On Oliver Sacks

Why is Oliver Sacks, who died in 2015, revered by readers around the world? Consider “The Man who Mistook his Wife for a Hat”, an eleven-page chapter from the collection of the same name published in 1986. It begins like this: “Dr P. was a musician of distinction, well-known for many years as a singer, and then, at the local School of Music, as a teacher. It was here, in relation to his students, that certain strange problems were first observed”. Dr P. could not recognize the faces of his students, only their voices. Yet, “he saw faces when there were no faces to see: genially, Magoo-like, when in the street, he might pat the heads of water-hydrants and parking-meters, taking these to be the heads of children”.

A few days later, Sacks visits Dr P. in his spacious apartment, whose atmosphere, we are told, evokes fin-de-siècle Berlin. In Sacks’s briefcase is the score of the Dichterliebe, for he knew that Dr P. admired Schumann. Art precedes medicine: Sacks sits down and performs the composition on a “wonderful old piano”, as Dr P. sings with “the most incisive musical intelligence”. Now the neurological examination can begin: Sacks turns on the television and asks his patient to identify the lead actress in an old film (it is Bette Davis); he removes an “extravagant red rose” from his buttonhole and asks him to identify it; he quizzes him about the plot of Anna Karenina. Dr P. fails the exam, and declares: “You find me an interesting case, I perceive. Can you tell me what you find wrong, make recommendations?”

“I can’t tell you what I find wrong”, Sacks replies, “but I’ll say what I find right. You are a wonderful musician, and music is your life. What I would prescribe, in a case such as yours, is a life which consists entirely of music. Music has been the centre, now make it the whole, of your life.” That was four years ago, he adds. “I never saw him again.” The concluding paragraph is piercing: “Despite the gradual advance of his disease (a massive tumour or degenerative process in the visual parts of his brain) Dr P. lived and taught music to the last days of his life”.

In this narrative, one of the many “clinical tales” that Sacks would go on to produce in his velvety prose, we see a writer who has an intuitive feel for dramatic structure and form; whose medical, scientific and philosophical knowledge is lightly worn, whose compassion is deep and expressed with tact. Sacks’s influence was felt beyond the world of books. “He was most remarkable”, Andrew Solomon wrote in a Guardian obituary, “for bringing humanity to medicine and scientific rigour to narrative non-fiction.”

At Oxford, Sacks read Sir Thomas Browne, Swift, Gibbon, Pope and Hume, but also Conrad Gesner’s Historiae animalium (1551), in an edition illustrated by Dürer’s sketch of a rhinoceros, and Louis Agassiz’s four-volume work on fossil fish. His book-lust, which encompassed modernist novels and philosophy, served a larger ambition, one that he conceived in his youth: to fuse science and literature. In Sacks’s work, one hears echoes of (among others) Gogol, Chekhov, Joyce and Nabokov. His early readers noted the powerful influence of Borges. Indeed, in its texture, tone, brevity and emotional power, “The Man who Mistook his Wife for a Hat” is strikingly Borgesian.

In public appearances, Sacks, with his thick white beard, seemed jolly and avuncular. But readers of his absorbing memoir, On the Move, published three months before he died in 2015, encountered a more insecure and self-destructive man. In that book, Sacks discussed his drug addiction in the early 1960s (which nearly killed him); his penchant for swimming in rough waters (on several occasions he nearly drowned); his obesity (he liked to eat from the plates of friends and patients, and his weight fluctuated between 190 and 300 pounds); and the shame of his homosexuality, which kept him celibate for thirty-five years.

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Lawrence Weschler, a staff writer at the New Yorker from 1981 to 2002, has now given us a companion volume to On the Move. In his first year at the magazine, with the support of his editor, William Shawn, Weschler began to research a long profile of Sacks, whose writing he first encountered as a student in 1974. He worked on the piece for four years – bestowing “slow, long-term attention” on his subject and amassing a vast amount of material. Weschler interviewed Sacks’s closest medical colleagues and dearest childhood friends (among them the stage director and medical doctor the late Jonathan Miller, and Eric Korn, a former TLS columnist), and met his elderly, eccentric father; he accompanied his subject on a rowing expedition (in which Sacks displayed superhuman physical strength) and took him to a Vermeer exhibition; and he observed his clinical techniques in nursing homes and decrepit public hospitals. With a rabbinical zest for ideas and disputation, these two Jewish intellectuals exchanged books and essays (by T. S. Eliot, Hannah Arendt, Albert Camus, Thomas Bernhard) and discussed them over Chinese food, or in each other’s homes.

The profile went to the graveyard; it was never published in the New Yorker. Sacks had candidly discussed his homosexuality with Weschler, and could not bear to see that revelation in print; he asked Weschler to bury the piece. Yet the two men remained intimate friends, and, when Sacks learnt that he was dying, he insisted that Weschler finish the project he had abandoned decades before.

