MR received minimal formal musical education. He had a few singing lessons early in his childhood and later sang in the high school choir where he acquired some basic knowledge of music theory and developed the skill of sight singing (singing from a musical score). MR maintained a passion for music throughout his adult years, keeping a vast collection of musical recordings from a broad range of styles and periods.
MR's recollection of his immediate difficulties post-stroke was that music sounded like a vacuum cleaner or washing machine. Approximately two weeks after his stroke, he also noticed he was unable to sing in tune. Environmental sounds, such as a telephone ringing, were also unrecognisable as evidenced by his inappropriate responses to these sounds. On a more positive note, however, he found his previous tinnitus had resolved.
Six months post-stroke, MR noted that music was beginning to sound 'musical' again. It remained highly homogenous, however, and was washed with a "Hawaiian or Country and Western twang". As a result, he experienced a loss of pleasure when listening to music. During this period, he also began experiencing pleasant sounding musical illusions that spontaneously arose from the fusion of environmental sounds, such as the chimes from his Japanese garden. He found these difficult to distinguish from real sounds but was eventually able to "control" them by not focusing on them.
From May 2003, MR described music as less homogenous yet still impoverished, remarking that large-scale orchestral works lacked the richness or grandness he remembered they once had. He maintained that when trying to track instrumental parts in an orchestral piece, he confused instruments that have similar pitch range, such as a flute and violin. MR also reported a lower level of confidence when tapping out rhythmic improvisations while listening to jazz music, a skill he once enjoyed.
MR reported that he still has trouble recognising common environmental sounds, such as the phone ringing, or locating sounds, such as a dog barking. He finds it easy, however, to recognise familiar voices of individuals, although when speaking in crowds, he claims to experience difficulty when all the speakers are not clearly visible to him. He commented that identifying voices of well known singers is difficult when they have similar timbres, although he professed to be able to discriminate between singers when they perform distinctly different genres or sing highly dissimilar vocal parts.
Finally, MR reported that he is no longer able to fully appreciate music or feel its emotional impact, except when submitting to musical illusions. He particularly laments the loss of emotional engagement when listening to pieces that used to incite a depth of emotion.