Weeks after a lightning bolt nearly killed him, a middle-aged doctor became obsessed with music. A brain that survives trauma, says neurologist Oliver Sacks, can develop some confounding new habits.
Tony Cicoria was 42, very fit and robust, a former college football player who had become a well-regarded orthopedic surgeon in a small city in upstate New York. He was at a lakeside pavilion for a family gathering one fall afternoon. It was pleasant and breezy, but he noticed a few storm clouds in the distance; it looked like rain.
He went to a pay phone outside the pavilion to make a quick call to his mother (this was in 1994, before the age of cell phones). He still remembers every single second of what happened next: “I was talking to my mother on the phone. There was a little bit of rain, thunder in the distance. My mother hung up. The phone was a foot away from where I was standing when I got struck. I remember a flash of light coming out of the phone. It hit me in the face. Next thing I remember, I was flying backward.”
Then—he seemed to hesitate before telling me this—“I was flying forward. Bewildered. I looked around. I saw my own body on the ground. I said to myself, ‘Oh s---, I’m dead.’ I saw people converging on the body. I saw a woman—she had been standing waiting to use the phone right behind me—position herself over my body, give it CPR. ... I floated up the stairs—my consciousness came with me. I saw my kids, had the realization that they would be okay. Then I was surrounded by a bluish-white light ... an enormous feeling of well-being and peace. The highest and lowest points of my life raced by me. No emotion associated with these ... pure thought, pure ecstasy. I had the perception of accelerating, being drawn up ... there was speed and direction. Then, as I was saying to myself, ‘This is the most glorious feeling I have ever had’—SLAM! I was back.”
Dr. Cicoria knew he was back in his own body because he had pain—pain from the burns on his face and his left foot—and, he realized, “only bodies have pain.” He wanted to go back, he wanted to tell the woman to stop giving him CPR, to let him go; but it was too late—he was firmly back among the living. After a minute or two, when he could speak, he said, “It’s okay—I’m a doctor!” The woman (she turned out to be an intensive-care-unit nurse) replied, “A few minutes ago, you weren’t.”
The police came and wanted to call an ambulance, but Cicoria refused, delirious. They instead took him home, where he called his own doctor, a cardiologist. The cardiologist, when he saw him, thought Cicoria must have had a brief cardiac arrest, but could find nothing amiss with examination or EKG. “With these things, you’re alive or dead,” the cardiologist remarked.
Cicoria also consulted a neurologist—he was feeling sluggish (most unusual for him) and having some difficulties with his memory. He found himself forgetting the names of people he knew well. He was examined neurologically, had an EEG and an MRI. Again, nothing seemed amiss.
A couple of weeks later, when his energy returned, Cicoria went back to work. There were still some lingering memory problems—he occasionally forgot the names of rare diseases or surgical procedures—but all his surgical skills were unimpaired. In another two weeks, his memory problems disappeared, and that, he thought, was the end of the matter.
What then happened still fills Cicoria with amazement, even now, more than a dozen years later. Life had returned to normal, seemingly, when “suddenly, over two or three days, there was this insatiable desire to listen to piano music.” This was completely out of keeping with anything in his past. He had had a few piano lessons as a boy, he said, “but no real interest.” He did not have a piano in his house. What music he did listen to tended to be rock music.
With this sudden onset of craving for piano music, he began to buy recordings and became especially enamored of a Vladimir Ashkenazy recording of Chopin favorites —the “Military” Polonaise, the “Winter Wind” Ã‰tude, the “Black Key” Ã‰tude, the B-flat minor Scherzo. “I loved them all,” Cicoria said. “I had the desire to play them. … At this point, one of our babysitters asked if she could store her piano in our house—so now, just when I craved one, a piano arrived, a nice little upright. It suited me fine. I could hardly read the music, could barely play, but I started to teach myself.”
Then, on the heels of this sudden desire for piano music, Cicoria started to hear music in his head. “The first time,” he said, “it was in a dream. I was in a tux, onstage; I was playing something I had written. I woke up, startled, and the music was still in my head. I jumped out of bed, started trying to write down as much of it as I could remember. But I hardly knew how to notate what I heard.” This was not too successful—he had never tried to write or notate music before. But whenever he sat down at the piano to work on the Chopin, his own music “would come and take me over.”
I was not quite sure what to make of this peremptory music, which would intrude almost irresistibly and overwhelm him. Was he having musical hallucinations? No, Cicoria said, they were not hallucinations—“inspiration” was a more apt word. The music was there, deep inside him—or somewhere—and all he had to do was let it come to him. “It’s like a frequency, a radio band. If I open myself up, it comes. I want to say, ‘It comes from heaven,’ as Mozart said.”
