*On the Move, Oliver Sacks, 2015.

These are my notes on On the Move, Oliver Sacks autobiography (billed as volume 2, but the publisher, volume 1 being Uncle Tungsten: Memories of a Chemical Boyhood, written a couple of decades earlier). This is part of the course of essay reading I am doing with CT; in particular, this is part of what we have dubbed ‘The Summer of Sacks.’ These are not, of course, essays, but we have become interested in Sacks, and it is interesting to see the essays against a fuller narrative of his life.

Contents

C1: On the Move

1948 – 1960, with flashbacks to boyhood and adolescence: London, Israel, Amsterdam

On his love of motorbikes and riding as an adolescent in London. Coming out as gay to his parents and rejection. Tea with a prostitute. On track to be a doctor; prelims at Oxford; love of libraries; interest in scientific history. Second worst in anatomy; getting drunk; deciding to take test for scholarship and winning it. Friendship with Kahlman Cohen, a logician who trained at Reed; hitchhiking around Europe together. J. J. Gibson’s lectures. Richard Selig: taking; in love; diagnosing his cancer; his death. Research at Oxford; wrong choice in labs due to being allured by professor’s lectures on history. Depressed; parents sent him to work on a kibbutz in Israel: he didn’t fit in, but it was a cure for his depression, and he got in good physical shape. After that, still in Israel, he learned to scuba dive. Losing virginity in Amsterdam. Begins medical school in London in 1956 and became MD in 1958. After that did residency and worked with Kemerer and Gilliatt in their neurology lab. On living as a closeted gay in London, with occasional visits to Amsterdam; affair with Bud.

C2: Leaving the Nest

1960: Motorcycling across Canada and around US Southwest, interleaved with residency; flashbacks to 1950’s and brother Michael’s schizophrenia. Canada.

Plans to do military service as doctor in New Guinea via England’s Colonial Service fell through when program ended. Also the draft was about to end, but feeling like it was a moral obligation S wanted to put in his time, but decided to do that by going to Canada and doing his service in the Canadian Airforce; but an officer interviewed him, suggested he travel of six months first, and so off he went, never to pursue the military service again.

Sacks travels across Canada, meets interesting people, one of whom urges him to pursue medicine, and gets drafted for a day of firefighting. A flashback to his home life, and his brother Michael’s schizophrenia, how he distanced himself from it, and the shame he still feels about not doing more.

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.
– Oliver Sacks, On the Move, p. 65

C3: San Francisco

1960–1961: Job at Mt Zion; SF area motorcycling. Friendship with Carol Burnett and Thom Gunn. Ride across U.S. and time with truckers. California and southern US.

After traveling across Canada, Sacks arrived in San Francisco, “a city I had dreamed of for years.” Without a green card that enabled him to work, he volunteered to work for Drs. Levin and Feinstein, a pair of neurosurgeons that he was hooked up with by Michael Kremerer, his neurology chief at Middlesex. Levin and Feinstein could not pay him a salary, but gave him occasional $20 notes (at a time when that was a lot), and arranged for him to get a room to live in at the Mt. Zion hospital. During this term S had purchases a new motorcycle, and fell in with a group that cycled around the bay area; he also happened upon a group of Hell’s Angels who he hung out with socially, a little. He obtained a green card after six months, and was able to do an internship at Mt. Zion — he felt this was re-treading old ground (it did not involve neurology), but it was a requirement for foreign-educated doctors. However, it also allowed him to interact with a talented group of international interns; and Levin and Feinstein allowed him to continue to evaluate their patients and also took him to conferences. During this time he also made friends with Thom Gunn, a poet he admired and whom another friend suggested he would be simpatico with; he did that, and it turned into a friendship. Later, as Sacks was leaving San Francisco for another circuit of the US, Thom suggested he keep a journal, which he did. An excerpt from the journal describes some time he spent with a trucker and his partner, and gives a glimpse of a trucker’s life on the road.

