Oliver Sacks had a memorable insight into what it was to stay human ‘in the face of unimaginable adversity’

I have just read in today’s newspaper of the death of the neurologist Oliver Sacks. As famous as a writer as in his chosen profession, he became widely known through his book Awakenings, which was followed by other brilliant accounts of neurological abnormality, such as The Man who Mistook His Wife for a Hat and The Island of the Colourblind.

Awakenings, in particular, which was first published in 1973, with many subsequent editions, was made into an acclaimed film starring Robin Williams and Robert de Niro. It detailed the lives of 80 post-encephalitic patients at Beth Abraham Hospital in the Bronx, New York, bringing a deeply humane perspective to the lives of these individuals, some of whom had been in a trance-like condition for decades, following the catastrophic encephalitis lethargica epidemic of 1916-1927.

Sacks started seeing these patients in 1966. The nurses who had been looking after them and who knew them best were convinced that behind their statuesque appearance in which they were “locked in”, there were “intact minds and personalities”, as he wrote in his preface to Awakenings. Sometimes there were brief respites when listening to music, the “profoundest non-medical medication”.

In 1969 Sacks was given permission to experiment with the drug L-DOPA, the precursor of dopamine used for Parkinson’s. The results were remarkable: an explosive “awakening” – which was sadly followed after several weeks by insidious reverses: side-effects of the medication, fluctuations in response, sensitivity to the drug and the difficulty of calibrating the precise amount needed by each patients. Eventually most of his patients reverted to their previous state.

In the preface Sacks wrote of his “duty … to record and bear witness” to what had happened. Like the permanent staff in Beth Abraham Hospital, he got to know, love, recognise and respect these seemingly catatonic individuals as people, who had somehow kept their higher faculties intact, their “intelligence, imagination, judgment and humour” in the face of “a unique catastrophe.” It gave him memorable insights into what it was to be human and to stay human “in the face of unimaginable adversity.”

I once asked a psychologist friend what he thought of Sacks. He was critical, replying that he thought Sacks had exploited his patients for the sake of his own literary ambitions. There is always a thin line and a delicate balancing act, when a doctor, who has privileged access to very vulnerable people, chooses to write about them. However, I disagree with my friend’s opinion. I think Sacks, who grew up in a secular Jewish family of doctors in Hampstead in the 1930s and who early on dropped all belief in God, nonetheless retained a deep reverence and respect for those he cared for. Writing about his patients – he had considerable talents as a writer – was a way to memorialise their courage, their indefatigable and tenacious humanity as they lived on, wholly forgotten by the wider world, in their long-stay hospital wards.

Sacks himself showed courage in facing up to the terminal liver cancer which he publicly announced in February this year. “Now I am face to face with dying, but I am not finished with living” he then wrote, adding “It is up to me now to choose how to live out the months that remain to me. I have to live in the richest, deepest, most productive way I can.”

Writing about Sacks’ 2015 memoir, On the Move, in a blog several weeks ago, I referred to his admiration for the care of the aged given by the New York Little Sisters of the Poor, for whom he acted as consultant neurologist from 1971. Noting the dedication of the Sisters and their “great religious devotion” he had written, “Their homes are about life – living the fullest, most meaningful life possible”. That is what he had wanted for the patients in his care. Now in the hands of the God of mercy, may he rest in peace.

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