Oliver Sacks

Based on Wikipedia: Oliver Sacks

The Doctor Who Made Neurological Case Studies Read Like Literature

In 1967, Oliver Sacks burned his first book. He had written it about his neurological patients at a chronic care facility in the Bronx, but during a moment of crushing self-doubt, he destroyed the manuscript completely. Ward 23, it was called. We will never know what was in it.

This act of literary self-immolation tells you something essential about the man who would later be called "the poet laureate of contemporary medicine" by The New York Times. Sacks was never quite sure of himself, never entirely confident that his peculiar blend of clinical observation and humanistic storytelling belonged in the world. And yet he kept writing, producing book after book that transformed how we think about the brain, consciousness, and what it means to be human.

His patients included a man who literally could not recognize his wife's face and tried to lift her head off like a hat. Survivors of a sleeping sickness epidemic who had been frozen in place for decades before Sacks awakened them with a new drug. An autistic professor who designed humane livestock facilities because she could think like an animal. A colorblind painter who experienced the world in shades that most of us will never see.

These were not case studies in the traditional medical sense. They were portraits, rendered with the attention of a novelist and the precision of a scientist.

A Childhood Shaped by Anatomy and Air Raids

Oliver Wolf Sacks was born in 1933 in Cricklewood, a neighborhood in northwest London. His parents were both doctors. His father Samuel had emigrated from Lithuania. His mother Muriel was one of the first female surgeons in England, a remarkable achievement for her era, and one of eighteen siblings in her own family.

Muriel Sacks had an unconventional approach to parenting. She would bring home deformed fetuses from the hospital and dissect them with her young son, teaching him human anatomy through hands-on experience. This detail, startling to modern sensibilities, hints at the household's unusual relationship with the human body—a comfort with its mysteries that would serve Oliver well in his later career.

The extended Sacks family was formidable. Among his relatives were the Israeli statesman Abba Eban, the Nobel Prize-winning mathematician Robert Aumann, and the writer and director Jonathan Lynn. Intellectual achievement was simply expected.

Then came the war.

In December 1939, when Oliver was six years old, he and his older brother Michael were evacuated from London to escape the German bombing campaign known as the Blitz. Their parents sent them to what they believed was safety at a boarding school in the English Midlands. It was not safe. It was a nightmare.

Unknown to their family, the two boys spent years subsisting on meager rations of turnips and beetroot while suffering cruel punishments from a sadistic headmaster. Oliver would not write about this experience publicly until decades later, in his memoir Uncle Tungsten: Memories of a Chemical Boyhood. The trauma of those years—the abandonment, the hunger, the cruelty—left marks that shaped his emotional life.

The Making of an Obsessive Mind

When Oliver finally returned home in 1943, at age ten, he found a different kind of salvation. His Uncle Dave, one of his mother's many siblings, took him under his wing and introduced him to chemistry. Not casual interest in chemistry. Obsessive, all-consuming devotion to chemistry.

The boy who had survived wartime abuse threw himself into experiments with a focus that bordered on compulsion. He built his own laboratory. He conducted reactions. He lost himself in the periodic table the way other children lost themselves in sports or adventure stories. This capacity for intense fixation—for becoming absolutely absorbed in a subject to the exclusion of everything else—would define his entire life.

At St. Paul's School in London, he formed lasting friendships with Jonathan Miller, who would become a famous theater director and physician, and Eric Korn, who would become a writer and rare book dealer. The three boys shared an intense interest in biology, discussing it with the fervor that other teenage boys might reserve for motorcycles or girls.

Medicine seemed inevitable. Both parents were doctors. The intellectual environment demanded something rigorous. In 1951, Oliver entered The Queen's College at Oxford to study medicine.

A Crisis of Purpose

Oxford should have been a triumph. In many ways it was. Sacks completed his preclinical studies and graduated with a degree in physiology and biology in 1956. But somewhere along the way, he lost his footing.

He had become fascinated by a course taught by Hugh Macdonald Sinclair on the history of medicine and nutrition. "It was the history of physiology, the ideas and personalities of physiologists, which came to life," Sacks later recalled. This was the kind of material that set his mind on fire—not just facts, but the stories behind the facts, the human beings who had discovered them.

