Oliver Sacks: Letters
“I found myself, in short, finding existing intolerable . . . I was in the grip of one might term a lethal neurosis.”
A well-renowned neurologist delved into the workings of the brain, while wrestling with his own mind and brain.
In July 1960, 21-year-old Oliver Sacks leaves England for the USA and Canada in order to invent himself in a new place. “Looking back at this period in his 2015 memoir On the Move, he writes, ‘I had a peculiar, unprecedented feeling of freedom . . . this was the new world . . . and—within limits—I could do what I wished.’” However, after a few months he becomes disillusioned with this new world. “Not only alcoholics, but cranks, psychotics, misfits, religious maniacs in uncomputed numbers . . . The ‘old country’ is mellow in comparison.”
After medical school, he accepts an internship at Mount Zion Hospital, San Francisco. In a letter to his parents, Sacks bemoans his internship. “I see this loathsome internship prolonged indefinitely, and no purpose. I am discovering, in a far more intense degree than ever before . . . an extreme aversion to patients, sickness, hospitals and particularly doctors.” He even doubts his choice of this profession. “The truth is, you know, I should never have become a doctor . . . it would really be a great shame and rather a waste to turn into a mediocre doctor with no love of medicine.” He is also frustrated that there is no treatment for his brother Michael’s schizophrenia.
To detract from his worries, Oliver begins to concentrate on his passions for weight-lifting, music and, especially, motorcycles. At times he infuses humor in his letters. He writes to his parents that he was on the way to a conference, riding his motorcycle at 3.00 a.m. Suddenly he ran out of gas and all the gas stations were closed. “I honked my horn up and down the main street and banged on doors; no answer. Then, if any of the inhabitants been awake, they might have seen a strange spectacle; an enormously bulky and muffled motorcyclist, one of Mount Zion’s favorite interns, dismantle his stethoscope and try to siphon petrol out of the cars standing in the town square.”
At that time, Oliver throws himself into his research. But the demons in his brain are back. Since his mother, a doctor, has a fanatical horror of homosexuality, he has to hide his own. He confides in Jeno Vincze, one of Sacks’ lovers, “cringing, and, apology, and explanations and pious wishes that I have been ‘normal.’ I am through with normal.”
While working with his patients, Sacks has to wrestle with his own deep depressions and suicidal thoughts, which to haunt him all his life.” He has no friends or social life in New York. “I found myself, in short, finding existing intolerable . . . I was in the grip of one might term a lethal neurosis.” Sacks attributes this neurosis to his parents’ pathology and paranoia. Eventually, he finds recognition and acceptance as a person and a doctor with the help of his therapist.
Late in 1966, as a neurologist, Sacks starts a number of part-time jobs in a headache clinic at Montefiore Hospital and, also, seeing patients at Beth Abraham Hospital. “I am, for the moment, less saturated in the Past, less committed to it. My clinic, my patients, give me a sort of satisfaction I haven’t had for a long time. . . .”
Oliver’s work with his migraine patients lead to both published books, Migraine and Hallucinations. In writing Hallucinations, he had, finally, fallen in love with work. Because of his own depressions and manias, he is able to understand the same symptoms in his patients.
At Beth Abraham, Sacks begins to notice that dozens of patients are so lethargic that they can’t move or talk. He finds out that they had been the same way for the past 40 years of their lives. He called it ‘’encephalitis lethargica,” similar to Parkinson’s disease. His research on Parkinson’s leads to his discovery that it can be treated with a new drug, Levodopa (L-dopa). So why not with the lethargic patients?
In 1969, Sacks starts to administer L-Dopa to a handful of lethargic patients as an experimental drug. At first, these patients wake up and begin to talk, walk and sing. But to Sacks’ disappointment, it is short-lived because of unexpected side effects. He thinks that the reason is that the dose is too little. “But he knew that they also presented him with a rare chance to document and understand the workings of the brain.”
On November 7, 1970, he writes to his parents “But now I have seen the whole melancholy round of L-Dopa (and it is round)-like the Earth: a man cannot escape from his Parkinsonism any more he can walk off the surface of the earth.” He continues his letter, writing his intention to publish a book on the effect of L-Dopa on Parkinson’s. (The New Yorker, Sept. 30, 2024).
Meanwhile, at the hospital, Sacks continues his treatment with a larger dose of L-Dopa and is encouraged when his patients wake up and become so active that some even go outside. However, it is short-lived. He uses this opportunity to write a book about his experiment. Awakenings, his seminal work on the results of L-Dopa on lethargic patients, is praised all over the world for his courage to try an experimental drug to treat patients with devastating illnesses, even though the results were not those he had hoped for.
At this time, the editor, Kate Edgar, feels it is important to interject an interlude from Sacks’ work. His correspondence with well-known writers and poets such as W. H. Auden and Thom Gunn need to be documented. In one of these letters, he describes his Jewish origins and his conflicted feelings about his Jewishness. “The dogmatic-doctrinal, legal-scholastic aspects of Judaism always disgusted me, and were a potent factor in driving me from Judaism; but the deep, peaceful, contemplative, hospital mood of the Seder nights . . . this drew me to Judaism.”
In 2015, Sacks is diagnosed with liver cancer. In Letters, he writes about survival in the face of hs own lifelong devastating illness. He also ponders the meaning of life. “Though I seem to write about disability and disease, I am always concerned with patients’ ability, and will do to survive-to make meaning, and dignity etc. out of their so-shattered lives . . . when moods of defeat, despair . . . visit me . . . I find a sense of hope and meaning in my patients, who do not give up despite devastating illness.” Later on, “I think the meaning of life is something we have to formulate for ourselves, we have to determine what has meaning for us.”
While in hospital, Sacks meets a rabbi and begins to study the Talmud (Book of Laws) with him. When his cancer gets worse, he wants to go into palliative care. “I feel now that I have done my work, at least done what I can, and that the time that remains to me should be a sort of peaceful end-of-life Sabbath, and I do have a sense of serenity and an acquiescence.”
In the end, Sacks, embracing his Jewishness, writes a piece called Sabbath.
Oliver Sacks died at home on August 30, 2015, leaving a legacy as the fearless neurologist who dared to delve into uncharted waters, using experimental drugs to treat his patients with devastating illnesses, a legacy of gratefulness and love to his former patients. He wrote a dozen books.
Letters is an intimate portrait into the life and work of Oliver Sacks through his own words, infused with compassion, melancholy, elation and humor, which affected the lives of family, friends, dignitaries, philosophers, writers, and musicians.