On the Move: A Life by Oliver Sacks. London: Picador, 2015
Reviewed by Paul Gordon, Psychotherapist
Earlier this year, not long before this book was published, neurologist Oliver Sacks, author of hugely popular works such as Awakenings, Hallucinations and The Man Who Mistake His Wife for a Hat, announced that he had been diagnosed with terminal cancer. Nine years ago, he had survived a rare tumour of the eye, an ocular melanoma, the removal of which had left him with unilateral blindness. It has now metastasised to his liver.
This memoir, engaging and compelling as it is, takes on an added poignancy in this light.
Sacks was born into a medical family. His father was a respected and highly regarded GP in north west London, still doing home visits – the ‘heart’ of medical practice he believed – in his 90s. (He would book a cab for a day to take him round.) His mother was one of the first female surgeons in the UK and specialised in gynaecology. She was also, as Sacks discovered, a secret supporter of young women who wanted to become doctors, even helping to pay their fees.
Early in his life, Sacks escaped death on a few occasions. Twice he had to be rescued from drowning. He was also addicted to amphetamines as a young man, which could have proven fatal had he not sought help. The epiphany happened when he found himself on one occasion having an animated conversation with two imagined friends for whom he was also cooking breakfast. He rescued himself by finding a therapist, Dr Shengold, who he continues to see twice-weekly to this day.
Sacks was also born into a motorbiking family. In his previous memoir, Uncle Tungsten, he recalled his father going off on his high-pitched Squirrel at the weekend to clear his mind. This exposure infected the young Sacks, who got into bikes at an early age. Sacks, the writer, regales his readers with the story of riding in Regent’s Park on a BSA Bantam when he realised that not only had the throttle seized, but the brakes were not powerful enough to stop the bike. He proceeded to ride around the park until he ean out of petrol. Lovers of bikes, such as myself, will be enthralled by his accounts of riding in the US, where he moved to in his 20s, and the beautiful BMW R60, which features on the book’s cover. The memoir’s title comes from a poem by his friend and fellow exile, Thom Gunn, also a biker.
In many ways, this memoir is an act of gratitude to the many people who have loved Sacks, who ‘got’ him, and who have consistently supported and encouraged him. There is the friend from childhood, polymath and doctor Jonathan Miller; Colin Haycraft, the publisher at Duckworth, who at one point lets Sacks live on the premises so that he can finish his work; the aforementioned poet Thom Gunn; and Carol Burnett, the medic whom he met at Mount Zion when they were both starting out. It is Burnett who Sacks calls when, one day at a lunch counter, he sees his coffee as green and a fellow customer as having the head of an elephant seal. Burnett sits with him through four days of delirium DTs, ‘the only stable point in a chaotic and shattered world’. There is also his remarkable Aunt Lennie, his mother’s sister, Helena Penina Landau, who set up the ‘Jewish Fresh Air School for Delicate Children’ in Delamere Forest in Cheshire, an endless encourager in her letters and cards, and a gentle critic until her death.
There is the inspirational teacher in neurology too, Michael Kremer, whom Sacks met at the Middlesex Hospital in 1959, shortly after qualifying. Kremer seemed, Sacks reflects, to be able to read people’s minds, to see things at a glance, and encouraged his students to use all their senses and intuition to get to know their patients, rather than merely resorting to standard questions.
But Sacks also shares stories of some of the appalling behaviour he experienced from colleagues. He was clearly delighted in 1966 to get a job seeing ‘real patients’ at a headache clinic in the Bronx area of New York. He quickly realised that the migraine patients presented with a whole range of problems, not just headaches. Sacks’ boss at the time viewed the junior doctor’s medical assessment as a threat to his own medical knowledge and standing, and proceeded to ban Sacks from access to his research data. Undeterred, Sacks made friends with a janitor and went in at night to copy all the notes he had himself taken during the day. Sacks shares a further dispiriting anecdote: while working at the Beth Abram hospital, he was informed by the director that he had to give up the flat he had been living in as the director needed it for his mother. Sacks refused and was promptly dismissed, ‘in a stroke, deprived of job, of income, of my patients, and of a place to live’.
