Lives of the fellows

Oliver Wolf Sacks

b.9 July 1933 d.30 August 2015
CBE(2008) BA Oxon(1954) MB BCh(1958) Hon DHumLit Georgetown(1990) Hon DSc Tufts(1991) Hon DHumLit College of Staten Island, New York(1991) Hon DSc New York Medical College(1991) Hon MD Medical College of Pennsylvania(1992) Hon DSc Bard(1992) Hon LLD Queen’s University, Ontario(2001) Hon MD Karolinska(2001) Hon LLD Gallaudet(2005) Hon DCL Oxon(2005) FRCP(2006) Hon MD Catholic University of Peru(2006) Hon DSc Cold Spring Harbor Laboratory, Watson School of Biological Sciences(2008) Hon DSc Warwick(2014)

Oliver Sacks was often introduced as the ‘poet laureate of medicine’, a mind explorer in the tradition of Sigmund Freud or sometimes just as ‘the most famous neurologist alive’. The man who mistook his wife for a hat (London, Duckworth; New York, Summit Books, 1985), An anthropologist on Mars (New York, Alfred A Knopf; London, Picador, 1995) and Musicophilia: tales of music and the brain (London, Picador, 2007) spawned a new genre of popular literature, inspired by the case histories of the Russian neuropsychologist Alexander Luria. Some were adapted for stage and film, and all 14 of his books were translated into more than 25 languages. Sacks’ detailed pathographies emphasised the intense, unique, inner life of each of his patients and their brains’ remarkable powers of compensation. For example, the lightning fast reactions of ticqueur ‘Witty Ticcy Ray’ allowed him to excel at table tennis and become a talented jazz drummer, while Simon Wiltshire, diagnosed with autism as a young child, went on to acquire the ability to memorise and draw wondrous cityscapes. Sacks emphasised his patients’ gifts, as well as describing their deficits, which led to his readers often feeling as if deficits of the brain could be an inspiring opportunity for growth. He sympathised with the notion of neurodiversity, an approach arising out of a belief that phenomena like word blindness and hearing voices stemmed from normal variation in the human genome and should not be classified as disease states.

Many young people came to share his intense enchantment with the human brain and were branded ‘neurophiliacs’. For them he was a loveable, shy, wacky, ‘Beat’ professor, who refused to follow the rules of the medical establishment and taught them that science is about opening as well as closing questions. A few were inspired to embark on successful careers in neurology as a direct result of reading his books. His detractors on the other hand accused him of an unhealthy exploitative relationship with his patients and derided him for taking a vainglorious ‘starring’ role in many of his books. He was also accused of spanophilia (a love of the rare), the fifth of his former chief Richard Asher’s [Munk’s Roll, Vol.VI, p.16] ‘Seven sins of medicine’ (Lancet. 1949 Aug 27;2[6574]:358-60). These barbed criticisms hurt him because he was a man of deep sensitivity and impeccable probity.

Oliver Sacks was born in north London into an Orthodox Jewish family of physicians. His father Samuel Sacks (‘Sammy’) was a well-known East End London general practitioner who went on doing house calls until he was 95, his mother, Muriel Elsie Sacks née Landau, was a general surgeon and gynaecologist. He attended St Paul’s School and then went up to Queen’s College, Oxford, before completing his clinical training at the Middlesex Hospital, Mortimer Street, where he was later senior house officer to the neurologists Michael Kremer [Munk’s Roll, Vol.VIII, p.265] and Roger Gilliatt [Munk’s Roll, Vol.IX, p.195]. He then left England for good and, after a brief spell in Canada, did a neurological residency at Mount Zion Hospital in San Francisco and a fellowship at UCLA. In 1965 he moved to New York, where he became an instructor at the Albert Einstein College of Medicine and later a consulting neurologist at the Bronx Psychiatric Center, Beth Abraham Hospital and the Little Sisters of the Poor Nursing Home. Between 2007 and 2012 he held the post of artist and professor of neurology at the neurological institute at Columbia University Medical Center, before moving to a similar position at New York University’s comprehensive epilepsy center, where he had previously worked in the 1990s. Up until his death he also held a visiting professor post at the University of Warwick in the UK, where he lectured to hundreds of students in both the arts and life sciences faculties.

His 1973 book Awakenings (London, Duckworth; New York, Doubleday), describing the effects of the amino acid L-DOPA on a group of severely disabled postencephalitic patients resident at Beth Abraham Hospital, a long-stay facility in the Bronx, won him the Hawthornden prize for imaginative literature, but it did not sell particularly well at the time and, unlike his earlier book Migraine (London, Faber and Faber; Berkeley, University of California Press, 1970), received mixed reviews from the medical press. But, after the book was made into an Oscar-nominated Hollywood film in 1990 starring Robert de Niro and Robin Williams, he became a celebrity and a box office attraction. He was now everybody’s best friend, which he did not discourage and, after years of derision, he was cynically recognised by the American Academy of Neurology for a lifetime achievement award.

