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Sacks juxtaposes medical,literary worlds

The non-fiction of Oliver Sacks, an English-born neurologist who now practices in New York, has received much popular attention for its intriguing and sympathetic descriptions of patients with unusual neurological disorders. Two books have even been dramatized as a movie and a play.

Few readers are likely to know as much about the author as they do about his work. But in an interview before Sacks' reading at Rackham on March 26, it became apparent that the unusual events and phenomena Sacks describes have their counterpart in his own equally interesting life.

Sacks' latest book, "An Anthropologist on Mars," tells the stories of seven patients. They range from a painter who becomes color-blind, to a blind man who undergoes operations to regain his sight, to a surgeon with Tourette's syndrome (a disease that results in uncontrollable tics and muscular spasms).

The essays go far beyond mere case histories, as Sacks integrates details of his patients' lives and personalities. He turns the book into a series of fascinating mini-biographies, which will likely prove as illuminating to readers as they were to Sacks himself.

"In a word? What word would you use?" Sacks mused, when asked what he'd learned from his patients.

"Survival, perhaps. On the one hand, how terribly and in how many ways one can suffer. And at the same time how, perhaps, with help, one can find resources in oneself and construct a self or a life on a quite other basis. The fact of adaptation, in all its different forms, so one doesn't feel that there's one way of being or one health."

This is a fact that Sacks exemplifies, as well. His unusual and multifaceted life defies the notion of one way of being.

Few doctors, for example, would spend as much time with their patients as he does. In "Anthropologist," Sacks describes inviting patients to his house, and traveling with them to places as diverse as Italy and Moscow.

Sacks explained the basis for this practice. "The first time I did anything like this, it was with great hesitation. It was in the early '70s, with a patient with Tourette's syndrome." Sacks jerked his arm to the right, imitating a Tourettic tic. "As he described to me some of the things he'd been through, I couldn't imagine what life was like for him unless he let me see it."

Sacks places great emphasis on this understanding of patients' disorders. "There may be some sort of overlap, with things we would regard as acceptably odd or pedantic," Sacks said. "But I think there are things of which `normal' people have no experience. Like color-blindness: You either are color-blind or you're not. ... You can't understand what it's like to be Parkinsonian or color-blind if you're not. But coming back to drugs and other things, you may be enabled to understand it."

Drugs? Yes, indeed. A footnote to one essay describes Sacks' experience of altered visual perception after marijuana use, which helped him understand the problems of a patient who regained his sight.

"Did I say that?" Sacks inquired, laughing sheepishly, when questioned about this footnote. "Well, with a migraine, you can have something called cinematic vision. You see a series of stills. Had I not experienced that myself, I would be yet unable to understand it. And, yes, I sort of took drugs -- I think that was very much more recreational. But I think there's a spin-off there, in that you are introduced to other sorts of minds and other forms of consciousness."

Sacks is somewhat set apart from other physicians, not only for his unusual perspectives, but because of his popular writings about his patients. However, he explained that this was not a recent development in his life.

"I think I probably started writing long before I saw any patients," Sacks said, as he disappeared into an adjoining room. He returned carrying a packet of felt-tip pens and a small notebook: "... Because I have walked around with pen and paper for as long as I can remember. I always like describing scenes of people and events. When I saw patients, it sort of fitted into this. The patient tells you their story, and you compare it with other stories, and create a story between you."

Sacks was influenced by his friendship with the poet W. H. Auden. He explained, "Although I went to his lectures when he was a professor of poetry at Oxford, in '55, I didn't meet him until the late '60s. ... I think he said, basically, that you must get out of the straitjacket of pure case history, and try to let every dimension enter, and somehow keep your balance. So in a way he guided me to be on a sort of adventure, or to be more ambitious."

This philosophy led to Sacks' writing six books. One of these -- "Awakenings" -- was made into a movie, an even more ambitious step. How did Sacks react to this unexpected event?

"With horror," Sacks said dryly. "I was first approached in the '70s. An option was taken, but nothing happened for 10 years and I didn't think of it very much. And then in '87, a script arrived, and my immediate reaction was to try and buy the rights back."

This impulse proved unwarranted, however. "I didn't have any sort of formal control, but I could discuss things and go to rehearsals. ... I did my best to give a point of departure. But mostly, I think they went to great trouble to make it a fair and sensitive picture."

Movie character, neurologist, writer, Sacks has an extraordinarily full resume, but one that makes sense to him. He explained this with a final anecdote about yet another surprising experience.

"My father had a motorcycle with a sidecar -- this is a common sort of thing on the English roads," Sacks began. "I rode motorbikes from the age of 16; I didn't actually drive a car until I was 30. So when I came to this country, I spent six months on the road. There is a sort of brotherhood or fraternity of motorcyclists on the road, and somehow when I was in San Francisco, I ran into sort of the local chapter. I gave them casual medical advice on this and that."

Unlike most readers, presumably, Sacks has no trouble reconciling the diverse images of physician and Hell's Angel. "Why not? One always wears several caps," he said.

He again went into an adjoining room and returned with a green cap. "Here's the medical cap, and there's the botanical cap, the swimming cap, the motorcycle helmet, the yarmulke ... whether these things are integrated or not, I don't know. But we all have sort of different selves."