Brain Pickings

Posts Tagged ‘Oliver Sacks’

09 JULY, 2015

Musicked Down the Mountain: How Oliver Sacks Saved His Own Life by Literature and Song

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The extraordinary survival story of “a creature of muscle, motion and music, all inseparable and in unison with each other.”

“Without music I should wish to die,” the poet Edna St. Vincent Millay wrote in a 1920 letter to a friend. One fateful afternoon half a century later, beloved British neurologist and writer Oliver Sacks (b. July 9, 1933) — a Millay of the mind, a lover of poetry, and a scientist of enormous spiritual exuberance — came to live this sentiment as more than a dramatic hyperbole.

In his superb 1984 memoir A Leg to Stand On (public library), Dr. Sacks tells the story of an extraordinary experience he had atop a Norwegian mountain a decade earlier, on “an afternoon of peculiar splendor, earth and air conspiring in beauty, radiant, tranquil, suffused in serenity,” many miles from the nearest human being — an experience in which the only thing that stood between him and his death was music; an experience that brought him not merely near death but in an intimate tango with it danced to the sound of life itself.

Oliver Sacks by Wendy MacNaughton for Brain Pickings

With his Thoreauesque prose, Dr. Sacks recounts the August day on which he set out to climb a Norwegian fjørd up a steep mountain path and before descending into hell:

Saturday the 24th started overcast and sullen, but there was promise of fine weather later in the day… I looked forward to the walk with assurance and pleasure.

I soon got into my stride — a supple swinging stride, which covers ground fast. I had started before dawn, and by half past seven had ascended, perhaps, to 2,000 feet. Already the early mists were beginning to clear. Now came a dark and piney wood, where the going was slower, partly because of knotted roots in the path and partly because I was enchanted by the world of tiny vegetation which sheltered in the wood, and was always stopping to examine a new fern, a moss, a lichen. Even so, I was through the woods by a little after nine, and had come to the great cone which formed the mountain proper and towered above the fjørd to 6,000 feet.

There, to his surprise, was a fence bearing an even more surprising sign: “BEWARE OF THE BULL!” Accompanying the cautionary verbal message was a visual one in the universal language of comic art: “a rather droll picture of a man being tossed.”

So absurd was the sign, so bizarre the very notion of a dangerous bull living up in the fjørd, that Dr. Sacks took it for a prank by the local villagers and carried on, walking past the fence and up the path, determined to make it to the top of the mountain by noon. Unperturbed by the awareness of this “not exactly a populous part of the world,” he felt rather liberated by the sense of solitude — the kind of soul-stretching solitude where, as Wendell Berry memorably put it, “one’s inner voices become audible.”

And, suddenly, his solitude was ruptured by a most prominent presence:

There were ambiguous moments when I would stop in uncertainty, while I descried the shrouded shapes before me. … But when it happened, it was not at all ambiguous!

The real Reality was not such a moment, not touched in the least by ambiguity or illusion. I had, indeed, just emerged from the mist, and was walking round a boulder as big as a house, the path curving round it so that I could not see ahead, and it was this inability to see ahead which permitted the Meeting. I practically trod on what lay before me — an enormous animal sitting in the path, and indeed totally occupying the path, whose presence had been hidden by the rounded bulk of the rock. It had a huge horned head, a stupendous white body and an enormous mild milk-white face. It sat unmoved by my appearance, exceedingly calm, except that it turned its vast white face up towards me. And in that moment, in my terror, it changed, before my eyes, becoming transformed from magnificent to utterly monstrous. The huge white face seemed to swell and swell, and the great bulbous eyes became radiant with malignance. The face grew huger and huger all the time, until I thought it would blot out the universe. The bull became hideous — hideous beyond belief, hideous in strength, malevolence and cunning. It seemed now to be stamped with the infernal in every feature. It became, first a monster, and now the Devil.

Wendy MacNaughton for Brain Pickings

Mustering a semblance of composure, Dr. Sacks spun on his heel mid-stride, turned around, and coolly began his descent. But the calm facade soon gave way to the irrepressible inner terror of the encounter:

I ran for dear life — ran madly, blindly, down the steep, muddy, slippery path, lost here and there in patches of mist. Blind, mad panic! — there is nothing worse in the world — nothing worse, and nothing more dangerous. I cannot say exactly what happened. In my plunging flight down the treacherous path I must have mis-stepped — stepped on to a loose rock, or into mid-air. It is as if there is a moment missing from my memory — there is “before” and “after,” but no “in-between.” One moment I was running like a madman, conscious of heavy panting and heavy thudding footsteps, unsure whether they came from the bull or from me, and the next I was lying at the bottom of a short sharp cliff of rock, with my left leg twisted grotesquely beneath me, and in my knee such a pain as I had never, ever known.

Always a master of extrapolating from the facts of his life the greater truths of human existence, he adds:

To be full of strength and vigor one moment and virtually helpless the next, in the pink and pride of health one moment and a cripple the next, with all one’s powers and faculties one moment and without them the next — such a change, such suddenness, is difficult to comprehend, and the mind casts about for explanations.

True to our tendency to leave our bodies after trauma, Dr. Sacks found himself, despite the excruciating pain, an almost disembodied observer of what was happening — but he used this disembodiment to his advantage, recasting his role in the unfolding drama from that of the patient to that of the professional physician. As if performing for an invisible audience of his students, he examined himself to determine the extent of the injury — “a complete rupture of the quadriceps tendon… muscle paralyzed and atonic.. unstable knee-joint… ripped out the cruciate ligaments.. considerable swelling, probably tissue and joint fluid, but tearing of blood vessels can’t be excluded…” — and proclaimed, aloud into the solitary stillness of the mountain air, that it was “a fascinating case!”

But he soon remembered that he was also the patient, the “case” in question:

Now, all of a sudden, the fearful sense of my aloneness rushed in upon me.

He realized, too, that at this altitude and latitude, he could easily freeze to death overnight, so his survival depended on being rescued before nightfall. He knew he had to climb down the mountain, closer to the villages, where his chances of being found would be higher.

What happened next was nothing short of astonishing — a supreme feat of the human spirit.

Mobilized by the life-or-death choice before him, Dr. Sacks found himself suddenly “very calm and composed.” Thanks to his personal quirk of carrying an umbrella at all times, he had used one as a walking stick up the mountain and had somehow clutched it by instinct during his fall. Ripping his anorak in two and snapping off the umbrella handle, he fashioned a makeshift splint for his limp leg — without one, he realized, he wouldn’t have been able to move.

Speaking to a truth we all too often forget or gloss over — the fact that “luck” is a contextual grace, relative rather than absolute — Dr. Sacks adds:

Mercifully, then, I had not torn an artery, or major vessel, internally… I had not fractured my spine or my skull in my fall. I had three good limbs, and the energy and strength to put up a good fight. And, by God, I would! This would be the fight of my life — the fight of one’s life which is the fight for life.

