Writer's block, neurosis and empathy: A rare look at Dr. Oliver Sacks' early career
Writer Lawrence Weschler first met author and neurologist Oliver Sacks in 1981. He was a newly-hired writer at The New Yorker. Having read Dr. Sacks book Awakenings, he was keen to do an in-depth profile of him, although at the time, the book had not been widely read, and Sacks was not well-known.
The book, which was published in 1973 recounted Sacks' time working with seemingly catatonic patients at Beth Abraham Hospital in the Bronx who had survived the 1917–28 epidemic of encephalitis lethargica. He treated them using a drug for Parkinson's L-Dopa, which led them to "awaken" although it was a temporary reaction and some later experienced uncontrollable side effects. The book was adapted into a 1990 film starring Robin Williams.
Weschler's memoir of their friendship And How are you Dr. Sacks? was published earlier this year. Dr. Goldman had a chance to speak to Lawrence Weschler about his relationship with Sacks this fall, at the Vancouver Writers' Festival.
He began by asking Weschler why he was drawn to writing about Dr. Sacks when the physicians was still relatively unknown.
When (Awakenings) came out it was widely dismissed. Doctors generally ,who were very much into the quantitative approach,were upset that it didn't follow those rules and they didn't believe it was true. In any case, it was just anecdotal. But I had a philosophy teacher at Santa Cruz... a man named Maurice Natanson, and as I graduated in 1974 he thrust a copy of Awakenings in my chest and almost broke my rib cage and he said 'Read this!' When I finally did read it, I was just drawn to it…. It's beautifully written. It's a harrowing story. The story of these people who had been frozen for 30 years and then had been just warehoused. And I remember as I read it that the empathy for the patients was amazing, but I was curious about the doctor himself because he was there as an active person but you didn't get a sense of what it was like for him.
What do you remember about that first meeting you had with him at his home, which was at that time on an island outside of Manhattan?
He was church-mouse poor. He was working in poor houses in institutions. He was incredibly neurotic. And as I say, untrammelled in this writer's block which took the form of graphomania. He was writing millions of words, just not the right words about this damn book. I went to the bathroom at one point and the bathtub in his bathroom in this little clapboard house had three windows, and in each of them was an air-conditioning unit because he overheated all the time. And so that was weird. And he was incredibly strong. He had been the California state heavyweight lifting champion at one point during a wild period of his life. He was unbelievably clumsy. We would go on trains and he would rip off the train door by accident.
And as part of your research you went with Sacks as he did rounds at Little Sisters at the Bronx psychiatric hospital?
At Bronx State Hospital and at Beth Abraham, which is where he'd had the awakenings of patients. Basically poor houses. And as he said, those were where you could find the jewels and that you had all the time in the world and nobody was expecting anything. So he would spend hours and hours and hours with patients.
You saw him in action. What struck you about that?
As I say he was a difficult person. He was very self-involved. People sometimes would ask you know, 'Does he ever talk to himself?' And the answer was, 'Especially when he's talking to you!' And, yet when he was with the patients, a psychiatrist friend of his described it — 'he is a doctor for the community of the refused.'
In your book you talk about Dr. Sacks concept of the 'neurology of the soul.' What did he mean by that?
Well, that medicine was obsessed with the disease the patient had. And he was much more concerned about the patient who had the disease. He was interested in a kind of existential medicine like, "How are you? What is it like to be you?' but more than that, 'What's your story?' Meaning he would take patients who were abandoned, who had been treated like objects in these warehouses and he would engage them and together the patient and the doctor would create this narrative. and the narrative would feature the patient as the subject of the story instead of just the object. This was hugely important therapeutically. Forget whether or not case histories are of value to medicine, I think they are, but to treat these patients you had to treat them as if they had a soul.
Weschler spent four years following Sacks on rounds, spending time with him on both coasts and interviewing his friends and colleagues. But at Sacks behest, he put the profile on hold. Sacks was hesitant because he was not ready to reveal he was gay. The two remained friends for more than 30 years, and before Sacks died in 2015, he told Weschler to return to the project.
So what did it feel like when he asked you at the end of his life, to write that book?
I said at the time that I had had an aircraft carrier going a hundred miles an hour and had been told to stop on a dime and then 30 years later was told to get back in that thing and start it up again. You know the propellers had fallen off and the anchor could be pulled out of the ground. It was not easy. And by the way, it was an act of grief. That's how I dealt with my mourning for him really sorting through complicated feelings because he wasn't an easy man. Everything you know about him that's wonderful — it's true. He was all that. But he was also just an incredibly exasperating and difficult person.
I think a lot of what I've been talking about has really has pertinence to the journalistic enterprise. I think I'm a better writer for having read him but also for having watched him work. To watch him grow from that the neurotic isolate renegade that he was when we first met, into this great public intellectual was quite wonderful. He made huge, huge. huge contributions. In some ways the biggest change was at his eighty-second birthday, just before he died. The head of the neurology department at Columbia University got up and toasted him and said that nowadays, when they go through the applications of recent doctors who want to do residencies in neurology at Columbia, 70 percent mentioned Oliver Sacks. The change that he helped bring about in medicine, from a time in 1975 when he was not only ignored, but reviled for what he was doing, to the kind of way medicine is being done now, is just enormous. In some ways that was his greatest accomplishment.
Edited for length and clarity