On the Move: A Life

by Oliver Sacks

Ghosts inhabit this house. When I go into the various rooms I feel overcome with a sense of loss.

I became terrified of him, for him, of the nightmare which was becoming reality for him. What would happen to Michael, and would something similar happen to me, too? It was at this time that I set up my own lab in the house, and closed the doors, closed my ears, against Michael’s madness. It was not that I was indifferent to Michael; I felt a passionate sympathy for him, I half-knew what he was going through, but I had to keep a distance also, create my own world of science so that I would not be swept into the chaos, the madness, the seduction, of his.

He never said this to anyone else—he knew it would sound bizarre, if not mad—and he had begun to think of our parents, his older brothers, and the entire medical profession as determined to devalue or “medicalize” everything he thought and did, especially if it had any hint of mysticism, for they would see it as an intimation of psychosis.

he would not say, “I need help,” but he would indicate it by an extravagant act, such as flinging a cushion or an ashtray to the floor in his psychiatrist’s office (he had been seeing one since his initial psychosis). This meant, and was understood to mean, “I’m getting out of control—take me into hospital.” At other times, he gave no warning but would get into a violently agitated, shouting, stamping, hallucinated state—on one occasion, he hurled my mother’s beautiful old grandfather clock against a wall—and at such times my parents and I would be terrified of him. Terrified, and deeply embarrassed—how could we invite friends, relatives, colleagues, anyone, to the house with Michael raving and rampaging upstairs? And what would their patients think? Both my parents had their medical offices in the house. Marcus and David also felt reluctant about inviting their friends into (what sometimes seemed to be) a madhouse. A sense of shame, of stigma, of secrecy, entered our lives, compounding the actuality of Michael’s condition.

I wondered whether systems in the brain concerned with the perception (or projection) of meaning, significance, and intentionality, systems underlying a sense of wonder and mysteriousness, systems for appreciation of the beauty of art and science, had lost their balance in schizophrenia, producing a mental world overcharged with intense emotion and distortions of reality. These systems had lost their middle ground, it seemed, so that any attempt to titrate them, damp them down, could tip the person from a pathologically heightened state to one of great dullness, a sort of mental death.

It is a question of not just medication but the whole business of living a meaningful and enjoyable life—with support systems, community, self-respect, and being respected by others—which has to be addressed. Michael’s problems were not purely “medical.”

one cannot abstract an ailment or its treatment from the whole pattern, the context, the economy of someone’s life.

this was a love without ambivalence, without conditionality. Nothing I could say could repel or shock her; there seemed no limit to her powers of sympathy and understanding, the generosity and spaciousness of her heart.

“Don’t try to memorize ‘syringomyelia’ from your textbooks—think of me. Observe this large burn on my left arm, where I leaned against a radiator without feeling heat or pain. Remember the twisted way I sit in a chair, the difficulty I have with speech because the syrinx is starting to reach into my brain stem. I exemplify syringomyelia!”

I felt that a student could not be reduced to a number or a test, any more than a patient could. How could I judge students without seeing them in a variety of situations, how they stood on the ungradable qualities of empathy, concern, responsibility, judgment?

There is a danger, when old friends meet, that they will talk mostly of the past.

Watching this ritual, which had occurred every year for more than 400 million years, I got a vivid feeling for the reality of deep time.

This sweet, unspoiled, preprofessional atmosphere, ruled by a sense of adventure and wonder rather than by egoism and a lust for priority and fame, still survives here and there, it seems to me, in certain natural history societies, whose quiet yet essential existences are virtually unknown to the public. One such is the American Fern Society, which holds monthly meetings and occasional field trips—“fern forays”—of one sort or another.

I particularly liked his 1989 book Wonderful Life, which gave one a tremendous feeling for the sheer luck—good or bad—which can befall any species of animal or plant and the huge role that chance plays in evolution. As he wrote, if we could “rerun” evolution, it would no doubt turn out completely differently every time. Homo sapiens was the result of a particular combination of contingencies that ended up producing us. He called this a “glorious accident.”

The point is not to stress contingency, but to identify it as a central theme for a genuine science based on the irreducibility of individuality, not as something standing against science but as an expectation of what we call natural law, and therefore as a primary datum of science itself.

He died at home in his library, surrounded by the books he loved.

These basic biases (towards, for example, food, warmth, and contact with other people) direct a creature’s first movements and strivings.

We must make our perceptions through our own categorizations. “Every perception is an act of creation,”

There then occurs with experience a selective strengthening of those mappings that correspond to successful perceptions—successful in that they prove the most useful and powerful for the building of “reality.”

The players are connected. Each player, interpreting the music individually, constantly modulates and is modulated by the others. There is no final or “master” interpretation; the music is collectively created, and every performance is unique.

“higher-order consciousness” was made possible in humans (and perhaps a few other species including apes and dolphins) by a higher level of reentrant signaling. Higher-order consciousness brings an unprecedented power of generalization and reflection, of recognizing past and future, so that finally self-consciousness, the awareness of being a self in the world, is achieved.

The act of writing is itself enough; it serves to clarify my thoughts and feelings. The act of writing is an integral part of my mental life; ideas emerge, are shaped, in the act of writing.

My journals are not written for others, nor do I usually look at them myself, but they are a special, indispensable form of talking to myself.

I am a storyteller, for better and for worse. I suspect that a feeling for stories, for narrative, is a universal human disposition, going with our powers of language, consciousness of self, and autobiographical memory.