Oliver Sacks’s Graphophilia and Other Compensations for a Life Lived “On the Move”

August 31, 2015 Dennis Junk

Near the midway point of his recently published autobiography, On the Move: a Life, neurologist and author Oliver Sacks recounts a time in 2000 when he was busy writing an earlier book, a memoir about his childhood love of chemistry called Uncle Tungsten. In his late 60s at the time, Sacks was working on a chapter about spectroscopy and found himself roaming the streets of New York with a miniature spectroscope, an instrument that allows you to see the unique spectral light patterns emitted by each of the elements. Peering in through the window of a gay bar, he was dazzled by the display of light, but then he realized that the people inside were disturbed by the apparition of this eccentric old man looking at them through a strange device. Instead of withdrawing, though, Sacks went to the door and “strode in boldly,” shouting, “Stop talking about sex, everyone! Have a look at something interesting.” As it turned out, some of the patrons did stop to take a look. Sacks writes that after a span of “dumbfounded silence,”

my childish, ingenuous enthusiasm won the day, and everyone started passing the spectroscope from hand to hand, making comments like, “Wow—cool!” After everyone had had a turn with the spectroscope, it was handed back, with thanks. Then they all resumed talking about sex again. (238)

This episode encapsulates in microcosm the poignancy that pervades Sacks’s entire autobiography, standing out even amid the multitude of likewise humorous and quietly touching scenes. Sacks has for years been telling us to stop and have a look at something interesting, whether it be the case histories of his tragically, yet fascinatingly, afflicted patients, some pivotal discovery in the history of neuroscience, or the story behind one of his own personal epiphanies. What you wouldn’t know from reading this story apart from the rest of the book, though, is that Sacks didn’t wander onto that particular scene by sheer coincidence.

Read in its context, this anecdote says a lot about what has afflicted Sacks himself for almost his entire life, leaving us to wonder if perhaps some of his infectious enthusiasm for science and literature and history—or at least the solitary proclivities that support it—came about through his efforts at compensating for those afflictions. Indeed, one of the pleasures of reading On the Move is learning about the origins of what would become his abiding preoccupations, the central themes that shine through in his writing, the ones that, along with his gracefully meticulous prose style and his unmistakable compassion, have earned his essays and books such widespread acclaim. But at times it’s somewhat of a shock to discover just how much Sacks himself was struggling—and continues to struggle—with impediments both physical and social. Just before going into the story about the spectroscope, for instance, he writes,

I am shy in ordinary social contexts; I am not able to “chat” with any ease; I have difficulty recognizing people (this is lifelong, though worse now that my eyesight is impaired); I have little knowledge of and little interest in current affairs, whether political, social, or sexual. Now, additionally, I am hard of hearing, a polite term for deepening deafness. Given all this, I tend to retreat into a corner, to look invisible, to hope I am passed over. This was incapacitating in the 1960s, when I went to gay bars to meet people; I would agonize, wedged into a corner, and leave after an hour, alone, sad, but somehow relieved. But if I find someone, at a party or elsewhere, who shares some of my own (usually scientific) interests—volcanoes, jellyfish, gravitational waves, whatever—then I am immediately drawn into animated conversation (though I may still fail to recognize the person I’m talking to a moment later). (236-7)

Sacks only recently began talking about his own prosopagnosia, or face blindness, the topic of an essay that gave one of his earliest books its provocative title, The Man Who Mistook His Wife for a Hat—though Sacks’s own condition is much milder than the man whose case he explored in the essay (or at least it was until his vision began failing). After reading On the Move, though, that title, along with the one for his next collection, An Anthropologist on Mars, which took its name from an essay about Temple Grandin and Asperger’s syndrome, both seem like they reveal as much about Sacks’s own alienation as about the unique lives of his patients.

Sacks’s homosexuality is also something he only recently began discussing, but it comes up early in his autobiography. One of the central themes of Sacks’s writing has been that what most of us are tempted to look at as disorders or diseases are often just different ways of perceiving and living in the world. When his parents found out about his homosexuality, his mother in particular responded with unforgivable harshness: “‘You are an abomination,’ she said. ‘I wish you had never been born.’ Then she left and did not speak to me for several days” (10). Sacks, however, does forgive her, or at least comes to understand her motives:

When, in 1951, my mother learned of my homosexuality and said, “I wish you had never been born,” she was speaking, though I am not sure I realized this at the time, out of anguish as much as accusation—the anguish of a mother who, feeling she had lost one son to schizophrenia, now feared she was losing another son to homosexuality, a “condition” which was regarded then as shameful and stigmatizing and with a deep power to mark and spoil a life. (61)

Today, it’s easy for most of us to think of homosexuality as just another aspect of healthy human diversity, not as a mental condition, certainly not as anything shameful; if anything, we recognize now, it was probably that stigma, and his mother’s inability to see past it, that threatened to spoil Sacks’s life. Remarkably, though, Sacks was by then questioning whether even his brother’s schizophrenia was best understood, and best treated, as a medical condition.

