Oliver Sacks Read online

  OLIVER SACKS: THE LAST INTERVIEW

  AND OTHER CONVERSATIONS

  Copyright © 2016 by Melville House Publishing

  “Neurologist Oliver Sacks” was originally broadcast on Fresh Air on October 1, 1987. Reprinted with permission by WHYY/NPR.

  “An Anthropologist on Mars” was originally broadcast on Charlie Rose in February 1995. Reprinted with permission by Charlie Rose/PBS.

  “Studs, Sacks, and Left-Handed Skills” was originally broadcast on The Studs Terkel Program in 1995. Courtesy of the Studs Terkel Radio Archive.

  “Oliver Sacks on Empathy as a Path to Insight” was published in the November 2010 issue of Harvard Business Review. Reprinted with permission.

  “The Joy of Aging” was originally broadcast on On Point on July 18, 2013.

  “Dr. Sacks Looks Back” was recorded live with Robert Krulwich at the Brooklyn Academy of Music on May 5, 2015. It was his last publicly released interview. Reprinted with permission by Radiolab/WNYC studios.

  Some of these interviews were transcribed and have been lightly edited for clarity.

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  CONTENTS

  Cover

  Title Page

  Copyright

  EDITOR’S NOTE

  NEUROLOGIST OLIVER SACKS

  Interview with Terry Gross

  Fresh Air

  October 1, 1987

  AN ANTHROPOLOGIST ON MARS

  Interview with Charlie Rose

  Charlie Rose

  February 1995

  STUDS, SACKS, AND LEFT-HANDED SKILLS

  Interview with Studs Terkel

  The Studs Terkel Program

  1995

  OLIVER SACKS ON EMPATHY AS A PATH TO INSIGHT

  Interview with Lisa Burrell

  Harvard Business Review

  November 2010

  THE JOY OF AGING

  Interview with Tom Ashbrook

  On Point

  July 18, 2013

  DR. SACKS LOOKS BACK

  Interview with Robert Krulwich

  Recorded live at the Brooklyn Academy of Music

  May 5, 2015

  About the Author

  EDITOR’S NOTE

  Dr. Oliver Sacks was “morbidly shy,” as one of the interlocutors in this collection notes—which may be why there were relatively few formal interviews with the great neuroscientist, physician, and bestselling author.

  It’s rather surprising, considering Sacks’s long career and prolific output. Between 1970 and 2015, he wrote fourteen books, including Awakenings (which was adapted into a film starring Robin Williams), the blockbuster The Man Who Mistook His Wife for a Hat, and On the Move, a memoir published just six months before his death in August 2015. He was also a regular contributor to The New Yorker, The New York Review of Books, and the London Review of Books, among other publications.

  For the most part, what seems to have convinced Sacks to grant interviews was the obligation to promote his work, and so the rarities collected herein were each conducted to coincide with the publication of a book and were broadcast on major programs such as Charlie Rose’s PBS television show, National Public Radio’s Fresh Air program, and the beloved icon Studs Terkel’s radio show. They are primarily accessible in audio format, and several were transcribed here for the first time by Melville House.

  In these transcriptions, we endeavored to preserve Sacks’s verbal characteristics—for example, his charming tendency to stutter and to often qualify his comments with the disclaimer “sort of.” Readers will also notice that some interviewers interrupt more than others (indicated with an em dash), and some are decidedly unhurried, relishing contemplative pauses (indicated with an ellipsis).

  The first interview, the first of several Sacks had with Fresh Air’s Terry Gross, offers an introduction to the doctor’s uniquely literary approach to his work—“describing states of mind as well as neurological conditions.” Both of the interviews that follow—with Charlie Rose and Studs Terkel, respectively—were released after the publication of the book An Anthropologist on Mars, but they take distinct approaches to their subject. The Rose interview is more obviously personal, even philosophical: Sacks discusses his family, his friendship with Robin Williams, his appreciation of the brain as an “unimaginably complex and beautiful” part of who we are, and his longing for faith in a God he cannot, in the end, believe exists. The interview with Terkel, meanwhile, hews closely to the book itself, but in doing so reveals the inner workings of the author, whom Terkel introduces as “a wonder of a neurologist, who has the soul of a poet but the writing gifts of a fine novelist.”

  The remaining interviews—with Lisa Burrell for the Harvard Business Review, Tom Ashbrook for NPR’s On Point, and Robert Krulwich for NPR’s Radiolab—were all conducted after Sacks was diagnosed with ocular cancer in 2005. They address mortality more directly, and explore the ways in which Sacks’s relationships to his patients had changed, now that he was a patient as well. Ashbrook’s interview was conducted shortly after Sacks’s eightieth birthday, when he’d been inspired to write an op-ed for The New York Times about his contentedness in old age (“I can write up a storm, and I can swim up a storm … I think swimming is one of the few activities one can do for the first century”).

