Inspiring Older Readers

posted on 07 Mar 2019

On the Move: A Life – the autobiography of Oliver Sacks

Nearly one hundred years ago there was a pandemic of encephalitis lethargica – sleepy or sleeping sickness. The pandemic killed tens of thousands around the world but those who survived were left in strange, ‘locked-in’ catatonic states, immobile for years or given to occasional bursts of frenetic movement. They required constant care for decades.

In the mid-1960s, there were still hundreds of these forgotten, institutionalised patients alive in hospitals in England, the US and Europe. It was the neurologist Oliver Sacks’ work with these patients that made him famous. Written about in his second book Awakenings, published very early in 1973, it introduced a lyrical, poet-scientist’s view of medicine to a global audience: what would previously have been published only in medical and neurological journals became a surprise bestseller. It was the basis of a subsequent TV documentary and in 1990 of a hugely popular film starring Robin Williams, who portrayed Sacks. Reviewing Awakenings on its first publication, the critic Frank Kermode wrote: “…this doctor’s report…is written in a prose of such beauty that you might well look in vain for its equal among living practitioners of belles lettres”.

When Sacks discovered these post-encephalitic patients he was working at the Beth Abraham hospital in the Bronx, having relocated from England to the US in 1960. The sort of bloodless, pious jargon that now dominates virtually all health debate – “holistic person-centred care”, “dignity and respect benchmarks”, or “Leading Change, Adding Value”, as one recent framework for care staff was titled – has no place in Sacks’ work. (This is the kind of jargon that is parroted most vociferously by those with the greatest ideological commitment to dismantling and privatising the NHS.) Sacks lived these principles throughout his life; they drove him; and he spared nothing – and especially not himself – in finding a way to capture the stories, the experience and the suffering of the people he cared for that would elevate these ‘case histories’ to the status of literature. He went on to publish sixteen books. The New York Times called him “the poet laureate of medicine”. He died from cancer in 2015 aged 82.

These, then, are the bare facts. But as with many extraordinary people, the bare facts serve only to render them more enigmatic. I have always found this to be especially the case with Sacks. Although he revealed a little of himself at various times in his writings – including an earlier memoir, Uncle Tungsten, published in 2001 – it wasn’t until his autobiography proper, On the Move, published in the year he died, that it became possible to take a fuller measure of the man.

But is his autobiography ultimately revealing – is it an explanation of what made the man, and how? Personally, I don’t think it is – but that is not to say that it isn’t utterly fascinating, often gripping, and of course superbly well written. It is all of these things – but paradoxically, Sacks the physician, the poet-scientist of neurology, emerges as such an unlikely, contradictory, disorganised and precarious figure that one wonders how he achieved anything at all.

For a start, how did a shy, socially inept young man, born into what one might describe as the North London Jewish intelligentsia (the Sacks family at times seems so large as to constitute its own diaspora) end up in the US? We do find out, but only after a fashion. (I think Sacks sometimes thinks we already know what he has omitted to tell us or has merely hinted at.)

He was approaching forty before he found his true role – the seeing of patients rather than medical research. By his own account he was a somewhat chaotic and undisciplined researcher. But prior to this he was a driven, obsessive figure, his life characterised by excess. Moving to the US in 1960, his twenties and thirties were dominated by hedonism, drugs, motorbikes, weightlifting, scuba diving, body-surfing, and a gradual discovery of – and quest for – intimacy with other gay men. Like others who made the same transatlantic relocation before him – such as the poet Thom Gunn, who was a friend, or David Hockney – the US seems to have offered Sacks liberation of a sort.

He was eventually to leave drugs behind – although he was, by his own admission addicted to amphetamines on a prodigious scale for several years. And after coming to terms with his homosexuality and abandoning the guilt and self-disgust that his early years had instilled in him, he spent thirty-five years in celibacy.

But in a sense these are only further examples of the extremes, the excess, that characterise Sacks’ behaviour. For instance, in his thirties he would take off for weekends on his BMW motorbike, thinking nothing of covering a thousand miles between leaving his hospital post on Friday night and returning to it on Monday morning.

In the early years at Beth Abraham hospital he volunteered for permanent on-call night duty, which all the other staff loathed. This entitled him to an adjoining apartment, which became an open house at all hours for colleagues, staff, doctors and patients, a sort of perpetual, revolving workshop or encounter group for clinical discovery.

Briefly back in England he was seeking a way to publicise the stories of the post-encephalitis patients he was caring for and was commissioned to write a piece for the BBC’s magazine, The Listener (its then-editor, Mary-Kay Wilmers, lived in the same neighbourhood). He jumped at the chance – and over the course of a few days sent her nine different versions of the piece.

Another neighbourhood acquaintance was Colin Haycraft, the publisher-owner of Duckworth, who commissioned the book that finally became Awakenings. Having completed the manuscript Sacks more or less moved into the Duckworth offices to continue correcting and amending the proofs of the book, pushing each heavily annotated page under Haycraft’s door as it was written. Flying back  to the US he became convinced that there were essential arguments, an underpinning architecture, that he had forgotten and without which the book would collapse. He eventually sent Haycraft over four hundred footnotes – material totalling more than three times the length of the book itself – which the publisher thankfully resisted. “You’ll swamp the book,” he told Sacks; “you can choose twelve footnotes.”

He was shy – it was “a lifelong disease”, he said – and yet he knew Thom Gunn, WH Auden, Jonathan Miller (another Jewish polymath), the antiquarian bookseller Eric Korn, Stephen Jay Gould, Francis Crick, Robert De Niro and dozens more.

He may not have been comfortable with celebrity but most certainly did crave recognition and validation. His books won prizes and have been read around the world – and yet Sacks himself says “my writings need extensive pruning and editing…I can get waylaid by tangential thoughts and associations in mid-sentence…I am haunted by the density of reality…I get intoxicated, sometimes, by the rush of thoughts and am too impatient to get them in the right order.” Writing clearly did not come easily: it was as compulsive an act as much else he did. Here as elsewhere, one catches a whiff of mania.

In his later years, and after decades of living alone, Sacks formed an enduring relationship with Bill Hayes, a writer and photographer, and they lived together in Greenwich Village until Sacks’ death. Apparently, Sacks often used to ask Hayes: “Do I seem like I am from another century? Do I seem like I am from another age?”

Overwhelmingly, the answer is yes. He was an essentially seventeenth century figure, he was our Francis Bacon, in many ways as strange and as mysterious as many of those whom he cared for. He was, as Bill Hayes has said of him, “the most unusual person I had ever known”.


Alun Severn

March 2019