What followed is a remarkable testament to how great art lodges itself in the soul, a Trojan horse of hope, installing in us a kind of dormant software of knowledge and resourcefulness activated in moments of acute need — like the need to fight for one’s life. As Neil Gaiman observed in his magnificent meditation on how stories last, great art “can furnish you with armor, with knowledge, with weapons, with tools you can take back into your life to help make it better.” That’s precisely what Dr. Sacks experienced as he realized that if he didn’t make it off the mountain by nightfall, he would likely freeze to death. Suddenly, he remembered Tolstoy’s Master and Man — a moving 1885 short story about a selfish master who undergoes a spiritual awakening as he brings his peasant back from the brink of hypothermia by lying on top of him to save his life. The memory of this story sparked a life-saving epiphany:

If only I had had a companion with me! The thought suddenly came to me once again, in the words from the Bible not read since childhood, and not consciously recollected, or brought to mind, at all: “Two are better than one … for if they fall, the one will lift up his fellow; but woe to him that is alone when he falleth, for he hath not another to help him up.” And, following immediately upon this, came a sudden memory, eidetically clear, of a small animal I had seen in the road, with a broken back, hoisting its paralyzed hindlegs along. Now I felt exactly like that creature. The sense of my humanity as something apart, something above animality and mortality — this too disappeared at that moment, and again the words of Ecclesiastes came to my mind: “For that which befalleth the sons of men befalleth beasts; as the one dieth, so dieth the other … so that a man hath no pre-eminence above a beast.”

A series of such life-saving literary epiphanies followed, carrying Dr. Sacks’s spirit over the abyss of desperation and connecting once more to his work with patients:

While splinting my leg, and keeping myself busy, I had again “forgotten” that death lay in wait. Now, once again, it took the Preacher to remind me. “But,” I cried inside myself, “the instinct of life is strong within me. I want to live — and, with luck, I may still do so. I don’t think it is yet my time to die.” Again the Preacher answered, neutral, non-committal: “To everything there is a season, and a time to every purpose under the heaven. A time to be born, and a time to die; a time …” This strange, profound emotionless clarity, neither cold, nor warm, neither severe nor indulgent, but utterly, beautifully, terribly truthful, I had encountered in others, especially in patients, who were facing death and did not conceal the truth from themselves; I had marvelled, though in a way uncomprehendingly, at the simple ending of Tolstoy’s “Hadji Murad” — how, when Hadji has been fatally shot, “images without feelings” stream through his mind; but now, for the first time, I encountered this — in myself.

With this unfeeling clarity, he came up with the kind of idiosyncratic ingenuity that only grave necessity sparks:

I proceeded, using a mode of travel I had never used before — roughly speaking, gluteal and tripedal. That is to say, I slid down on my backside, heaving or rowing myself with my arms and using my good leg for steering and, when needed for braking, with the splinted, flail leg hanging nervelessly before me. I did not have to think out this unusual, unprecedented, and — one might think — unnatural way of moving. I did it without thinking, and very soon got accustomed to it. And anyone seeing me rowing swiftly and powerfully down the slopes would have said, “Ah, he’s an old hand at it. It’s second nature to him.”

Wendy MacNaughton for Brain Pickings

Always extrapolating from the particular to the universal and using his personal experience as raw material for advancing his scientific work to the benefit of all humanity, he adds:

So the legless don’t need to be taught to use crutches: it comes “unthinkingly” and “naturally,” as if the person had been practicing it, in secret, all his life. The organism, the nervous system, has an immense repertoire of “trick movements” and “back-ups” of every kind — completely automatic strategies, which are held “in reserve.” We would have no idea of the resources which exist in potentia, if we did not see them called forth as needed.

In a sentiment that speaks to the same alignment of haste and hopelessness against which Kierkegaard admonished two centuries earlier, Dr. Sacks remarks:

I could not hurry — I could only hope.

At that point, he thought of crying for help, and did — “lustily, with huge yells, which seemed to echo and resound from one peak to another.” But the cries suddenly reawakened his terror of the bull and made him fear a vengeful attack by the beastly overlord of the fjørd. So he descended in perfect silence, too afraid to even whistle, as “the hours passed, silently, slithering.”

Suddenly, he came upon a seemingly insurmountable obstacle — a stream he had been reluctant to cross even on his able-bodied way up, which he now had to traverse somehow. Unable to “row” himself across it with his gluteal-tripedal technique, he flipped into a facedown position and, with rigid outstretched arms — lest we forget, Dr. Sacks had been a weightlifting champion just a few years earlier — he propelled himself across the rapid-flowing, ice-cold stream, his head barely above water, exhorting himself:

Hold on, you fool! Hold on for dear life! I’ll kill you if you let go — and don’t you forget it!

But when he made it to the other shore, he faced another fork in this otherworldly road between life and death, one chillingly familiar to mountaineers and polar adventurers alike:

Somehow my exhaustion became a sort of tiredness, an extraordinarily comfortable, delicious languor.

“How nice it is here,” I thought to myself. “Why not a little rest — a nap maybe?”

The apparent sound of this soft, insinuating, inner voice suddenly woke me, sobered me and filled me with alarm. It was not “a nice place” to rest and nap. The suggestion was lethal and filled me with horror, but I was lulled by its soft, seductive tones.

“No,” I said fiercely to myself. “This is Death speaking — and in its sweetest, deadliest Siren-voice. Don’t listen to it now! Don’t listen to it ever! You’ve got to go on whether you like it or not. You can’t rest here — you can’t rest anywhere. You must find a pace you can keep up, and go on steadily.”

This good voice, this “life” voice, braced and resolved me.

Another, life-saving Siren took over — music’s miraculous power to enliven, which he had witnessed in his patients and recorded in his now-legendary book-turned-movie Awakenings, published just a few months before his encounter with the taurine devil. He recounts:

There came to my aid now melody, rhythm and music. Before crossing the stream, I had muscled myself along — moving by main force, with my very strong arms. Now, so to speak, I was musicked along. I did not contrive this. It happened to me. I fell into a rhythm, guided by a sort of marching or rowing song, sometimes the Volga Boatmen’s Song, sometimes a monotonous chant of my own, accompanied by these words “Ohne Haste, ohne Rast! Ohne Haste, ohne Rast!” (“Without haste, without rest”), with a strong heave on every Haste and Rast. Never had Goethe’s words been put to better use!

Oh, how Goethe, himself an ardent advocate of science, would have rejoiced in knowing that his art was nothing short of life-saving for one of humanity’s greatest scientific minds. This melodic transcendence uncorked a surprising reservoir of perfectly paced strength Dr. Sacks didn’t know he had:

I no longer had to think about going too fast or too slow. I got into the music, got into the swing, and this ensured that my tempo was right. I found myself perfectly co-ordinated by the rhythm — or perhaps subordinated would be a better term: the musical beat was generated within me, and all my muscles responded obediently — all save those in my left leg which seemed silent — or mute? Does not Nietzsche say that when listening to music, we “listen with our muscles?” I was reminded of my rowing days in college, how the eight of us would respond as one man to the beat, a sort of muscle-orchestra conducted by the cox.