The results are stirring. There is hardly a dull page in And How Are You, Dr Sacks? – Weschler calls it a “biographical memoir” – which was initially researched between 1981 and 1984. His subject, then approaching fifty, was emerging from a cul-de-sac into distinction and fame. “In retrospect”, Weschler notes, “one sees the first half of the eighties as the virtual hinge of his professional and creative progress, as he seethed and churned to escape the demons of self-involvement veritably blocking any further advancement.” The book has an appealing tone and structure: it is quirky, collage-like, diaristic, defiantly bookish. When Weschler opened his old filing cabinets, he realized that his notebooks teemed with the kind of “table talk” that lit up Boswell’s Life of Johnson. Here is Sacks on why he chose neurology: “The heart … is just a pump. Neurology is the only branch of medicine that could sustain a thinking man”. On the beneficial effects of laughter: “the self who laughs is greater than the self who suffers – is momentarily outside the suffering self, liberated from it, laughing at it”. On Thomas Mann: “I’ve been reading The Magic Mountain. I am increasingly bothered by Mann – he is on the side of disease. He writes about pathology and calls it life”.

Future writers on Sacks will ransack Weschler’s book, not only because it is the most intimate portrait of him we are likely to get, but also because it illuminates the critical turning points in his early life and career: his flight from England in 1959; his California sojourn in the 1960s, when he was obsessed with solitary motorcycle journeys and drugs; his friendship with the poet Thom Gunn; and the protracted struggle to complete a book some close friends urged him to discard, A Leg To Stand On.

Sacks’s parents, who met at the Ibsen Society, are treated benevolently in On the Move. The memoir left readers with the impression that his departure from England on his twenty-seventh birthday was, in large part, an escape from a “tragic, hopeless, mismanaged brother”, who was schizophrenic. A more harrowing portrait of his early years – defined by what Sacks, in 1981, called “Jewish cruelty” – emerges from Weschler’s book. “My own parents”, Sacks informed his Boswell, “though not fanatically Orthodox, lived in a ghetto of their own making. My father to this day is always amazed when a goy turns out to be human.” When Weschler interviewed Eric Korn in 1982, he asked him to describe the house Sacks grew up in. “Ah yes, the incredible morbidity of 37 Mapesbury Road”, Korn replied. “It was like something out of a Hitchcock movie.”

Sacks’s mother was among the first female surgeons in London – “a veritable spider of a woman, in spite of being a very good doctor and a very kind woman outside her family”, according to Korn. Weschler reveals that when Sacks was about twenty, he ghost-wrote a book with his mother (Women of Forty: The Menopausal Syndrome, 1956), of which, Sacks insisted, 200,000 copies were in print. Weschler describes Oliver’s relationship with his mother as “too close”:

He was her youngest and a prodigy. She showered him with attention, often deeply affirming but at other times wildly inappropriate. Reading him D. H. Lawrence stories that were decidedly beyond his ken, for example. Or how one of the first buried memories to emerge during his psychoanalysis years later was how she used to bring home monstrosities from surgery – deformed embryos, fetuses in jars – this when he was ten, and then, when he was twelve, how she brought him along to perform the dissection of a child’s corpse.

Weschler is off by two years. In his earlier memoir, Uncle Tungsten: Memories of a chemical boyhood (2001), Sacks noted that he performed the autopsy, on a fourteen-year-old girl at the Royal Free Hospital in London, when he himself was fourteen. His mother “thrust the scalpel into my hand – she would be back in half an hour, she said, to see how I was getting on”.

The Yiddish-speaking father was a music-mad physician who began his practice in 1917. When Weschler met him in London in 1982 (“a short, roly-poly man with a little squib of a mustache”) he was sprightly and still practising medicine; he went to concerts nearly every evening, and kept dried fish in the boot of his car, which he handed out to patients and friends. When Oliver was in his late teens, his father inquired, in a menacing tone: “You don’t seem to have many girlfriends … perhaps you prefer boys?” “Yes, I do”, Oliver replied. The next morning his mother came down “with a face of thunder” and “hurling Deuteronomical curses”. Sacks would never forget a pungent offhand remark from his schizophrenic brother, a coda to the emotional history of the Sacks family: “I went mad so the rest of you could stay sane”.

In early 1962, Sacks began a residency at UCLA. One of his colleagues there, Bob Rodman, recalled him as “a big barrel-chested oddball”, who, on one occasion, drank blood chased down with milk: “There was something about his need to cross taboos”, Rodman told Weschler. He lived near Muscle Beach in Venice, and took up weight-lifting, once doing a squat with a 600 lb bar on his shoulders. He also began using amphetamines, as he admitted in his own writings and interviews. But what Sacks told Weschler still has the power to surprise: “I was a weekend addict … I’d take upward of a thousand milligrams. Now, a tablet is five milligrams, so I was taking doses of hundreds of tablets crushed and laced into a milk shake”. A reckoning was imminent. On New Year’s Eve, 1965, Sacks looked in the mirror and said to himself: “Ollie, old boy, you keep this up and you will not make it another year”. He soon found an analyst, Dr Leonard Shengold, who persuaded him to give up drugs. Shengold and Sacks would see each other twice a week for the next half-century.

