Why Your Brain Is Humming to Itself

NPR's Robert Krulwich talks to Dr. Oliver Sacks about his new book, Musicophilia, about the relationship of music and neurology.

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LAURA CONAWAY: Thanks, Alison.

ALISON STEWART, host:

Laura Conaway, thanks so much. So next hour, can I get you to come in and do some of the On The Blog with me?

CONAWAY: Let's talk blog.

STEWART: You know, I got - I got called out for singing the blues on the blog. Did you see that?

CONAWAY: Can we get you to sing - we're going to have to get you to sing again. Actually, someone came to your defense just a second ago.

STEWART: They did?

CONAWAY: They did!

STEWART: Oh, that's so exciting.

CONAWAY: We'll have a blues-off.

STEWART: Because I was just kind of, you know, joshing a bit.

CONAWAY: You were letting it go.

STEWART: I like to sing, you know? I like my music.

CONAWAY: People should sing. It's happy.

STEWART: I know. Well, thank you so much. We'll get back to you in just a minute. You know, music people, they don't make it easy on us. They - you know, they don't give us new releases every day. They don't space it out. Nope. They don't back up the truck every Tuesday and dump everything on us at once. You know what? Sometimes they don't answer their telephones, like Lizzy Goodman, who is actually going to be our guest in the next segment.

And if the control can give me a heads up? A yes or a no? Do you have the emergency Krulwich animation? I did it to you people, do you know what happened? I sent an email to my boss at 6:50 just saying, hey, do we have the emergency Krulwich on backup, just in case? You know, kind of like taking an umbrella on the day it's going to rain.

She told me we do indeed. It's time to deploy the Krulwich. It's a story about a new book called "Musicophilia," written by Oliver Sacks. It's about the intersection of music and neurology. Mr. Krulwich interviews a deaf woman who constantly hears music playing in her head, and thought she was going mad. But Dr. Sacks concluded the hearing cells in her brain started just making stuff up. Let's listen.

ROBERT KRULWICH: We will begin with the patient, says Dr. Oliver Sacks, neurologist and author.

Dr. OLIVER SACKS (Neurologist, Author): This is an intelligent, very deaf woman.

Ms. CHERYL C (Deaf Patient): I had been steadily losing my hearing.

KRULWICH: Dr. Sacks, in his new book "Musicophilia," calls her "Cheryl C," not her real name, but about five years ago, she was at home with her husband, in bed, reading.

Ms C: And all of a sudden, I heard horrific noises.

Dr. SACKS: She heard engines going to and fro.

Ms. C: Trolley cars.

Dr. SACKS: There were sounds, there were voices, there were bells, there were screaming, there was clanging.

Ms. C: Cymbals.

KRULWICH: And all of a sudden, just "pow"?

Ms. C: Just all of a sudden.

KRULWICH: Trolley cars?

Ms. C: And I turned to my husband who was...

Mr. C (Husband of "Cheryl C"): Yeah, I was there. I mean, she jumped up and said I've got these noises.

Ms. C: I ran out of the bedroom.

Mr. C: Such a strange thing happening...

Dr. SACKS: She rushed to the window, expecting to see a fire engine. And there was nothing there.

Mr. C: There was nothing.

Ms. C: And I suddenly realized that these horrendous noises were in my head.

Dr. SACKS: She was having a hallucination, a sort of monstrous hallucination. She was terrified. She thought she was going mad.

KRULWICH: And then, after maybe 20 minutes of clanging and banging, just as suddenly...

Dr. SACKS: The noise was abruptly replaced by the sound of music.

Ms. C: "Michael Row Your Boat Ashore."

KRULWICH: And that song was followed by a slew of other songs.

Ms. C: Hymns, spirituals, patriotic songs, things I knew.

Dr. SACKS: And from that point on her hallucinations took the exclusive form of music.

Ms. C: Playing incessantly. I can't stop it.

KRULWICH: Wouldn't you worried that you'd become a crazy person?

Ms. C: Yeah, I thought I might be going nuts. And that bothered me.

KRULWICH: So, she went to see Dr. Sacks, who examined her, and did all kinds of tests.

Dr. SACKS: She first wondered if she was going crazy, if this was like hearing voices.

Ms. C: And he assured me that, you know, I wasn't.

Dr. SACKS: These are not psychotic hallucinations.

Ms. C: It was neurological, there was something causing it.

KRULWICH: But what was causing it? Dr. Sacks told Cheryl that because her hearing was so compromised...

Dr. SACKS: She was profoundly deaf.

KRULWICH: Hardly any sounds were coming into her brain, so the cells in her brain, dedicated to hearing, those neurons were under-stimulated.

