Oliver Sacks: genius as a neurologist, writer, and patient

The best definition of genius that I know is “the ability to see what no one has seen where everybody is watching.” I think this is the best definition because it applies to all areas where it is possible to recognize a genius; it applies from whoever saw that the Earth revolves around the sun and not the opposite to who saw that the best way to scoring against England was not to give the ball to anyone. Well, Oliver Sacks noticed things that physicians, writers, and patients often overlook.

1

The physician

Which he resisted being. He entered medical school to follow the footsteps of his parents and one of his older brothers; however, after completing his studies, he tried to enter the air force as a pilot; fortunately, he failed. After an introspection journey in Canada, he decided to begin his specialization studies in Neurology and moved to the United States.¹

Although not from his invention, two ideas, which are often forgotten, stand out his role as a physician:

• 1)

  The interrogation as the most useful clinical tool

  When Oliver Sacks studied Neurology, neurological examination was already “the dark art full of eponyms,” which currently is. The furor for neurophysiological studies was beginning. However, he recognized that although these tools are useful both in exploration and paraclinical studies, the patient was a passive entity. Hence, there was no real exchange of information.

  Although outdated and little sophisticated, it is in the open forum where patients express their reason for consultation, what most afflicts them, causing to break the routine and expose themselves with a stranger.

  Sacks main advice to all doctors in training was “listen without judgments and thoroughly to all your patients”.²

• 2)

  Claude Bernard

  Everybody has been told that “there are sick people and not diseases”; however, is not unusual to talk about patients just as bed numbers or diagnoses. Although the names were fictitious or abbreviated to respect the privacy of patients, he never stopped using them. In his books, lectures, and interviews, there were always Dr. P, Shirl Jennings, Rosalie, not only due to his humanism but also due to the conviction that two people may have the same diagnosis but need different treatments: it is not the same to be color-blinded than to be color-blinded and a painter.

2

The writer

Of whatever. Regardless of whether it was a novel, a letter to his teacher or a note of a patient's evolution,³ Oliver Sacks exploited the natural ability of the human brain to tell and retain stories.⁴

He realized that texts have different objectives and may be targeted to different types of readers; however, the transmission of a written idea will always be more effective if it is immersed in a story. His literary style was always described as almost “conversational” and “easy to read.” Even his medical notes were described as “narratives”.³ This style was conscious and deliberate since he came to recommend the prose explicitly for the registration of ideas and clinical experience with scientific objectives.⁵

In one of his autobiographical books, Uncle Tungsten,⁶ Oliver Sacks narrates a memory, which later he acknowledged never having lived and, moreover, he was not able to identify what was different from a similar but true memory.⁷ In other words, he acknowledged that the human brain and its tendency to tell stories is capable of enriching a fictional story to make it indistinguishable from a real one, a resource that any writer cannot afford to refuse.

In his own words, Sacks said “every act of perception is, to some extent, an act of creation, and every act of memory is, to some extent, an act of imagination”.⁸

Accordingly to his passion for writing, Sacks used to write a journal on every trip he made. Fortunately, he came to Mexico in 2000, and moreover, he came to Oaxaca (hence the Oaxaca Journal).⁹ The following are some extracts that reflect his personality and observation capacity: “I often go to professional meetings of neurologists and neuroscientists. However, the feeling at that meeting was quite different: there were freedom, comfort, and lack of competition as I had never seen in a professional congress…” In Oaxaca, on his way to Yagul: “I am starting to get a sense of a life, a culture, deeply different from mine. Somehow, the feelings are similar to those in Rome or Athens, but very different in other ways, because this culture is so different: so completely oriented to the sun, the sky, the wind, the weather, as a start. The buildings look outwards, life faces outward, while in Greece and Rome the focus is inwards …”. “I know that Oaxaca has the richest flora of Mexico. Now, I realize that it also has the most varied and tasty food. I think I am starting to fall in love with this place”.⁹

3

The patient

Oliver Sacks was a patient that suffered from migraines, prosopagnosia, secondary unilateral blindness and a rare variety of melanoma with an even rarer outcome.¹⁰ Sacks never focused on the unexplained and irremediable aspects of his sufferings; he accepted them as they were and focused on adapting and learning from himself through them. His curiosity was such that he came to experiment with illegal drugs,¹¹ and to perform magnetic resonance imaging while having hallucinations.¹²

“Sufferings will decrease if we have an introspective and learning attitude from them.” For any patient, this message is eccentric but powerful regardless of whether he has a simple cold or terminal cancer. Thanks to this attitude, at the end of his days he wrote: “I cannot pretend I am not afraid, but the prevailing feeling in me is gratitude”.¹⁰

Perhaps the most important insight from Oliver Sacks was to realize that the brain is the most human of our organs and that its development ends only with death. His point of view is something that often goes unnoticed, although many are looking.