Somehow, with this “music,” it felt much less like a grim anxious struggle. There was even a certain primitive exuberance, such as Pavlov called “muscular gladness.” And now, further, to gladden me more, the sun burst from behind the clouds, massaged me with warmth and soon dried me off. And with all this, and perhaps other things, I found my internal weather was most happily changed.

More than thirty years later, in his 2007 book Musicophilia, Dr. Sacks would come to illuminate the neurological underpinnings of this astounding connection between music and the mind. But here, one limp foot over the precipice of death atop the Norwegian mountain, he simply observed with awe the way in which music led his mind to mobilize his body into the rhythmic motion that would carry him to survival:

It was only after chanting the song in a resonant and resounding bass for some time that I suddenly realized that I had forgotten the bull. Or, more accurately, I had forgotten my fear — partly seeing that it was no longer appropriate, partly that it had been absurd in the first place. I had no room now for this fear, or for any other fear, because I was filled to the brim with music. And even when it was not literally (audibly) music, there was the music of my muscle-orchestra playing — “the silent music of the body,” in Harvey’s lovely phrase. With this playing, the musicality of my motion, I myself became the music — “You are the music, while the music lasts.” A creature of muscle, motion and music, all inseparable and in unison with each other — except for that unstrung part of me, that poor broken instrument which could not join in and lay motionless and mute without tone or tune.

As a child I had once had a violin which got brutally smashed in an accident. I felt for my leg, now, as I felt long ago for that poor broken fiddle. Admixed with my happiness and renewal of spirit, with the quickening music I felt in myself, was a new and sharper and most poignant sense of loss for that broken musical instrument which had once been my leg. When will it recover? I thought to myself. When will it sound its own tune again? When will it rejoin the joyous music of the body?

Wendy MacNaughton for Brain Pickings

At last, he could see the village in the distance — close enough to see it but not close enough for his cries for help to be heard, a tortuous rift between possibility and impossibility that once again reminded him of the interconnectedness of all life:

An anguish of yearning sharpened my eyes, a violent need to see my fellow men and, even more, to be seen by them. Never had they seemed dearer, or more remote… There was something impersonal, or universal, in my feeling. I would not have cried “Save me, Oliver Sacks!” but “Save this hurt living creature! Save life!,” the mute plea I know so well from my patients — the plea of all life facing the abyss, if it be strongly, vividly, rightly alive.

Slowly losing hope that he would live to see another tomorrow, his mind began unraveling the yarn of yesterdays of which a life is woven:

As the blue and golden hours passed, I continued steadily on my downward trek, which had become so smooth, so void of difficulties, that my mind could move free of the ties of the present… Hundreds of memories would pass through my mind, in the space between one boulder and the next, and yet each was rich, simple, ample, complete, and conveyed no sense of being hurried through… Entire scenes were re-lived, entire conversations re-played, without the least abbreviation. The very earliest memories were all of our garden — our big old garden in London, as it used to be before the war. I cried with joy and tears as I saw it — our garden with its dear old iron railings intact, the lawn vast and smooth, just cut and rolled (the huge old roller there in a corner); the orange-striped hammock with cushions bigger than myself, in which I loved to roll and swing for hours; and the enormous sunflowers, whose vast inflorescences fascinated me endlessly and showed me at five the Pythagorean mystery of the world…

All of these thoughts and images, involuntarily summoned and streaming through my mind, were essentially happy, and essentially grateful. And it was only later that I said to myself “What is this mood?” and realized that it was a preparation for death. “Let your last thinks all be thanks,” as Auden says.

Just as the sun set and dusk began descending with its promise of darkness and death, the improbable happened: Two reindeer hunters, a father and a son, emerged atop a nearby rock as though out of thin air, saw that struggling “creature of muscle, motion and music,” and ran toward him. Dr. Sacks recounts:

I had become almost totally unaware of the environment, having, at some level, given up all thoughts of rescue and life, so that rescue, when it came, came from nowhere, a miracle, a grace, at the very last moment.

As if this miraculous salvation by literature, music, and human kindness wasn’t already a most remarkable testament to Dr. Sacks’s genius and tenacity of spirit, the story took an even more moving turn as he found himself at the hospital, at once immensely grateful for his life and terrified of the long journey toward an uncertain recovery:

There was to be another story or, perhaps, another act in the same strange complex drama, which I found utterly surprising and unexpected at the time and almost beyond my comprehension or belief.

Dr. Sacks during his recovery (photograph courtesy of Oliver Sacks)

Bedridden in a small Norwegian hospital, in the so-called care of an uncaring and downright hostile nurse, he found most anguishing of all the complete privation of music. He longed for it “hungrily, thirstily, desperately.” At last, a friend brought him a tape recorder with a single cassette — Mendelssohn’s Violin Concerto.

Dr. Sacks recounts the reprise of music’s enlivening role in the story of his survival:

It was (and remains) a matter of amazement to me that this charming, trifling piece of music should have had such a profound and, as it turned out, decisive effect on me. From the moment the tape started, from the first bars of the Concerto, something happened, something of the sort I had been panting and thirsting for, something that I had been seeking more and more frenziedly with each passing day, but which had eluded me. Suddenly, wonderfully, I was moved by the music. The music seemed passionately, wonderfully, quiveringly alive — and conveyed to me a sweet feeling of life. I felt, with the first bars of the music, a hope and an intimation that life would return to my leg — that it would be stirred, and stir, with original movement, and recollect or recreate its forgotten motor melody. I felt, in those first heavenly bars of music, as if the animating and creative principle of the whole world was revealed, that life itself was music, or consubstantial with music; that our living moving flesh, itself, was “solid” music — music made fleshy, substantial, corporeal.

[…]

The sense of hopelessness, of interminable darkness, lifted… A sense of renewal grew upon me.

Dr. Sacks during his recovery (photograph courtesy of Oliver Sacks)

In the remainder of A Leg to Stand On — a book as invigorating as Mendelssohn’s concerto — Dr. Sacks goes on to explore the mysterious machinery that carries the human mind and body to recovery after serious injury. Complement it with Dr. Sacks on storytelling and the psychology of writing and his breathtaking autobiography, which remains one of the most rewarding reading experiences of my life.

Original illustrations by Wendy MacNaughton

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19 JUNE, 2015

Oliver Sacks on Storytelling, the Curious Psychology of Writing, and What His Friendship with the Poet Thom Gunn Taught Him About Creativity and Originality

By:

“The act of writing is an integral part of my mental life; ideas emerge, are shaped, in the act of writing… a special, indispensable form of talking to myself.”

Who we are and who we become is in large part the combinatorial product of the people and ideas we surround ourselves with — what William Gibson so memorably termed our “personal micro-culture” and Brian Eno called “scenius.” The more different those people are from us, the more they expand the echo chamber of our own mind, the more layered and beautiful the symphony of the spirit becomes. Nowhere is this self-expansion via relationship more evident than in the friendships between great artists and great scientists, one of the most heartening examples of which is the friendship between legendary neurologist Oliver Sacks and the poet Thom Gunn.

