Oliver Sacks

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“He Had Apparently Mistaken His Wife For A Hat!”

August 31, 2015 in Books, Excerpts, Science/Tech | Permalink

Sad to hear of the passing of Dr. Oliver Sacks, the neurologist and writer, who made clear in his case studies that the human brain, a friend and a stranger, was as surprising as any terrain we could ever explore. It feels like we’ve not only lost a great person, but one who was uniquely so. He became hugely famous with the publication of his 1985 collection, The Man Who Mistook His Wife For A Hat, which built upon the template of A.R. Luria’s work with better writing and a wider array of investigations. Two years prior, he published an essay In the London Review of Books that became the title piece. An excerpt: 

I stilled my disquiet, his perhaps too, in the soothing routine of a neurological exam – muscle strength, co-ordination, reflexes, tone. It was while examining his reflexes – a trifle abnormal on the left side – that the first bizarre experience occurred. I had taken off his left shoe and scratched the sole of his foot with a key – a frivolous-seeming but essential test of a reflex – and then, excusing myself to screw my ophthalmoscope together, left him to put on the shoe himself. To my surprise, a minute later, he had not done this.

‘Can I help?’I asked.

‘Help what? Help whom?’

‘Help you put on your shoe.’

‘Ach,’ he said, ‘I had forgotten the shoe,’ adding, sotto voce: ‘The shoe! The shoe?’ He seemed baffled.

‘Your shoe,’ I repeated. ‘Perhaps you’d put it on.’

He continued to look downwards, though not at the shoe, with an intense but misplaced concentration. Finally his gaze settled on his foot: ‘That is my shoe, yes?’

Did I mishear? Did he mis-see? ‘My eyes,’ he explained, and put a hand to his foot. ‘This is my shoe, no?’

‘No, it is not. That is your foot. There is your shoe.’

‘Ah! I thought that was my foot.’

Was he joking? Was he mad? Was he blind? If this was one of his ‘strange mistakes’, it was the strangest mistake I had ever come across.

I helped him on with his shoe (his foot), to avoid further complication. Dr P. himself seemed untroubled, indifferent, maybe amused. I resumed my examination. His visual acuity was good: he had no difficulty seeing a pin on the floor, though sometimes he missed it if it was placed to his left.

He saw all right, but what did he see? I opened out a copy of the National Geographic Magazine, and asked him to describe some pictures in it. His eyes darted from one thing to another, picking up tiny features, as he had picked up the pin. A brightness, a colour, a shape would arrest his attention and elicit comment, but it was always details that he saw – never the whole. And these details he ‘spotted’, as one might spot blips on a radar-screen. He had no sense of a landscape or a scene.

I showed him the cover, an unbroken expanse of Sahara dunes.

‘What do you see here?’I asked.

‘I see a river,’ he said. ‘And a little guesthouse with its terrace on the water. People are dining out on the terrace. I see coloured parasols here and there.’ He was looking, if it was ‘looking’, right off the cover, into mid-air, and confabulating non-existent features, as if the absence of features in the actual picture had driven him to imagine the river and the terrace and the coloured parasols.

I must have looked aghast, but he seemed to think he had done rather well. There was a hint of a smile on his face. He also appeared to have decided the examination was over, and started to look round for his hat. He reached out his hand, and took hold of his wife’s head, tried to lift it off, to put it on. He had apparently mistaken his wife for a hat!•

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An Oliver Sacks Reading List Of 50 Books

May 22, 2015 in Books, Excerpts, Science/Tech | Permalink

The Strand in NYC, the only brick-and-mortar bookstore I still go to regularly, asked Oliver Sacks to create a shelf of his favorite titles. Below are the first ten. (The Weisman book is a particular favorite of mine.) See the whole list here.

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“One Day He Gave It All Up—The Drugs, The Sex, The Motorcycles, The Bodybuilding”

April 30, 2015 in Books, Excerpts, Science/Tech | Permalink

Oliver Sacks on a motorcycle in NYC, 1961. (Photo by Douglas White.)