Sinclair invited him to do research in the Laboratory of Human Nutrition. Sacks chose to study Jamaica ginger, a patent medicine that was both toxic and commonly abused. It caused irreversible nerve damage in those who consumed it. The subject was medically significant and historically fascinating.

But the research went badly. Sacks received little guidance or support from Sinclair. He spent months on the project, wrote up his findings, and then simply stopped. The disappointment sent him into what he described as "a state of quiet but in some ways agitated despair."

His parents and tutor could see he was struggling. Their prescription was physical labor. They sent him to spend the summer of 1955 on Kibbutz Ein HaShofet in Israel, where he would work the land instead of torturing himself in a laboratory.

The kibbutz saved him, at least temporarily. Sacks called it "an anodyne to the lonely, torturing months in Sinclair's lab." He lost sixty pounds from his previously overweight body through hard physical work. He went scuba diving at Eilat on the Red Sea. He began to reconsider everything.

I wondered again, as I had wondered when I first went to Oxford, whether I really wanted to become a doctor. I had become very interested in neurophysiology, but I also loved marine biology... But I was "cured" now; it was time to return to medicine, to start clinical work, seeing patients in London.

Becoming a Doctor, Losing His Way

Sacks returned to Oxford and Middlesex Hospital Medical School in 1956. For two and a half years he rotated through surgery, orthopedics, pediatrics, neurology, psychiatry, dermatology, infectious diseases, and obstetrics. He helped deliver babies in people's homes. In 1958 he graduated with his medical degrees.

His eldest brother Marcus had trained at Middlesex, and Oliver followed in his footsteps for his house officer rotations. He worked in the medical unit for six months, then the neurological unit for another six. By June 1960, he was fully qualified.

And completely uncertain about what to do next.

On his twenty-seventh birthday, July 9, 1960, Sacks got on a plane and left Britain for Montreal, Canada. He visited the Montreal Neurological Institute. More surprisingly, he also visited the Royal Canadian Air Force and told them he wanted to be a pilot.

The Royal Canadian Air Force gave him interviews and checked his background. They concluded that he would be best suited for medical research rather than flying. But even that didn't work out. Sacks kept making mistakes. He lost data from several months of research. He destroyed irreplaceable slides. He misplaced biological samples. His supervisors began to have serious doubts.

"You are clearly talented and we would love to have you," the head medical officer told him, "but I am not sure about your motives for joining."

They suggested he travel for a few months and reconsider his life choices. Sacks spent three months wandering through Canada into the Rocky Mountains, keeping a journal that would later be published as Canada: Pause, 1960.

California: Drugs, Bodybuilding, and Motorcycles

In 1961, Sacks arrived in the United States. He would never leave, though he would never become a citizen either. "I rather like the words 'resident alien,'" he told The Guardian in 2005. "It's how I feel. I'm a sympathetic, resident, sort of visiting alien."

He completed an internship at Mount Zion Hospital in San Francisco and a residency in neurology and neuropathology at the University of California, Los Angeles. During this time, he lived in a rented house in Topanga Canyon, a bohemian enclave in the Santa Monica Mountains.

What happened next defies the image of a future distinguished neurologist.

Sacks embarked on what one observer called "staggering bouts of pharmacological experimentation." He tried virtually every recreational drug available in early 1960s California. He became a serious bodybuilder at the legendary Muscle Beach, at one point holding a California state record after performing a full squat with six hundred pounds across his shoulders. He bought a motorcycle and racked up more than one hundred thousand leather-clad miles on it.

He became close friends with the poet Thom Gunn, drawn to what he called Gunn's "wild imagination, his strict control, and perfect poetic form." The combination of apparent opposites—wildness and control, chaos and structure—seemed to resonate with Sacks's own contradictions.

And then one day he gave it all up. The drugs, the bodybuilding, the motorcycle, the entire California lifestyle. He moved to New York City.

