Hallucinations—the title of Oliver Sacks’ 12th and most recently published book, seems a bit truncated, or at least understated, given the near-ubiquitous use these days of subtitles in the realm of nonfiction book publishing, subtitles that tend toward making evermore grandiose claims for the significance of the subject matter of a given work. (Doubtful? Just take a look at the installments of the latest New York Times Nonfiction Hardcover Bestsellers List where Hallucinations resides, as of the writing of this review, just a few notches below Bill O’Reilly’s blaringly titled Killing Lincoln: The Shocking Assassination that Changed America Forever). So maybe Sack’s single word title and eschewal of the kind of subtitle that loudly declares the significance of the book at hand indicates a kind of elegant modesty about the content.
And indeed it does. Readers familiar with Sacks’ other works—some of the more well-know are The Man Who Mistook His Wife for a Hat and Awakenings (also adapted to film)—will recognize the style here: learned but not pretentious, fine but not ostentatious, informative but not dense.
Perhaps recognizing that his title does less of the heavy lifting than is typical for a volume of nonfiction, Sacks simply defines his subject matter at the very outset of the book: “hallucinations are defined as percepts arising in the absence of any external reality—seeing things or hearing things that are not there.” That straightforward definition, however, hardly begins to suggest the complexity of the bewildering, bizarre, and sometimes terrifying subject matter of the next 15 chapters.
As for those chapters, taken altogether they are less a comprehensive study or encyclopedic cataloguing of hallucinations than a collection of essayistic meditations on a related theme. Or as Sacks himself writes, “Here, then, is a sampling which I hope will give a sense of the great range, the varieties, of hallucinatory experience, an essential part of the human condition.” In other words, hallucinations are not uniform and a study of them must allow for the pronounced differences of brain chemistry, psychological constitution, and cultural context of the individuals who experience them.
For its part, Hallucinations considers, among other things, such astonishingly varied and complex set of psychical phenomena as the rich illusions that present themselves to individuals subjected to sensory deprivation, the terrifying apparitions that menace those on the verge of sleep, the painful phantom limbs of persons who have undergone amputation, the distinct voices that call back to life those on the verge of death (be it accidental or self-inflicted), and the out-of-body experiences that transport those who have, by all medical standards at least, exited life to a dimension of extrasensory perception.
As in previous works, Sacks’ sources are varied and easily interwoven with one another: medical and scientific studies (made more palatable but not dumbed down by Sacks’ prose), case histories, works of art and literature and, not least, personal anecdotes. For here, again as in previous works, Sacks’ frankly recounts his own pertinent experiences. In this instance, those experiences mainly (though not exclusively) concern the sometimes distressful drug experimentation that Sacks, now in his 80s, undertook as a younger man, particularly a one-time encounter with a large dose of morphine and the effects of withdrawal from chloral hydrate.
The successful integration of so many disparate materials, and kinds of materials, keeps the pace of Hallucinations lively (at nearly 300 hundred pages, it’s not exactly slender, but it never feels ponderous). As does Sacks’ ability to explain the physiological mechanisms at work in the production of hallucinations without detracting from their essential strangeness; explanation does not equal reduction. This is important because Sacks, a now semi-retired neurologist, insists that science is making substantial progress in understanding how the brain functions:
“Though the phenomena of hallucinations are probably as old as the human brain, our understanding of them has greatly increased over the last few decades. This new knowledge comes especially from our ability to image the brain and to monitor its electrical and metabolic activities while people are hallucinating. Such techniques, coupled with implanted-electrode studies (in patients with intractable epilepsy who need surgery), have allowed us to define which parts of the brain are responsible for different sorts of hallucinations.”
Obviously as a physician Sacks recognizes the need to relieve patients of painful or debilitating conditions—and lauds the medical advances that abet the effort to do so—but he does not arrogantly presume that patients, and their experiences, are simply problems to be solved or mere obstacles on the road of medical and scientific progress.
Rather, Sacks aims to rescue hallucinations from their almost wholly pejorative connotations (one seldom, after all, hears a phrase like, “You must have been hallucinating” used positively) as the refuge of individuals constitutionally unsuited to inhabiting “consensus reality”. Not so, Hallucinations insists. Hallucinations may simply seem to be the experiential province of the abnormal, the insane, or the substance-addicted, but a more thorough and humane consideration, the sort that this book provides, suggests that they are a means by which virtually all of us—at some time or another, in some form or another, for some reason or another—cope with the enormous challenges and frequent bewilderments of being human in this world.