LYNN NEARY, host:
We all like music. Who doesn't? But what would happen if the songs we hear in our heads, what if they stayed and stayed?
NPR's science correspondent Robert Krulwich has the story.
ROBERT KRULWICH: We will begin with the patient, says Dr. Oliver Sacks, neurologist and author.
Dr. OLIVER SACKS (Neurologist): This is an intelligent, very deaf woman.
KRULWICH: Who has a hearing aid now, a cochlear implant, but back when she was in her 60s...
CHERYL C: I had been steadily losing my hearing.
KRULWICH: And then, about fiver years ago, Cheryl C, as Dr. Sacks calls her in his new book, "Musicophilia," she was at home with her husband in bed, reading.
CHERYL C: And all of the sudden I heard horrific noises.
Dr. SACKS: She heard engines going to and fro.
CHERYL C: Trolley cars.
Dr. SACKS: There were sirens, there were voices, there were bells, there was screaming, there was clanging.
CHERYL C: Cymbals.
KRULWICH: And all of a sudden, just pow?
CHERYL C: Just all of the sudden.
KRULWICH: Trolley cars?
CHERLY C.: And I turned to my husband, who was in the...
Unidentified Man (Husband): Yeah, I was there. I mean she jumped up and said I've got these noises.
CHERYL C: I ran out of the bedroom.
Unidentified Man: Such a strange thing happening.
Dr. SACKS: She rushed to the window, expecting to see a fire engine, and there was nothing there. There was nothing.
CHERYL 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.
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.
CHERYL C: "Michael Row Your Boat Ashore."
KRULWICH: And that song was followed by a slew of other songs.
CHERYL C: Hymns, spirituals, patriotic songs, things (unintelligible)...
Dr. SACKS: And from that point on her hallucinosis took the exclusive form of music.
CHERYL C: Playing intensively. I can't stop it.
KRULWICH: Weren't you worried that you had become a crazy person?
CHERYL C: Yeah, I thought I might be going nuts.
(Soundbite of laughter)
CHERYL C: 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. This was like hearing voices.
CHERYL C: And he assured me that, you know, I wasn't.
KRULWICH: Whatever is wrong with you has a physical explanation, he thought.
CHERYL 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, hallucinatory output of their own.
KRULWICH: And therefore the reason there is 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.
CHERYL C: Dr. Sacks explained to me that my brain just decided to make some music - and so I'd hear something. 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, okay, let's pause. Let's stop the story of Cheryl just for a moment because to understand Cheryl it will help if you met Michael Sandou, a New York City graduate student. I said why, who's Michael Sandou? And he said, well, just ask him to tell you the story that he told me. So I did.
Mr. MICHAEL SANDOU (Graduate Student): I was - it was a story about being extremely bored, really, which is why I was - almost felt silly coming down here and telling you the 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. SANDOU: And I didn't know anything about sailing and just thought it would be exciting to go.
(Soundbite of laughter)
Mr. SANDOU: And I found it the opposite.
(Soundbite of laughter)
Mr. SANDOU: It was so boring. There is no wind.
KRULWICH: So he spent more than two weeks mostly staring at totally flat water.
Mr. SANDOU: In a few days I had read every book I brought, and it just went on and on and on.
KRULWICH: Until finally one afternoon, sitting on his birth listening to a refrigerator hum, he heard...
Mr. SANDOU: Heavy metal guitar solos.
(Soundbite of laughter)
KRULWICH: There's no radio, no CD, no music playing anywhere, and yet...
Mr. SANDOU: In my head, it's... (makes guitar sounds) ...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. SANDOU: No.
KRULWICH: But the guitar kept playing and playing and then later he had a second hallucination.
Mr. SANDOU: Highland bagpipe, 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 as with Cheryl when you're deaf.
Dr. SACKS: Something like 2 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.
CHERYL C: I have learned to live with it.
KRULWICH: But that doesn't mean she likes living with it. It never stopped.
CHERYL C: I would wake up in the morning and think, what, what's the tune de jour, what are we going to be hearing today? And there was always one there.
KRULWICH: And that's when she thought about cochlear implants. She heard about an ear doctor.
CHERYL C: He'd had a patient, he had told us about Sacks, who had musical hallucinations, received a cochlear implant, and her hallucinations disappeared. So...
KRULWICH: That makes sense, right? I mean, 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.
CHERYL C: So I wanted to do it.
KRULWICH: And so she did it. She took a chance. She had the operation. She got the implant. She woke from the operation and...
CHERYL C: I heard the music. It was inside me.
KRULWICH: Oh, still there. Her brain cells for some reason continued to produce their own music, plus she can now hear real music coming through the implant. And the curious thing is the implants have such a narrow range, real music feels flat to Cheryl.
CHERYL C: It sounds tinny. I really don't hear a musical intervals the way you would like to.
