Why Oliver Sacks Always Goes Too Far

The neurologist’s new memoir, On the Move, is a celebration of the fullness of human experiences.

When the celebrated neurologist and writer Oliver Sacks was a schoolboy, a teacher noted on his report card: “Sacks will go far, if he does not go too far.” It was a perceptive comment, for as it turned out, “going too far” was something Sacks would do throughout his life. The child pushed the limits of his chemistry set until the house filled with smoke, the young man filled himself with drugs at first for pleasure and experimentation—and then because of addiction. Recreational swimming would last for several hours in choppy waters, motorcycle rides would cross a continent, working out would result in his setting a California state record in weight lifting. “In the absence of internal controls,” he tells us in his memoir, “I have to have external ones.” As a gay man growing up in post-war England, sex was dangerous, and so in this domain Sacks displayed prudence (except when he didn’t, as when visiting Amsterdam). But after a “joyous” 40th “birthday fling” with a younger man, he has no sex for the next 35 years. Even in renunciation, he went very far indeed.

And Sacks settled far from home. Having completed his studies in medicine, he left his native England for North America.  Both his parents and two of his brothers were doctors, and he needed space—plenty of space. Perhaps more importantly, his brother Michael was schizophrenic, and the suffering that filled the family home was more than Oliver could bear. Oliver was the youngest Sacks, and he would make his career, and his “good name,” in the United States.

Going far career-wise was something Sacks fervently desired. “Here I am, look what I can do,” is how he describes his feelings about his first professional intervention into the American neurological community. Sacks would develop a genius for recognition of another sort, for paying attention to people whose illness might have rendered them invisible but for his gift of seeing them as beings with histories, with contexts. This genius he combined with his own craving for recognition—writing as a witness to the lives of others in such a way that he himself would be acknowledged through the quality of his testimony.

Many people discovered Sacks through his book Awakenings (1973) and the 1990 movie based upon it starring Robin Williams (as Sacks) and Robert DeNiro (as a patient). Sacks powerfully described his work with hospitalized patients seemingly frozen in a decades-long Parkinsonian sleep. For many years merely warehoused, they received from him the gift of attention; and then he treated them with the experimental drug L-DOPA, which seemed to bring them back to life. The physical awakenings turned out to be short-lived, alas, but the book raised powerful questions as to how we recognize and care for people living with, or rather alive within, profound illness.

Although he has always taken voluminous notes on his patients and filled hundreds of thousands of journal pages on myriad ideas that compelled him, Sacks often suffered from writer’s block. He tells us of his struggle to finish Awakenings, finally doing so as a tribute to his recently deceased mother. Sack’s tribute parallels Freud’s writing of The Interpretation of Dreams, which he had described as a reaction to the loss of his father. Both men lost a parent when they were about 40—Freud turning his attention to his patients’ dreams, Sacks striving to help his patients awaken from their slumbers.

Sacks sees himself in the tradition of Freud and of the Russian neurologist A. R. Luria, medical men who took upon themselves the depiction of the fullness of a patient’s life and not just the course of an illness. Their case studies are powerful narratives, and Sacks, too, wanted his clinical portraits to be recognized as literary achievements. When his friend, the poet W.H. Auden, praised Awakenings as a masterpiece, Sacks tells us he wept.

If Awakenings opened the door to literary acceptance and growing recognition, The Man Who Mistook His Wife for a Hat (1985) turned the neurologist/author into a public figure. The case study for which the collection is entitled is of a man with visual agnosia, the inability to recognize objects, even people. Sacks helps us see the world from this man’s perspective, and from the points of view of those who cared about him. Sacks has does the same for people with Tourretes, aphasia, amnesia, autism. He’s written before about his own prosopagnosia, which hinders his ability to recognize the faces of people he knows—even those he knows well. As a writer, he shifts our gaze from the horror of deficits to the wonder at the human ability to find a way to make sense of, even thrive in, an altered world. He says of his subjects that “[t]heir ‘conditions’ were fundamental to their lives and often a source of originality and creativity.”

Sacks, often drawing on his own suffering, doesn’t romanticize the horror that many of his patients have faced over the years. He just recognizes that “there is no prescribed path of recovery”; patients must create their own solutions to the challenges they face. Sacks has deep affinities with those poets and scientists who are at home with contingency, with the fact that our complex brains, and our complex lives, can come together in ways that we make meaningful through narrative reconstruction but that could never has been predicted in advance. He relates, tellingly, his attraction to Gerald Edelman’s neural Darwinism, picturing the brain “as an orchestra … without a conductor, an orchestra which makes its own music.” And he begins the book with an epigram from Kierkegaard: “Life must be lived forwards but can only be understood backwards.”

I’ve met Oliver Sacks only briefly, and he contributed an essay on Freud’s early neurological work to a volume I edited. Over the years, though, I had the sense of getting to know him while reading his intensely engaging accounts of people who take in the world or react to it so very differently than most. Like many of his readers, some months ago I responded with a sense of real personal sadness when reading Sacks’ New York Times op-ed announcing his “bad luck” of now facing a terminal cancer. I felt as if a vital window on the world were being closed.

On the Move is a glorious memoir that throws open that window and illuminates the world that we have seen through it. In this volume Sacks opens himself to recognition, much as he has opened the lives of others to being recognized in their fullness. In brief remarks on his almost 50 years of psychoanalysis, Sacks tells the reader that his analyst, Leonard Shengold, “has taught me about paying attention, listening to what lies beyond consciousness or words.” This is what Sacks has taught so many through his practice as a healer and through his work as a writer.

The author’s father, a doctor who continued to see his patients into his 90s, was described by the Chief Rabbi of England as a tzaddik, a righteous one. Oliver Sacks has taught us to try to apprehend the world righteously, with generosity and with care. He, like his father, might be called a tzaddik; but I suspect the son who would “go far” would be happy enough just to be recognized as a mensch.