Oliver Sacks

On the Move

“I wondered how his mind worked, how he saw the world. Above all, I wondered about his capacity for emotion and for relationship with other people. ”

In his last published essays, Oliver Sacks (July 9, 1933 – August 30, 2015) wrote that although he was facing death, he was not done living. I imagined him riding off the page onto an infinite celestial canvas.

On a motorcycle, of course.

Photograph of Oliver Sack's "On the Road" in the Examined Life Library.
Oliver Sacks, 1956.

My first motorbike, when I was eighteen, was a secondhand BSA Bantam with a little two-stroke engine and, as it turned out, faulty breaks. I took it to Regent’s Park on its maiden ride which turned out to be fortunate, possibly lifesaving, because the throttle jammed when I was going flat out and the breaks were not strong enough to stop the bike or even slow it more than a little. Regent’s Park is encircled by a road, and I found myself going round and round it, perched on a motorbike I had no way of stopping. I hooted or yelled to warn pedestrians out of the way, but after I had made two or three circuits, everyone gave me a free path and shouted encouragement.

Sacks’ movement and achievement is extraordinary, he seemed to succeed in everything he did,1 doings as varied as four or five people combined. The poet laureate of medicine sat between mind and brain his entire life pulling at each side to come together.

“I am equally drawn to the scientific and the romantic and continually see both in the human condition” Sacks wrote in his book of neurological case studies of broken minds and full, abundant souls.

I feel myself a naturalist and a physician both; and that I am equally interested in diseases and people; perhaps, too, that I am equally, if inadequately, a theorist and dramatist, am equally drawn to the scientific and the romantic and continually see both in the human condition, not least in that quintessential human condition of sickness—animals get diseases, but only man falls radically into sickness.

From The Man Who Mistook His Wife for a Hat

Raised in a “medical” household, Sacks’ future seemed mapped out from an early ago but he only really began to focus his energy on neurology when his old brother Michael showed symptoms of schizophrenia.

Every so often – it happened many times in the 1940’s and early 1950s, while I was still at school – he became floridly psychotic and delusional. Sometimes there was a warning of this: He would not say, “I need help,” but he would indicate it by an extravagant act, such as flinging a cushion or an ashtray to the floor in his psychiatrist’s office (he had been seeing one since his initial psychosis). This meant, and was understood to mean, “I’m getting out of control – take me to the hospital.” At other times, he gave no warning but would get into a violently agitated, shouting, stamping, hallucinated state-on one occasion, he hurled my mother’s beautiful old grandfather clock against a wall – and at such times my parents and I would be terrified of him. Terrified and deeply embarrassed.

What initially appeared as fear and embarrassment grew, as Sacks’ matured, into an unshakable desire to know what was going on in his brother’s mind and thus understand how better to help him.2

When I left England on my twenty-seventh birthday, it was, among many other reasons, partly to get away from my tragic, hopeless, mismanaged brother. But perhaps, in another sense, it would become an attempt to explore schizophrenia and allied brain-mind disorders in my own patients and my own way.

When we explore how our brightest stars were compelled to create, to write, to do – like George Orwell and Maya Angelou who seized their pens when they saw injustice or David Attenborough and Gerald Durrell who entered the natural sciences from a childhood of exploration and discovery – we find at its heart a desire to understand, and help others understand.

Photograph of Oliver Sack's "On the Road" in the Examined Life Library.
Oliver Sacks in Greenwich Village, 1961.

Sacks’ spent his career as a neurosurgeon working alongside patients with severe and misunderstood brain injuries or abnormalities.

Late in 1987, I met Stephen Wiltshire, an autistic boy in England. I was astounded by the hugely detailed architectural drawings which he had started doing at the age of six; he had only to glance at a complex building or even a whole cityscape for a few seconds before drawing the whole thing accurately from memory. Now thirteen, he was already published a book of his drawings, even though he was still withdrawn and virtually mute.

I wondered what lay beneath Stephen’s extraordinary skill in instantly “recording” a visual scene and reproducing it in minute detail; I wondered how his mind worked, how he saw the world. Above all, I wondered about his capacity for emotion and for relationship with other people. Autistic people had been seen, classically, as being intensely alone, incapable of relationships with others, incapable of perceiving others’ feelings or perspectives, incapable of humor, playfulness, spontaneity, creativity… but even my brief glimpse of Stephen had given me a much warmer impression.

In the time he spent with Stephen, who is now a successful artist and OBE Sacks grew to know another another extraordinary individual with autism, Temple Grandin, the great reformer and champion of animal welfare.

In Sacks’ 1993 New Yorker essay on Grandin, he wrote:

What is it like to be keenly intelligent and to care deeply about science and animal life—but to feel absolutely alienated from even the simplest human emotions and interactions? Temple Grandin knows, and her experiences offer rare insight into the enigma of autism.

Read full article here.

As was with Sacks, often a heart so open and willing carries its pulse at a price of guilt.

I could, I should, have been more loving, more supportive, while I was back in London, in medical school; I could have gone out with Michael to restaurants, films, theaters, concerts (which he never did by himself); I could have gone with him on visits to the seaside or the countryside. But I didn’t, and the shame of this – the feeling that I was a bad brother, not available to him when he was in such need – is still hot within me sixty years later.

And to his editor Sacks expresses doubt that publishing others’ stories would actually do more harm than good.

September 19, 1972

Dear Mr. Haycraft,

I seem to be in one of those sky, dead depressed phases where one can only do nothing or blunder round in circles. The damn thing is that it needs only three days good work to finish the book, but I don’t know whether I am capable of this at the moment.

I am in such an uneasy, guilt-stricken mood at the moment that I think I can’t bear the thought of any of my patients being recognizably exposed, or the hospital itself being recognized in Awakenings– maybe this is one of the things which is inhibiting me from finishing the book.3

Photograph of Oliver Sacks "On the Road" in the Examined Life Library.
Oliver Sacks writing on a train.

Balance comes when you move body and mind in sync. So how does a physical being such as Sacks move his mind forward? “I discovery my thoughts through the act of writing, in the act of writing.”

On the Move is a memoir of movement, both emotionally, professionally and physically. Accompany its warm velocity with Sacks’ clinical cases, each an attempt to give personhood to individuals lacking basic elements of person, Alan Lightman’s quest to balance science and that which is beyond knowing, Stephen Grosz case studies on our desire to understand and be understood. And my own compilation of motivations and beginnings. Or journey over to “A Neurologist’s Notebook,” essays by Sacks from 1992 until his death in 2015.

Illustration of Oliver Sacks.