Two of his three older brothers were already on their way to becoming doctors by the time Oliver and the third brother, Michael, began entering into a type of conspiracy against anyone who sought, by some crude chemical means, to cure him. Michael was an avid reader of communist pamphlets and enjoyed his job as a messenger because he saw it as serving a heroic cause. Oliver writes,

He once told me that the seemingly humdrum messages he delivered might have hidden, secret meanings, apparent only to the designated recipient; this was why they could not be entrusted to anyone else. Though he might appear to be an ordinary messenger with ordinary messages, Michael said, this was by no means the case. He never said this to anyone else—he knew it would sound bizarre, if not mad—and he had begun to think of our parents, his older brothers, and the entire medical profession as determined to devalue or “medicalize” everything he thought and did, especially if it had any hint of mysticism, for they would see it as an intimation of psychosis. But I was still his little brother, just twelve years old, not yet a medicalizer, and able to listen sensitively and sympathetically to anything he said, even if I could not fully understand it. (60)

When Michael began taking Largactil (or Thorazine, as it’s called in the U.S.) in the early 1950s, this blending together of the real world with his fantasy life came to an end. Michael became dull and lazy. The drug is, after all, a tranquilizer.

The treatment wasn’t altogether sinister, however, as Michael’s schizophrenia was often truly debilitating, and his delusions and violent mood swings were not only dangerous at times—they were a nerve-rackingly constant source of anxiety for anyone close to him, including his little brother. As Oliver writes,

When I left England on my twenty-seventh birthday, it was, among many other reasons, partly to get away from my tragic, hopeless, mismanaged brother. But perhaps, in another sense, it would become an attempt to explore schizophrenia and allied brain-mind disorders in my own patients and in my own way. (65)

Thus equipped with the insight that neurological patients often see their own conditions much differently from the way doctors see them—not merely as problems needing to be fixed but as rare if onerous gifts intricately tied up with their sense of who they are and what their place is in the world—while at the same time still tormented by the condemnation of his mother and forever ill-at-ease in casual social exchanges, Sacks came to America, to explore, to see where he might fit in, to stay on the move so as to outpace some ultimate reckoning the nature of which he couldn’t begin to anticipate.

On the Move reads briskly. The chapters are broken into mostly light-hearted and often quite funny anecdotes, vignettes, and mini-essays, while the overarching structure of the autobiography builds on the themes introduced in the earliest pages. When Sacks’s father, wondering why his son never seemed to be interested in any girls, asked him if he might prefer boys, the young Oliver responded, “Yes, I do—but it’s just a feeling—I have never ‘done’ anything” (10). While he would eventually get around to doing something with a handful of lovers, all these relationships were remarkable either for their brevity or for their lack of intimacy. In London in 1973, Sacks, celebrating his 40th birthday, met a young man from Harvard and spent the following week with him. Though it’s a little heartbreaking, it’s not exactly surprising when Sacks reveals that “after that sweet birthday fling I was to have no sex for the next thirty-five years” (203). It would have been under thirty years into this unenforced sentence of celibacy when Sacks burst into that gay bar in 2000 and shouted at the patrons to stop talking about sex so they could have a look at something interesting.

The multiple sections of each chapter are connected thematically, so they jump around in time to some degree, even as the overall temporal direction is forward from Sacks’s early childhood into the present. The descriptions tend to come as though from a distance, as Sacks resists the temptation to fill in details lost to the void of normal forgetfulness—though several of his quoted letters, journal entries, and unpublished narrative essays do intermittently lend some enticing texture to many of episodes he recounts. As effortlessly engaging as each section is on its own, the rapid-fire cascade of what appear at first glance like loosely connected, even somewhat shallowly rendered reminiscences could easily detract from any sense of progression, blunting any compulsion toward further reading. What saves On the Move from being submerged in tedious and chatty meandering is the general picture that incrementally emerges through the reprisal of themes harking back to Sacks’s childhood and the earliest pages of the book. Considered collectively, the individual sections come to seem like tiles comprising an intricate mosaic, a portrait of a man on a quest that’s part scientific expedition and part something much more personal, a search for a manageable form of human connection, and for a viable reconciliation of his two professional roles, each of whose objectives are frequently at odds with the other’s.

