her seizures, “but it seemed to her the acme of sanity and health--the very key, indeed the door,
to sanity and health. Thus she felt her illness as health, as healing” (pg.152). She even says,
“there’s a sort of completeness I never had before” (pg.153). Mrs. O’C is able to perceive
positive parts of her otherwise negative experience. Another patient, Rebecca, has a low IQ and
is unable to understand many everyday things. However, she is able to love deeply, a quality that
may have even been enhanced because of her condition. She is also a very gifted actress and able
to put her passions into theater exceptionally well, probably because of the way she sees the
world, a perceptive quality attributed to her condition. Sacks realizes that “the tests had given no
inkling of anything but the deficits, anything, so to speak, beyond her deficits. They had given
me no hint of her positive powers, her ability to perceive the real world” (pg. 90). The tests
reveal only the problems, and thus do not give an accurate representation of the patient. and what
treatment is most likely to help her. Mrs. O’C’s and Rebecca's condition presented some
advantages, but they were realized through the patient's own experiences outside of clinics,

hospitals and tests. The way cognitive sciences evaluate patients doesn’t take into consideration
the patient’s life as a whole.
There is more to every “defect” than what is originally observed and it takes more than
just testing and diagnosis to get the full picture. Cognitive scientists get too caught up in “fixing”
the patient, rather than understanding how to really help them. Oliver Sacks sums it up on page
182 when he says, “it has to do with qualities of mind which are preserved, even enhanced, so
that, though ‘mentally defective’ in some ways, they may be mentally interesting, even mentally
complete, in others.” Tests, research, and conclusions about cognitive issues reduce the issues to
black and white depictions of the brain, but human mental processes are more complicated than
that. Patients won’t get the best treatment possible unless cognitive scientists also look at the
gray areas.