Saturday, May 9, 2015

The wonder and the weirdness

Originally published in The Weekend Australian, May 9-10, 2015

In February of this year, Oliver Sacks, the neurologist who practices medical writing as an art, published an essay announcing he is terminally ill. The cancer that cost him the sight of his right eye nine years ago has spread to his liver; he can now count his remaining time in months. The announcement was made with characteristic understatement (“my luck has run out”). It was characteristic, too, in its verve. Skipping self-pity, Sacks spoke bracingly of the time he has left. Resolving to live the rest of his life ecstatically, he made you resolve to live yours that way too. 

On the Move, the loose and slightly stand-offish autobiography that looks destined to be his last non-posthumous work, is the book of a man who has already written his masterpieces. Writing about himself, Sacks never quite attains the focus and gusto of his clinical case histories, which have been collected in such books as The Man Who Mistook His Wife for a Hat and An Anthropologist on Mars. A famously shy man, he is at his most incisive and forthcoming when examining minds other than his own. The current book offers some clues about why that is, but it’s up to the reader to put them together. Sacks isn’t interested in treating himself as a mystery.         

He was born in London in 1933. His Orthodox Jewish parents were both doctors – his mother a surgeon, his father a GP. When Oliver was 18, and just about to leave for Oxford, his father gently confronted him about his apparent preference for boys over girls. His mother was less subtle about it: quoting from the Book of Leviticus, she called her son an “abomination,” and said she wished he’d never been born.  

This outburst was never spoken of again, but it left its mark. In Britain in the 1950s, as in Australia, homosexual acts were against the law. Sacks mentions the haunting case of Alan Turing, the computer genius who helped crack the Enigma code during the war, and was rewarded by being prosecuted for sodomy. Offered the choice between prison and chemical castration by hormone treatment, Turing opted for the latter. 

The terrified young Sacks, then, was obliged to leave the country in order to have legal sex. He lost his virginity in Amsterdam the age of 22, in a less than ideal way. He drank himself into unconsciousness, woke up in the bed of a strange but friendly man, and was informed that he had been “buggered” in the interim. To put it another way, he was raped. Sacks himself doesn’t put it that way – it isn’t his style to make a big deal of things. Nor does he spend much time wondering, at least aloud, about the extent to which the fear and shame imposed on his sexual salad days overshadowed his later life, which has been dogged by a shyness that he has elsewhere called a “disease.” “It has sometimes seemed to me,” he writes, “that I have lived at a certain distance from life.” He reveals, strikingly, that after a “fling” on his fortieth birthday, he went without sex for a period of 35 years. If Sacks were one of his own case studies, he’d have energetically speculated about the reasons for these things. But this isn’t that sort of autobiography. We’re told, at one point, that he has been seeing the same psychoanalyst for the last 49 years. What they’ve been talking about we’re mainly left to guess.   

At the age of 27, Sacks left Britain for Canada and then America. The move wasn’t meant to be permanent, but he has lived and worked in the US ever since. His portrait of the neurologist as a young man, in San Francisco and then in New York, gives us a figure radically at odds with his latter-day image. The younger Sacks was a rugged long-distance motorcyclist, a record-breaking weightlifter, and a heavy user of LSD and amphetamines. 

He also harboured an ambition to write. His first book was Migraine, which arose from his work at a headache clinic in the Bronx. “There is only one cardinal rule,” he wrote in the book’s conclusion. “One must always listen to the patient.” That commitment has been vital to Sacks’s success, as both a physician and a writer. When I first read his headache book I was suffering from hellish migraines myself, and dreamed of encountering a neurologist as intrepid and engaged as its author. I can’t say I ever found one. 

Sacks’s boss at the headache clinic deemed the book “trash”, and fired him when he insisted on publishing it. This set a pattern: his peers either ignored or badmouthed his books, while general readers increasingly loved them. The trend continued with Awakenings, in which Sacks chronicled his work with patients entombed in their own bodies by encephalitis lethargica, or sleepy sickness. Sacks, who was shaggily portrayed in the movie version by Robin Williams, correctly intuited that these patients could be unfrozen by the drug L-dopa, which had proved useful as a treatment for Parkinson’s disease. 

Sack’s extraordinary powers of empathy as a doctor seem to have come from his father, the old-school GP who was still making house calls at the age of 93. You get the sense that he comes most alive in the presence of his patients, the way his patients, in Awakenings, finally came alive in his. “In a sense,” Sacks confesses, he was “in love with” his patients – “the sort of love, or sympathy, which makes one clear-eyed.” 

Outside the clinic, Sacks has been less lucky in love. Although he doesn’t say so outright, his uncanny ability to connect with his patients seems to be linked to his diffidence in the world at large. He is a curious man, in both senses of the word. Compounding his shyness, and perhaps explaining it, is the fact that he is face-blind: he has a rare condition that limits his ability to recognize faces, even his own. Having already written about this in The Mind’s Eye, Sacks makes only cursory reference to it in the current book. On this question as on others, he passes up the chance to provide us with a final reckoning.   

But one could put that another way, and indeed one should. Sacks has given us a full and rich account of himself already, in his books about the exceptional brains of others. The charm of his case histories lies in their readiness to flit playfully between genres, including autobiography. Sacks the man, with his ardent and cultured mind, is always present in them. You never know, reading him, when you’ll encounter the flash of art, the nimble leap from the specific to the general – from the subject of the study to everyone else, including you. Writing about a man plunged into a world of grey by radical colourblindness, say, Sacks makes you aware, as never before, of the vividness of a life lived in colour. 

Something similar happens in the title essay of An Anthropologist on Mars. The subject is Temple Grandin, the autistic savant who lacks a sense of the world’s beauty, and must comprehend the universe with her intellect only. “But do you get a feeling of its grandeur?” Sacks asks her. Grandin replies that she doesn’t. “You get such joy out of the sunset,” she tells him. “I wish I did, too.” At such moments Sacks startles you into appreciating the routine miracles of everyday mental functioning. He’ll be missed for the reason any great writer is missed: for his capacity to evoke the wonder and weirdness of being here.