The Epiphany

The transformation came, fittingly, through a book. Sacks was reading a work by Edward Liveing, a nineteenth-century physician who had written extensively about migraines. The reading was enhanced, or perhaps enabled, by amphetamines.

Whatever chemical assistance was involved, the result was a moment of crystalline clarity. Sacks decided he would chronicle his observations on neurological diseases and oddities. He would become, as he put it to himself, "the Liveing of our Time."

This was not false modesty or grandiose delusion. It was a genuine calling, experienced with the force of religious conversion. Sacks had found his purpose: to do for neurology what Liveing had done for migraines, to transform clinical observation into literature.

The Sleepers of the Bronx

In 1966, Sacks joined the faculty of Yeshiva University's Albert Einstein College of Medicine. But his most important work would happen at Beth Abraham Hospital, a chronic care facility in the Bronx.

There he encountered a group of patients who seemed like something out of a fairy tale, frozen in time by an enchantment. These were survivors of the encephalitis lethargica epidemic that had swept through the world in the 1920s. The disease, sometimes called sleeping sickness, had left them in a state of profound neurological impairment. Many could not move on their own. Many could not speak. Some had been essentially motionless for decades.

In the late 1960s, a new drug called levodopa, or L-DOPA, was being used to treat Parkinson's disease. Sacks wondered if it might help his frozen patients at Beth Abraham. The results were extraordinary—and ultimately heartbreaking.

When given L-DOPA, patients who had been immobile for thirty or forty years suddenly awakened. They moved, they spoke, they remembered who they had been before the disease took them. For a brief period, it seemed like a miracle cure.

Then complications set in. Side effects emerged. Many patients could not tolerate continued treatment. Some returned to their previous frozen states. The awakening, for most, was temporary.

Sacks wrote about this experience in his 1973 book Awakenings. It was not a typical medical text. It read more like a work of literature, full of individual portraits, emotional complexity, and philosophical reflection on what the awakenings revealed about consciousness, identity, and the relationship between brain and self.

A documentary was made about the patients in 1974 for the British television series Discovery. In 1990, Awakenings was adapted into a feature film starring Robin Williams as Sacks and Robert De Niro as one of the awakened patients. The film was nominated for three Academy Awards.

The Man Who Mistook His Wife for a Hat

Sacks's most famous book appeared in 1985. The Man Who Mistook His Wife for a Hat is a collection of clinical case studies, but to call it that misses what makes it remarkable.

The title case describes a man with visual agnosia, a condition in which the brain cannot properly interpret what the eyes see. This particular patient could see perfectly well in a physical sense, but he could not recognize objects or faces. When looking at his wife, he saw shapes and colors but could not identify them as constituting a person. At the end of one examination with Sacks, the man reached out and tried to lift what he thought was his hat. It was his wife's head.

The story could be told as a clinical curiosity, a strange malfunction of neural wiring. Sacks told it as a human tragedy and a philosophical puzzle. What does it mean to see? What is the relationship between perception and understanding? How much of what we take for granted about reality is actually constructed by our brains?

The book was edited by Kate Edgar, who became Sacks's long-term collaborator and, in his words, a "mother figure." He said he did his best work when she was with him. Their partnership would produce many of his most acclaimed books, including Seeing Voices, Uncle Tungsten, Musicophilia, and Hallucinations.

The title story of The Man Who Mistook His Wife for a Hat was adapted into an opera by the composer Michael Nyman in 1986. This was not the last time Sacks's work would inspire musical treatment. His case studies seemed to lend themselves to artistic adaptation in ways that more conventional medical writing never could.

Writing as a Way of Seeing

Sacks considered his literary style to have grown out of a nineteenth-century tradition of "clinical anecdotes"—detailed narrative case histories that read more like short stories than medical reports. He called this approach "novelistic."

His most important intellectual influence was the Russian neuropsychologist Alexander Luria, with whom he corresponded from 1973 until Luria's death in 1977. Luria had pioneered a similar approach to case studies, treating patients as individuals with stories rather than as collections of symptoms. The two men became close friends through their letters, united by a shared vision of what neurological writing could be.

