Oliver Sacks’s Lifelong Search for Recognition

Letters, a collection of just a small portion of Oliver Sacks’s correspondence, runs past 700 pages. The life of the world-famous neurologist and author was not a small one. In an early letter, the 27-year-old Sacks recounts hiking in remote Canada and coming upon a man struggling with a leg injury. “I’m a doctor, can I help?” Sacks recalls asking him. “So am I,” said another man approaching from a different trail. A fantastic coincidence, Oliver writes to his parents and aunt back in London—“the only injured man in a thousand square miles met in the same moment the only two doctors in a thousand square miles.” The letter goes on to note that both doctors were good Jewish boys, and then luxuriates in a description of the landscape, the hikes to come, the people he has met, and his plans to make his way to San Francisco. Sacks asks his parents to share this “mammoth letter” with his friends, who might in turn share it with others.

Over a lifetime, Sacks would journey far—from gay, bohemian California to a monastic life in New York. He also traveled from academic neuropathology to engaging and popular clinical tales about eccentric patients that revealed their humanity and ours as readers. Writing would be his way of seeking recognition, of staying connected with friends and family—and with his own experience.

In the past two decades, we have learned much about Sacks, the doctor and the man. In 2001, he published a charming memoir of his boyhood fascination with science, Uncle Tungsten, and then, shortly before he died of cancer in 2015, he brought out his autobiography, On the Move. Around that time, he finally gave his friend Lawrence Weschler permission to reveal Sacks’s homosexuality in an authorized biography; And How Are You, Dr. Sacks was released in 2019. And now we have Letters, gracefully constructed by Sacks’s friend and longtime editor, Kate Edgar, offering an intimate sense of his intensity, internal conflicts, whimsy, ambition, and profound interest in how the human condition is expressed through our biology and our culture. In these writings, we discover a man as eager to be properly acknowledged as his patients were, a doctor whose empathy sprang from his own longing to be understood—a longing that for most of his life would be fulfilled through his writing, both public and personal.

After leaving the Canadian wilderness, Sacks headed to San Francisco in search of adventure and poetry. Often known by his middle name, Wolf, the young doctor cut a wide swath as he ate, drank, and partied his way through town. “For a belly-oriented type like me, SF is second to very few places in the world,” he wrote. Freedom for him was being on the other side of the world from his physician parents and schizophrenic brother. Freedom also meant putting on the leathers and riding his motorcycle without a destination. And Sacks wanted to be seen! He became a championship-caliber weight lifter, specializing in squats. He described a weekend at Golden Gate Park: reading Henry James and Charles Darwin before winning third place among the heavyweights. He relished bulking up—in one letter proudly telling his parents that “I love to shake the pavement as I walk, to part crowds like the prow of a ship.”

But this craving for visibility was precariously perched atop fears for his own sanity. He wondered whether he would ever really know or be known by another person. There were periods of wild exuberance followed by crippling self-doubt. One also sees self-sabotage, as Sacks repeatedly broke the rules of decorum expected of medical residents. And then there were the drugs. Sacks’s California experiment was replete with amphetamines and psychedelics, as he pushed his body, including his brain, almost as far as one could.

Still, he managed to do some good work in neurology and was offered a position at the Albert Einstein College of Medicine in New York City. He gave up weight lifting, fell in love, and eventually weaned himself off the drugs. His connectivity to his partner, Jenö, was all-consuming—until it wasn’t. Early on in their time together, he wrote, “I never saw the golden light before we met in Paris,” and then simply, “I love you insanely.” But after a few months: “Perhaps I came so close to you knowing that reality would not permit it for very long; I yielded to a dream, knowing I would wake. I have woken.”

[Read: Why Oliver Sacks always goes too far]

Not long after the relationship with Jenö, Sacks began psychoanalysis with the prominent clinician Leonard Shengold, which turned into a decades-long course of treatment. Sacks told his brother Marcus what he doubtless learned with Shengold: If you don’t get to the roots of your problem, “you will be condemned to recapitulate certain situations over and over again.” Or, as he put it to his parents, “there should be less blaming and naming and more understanding.”

