Our Aphasiac Friends

Oliver Sacks

Aphasia, roughly, is a disorder caused by damage to the portions of the brain that control language. Among the many types of this acquired disorder there are those where the aphasiac lacks literal understanding of words and phrases when uttered unemotionally, unexpressively. A pure digital voice without "feeling-tone", speech melody, gestures, grimace cannot be be grasped. On the other hand, an emotional speech is understood by aphasiacs without remembering the (any) words.

When British neurogist Oliver Sacks once during the eighies of the last century passed an aphasia ward, hearing laughter from the room where the aphasiacs were watching a Reagen speech, he found them umused, bewildered and partly outraged. Because, what the sequence of expressions of the old actor's TV speech told them was nonsense. The aphasiacs' deficit may evolve to an increased sensitivity in grasping the whole of communicative actions:

"To such a grimace, to any falsity or impropriety in bodily appearance or posture, aphasiacs are preternaturally sensitive. And if they cannot see one—this is especially true of our blind aphasiacs—they have an infallible ear for every vocal nuance, the tone, the rhythm, the cadences, the music, the subtlest modulations, inflections, intonations, which can give—or remove—verisimilitude to or from a man’s voice.

In this, then, lies their power of understanding—understanding, without words, what is authentic or inauthentic. Thus it was the grimaces, the histrionisms, the false gestures and, above all, the false tones and cadences of the voice, which rang false for these wordless but immensely sensitive patients. It was to these (for them) most glaring, even grotesque, incongruities and improprieties that my aphasic patients responded, undeceived and undeceivable by words."

In the same room present that day, there were also persons suffering the flip-side of the aphasic diagnosis: being able to understand the meaning of words and complicated grammatical structures, but unable to tell an angry from a sad voice: tonal agnosia. Grammitically incorrect phrases, slang or untypical usage of words may confuse tonal agnosiacs. They would probably love Stephen W. Hawking's voice.

Sacks reports of one of the female agnosiacs:

"[she] also listened, stony-faced, to the President’s speech, bringing to it a strange mixture of enhanced and defective perceptions — precisely the opposite mixture to those of our aphasiacs. It did not move her — no speech now moved her — and all that was evocative, genuine or false completely passed her by. [...] ‘He is not cogent,’ she said. ‘He does not speak good prose. His word-use is improper. Either he is brain-damaged, or he has something to conceal.’ Thus the President’s speech did not work for [her] either, due to her enhanced sense of formal language use, propriety as prose, any more than it worked for our aphasiacs, with their word-deafness but enhanced sense of tone."

In some European parliaments speeches are simultaneously translated into sign language. TV news sometimes display a small portion of the screen reserved for a sign language interpreter. One may well wish that the interpreters would be joined by one of Sacks' patients to mirror all the lies. Or let every president hold his new year's eve speech accompanied by an aphasiac smiling into the camera. In times of a happy revival of torture, one may well wish for a trained, hyper-sensitive aphasiac interrogator as a more elegant solution to the ticking bomb scenario than Alan Dershowitz midieval suggestion.


Oliver Sacks' clinical tale "The President's Speech" can be read online. It is entailed in Sacks [1985].