The highs and lows of Oliver Sacks

ON THE MOVE
A life
Oliver Sacks
LexisNexis
166 pages; Rs 295

In this final rambling memoir, Dr Oliver Sacks, neurologist and science writer, brings his empathy and diagnostic skills to bear on himself, honestly and without restraint. Sacks is present in every book he has written. But he is mostly a narrator, the doctor who explains oddities of brain function. It is the patient, the one afflicted, who is the focus of attention. Even in autobiographical works like Uncle Tungsten and A Leg to Stand On, he maintains high levels of personal reticence.

The lowering of barriers may have been prompted by knowledge of his impending death. In early 2015, Sacks announced his cancer had progressed to a point where he had months to live. He died in August. He worked till the end, meeting patients, giving lectures and, above all, writing.

On the Move was published in May. The title is borrowed from a poem by his friend, the poet Thom Gunn. The book starts with a teenager studying medicine in England. It samples interesting moments in his life all the way till 2015.

He was born into an English-Jewish family in 1933. Both parents were doctors and so were two of his three elder brothers. Sacks fled the prospect of doing national service and ended up studying in California. He was also escaping a stifling family situation. His mother disapproved of his sexual orientation and the household was often disrupted by the "florid psychosis" of his third brother, a schizophrenic.

He became a clinical practitioner in New York. He had always been a compulsive journal-keeper. Over the years, his case notes transmuted into utterly fascinating books. He kept abreast of new developments; that, in itself, was impressive as neurology evolved. But his books work in literary terms because, quite apart from the medicine, the patients are treated like "normal" people, characters described with humour and empathy. He changed the patterns of lay understanding of, and engagement with, neurology. His intense case studies not only defined his life; they connected readers to pseudonymous strangers.

In-between full-time practice and writing, Sacks rode fast motorcycles. As an intern, he often rode 500 miles (800 km) on Friday nights to see the sun rise in Grand Canyon on Saturday morning. He also swam and went scuba-diving, sometimes putting himself at serious risk. He lived on Muscle Beach and set a California state power-lifting record, squatting 600 pounds (272.4 kg). He spent the summer of 1955 on a kibbutz, recovering from depression triggered by a failed research project.

He has suffered his share of angst. He describes the highs, hallucinations, insights and physical damage of years of intense drug abuse. He suffered from an unusual and embarrassing condition - prosopagnosia, which is an inability to recognise or remember faces. He also suffered many accidents, breaking bones and tearing muscles while swimming, biking, driving, lifting weights, and being chased off a mountain by a bull. He has endured horrific pain due to spinal damage. Late in life, he lost an eye to cancer. In every instant, he studied himself and his pain, with an absence of self-pity and cool attention to detail.

Sometime, somewhere, perhaps with the help of years of therapy, he came to terms with his homosexuality and his mother's brutal response to his coming out ("I wish you had never been born"). Sacks lost his virginity in terrifying fashion. He got blind drunk and awoke the next morning to discover he had been violated by a stranger who gave him coffee and sound advice about the dangers of getting drunk and passing out on the street.

He had a few affairs, followed by a long hiatus after he turned 40. He says he was celibate for 35 years before he found love at age 75 with the writer, Bill Hayes. A pop psychologist would infer that he sublimated his libido into work during that sexual drought. He worked 24x7 at his clinical practice and he wrote and rewrote his manuscripts. An obsessive man, he lost himself in his enthusiasms to the point where, for example, he walked around Manhattan during a lunar eclipse, thrusting his telescope at strangers and demanding they look at the moon.

His wide-ranging interests meant that his friendships also ranged across professions. There are little vignettes about interactions with scientific geniuses like Francis Crick and Gerald Edelman, actors of the calibre of Robert De Niro and Robin Williams, and writers like Gunn, Richard Selig, Jonathan Miller, Stephen Jay Gould and W H Auden. His family is also described in detail as is his encounter with the Queen.

There are dangling threads, matters mentioned in passing, which tantalise, for this is not a comprehensive account. There is an absence of the political. There is nothing about Obamacare, or the Lesbian, Gay, Bisexual and Transgender movement, to mention just two issues that affected him. Most of all, we never learn how a young man, once criticised by Gunn for lack of empathy, developed precisely that quality to such a degree.

There may be answers in his journals. One hopes those will be placed in the public domain after redaction. But until then, this book will serve to illuminate us about the inner life of an extraordinary individual who told his parents that he would live a "fairly happy and useful life". He kept that promise.