I’ve read most of Lawrence Weschler’s books and gotten so much from them, particularly Seeing Is Forgetting the Name of the Thing One Sees and Vermeer in Bosnia. In a new Vanity Fair article, he uses passages from a long-shelved biography of his friend Oliver Sacks, the terminally ill neurologist, to profile the doctor in a way only a confidante and great writer can, revealing the many lives Sacks has lived, in addition to the public-intellectual one we’re all familiar with. Weschler is convinced that Sacks’ period of excessive experimentation with drugs when young led to his later scientific breakthroughs. An excerpt:

I had originally written him a letter, sometime in the late 70s, from my California home. Somehow back in college I had come upon Awakenings, published in 1973, an account of his work with a group of patients who had been warehoused for decades in a home for the incurable—they were “human statues,” locked in trance-like states of near-infinite remove following bouts of a now rare form of encephalitis. Some had been in this condition since the mid-1920s. These people were suddenly brought back to life by Sacks, in 1969, following his administration of the then new “wonder drug” L-dopa, and Sacks described their spring-like awakenings and the harrowing siege of tribulations that followed. In the book, Sacks gave the facility where all this happened the pseudonym “Mount Carmel,” an apparent reference to Saint John of the Cross and his Dark Night of the Soul. But, as I wrote to Sacks in that first letter, his book seemed to me much more Jewish and Kabbalistic than Christian mystical. Was I wrong?

He responded with a hand-pecked typed letter of a good dozen pages, to the effect that, indeed, the old people’s home in question, in the Bronx, was actually named Beth Abraham; that he himself came from a large and teeming London-based Jewish family; that one of his cousins was in fact the eminent Israeli foreign minister Abba Eban (another, as I would later learn, was Al Capp, of Li’l Abner fame); and that his principal intellectual hero and mentor-at-a-distance, whose influence could be sensed on every page of Awakenings, had been the great Soviet neuropsychologist A.R. Luria, who was likely descended from Isaac Luria, the 16th-century Jewish mystic.

Our correspondence proceeded from there, and when, a few years later, I moved from Los Angeles to New York, I began venturing out to Oliver’s haunts on City Island. Or he would join me for far-flung walkabouts in Manhattan. The successive revelations about his life that made up the better part of our conversations grew ever more intriguing: how both his parents had been doctors and his mother one of the first female surgeons in England; how, during the Second World War, with both his parents consumed by medical duties that began with the Battle of Britain, he, at age eight, had been sent with an older brother, Michael, to a hellhole of a boarding school in the countryside, run by “a headmaster who was an obsessive flagellist, with an unholy bitch for a wife and a 16-year-old daughter who was a pathological snitch”; and how—though his brother emerged shattered by the experience, and to that day lived with his father—he, Oliver, had managed to put himself back together through an ardent love of the periodic table, a version of which he had come upon at the Natural History Museum at South Kensington, and by way of marine-biology classes at St. Paul’s School, which he attended alongside such close lifetime friends as the neurologist and director Jonathan Miller and the exuberant polymath Eric Korn. Oliver described how he gradually became aware of his homosexuality, a fact that, to put it mildly, he did not accept with ease; and how, following college and medical school, he had fled censorious England, first to Canada and then to residencies in San Francisco and Los Angeles, where in his spare hours he made a series of sexual breakthroughs, indulged in staggering bouts of pharmacological experimentation, underwent a fierce regimen of bodybuilding at Muscle Beach (for a time he held a California record, after he performed a full squat with 600 pounds across his shoulders), and racked up more than 100,000 leather-clad miles on his motorcycle. And then one day he gave it all up—the drugs, the sex, the motorcycles, the bodybuilding. By the time we started talking, he had been pretty much celibate for almost two decades.•

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“He Is The Doctor Who Also Writes About The Dark Continent Of Human Illness”

