Oliver Sacks, MD, FRCP: We are wired for speech, we are wired for spoken language, for expressing and understanding spoken language. That’s to say any human being who is exposed to language at a critical stage of development in their second or third year will acquire language without any explicit form of teaching. Comsky above others has spoken wonderfully about this, but basically exposure to language activates language parts of the brain. However we are not wired for written language in the same way. Written language only goes back five or seven thousand years. There is no built-in circuitry in the brain for written language. But a circuitry is developed through learning to write. A circuitry which may be somewhat different in different people. In other words what is already in the brain is recruited and pressed into a new use when one learns to write. So in this way is music like speech? Or is it like writing? I’m inclined to think, but here only one can speculate, that both of these are involved. I think there are certain aspects of music which do not have any equivalent in speech, in particular the pulse of music, the steady rhythm, and its synchronization with movement.  I think there is good reason for supposing for that is built in, and there are anatomical connections, which are strongly and almost exclusively developed in human beings.

Oliver Sacks: Although personally music has been very important to me from before I can remember. As a physician it only hit me really in the 1960s, and that was when I found myself at a hospital in the Bronx seeing the frozen post-encephalitic patients whom I later wrote about in Awakenings. These were people with very profound Parkinsonism, so profound that sometimes they would stay absolutely motionless for hours on end and could not initiate any movement or speech or indeed thought, although one learned that later, but so much so, “What’s going on with these people?” “Are they there?” “Is there anyone at home?” And it was originally the nurses and people who knew of these patients well who said they could be transformed by music. If there’s music, these people could dance, they could sing, they could talk, they can do things, they can think, they can become almost normal while music is there.

And then I saw this for myself, and I was stupefied. I don’t know what term to use. And 40 years later I find it astounding and it needs to be seen as someone for whom music—someone for whom movement is unimaginable suddenly able to move. But it strictly goes with the music, and when the music stop, they stop. So music therapy for these Parkinsonian patients was my first experience as a physician, and I wondered what sort of music was involved or any music could do so. It didn’t have to be familiar music or loved music. It doesn’t sometimes have to be a conscious attention to the music. But obviously the rhythm and the beat and pulse of music was very important. And this would spontaneously and almost automatically I think allow people to move. So the good music had a strong rhythm, not overwhelming but a strong rhythm. But obviously I think if people like the music, so much the better.

Interviewer: And what have you found out about or what do you believe is going on in the brain that creates this effect?

Oliver Sacks: Well, this reminds me of the way in which all of us want to keep time and tap time, and how children spontaneously start to dance or keep time to music they hear or imagine. And that seems to be a very strong human attribute to have motor responses, movements synchronized with the pulse of music, the sounds.  And uniquely in the human brain, at least uniquely among mammals, one finds connections between the auditory parts of the brain and what’s called the dorsal pre-motor cortex, some of the motor parts. And it seems to be this conjunction of auditory and motor, which is so crucial for all of us in responding to music, but especially if you have something like Parkinson’s. So I think that’s one of the very important thing whether the shape of the melody and the life of the music. Kant the philosopher called the music the quickening art. And music seems inherently alive and to give a feeling of life and emotion and ongoing, and of a journey, a sort of trajectory. And I suspect important all of these could be important as well. It’s just not the rhythm.  Everything in music carries one along.

Also read Concetta Tomain’s article, “How Music Can Reach the Silent Brain.”

Oliver Sacks: And you’ll find that even a few minutes of five finger exercises will make functional changes in the brain, so the brain’s response to music in physiological terms is almost immediate although obviously it would take months or whatever to have anatomical changes. But a year of Suzuki training will produce physical changes in the brain, and there have been studies looking at the brains before and after a year of training. And so whatever gifts a  person has or doesn’t have, musical training seems to be very important, the more so if it’s early.

If music can so alter the brain, at least the musical parts of the brain, when people are young, one would wonder the role of music in education, and whether this enlargement and benefit can spread to other parts of the brain, whether it will facilitate reading, memory, concentration, focus, and there’s quite a lot of evidence that this is the case, and therefore strong arguments for including music in education. But I stress this is something beyond the so-called Mozart effect. A little Mozart under the pillow, a teaspoon of Mozart, while it’s very pleasant and it may introduce people to Mozart, in itself, that’s not enough. There needs to be real engagements with music and a lot of it.

Oliver Sacks: Now there’s no one musical center, there are 15 or 20 different systems in the brain. But in general many of the musical parts of the brain, if I could put it this way, are close to the memory parts and close to the emotional parts. And so music tends to embed itself in memory and to evoke emotions with an immediacy beyond, I think, of any other stimulus with the possible exceptions of smells. But in particular when people really have chills and thrills and sort of their hair stands on end with music enraptured, then you can find the particular systems of the brain rewards systems are activated, the same systems which are activated when one falls in love, or is overwhelmed with beauty generally. But that being said, that leaves the problem “So what’s beauty?” It’s just not sort of pleasure, it’s the whole nature of aesthetic and beauty and the sublime, which is so overwhelming in music or can be.