“I give them some of my own powers, and some of my phantasies too. I write out symbolic versions of myself.”
So wrote the late Oliver Sacks, practising and academic neuropathologist, pioneer of narrative medicine, and a man who maintained a unique intellectual figure for four decades. This and more was revealed in Rachel Aviv’s investigation into his diaries and letters, as published in the New Yorker this month.
Sacks had shot to fame in the 70s with Awakenings, his account of working with encephalic sleeping sickness survivors. The patients had been existing in a vegetative state since the pandemic of the 1920s. After administering a pioneering treatment, Sacks sat with them as they returned to themselves and gave extraordinary accounts of their comatose decades.
In the 80s he followed Awakenings with the hugely successful The Man Who Mistook His Wife for a Hat. The book was a selection of case studies of patients with neuropathological disorders. With striking empathy and eloquence, Sacks gave voice to the suffering of his patients but also the vividness and beauty of the unique life and experience they did have.
His work inspired the concepts of narrative medicine and the entire field of medical humanities. His texts were required reading for a generation of medical students, teaching them not to forget the person behind the condition.
It was all just too beautiful, too poetic and too on-point to be real.
As Aviv reports, while suffering writer’s block while writing his first book in the 1960s, Sacks wrote in a letter to his analyst that he felt like “Rilke’s image of the caged panther, stupefied, dying, behind bars”, referencing an obscure poem written in 1903.
In Awakenings, Sacks asks a patient, “What’s it like being the way you are? What would you compare to?” To which the patient replies, “Caged. Deprived. Like Rilke’s ‘Panther.’”
Sacks had also written to his first great love, also in the 1960s, that he was so smitten that “his blood felt like champagne.” Similarly, a sleeping sickness patient, returning to life, supposedly said, “Oh, Dr Sacks. I am so happy, so very, very happy. I feel so good, so full of energy. So tingly, like my blood is champagne.”
In a letter to his brother that contained a copy of The Man Who Mistook His Wife for a Hat, Sacks wrote, “these odd Narratives—half-report, half-imagined, half-science, half-fable, but with a fidelity of their own—are what I do, basically, to keep MY demons of boredom and loneliness and despair away.”
In his journal, Sacks describes a sense of “hideous criminality” and “severe self-recrimination” for these “fabrications”.
Sacks had been a great voice for appreciating the significance of subjective experience in illness and healing. His name will now become a warning about the epistemic shakiness of invoking the subjective in science, and about qualitative material that fits a story slightly too well.
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