In On the Move: A Life (public library) — the immeasurable and incompressible rewards of which I have previously extolled at great length and with great love — Dr. Sacks, a Thoreau of the mind, recounts how his relationship with Gunn shaped his own evolution as a writer. In fact, his very autobiography is titled after Gunn’s poem “On the Move” from his 1959 collection Sense of Movement.

Thom Gunn in the early 1960s, around the time Dr. Sacks met him (Courtesy of Oliver Sacks)

To be sure, Sacks’s love affair with writing predates his meeting Gunn and even his foray into science. Nicknamed Inky as a boy for his voracious appetite for pen and paper, which covered everything in ink, he began journaling at an early age — a formative practice of learning to think on paper and converse with himself. Joining the extensive roster of celebrated writers who championed the creative benefits of keeping a diary and speaking to the potency of journaling as an antidote to Tom Waits’s complaint about the inopportune timing of the muse, Sacks writes:

I started keeping journals when I was fourteen and at last count had nearly a thousand. They come in all shapes and sizes, from little pocket ones which I carry around with me to enormous tomes. I always keep a notebook by my bedside, for dreams as well as nighttime thoughts, and I try to have one by the swimming pool or the lakeside or the seashore; swimming too is very productive of thoughts which I must write, especially if they present themselves, as they sometimes do, in the form of whole sentences or paragraphs…

But for the most part, I rarely look at the journals I have kept for the greater part of a lifetime. The act of writing is itself enough; it serves to clarify my thoughts and feelings. The act of writing is an integral part of my mental life; ideas emerge, are shaped, in the act of writing.

My journals are not written for others, nor do I usually look at them myself, but they are a special, indispensable form of talking to myself.

Dr. Sacks captures a thought in his journal at Amsterdam's busy train station (Photograph: Lowell Handler)

He adds:

The need to think on paper is not confined to notebooks. It spreads onto the backs of envelopes, menus, whatever scraps of paper are at hand. And I often transcribe quotations I like, writing or typing them on pieces of brightly colored paper and pinning them to a bulletin board.

What Sacks is describing is akin to a commonplace book — that Medieval Tumblr in which thinkers recorded quotations and ideas from whatever they were reading, assembling a personal archive of the ideas that shaped their own minds. (Brain Pickings is essentially one giant commonplace book, and this very piece a sort of bulletin board pinned to which is my discourse with Sacks’s extraordinary text.)

Another thought recorded atop a car roof on the side of the road (Courtesy of Oliver Sacks)

By the time he was in graduate school, Sacks began externalizing these inner conversations, doing for others what he had been doing for himself on the pages of his journals — clarifying the complexities of mental life at the intersection of science and storytelling, honing the singular gift for which he is so beloved today.

He was so electrified by working with patients at a migraine clinic in the mid-1960s that he felt compelled to transmute these insights into a book. But when he finally finished the manuscript and showed it to his boss at the clinic — a prominent but petty and egomaniacal neurologist by the name of Arnold P. Friedman — he was curtly told that the manuscript was garbage, that he had to destroy it, and that he dare not think about turning it into a book ever again; or else, Friedman threatened, Sacks would be promptly fired and barred from getting another job anywhere in America. Friedman confiscated the manuscript and locked it away.

Still, Sacks trusted that he had written something substantive and important — something that might forever change our understanding of how the mind works. He suppressed his feelings for months but, finally, the resentment exploded into action: One night, with the help of the clinic’s janitor, he sneaked in and, between midnight and 3 A.M., arduously copied his own notes by hand. The next day, he told Friedman he was taking a long leave to London and when his boss demanded a reason, Sacks responded that he had no choice but to write the forbidden book.

He was fired via telegram a week later. And yet a strange sense of liberation set in, which he poured into the writing.

But if this wasn’t courageous enough an act, he soon performed what is perhaps the greatest act of creative courage — the same one John Steinbeck had performed three decades earlier in destroying a manuscript he didn’t feel was good enough and rewriting it from scratch into what would become his Pulitzer-winning novel The Grapes of Wrath, the cornerstone of his Nobel Prize. Sacks recounts:

I was dissatisfied with my 1967 manuscript and decided to rewrite the book. It was the first of September, and I said to myself, “If I do not have the finished manuscript in Faber’s hands by September 10, I shall have to kill myself.” And under this threat, I started writing. Within a day or so, the feeling of threat had disappeared, and the joy of writing took over. I was no longer using drugs, but it was a time of extraordinary elation and energy. It seemed to me almost as though the book were being dictated, everything organizing itself swiftly and automatically. I would sleep for just a couple of hours a night. And a day ahead of schedule, on September 9, I took the book to Faber & Faber. Their offices were in Great Russell Street, near the British Museum, and after dropping off the manuscript, I walked over to the museum. Looking at artifacts there — pottery, sculptures, tools, and especially books and manuscripts, which had long outlived their creators — I had the feeling that I, too, had produced something. Something modest, perhaps, but with a reality and existence of its own, something that might live on after I was gone.

I have never had such a strong feeling, a feeling of having made something real and of some value, as I did with that first book, which was written in the face of such threats from Friedman and, for that matter, from myself. Returning to New York, I felt a sense of joyousness and almost blessedness. I wanted to shout, “Hallelujah!” but I was too shy. Instead, I went to concerts every night — Mozart operas and Fischer-Dieskau singing Schubert — feeling exuberant and alive.

Sacks’s jubilant intuition wasn’t misplaced — that manuscript became his 1970 debut Migraine, which was welcomed with wholehearted critical acclaim and catapulted him into the status of masterful science storyteller. When the book came out, he found out that Friedman had adapted the original manuscript and attempted to publish it under his own name — a tragicomic testament to the fact that it is Sacks’s singular gift as a writer and storyteller, not his scientific genius alone, that make him the cultural icon he is today.

Dr. Sacks recovering in the hospital with nothing but a typewriter by his side. He had broken his leg in Norway, falling down a slippery canyon while being chased by a bull. (Courtesy of Oliver Sacks)

Sacks had befriended Thom Gunn in the early 1960s, but it wasn’t until after the publication of Migraine that he was able to engage with the poet in conversations about writing more confidently — a confidence further nurtured by Gunn’s encouraging feedback which, alongside the staunch support of Sacks’s beloved aunt Lennie, was instrumental in emboldening the budding writer to embark upon this far from easy path.

He talked with Gunn about “the process of writing, the rushes and stoppages, the illuminations and darknesses, which seemed to be part and parcel of the creative process.” Long before cognitive scientists came to study the psychology of writing, Gunn captured the mysterious psychological messiness of the process in one of his letters to Sacks:

I am a bit slothful at the moment. My pattern seems to be: a long cessation of any coherent writing after I have completed a MS, then a tentative start followed by, during the next few years, various separate bursts of activity, ending with a sense of the new book as a whole, in which I make discoveries about my subject(s) that I have never anticipated. It’s strange, the psychology of being a writer. But I suppose it’s better not to be merely facile — the blocks, the feelings of paralysis, the time when language itself seems dead, these all help me in the end, I think, because when the “quickenings” do come they are all the more energetic by contrast.

