And How Are You Dr. Sacks? Read online

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  In memory

  During the four years in the early eighties

  that I spent in his often near-continuous company,

  Oliver Sacks would sometimes refer to himself

  as a clinical ontologist,

  by which I came to understand

  he meant a doctor whose entire practice

  in relation to his patients

  revolved around the question,

  How are you?

  Which is to say,

  How do you be?

  For, as he had come to understand:

  Being is Doing.

  Prologue

  Heading out to City Island that first time in late June 1981, I’ll grant you, I was trawling, vaguely, for another story.

  I’d only just transplanted myself to New York City from my original stomping grounds in Los Angeles, largely owing to the success of my previous tale, which a few months earlier I’d somehow managed to sell, pretty much over the transom, to The New Yorker.

  While still back in California early that spring, only recently turned twenty-nine, I’d come home late one evening to my Santa Monica apartment to find the light blinking on my answering machine. Answering machines must have seemed pretty newfangled in those days, because the feathery voice on the tape began haltingly, “Mr. Weschler, is this Mr. Weschler?… Mrs. Painter, do you think he can hear me? Should I leave a … Mr. Weschler? This is William Shawn of The New … aaaah, Mrs. Painter, how can I tell if the thing is working?… William Shawn of The New Yorker magazine, and I am just calling to say that we all very much admired the piece you submitted to us a few months ago and we were wondering if … oh dear, Mr. Weschler, if you are getting this message could you please call us back at the following number”—and so forth—“Mrs. Painter, I don’t think he got any of that at all.”

  However, I did, I had, and in later years I’d be very grateful for the momentary filter of that answering machine: Had I happened to have been home and picked up the ringing phone, I’m sure I’d have assumed it was one of my friends pulling my leg and blurted, “Yeah, and I’m Bernardo Bertolucci” or something and just hung up.

  The piece in question, a book-length midcareer biography of the California Light and Space artist Robert Irwin, had been four years in the making, as I subsequently explained to Mr. Shawn on a visit to New York a few months later, when he invited me to lunch at his usual haunt, a corner banquette at the Algonquin, from which he could survey the entire room while pretty much disappearing, mouselike, into the background. He urged me to sample anything on the plank-long menu the waiter had just extended—nervously I chose the first thing that caught my eye, the day’s special, lobster-stuffed filet of sole—at which point Mr. Shawn ordered “the usual” (cornflakes, as it turned out). He then turned the full force of his penetrating curiosity upon me (that of the Iron Mouse, as I’d subsequently hear him called).

  “It appears that you currently live in California,” he said, “but, I mean, where were you born?” (His was hardly an unusual New York prejudice in those days: My Irwin book had by that point garnered more than half a dozen rave rejections from New York publishers, all assuring me that they definitely wanted a look at my next manuscript, though they couldn’t very well see how they could be expected to succeed in publishing anything about a California artist.) “Van Nuys, California,” I responded, “in the San Fernando Valley suburbs of Los Angeles.” Still confounded, Mr. Shawn bore down: “But, I mean, where did you go to school?” Birmingham High, in Van Nuys. “And college?” Cowell College at the University of California at Santa Cruz. Things clearly weren’t adding up, but Mr. Shawn, a first-rate reporter in his own right, continued probing until he was able to establish that all of my grandparents had been Viennese Jews who’d variously arrived in flight from Hitler (indeed, my maternal grandfather had been the eminent Weimar-era émigré composer Ernst Toch)—a category, at last, that he could comprehend.

  Following that lunch meeting, Mr. Shawn offered me a job as a staff writer at The New Yorker, and soon thereafter I moved to New York. The magazine would eventually publish half of my Irwin book across two issues, but as things developed, before that I’d also begun reporting for the magazine from Poland (at the height of its Solidarity passion) and soon afterwards would be submitting a whole variety of one-offs (one on the marvelous Louisiana Museum of Modern Art in Humlebaek, Denmark, for example, and another on the antic nonagenarian musical lexicographer Nicolas Slonimsky). But I was still looking for a subject upon whom I could direct the sort of slow, long-term attention I’d previously lavished on Irwin, and in the back of my mind I thought that this at the time still barely known, clearly quite idiosyncratic neurologist, out there on City Island, might just be the one.

  * * *

  Nor was I calling entirely out of the blue: He and I had already engaged in a few rounds of correspondence during the preceding year.

  I’d first heard of Oliver Sacks during my last year at Santa Cruz, in 1974, the year after his remarkable chronicle Awakenings was published. It’s worth recalling that Oliver’s second book was hardly a bestseller when it first appeared (any more so than his first book, Migraine, published a few years earlier and marketed, to the extent it had been at all, to a relatively limited niche market, had been). Although Awakenings had been fervently hailed by literary critics (W. H. Auden, Frank Kermode), it had gone largely dismissed in medical circles, and in any case did not really catch fire on either side of the Atlantic. But Maurice Natanson, the lead phenomenologist at Cowell College—a Husserl scholar who looked more like Buber—started touting it almost from the start, which would have been just like him.