February 20, 2015 in Books, Excerpts, Science/Tech, Videos | Permalink

So sad to learn of Oliver Sacks’ terminal illness. I read The Man Who Mistook His Wife for a Hat at a young age, and I didn’t know what the hell to make of it, so stunned was I to find out that we’re not necessarily in control of our minds. In this piece of writing and so many others, Sacks examined the brain, that mysterious and scary thing, and because of his work as an essayist as well as a doctor, that organ is today a little less mysterious, a little less scary. It doesn’t mean he was always right, but how could anyone be when sailing in such dark waters? Sacks was accused sometimes of being a modern Barnum who used as diverting curiosities those with the misfortune of having minds that played tricks on them–even stranger tricks than the rest of us experience–and sometimes I cringed at the very personal things he would reveal about his subjects, but I always felt he strived to be ethical. We certainly live in an era when the freak show still thrives, albeit in a slickly produced form, but I don’t think that’s where Sacks’ work has ever lived. His prose and narrative abilities grew markedly during his career as he he came to realize–be surprised by?–his own brain’s capabilities. I hope he has a peaceful and productive final chapter. 

A profile of Sacks by Diane Sawyer with good 1969 footage of his work as a young doctor.

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“We Often Think Of Insects As Tiny Automata—Robots With Everything Built-In And Programmed”

April 6, 2014 in Books, Excerpts, Science/Tech | Permalink

While plant and insect brains may not be as complicated as human ones, they’re very complex and likely resemble our processes more than we commonly believe. From Oliver Sacks in the New York Review of Books:

“Where Aplysia has only 20,000 neurons distributed in ganglia throughout its body, an insect may have up to a million nerve cells, all concentrated in one brain, and despite its tiny size may be capable of extraordinary cognitive feats. Thus bees are expert in recognizing different colors, smells, and geometric shapes presented in a laboratory setting, as well as systematic transformations of these. And of course, they show superb expertise in the wild or in our gardens, where they recognize not only the patterns and smells and colors of flowers, but can remember their locations and communicate these to their fellow bees.

It has even been shown, in a highly social species of paper wasp, that individuals can learn and recognize the faces of other wasps. Such face learning has hitherto been described only in mammals; it is fascinating that a cognitive power so specific can be present in insects as well.

We often think of insects as tiny automata—robots with everything built-in and programmed. But it is increasingly evident that insects can remember, learn, think, and communicate in quite rich and unexpected ways. Much of this, doubtless, is built-in—but much, too, seems to depend on individual experience.

Whatever the case with insects, there is an altogether different situation with those geniuses among invertebrates, the cephalopods, consisting of octopuses, cuttlefish, and squid. Here, as a start, the nervous system is much larger—an octopus may have half a billion nerve cells distributed between its brain and its ‘arms’ (a mouse, by comparison, has only 75 to 100 million). There is a remarkable degree of organization in the octopus brain, with dozens of functionally distinct lobes in the brain and similarities to the learning and memory systems of mammals.”

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“It Is Startling To Realize That Some Of Our Most Cherished Memories May Never Have Happened”

February 1, 2013 in Books, Excerpts, Politics, Science/Tech | Permalink

From Oliver Sacks’ new article in the New York Review of Books about memory distortion, a passage about Ronald Reagan “misremembering”:

“Daniel Schacter has written extensively on distortions of memory and the ‘source confusions’ that go with them, and in his book Searching for Memory recounts a well-known story about Ronald Reagan:

In the 1980 presidential campaign, Ronald Reagan repeatedly told a heartbreaking story of a World War II bomber pilot who ordered his crew to bail out after his plane had been seriously damaged by an enemy hit. His young belly gunner was wounded so seriously that he was unable to evacuate the bomber. Reagan could barely hold back his tears as he uttered the pilot’s heroic response: ‘Never mind. We’ll ride it down together.’ The press soon realized that this story was an almost exact duplicate of a scene in the 1944 film A Wing and a Prayer. Reagan had apparently retained the facts but forgotten their source.

