Between October 1918 and November 1919, half the world's population contracted 'flu, and of these twenty-one million died. It is believed--by those who understand such things--that the virus' etiology, or pattern of behavior in growth, ramification, and mutation, was preceded by related outbreaks of encephalitus lethargica, or sleeping sickness. This was more widespread than is largely known, and for a half-century after hospital wards throughout the nation were colonized by its comatose victims. The subjects of Awakenings, the second book of Dr. Oliver Sacks, were among them.
Awakenings, first published in 1973, records the sudden startling resurrections of ten of these sleepers under the administration of an experimental drug, LDopa. They had slept unmindful of Pearl Harbor, or the Second World War, or Hiroshima, or Auschwitz, or of the passing generations in their own families. What might be conveyed in the lucid intervals induced by LDopa was therefore a delicate matter. Imagine missing thirty years of references: tasers, Google, Quark, iPod... on back, and a likely amount of personal experience, and the memories made with those experiences, and the scope of the problem is stated, if not understood.
What were they undergoing while asleep? According to one of Sack's patients, she was viewing a map within a map within a map ad infinitum, or its converse, a map dematerializing into a seemingly infinite sequence of dematerializing maps; she was entranced in a redundancy and could not wake. This lasted thirty years.
This particular case intrigued the Nobel-prize laureate playwright Harold Pinter, who used it as the basis for the one-act play A Kind of Alaska. This unfortunately becomes operatic, whereas in fact the actual patient had no more means of communicating than if she had been buried alive. The trouble with art, as opposed to diagnosis, lies in its additional sentimental effects.
The film version of Awakenings, despite decent performances by Robert DeNiro and Robin Williams, does this, too. What is credible about Sacks is that he does not. As a Doctor, he may conjecture but he can not simplify his findings. He must see what is before him in order to help. And in order to begin to know what the patient is undergoing, he must know what he does not know. He does not know what it is like to be autistic with exact graphic recall (An Anthropologist From Mars) or to have to "channel" Tourette's syndrome (The Man Who Mistook his Wife for a Hat) or to be struck by lightning and--surviving that--to develop an unforeseen obsession with playing Chopin on the piano (Musicophilia). He knows how to pose exploratory questions whose answers will always be partial, and that what it feels like is a mystery.
It is this recognition of the mysteriousness of another person's experience which gives these cases their dimensionality. Rereading them alongside several contemporary novels, I could not help but notice how much more real these case histories seemed--their personal details just sketched in--compared to their over-upholstered fictional counterparts. They were more "real" in part because Sacks, as a narrator, never forgets what he can not know; whereas the characters of the novels I was reading seemed pinned to the walls in their own garments, so omniscient was the authors' tone. Sacks' artistry is such, moreover, that he puts the reader through the case's
perplexities, the doctor's perplexities, and the patient's, and the questions that get bumped against. The reader participates in the questions of What is wrong? How to get well? And what are the conditions in which human identity may operate?
One may function, it turns out, without an understanding of human emotion or emotional affect, without hearing, without the proprioceptive--or situating-yourself-in-space--sense, without color, taste, or smell. You can reconstruct your world around the perceptual gaps that are felt but whose nature--being gaps--have no means of calibration, or comparison. Lose the sense of hearing and compensatorily become part of a spatial species. Lose the ability to see in color (even in dreams!) and become a "smeller" by default. Damaged memory, too, has its peculiar conduits with their idiosyncratic picklocks and skeleton keys, should neural passages be blocked. The titular hero of The Man Who Mistook His Wife for a Hat negotiates the world through unspooling a melody as sight fails him.
The doctor's responsibility is to deduce how the patient has adapted, what the adaptation consists of, what its social and emotional effects are, and how to integrate the patient into the human flow to the greatest degree of functionality possible. It is an attempted rescue from "the land of unlikeness." It is the human need to overcome isolation which gives these case histories their poignancy, the awareness that every sensory impairment or deterioration of memory drives a patient far from human community. In an actual sense, to get well is to belong again. What humbles, in the course of reading Sacks, is the realization of what human beings struggle through in order to overcome their enforced involuntary singularity. I find these struggles heroic and beautiful, however bizarre, and lessons in compassion and attentiveness from Sack's example.
Oliver Sacks is a wise and clear-sighted guide to how much human strangeness can exist in an ordinary hospital, to how delicate the equipoise of the senses is and how easily unbalanced it may be, and to the sudden irruption of the imponderable into the fabric of daily life. I like him when he botanizes, too, which he does ably ,and two of his three memoirs have great charm. The third, A Leg To Stand On, which deals with a near fatal accident on an Alp, and the states of mind during the long recovery afterwards, is great beyond its apparent brevity. It is so in part because the Doctor finds himself in territory in which he is an unknown to himself. He must watch his new self--one with a damaged leg--with the same empirical judiciousness has he did his patients. He must be patient with himself. He remembers and states the feelings of physical recovery in a way almost any reader will recognize as their own. Doppelgedanken, the German term for expressing what a reader has felt but been unable to state, is what Sacks performs on these pages.
But there is very little of Sacks' work which is not worth reading, and re-reading. The slightest works are the Oaxacan Journal and Uncle Tungsten, the least appealing perhaps The Island of the Colorblind. Awakenings, The Man Who Mistook His Wife for a Hat, An Anthropologist on Mars, and the recent Musicophilia have been accorded classic status almost by immediate consensus, while a deaf friend has described Seeing Voices to me as the best book on the subject of the deaf. Intentionally or not, Sacks seems to have written about the entire perceptual spectrum, and made from it a kind of Comedie Humaine of the senses. It's an unusual route into the domain of literature, but he can be placed on a shelf near Italo Calvino, Jorge Luis Borges, and W.G. Sebald.