After the publication of Sacks's first book, Migraine, in 1970, his friend the poet W. H. Auden wrote a review that contained advice Sacks would carry with him for the rest of his career: "Be metaphorical, be mythical, be whatever you need."

Permission granted, Sacks became exactly that. His case studies were rich with literary allusion, philosophical speculation, and emotional depth. He concentrated not just on what had gone wrong in his patients' brains, but on how they experienced their conditions, how they adapted to them, how they found meaning despite them.

In his 1995 book An Anthropologist on Mars, which won a Polk Award for magazine reporting, Sacks profiled Temple Grandin, an autistic professor of animal science who had designed more humane livestock handling facilities. Grandin's autism, Sacks argued, was not simply a deficit. It gave her the ability to think visually in ways that neurotypical people could not, to understand how animals perceive the world because her own perception was so different from the norm.

This became a recurring theme in Sacks's work: the idea that neurological conditions, while genuinely disabling, could also reveal hidden capacities, "latent powers, developments, evolutions, forms of life that might never be seen, or even be imaginable, in their absence."

The Island of the Colorblind

Sacks was not content to see patients only in hospitals. He traveled to find them.

In his 1997 book The Island of the Colorblind, he wrote about his journey to Pingelap, a tiny atoll in Micronesia where an unusually high percentage of the population has achromatopsia—complete colorblindness accompanied by extreme sensitivity to light and very low visual acuity.

The condition is rare in most of the world, affecting perhaps one in thirty thousand people. On Pingelap, it affects roughly one in twelve. The reason is a genetic bottleneck: in the late eighteenth century, a typhoon killed most of the island's population, and one of the survivors carried the gene for achromatopsia. As the population rebuilt from this small group, the gene became much more common.

Sacks went to Pingelap not just to study the condition but to understand how a community adapts when a significant portion of its members experiences the world in radically different ways. What does it mean to live in a society where colorblindness is common? How do the colorblind and the color-sighted relate to each other? What can they teach each other about perception?

Music and the Brain

Sacks's work at Beth Abraham Hospital had introduced him to the profound effects of music on neurological patients. People who could not speak could sometimes sing. People who could not walk could sometimes dance. Music seemed to reach parts of the brain that other stimuli could not access.

This observation led to the founding of the Institute for Music and Neurologic Function, of which Sacks was an honorary medical advisor. The Institute honored him in 2000 with its first Music Has Power Award, and again in 2006 to commemorate "his 40 years at Beth Abraham and honour his outstanding contributions in support of music therapy and the effect of music on the human brain and mind."

In 2007, Sacks published Musicophilia: Tales of Music and the Brain, exploring the many ways that music interacts with neurology. He wrote about people who hallucinated music, people who lost the ability to hear music as music, people whose neurological conditions were uniquely responsive to musical therapy. The book demonstrated that his interests had expanded far beyond the traditional boundaries of clinical neurology into something more like the philosophy of mind.

A Distinguished Career

Sacks served as an instructor and later professor of clinical neurology at Yeshiva University's Albert Einstein College of Medicine from 1966 to 2007. He simultaneously held an appointment at the New York University School of Medicine from 1992 to 2007.

In 2007, he joined the faculty of Columbia University Medical Center as a professor of neurology and psychiatry. Columbia also created a special position for him: the first "Columbia University Artist," a title recognizing "the role of his work in bridging the arts and sciences." He was based at the university's Morningside Heights campus, where he could interact with scholars and artists from across disciplines.

He was also a visiting professor at the University of Warwick in the United Kingdom, maintaining connections to his home country even as he remained a permanent resident alien of the United States.

In 2012, he returned to New York University School of Medicine, serving as a professor of neurology and consulting neurologist in the school's epilepsy center.

Throughout his career, he maintained a busy hospital-based practice in New York City. Despite enormous demand, he accepted only a very limited number of private patients. He served on the boards of The Neurosciences Institute and the New York Botanical Garden, reflecting his lifelong interests in both brain science and the natural world.