That simple statement became the credo of Sacks’s career. He got his opportunity to put it into practice when working with postencephalitic patients at the Beth Abraham hospital in the late 1960s. They had long suffered from a severe form of Parkinson’s, and he described his excitement, his frustration, and ultimately his crushing disappointment as his patients only temporarily “awoke” from their catatonia. Sacks told their stories in his extraordinary book Awakenings. The doctor had discovered how he could help, and how he could be seen as a helper.

It was almost enough. During this period of intense work and creativity, Sacks wrote to his parents that he felt he would never have satisfactory human relationships: “I expect constantly to be abandoned or deprived of what I have.” But, he added, “I have a great compensation: I can think, I can sublimate, I can channel my thwarted ardours into work.”

And work he did, with fierce intensity. And through that work, the letters show, he did establish relationships—rewarding ones with patients whose afflictions had seemed to push them beyond the pale of human understanding. Sacks extended his sympathy and intelligence far enough to connect with them, and he managed to tell their stories in ways that brought him recognition, too. He expressed some ambivalence about this, and seemed to ask himself: Am I getting their stories right? Am I invading their privacy? Am I their physician or simply their interlocutor? Sacks had his questions answered by a patient who, not having spoken for a decade, thanked him: “I am reborn. I have been in prison for thirty-three years. You have released me from the custody of my symptoms.”

These letters show how Sacks’s work released him, at least partially, from the custody of his symptoms. He discovered in himself an almost uncanny ability to pay attention to the lives of people most doctors want quickly to analyze, classify, and medicate. Avoiding sentimentality, he is a powerful enough writer to bring us into the worlds of people with neurological conditions quite unlike those of most of his readers. That’s a heavy lift, and by accomplishing it, Sacks received worldwide acclaim that caused him both satisfaction and guilt. “The bad part [of myself] is full of hate and fear and blame,” he wrote, “and is as selfish and destructive as the other is altruistic and constructive.” Psychoanalysis, he noted, only “softened” these elemental conflicts.

[Read: The Oliver Sacks reading list]

So much sublimation! It’s through his writing that he recognized others and sought to make himself known. He wanted to be seen as both a healer and an artist. He cared more about praise from the poet W. H. Auden (and later his artist friends) than he did about getting an article published in a scientific journal. In academic science, he wrote, “the very flesh of the subject has escaped, like a jellyfish through a tea-strainer.”

Although Awakenings brought Sacks public attention (and eventually a Hollywood movie), his greatest success came after the publication of 1985’s The Man Who Mistook His Wife for a Hat, a volume of clinical tales that humanized people with serious neurological disorders. The fame afforded Sacks financial freedom, as well as more opportunities to tell the stories of people whose isolation had previously seemed impenetrable. He remained, for the most part, grounded in neurology—his stories always scientifically rigorous and deeply observed—but he insisted that this ground could be fertile for understanding how we create our identities. “One needs a neurology of freedom,” he wrote, “transcending a neurology of reflexes, systems, cybernetics, and puppets.” He aimed to “convey a human reality, a reality at once clinical, phenomenal, historical.”

Sacks’s letters are filled with wonder about the nature of memory, language, and, in particular, problems of recognition. He himself had a striking inability to recognize faces—even his own when he caught a glimpse of it in a reflective surface. And he was fascinated by how people thought to be incapacitated could suddenly reveal deep resources for feeling, thinking, acting. He wrote warmly about music’s ability, for example, to help restore memory and mobility to those whose lives seemed otherwise so restricted.

There are also lovely letters to young people who express an interest in science. He wrote to students whose classmates found them a little odd, or whose parents were worried about their curiosities. He knew something about this. His letters show a man who feared abandonment and craved acknowledgment but discovered through his practice the rewards of his great gifts of feeling, of thoughtfulness, and of care. I am a doctor, I can help, he said as a young man in the wilderness. Letters show how his long and fruitful life came to fully embody that simple statement.