His music is ceaseless. “It never runs dry,” he continued. “If anything, I have to turn it off.”
Now he had to wrestle not just with learning to play the Chopin, but to give form to the music continually running in his head, to try it out on the piano. “It was a terrible struggle,” he said. “I would get up at 4 in the morning and play till I went to work, and when I got home from work I was at the piano all evening. My wife was not really pleased. I was possessed.”
Cicoria came to think that he had had a sort of reincarnation, that he had been transformed and given a special gift, a mission, to “tune in” to the music that he called, half metaphorically, “the music from heaven.”
Some years passed, and his new life, his inspiration, never deserted him. He continued to work full-time as a surgeon, but his heart and mind now centered on music. He got divorced in 2004, and the same year had a fearful motorcycle accident. He was found in a ditch, unconscious and badly injured. He again made a complete recovery, though, and was back at work in two months. Neither the accident nor his divorce seemed to have made any difference to his passion for music.
I have never met another person with a story like Tony Cicoria’s. When he asked me what I thought of his story, I asked him what he thought, and how he would interpret what had happened to him. He replied that as a medical man he was at a loss to explain these events, and he had to think of them in “spiritual” terms. I countered that, with no disrespect to the spiritual, I felt that even the most astounding transformations must have some physical basis or at least some physiological correlate in neural activity.
I had asked him at one point whether he experienced other changes after the lightning strike—a new appreciation of art, perhaps, or new beliefs? Cicoria said he had become “very spiritual” since his near-death experience. He had started to read every book he could find about near-death experiences and about lightning strikes. He felt he could sometimes see “auras” of light or energy around people’s bodies—he had never seen this before the lightning bolt.
Immediately following the lightning strike, of course, Cicoria had an out-of-body experience. Many supernatural or mystical explanations have arisen to explain out-of-body experiences, but they have also been a topic of neurological investigation for a century or more. There is some evidence that both the visuospatial and vestibular aspects of out-of-body experiences are related to disturbed function in the cerebral cortex, especially at the junctional region between the temporal and parietal lobes.
But it was not just an out-of-body experience that Cicoria reported. He saw a bluish-white light, his life flashed past him, he had a sense of ecstasy, and, above all, he had a sense of something transcendental and enormously significant.
What could be the neural basis of this? Similar near-death experiences have often been described by people struck by lightning, involved in sudden accidents, or, most commonly, revived after a cardiac arrest. All of these are situations likely to cause a sudden drop in blood pressure and cerebral blood flow (and, if there is cardiac arrest, a deprivation of oxygen to the brain). There is likely to be intense emotional arousal and a surge of noradrenaline and other neurotransmitters in such states. We have, as yet, little idea of the actual neural correlates of such experiences, but the alterations of consciousness and emotion that occur are very profound and must involve the emotional parts of the brain—the amygdala and brainstem nuclei.
What about Cicoria’s sudden musicophilia, his sudden passion for music—and why was there such a delay in its development? What was happening in the six or seven weeks that elapsed between his cardiac arrest and the rather sudden eruption of musicality?
We know that there were immediate after-effects of the lightning strike: his out-of-body experience, his near-death experience, the disturbance of memory that lasted a couple of weeks. Changes in his brain were presumably occurring in the weeks afterward, when his brain was reorganizing—preparing, as it were, for musicophilia. Cicoria feels that he is a “different person” now—musically, emotionally, psychologically, and spiritually. That is my impression, too.
One spring not long ago, Cicoria took part in a 10-day music retreat for gifted amateurs and young professionals. The camp doubles as a showroom for Erica vanderLinde Feidner, a concert pianist who also sells pianos. Cicoria had just bought one of her pianos, a Bösendorfer grand. The time and place were right, Cicoria felt, to make his debut as a musician.
He prepared two pieces for his concert: his first love, Chopin’s B-flat minor Scherzo; and his own first composition, which he called Rhapsody, Opus 1. His playing, and his story, electrified everyone at the retreat. Many, in fact, expressed the fantasy that they, too, might be struck by lightning. Cicoria played, said Feidner, with “great passion, great brio”—and if not with supernatural genius, at least with credible skill. That was in itself an astounding feat for someone who had taught himself to play at 42.
From the book Musicophilia by Oliver Sacks. ©2007 by Oliver Sacks. Reprinted by permission of the publisher Alfred A. Knopf. All rights reserved.