  The final interview was presented to a live audience at the Brooklyn Academy of Music on May 5, 2015, after Radiolab’s host Robert Krulwich had visited Sacks and recorded their conversation in his home. It is by far the most poignant in the collection. Sacks was keenly aware that this interview was to be among his last. Of his latest diagnosis, Sacks said, “One or two people have written to me, you know, consoling me, and said, ‘Well, you know, we all die.’ But fuck it! It’s not like, We all die. It’s like, You have four months.” It’s poignant, too, for the decades-long friendship between Krulwich and Sacks, which is evoked in the candor and wonderful intimacy of their dialogue.

  The conversations collected herein, then, span nearly thirty years and cover a range of topics, but they are unified by the spirit of warmth, empathy, and ingenious curiosity for which Sacks was so famous and rightly beloved.

  NEUROLOGIST OLIVER SACKS

  INTERVIEW WITH TERRY GROSS

  FRESH AIR

  OCTOBER 1, 1987

  GROSS: Dr. Oliver Sacks, welcome to Fresh Air.

  SACKS: Nice to be here.

  GROSS: Before we talk about the medical and spiritual implications of the work that you do, I’m going to ask you to tell the story of “The Man Who Mistook His Wife for a Hat,” one of the case studies that you’ve written about. This was a music teacher and singer who didn’t recognize that he had a disorder. What were the symptoms that he was showing?

  SACKS: Um, well, the first problem was that he had difficulty recognizing his students at the music academy. As soon as they spoke, he recognized them at once, but he couldn’t recognize them visually. And soon he couldn’t’ recognize anyone or anything visually. He couldn’t recognize his wife, he couldn’t recognize himself, he couldn’t recognize common objects. He saw them perfectly clearly, but what he saw carried no meaning for him. And no sense. And this prompted him to sort of ingenious but sometimes wild and sometimes absurd guesses as to what he might be seeing.

  GROSS: And you title the case study “The Man Who Mistook His Wife for a Hat” because in reaching for his hat, he reached for his wife’s head by mistake.

  SACKS: Well, when I saw him in the first interview, he was obviously not demented, but a delightful, intelligent, civilized man with a sense of humor. He kept encountering the fact that he made mistakes, but he didn’t recognize what the problem was. It mixed with all his intactness. There was a succession of absurd mistakes. At one point, he confused his left foot with his shoe and he didn’t seem to know which was which, and then right at the end when he went to reach for his hat, he got his wife’s head instead.

  GROSS: What is the condition that he had?

  SACKS: Well, this is called a visual agnosia. And what happens is that the normal meeting between visual input, between images and the person’s memories and, um, ideas, feelings, and expectations doesn’t occur. And so this goes with a problem in the visual association areas at the back of the brain. So he sort of had raw vision, a sort of raw seeing which didn’t ascend into the realm of meaning.

  GROSS: Although he couldn’t make sense of what he saw, he was a musician and singer and he still had perfect musical sense, and your prescription to him was music. Why?

  SACKS: Well, he was really absolutely lost in this meaningless, shattered visual world, and he desperately needed some way of organizing himself. Now, I think all of us tend to either use internal speech or internal music to organize ourselves to some extent. One has things like nursery rhymes—“One, two, buckle my shoe”—or marching songs, or work songs, but the song as a unit of organization became tremendously important and crucial for this man who was so totally lost visually, couldn’t use any visual organization but in fact was a marvelous musician and singer, a man who sort of generated songs all the while. And one saw again and again that he couldn’t do it, he couldn’t shave, he couldn’t eat, unless he really set the activity to music internally. On one occasion when he was eating t
here were interruptions: the postman suddenly knocked at the door, and this completely shattered the activity. He was quite bewildered for a few seconds before he was able to recapture the melody of eating.

  GROSS: You know your prescription of music reminds me of something your friend the poet W. H. Auden had said to you, which is that, um, well he spoke of the poetic and the religious states of affliction, and I wonder what you think, how that applies to your work. The poetic and religious states of affliction.

  SACKS: I thought you were going to actually quote one of Auden’s favorite quotations from Novalis, where Novalis says, “Every disease has a musical problem, and every cure has a musical solution.” And certainly with Dr. P, as with many of my Parkinsonian patients—people sometimes who can’t move unless they sing or dance—one sees absolutely they’ve been “un-music-ed” by disease and can be “re-music-ed” back into health.

  I think that the poetic and the religious are almost sometimes an integral part of patients’ perceptions, as to what may be happening with them. Something I describe in the Hat book, and also at more length in an earlier book, A Leg to Stand On, is a patient whom I saw as a student, who had apparently lost his left leg. He was found on the floor, very bewildered; he had apparently thrown himself out of bed in a peculiar way, and the story he gave was that he had woken up from sleep. He had found that there was a foreign leg in the bed with him, disgusting object. He threw it out, then, now horribly, he had come out with it, and now it was attached to him. And I said, “But it’s your leg.” And he said, “Shouldn’t I know my own leg?” And I said, “Yes, you should.” And he said, “Well, I know it’s not my leg.” Now this thing for him was not only … was terribly wrong. It felt ugly, it felt hateful, it felt obscene, it felt unholy, it felt an offense against nature.