…reading break…

C4: Muscle Beach

1962 – 1965. Internship at Mt Zion and 3 year residency at UCLA; and his night/weekend life of weightlifting, swimming, and drug use..

Sacks buys a new BMW motorcycle to replace his defunct machine, and rides west across the U.S. to begin his internship with xxxx at Mt Zion hospital. In 1962 Sacks begins his residency at UCLA, and participates in a journal club where he tries to convince others to read 19th century papers — they’re not interested, except for his friend Eric Korn (who eventually drops out and become an anitquarioan bookseller specializing in Darwinia). At this time he published his first paper on Myoclonus, and wrote a small book whose manuscript was lost when the scholar he sent it to died. In 1964 he had a patient who suffered from acute jerking of his limbs; a few weeks later the patient died in an automobile accident, and Sacks was able to examine his brain which showed axonal swelling, and suggested a rare disease characterized by Halvorden and Spatz in 1922. Eventually, towards the end of his internship, this lead to a photo-exhibit on axonal dystrophy, which was successful enough to get him a number of job offers.

At the same time, we hear much more about the night/weekend side of Sacks’ live when he exchanges his white hospital uniform for his black motorcycle leathers. There are solo motorcycle trips around the southwest, including two violent interactions with aggressive motorists; an ambiguous almost-love affair with Mel, the aftermath of which left him shaken and depressed; there is his increasing involvement in the weight lifting community, and the friends he made; there is a near-death experience (and two more in a footnote) as a consequence of being out in rough water; and there is experimentation with an increasing array of drugs, culminating in amphetamine addiction. Sacks clearly took a variety of physical risks, which may have been encouraged by insecurity and depression.

C5: Out of Reach

1965 – 1968. Fellowship at Einstein school of Medicine; transition to clinical work at a headache clinic; his first book, Migraine. At the same time he became increasingly dependent on amphetamines, but finally realized that he had to quit and started seeing an analyst who helped him.

Sacks’ fellowship did not work out well — he made a discovery which turned out to be an artifact. Likewise, he was studying myelin for his work in neurochemistry, but lost nine months of experimental data when he failed to secure his lab notebook to his motorcycle. He continued with his research, but after several mishaps culminating in the loss of his entire sample of myelin, he was shunted into clinical work.

Sacks recounts an episode where he was invited to an Angel Dust (PCP) party, and arrived late, and found the participants in horrible states; he called the ambulance, and people were taken to Bellevue, some of whom remained there for weeks. At this time he also encountered a paper, and read literature, on the awful effects of PCP. This — especially the party — appears to have shaken him but he does not say that this led him to stop using drugs.

Sacks meets a man named Karl in Amsterdam, and they have an Amphetamine-fueled love affair in Paris. (I’m not sure when this occurs relative to the Angel Dust party.) However, as they correspond for months afterwards, the effect wears off and they fall out of love. (Three years later — after Sacks has stopped using drugs — Karl comes to New York and they meet up: Karl is in terrible shape, completely ravaged by speed, and Sacks reacts with horror.) Sacks is continuing to use amphetamines, and then used a hypnotic to get to sleep at night; when he runs out, he develops delirium tremors and calls his friend Carol Burnett in a panic; she nurses him through it. About New Years, 1966, he has an epiphany and realizes he will not last another year if he stays on his course; he seeks out and works with Dr. Shengold, an analyst who requires him to quit drugs as a condition of working with him. Sacks is still seeing him 49 years later, as he writes this autobiography.