  Come to think of it, the entire Awakenings drama had been taking place during the very years I’d been studying in Santa Cruz—starting the spring just before my arrival at Cowell, in April 1969, when Oliver, back at the institutional home he was calling Mount Carmel in the book, had become convinced that eighty of the place’s five hundred hopelessly lost causes (catatonics, assorted other demented, Parkinsonians, stroke victims, and the like) were not like the others, that even though they seemed to be “human statues” (locked in deep trancelike states from which they had apparently not emerged for years), some achingly attenuated form of life seemed to be persisting there deep inside. On that hunch, he’d resolved to bring them together, segregate them from the rest of the population, and study and care for them as a group. Even before that ward was established, though, Oliver had begun hearing reports of a remarkable new “miracle drug,” L-DOPA, which was said to be having surprising results with severely impacted Parkinson’s patients. So with some trepidation (for he was suspicious of such claims), he decided to try the drug on his patients. The results that summer were astonishing—a complete springlike Awakening—patients who had neither moved nor spoken in years suddenly emerging joyously active and voluble, and the ward ve
ritably brimming over with blithe energy. The springlike summer did not last, however, and by September (just as I was entering Cowell), the ward at Mount Carmel had descended into the phase Oliver would come to call Tribulation, a bedlam of horrific and screeching side effects and side effects of side effects. Some of the patients never made it through to the other side, though over the years others did, at length achieving a measure of surcease—Accommodation, as Oliver was to call this extended final phase—nothing ever again as wondrous as their brief summer resurrection nor quite as bad as the prior decades of their deep winter freeze.

  I’d taken the better part of a year off during my time at Cowell (tending to my composer grandfather’s estate in the wake of the death of my grandmother), so I was still there when Oliver published Awakenings, which in turn is how it came to pass that during the last weeks of my senior year, Natanson, glowering, as was his wont (a glower that was at the same time a kind of benediction), thrust the book into my chest as we passed each other in the hall. “Read this,” he commanded.

  It would still be a few years before I got around to reading Awakenings. However, the impact of reading the book when I finally did proved utterly galvanizing, and I couldn’t stop thinking about it. I was quite overwhelmed, albeit a bit puzzled. Because (and it took a while to narrow in on the precise nature of that sense of perplex) for all the drama and fellow feeling evoked by the text, the figure of the doctor himself was remarkably fugitive, held back, subdued. What, I wondered, must all those awakenings and their churning aftermaths have been like for him? The more I continued to ponder the question, to hone and focus it, the more I came to sense that the true deep drama of the story had less to do with his decision to administer the drug and all that followed from that but rather with the mystery—what could it have been about him and his professional formation and his own past?—behind the fact that before all that he and he alone had proved to have the (what?) … the perspicacity to notice those particular living statues as somehow distinct from all the others, and then the moral audacity to imagine that there might in fact be ongoing life persisting deep within those long-extinguished cores.

  Being a good little instance of my own specific type in that specific time and place (a free-floating would-be intellectual back in my hometown of Los Angeles in the late 1970s), I responded to those questions in the way we all seemed to be doing in those days: by writing a preliminary screenplay treatment. And that was what I’d first mailed to Oliver in the fall of 1980 (around the time I’d completed my Irwin project and was beginning to shop it around), asking if anyone else had approached him about the idea of turning his book into a film, and, if not (and if upon reading the treatment he found it worthy), whether he might be willing to let me pursue the matter.

  There followed several months of silence, but then, early in 1981, in fact on February 13, my twenty-ninth birthday (when he would have been forty-seven), I finally received an envelope containing a letter he’d written some months earlier but somehow misaddressed, which got returned and then mislaid, but eventually, according to the cover note, recovered and was now being sent off once again. “I am most grateful for the kind things you say,” the letter began,

  and happy that AWAKENINGS apparently found some deep resonances in you. One always has the fear that one lives/works/writes in a vacuum, and letters like yours are very precious as evidence to the contrary. Indeed, I never regard the writing of anything as “completing” it—the circle of completion must be made by the reader, in the individual responses of his heart and mind—then and only then is the circle of the Graces—of Giving, Receiving, and Returning—complete.

  The letter graciously went on to explain how there had indeed been occasional interest in a film version of his book, though nothing definitive and nothing specific at the moment, so he was not averse, but that we should at some point in the months ahead try to get together to discuss things further. Which was fine by me: I was still mainly busy trying to place that Irwin manuscript (it was a few months out yet from Mr. Shawn’s phone call).

