Doctor P, a distinguished singer, visits a neurologist. He is suffering from a profound visual agnosia. He can see but he cannot recognise. At the doctor's consulting room, he mistakes his wife for a hat stand.

After conducting a series of tests, the neurologist is none the wiser, failing to understand how a man with such visual devastation can manage the simplest practicalities of life such as dressing, eating, washing, Mrs P finally comes to his rescue by pointing out that her husband hums and sings his way through the day with dressing songs, eating songs, and bathing songs. The neurologist realises that Doctor P has substituted the world of music for the world of vision. With an inner soundtrack consisting largely of Schumann, Doctor P negotiates the pressing visual realities of living, making rudimentary sense of the world. But when the music stops, when Doctor P is interrupted, his fragile world shatters into abstraction.

Based on the true case study by Dr Oliver Sacks, it was the inspiration of Michael Nyman, (the composer usually associated with Peter Greenaway) to turn the story into a neurological opera - the perfect medium for this story.