It was Jonathan Miller who urged Sacks to look up the thirty-year-old Thom Gunn when he got to San Francisco. “He’s your sort of person.” In On the Move (Sacks borrowed the title of his memoir from the poem by Gunn), Sacks wrote that he was attracted to Gunn’s warmth, geniality and “fierce intellectual integrity”. To Weschler, he went further: “What had excited me in Thom Gunn’s poetry was its homoerotic lyricism, a romantic perverseness. The perverse transmuted into art”. From the onset of their friendship, in 1961, Gunn read drafts of Sacks’s work and provided hard-edged, sympathetic criticism. In 1973, after Sacks published Awakenings – a remarkable account of how he used L-dopa to resuscitate postencephalitic patients in a New York nursing home – Gunn sent him a letter that Sacks carried in his wallet for months.

Weschler interviewed Gunn in 1982, at a small espresso bar in the Castro. They discussed that letter. Sacks, Gunn explained, “has gone through the most extraordinary changes of anybody I have ever known”. When he first got to know Sacks in the early 60s, “he seemed to have a great inability to put himself inside the skin of others”:

The first Oliver I knew would have been the last person I would have thought capable of writing Awakenings. It was precisely his problem that he couldn’t sympathize with people enough. It wasn’t that he was lacking in kindness; rather he was lacking in sympathetic imagination. And that is of course what he has now – both in his conduct and his talk and his life and his writing – more than anyone else I know.

How did that transformation occur, Weschler inquired. “I know it’s unfashionable and dated to say this kind of thing, but I think Oliver might support me in saying this”, Gunn explained. “I think it may have had something to do with his taking a lot of acid, at a time when we were all taking a lot of acid … he did do a lot of chemical experimentation, I mean, outrageously extreme, far more than anyone else I knew.”

In 1974, Sacks went hiking in Norway. He was alone, and ignored a sign at the bottom of a mountain that said “Beware of the Bull”. He met the creature a few hours later. In On the Move, he wrote that his “fear induced a sort of hallucination: the bull’s face seemed to expand until it filled the universe”. He ran and lost his balance; his left leg was severely damaged. Dr Sacks was now a patient, and was determined to compose a narrative about the experience. But the project became a labyrinthine journey into himself, and left his friends and colleagues exasperated. “I think his Leg book is nonsense”, Korn said. Sacks’s London editor, Colin Haycraft, told Weschler: “It’s becoming a crushing bore, alas”. A Leg To Stand On took a decade to write, and when it appeared in 1984, it attracted unfavourable reviews.

Quite often, reading Sacks is like reading the mid-twentieth-century New Yorker writer Joseph Mitchell – one wonders, can this be completely true? In an author’s note in his collection Up in the Old Hotel (1992), Mitchell revealed that certain pieces that had appeared decades earlier in the New Yorker were “fictional”; others were “factual”. Weschler quotes a remark by Alan Bennett about Bruce Chatwin who, he suggested, “like Sebald, Kapuściński and Oliver Sacks”, operates “on the borders of truth and imagination”. Sacks himself could be opaque on matters of factuality. In 1983, he told Weschler, apropos his narrative about Dr P., which had appeared in the London Review of Books: “I mean, perhaps it’s a case that I seized on certain themes, imaginatively intensified, deepened, and generalized them. But still”. Two weeks later, Sacks said: “I don’t tell lies, though I may invent the truth”.

Weschler puts Sacks in the same category as Ryszard Kapuściński. For the work of both, he coins the term “Rhapsodic Nonfiction”. He notes that Sacks, as a writer, was blazing his own trail: “trying to advocate for and model a different sort of medicine on behalf of chronic, often institutionally warehoused and largely abandoned patients … the sort of patients often referred to as ‘hopeless’ or ‘mere vegetables’”. What’s more,

And here – and this is something Oliver’s blithe critics often failed to notice – narrative of this sort was part of the therapy itself. Helping to turn an It back into an I … or maybe a patient (an object) back into an agent (a subject) … Such people were privileged witnesses to and actors along the very remotest stretches of human possibility, and as such had marvelous stories to offer about such extreme vantages and experiences.

This is a matter on which a future biographer of Sacks will have to elaborate. It won’t be easy: many of the individuals Sacks wrote about are dead; others may prefer silence when confronted with questions about their treatment. Differentiating the factual from the fictional in Sacks’s work – and establishing the degree to which he, in his own words, invented the truth – is a herculean task for even the most enterprising biographer.