When you consider the difficulty of arranging all the heartbreaks, triumphs, turning points, and tragedies that make up several decades of memories—along with all the scattered impressions and one-off encounters that have left their indelible marks—all into a book of under four hundred pages, you begin to appreciate the near impossibility of writing an autobiography that captures at all suitably the essence of a life. Most works in the genre rely heavily on the author’s celebrity for whatever modicum of interest they manage to pique. A man with an oeuvre as impressive as Sacks’s could also have coasted along on the promise of delivering the dish about what went on behind the scenes of his earlier works, all of which foregrounded the patients rather than the good doctor himself. With all those previous books, too, Sacks had the luxury of focusing closely in on the individuals, events, and relationships that he felt best illuminated whatever neuropsychological phenomenon he was then exploring—the memoirist’s advantage of a narrow scope. Approaching On the Move, Sacks faced the formidable challenge of composing an entire autobiography, which meant having to condense a long and extraordinarily rich life into a dozen or so chapters. The style and structure he adopted to meet this challenge, while much different from the methods on display in past books, serve as one more testament to his literary ingenuity.

On the Move does feature its fair share of celebrities, both Hollywood types like Robert De Niro and Robin Williams and scientific types like Stephen Jay Gould and Francis Crick. You also get plenty of background to the stories told in Sacks’s groundbreaking books. A vital theme recurring throughout the book, however, is Sacks’s seemingly endless struggle to find the best way to represent his experiences, and the characters at the center of them, in a prose register that does justice to the real lives, the real dignity and spirit of his subjects, while at the same time casting light on the neurological phenomena that so fascinate him. What has always made Sacks’s books so wonderfully engrossing, and what makes Sacks himself such a treasure, is his dual identity as a profoundly compassionate doctor and a consummate artist, one in constant search of the ideal form to convey his stories. His essays and books aren’t just cogent explorations of scientific mysteries; they consistently achieve the status of true literature. And now, with On the Move, Sacks has bequeathed to us a masterpiece of the autobiographical form.

As with all artistic masterpieces, though, you don’t close this book with any unalloyed feeling of uplift. Oliver Sacks’s life and his career raise some troubling questions about the driving impulse behind scientific and literary achievement. Again and again throughout his life, Sacks has played the role of outsider, either by force or by choice. The early chapters of On the Move in which he recounts his days as a motorcycling aficionado give a sense of what it took for him to quell his fears of isolation and unworthiness. He writes,

There is a direct union of oneself with a motorcycle, for it is so geared to one’s proprioception, one’s movements and postures, that it responds almost like a part of one’s own body. Bike and rider become a single, indivisible entity; it is very much like riding a horse. A car cannot become part of one in quite the same way. (96)

Sacks would usually experience this union of man and machine over the course of long journeys he embarked on by himself. He would thus spend hour after hour, alone but connected with a near-living machine that responded intimately to his bidding, and forever moving toward something, away from certain other things—this is Sacks in his element. But the motorcycling that gave him such joy wasn’t completely without a social dimension:

America, I imagined, was a classless society, a place where everyone, irrespective of birth, color, religion, education, or profession, could meet each other as fellow human beings, brother animals, a place where a professor could talk to a truck driver, without the categories coming between them.

I had had a taste, a glimpse, of such a democracy, an equality, when I roved about England on my motorcycle in the 1950s. Motorcycles seemed, even in stiff England, to bypass the barriers, to open a sort of social ease and good nature in everyone. “That’s a nice bike,” someone would say, and the conversation would go from there. Motorcyclists were a friendly lot; we waved to one another when we passed on the road, made conversation easily if we met at a café. We formed a sort of romantic classless society within society at large. (72-3)

Sacks could, in such a society, avoid being forced to answer for his difficulty recognizing faces. He could escape questions about his sexual preferences. Even within this ideal society, though, Sacks was given to withdrawing. He writes of being accepted by the Hells Angels, for instance, who were charmed by the notion of a biker with an MD, but he never actually got around to going on any rides with them.