Sacks reflects on the sincerity of his friend’s values:

It was crucial for Thom that his time be his own; his poetry could not be hurried but had to emerge in its own way… “My income,” [he] wrote, “averages about half that of a local bus-driver or street sweeper, but it is of my own choosing, since I prefer leisure to working at a full-time job.” But I do not think Thom felt too constrained by his slender means; he had no extravagances (though he was generous with others) and seemed naturally frugal. (Things eased up in 1992, when he received a MacArthur Award, and after this he was able to travel more and enjoy some financial ease, to indulge himself a bit.)

I was particularly taken, and felt a deep kinship, with Sacks’s parenthetical note about Gunn’s ethos regarding writing about the writing of others:

Thom rarely reviewed what he did not like, and in general his reviews were written in the mode of appreciation.

Despite knowing his friend’s disposition toward criticism, Sacks recounts:

I sometimes felt terrified of his directness — terrified, in particular, that he would find my writings, such as they were, muzzy, dishonest, talentless, or worse.

But their relationship lived up to Emerson’s assertion that “a friend is a person with whom [one] may be sincere” — Gunn’s feedback, always in the spirit of Samuel Beckett’s masterwork of constructive criticism, was monumentally beneficial to Sacks’s development as a writer, who was “eager for [Gunn’s] reactions, depended on them, and gave them more weight than those of anyone else.”

Dr. Sacks on the set of the cinematic adaptation of his book Awakenings, with Robin Williams, 1989 (Courtesy of Oliver Sacks)

But the feedback that most touched him was about his 1973 book Awakenings — a cultural classic that has was eventually made into a film starring Robin Williams as Sacks. Gunn wrote:

Awakenings is, anyway, extraordinary. I remember when, some time in the late Sixties, you described the kind of book you wanted to write, simultaneously a good scientific book and worth reading as a well-written book, and you have certainly done it here… I have also been thinking of the Great Diary you used to show me. I found you so talented, but so deficient in one quality — just the most important quality — call it humanity, or sympathy, or something like that. And, frankly, I despaired of your ever becoming a good writer, because I didn’t see how one could be taught such a quality… Your deficiency of sympathy made for a limitation of your observation… What I didn’t know was that the growth of sympathies is something frequently delayed till one’s thirties. What was deficient in these writings is now the supreme organizer of Awakenings, and wonderfully so. It is literally the organizer of your style, too, and is what enables it to be so inclusive, so receptive, and so varied… I wonder if you know what happened. Simply working with the patients over so long, or the opening-up helped by acid, or really falling in love with someone (as opposed to being infatuated). Or all three…

Sacks adds:

I was thrilled by this letter, a bit obsessed, too. I did not know how to answer Thom’s question. I had fallen in love — and out of love — and, in a sense, was in love with my patients (the sort of love, or sympathy, which makes one clear-eyed).

But it was in Gunn’s poetry that Sacks found something else — something tremendously important to our understanding of how creativity works and the constant, necessary dialogue between influence and so-called originality mediated by our imperfect memory, of which Sacks has written beautifully. Reflecting on Gunn’s intricate tapestry of influences — his creative lineage of what Margaret Mead termed our “spiritual and mental ancestors” — Sacks writes:

I loved the sense of history, of predecessors, in many of Thom’s poems. Sometimes this was explicit, as in his “Poem After Chaucer” (which he sent me as a New Year’s card in 1971); more often it was implicit. It made me feel at times that Thom was a Chaucer, a Donne, a Lord Herbert, who now found himself in the America, the San Francisco, of the late twentieth century. This sense of ancestors, of predecessors, was an essential part of his work, and he often alluded to, or borrowed from, other poets and other sources. There was no tiresome insistence on “originality,” and yet, of course, everything he used was transmuted in the process.

Gunn himself, echoing Montaigne’s sentiments about originality, addressed this in an autobiographical essay:

I must count my writing as an essential part of the way in which I deal with life. I am however a rather derivative poet. I learn what I can from whom I can. I borrow heavily from my reading, because I take my reading seriously. It is part of my total experience and I base most of my poetry on my experience. I do not apologize for being derivative… It has not been of primary interest to develop a unique poetic personality, and I rejoice in Eliot’s lovely remark that art is the escape from personality.

Dr. Sacks at home on City Island, the Bronx (Courtesy of Oliver Sacks)

And yet art requires undisturbed personal space for the “quickenings” of the creative process to unfold slowly — something Sacks protected with great discipline as he blossomed into a prolific writer himself. In his house on City Island, he tacked a sign to the wall above his desk that simply read “NO!” — “reminding myself to say no to invitations so I could preserve writing time,” he explains. It is no accident that Sacks dedicates the final sentences in his autobiography to this great love of writing and, in a sentiment that calls to mind the psychology of flow, fuses it with his great gift for science:

I am a storyteller, for better and for worse.

I suspect that a feeling for stories, for narrative, is a universal human disposition, going with our powers of language, consciousness of self, and autobiographical memory.

The act of writing, when it goes well, gives me a pleasure, a joy, unlike any other. It takes me to another place — irrespective of my subject — where I am totally absorbed and oblivious to distracting thoughts, worries, preoccupations, or indeed the passage of time. In those rare, heavenly states of mind, I may write nonstop until I can no longer see the paper. Only then do I realize that evening has come and that I have been writing all day.

Over a lifetime, I have written millions of words, but the act of writing seems as fresh, and as much fun, as when I started it nearly seventy years ago.

Oliver Sacks writing in his seventies (Photograph: Bill Hayes)

Every page of the altogether magnificent On the Move emanates this contagious delight in writing and furnishes an equivalent delight in reading — a sense of being invited, in the most generous way possible, into a lifetime of Sacks’s conversations with his own luminous, incessantly quickening mind. Take another step inside.

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26 MAY, 2015

The Power of Unconditional Love: How Oliver Sacks’s Beloved Aunt Shaped His Life and Inspired His Courageous Dance with Death

By:

“I shall hope against hope that you may weather this misery, and be restored again to the joy of full living.”

The history of creative culture is strewn with silent supporters whose unconditional love and encouragement have carried artists and thinkers to greatness. Although practical help can be enormously vitalizing — without the patronage of Nadezhda von Meck, Tchaikovsky may have never become Tchaikovsky; without the man who helped him quit his soul-sucking day-job to become a full-time writer, Bukowski may have died a postal worker — it is spiritual support that best sustains the creative spirit: What would young James Joyce have been without Ibsen or Maurice Sendak without Ursula Nordstrom or Albert Camus without his childhood teacher or Beckett without his one true believer?

One of the most touching testaments to this nourishing power of unconditional support comes from Oliver Sacks and his relationship with his aunt Lennie, which Dr. Sacks recounts with great affection in On the Move: A Life (public library) — his magnificent memoir of love, lunacy, and a life well lived, one of the most moving books I have ever read.

Lennie (Courtesy of Oliver Sacks)

Lennie, born Helena Penina Landau in 1892, was one of his mother’s six sisters and the founder of London’s poetically named Jewish Fresh Air School for Delicate Children. “Delicate,” as Dr. Sacks explains, could refer to “anything from autism to asthma or simply ‘nerviness'” — but the school’s focus bespoke, most of all, Lennie’s keen sensitivity to difference and to children’s anguishing consciousness of being different, whatever the degree or direction of difference.