215Reagan was a vigorous sixty-nine-year-old at the time, was to be president for eight years, and only developed unmistakable dementia in the 1990s. But he had been given to acting and make-believe throughout his life, and he had displayed a vein of romantic fantasy and histrionism since he was young. Reagan was not simulating emotion when he recounted this story—his story, his reality, as he believed it to be—and had he taken a lie detector test (functional brain imaging had not yet been invented at the time), there would have been none of the telltale reactions that go with conscious falsehood.

It is startling to realize that some of our most cherished memories may never have happened—or may have happened to someone else. I suspect that many of my enthusiasms and impulses, which seem entirely my own, have arisen from others’ suggestions, which have powerfully influenced me, consciously or unconsciously, and then been forgotten.”

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“It Was Nothing Like What I Had Seen When Stoned”

December 26, 2012 in Excerpts, Science/Tech, Urban Studies | Permalink

I’ve never used illegal drugs, but my experience with people who have is that, members of the Grateful Dead excepted, heavy LSD users are the biggest assholes, even worse than cokeheads. Maybe because they’ve briefly glimpsed the world through cleansed doors of perception and are disappointed by the reality they face when they come down? But most likely it’s just because they’re assholes. From Jon Wiener’s  Los Angeles Review of Books interview with neurologist Oliver Sacks, who’s neither an asshole nor a heavy user of drugs, a conversation about the doctor’s long-ago experimentation with acid:

“Jon Weiner:

When and how did you first come to take LSD?

Oliver Sacks:

I think it was a few months after I smoked that joint. There was a lot of LSD around. In one of the early experiences I had with LSD, recklessly, I had mixed it with some other drugs and topped it off with some cannabis. I’d been reading about the color indigo, and was puzzled by the fact that no two people seemed to agree on what indigo was. Newton added indigo to the spectrum because he thought the spectrum ought to have seven colors, as the musical scale has seven notes.

Anyhow I got stoned on acid. And when I was really high, I said, ‘I want to see indigo, now!’ And, as if thrown by a paintbrush, a huge, trembling, pear-shaped drop of purest indigo appeared on the wall in front of me. It seemed wonderfully luminous, and sort of numinous at the same time. So much so that I thought, ‘This is the color of heaven. This must be the color which Giotto tried to get into his paintings but could never get. And maybe he couldn’t get it because it doesn’t exist.’

I lent toward this in a sort of rapture, and it suddenly disappeared, leaving me with an immense sense of loss. I had had a sense of bliss or rapture, almost orgasm, seeing the indigo.

For months after, I kept looking for indigo. I went to a mineralogical museum and looked at azurite, which is often described as indigo. But it was nothing like what I had seen when stoned.

I did see indigo again, curiously. I was at a concert, listening to some Monteverdi. And I was enraptured by the music, thrown into a sort of ecstasy. The concert was in the Egyptology gallery of a museum in New York, and in the interval I went out and saw some of the lapis lazuli things. And they were indigo. And I thought, ‘It really exists.’ But then, after the concert, I went again, and it wasn’t indigo. I’ve never seen it since.'”

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“Up To About 1800, People Were Allowed To Have Visions Or To Hear Voices”

December 10, 2012 in Books, Excerpts, Science/Tech | Permalink

Oliver Sacks recently sat for an interview with Tim Adams at the Guardian to discuss his new book, Hallucinations. One exchange concerning a shift toward rationalism in the last 200 years, although we continue to create mundane ways to distance ourselves from facts:

“Guardian:

It seems that such visual disorders at certain points in history have been more ‘believable’ and also, therefore, more commonly noted?

Oliver Sacks:

Yes, in other places and at other times, hallucinations were far more acceptable. Up to about 1800, people were allowed to have visions or to hear voices. They were seen to have some external spiritual reality; they were ghosts or angels or demons. The word hallucination only really became a pejorative at the end of the 18th or early 19th century. We still associate it with madness. But how those who hallucinate understand what they see also changes. We are more likely to see UFOs and aliens when people in earlier times would see angels.”

