BOOK OF THE DAY
On the Move: A Life by Oliver Sacks – review
A revealing autobiography of a shy, withdrawn young man whose neurological work stretched to the very horizons of human potential
Will Self
Fri 8 May 20015
Oliver Sacks, the eminent neurologist and writer, whose many books have done perhaps more than any other body of work to explain the mysteries of the brain to a general readership, is a strong supporter of the “narrativity” theory of the human subject. Suitably enough – given this is an autobiography – Sacks restates the notion here: “Each of us … constructs and lives a ‘narrative’ and is defined by this narrative.” Elsewhere he asserts: “I suspect that a feeling for stories, for narrative, is a universal human disposition, going with our powers of language, consciousness of self, and autobiographical memory.” Setting to one side the truth or otherwise of this contention (personally I think it’s only the social being that is narrated – to ourselves we are always “such stuff as dreams are made of”), for a man who views his life in dramatic terms, On the Move presents the reader with some quite startling narrative leaps. Perhaps the most extreme of these are two seemingly throwaway remarks Sacks makes concerning his sexual life: aged 21, and desperate to lose his virginity, he found himself in the tolerant atmosphere of Amsterdam – yet, trammelled by his Orthodox Jewish upbringing and the social repression of the era, he was unable to act, and instead sat in a bar all evening drinking “Dutch gin for Dutch courage”. He remembered nothing between staggering out of the bar and awaking the next morning in a strange bed, being served coffee by a man who explained: “He had seen me lying dead drunk in the gutter … had taken me home … and buggered me.” A demon even at that age when it came to details, Sacks asked “Was it nice?” to which his ravager replied “Yes … Very nice”, before rounding off the bizarre episode by commiserating: “He was sorry I was too out of it to enjoy it as well.”
The second remark is even stranger: swimming in Hampstead ponds on his 40th birthday, Sacks was approached by a handsome young student from Harvard. A delightful week-long interlude followed: “ … the days full, the nights intimate, a happy, festive, loving week”. It was a great benison – all the greater, because: “It was just as well that I had no foreknowledge of the future, for after that sweet birthday fling I was to have no sex for the next 35 years.”
Accustomed to the contemporary obsession with “identity” (and sex for that matter), we might expect the autobiography of a gay man – especially one from a Jewish immigrant background who ends up emigrating to the US from Britain – to be preoccupied by differences of sexuality and heritage. But Sacks is a man of his generation, and while no prude, nor a jealous guard of his own privacy, nonetheless the personal and existential aspects of this autobiography are definitely secondary to the main business of his life, which has been the practice of neurology and the chronicling of the insights this practice has afforded. In part the light touch on these matters can be explained by a desire not to repeat himself: Sacks’s memoir of his boyhood,Uncle Tungsten, brilliantly realised a portrait of his eccentric family of medics, scientists and technologists, while also recording the traumas of his wartime evacuation and the burgeoning of his own vocation.
Then again, throughout Sacks’s literary oeuvre there has been a determination to put himself in the frame: whether writing, inAwakenings (1973) about the post-encephalitic patients he bestirred from half-century-long swoons, or, in An Anthropologist on Mars (1995) and many other works, about the bizarre psychic, cognitive and perceptual worlds of people with autism, Tourette syndrome, congenital blindness, and a host of other “neuro-atypical” conditions, he has always been at pains to emphasise the interpersonal dimension. For Sacks there can be no conception of the mind in isolation: personhood is a property ever emerging from social and perceptual interaction. Not that this perspective came to him fully realised at the outset; rather the impression On the Move conveys is of a shy and withdrawn young man, who, through a combination of unusual life experience and intensive medical practice, comes to realise in himself an almost preternatural sensitivity to the perspectives of others, no matter how alien these may be.
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You don’t need to be a psychologist to see Sacks’s unusual depth of involvement with his patients as some sort of substitute for those 35 romance-free years. The poet Thom Gunn, a friend of the author’s, remarked that he’d worried Sacks was deficient in empathy until he became a clinician. Sacks himself is even more forthright: “I had fallen in love – and out of love – and, in a sense, was in love with my patients.” The criticisms levelled at Sacks – that his books are exploitative, presenting disabled and damaged people as a sort of freak show – are exposed as a nonsense by the books themselves, but if you were in any doubt, the quite unselfconscious accounts given here of Sacks’s extraordinary openness to his patients, should lay them to rest. He writes of intervening during a strike by support workers at Beth Israel, the New York hospital where he worked for many years: “We spent the next four hours turning patients, ranging their joints, and taking care of their toilet needs”. Elsewhere – just as an aside – he mentions that his apartment at the hospital “was always open” to patients. And while he is not known especially as a critic of the psychiatric gulag, many of his experiences in these hospitals move him to anger: “In some of these places, generically referred to as ‘the manors’, I saw the complete subjugation of the human to medical arrogance and technology.”
