by Fraser Hibbitt for the Carl Kruse Blog
Writing in the introduction to Oliver Sacks’ most popular work, The Man Who Mistook His Wife for a Hat, author Will Self relates the personal experience of the younger Sacks at his breakthrough moment: ‘In a sort of catatonic concentration so intense that in ten hours I scarcely moved a muscle or wet my lips, I read steadily through the five hundred pages of Megrim. Sacks, who was researching for what would be his first book Migraine, had, in all this intensity, lit upon the method that would inform the rest of his life. What had detained him through the ten-hour stretch, so much so that it ‘seemed to me almost as if I were becoming Liveing [author of Megrim] himself … at times I was unsure whether I was reading the book or writing it’, was something that had gone quite out of vogue: the humane medical case-study.
How to understand abnormality, suffering, and estrangement from one’s body and mind, appeared to the keenest of the Victorian medical minds, to be contained in the art of narrative. Maladies, like the classic teleology of a story, had their rises and falls, their beginning, middle, and end, and as the ideas and themes of a story are readily conceived through this teleology, this form, so perhaps too could the malady be investigated in this manner. There is, of course, always a danger of losing sight of the human during the investigation; the desire to know and understand disease ought to be informed by the individual who experiences the disease; Sacks uses this quotation attributed to Canadian physician William Osler as a preface to his An Anthropologist on Mars: ‘Ask not what disease the person has, but rather what person the disease has’.
This means a closing of distance between the suffering individual and the physician; the willingness to “enter” the sufferer’s world, not to deny it, or colour it with ready-made knowledge of past inquiries, and the altogether humane instinct of the 19th-century medical literature was what impressed Sacks so inwardly whilst reading Liveing. The fact that the twentieth-century medical literature had decided on a different route in their relationship to disease, and by extension individual lives, was only a greater impetus to bring back the nineteenth-century tradition. The colder kind of empiricism prevailing in the mid-twentieth century medical sciences was at ease seeing an individual as a means to ‘a soulless neurology’, or a ‘bodiless psychology’.
All this has a direct and powerful implication in how one views themselves, how they embody their experience and their world. When medical conditions are systematised at the expense of the individual, words like abnormality take on a different hue; if you can “get back” to point A then all will be well. To deny the individual experience of a disease is to effectively limit the individual’s conception of themselves; they are cut off from their “normality” and are now inhabited by an unknown. It is true, I do not know what to do when something out of the ordinary happens to me, or if I began to develop symptoms of a nature I had never encountered before, then I would be in need of medical recourse. The problem is that the issue of self-hood has been taken for granted from the very beginning, i.e. something that can function well enough during the quotidian, but if you were to look over the experiences of an individual life, its career would be of a shifting between a multiplicity of both mental and physical states; normality, however you understand it, seems entirely unbecoming, and as Sacks’ books show us time and time again, irrelevant.
In a way, Sacks’ desire and it is a desire he very much fulfilled, was to re-examine this existential ground through his writings. The method he chose was dedicated to embodying the individuals he treated and met throughout his life. The after-image from the Liveing epiphany was, if such things can be put so grossly in words, the individual life is not individual and the narrative is the closest frame we have for understanding such a wonder. Sacks’ other desire was, of course, to understand the diseases he was treating; he was a lover of what he called the “nonhuman” just as much as the human – he carried around a paper copy of the periodic table in his wallet. His interest in the non-human world was intense, endearing: ‘Elements and birthdays have been intertwined for me since boyhood, when I learned about atomic numbers. At eleven, I could say “I am sodium (element 11), and now at seventy-nine, I am gold’.
Over the course of his life, Sacks brought out the life of such a wide range of neurological conditions that it is difficult, near impossible, to come away from a reading without a deeper appreciation of the brain and the capacities of the mind. From the very beginning of his career, Sacks was not afraid to make himself the subject of his interest. His late twenties were filled with exploration and drug experimentation – something he would speak about near the end of his life in his autobiography On the Move. We see a different guise in his book A Leg to Stand On, which tells the tale of his near-fatal hiking accident in Norway. In the book, Sacks outlines the process of being on the other side of the patient-doctor dynamic, about the ideational loss of his leg (a failure in proprioception), and the final “coming back to life”; we see glimpses of Sacks too in his other books: details of his prosopagnosia (a condition which causes the individual to struggle when interpreting faces, facial expressions and cues); his relationship with music in Musicophilia; his final words of gratitude as his cancer progressed.
In reading Sacks, a very powerful point begins to resonate over and over again. His, I would say “re-examination”, but he is not revolutionary when it comes to knowledge; it is his “re-observation” of the mind, the mind in the actual context of living, that makes his work engrossing. Sacks was criticised in his career: “The man who mistook his patients for a literary career”, or the calling of his work a “high-brow freak show”. Any reading of Sacks will convey the dignity and care with which he speaks of his time with his patients and the lasting effect these people have had upon his life, ideas, and morality. I do not want to overreach here, Sacks was a doctor and, like any other doctor, deals with a side of humanity that most of us leave untouched, or, for better or worse, are only able to say a few abstract terms about. The people he writes about appear, at first, quite alien, almost yes for spectacle, but no sensitive mind can carry on in his direction. The powerful point in Sacks always relays us back to the person as a person.
The Carl Kruse Tech Blog Homepage is at http://carlkruse.at.
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Other articles by Fraser include ChatGPT, On The Consolation of Psychedelics, and the James Webb Space Telescope.
An older Carl Kruse blog is at https://carlkruse.blogspot.com/