In October of 1966 he began to see patients in a headache clinic, and this enabled him to taper off drugs. (He had one final experience in early 1967, during which he saw that he could write a book on migraine, and perhaps other books as well.) The headache clinic was founded and run by Arnold Friedman, who initially took a shine to Sacks, and then appears to have gotten jealous, particularly when Sacks wrote Migraines. This stemmed from the 1967 amphetamine fueled epiphany he’d had, and while he was on vacation in Europe, the book ‘gushed; out of him in a couple of weeks. He showed it to Friedman who said he’d have someone review it, and produced a venomous review (which, it is implied, was likely written by Friedman himself). Sacks held off for a while, but then in 1968 he took vacation (Friedman fired him because Sacks admitted that it was to write the book) and produced a second version in about 9 days, in something of a manic state. He submitted the book, and the publisher accepted it, but did not publish it until Sacks hired an agent who pressured them. It was published to good reviews in 1970. It turned out later that Friedman had plagiarized some of the chapters, and tried to discourage Sacks from publishing, likely to hide the fact. Sacks is remarkably philosophical about the incident.

The chapter ends with a section on Aunt Lennie, his favorite Aunt, one who encouraged and accepted him in all things. It’s a nice story.

…reading break…

C5: Awakenings

1966 — 1976. After being fired from the migraine clinic, he begins seeing patients at Beth Abrams; this leads to his interest in the encephalitis lethargic epidemic of the early 1920s, and eventually to his book and documentary: Awakenings. Also descriptions of his interactions with his mother and Luria (on Awakenings), and a brief affair he had.

In 1966 Sacks begins seeing patients at Beth Abrams which has many patients who were victims of the encephalitis lethargic epidemic of the early 1920s. He becomes interested in post-encephalitic syndrome because this is a disease that effects every patient differently, and causes disturbances at every level of the nervous system; he comments that he saw lots of ‘fossil’ behaviors that seemed prehuman: clawing, grooming, panting, lapping, etc. He pays attention to the nurses, who believed that many of them had intact minds and personalities locked behind their disabilities. He arranges to have all the patients moved into one ward. Eventually he tries dosing them with large amounts of L-Dopa, and they respond… Eventually this leads to his book Awakenings, started in 1972 (with encouragement and support of his mother), and published in 1973, with a documentary produced in 1974.

In 1971, as he is working on some of the case histories that will make up Awakenings (originally written in 1969, but discarded when Faber and Faber was not interested), a friend gives carbon copies to Colin Hayworth, a former classmate who now runs a publishing house. Hayworth is encouraging, and does a variety of things to urge Sacks to write the book, including putting some of his case studies into proofs.

Luria: Heard lecture in 1958; read two books in 1966, and Mind of a Mnemonist in 1968. The latter changed the course of his life, serving as a model of the short but deep sort of case histories that he would come to write. He would later, upon the publication of Awakenings, receive letters of praise from Luria.

The chapter also provides accounts of his friendship with W. D. Auden, and a brief affair he had — his last for thirty five years.

C7: The Bull on the Mountain

1973 — 1983. Ward 23; hiking accident and leg injury and healing; he works on A Leg to Stand On for ten years, which is finally published in 1983. Also Jonathan Cole contacts him and come to work with him and develops into another ‘medical writer.’

Visits to the Lake Jefferson hotel, at first by motorcycle (which he gave up in the early 70’s because ‘too dangerous!”) and then by car , where he swam and road horseback and would bicycle a lot, with 2 gallon-jugs of hard cider. 1978 death of Aunt Lennie. 1979 vacation to Holland with Eric Korn.

Fired from Beth Abrams (he is reinstated in 1975) when he objected to being moved out of his lodgings next door to make room for the Director’s mother, Sacks makes do with various odd consulting jobs, and the gets a half-time position at Bronx State and a job in its hospital. This goes awry after he challenges the locked-ward reward-punish model; he ends up leaving, and going to Norway where he intends to write a book on Ward 23.

But, while hiking in Norway, he has an encounter with a bull, and severely injures his leg. His recovery is slow, and he has initially lost all feeling in his leg and as sensations return he has the feeling it is not his leg, which lead him to think about sensory maps in the brain.