As a young man Sacks had experimented with ‘speed’ (amphetamines), narcotics (including morphine pinched from his father’s doctor’s bag) and psychedelic drugs, including LSD and morning glory seeds, and he had hung around with the power lifters on Muscle Beach, where he held the Californian record for squat and press. During his teenage years and to the chagrin of his parents he bought a Norton motorbike and adored the exhilaration of speeding along the North Circular Road to meet his rocker friends at the Ace Café. Such was his love of food and water (he was a graceful, powerful, long-distance swimmer), that he once confessed to me that if he ever came back as an animal he would like to be a blue whale swimming the oceans with his mouth open devouring delicious krill.

Despite these belated confessions of sensation seeking and renegade behaviour described in his frank memoir On the move: a life (London, Picador, 2015), Sacks was a traditionalist who enjoyed the camaraderie of the medical profession and continued to see medicine as a calling rather than a business. His great passion for life, engaging diffidence and unflinching kindness were immediately obvious to all who met him. From his home he ran a global neurological practice, visiting patients all over the world and corresponding in his characteristic large handwriting with many of those he was unable to see (especially those under 10, over 90 or in prison). Every day he received a pile of letters from people he had never seen as patients but who had been inspired and encouraged by his books and wished to thank him. He had made them realise they were not grotesque freaks or just ‘pathology on legs’.

A figure of the arts as much as the sciences, he counted among his friends W H Auden, Thom Gunn and Jonathan Miller. He was a Victorian diarist who loved ferns and cephalopods, and had a penchant for radishes. He followed in the innocent tradition of the great naturalists like Wallace, Bates and Spruce, but despite his aversion to computers and even typewriters he was also hooked, like many of his readers, on the exciting modern notion of neuroplasticity. In 2002 he was awarded the Lewis Thomas prize by Rockefeller University, which recognizes the scientist as poet. Many of his essays and meditations were published in The New Yorker and The New York Review of Books. He was an honorary fellow of both the American Academy of Arts and Letters, and the American Academy of Arts and Sciences, and held honorary doctorates from many universities, including Oxford (of which he was particularly proud), the Karolinska Institute, Georgetown, Bard, Gallaudet, Tufts and the Catholic University of Peru.

Despite his literary acclaim, he never lost his enthusiasm for medicine and the art of healing. Critics accused him of a naïve dilettante approach to neurology in his books, but he also continued to publish in high impact peer-reviewed, learned journals throughout his career, including articles on ‘Hallucinations of musical notation’ in Brain in 2013 (Brain 2013:136;2318-2322) and ‘Prosopometamorphopsia and facial hallucinations’ in The Lancet in 2014 (Lancet. 2014 Nov 29;384[9958]:1998). One of his only minor disappointments was that some of his neurological colleagues who he continued to hold in high esteem had lacked the imagination to understand what he was all about. He once said that he imagined himself as a comet, hurtling through the neurological heavens, observing things as he went speeding by, constantly in motion and not bound to a home.

In his 2011 book The mind’s eye (London, Picador) Sacks described case studies in which people whose ability to navigate the world visually had been severely compromised. Autobiography was never too far away in his writing, and in this collection of case reports he also related how his own sight had been restricted by a scotoma that resembled the shape of Australia caused by a melanoma on his retina and how his long-standing face blindness had forced him to recognise his friends from their voices or silhouettes.

Five years later, Oliver died from melanomatous metastases on his liver at home in Greenwich Village surrounded by his close friends and having spent his final days playing the piano, writing to friends, swimming, eating smoked salmon and completing several essays which became part of a slim book of spare beauty called Gratitude (New York, Knopf; London, Picador, 2015). In one of these he reminded his readers of the sanctity of life: ‘When people die, they cannot be replaced. They leave holes that cannot be filled, for it is the fate – the genetic and neural fate – of every human being, to be a unique individual, to find his own path, to live his own life, to die his own death.’

Andrew Lees

[Sacks OW. ‘The origin of “Awakenings”’. Br Med J (Clin Res Ed) 1983;287:1968; The Guardian 30 August 2015 – accessed 16 May 2016; The Telegraph 30 August 2015 – accessed 16 May 2016; The New York Times 31 August 2015 – accessed 16 May 2016; Los Angeles Times 31 August 2015 – accessed 16 May 2016; The Economist 5 September 2015 – accessed 16 May 2016; BMJ 2015 351 4800 – accessed 16 May 2016; The Lancet 2015 386(9999) 1130 – accessed 16 May 2016]

(Volume XII, page web)

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