In that sense, young Oliver was certainly a “delicate” child, and a “delicate” young man, and it was Lennie’s unflinching support that carried him forward — toward becoming a writer and, above all, toward becoming himself. Where his mother had summarily rejected him, proclaiming that he was “an abomination” for being gay, Lennie accepted him unconditionally and enveloped him in her wholehearted love. Dr. Sacks writes:

I felt very loved by her, and I loved her intensely too, and this was a love without ambivalence, without conditionality. Nothing I could say could repel or shock her; there seemed no limit to her powers of sympathy and understanding, the generosity and spaciousness of her heart.

Although Lennie had been close with his mother throughout Oliver’s childhood, it wasn’t until he moved to Canada and they were separated by an ocean that his own closeness with Lennie — who was exactly forty years his senior — began to blossom through their frequent and sincere correspondence. She addressed his letters “Darling Bol,” and occasionally “Boliver,” which Dr. Sacks contrasts with his parents’ more formal and somber “Dear Oliver,” adding:

I did not feel she used the word “Darling” lightly.

Lennie — a woman who paid generous and loving attention to the world, noticing and noting the blooming almond trees outside her window — was also the first person in Dr. Sacks’s life to encourage his foray into writing, the very vocation he came to see as a pillar of his identity. (“I am a storyteller, for better and for worse,” he reflects in the closing pages of his autobiography, leaving no ambiguity as to his sense of purpose.) He recounts Lennie’s emboldening faith in his creative destiny:

She had felt, since my boyhood days, that I could and should be “a writer.”

So when Dr. Sacks made his first tentative steps into professional journalism in the 1960s, writing for a short-lived magazine called Seed, Lennie cheered on:

I am much enjoying Seed and like its whole format — the cover design, the luxurious paper, the lovely print, and the feeling for words that all you contributors have, whether grave or gay. . . . Will you be dismayed when I say how gloriously young (and of course vital) you all are.

In another letter, she further fertilized the spouting seed of the writing life:

You certainly seem to have found a more satisfying outlet for your restless and searching spirit. . . . I do miss you.

Eventually, 27-year-old Oliver sent her a number of pages from his travel journals, which he considered his first “pieces” — “self-conscious and precious in tone” but ones he hoped to publish one day. Lennie responded:

I received your amazing excerpts from your journals. I found the whole thing breathtaking. I was suddenly conscious that I was gasping physically.

When Dr. Sacks sank into a depression, Lennie was once again his steadfast support, writing in a letter:

You’ve got so much in your favour — brains, charm, presentability, a sense of the ridiculous, and a whole gaggle of us who believe in you.

But for Dr. Sacks, she was a gaggle of one, the nourishing power of her faith in him a potent source of spiritual vitality:

Len’s belief in me had been important since my earliest years, since my parents, I thought, did not believe in me, and I had only a fragile belief in myself.

Under the beams of Lennie’s warming love, that fragile belief was fortified into a lifelong dedication to writing. A few years later, Dr. Sacks published his first book, Migraine, followed by the now-legendary Awakenings, which was eventually adapted into the famous film of the same title starring Robin Williams as Dr. Sacks.

Dr. Sacks on the set of the cinematic adaptation of his book Awakenings, with Robin Williams, 1989 (Courtesy of Oliver Sacks)

But it was Lennie’s exit from Dr. Sacks’s life that provided at least as vital an influence as her supportive presence.

When 86-year-old Lennie was admitted to the hospital for a simple operation, something went terribly wrong and she awoke hooked to an IV. Dr. Sacks writes:

When Lennie learned of this, she felt that life with intravenous nourishment and a spreading cancer was not worthwhile. She resolved to stop eating, though she would take water. My father insisted she be seen by a psychiatrist, but the psychiatrist said, “She is the sanest person I have ever seen. You must respect her decision.”

I flew to England as soon as I heard about this and spent many happy but infinitely sad days at Lennie’s bedside as she was growing weaker. She was always and totally herself despite physical weakness.

What a stark contrast this offers with Dr. Sacks’s earliest experience of losing a loved one — the death of his first great love from cancer at a young age was felt as a rupture, with a heartbreaking sense of absence, whereas his final days with Lennie were filled with a deep sense of communion and wholehearted presence.

I am reminded, too, of Albert Camus, who famously asserted that the decision whether to live or whether to die is the most important question of philosophy. But a more important question, perhaps — one at the heart of Lennie’s choice — is how to live and how to die.

Dr. Sacks captures this beautifully in his final letter to her from the end of 1978 — a letter he never knew if she read:

Dearest Len,

We have all of us been hoping so intensely that this month would see your return to health; but, alas! this was not to be.

My heart is torn when I hear of your weakness, your misery — and, now, your longing to die. You, who have always loved life, and been such a source of strength and life to so many, can face death, even choose it, with serenity and courage, mixed, of course, with the grief of all passing. We, I, can much less bear the thought of losing you. You have been as dear to me as anyone in this world.

I shall hope against hope that you may weather this misery, and be restored again to the joy of full living. But if this is not to be, I must thank you — thank you, once again, and for the last time, for living — for being you.

Love, Oliver

Dr. Sacks on his new 250cc Norton motorbike in 1956 (Photograph: Charles Cohen)

Suddenly, a luminous thread reveals itself between Lennie’s courageous exit from life and Dr. Sacks’s own. “It is up to me now to choose how to live out the months that remain to me,” he wrote in his breath-stopping farewell to the world as he confronted his own terminal cancer diagnosis. “I have to live in the richest, deepest, most productive way I can… I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.”

As I reread and reread On the Move, hoping against hope that Dr. Sacks weathers mortality, I find myself filled with a profound sense of gratefulness for all that he has given us, for the innumerable ways in which he was elevated and illuminated our world, for everything that he is. And my soul echoes: “Thank you, once again, and for the last time, for living — for being you.”

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18 MAY, 2015

Love, Lunacy, and a Life Fully Lived: Oliver Sacks, the Science of Seeing, and the Art of Being Seen

By:

A touching celebration of the “intense sense of love, death, and transience, inseparably mixed.”

“I have been able to see my life as from a great altitude, as a sort of landscape, and with a deepening sense of the connection of all its parts,” visionary neurologist Oliver Sacks wrote in his poignant, beautiful, and courageous farewell to life. In one final gesture of generosity, this cartographer of the mind and its meaning maps the landscape of his remarkable character and career in On the Move: A Life (public library) — an uncommonly moving autobiography, titled after a line from a poem by his dear friend Thom Gunn: “At worst,” wrote Gunn, “one is in motion; and at best, / Reaching no absolute, in which to rest, / One is always nearer by not keeping still.” Sacks’s unstillness is that of a life defined by a compassionate curiosity — about the human mind, about the human spirit, about the invisibilia of our inner lives.

