The Man Who Stopped at Nothing

Some writers lead us into lives we’d never otherwise imagine; Michael Herr, writing on the fear and madness of war, was one; Thomas Merton on monastic seclusion, another. Oliver Sacks was one as well. He was an explorer of mind and brain, where words like inconceivable, or magical, or sometimes alas tragic, are not overblown but just plain fact. Everyone’s heard of the man, his wife and the hat – but Sacks met many, many others whose lives were just as much sources of wonder. He was open to them because his own experience was extraordinary too. His writings and his life are almost equally absorbing.

He was a big, untidy man, superhumanly strong and awkward; like Tolstoy’s Pierre Bezukhov, shy but full of feeling. In the Sacks family, career meant medicine, but for him some options were ruled out straightaway; he was never going to be a surgeon, with what Jonathan Miller – a lifelong friend – called his sheer ‘flat-footed Jewish clumsiness’. As for laboratory research, when he absent-mindedly dropped his lunch into a biochemical culture he was firmly ejected. ‘You are a menace,’ he was told. ‘Go and work with patients.’ He was not only large in build, but in compassion and curiosity too, and also in recklessness and self-doubt. Will Self called his life ‘an adventure in ideas’. It was one in conflicts as well. His background was orthodox Jewish from Cricklewood, north London; he embraced Jewishness but was still up for startling, un-kosher rebellions like blood milkshakes or fried placentas. ‘He stopped at nothing!’ said Miller. The Sacks home didn’t readily admit gentiles, but his parents were doctors for everyone regardless of belief. In fact they were so dedicated that while they tended the needy during the war they sent their youngest sons out of the way to boarding-school, without noticing that for two years the boys were viciously bullied, abused and beaten. Pleas for rescue were ignored. Oliver’s brother became schizophrenic, and he himself lost what he called ‘the three Bs, the ability to bond, belong, and believe’ – that’s believe as in trust. Things were made worse by the fact that he was gay. He wanted it kept secret from his mother; he was her prodigy and she his formidable guide. But she found out, and ‘with a face he’d never seen before’ cursed him with Old Testament thunder and wished he had not been born. He became hypersensitive to inner life, and an outsider. Not long after his mother’s outburst he left England for internships in America. He was still raw, beyond the usual uncertainty of youth. In those days homosexuality was a crime – Alan Turing’s fate was hard to forget. Perhaps it’s no surprise he went off the rails and on to drugs. He became a bodybuilder pumping iron on LA’s Muscle Beach, and a biker on terms with Hell’s Angels. Leaving the ward on a Friday night he’d swallow a handful of amphetamines, then, lying flat on the tank of his monstrous BMW, he’d hurtle through the night at the highest speed it could reach. The headlight and the drugs would create ‘all kinds of strange reversals and illusions’ as the road sped by. He took refuge in danger like this. However, he did go and work with patients, and probably they saved him from an early death. He had always been intrigued by consciousness, whether human or other. What was ‘I’ for a bat, for instance, or an octopus? And, now he was caring for them, what was ‘I’ for a sleeping-sickness patient unresponsive and rigid for decades? Or for that same patient briefly restored to previous life by L-DOPA? When we look into the wounded consciousness of others, he asked, are we looking at ourselves? Are we frightened to look in the mirror? The L-DOPA patients were, of course, the subject of Awakenings (1973), which first brought him recognition, if not immediately in science then by way of the arts: a film, a play, an opera, a ballet. Early in his career he sat in on a clinic where a mentally impaired adolescent girl was being assessed. She failed test after test; failures were in fact the whole point of the tests – they charted her limits. By chance he spotted her later in a park and they talked. Immediately he saw that away from the clinic she lived in her own complex imaginative reality – one perhaps not reachable by someone normally able. He realized that difference might not always be just loss. It widened his understanding of what being human is, and formed his approach to patients. For him they were not cases but complete people he knew in depth, combining ‘the objectivity of science with the intense sense of fellow feeling, and the sheer wonder, and sometimes tragedy, of it all’. He wrote about them as Dickens or Melville might. He explored the stupendous powers that sometimes appear in otherwise drastically limited ‘savants’, like the Lin twins, who couldn’t manage arithmetic but who could ‘see’ prime numbers twenty digits long – which no computer of the time could reveal. Or the nineteenth-century blind black slave boy Tom, scarcely verbal but an excellent self-taught pianist who could also, as a joke, play one tune with his left hand and another with his right, while singing a third. Sacks explored hallucinations too, such as the fairies Conan Doyle saw, or Dostoevsky’s personal interviews with God. Or Maupassant’s meeting his own double. It’s problematic meeting oneself – it may feel unclear which self is hallucinating. Sacks himself, travelling up the Amazon with a fever, found himself in a Jane Austen novel (though he was actually more a Dickens man). If he got up – for some water perhaps – his fellow characters would disappear from sight. When they returned, he’d find the story had moved on without him. Neurology fast became Sacks’s life, though neurology of a kind very out of favour: literary, personally engaged, humanely perceptive. He was both therapist and explorer, fascinated by the vast variety of what our fragile minds can achieve, and by the creative adaptations our brains sometimes have to make for them to do so. He engaged with humanity of every kind. He’d sit till dawn with the damaged and delirious, somehow tuned to their frantic thoughts, and he’d bring comfort. Here’s what Sister Lorraine of the Little Sisters of the Poor had to say. (Sacks worked for the Little Sisters for nothing; it was a nursing order so poor the nuns had to beg on the streets of Brooklyn.)

