[12 December 2010]
Oliver Sacks’ spelunking career has taken him into many strange caves. In collections such as The Man Who Mistook His Wife For a Hat, Awakenings and An Anthropologist on Mars, the neurologist and author has carefully lowered himself into some of the bumpiest and most convoluted crania in our human universe.
For those unfamiliar with Sacks’ work, his approach is that of a nearly ideal diagnostician—humane, knowledgeable and compassionate, he manages to take on exceptionally bizarre neurological disorders while making them seem, if not exactly normal, at least fully human. The title piece in The Man Who Mistook His Wife For a Hat, for example, is about precisely that—a man suffering from a neurological disorder called agnosia that causes him, despite normal eyesight, to be unable to recognize familiar objects such as his wife’s face. Others of his essays—most of his books are collections of anecdotal but erudite clinical studies—concern autistic savants, synesthetes, victims of Tourette’s syndrome and Parkinsonism, and very odd one-offs, like a man who did not “recognize” his own leg, seeing instead something, in the words of a fellow neurologist, “dead, cold, hairy in bed with him.”
If Sacks’ books have a weakness, it is that every once in a while, the stories he tells seem too good to be true, which is to say too strange to be real—“from the far borderlands of neurological experience,” as his own biography puts it. It isn’t that the disorders themselves aren’t genuine—they are—but rather that so many of them seem to find their way from the borderlands to the author’s offices at Columbia University, where he is a professor of neurology and psychiatry.
Then one remembers that Sacks is by nature an explorer, and clearly relishes the opportunity to seek out new wrinkles in the human cerebrum. His renown as a writer, and the compassion and insight with which he describes those who dwell in the darkness of neurological disorders, undoubtedly also encourages many patients to request his services personally.
His literary case-load is also augmented by his own encounters with illness, including migraines and, in A Leg To Stand On, a leg injury (he was gored by a bull) that, just as was the case with his patient, turns his leg into a thing he thinks of as alien and disembodied. He even describes the interesting olfactory consequences of his experiences as a young medical student taking “massive doses of amphetamines.”
Now, in The Mind’s Eye, Sacks once again turns to himself as a case study. Beginning in 2005, after being diagnosed with an ocular melanoma in his right eye, Sacks recounts his physical and psychological responses to “The Darkness”, as he calls the slowly encroaching loss of sight in that eye, and to the bizarre visual patterns—tilings, tessellations and “radial patterns like filigreed doilies” —that flare in his diminished vision.
The sudden asymmetry of his vision also results in him seeing the world for the first time two-dimensionally. “Looking through the window with my unpatched left eye,” he recounts, “I am startled to see cars stuck in the branches of trees, like toys.” Another time, he “spotted a man crossing the road in Union Square, with an enormous scaffolding on his shoulders” before realizing that “the scaffolding was thirty feet behind him.” This is the sort of thing that happens when stereoscopic vision is snatched away after a lifetime of regarding the world, naturally and unthinkingly, as a three-dimensional phenomenon.
And when vision is lost entirely? Sacks’ left eye was damaged in a childhood fight, so this prospect becomes a terrifying possibility, and as he endures his inner dusk and awaits the diagnoses of his peers, he recounts the true stories of blind scholars who developed incredible compensatory skills, like the French Resistance fighter who constructed a mental screen “upon which whatever he thought or desired was projected and, if need be, manipulated, as on a computer screen.” This “inner vision” was so well-developed that he “noticed”, and described, mountain vistas better than his sighted friends.
Looking at the experiences of extraordinarily accomplished blind people is typical of Sacks, who focuses his attention, here and in other books, not only on pathology, but on the miraculous accommodations that some people are able to make with dimming prospects and painful losses. Indeed, these stories themselves, and his recounting of them in this book, begin to seem like Sacks’ own attempt, using the tools he knows best, to cancel out his pain and apprehension.
Of course, not every form of compensation is equally inspiring, and not every subtracted faculty is replaced with some new inner radiance. In his earlier essay “The Disembodied Lady”, for example, he tells of a woman who lost awareness not only of her leg but of her entire body, and of the position of, and relationship between, her body parts, causing her to flail, stumble and ultimately collapse. Before this “proprioceptive disorder” struck her, this young woman was a horseback rider and hockey player. Now, her hands would literally “wander away” from her body unless she attempted to consciously control them, and she began to feel that her body was “dead, not-real, not-hers”.
Over time, she learned to “operate” (not a word that Sacks uses) her body as if it were a puppet, and thereby to live an unsatisfactory simulacrum of an ordinary existence, and though this clinical case study concerns a condition that is far from the worst a neurologist will encounter in his career (that distinction is probably preserved for “locked in” syndrome), there’s something peculiarly depressing about this woman’s case.
It’s not so much that, as Sacks informs us, her illness is incurable. It’s that it is ours. At the beginning of the essay, Sachs reproduces a quote from Ludwig Wittgenstein, who wrote, “(t)he aspects of things that are most important for us are hidden because of their simplicity and familiarity”, the inescapable and paradoxical corollary being that once these things (vision, movement, cognition) are no longer simple or familiar, they are suddenly very much “present”, and very much missed.
This, I think, is how all of us—all, that is, except for the radiantly blind—meander through our existences, insensible to the force that animates our flesh into something loving and seeing and feeling, but at the same time all too keenly aware of whatever it is we have lost.
What we’ve lost is not always neurological or even physical—it could be a disappointment permanently lodged in one’s psyche, or the painful betrayal of a friend—but whatever it is, the throbbing of that loss is capable of utterly eclipsing everything else. So on our daily rounds to our work and our other obligations, we “operate” ourselves mechanically, all too aware that whatever miserable condition we are facing is incurable except in death.
This is not Sacks’ metaphor at all. If anything, his eloquent accounts of his patients’ struggles with illness, and of his own medical problems, can reawaken, at least temporarily, an appreciation of how fortunate we are to move through this world with all, or at least most, of our faculties intact. If, later on, we find ourselves once again shuffling numbly through our secret miseries, we can only be helped by remembering, as books like The Mind’s Eye illuminate for us, that there are few human failings worse than taking for granted life and its manifold hidden miracles.