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“My Memory Flows Like A Movie—Nonstop And Uncontrollable”

May 31, 2012 in Excerpts, Science/Tech, Urban Studies, Videos | Permalink

The opening of “Remember This,” Joshua Foer’s excellent 2007 National Geographic piece about people with extreme memories and those of us with more average neural connections governing the data and images we retain:

“There is a 41-year-old woman, an administrative assistant from California known in the medical literature only as ‘AJ,’ who remembers almost every day of her life since age 11. There is an 85-year-old man, a retired lab technician called ‘EP,’ who remembers only his most recent thought. She might have the best memory in the world. He could very well have the worst.

‘My memory flows like a movie—nonstop and uncontrollable,’ says AJ. She remembers that at 12:34 p.m. on Sunday, August 3, 1986, a young man she had a crush on called her on the telephone. She remembers what happened on Murphy Brown on December 12, 1988. And she remembers that on March 28, 1992, she had lunch with her father at the Beverly Hills Hotel. She remembers world events and trips to the grocery store, the weather and her emotions. Virtually every day is there. She’s not easily stumped.

There have been a handful of people over the years with uncommonly good memories. Kim Peek, the 56-year-old savant who inspired the movie Rain Man, is said to have memorized nearly 12,000 books (he reads a page in 8 to 10 seconds). ‘S,’ a Russian journalist studied for three decades by the Russian neuropsychologist Alexander Luria, could remember impossibly long strings of words, numbers, and nonsense syllables years after he’d first heard them. But AJ is unique. Her extraordinary memory is not for facts or figures, but for her own life. Indeed, her inexhaustible memory for autobiographical details is so unprecedented and so poorly understood that James McGaugh, Elizabeth Parker, and Larry Cahill, the neuroscientists at the University of California, Irvine who have been studying her for the past seven years, had to coin a new medical term to describe her condition: hyperthymestic syndrome.

EP is six-foot-two (1.9 meters), with perfectly parted white hair and unusually long ears. He’s personable, friendly, gracious. He laughs a lot. He seems at first like your average genial grandfather. But 15 years ago, the herpes simplex virus chewed its way through his brain, coring it like an apple. By the time the virus had run its course, two walnut-size chunks of brain matter in the medial temporal lobes had disappeared, and with them most of EP’s memory.”

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Oliver Sacks discussing his pen pal Alexander Luria, the neuropsychologist who authored The Mind of a Mnemonist:

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“I Just Assumed That I Was Very Bad At Recognizing Faces”

December 1, 2010 in Books, Excerpts, Science/Tech | Permalink

Sacks wrote about face-reognition disorders in the title piece of his 1985 collection, "The Man Who Mistook His Wife for a Hat."

I’ve mentioned before that I have a neurological glitch, called prosopagnosia or face-blindness, which causes me problems with face recognition. I can see faces just fine, but I have trouble identifying them out of context. I’m usually okay with people I see on a regular basis, less so with those I run into infrequently or haven’t seen in a long time. It causes countless misunderstandings.

Thankfully, I don’t have  a very severe level of face-blindness, but Oliver Sacks does. It’s so bad for the doctor that he actually can’t recognize himself in a mirror. The neurologist writes about dealing with the disorder in his latest excellent collection of case studies, The Mind’s Eye. An excerpt from his essay, “Face-Blindness”:

“I just assumed that I was very bad at recognizing faces as my friend Jonathan was very good–that this was just within the limits of normal variation, and that he and I just stood on opposite ends of a spectrum. It was only when I went to Australia to visit my older brother Marcus, whom I had scarcely seen in thirty-five years, and discovered that he, too, had exactly the same difficulties recognizing faces and places that it dawned on me that this was something beyond normal variation, that we both had a specific trait, a so-called prosopagnosia, probably with a distinctive genetic basis.