There are also the disappointments. Faber, who had published his first book Migraine in 1971, turned down Awakenings; he lost two manuscripts; a suitcase full of precious notes and photos never reached his new home; he had to watch in horror as nine months of research notes were destroyed by traffic on the South Bronx expressway because of his failure to secure his bag properly to his bike. There was the long struggle, eight years, to write A Leg to Stand On, Sacks’ account of breaking his leg in Norway while escaping from a bull, and his subsequent experience of perceiving the injured limb as an alien object. A review of the book, by the British poet James Fenton, Sacks recalls, ‘upset me deeply and brought me to a depressive halt for three months’. However, he is later uplifted by a more positive review in the New York Review of Books by the eminent psychologist Jerome Bruner. This affirmation energised Sacks and led to an explosion of writing that included the completion of The Man Who Mistook His Wife for a Hat.
In all of these works, Sacks created a new form of writing, although he himself would be the first to acknowledge a debt to the works of his intellectual mentor, the Russian neuropsychologist Alexander Luria. When he read Luria’s The Mind of a Mnemonist in 1968, Sacks believed that he was reading a novel. (Sacks discusses Luria here https://www.youtube.com/watch?v=eGqLfP-LtgE)
When Sacks’ first book Migraine appeared, it was favourably reviewed in The Times – ‘balanced, authoritative, brilliant’ – but Sacks, who had returned home for the event, recalls his father coming into his bedroom ‘pale and shaking’, believing that his son had committed a grave impropriety and that the medical authorities might misconstrue the article as advertising.
Sacks admits to what he calls a ‘too-muchness’, an inability to let things go when he is writing. Mary-Kay Wilmers, the editor of The Listener, a magazine then published by the BBC, asked him in 1972 to do a piece – his first ever commission – which he completed in one sitting. However, over the course of the following week, he sent Wilmers not just one, but eight alternative versions. When he cannot choose, Wilmers does, selecting ‘the seventh (or was it the sixth?) version’. Similarly, the footnotes to Awakenings came to three times the length of the book, threatening to sink the text, as his publisher Colin Haycraft states. Haycraft encouraged him to settle for a total of twelve footnotes.
Throughout the book, there is the shadow of Sacks’ younger brother Michael, ‘odd’ from an early age, who later became psychotic. He seemed to respond well to the early generation of anti-psychotic drugs, but soon demonstrated all the negative reactions – ‘grossly parkinsonian’ – so common in such cases. Michael spent his life in and out of mental institutions, ending his days in a care home on the same road where he had lived with his parents until their deaths.
I have never really understood objections to Sacks’ writing. Far from portraying people as strange specimens to be looked at, it seems to me that he has always reminded us that the realms of being human are wider than we might feel comfortable with, and that we have to find a place for those whose behavior may well be different or even bizarre. At one point, Sacks mentions being in love with his patients, ‘the sort of love or sympathy that makes one clear-eyed’. He reminds us that our ways of responding to illness are not the only ones. In 1987, he visited the La Crete Mennonite community in Alberta, which had a very high concentration of people with Tourette’s syndrome. The experience showed him how something like Tourette’s syndrome, neurological in origin, could be modified by context and culture, in this case, ‘a deeply supportive religious community in which Tourette’s was accepted as God’s will’.
Sacks is not offering any great insights or profound thoughts on life here, but perhaps something more important, the example of a life lived fully, recounted with candour and generosity, and without a hint of self-pity. He even succeeds in being open hearted towards his mother, who, he reveals, told him ‘You are an abomination. I wish you had never been born’ on learning that her son was sexually attracted to men. She was, Sacks comments, ‘haunted by the terrible verses in Leviticus’.
It seems fitting to end with Sacks’ own words. In the article announcing his diagnosis of metastatic cancer, he reflects: ‘I cannot pretend I am without fear. But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers.’ (New York Times, 19 February 2015).