The book is not so much an autobiography in the strict sense as a dialogue with time on the simultaneous scales of the personal (going from world-champion weightlifter to world-renowned neurologist), the cultural (being a gay man looking for true love in the 1960s was nothing like it is in our post-DOMA, beTindered present), and the civilizational (watching horseshoe crabs mate on the beaches if City Island exactly as they did 400 million years ago on the shores of Earth’s primordial seas). This record of time pouring through the unclenched fingers of the mind’s most magnanimous patron saint has become one of the most rewarding reading experiences of my life — one I came to with deep reverence for Dr. Sacks’s intellectual footprint and left with deep love for his soul.

Dr. Sacks on the set of the cinematic adaptation of his book Awakenings, with Robin Williams, 1989 (Courtesy of Oliver Sacks)

Like Marie Curie, whose wounds and power sprang from the same source, Dr. Sacks’s character springs from the common root of his pain and his pleasure. At eighty, he reflects on a defining feature of his interior landscape:

I am shy in ordinary social contexts; I am not able to “chat” with any ease; I have difficulty recognizing people (this is lifelong, though worse now my eyesight is impaired); I have little knowledge of and little interest in current affairs, whether political, social, or sexual. Now, additionally, I am hard of hearing, a polite term for deepening deafness. Given all this, I tend to retreat into a corner, to look invisible, to hope I am passed over. This was incapacitating in the 1960s, when I went to gay bars to meet people; I would agonize, wedged into a corner, and leave after an hour, alone, sad, but somehow relieved. But if I find someone, at a party or elsewhere, who shares some of my own (usually scientific) interests — volcanoes, jellyfish, gravitational waves, whatever — then I am immediately drawn into animated conversation…

But Dr. Sacks’s intense introversion is also what made him such an astute listener and observer — the very quality that rendered him humanity’s most steadfast sherpa into the strange landscape of how minds other than our own experience the seething cauldron of mystery we call life.

On one particular occasion, the thrill of observation swelled to such proportions that it eclipsed his chronic introversion. He recounts:

I almost never speak to people in the street. But some years ago, there was a lunar eclipse, and I went outside to view it with my little 20x telescope. Everyone else on the busy sidewalk seemed oblivious to the extraordinary celestial happening above them, so I stopped people, saying, “Look! Look what’s happening to the moon!” and pressing my telescope into their hands. People were taken aback at being approached in this way, but, intrigued by my manifestly innocent enthusiasm, they raised the telescope to their eyes, “wowed,” and handed it back. “Hey, man, thanks for letting me look at that,” or “Gee, thanks for showing me.”

In a sense, Dr. Sacks has spent half a century pushing a telescope into our hands and inviting us, with the same innocent and infectious enthusiasm, to peer into an object even more remote and mysterious — the human mindscape — until we wow. And although he may paint himself as a comically clumsy genius — there he is, dropping hamburger crumbs into sophisticated lab equipment; there he is, committing “a veritable genocide of earthworms” in an experiment gone awry; there he is, watching nine months of painstaking research fly off the back of his motorcycle into New York’s densest traffic — make no mistake: This is a man of enormous charisma and grace, revealed as much by the details of his life as by the delight of his writing.

Dr. Sacks's official portrait as a UCLA resident, taken at the neuropathology lab in 1964 (Courtesy of Oliver Sacks)

Nowhere does Dr. Sacks’s grace shine most luminously than in the disarming vulnerability — sometimes pensive, often poignant, always profound — with which this great seer discusses the heartbreak of not being seen himself, especially when it comes to the most intimate frontier of the human psyche. He recounts a pivotal conversation with his father as he was about to depart for his university studies at Oxford at the age of eighteen:

“You don’t seem to have many girlfriends,” he said. “Don’t you like girls?”

“They’re all right,” I answered, wishing the conversation would stop.

“Perhaps you prefer boys?” he persisted.

“Yes, I do — but it’s just a feeling — I have never ‘done’ anything,” and then I added, fearfully, “Don’t tell Ma — she won’t be able to take it.” But my father did tell her, and the next morning she came down with a face of thunder, a face I had never seen before. “You are an abomination,” she said. “I wish you had never been born.” Then she left and did not speak to me for several days. When she did speak, there was no reference to what she had said (nor did she ever refer to the matter again), but something had come between us.

Photograph by Oliver Sacks, 1960s (Courtesy of Dr. Sacks for Brain Pickings)

This experience, which left an indelible imprint of shame on young Oliver’s mind, is doubly perplexing and heartbreaking in the context of his parents’ credentials — both were prominent physicians, which would ordinarily imply the unsuperstitious critical thinking that science espouses. In fact, his mother, a female surgeon and anatomist at the dawn of the twentieth century, was a trailblazer for women in science — so much so that his father would jokingly refer to himself as “the husband of the eminent gynecologist Elsie Landau.” And yet even here, Dr. Sacks is able to transcend the personal devastation and perform the great act of empathic inquiry that became the raw material of his work — a dedication to considering the complex reality of another, very different mind:

We are all creatures of our upbringings, our cultures, our times. And I have needed to remind myself, repeatedly, that my mother was born in the 1890s and had an Orthodox upbringing and that in England in the 1950s homosexual behavior was treated not only as a perversion but as a criminal offense. I have to remember, too, that sex is one of those areas — like religion and politics — where otherwise decent and rational people may have intense, irrational feelings.

And herein blooms a vibrant example of the very thing that makes the book so extraordinary — the elegance with which Dr. Sacks bridges the observations of the mind with the tribulations of the heart:

My mother did not mean to be cruel, to wish me dead. She was suddenly overwhelmed, I now realize, and she probably regretted her words or perhaps partitioned them off in a closeted part of her mind. But her words haunted me for much of my life and played a major part in inhibiting and injecting with guilt what should have been a free and joyous expression of sexuality.

That paralyzing inhibition followed him into university, but because guilt is a judgment of reason and the heart has its own emotive will, he eventually found himself falling in love for the first time — in spite of himself, in spite of his mother’s anguishing admonition, in spite of his brother’s well-meaning but woefully misguided effort to alleviate his sexual shyness by introducing him to a kindly French prostitute, who sensed young Oliver’s predicament and instead had “a nice cup of tea” with him.

Oliver Sacks in Oxford in 1953 (Photograph: David Drazin)

At Oxford, he met a young fellow named Richard Selig — a Rhodes scholar of enormous “vitality and love of life,” who “bore himself like a lion.” Dr. Sacks recounts those first flutterings of love:

We got talking; I suspect that it was he who started a conversation, for I was always too shy to initiate any contact and his great beauty made me even shyer… His knowledge of the world was far greater than mine, even given the disparity of age (he was twenty-four; I was twenty), far greater than that of most undergraduates who had gone straight from school to university with no experience of real life in between. He found something interesting in me, and we soon became friends — and more, for I fell in love with him. It was the first time in my life I had fallen in love. I fell in love with his face, his body, his mind, his poetry, everything about him. He would often bring me just-written poems, and I would give him some of my physiology essays in return.

