The Man Who Mistook His Wife For a Hat is a collection of ten short stories, each dealing with a different common neurosis experienced by the patient. Unlike many of Sacks’s previous books, this one did not require the patient to be in actual physical contact with the writer or the writing itself, which is both a good and a bad thing. Because the neurosis, or idiopathic sexual disorder, which this book is called, is psychological, it does not have as many illustrations to help explain its symptoms nor does it offer an abundance of diagnostic information, as do much of Sacks’s other writings. This collection illustrates Sacks’s gift as a narrative writer; it is also very richly illustrated, with thick boards providing background and supporting detail, like those seen on many medical textbooks. Like most of Sacks’s work, the focus is on the human condition and the effect of neurosis, specifically sexual neurosis, upon those affected by it.
In the story “The Man Who Mistaken His Wife For a Hat,” Dr. George Grant is a successful New York City plastic surgeon who is married, proud and self-confident. He has an easy way of putting people at their ease with his smooth talk and reassuring face, but beneath the confidence is the worry of his sexuality. At a party, he sees several men having sex with one woman. When confronted, he realizes that the women are “both women, both lovers.” This enraging revelation fuels his drive to find the true cause of the neurosis, but before he can do so, he has to deal with one more problem: a patient with an equally strange sexual predicament.
Both women have similar symptoms, stemming from a unique type of neurosis. One woman has a strange preoccupation with hats, identifying the female partner in the same room as her husband without realizing they are not the same person. The other woman also has an overwhelming desire to wear a hat almost everywhere, even when her husband is not around. While the man who mistook his wife for a hat tries desperately to distance himself from this peculiar neurosis, the wife who cannot escape hats eventually gives up the struggle to survive.