Sacks met Gunn when he was living in San Francisco and converting his English qualifications to American ones. It was a period in his life defined as much by motorcycling as by medicine – hence the book’s title – and Sacks’s embrace of physicality and risk will be a surprise to any reader who expects a neurologist to be a cold technician. While living in London, Sacks had been a member of the Ton Up Boys bikers’ club that once frequented the Ace cafe on the city’s North Circular bypass. He embarked on an enormous circuit of his new-found home by bike, taking photographs and writing an extensive journal as he went. Then, living in Los Angeles in the late 60s, Sacks became a habitue of Muscle Beach, and even gained a Californian weight-lifting record. At the same time, he was experimenting with a wide range of mood-altering drugs, experiences he wrote about in greater depth in his bookHallucinations (2012). He later moved to New York, where he lived on City Island off the Bronx, and regularly swum around it – swimming remains one of his passions to this day.
It is surely Sacks’s apprehension of his own physicality in these myriad ways that has synergised with his intense clinical experience to produce some of his most fruitful and intellectually exciting work. I began this review hoping to synopsise Sacks’s entire life, but it’s a hopeless task. His truly has been a life lived to the full – and beyond. Friendships with such divergent luminaries as Francis Crick and WH Auden, and with his childhood companions Jonathan Miller and Eric Korn, bring a roseate glow to reminiscence without ever rendering it sickly. The detailed examinations of his own writing life – including the eight traumatic years it took him to writeA Leg to Stand On (1984) – are set beside pen portraits of the many patients who have shared their lives with him. The fruits of success are counterpointed with some quite astonishing professional setbacks, including manuscripts lost and books plagiarised. But while this autobiography foregrounds Sacks’s human relationships, it is the adventure of ideas he has undertaken that has bestowed on his life its remarkable originality.
When Sacks began practising as a neurologist, the theoretical understanding of the relationship of the brain to the conscious mind was still based on gross anatomy: if a portion of the brain was damaged, we might be able to discover by observation of the patient what its function was. The advances in brain-imaging have informed new conceptions of the brain, as a highly plastic environment in which there is constant reorganisation. In the early 1990sSacks became acquainted with Gerald Edelman and his theory of “neural Darwinism”, by which individual consciousness is explained as the function of a process of natural selection between cohorts of competing nerve cells. Sacks describes Edelman’s theory as “the first truly global theory of mind and consciousness, the first biological theory of individuality and autonomy”. Sacks’s enthusiasm for Edelman’s ideas is more than understandable: the sort of conundrums and paradoxes he has investigated in his own patients for decades have all inclined him towards this, the great riddle of human being. Sacks reports that Edelman once said to him, “You’re no theoretician”, to which Sacks replied “I know … but I am a field-worker, and you need the sort of fieldwork I do for the sort of theory making you do.” To which Edelman readily assented.“Field worker” is something of an understatement when it comes to Sacks, unless your idea of a field is incredibly wide – stretching, in fact, to the very horizons of human potential. While not especially forthcoming about his relationship with his father (a doctor who lived and practised into his 90s), Sacks does quote a letter the then chief rabbi, Jonathan Sacks (no relation), sent him after Sacks senior’s death: “He was a true tzaddik – I thought of him as one of the 36 ‘hidden righteous’ whose goodness sustains the world.” In February, Oliver Sacks announced in an interview that the ocular melanoma that had cost him the sight in his right eye seven years ago has returned, and he is now terminally ill. Considering now the vast range of his achievements – which have been moral, and dare I say it, spiritual (despite Sacks describing himself as an “old Jewish atheist”) – I have no hesitation in extending the chief rabbi’s encomium down the generations: Oliver Sacks, like his father, is a true tzaddik, although there’s been nothing particularly covert about his righteousness – any more than his homosexuality. Perhaps it is because he has kept on the move that he has always been able to hide in plain sight.
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