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If you like Oliver Sacks's story, you might also like:
Roger Bannister,
Keith Black,
Benjamin Carson,
Francis Collins,
Judah Folkman,
Stephen Jay Gould,
Jonas Salk,
John Sexton,
Andrew Weil and
Edward O. Wilson

Oliver Sacks's
recommended reading: Madame Curie

Related Links:
Sacks.com
Sacks Bio
Sacks Foundation

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Oliver Sacks
 
Oliver Sacks
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Oliver Sacks Interview

Neurologist and Author

June 17, 2000
Scottsdale, Arizona

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  Oliver Sacks

One of your first books to attract widespread attention was Awakenings, in which you discussed your experience working with some very unusual patients you met at a hospital in the Bronx. Could you describe those patients for us, and what happened to them?


Oliver Sacks: I still go to the hospital. About 34 years ago, when I went there in '66, as soon as I entered the hospital, I was struck by strange, motionless, transfixed figures, some of them in very odd positions, standing in the lobby and the passages. I had never seen anyone like this. I'd seen catatonic patients on the back wards, but this was obviously something different. And I was very amazed and horrified when I found that some of these patients had been there for 30 or 40 years -- the hospital had been opened in 1920 for these first victims of the epidemic sleeping sickness, the encephalitis lethargica -- and that medicine and surgery apparently could do nothing for these patients and that, further, many of them had been dumped there by their relatives, or their relatives had died, and in effect, they had been abandoned and had been out of the world for decades. I had never really heard of this sort of situation. There'd been very few accounts of such patients, although one account referred to them rather dismissively as "extinct volcanoes." But you know, the nurses and others who knew them well -- and I came to feel this myself -- were convinced that there were intact minds and personalities inside these petrified bodies.


You once used the expression "dormant volcanoes."


Oliver Sacks: Yeah, and I wondered whether these people, rather than be extinct volcanoes, might be dormant, and whether both the possibilities of health and of disease in a way were smoldering in them. So what would happen if you uncapped them? And also, what would it be like for someone whose life had been severely dislocated with a discontinuity -- for better or worse, we live our lives from day to day and year to year. We can't imagine this sort of suspension. What would it be like for these people if they did awaken, if they did come to? And I hesitated for two years before I tried any medication. There were astounding things. One patient especially stays in my mind. She was actually made the subject of a play by Harold Pinter. But when she came to, she was tremendously animated, but in a strange way. She had the speech and the gestures of a young woman from the 1920s. She looked like a flapper come to life. She spoke about Gershwin as if he were still alive. And I wondered where she was, and I asked her some questions. She was a very bright, quick woman, and she said, "I know the date of Kennedy's assassination." She said, "I know the date of Pearl Harbor." She spoke of these things as sort of flashbulb memories, but she indicated there'd been no coherent -- no sense of coherent living. She says, "I know it's 1969," she said, "but I feel it's 1926. I know I'm 64, but I feel I'm 21." And in some sense, she had dropped through a vacuum from the 1920s to the 1960s, from her 20s to her 60s. She said she didn't like our world very much. She said that everything which had had meaning for her had vanished, and after ten days of this strange 1920-ish animation, she went back into the state she had been before, and nothing we could do. You know, this wasn't the case for most of the patients, but I think with her, the challenge of coming into an alien world and an unfamiliar world, making a new identity, was too great. So I mean the awakening was as much an existential as a medical. On the one hand, there was all the physiological side effects of this and that. I think some of the relatively short action of the medication, and some of the way in which it activated other symptoms -- well, this was one set of problems. But the other was to be reactivated, to be awakened and put back into operation after being out of operation for 40 years and feeling oneself sort of outmoded.


How did you come to think that L-dopa would have an affect on these patients?

Oliver Sacks: Well, there were two things.


There had been an account in early 1967 of the effects of L-dopa on people with ordinary Parkinson's disease, and it was touted as a sort of miracle drug. Now one of my patients -- in fact, the original Leonard L., who was somewhat different from the movie version, a very bright man -- he was the one who drew my attention to this, and he spoke of Dopamine, the neurotransmitter needed in the brain, as "resurrectamine". He spoke of Cotzias, the physician who had introduced L-dopa, as "the chemical messiah." You know, one sees the depth of intelligence and hope and irony and desperation here. Well, my patients did have Parkinsonian-- sort of clinical features of Parkinsonism,-- but they didn't have ordinary Parkinson's Disease. I'm sorry, this sounds a little confusing. But Parkinsonism for them was part of a much more complex, strange, long-standing disease. And because of the complexity of the disease and its duration, I didn't know how L-dopa would -- how they would do with L-dopa. I think it couldn't be known.


It must have seemed at first like a miracle, although we've heard you say you don't believe in the supernatural.


Oliver Sacks: One of my fellow speakers, who has done and is doing beautiful major work in genetics, has a fine scientific mind, also said that he spoke of his belief in a caring personal God and the supernatural. And he said that he saw no incompatibility between these modes of thought or forms of belief. They didn't seem to be in two compartments of his mind. And there's something about the reiteration of the word "supernatural" which made me take issue with him and explode a little bit. And I said that, for me, I thought there was and always had been an incompatibility between a belief in the natural world and anything else. Indeed, I could not imagine a supernatural world, and that I thought any belief in the supernatural was similar to a belief in the occult, and therefore, that I found what he said, in a sense, unintelligible. I think I also -- I forget exactly what I said in the heat of the moment -- I also said that for myself, beside scientific interests, I had a passionate feeling for music and for art and for the beautiful, and sometimes for the sublime, and that I thought that I had experienced feelings of the sacred and the holy and the religious. And yet, for me, this was all part of being a human being and of the natural world. And I couldn't imagine -- I didn't see the sense of positing anything supernatural, although I saw why it might be done. I think I also indicated -- or I wanted to indicate -- my respect for believers. Amongst other things, I work in an Orthodox Jewish hospital and also an orthodox Catholic hospital. And I never -- I usually don't take issue with people. I feel it's partly their business. But since this actually came up before an audience, I did take issue with it.


What was it like when the patients started declining after they had this amazing recovery? How did you deal with that yourself?


Oliver Sacks: When the patients started declining, I felt bewildered, anxious, sometimes guilty. I didn't know what was happening. I tried all sorts of ways of restoring or retrieving the original response, and at the same time, I think, of perhaps preparing patients for what might be some continuing -- but now only partial and less dramatic -- response. I think finally it was probably accepted by all of us that some sort of decline was perhaps a physiological necessity, maybe associated with the amount of damage there had been to the nervous system and the fact that one was perhaps trying to stimulate the one or two percent of cells which remained in certain systems to do the whole job. Contrary to the movie which, in a way, shows everything as ending in '69, many of the patients made accommodations, and some of them lived 15 or 20 years afterwards, at least with sort of a partial animation. But it was a -- you know, as the person who gave the L-dopa, I tended to be invested by them almost with too much hope and power, and then they got angry with me or whatever. One of the patients said that L-dopa had become "Hell-dopa." A very, very complex business. Morally complex, medically complex.

[ Key to Success ] Perseverance


What do you mean?

Oliver Sacks: The medical life is very complex, and it is maybe sometimes these existential and ethical complexities which make me look back wistfully, as it were, to the days of physics and chemistry, when there were all sorts of intellectual challenges and sometimes torments, but not quite these particular existential or ethical ones.

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