KRULWICH: But the music that she hallucinates...
CHERYL C: Yes, it's great. Everything hits the right note. It's fine.
KRULWICH: So for Cheryl, when I sing...
(Singing) Michael row...
(Speaking) ...she hears...
(Singing, tinny) ...Michael row your boat ashore.
(Speaking) Real sounds sound terrible. But when Cheryl's brain hallucinates "Michael Row Your Boat Ashore"?
(Soundbite of music)
CHERYL C: It sounds the way music should sound.
KRULWICH: Isn't that weird? So...
CHERYL 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.
(Soundbite of music)
NEARY: You can hear more stories by Robert Krulwich in his podcast, Krulwich on Science at npr.org/podcast. Transcript provided by NPR, Copyright NPR.
We are all, to some extent, human jukeboxes. And while hit tunes or ad jingles sometimes stick too long, for the most part we control what's inside our heads. But what happens when a person loses control?
Everybody hears things. If I asked you, right now, to play "God Bless America" in your head (go on, do it), you could make it happen.
If I asked for "Michelle My Belle," as sung by Paul McCartney, most of you could do that, too.
We are all, to some extent, human jukeboxes, able to program for pleasure and for reference. And while music sometimes sticks around longer than we would like -- like a hit tune or an advertising jingle -- for the most part we control what's inside our heads.
This story, however, describes what can happen when a person loses control.
For some people, the music comes unbidden, sticks around, makes too much noise and won't go away.
Cheryl C., (not her real name) is a patient of the well-known author and neurologist Dr. Oliver Sacks. Her story appears in his new book Musicophilia.
What Is Going On?
About five years ago, Cheryl was in bed reading when all of a sudden she heard a tremendous clamor. As Sacks tells it, "There were sirens, there were voices, there were bells, there was screaming, there was clanging.
She jumped up, rushed to the window to see what could be creating such noise. But when she looked she saw nothing.
I suddenly realized that these horrendous noises were in my head, she says.
After about 20 minutes or so, equally mysteriously, the cacophony suddenly turned into music, a much too loud version of "Michael Row Your Boat Ashore," which then resolved into another song, then another. The outdoor noise had stopped, but the music kept going and going.
Eventually she went to Sacks, who examined and tested her and offered a possible explanation for what had happened.
Cheryl had been growing deaf and by her late 60s, her hearing was so compromised she could barely hear people on the phone. When she played bridge, her partners would have to repeat their bids in extra loud voices. There was less and less sound reaching her brain.
Sacks suspected that the region of her brain devoted to auditory work had so little input, so little to do, the cells in that part of her brain began fabricating output. In other words, her brain was hallucinating.
"Dr. Sacks explained to me that my brain just decided to make some music so Id hear something," she says.
"This is not uncommon. This is not psychotic. This is often associated with deafness," says Sacks.
Musical hallucinations appear in a small percent of people who are very deaf. People in sensory deprivation chambers find themselves hearing mysterious sounds within an hour or so. It can happen to sailors who spend time alone at sea, to people on empty stretches of desert, to people who are extravagantly bored or unstimulated by their environments. And maybe, Dr. Sacks suggested, not hearing triggered the music inside Cheryl.
Three Intriguing Questions
First, where do these musical hallucinations come from? Why "Michael Row Your Boat Ashore"? Why the cars crashing? Why does an amateur sailor tell us (hes in the Morning Edition broadcast) he heard a heavy metal guitar solo when he hates heavy metal? Why an intricate bagpipe tune when he has no special knowledge or fondness for bagpipes?
Who is choosing these sounds? Obviously the brain got them from somewhere. Or maybe the brain is making them up from scattered parts, creating its own montage? Or are they memories? Right now, it is fair to say nobody really knows.
When I asked Sacks if he thought the music was entirely accidental, all random, he scoffingly quoted his friend the poet W.H. Auden, "random, my bottom!" There is some method here, but thats still a mystery.
"I mean, by the nature of things, there cannot be anything random in the mind. You know, there must be determinance," Sacks says.
Second, Cheryl C. reasoned that if her brain cells needed real sounds from the outside world, she could provide them. She recently got a modern hearing aid, a cochlear implant, surgically placed in both ears.
Now her brain cells are getting signals from real voices, real places, and yet, while in some people cochlear implants immediately stop musical hallucinations, in Cheryl C. it didnt work. Her inner music continues. Why?
Third, what is it like to be stuck with relentless music, music that arrives unbidden? How does one cope? Cheryl C. says for her it isnt so terrible (and she has been listening for five years). Should something like this ever happen to you or to someone you know, her advice:
"I think the best way to deal with it is to just get on with your life, and do what you have to do and keep it in the background and in perspective," she says.
The story of Cheryl C. can be found in detail in Oliver Sacks new book, Musicophilia (Knopf 2007).