  Now, the particular physiology in his case was that he had a tumor in the opposite side of the brain which had expanded, which had bled while he slept, and had blotted out the part of the brain which represents the leg, so the leg image had been obliterated. Therefore, he could not recognize his leg as his own. Therefore, it seemed absolutely other. But the “absolutely other” always seems uncanny, and horrible, and obscene, and unholy, and godforsaken … and words like this, or concepts like this, would be used by every patient, irrespective of background, of intelligence, of education. The alienation is almost intrinsically in the area of subjectivity, is sort of felt as anti-poetic, antireligious. And by the same token, when it comes back, there is the feeling, to quote Dante, of the “holy and glorious flesh” restored. And so I think even at this level, sort of, the body and health is always felt as sort of beautiful and holy, although one may not appreciate this unless it’s taken away, and one suddenly deals with a sort of radically depreciated world.

  GROSS: Your way of writing case studies is really very literary. It’s not empirical, it’s not cut-and-dried. You’re really describing states of mind as well as neurological conditions. And I’ve wondered if patients talk to you that way, if they are as descriptive as you are in telling their stories.

  SACKS: I think, obviously this will depend on the condition and the patient, but above all I think of the situation, and that if a patient is not permitted, implicitly or explicitly, to talk about himself, if he’s reduced, if he’s given a sort of catechism—Do you have this? Do you have that?—then he will reduce himself to a list of symptoms. He won’t say what it’s actually like. He won’t depict the world he is in, which he has been thrust into. But I think that if patients have a complaint, sometimes more serious or as serious as their primary complaint, it is that they can’t communicate what it’s like. And I think that a major act of the doctor is somehow to—Dr. Quincy once talked about “the pressure of the incommunicable upon the heart”—is to let the patient try to communicate, and the doctor must sort of help him, must reach out, delicately, to assist this trembling communication. And, um, so that between them, the way it is, the world of illness can come into being.

  GROSS: You’ve done a lot of your work on back wards of hospitals, charity hospitals, asylums. Why have you gone there looking for the kinds of cases you were interested in studying?

  SACKS: Well, I’m, it’s really not quite in that order. I was there, in places which most of my colleagues wouldn’t be seen dead in, and which no ambitious young doctor would go to, and which are felt to be the sticks. But in fact here, there is, you know, there is the priceless gift of leisure. There’s no pressure to diagnose, there’s no pressure to do anything. Also you can encounter a complete world. I mean these places are really little worlds. And I think an un-pressed exploration of getting deeper and deeper is possible in such places, and hardly possible in any other places.

  GROSS: There’s no pressure because they’re considered hopeless anyways?

  SACKS: Partly. This was well-realized by the founders of neurology, by Hughlings Jackson and Charcot in the last century—they spent much of their lives in chronic hospitals, institutions, asylums. But now, um, now doctors don’t … but certainly, with the patients I describe in Awakenings, these people which had been in hospital for forty years or more, since the great Sleeping Sickness epidemic, I had no idea that such patients existed, that such lives existed, until I went into a chronic hospital.

  GROSS: Has that happened other times too, that you’ve found disorders that have not really been described before?

  SACKS: Ah, well, certainly they haven’t been described with the richness and the fullness which they should have. Um, the, in general, I think description has become sort of obsolete.

  GROSS: You’ve described it as almost a nineteenth-century art in medicine.

  SACKS: I mean, I love nineteenth-century medicine and science. It may have been so short, in a way, on certain empirical remedies, and even relatively short on physiological concepts, and of course so short on technology, but the respect for the patient and for the detail of what was happening to them, I think could often generate almost, you know, novelistically rich and at the same time medically and scientifically accurate descriptions, so much so now that major discoveries have been made by going back over nineteenth-century descriptions. Now we can see what went on. I think most of the descriptions now are so meager, so threadbare, and also … too quick to diagnose, to pin labels on.

  GROSS: When you are working with patients who have been almost abandoned by the medical profession, it’s just a kind of a caretaking type of thing, are you able to do anything to really change their condition, or are you more interested in observing them? And let’s leave out the Sleeping Sickness patients, because you were able to administer a drug there that totally changed their condition, but in other cases when there isn’t a drug that’s going to change their state, what can you do?

  SACKS: Um, my first notion is to try to understand, to try to understand with the patient, what’s going on. Now, from the understanding, treatment may come. So that for example with one case I describe in the Hat book, as I call it for short, there’s a Parkinsonian man who leaned grossly to one side, although he wasn’t aware of this. He was surprised that people commented. I took a videotape of this, I played it back to him, and it as only when he saw this that he realized what was happening, and he then he asked a very acute question. He said he wondered whether there were balancing mechanisms—he used to be a carpenter—like spirit levels, like bubble levels in the head which had been impaired by his disease. And I said, “Yeah, exactly.” And he then thought again, and he wondered if one couldn’t make such little levels outside the head, for example attached to, by a nose-clip, the glasses, and whether this would serve to balance him. And I said, that’s a wonderful idea, let’s try it. And in fact it worked beautifully. Now here is a man who, all I did in a sense, was to—

  GROSS: Give him a metaphor!

  SACKS: Um, yes, or, he gave himself a metaphor. I assisted his understanding, and indeed his movement to a cure. And I love this sort of collaboration, when it’s possible.

  GROSS: I thank you very much for talking with us about your work, thank you for being here.