That there were others like me was brought home in various ways. The meeting of two people with prosopagnosia, in particular, can be very challenging. A few years ago I wrote to one of my colleagues to tell him that I admired his new book. His assistant then phoned Kate to arrange a meeting, and they settled on a weekend dinner at a restaurant in my neighborhood.

‘There may be a problem,’ Kate said. “Dr. Sacks cannot recognize anyone.’

‘It’s the same with Dr. W.,’ his assistant replied.

Somehow we did manage to meet and enjoyed dinner together. But I still have no idea what Dr. W. looks like, and he probably would not recognize me, either.”

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New York Times Notable Nonfiction Books 2010: Drinking, Disease, Lincoln, Neuroscience, Etc.

November 26, 2010 in Books, Excerpts | Permalink

Siddhartha Mukherjee, the author of "The Emperor of All Maladies," is an oncologist.

The New York Times has published its list of 100 Notable Books of 2010. Below are the non-fiction books included that I’ve read or most want to read:

“THE EMPEROR OF ALL MALADIES: A Biography of Cancer. By Siddhartha Mukherjee. (Scribner, $30.) Mukherjee’s powerful and ambitious history of cancer and its treatment is an epic story he seems compelled to tell, like a young priest writing a biography of Satan.

THE FIERY TRIAL: Abraham Lincoln and American Slavery. By Eric Foner. (Norton, $29.95.) Foner tackles what would seem an obvious topic, Lincoln and slavery, and sheds new light on it.

LAST CALL: The Rise and Fall of Prohibition. By Daniel Okrent. (Scribner, $30.) A remarkably original account of the 14-year orgy of lawbreaking that transformed American social life.

THE BOOK IN THE RENAISSANCE. By Andrew Pettegree. (Yale University, $40.) A thought-provoking revisionist history of the early years of printing.

THE MIND’S EYE. By Oliver Sacks. (Knopf, $26.95.) In these graceful essays, the neurologist explores how his patients compensate for the abilities they have lost, and confronts his own ocular cancer.”

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Oliver Sacks And The Identity Crisis

October 14, 2010 in Science/Tech | Permalink

"Mark," a protrait by Chuck Close, who also has face-blindness. No wonder he's spent the majority of his career painting faces.

I’ve mentioned before that I have a fair degree of face-blindness, a neurological condition that makes it difficult to recognize faces out of context, even if I know a person well. If I don’t see someone regularly or haven’t seen them in a while, it’s particularly difficult to decipher identity. Neurologist Oliver Sacks, who has face-blindness, wrote about the condition recently in the New Yorker. In addition to that article, the publication’s website has a free podcast in which Sacks discusses the condition further. Listen here.

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Science/Tech: The Curious Case Of Face Blindness

June 29, 2010 in Science/Tech | Permalink

This may be Oliver Sacks' face. I'm not sure. Neither is he. (Image by Erik Charlton.)

I was born with an odd neurological glitch called Face Blindness. It makes it difficult for me to recognize faces, even of people I know well. I don’t have it 100%, so I’m very good at recognizing people in context, but if I’m not expecting to see someone, it’s 50-50 that I can recognize them before I hear their voice. I can see their faces just fine; but the recognition mechanism malfunctions. People who wear hats and sunglasses pose additional problems. And for me, blond people are tougher to recognize than dark-haired people, perhaps because most of the people who I grew up around were ethnic and I have more practice with them. I don’t know.

I’ve had otherwise intelligent people acknowledge to me that they carried on feuds with me (that I knew nothing about) because I had “snubbed them.” When I’ve told others of this condition, they tend to brush it away because people often have rather large and fragile egos and expect you to acknowledge them no matter what. I can only imagine what it’s like for those who have Face Blindness completely–they can’t even recognize themselves in a mirror!

Two people who also have Face Blindness are neuroscientist Oliver Sacks and artist Chuck Close. A big thanks to Marginal Revolution for pointing me in the direction of this NPR show in which the two men discuss coping with Face Blindness. Listen to it here.

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