  Oliver and I continued to correspond sporadically through this period, and though I somehow misplaced those letters during my ensuing move to New York, I remember one in particular in which I suggested that I understood why he’d assigned the institutional home in question the clever pseudonym of Mount Carmel (Saint John of the Cross, Dark Night of the Soul, and so forth), but that it seemed to me that his text was much more kabbalistic (shades of Natanson, again), which is to say Jewish rather than Christian mystical—was I wrong? To which he replied with the first of his mammoth multipage handwritten responses. For indeed, as he went on to explain, the actual place was named Beth Abraham, in the Bronx, his family was deeply Jewish in all directions, in fact his first cousin was the legendary Israeli foreign minister and polymath Abba Eban, the Balfour Declaration had first been broached and stenographically massaged in various London family basements before he was born, and perhaps most important, the great inspiration of his medical life was the Soviet neuropsychologist A. R. Luria, who, who knows, may perhaps have been a descendant of the great sixteenth-century Palestinian Jewish mystic Isaac Luria, one of the principal students and explicators of that ur-kabbalistic text, the Zohar.

  After that exchange, our contacts became more and more cordial (even though the initial pretext of a possible screenplay gradually seemed to fall away as I became more consumed with my dawning New Yorker responsibilities), until that day in June 1981 when I rented a car and drove out to meet Dr. Oliver Sacks in person in his own relatively new home on City Island.

  Later that evening, I recorded my impressions of the visit in the first volume of what would become a veritable shelf of notebooks chronicling our deepening friendship. Here follow some extracts from that first entry:

  Sacks lives today out on City Island, an approximately thirty-minute drive out of Manhattan, through the Bronx, and out onto a small almost quaint fishing island. He has lived there for about nine months, having slowly migrated across a succession of stages, from Greenwich Village, where he lived when he first alighted in the city, on through Mt. Vernon, where he rented an apartment just before this. His house, at 119 Horton Street, is near the end of the island, the terminus of this somehow unexpected urban appendix jutting out into the Sound from the Pelham Bay district of the Bronx. It is a brief walk to the narrow beach at the end of the street, a walk he tells me he takes often. He thinks of himself as only partially terrestrial, or rather, as entirely amphibious.

  Indeed, he says, in the old days not too long ago, when he still lived in the Bronx, he used to set out swimming from Orchard Beach over there (pointing north) on the mainland, sometimes circling the Island, for example. And one day not that long ago he came ashore on the pebbly beach at the end of the Horton spur. He ambled up the short street, dripping wet, slogging along. He saw a quaint red house. He thought, What a quaint red house. He saw people moving boxes out of the house. He saw that one of the people was a former student. He ambled up and was beckoned in. “No, no I’m dripping wet.” “But no, please, do come in.” He acceded. He liked the house, was told that it was on the market, walked back out, said goodbye, walked on up Horton, turned left on the main drag, continued walking on up the road, trailing drops from his sopping trunks, walked into a realtor’s office, inquired after the house on Horton St., and somehow bought it on the spot.

  The house itself, with its rickety front porch and little back garden—and its eccentric occupant—reminds me of the pictures I’ve seen of Joseph Cornell’s out on Utopia Parkway.

  Sacks is a large robust fellow, given to impish childlike outbursts, his chest proportioned like a squat child’s, his motions and postures often awkward like a child’s, as well.

  When we first meet I tell him he does not look like I’d expected. “My physical look changes radically over time,” he replies. “Sometimes I’m bearded, sometimes I’m not; sometimes I weigh 190 pounds, sometimes I weigh 300” (“That must be some beard,” I ha
zard). He is currently somewhat closer to the former. He has severe back problems, the result of several accidents, “worldly infelicities”—and when we go to dinner, a brief walk to the nearby fish restaurant, he carries along a narrow square curved lumbar support pillow (“something of a cross between a prosthesis and a transitional object,” he jokes). At dinner he suffers recurrent heat flashes, his face reddening and his brow glistening with sweat, and when we return to his home he heaves himself before the air conditioner in his study (there is one in every room) and basks in its shivery flow, relieved at last. He kneels before the thrumming machine, as if in ecstatic prayer (a contented seal).

  He tells me he had to get a house for his home—this is his first—in part to house his “secret production.” He points to a long shelf parallel to his bed, atop which at least thirty notebooks are neatly arrayed. “At most times I am either talking, listening, or writing: That’s from the last six months.”

  In other rooms, hundreds of casebooks—notebooks devoted to individual patients whose names appear on the spines—are piled one atop the next. In one room, by the study, there is a veritable tilework of audiotape cassettes in their plastic boxes, a wailing wall of contained pain. There are also dozens of videotapes.

  He is thinking of writing a book to be entitled “Five Seconds”—a detailed study of the myriad, speeded up lives that a single ticcing Touretter can live through in any random five seconds—he needs to use high speed video equipment in order to even begin to capture it all. He insists every face-change or yelp is significant: and that they all relate, one to the next.

  His bookshelves teem with philosophy: Nietzsche, Schopenhauer, Leibniz, Spinoza, Hume, Heidegger, Husserl …

  He tells me that as a youth he read philosophy uncomprehendingly, but that afterwards he tended to drift away, focusing instead on his scientific studies. His patients, he says, coming to him with their “philosophical emergencies,” forced him back to philosophy.