Greatest science books: After news about Oliver Sacks’s “lies”, we reread The Man Who Mistook His Wife for a Hat

Sometimes a popular science book goes out of style because new evidence refutes its central thesis or because it contains outdated attitudes. And sometimes a metaphorical bomb is thrown at him.

This is the case of Olivier Sacks’ work. The man who mistook his wife for a hat. It is a seminal work that inspired an entire generation of psychology students and researchers, including me. But thanks to some shocking revelations about Sacks’ approach to factual accuracy, the book’s reputation has skyrocketed. Is there anything to salvage from the wreckage?

I first read The man who mistook his wife for a hat (From now on Hat) about 25 years ago, when I was studying psychology. This is a collection of case studies of people, primarily Sacks’ patients, suffering from neuropsychiatric disorders. Sacks takes us into the lives of people with amnesia, neurosyphilis, Tourette syndrome and much more. It describes the difficulties these people face in everyday tasks, such as having a conversation or getting dressed, explores the neurological basis of their illness, and reflects on what they tell us about the nature of the human mind.

Rereading it now, there are details I don’t like. The book was first published in 1985 and contains language that would not be accepted today, particularly about people with developmental delays. Moreover, Sacks sometimes becomes knotted while thinking about his patients’ deeper implications about the nature of thought.

But for the most part, rereading reminded me what I loved about the book in the first place. Sacks’ image in the field of psychology is that of a cuddly, humanistic grandfather, and there’s a reason for that: the book is deeply empathetic.

Chapter 3, “The Disembodied Lady,” tells the story of a woman, “Christina,” who suffered severe nerve damage, resulting in the loss of her proprioception – her perception of her body’s position in space. Close your eyes and touch your nose with your finger: this is your proprioception at work. Lacking proprioception, Christina found that simply boarding a bus was a laborious task. Because his movements were so clumsy, people often accused him of being drunk.

In telling these stories, Sacks argues that society needs to be more tolerant of those whose brains have been damaged, and of those whose brains are simply wired in different ways. He doesn’t use the modern word “neurodiversity”, but the germ of this idea is present everywhere. Hat.

The main problem with this book is that we don’t know how true it is. Some of it may be made up. We know this because journalist Rachel Aviv was given access to Sacks’ private correspondence and diaries through the Oliver Sacks Foundation. Aviv wrote about his findings in The New Yorkers in 2025. In his journals, Sacks wrote of his “guilt” for “my lies” and his “falsification” in 2025. Hat.

Aviv has established that a handful of stories in the book are at least partly false. For example, Sacks describes a patient named “Rebecca” with severe developmental delay, to the point that “she couldn’t confidently open a door with a key,” but who nevertheless thrived in a theater troupe. Aviv found no evidence of this transformation in Sacks’ documents. “Instead of bearing witness to his reality, he [Sacks] reshapes it,” she wrote. Elsewhere, Sacks claims that a pair of identical twins with severe neurological difficulties were nonetheless able to spontaneously identify six-digit prime numbers – something never seen before or since.

The result is that it is impossible to know to what extent Hat we should trust. Most case studies have never been published in scientific journals and there is no independent verification. All we have is Sacks’ word – and in his diary he admitted to lying. My feeling is that we shouldn’t believe extraordinary cases, like the prime number-calculating twins, but many stories – like Christina’s – are much more in line with the outside evidence.

Aviv made it clear that Sacks was dealing with his own personal demons. He did not publicly reveal his homosexuality until later in life and was often celibate, consumed by guilt and self-loathing. Unable to fully express this aspect of his identity, Sacks transmuted his own pain into the stories he told about his patients – and then felt guilty for doing so. I find this whole story deeply sad: when he was young, Sacks internalized society’s homophobia, causing him immense suffering and harming his work.

Perhaps the biggest problem with Hat is that Sacks wrote it and his publishers marketed it as nonfiction. Yet its greatest achievement is something we usually associate with fiction: putting the reader inside the minds of people whose experiences and perceptions are radically different. This is not a reliable description of neuropsychiatric facts, but if you read it knowing that, you will nevertheless find that it expresses something true.