Another obsession that took hold of Sacks as a young man, and that takes up a significant portion of the first half of his autobiography, was weightlifting. This endeavor too brought Sacks into a community of sorts, and yet he participated in this loose-knit society in just as marginal a way as he did that of his biker comrades. Sacks’s descriptions of motorcycling suggest that for him riding was a way of settling the paradox of a fiercely guarded man quietly yearning to connect and belong, in union with a machine that could create the illusion of sentience, even acceptance. With weightlifting too, we see him engaged in solitary exercises that nonetheless take place in, and derive their significance from, a group of likeminded fellow practitioners. But Sacks reveals later in the book that what he was after with bodybuilding was much more straightforward.

I sometimes wonder why I pushed myself so relentlessly in weight lifting. My motive, I think, was not an uncommon one; I was not the ninety-eight-pound weakling of bodybuilding advertisements, but I was timid, diffident, insecure, submissive. I became strong—very strong—with all my weight lifting but found that this did nothing for my character, which remained exactly the same. And, like many excesses, weight lifting exacted a price. (122)

If motorcycling was for Sacks an attempt to square the circle of his competing needs for solitude and companionship, weightlifting seems to have been more about wanting to make himself powerful to compensate for feelings of powerlessness. Both obsessions, crucially, could be indulged in solitude, but both likewise attracted a circle of fellow enthusiasts. If there’s a single thread that ties the diverse episodes of Sacks’s autobiography together, it would be this theme of lonely intimacy, connection at a distance, roaming the far reaches in search of home.

Sacks, it becomes clear, is not only perfectly aware of the repetition of these notes throughout the book; he’s using them quite deliberately and to striking effect. The title of the book derives from a poem by Thom Gunn, one of Sacks’s many close friends living at a distance. The two routinely shared lessons learned from their lives as writers, as well as insights gleaned from their experiences with hallucinogens and other drugs. Sacks writes,

We had launched on journeys, evolutions, developments, that could not be entirely predicted or controlled; we were constantly in motion. In “On the Move,” which Thom wrote in his twenties, are the lines

            At worst, one is in motion; and at best,

            Reaching no absolute, in which to rest,

            One is always nearer by not keeping still. (278)

“Reaching no absolute” captures much of the essence of Sacks’s identity. Over the course of the autobiography, the stage on which he struggles with the many nuances and contradictions of his life shifts from the road and the gym to the hospitals housing his patients and the pages containing his prose. In his professional life, his obsessions have made him just as unplaceable as he is in his personal life. He’s had all the practical difficulties of balancing his patients’ needs with his readers’ desires, his desire to maintain his scientific professionalism with his graciousness toward his audience (a comment he once received from an editor: “The book is too easy to read. This will make people suspicious—professionalize it” [151]), and his role as a doctor with his role as a writer. But his stake in each of these struggles has always been deeply personal.

Despite the theme of never-ending motion, On the Move does offer a gratifying sense of direction as we see how Oliver Sacks became the great figure we recognize today by that name. This evolution was as much personal as it was scientific, since to write his breakthrough work Awakenings, the inspiration for a movie of that title starring Robin Williams as a stand-in for Sacks, he not only had to do experimental drug treatments with catatonic patients, but he also had to arrive at an understanding of what his role could be as a doctor and a friend to his subjects, and as a writer turning them into semi-fictional characters. He then had to figure out how to convey something of the essence of that relationship to his readers. One of his favorite responses to the finished book came from none other than Thom Gunn, one of his partners in constant motion. Comparing Awakenings to some of Sacks’s earlier writing, Gunn admits he saw those initial works as deficient and despaired of his friend’s prospects for overcoming the underlying shortcoming. In a letter, Gunn explained,

What I didn’t know was that the growth of sympathies is something frequently delayed till one’s thirties. What was deficient in these writings is now the supreme organizer of Awakenings, and wonderfully so. It is literally the organizer of your style, too, and is what enables it to be so inclusive, so receptive, and so varied…. I wonder if you know what happened. Simply working with the patients over so long, or the opening up helped by acid, or really falling in love with someone (as opposed to being infatuated). Or all three… (276).

Sacks doesn’t have any fully resolved answer to the question of what precipitated the transformation, but he suggests that both his own and Gunn’s development had much to do with “the sense of history, of predecessors” (277).

Sacks’s coming into his own with the publication and success of Awakenings does place him in an easily recognizable position among the scientists and explorers of yore, so much so that it makes you wonder if his alienation could be attributed to him having been born some hundred-odd years too late. His essays often read like dispatches from exotic regions, messages home about how much stranger, how much scarier, and how much more wonderful the world is once you step beyond the bounds of your own personal known world. This element to his writing didn’t come about through chance. He writes,

I used to delight in the natural history journals of the nineteenth century, all of them blends of the personal and the scientific—especially Wallace’s Malay Archipelago, Bate’s Naturalist on the River Amazons, and Spruce’s Notes of a Botanist, and the work which inspired them all (and Darwin too), Alexander von Humbolt’s Personal Narrative. It pleased me to think that Wallace, Bates, and Spruce were all crisscrossing one another’s paths, leapfrogging, on the same stretch of the Amazon during the selfsame months of 1849 and to think that all of them were good friends. (They continued to correspond throughout their lives, and Wallace was to publish Spruce’s Notes after his death.)