The leg incident taught me in a way which I could not , perhaps, have learned otherwise about how one’s body and the space around one are mapped in the brain and how this central mapping can be profoundly deranged by damage to a limb, especially if this is combined with immobilization and encasement. It also gave me a feeling of vulnerability and mortality which I had not really had before. In my earlier days on the motorbike, I was audacious in the extreme. Friends observed that I seemed to think of myself as immortal or invulnerable. But after my fall and my near death, fear and caution entered my life and have been with me, for better or worse, ever since. A carefree life became a careful one, to some extent. I felt this was the end of youth and that middle age was now upon me.
—Oliver Sacks, On the Move, p. 218

Eventually, with the encouragement of Colin Hayworth, who had published Awakenings, he produces the manuscript of A Leg to Stand On. However, during the summer of 1975, something “goes wrong,” between Sacks and Hayworth, and their interactions became very negative, and book languished. Subsequently he wrote and re-wrote various versions of the book, and corresponded with Hayworth and Luria about it in voluminous letters. Finally, in 1983, he sent a 300+ page version of it to Hayworth who, though infuriated, edited down to 58,000 words and finally published it. (At this time, while working with his American publisher, he was connected with Kate Edgar, who has worked with him as an editor on his subsequent books ever since.)

During this period he begins working in — or consulting at — nursing homes run by The Little Sisters of the Poor, and finds their approach to treating patients as whole people in line with his own. A very 18th century approach. This stands in contrast to other nursing homes, where patients are treated horribly.

In 1976 he receives a letter from Jonathan Cole, a medical student, who wishes to work with him during his elective period. They arrange for this to happen in 1977, and they develop a good relationship; eventually Cole develops into a medical writer on the middle of Sacks.

There is a flashback to time spent at the Lake Jefferson Hotel, a mention of giving up motorcycling in the early 70’s because it was too dangerous (I wonder if this coincides with the revelation he describes in connection with the ‘leg incident’), and trip to Norway with Eric Korn, where he an incident occurred that made him realized that he was loved by many. He wonders if, in part, this difficulty was connected to being evacuated and separated from his family during the War.

C8: A Matter of Identity

1971 – 1985. While working on A Leg to Stand On, Sacks also developed an interest in Tourettes and made friends with and carried out in-depth studies of several people with Tourettes. During this time he also began working with the deaf, and published a number of articles which eventually coalesced into The Man Who Mistook his Wife for a Hat, which made him famous in the US.

While working on A Leg to Stand On he had also been pursuing other things. Tourettes became an interest because some of the symptoms of ‘awakened’ patients were Tourettes like, and that lead to a long term friendship with ‘Witty Ticcy Ray.’ Became involved with the Tourettes Syndrome Association in 1974.

Met John P whom he studied closely, but then after they made a documentary it all went awry in 1978, as his concern about publicity morphed into paranoia and psychosis.

Wrote a full length case history of “Witty Ticcy Ray” in 1980. In 1983 went to a writers retreat, and had one productive day during which he wrote an entire article, and 29 blocked days where he produced nothing. The publication of this left him feeling encouraged, and he wrote five more pieces which would eventually form the nucleus of The Man Who Mistook his Wife for a Hat. This book made him famous in the US (Awakenings really had only gotten notice in England).

An episode of working with deaf people. Meeting and involvement with Leon Handler, the Tourette’s photographer. Involvement with Gallidet protest, and then work on ASL.

Describes an impromptu trip to New Zealand, for which he neglected to secure a visa. Allowed to visit for only 10 days, he connected with his brother Marcus, and formed a long-lasting relationship unlike that he’d had with other brothers.

A few interim reflections

In conversation with CT, we discussed how Sacks always seemed to attract people who would help him. CT suggests that perhaps he put off an aura of ‘needing help’ or ‘being open to help.’ This is most evident in his writing, where the degree and intensity of help and assistants he attracts is astonishing; but we can also see that he impressed others, from the various medical practitioners who helped him at various points in his career, to the friendships he formed with patients (e.g. Ric and Lionel, the Tourettes people).

