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Oliver Sacks: A Neurologist At The 'Intersection Of Fact And Fable'

Oliver Sacks was an author, physician and a professor of neurology at the New York University School of Medicine.
Chris McGrath
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Oliver Sacks was an author, physician and a professor of neurology at the New York University School of Medicine.

Neurologist Oliver Sacks, who died Sunday, once described himself as an " old Jewish atheist," but during the decades he spent studying the human brain, he sometimes found himself recording experiences that he likened to a godly cosmic force.

Such was the case once when Sacks tried marijuana in the 1960s: He was looking at his hand, and it appeared to be retreating from him, yet getting larger and larger.

"I was fascinated that one could have such perceptual changes, and also that they went with a certain feeling of significance, an almost numinous feeling," Sacks told Fresh Air's Terry Gross in 2012. "I'm strongly atheist by disposition, but nonetheless when this happened, I couldn't help thinking, 'That must be what the hand of God is like.' "

Sacks was the author of numerous books that examined the mysteries of perception, memory and consciousness. Often his books described patients with unusual neurological disorders and brain injuries — such as The Man Who Mistook His Wife for a Hat.

Sacks' 1973 book Awakenings,which was adapted into a film starring Robin Williams and Robert DeNiro, chronicled the neurologist's work treating patients who had spent decades in a catatonic state caused by encephalitic lethargica. Some of the patients emerged from their catatonia after Sacks administered the drug L-dopa.

In a 1985 interview, Sacks told Gross that watching the patients emerge from the catatonic state was like standing at "the intersection of fact and fable. You see infinitely moving, dramatic, romantic situations, but also clearly based on the state of the nervous system."

Fresh Air remembers Sacks with two interviews from 1985 and 2012.

Interview Highlights

On the catatonic state of the patients he described in Awakenings

I suppose the first impression was that I had entered a museum or waxwork gallery. They were motionless figures who were transfixed in strange postures — sometimes rather dramatic postures, sometimes not — with an absolute absence of motion, without any hint of motion. So everything looked frozen, and then, very suddenly, sometimes one of these patients would be released from this state and would speak and move, then you could see what a vivid, alive, real person was there, imprisoned in a sort of way by some strange physiological change.

On the sudden and gradual reactions to the L-dopa

The suddenness was incredible and nothing which I had read about gave me any hint of this. Patients with ordinary Parkinson's disease don't respond in this sudden way. They tend to warm up gradually, maybe one had seen, as it were, a built-in tendency to suddenness with these patients in the way in which they might suddenly snap out of things if there was a fire engine or a sneeze or something like this. Some of the patients came out more slowly, some instantly changed. With the patients who came out more slowly, one would see over a period of days a sort of melting of the rigidity of the frozen picture. There would be the beginnings of spontaneous movement, the beginnings of speech, the beginnings of attention and looking around, the beginnings of animation.

On the fable-like qualities of neurology

There was a quality of a fable about this in the spring in the summer of '69. I thought of the Sleeping Beauty, of Rip Van Winkle and all the others in a sort of way. ... There was great joy and a sort of lyrical delight in the world which had been given back. I remember one patient stroking leaves and looking at the nightlights of New York on the horizon and everything was a source of delight and gratitude. It was like seeing frozen figures thawing. And with this, a great delight as an awakening or sort of resurrection might be expected to have.

On a patient communicating with a spelling board before the L-dopa, "I have no exit. I'm trapped in myself. This stupid body is a prison with windows but no doors."

I think illness and deep illness may force one to think, even if one hasn't been a thinking person before. And perhaps force one to think in the terms in which all people think of, which are terms of metaphor, of the imagination, of myth. If you just catechize patients, if you give them the usual neurological catechism, if you interrogate them in a narrow way, you get narrow answers. Sometimes one has to do this sort of medicine, but I think this sort of quick interrogatory medicine is too common. At least in a chronic hospital you have in some sense, for better or worse, all the time in the world.

On trying hallucinogenic drugs

I think I sometimes just wanted pleasure. I wanted to see a visually and perhaps musically enhanced world. I wanted to know what it was like ... . I would often keep notes when I got stoned.

On a memorable hallucination while taking LSD

I had been reading about the color indigo, how it had been introduced into the spectrum by [Isaac] Newton rather late, and it seemed no two people quite agreed as to what indigo was, and I thought I would like to have an experience of indigo. And I built up a sort of pharmacological launchpad with amphetamines and LSD, and a little cannabis on top of that, and when I was really stoned I said, "I want to see indigo   now." And as if thrown by a paintbrush, a huge pear-shaped blob of the purest indigo appeared on the wall.

Again it had this luminous, numinous quality; I leaped toward it in a sort of ecstasy. I thought, "This is the color of heaven." ... I thought maybe this is not a color which actually exists on the Earth, or maybe it used to exist or no longer exists. All this went through my mind in 4 or 5 seconds, and then the blob disappeared, giving me a strong sense of loss and heartbrokenness, and I was haunted a little bit when I came down, wondering whether indigo did exist in the real world.

I would turn over little stones. I once went to a museum to look at azurite, a copper mineral which is maybe the nearest [to] indigo, but that was disappointing. I did in fact have that experience again, but when I had it the second time, it was not with a drug, it was with music — and I think music can take one to the heights in a way comparable with drugs.

On hallucinations that accompany bereavement

With any hallucinations, if you can do functional brain imagery while they're going on, you will find that the parts of the brain usually involved in seeing or hearing — in perception — have become superactive by themselves. And this is an autonomous activity; this does not happen with imagination. But hallucination, in a way, simulates perception, and the perceptual parts of the brain become active. ... There's obviously a very, very strong passionate feeling of love and loss with bereavement hallucinations, and I think intense emotion of any sort can produce a hallucination. ...

With hallucinations one remembers them, unlike dreams, and on the whole they're not like dreams because dreaming, you're asleep, you're only a dreaming consciousness, whereas here you're awake and observing yourself.

On the connection between drugs, hallucination and religion

I'm very intrigued by the relationship between drugs and religion and hallucination and religion. There's a long chapter [in Sacks' book, Hallucinations] on epilepsy, which, at one time was called the "sacred disease" — although Hippocrates said there was nothing sacred about it. ... There is a sort of seizure, which some people get called an "ecstatic seizure," when there will be a feeling of bliss or rapture, a feeling of being transported to heaven, sometimes of hearing angelic voices or seeing angels or communing with God.

Experiences like this can happen with seemingly quite irreligious people who have — who don't seem to have an iota of religious disposition, but the experience may be rather overwhelming and may lead to conversion.

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