The Writer's Life

After burning Ward 23 in 1967, Sacks never stopped writing. His books have been translated into more than twenty-five languages. He became a regular contributor to The New Yorker, the New York Review of Books, The New York Times, and the London Review of Books. He published hundreds of articles, both peer-reviewed scientific papers and essays for general readers, covering neurology, the history of science, natural history, and the natural world.

In 2001, he was awarded the Lewis Thomas Prize for Writing about Science, an honor that recognized his unique contribution to science communication.

His work was adapted into an extraordinary range of media. The man who had started by writing case studies for medical journals lived to see his stories become feature films, operas, ballets, plays, animated short films, dance performances, and works of visual art. The New York Times observed that his work was "featured in a broader range of media than those of any other contemporary medical author."

The 1990 film of Awakenings, starring Robin Williams and Robert De Niro, brought his work to a mass audience. The romantic drama At First Sight (1999) was based on an essay from An Anthropologist on Mars, and Sacks even appeared in the film in a small role as a reporter. The composer Tobias Picker, a friend of Sacks, wrote both a ballet and an opera inspired by Awakenings; the opera premiered at Opera Theatre of Saint Louis in 2022.

In 2024, a television series called Brilliant Minds premiered, based on Sacks's life and work. The poet laureate of contemporary medicine had become a character in popular culture.

Injuries and Revelations

In 1974, a year after the publication of Awakenings, Sacks was mountaineering alone above Hardangerfjord in Norway when he fell off a cliff. He severely injured his left leg. The accident was nearly fatal.

For most people, this would simply be a frightening experience to recover from. For Sacks, it became material for a book. A Leg to Stand On, published in 1984, describes the experience of losing and regaining the sense of ownership of his own limb. After the injury, his leg felt alien to him, not fully his own. The neurological and philosophical implications of this experience—what does it mean for a part of your body to feel like it belongs to you?—became the subject of sustained reflection.

This willingness to turn his own experiences into case studies characterized Sacks's later career. In 2012, he published a long article in The New Yorker about his youthful drug experiences, material that would later be incorporated into his book Hallucinations. He was unusually willing, for a physician of his generation and stature, to discuss his own neurological and psychological peculiarities.

A Complicated Legacy

After Sacks's death in 2015, researchers examining his journals and letters made troubling discoveries. Some of his work, they found, appeared to have been fraudulent or exaggerated.

The precise nature and extent of these problems remains a matter of scholarly investigation. For readers who had been moved and enlightened by his books, the revelations were painful. Here was a writer who had built his reputation on precise clinical observation, on the careful recording of what his patients experienced, and some of it may not have been entirely true.

This complication does not erase Sacks's contributions. His books remain beautifully written. His central insight—that neurological case studies could be literature, that patients were people with stories rather than collections of symptoms—changed how many doctors and scientists think about their work. The questions he raised about consciousness, perception, and identity remain compelling regardless of whether every detail of every case study was accurate.

But it does remind us that the poet laureate of contemporary medicine was a human being, with human failings. The man who could see so deeply into his patients' experiences was, perhaps, not always entirely honest about what he saw.

The Resident Alien

Oliver Sacks lived in the United States for more than fifty years without ever becoming a citizen. He told interviewers that he had declared his intention to become a citizen in 1961 but somehow never got around to completing the process. He thought it might reflect "a slight feeling that this was only an extended visit."

This sense of permanent provisionality—of being present but not quite belonging—may have been essential to his work. Sacks was always an observer, always slightly outside whatever he was studying. His patients' neurological conditions were, in a sense, distant countries he could visit but never fully inhabit. He could describe what he saw with extraordinary vividness, but he was always looking from the outside in.

"I'm a sympathetic, resident, sort of visiting alien," he told The Guardian. It was as good a description of Oliver Sacks as any he ever wrote about anyone else.

He died on August 30, 2015, at the age of eighty-two. He had published his final memoir, On the Move: A Life, just months before. In it, he finally told the full story of his life: the wartime trauma, the drug years, the bodybuilding, the motorcycles, the decades of celibacy, the late-life romance with the writer Bill Hayes. He had spent his career illuminating other people's hidden neurological lives. At the end, he turned that same compassionate attention on himself.