I look on Our Lord as the Divine Physician and in a way – I hope this is not sacrilege – I look on [the] Doctor in the same way: he heals, but not just the superficial problems, he heals underneath . . . It must be profound experience. It can’t be just brilliance.

It’s hard to exaggerate how unwelcome his ideas were to scientists sixty years ago, when neurology was doing its best to look like physics. There can’t be many doctors more loved by their patients than Oliver Sacks, but he wasn’t loved by his colleagues, and in turn he scorned their refusal to swim beyond the shallows of scientific proof. ‘They are addicted to their fragmentations, their specializations,’ he said. ‘They resent creativity.’ Not surprisingly he was ignored or accused of making things up. And to be honest he did sometimes transgress; ‘I don’t tell lies,’ he said, ‘though I may invent the truth.’ He was neurotic about his place in science, swinging between moods of grandiosity and doubt. The man who mistook his wife for a hat was Dr P, a singing teacher at the Juilliard School who could no longer recognize his students – at least not by their faces, only by their voices. A visit to Dr Sacks was arranged. After an awkward moment when P tried to shake hands with a grandfather clock, Sacks gave him a rose to look at, and waited to see what happened. ‘A convoluted red form with a linear green attachment,’ P said. But what was it? P guessed only when he took a sniff. Sacks produced something more difficult. ‘A continuous surface,’ P said after a pause, ‘infolded on itself . . . It appears to have five outpouchings, if that is the word . . . a container of some sort? . . . It could be a change purse . . . for coins of five sizes?’ The first thing most of us would see – that it was a glove – was what he couldn’t see. Stroke damage had cost him his sense of the ‘thingness’ of things. That’s why he came to reach not for his hat but his wife’s head instead. Amazingly, P had no idea anything was wrong with him. Yet despite that, with his wife’s help he’d already adjusted to cope. ‘How does he get dressed?’ Sacks asked in a quiet moment. ‘I put his usual clothes out, in all the usual places, and he dresses without difficulty, singing to himself. He does everything singing to himself. But if he is interrupted . . . he comes to a complete stop, doesn’t know his clothes – or his own body . . . He can’t do anything unless he makes it a song.’ The musical centres of P’s brain were in some inexplicable way standing in for the visual. The Man Who Mistook His Wife for a Hat (1985) was a bestseller in twenty languages. That didn’t silence critics; there were jibes about the man who mistook his patients for a literary career. But change was coming. It casts an ironic light on human nature, even the human nature of scientists, that what made most difference was an Oscar-nominated film starring Robin Williams and Robert De Niro. The book Awakenings had been met with scorn or silence, but the film of it caught people’s imagination. It spread the feeling that ‘hopeless cases’ could be reached out to, not just categorized and medicated; it created a mood to which not even the most austere and fatalistic neurologists were completely immune. So the tide of Sacks’s prestige turned. Outsider became international treasure. I recently read that of students opting to study neurology, 70 per cent now cite Oliver Sacks as the reason. And for readers like ourselves he has opened a new continent.

Extract from Slightly Foxed Issue 79 © Grant McIntyre 2023