They were all, in a sense, amateurs—self-educated, self-motivated, not part of an institution—and they lived, it sometimes seemed to me, in a halcyon world, a sort of Eden, not yet turbulent and troubled by the almost murderous rivalries which were soon to mark an increasingly professionalized world. (330)

All these great friends, traveling far and wide, corresponding at a distance, fueled by an insatiable wonder, and all writing unforgettable tales of their adventures—how could Oliver Sacks not love these stories? How could he not feel perfectly at home as his own career began to take on a shape resembling this lost ideal, even if the resemblances were only superficial?

On the Move, as the autobiography of a scientist, is as much about the author’s evolution as an intellectual as it is about his personal development. The penultimate chapter is primarily focused on Gerald Edelman’s theory of neural Darwinism. The idea strikes Sacks as so compelling and far-reaching in its implications that he remembers feeling grateful when the full realization of its import sank in. “I thought, ‘Thank God I have lived to hear this theory.’ I felt as I imagined many people must have felt in 1859 when the Origin came out” (365). It’s not the least bit surprising that Sacks felt this way about a theory of neurological and mental development, especially one that could explain the quintessential uniqueness of each individual. What’s remarkable—genius really—is how the discussion of neural Darwinism ties so many of the book’s themes so neatly together.

What is the theory? The idea is that the mind emerges from the communication of a variety of distantly located regions of the brain. Sacks explains,

Such correlation and synchronization of neuronal firing in widely separated areas of the brain is made possible by very rich connections between the brain’s maps—connections which are reciprocal and may contain millions of fibers. Stimuli from, say, touching a chair may affect one set of maps; stimuli from seeing it may affect another set. Reentrant signaling takes place between these sets of maps as part of the process of perceiving a chair. (363)

This reentrant signaling is a type of real-time updating of maps based on information coming in from various sensory inputs, as it gets channeled through and incorporated into still other maps. It wouldn’t be too much of a stretch to use as a metaphor for reentrance the rich correspondences of nineteenth century explorers and scientists, all collaborating to generate a more comprehensive and accurate view of the natural world. “And in its broadest sense,” Sacks writes, “neural Darwinism implies that we are destined, whether we wish it or not, to a life of particularity and self-development, to make our own individual paths through life” (369).

Sacks’s endorsement notwithstanding, the scientific community is far from reaching a final verdict on Edelman’s theory. It may however receive quite a boost from Sacks’s treatment in his book (especially considering that Edelman’s own writing is significantly less reader-friendly). But what I was left wondering when I turned over the last page of On the Move was how much Sacks’s love of writing owed to his need to correspond at a distance, a need that very likely arose from the insecurity and rejection he experienced as a young man. You can’t be a great writer until you’ve found your great subject. For Sacks, this was neurology. But you can’t be either a great writer or a great doctor unless you’re driven by a mad passion to explore, understand, tinker, and improve. When Sacks writes about being shy and hiding out in a corner of some bar, we know he was probably busy either filling a notebook or marking up some text written any time in the last three centuries. While he’s sitting there failing to connect with his fellow humans, in other words, he’s working to produce the very pieces of writing that make him such a treasure to all of us. If he’d had a choice to begin with, would Sacks have considered this a good trade? Would any of us?

Even if the obsession that underlies successful scientific and literary careers doesn’t originate as a compensation for some social debility, then that same obsession, once developed, is likely to become a social debility in its own right. I think about this now that Sacks is gone and any opportunity I had to write to him about how much his work has delighted, fascinated, influenced, and inspired me over the past two decades is gone with him. After his New York Times essay in February, in which he revealed that he had terminal cancer, I, along with probably thousands of other readers, felt a tiny panicked urge to write and express our gratitude before it was too late. Thinking of those thousands of others, I decided writing would be pointless. But that’s the paradox I’m left with: a man who touched countless lives but who remained unreachable, often despite himself, in his own life. The chief solace we have is that while Sacks’s personal struggles may not have ever been resolved, the scientific and literary work those struggles made way for remain for still more countless others to be touched by in the future.