[…]

We would go on long walks together, talking about poetry and science. Richard loved to hear me wax enthusiastic about chemistry and biology, and I lost my shyness when I did so. While I knew that I was in love with Richard, I was very apprehensive of admitting this; my mother’s words about “abomination” had made me feel that I must not say what I was. But, mysteriously, wonderfully, being in love, and in love with a being like Richard, was a source of joy and pride to me, and one day, with my heart in my mouth, I told Richard that I was in love with him, not knowing how he would react. He hugged me, gripped my shoulders, and said, “I know. I am not that way, but I appreciate your love and love you too, in my own way.” I did not feel rebuffed or brokenhearted. He had said what he had to say in the most sensitive way, and our friendship continued, made easier now by my relinquishing certain painful and hopeless longings.

But just as young Oliver was making peace with the fact that he and Richard will only ever be friends — lifelong friends, perhaps — life took one of its cruel turns. One day, Richard showed up in Oliver’s room, concerned about a lump in his groin and asked his friend — since he was a medical student — to take a look. Oliver’s fears were confirmed — it was a malignant tumor. Richard was told he had no more than two years to live, and he never spoke to Oliver again. “I was the first to recognize the deadly import of his tumor,” Dr. Sacks writes with wistfulness so palpably and heartbreakingly unmitigated by the lapse of six decades, “and perhaps he saw me now as a sort of messenger or symbol of death.”

He was so devastated that his studies began to suffer and his parents decided it was best for him to take a leave from Oxford and spend some time in “a friendly and supportive community with hard physical work from dawn till dusk” — so, in 1955, he joined a kibbutz. The experience was transformative in not just the intended ways:

I had gone to the kibbutz as a pallid, unfit 250 pounds, but when I left it three months later, I had lost nearly 60 pounds and, in some deep sense, felt more at home in my own body.

Oliver Sacks in Greenwich Village in 1961, on his new BMW R60 (Photograph: Douglas White)

This was the start of Dr. Sacks’s love affair with the world of physique and strength training — a deeply personal proto-demonstration of something he’d later come to demonstrate as a pioneering neurologist: that the mind is indivisible from the body. In the years that followed, as he returned to clinical work, he also began weight training with a clinician’s systematic rigor. Eventually, he sliced through the country on the back of his beloved motorbike, armed with a camera and a newfound love for landscape photography — this, it bears repeating, is a man of ample talents — and made his way to Venice’s famous Muscle Beach. There, he came to be known as Dr. Squat for squatting with a gobsmacking 600 pounds — a feat by which he set the California state record in 1961. (Having done bodybuilding myself in a past life, my admiration for Dr. Sacks doubled.)

Dr. Squat setting the California state record in 1961

Eventually, Dr. Squat traded in his bike leathers and weightlifting belt for the white coat of Dr. Sacks. He fell in love again with a young man named Mel, only to have his heart broken by Mel’s conflicted rejection:

We enjoyed each other’s company for a year — the year of my internship at Mount Zion. We would go on weekend motorbike rides together, camping out, swimming in ponds and lakes, and sometimes wrestling together. There was an erotic frisson here for me, and perhaps for Mel too. Erotic with the urgent opposition of our bodies, though there was no explicit sexual element, nor would an observer have thought we were anything more than a couple of young men wrestling together. Both of us were proud of our washboard abdominals and would do sets of sit-ups, a hundred or more at a time. Mel would sit astride me, punching me playfully in the stomach with each sit-up, and I would do the same with him.

This I found sexually exciting, and I think he did too; Mel was always saying, “Let’s wrestle,” “Let’s do abs,” though it was not a purposively sexual act. We could work our abdominals or wrestle and get pleasure from it, at one and the same time. So long as things went no further.

I felt Mel’s fragility, his not fully conscious, lurking fear of sexual contact with another man, but also the special feeling he had for me, which, I dared to think, might transcend these fears. I realized I would have to go very gently.

But like those of us who have experienced the devastating disappointment of failing to dissolve another’s private conflictedness by the sheer force of love, Dr. Sacks discovered that all the gentleness in the world was hapless against the hard edges of Mel’s inner inhibitions. When the erotic and romantic tension between them became too much to bear, Mel left, leaving behind the cold ashes of a could-have-been. Its unlived potentiality — like all great unrealized longings — reveals itself as scar tissue of the soul as Dr. Sacks looks back a lifetime later:

I had had dreams, in our “honeymoon” period, that we would spend our lives together, even into a happy old age; I was all of twenty-eight at the time. Now I am eighty, trying to reconstruct an autobiography of sorts. I find myself thinking of Mel, of us together, in those early, lyrical, innocent days, wondering what happened to him, whether he is still alive… I wonder if he will read what I have just written and think more kindly of our ardent, young, very confused selves.

Photograph by Oliver Sacks, 1960s (Courtesy of Dr. Sacks for Brain Pickings)

The heartbreak of this almost-romance catapulted Dr. Sacks into a harrowing bout of amphetamine addiction, which he barely survived. After a couple of other short-lived infatuations, he entered a somewhat undeliberate period of celibacy that would last nearly four decades. What he didn’t find in romantic love he found in his work with patients — a profound sense of purpose and a deep love for how his work touched human lives. He writes:

It was crucial for me to find something with meaning, and this, for me, was seeing patients… I found my patients fascinating, and I cared for them. I started to taste my own clinical and therapeutic powers and, above all, the sense of autonomy and responsibility which I had been denied when I was still a resident in training.

Over the decades that followed, that fusion of fascination and love propelled Dr. Sacks into becoming the most influential neurologist of our time, irrevocably changing our understanding of the human mind and how it shapes the spirit. And because life has a way of dancing with its own strangeness, it was through the love of his work that Dr. Sacks finally found the love of his life. (As some wise friends have memorably advised, “If you are looking for the love of your life, stop; they will be waiting for you when you start doing things you love.”) Dr. Sacks writes:

Shortly after my seventy-fifth birthday in 2008, I met someone I liked. Billy, a writer, had just moved from San Francisco to New York, and we began having dinners together. Timid and inhibited all my life, I let a friendship and intimacy grow between us, perhaps without fully realizing its depth. Only in December of 2009, still recuperating from knee and back surgeries and racked with pain, did I realize how deep it was. Billy was going to Seattle to spend Christmas with his family, and just before he went, he came to see me and (in the serious, careful way he has) said, “I have conceived a deep love for you.” I realized, when he said this, what I had not realized, or had concealed from myself before — that I had conceived a deep love for him too — and my eyes filled with tears. He kissed me, and then he was gone.

[…]

There was an intense emotionality at this time: music I loved, or the long golden sunlight of late afternoon, would set me weeping. I was not sure what I was weeping for, but I would feel an intense sense of love, death, and transience, inseparably mixed.

Oliver Sacks (Photograph: Nicholas Naylor-Leland)

On the Move, the dedication page of which reads simply “for Billy,” is unsynthesizably transcendent in its totality — so immensely rewarding, so rich in private human truth and shared human wisdom, that compressing it into anything less than the full 416 pages is an injustice. As Dr. Sacks bids the world adieu, he leaves us with this miracle of a book — the ultimate gift of “love, death, and transience, inseparably mixed.”

Photographs courtesy of Oliver Sacks; special thanks to Kate Edgar

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