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.
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:
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.
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.”
“So many doors open when you are present with an angle.”
By Maria Popova
“It is through [the] invisible holes in reality that poetry makes its way,” Adrienne Rich wrote in her sublime meditation on the art of the possible. Nothing gashes through reality more invisibly yet powerfully than love and nothing fills that rapturous rip more wholly than Anne Sexton’s 1969 volume Love Poems (public library) — a remarkable collection Sexton described as “a celebration of touch… physical and emotional touch,” published two years after she received the Pulitzer Prize.
In our second collaboration following a series of visual haikus based on Denise Levertov’s poetry, I asked the multidimensionally talented and thoughtful Montreal-based artist and musicianOhara Hale to bring to life my reading of Sexton’s “Song for a Lady” — one of the most bewitching and beautiful poems in the volume, and in any volume by any poet, celebrating the sensual love between two women.
Hale’s resulting animation, for which she composed an original score, is quite like poetry in that it distills the essence of a thing through an exquisite economy of form, using only line and perspective to channel an immensity of meaning.
SONG FOR A LADY by Anne Sexton
On the day of breasts and small hips
the window pocked with bad rain,
rain coming on like a minister,
we coupled, so sane and insane.
We lay like spoons while the sinister
rain dropped like flies on our lips
and our glad eyes and our small hips.
“The room is so cold with rain,” you said
and you, feminine you, with your flower
said novenas to my ankles and elbows.
You are a national product and power.
Oh my swan, my drudge, my dear wooly rose,
even a notary would notarize our bed
as you knead me and I rise like bread.
Hale’s concept, predicated on the mesmerism of angles, was inspired by legendary neurologist Oliver Sacks and his work on how the blind see the world. It sparked in her a fascination with how they construct a kaleidoscope of angularity, which led her to imagine how a dog is perceived not as a single dog but as a million dogs, each “seen” from a different angle. Many of the angles don’t resemble a “dog” in the pictorial sense but still contribute to the understanding of what a dog is.
This way of deconstructing the world into fragments and reconstructing them into a wholeness of understanding is so different from how we see via regular vision that, as Dr. Sacks so movingly wrote in The Mind’s Eye, the newly sighted are often utterly overwhelmed by having to process information in this new way and revert to “blindness,” closing their eyes and continuing to navigate the world scanning for angles.
Hale explains how this fascinating phenomenon planted the seed for her Sexton animation:
I love the idea of an unrecognized shape being called a “dog.” It doesn’t look like a dog, but it is a dog. If you look close enough you might see more than what you assume is in front of you.
Each frame is a piece of artwork to me. My favorite frames are the ones that look nothing like the object at hand, yet it is the object.
In this animation, we are looking at each angle of a swan, slowly. Sometimes, you may not recognize it at all; sometimes, you may. The lines are true and present and simple — inviting the viewer to appreciate each frame as its very own piece of art; to sit with it.
The swan, of course, is the object of this love poem. To love something is to truly love every angle, inside and out — the attractive and the unattractive, the familiar and the unfamiliar. To love something fully is to appreciate and understand each angle.
To me, this animation is an example of love, an experience of love, a viewpoint of love. So many doors open when you are present with an angle.
Like a poet, moving from the particular to the universal, Hale zooms out into a wider perspective on how our intimacy with all angles helps us swing open the doors of perception. She adds:
Life is made of many angles. It is important to investigate as many angles as you can. Perspectives. This is true in the physical world as it in the mental and spiritual world, too — true to all angles of existence.
If we approach life with this type of eyes, we can widen our perspective and see more: The more you can understand, the more you can love, the more compassion you have, and in a world of compassion, will you find peace. Suddenly, you find in the palm of your hand the entire universe — exactly where it has always been.
A touching celebration of the “intense sense of love, death, and transience, inseparably mixed.”
By Maria Popova
“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 neurologistOliver Sacks (July 9, 1933–August 30, 2015) 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 of 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.
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.
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.
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.
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.
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.)
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.
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.
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
“We see with the eyes, but we see with the brain as well.”
By Maria Popova
While our delusions may keep us sane, hallucinations — defined as perceptions that arise independently of external reality, as when we see, hear, or sense things that aren’t really there — are an entirely different beast, a cognitive phenomenon that mimics mysticism and has no doubt inspired mystical tales over the millennia. In the 18th century, Swiss lawyer-turned-naturalist Charles Bonnet, the first scientist to use the term evolution in a biological context, turned to philosophy after deteriorating vision rendered him unable to perform the necessary observations of science. Blindness eventually gave him a special form of complex visual hallucinations, known today as Charles Bonnet syndrome, but he was otherwise fully lucid and marveled, as a cognitive scientist might, at “how the theater of the mind could be generated by the machinery of the brain.”
Some 250 years later, pioneering neurologist Oliver Sacks (b. July 9, 1933) — who has previously explored the necessary forgettings of creativity and how music impacts the mind — picked up Bonnet’s inquiry in his immeasurably fascinating book Hallucinations (public library). In this TED talk based on the book, Sacks draws on his extensive clinical experience of working with patients, illuminating that astounding “theater of the mind” to shed light on what hallucinations reveal about how the mind works.
We see with the eyes, but we see with the brain as well. And seeing with the brain is often called imagination. And we are familiar with the landscapes of our own imagination, our inscapes. We’ve lived with them all our lives. But there are also hallucinations as well, and hallucinations are completely different. They don’t seem to be of our creation. They don’t seem to be under our control. They seem to come from the outside, and to mimic perception.
In the book, Sacks offers a detailed definition of hallucinations, contrasting them with regular perception and peering into their promise for better understanding the brain and the human mind:
When the word “hallucination” first came into use, in the early sixteenth century, it denoted only “a wandering mind.” It was not until the 1830s that Jean-Étienne Esquirol, a French psychiatrist, gave the term its present meaning — prior to that, what we now call hallucinations were referred to simply as “apparitions.” Precise definitions of the word “hallucination” still vary considerably, considerably, chiefly because it is not always easy to discern where the boundary lies between hallucination, misperception, and illusion. But generally, hallucinations are defined as percepts arising in the absence of any external reality— seeing things or hearing things that are not there.
Perceptions are, to some extent, shareable — you and I can agree that there is a tree; but if I say, “I see a tree there,” and you see nothing of the sort, you will regard my “tree” as a hallucination, something concocted by my brain or mind, and imperceptible to you or anyone else. To the hallucinator, though, hallucinations seem very real; they can mimic perception in every respect, starting with the way they are projected into the external world.
When you conjure up ordinary images— of a rectangle, or a friend’s face, or the Eiffel Tower —the images stay in your head. They are not projected into external space like a hallucination, and they lack the detailed quality of a percept or a hallucination. You actively create such voluntary images and can revise them as you please. In contrast, you are passive and helpless in the face of hallucinations: they happen to you, autonomously — they appear and disappear when they please, not when you please.
Hallucinations are “positive” phenomena, as opposed to the negative symptoms, the deficits or losses caused by accident or disease, which neurology is classically based on. The phenomenology of hallucinations often points to the brain structures and mechanisms involved and can therefore, potentially, provide more direct insight into the workings of the brain.
Hallucinations, which goes on to explore how advances in neuroimagining in the last few decades have greatly enhanced our understanding of hallucinations and the brain, is a mind-bending read in its entirety. Complement it with Sacks on the psychology of plagiarism.