It seems clear that Sacks was always financially stable. He appears to have come of a wealthy family of doctors, with a manor house in London, though he certainly describes borrowing money from friends at times, e.g., to buy a motor cycle. He was also, pretty early on, able to help support his ‘monstrous aunt’ (as we will see in the next chapter.

And it seems evidence that Sacks was a man of strong convictions with moments of brilliance. A particularly notable incident is when he was able to convince a director to allow him to move all the post-encephalitic patients into a single ward, a task that must have been logistically complex. This is one of the earlier examples of him trying to create community for his patients, and to enable them — in spite of the challenges they faced — to live full lives.

…reading break…

C9: City Island

1979 – circa 1990. Finding a house on City Island; his neighborhood and community; swimming at the beach. The people he knew at the time: 2nd cousin Aubrey; his monstrous Aunt; Larry; the Capps (formerly Capplins). The ‘translations’ of Awakenings into other media, and particularly the making the of film and his interactions with the actors.

Friendship and exchanges with Thom Gunn in later years and towards end of life
Would do six hour swims around City Island; on one of these he spotted a house for sale and bought it
City Island was a real neighborhood with its own customs and local feel.Sacks describes some of his neighbors: Skip and Doris; David a sometimes swimming partner. In the 1990’s he reconnected with Larry a now-homeless drug-addicted weight-lifting friend from years ago
1994: Adopted a cat for a while
This is where he first engaged Helen Jones, his housekeeper, who would later learn to make gefilte fish
Talks about his cousins Al and Aubrey and the “dear monstrous” Carmel Capp.
Awakenings inspires a play (by Harold Pinter) and film (by Parks and Lasker) and Hat an opera (by Michael Naiman).
Talks about working with Robin Williams as he prepares for Awakenings film;

C10: Voyages

A somewhat scattershot chapter spanning much of his later life. Primarily talks about voyages, and the interactions and relationships that led up to them. Also discusses interactions with various scientific figures of note. Didn’t find this chapter so interesting.

…A bit of speculation, but as this book was completed or at least assembled after Sack’s death, it is conceivable that he did not fully finish this and the subsequent chapters which seem short on the narrative side.

The final portion of his brother Michael’s life, in particular in the context of his relationship with his father after his mother died.
Meetings with autistics: Steven Wilshire and Temple Grandin the fed in to An Anthropoligist on Mars.
Encounters with blind-from-birth-people who have had their sight restored, and other people with unusual visual deficits; work with Richard Gregory.
Trip to Guam with John Steele to study a population with endemic progessive supranuclear palsy; while there also heard about and eventually visited “The Island of the Colorblind” to make documentaries, all of which eventually found their way into the aforenamed book.
Interactions with Roald Hoffman.
Trip to Oaxaca
Exchanges with Steven Jay Gould and discussions of the role of chance and contingency in evolution, and how that evolved into the documentary A Glorious Accident, and then into a book.

C11: A New Vision of the Mind

Mildly interesting. HIs relationships with various famous neuroscientists…

The account of the colorblind artist, and his encounter and subsequent interactions with Richard Siegal whom he by chance encountered at a concert where he was writing up notes about the artist.
His relationship with Francis Crick, and their interactions.
His relationship with Gerald Edelman and his interest in neural Darwinism: neuronal groups organized into dynamic maps that engage in re-entrant signaling.
Examples of people who have knowledge but don’t know that they know what they know: e.g., blindsight, where part of their brains know what is in their blind spots…

C12: Home

A bit of a grab bag, and an increasing array of chronic medical problems, one of which will later end his life.

How England felt less of a home after his father died and the family house was sold
His receiving a knighthood
The origin of his book Musicophilia.
His diagnosis with cancer in 2005; his loss of sight in his right eye due to radiation in 2009 — but the latter did stimulate him to take extensive notes on his experience and eventually to write the book “The Minds Eye.”
The advent of sicatica and its impact on his life; it recedes after a few months, though it is not clear why.
His meeting and relationship with Billy, beginning in 2008
A few comments on journal-keeping and note-taking, and the pleasure of writing.