Dr. SACKS: If the hearing parts of the brain, they're not getting their normal input, start to produce a factitious, a hallucinatory output of their own.

KRULWICH: And therefore the reason there's music in Cheryl's head is she got so deaf, the hearing cells in her brain, desperate for exercise, started making stuff up. That's kind of what he told her.

Ms. C: Dr. Sacks explained to me that my brain just decided it likes music, and so I hear something!

KRULWICH: So in effect, he's telling you that what you got in your head is your brain humming to itself, basically.

Ms. C: That is, really, what it is.

KRULWICH: Oh, come on, I thought. That can't be. But Dr. Sacks says this happens all the time.

Dr. SACKS: This is not uncommon. This is not psychotic. This is often associated with deafness...

KRULWICH: Or even with boredom. People stuck in faraway places...

Dr. SACKS: Where there is a vast silence, they may start to hear things.

KRULWICH: I said, what are you talking about? He said, OK, let's pause, let's stop the story of Cheryl just for a moment, because to understand Cheryl, it will help if you've met Michael Sundoo (ph), a New York City graduate student. I said why? Who is Michael Sundoo? And he said, well, just ask him to tell you the story that he told me. So, I did.

Mr. MICHAEL SUNDOO (Patient): It was a story about being extremely bored, really. Which is why I was almost felt silly coming down here and telling you this story.

KRULWICH: But to speed things up, Michael was invited by a school friend to sail on a boat from the Caribbean to Connecticut.

Mr. SUNDOO: And I didn't know anything about sailing, and just thought that it would be exciting to go. And I found it the opposite. It was so boring! There was no wind.

KRULWICH: So he spent more than two weeks mostly staring at totally flat water.

Mr. SUNDOO: In a few days I had read every book I'd brought. And it just went on, and on, and on.

KRULWICH: Until finally one afternoon, sitting on his berth listening to a refrigerator hum, he heard...

Mr. SUNDOO: Heavy metal guitar solos.

KRULWICH: There's no radio, no CD, no music playing anywhere, and yet...

Mr. SUNDOO: In my head it's (Mimics guitar solo).

Forever. And I don't like heavy metal. I mean, punk yes, metal no.

KRULWICH: Had this ever happened to you before that you remember?

Mr. SUNDOO: No!

KRULWICH: But the guitar kept playing and playing, and later, he had a second hallucination...

Mr. SUNDOO: Highland bagpipes. And I don't know anything about the bagpipe!

KRULWICH: But Michael's brain produced those bagpipes, just as Cheryl's brain had produced "Michael Row Your Boat Ashore." Brains, even healthy brains, do this when there's nothing real coming in, especially if you're deaf.

Dr. SACKS: Something like two percent of people with severe deafness can get musical hallucinations and although it may be very annoying or intrusive, things tend to die down, and one tends to get used to it.

Ms. C: I have learned to live with it.

KRULWICH: But that doesn't mean she likes living with it. It never stopped.

Ms. C: I would wake up in the morning and think, what's the tune de jour? What am I going to be hearing today? And there was always one there.

KRULWICH: And that's when she thought about cochlear implants. She'd heard about an ear doctor...

Ms. C: He had had a patient, he had told this to Dr. Sacks, who had musical hallucinations, received a cochlear implant, and her hallucinations disappeared.

KRULWICH: That makes sense, right? Because if this is idle neurons wanting to do something, if you bring the world back into your head, presumably those neurons would have something to do.

Ms. C: The songs would disappear. So, I wanted to do it.

KRULWICH: So, she did it. She had the operation, she got the implant, she woke up from the operation, and...

Ms. C: I heard the music, it was inside me.

KRULWICH: Oh, still there. Her brain continues to produce its own music, plus, now she can hear real music coming through the implant, and the curious thing is because implants have such a narrow range, real music feels flat to Cheryl.

Ms. C: It sounds tinny. I really don't hear musical intervals the way you would like to.

KRULWICH: But the music that she hallucinates...

Ms. C: Yes, it's great. Everything hits the right note. It's fine!

KRULWICH: So for Cheryl, when I sing (Singing clearly) "Michael Row," she hears (Singing from distance) "Michael Row Your Boat Ashore." Real sounds sound terrible. But when Sheryl's brain hallucinates "Michael Row your Boat Ashore"?

(Soundbite of big band)

KRULWICH: Oddly...

Ms. C: It sounds the way music should be.

KRULWICH: Isn't that weird? So...

Ms. C: The whole thing is a little weird. But I try not to think about it that way.

KRULWICH: Robert Krulwich, NPR News, New York.

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