Oliver Sacks

Dear Memoir

I met your kind in college.  It was in Kay Redfield Jamison’s An Unquiet Mind. Your pages were musty, your spine well-broken.  Your words engulfed me, lassoed me in the undertow of Jamison’s death-thoughts and hallucinations.  You suited her telling just right.  When I closed the cover I knew Jamison, could feel the tumult of living bipolar and discovering it so late in life.

What happened next?  I did not seek another incarnation of you. Instead, I met your cousins, the Personal Essays.  They were enchanting, always touching my arm and pulling me aside to confide some story well worth my time through its hilarity or gravity.  My favorite of these cousins?  Bernard Cooper‘s “Winner Taking Nothing,” Adam Gopnik‘s “Bumping into Mr. Ravioli,” James Baldwin‘s “Notes of a Native Son,” Joan Didion‘s “Goodbye to All That,” and E.B. White‘s “Once More to the Lake.”

Then your sedate, worldly wise, and pondering cousins came to dinner.  These were the books of Literary Journalism.  How I liked meeting Tracy Kidder‘s Mountains Beyond Mountains and Old Friends, Truman Capote‘s In Cold Blood, the nonfiction sections of Joseph Mitchell‘s Up in the Old Hotel, and Anne Fadiman‘s The Spirit Catches You and You Fall Down.

Next to these sat their children, sun-burnt and bespectacled.  The Researched Essays.  They brought bug jars, binoculars, and yellowed biographies to the dinner table, and whatever our conversation topic, they had some trivia to toss us, or excused themselves and consulted Britannica.  They were brilliant and conversational; still, I chose favorites–Anne Fadiman’s At Large and At Small, David Foster Wallace‘s “David Lynch Keeps His Head,” Gay Talese‘s “New York is a City of Things Unnoticed,” and John McPhee‘s “The Search for Marvin Gardens.”

Halfway through dinner, in flowed your niece, the Lyric Essay, with emerald rings on her fingers and hair down to her waist.  I loved Lia Purpura‘s “Glaciology,” John D’Agata‘s “Notes Toward the Making of a Whole Human Being,” and Albert Goldbarth‘s “After Yitzl.”  After dinner, we sat in the guest room and I tried on her rings.

Your relatives were such good company that I forgot about you.  And when I turned back to you, I found we’d grown apart.

One day we grabbed coffee and you talked about yourself for hours.  At first, I was intrigued.  Your tale began with the promise that you’d make it artistic.  Or funny.  Or that if you talked about yourself long enough, we’d find a scrap or two in common.   I left that day thinking what you told me was kind of hollow. Your stories–of an abusive stepfather in Tobias Wolff‘s This Boy’s Life, or an impoverished upbringing in upstate New York in Sonja Livingston‘s Ghostbread–were just about you.  They never connected to something larger.

It was like Ander Monson said in Vanishing Point, his book of critical essays:

We can… fault the assumption that individual experience–sans connection to something larger, beauty or social action, for instance–is in itself interesting as a primary subject… Asserting the primacy of the I suggests that we should care about it because it is an I, because it has incurred slights at the hands of others, of the world.  And we should care.  Sure, I agree with that; everyone is special… and inhabiting their experience allows us to share it, know it… But I still don’t want to read what most people have to say about themselves if it’s just to tell their story.  I want it to be art…

You tried to make it art.  In Ghostbread, you gave me childhood experiences like a pile of Polaroids.  They were beautiful snapshots, but the pile did not make a whole.  In the end, it was just fragments of a life–people came and went and never mattered.

And your stories never got to the point where I felt like, “Yes!  This is what life feels like.”  I believe your stories were true, but they didn’t feel true.

It’s like an anecdote that Stephen King wrote about in The Green Mile. This, at least, is how I remember Steven King’s story.  This kid chopped his finger off and then went to a tent revival, a healing service.  Church folk prayed over the finger and the finger grew back.  And the Green Mile character believed the tale was true because the boy said his finger itched when it grew back.  That itch made the difference between credibility and dismissal.  These are the details I craved in your pages but did not find.

I always heard John Gardner quoted in creative writing workshops: fiction should be a “vivid and continuous dream.”  Memory is vivid but it isn’t continuous.  Maybe memory isn’t thick enough for what your pages ask of it–to create wallpapered, furnished dreams the reader can inhabit.

We met again.  We drank cafe au lait.  I read Dave Eggers‘s A Staggering Work of Heartbreaking Genius, Oliver Sacks‘s Uncle Tungsten, Madeleine L’Engle‘s Two-Part Invention.

You began to win me back.

Dave Eggers disarmed me with his “Rules and suggestions for the enjoyment of this book” and his Acknowledgments section which acknowledged all the book’s conceivable flaws, including “the Self-Aggrandizement as Art Form Aspect.”  He did it, proved himself an “I” worth listening to.  And he was being so postmodern, so aware of the expectations of the form; this meant that even when Eggers was solipsistic, well, it was a commentary on being solipsistic.

Oliver Sacks stretched your possibilities because he told about his childhood without a trace of solipsism.  Maybe this is because he is Oliver Sacks and all parts of the world enchant him.  He can’t tell a scientific story without quoting Milton or Auden, much less tell his own story without praising what he was reading or learning from his relatives.  The world outside his head is fully and wonderfully present in Uncle Tungsten.  Is that something peculiar to Sacks, something not all your legion of writers can manage?  I hope not; a single “I” floating solo through life is flimsy.

Ander Monson corroborates:

I can’t see a way to stop… thinking about the I, examining myself… in text and thought.  Perhaps the answer… is in research, in listening, in exploring, in taking notes.  It’s harder, yes.  It’s finding, creating, or uncovering another subject–something else to rely on or parse beyond the self.

Madeleine L’Engle, too, did more than narrate her own experience, and this made you beautiful.  Two-part Invention was about her marriage, and marriage exists as something third, not fully one person or the other.  Throughout her journal-memoir, L’Engle’s version of first-person was inviting: honest without pedantry and revelatory without narcissism.  I felt like I was being offered her experiences, like she was saying, “I want you to know the real me, the way I’d be if you stopped by when my house was a wreck.”  This is a generous, self-giving narrator, who humbly gives herself in hope of connection.

Maybe this humility is your greatest possibility.

photo by:

The Courtyards of Rebirth:
Oliver Sacks’s Awakenings, Part II

Right now, the allegory I most closely associate with Oliver Sacks‘s Awakenings comes from the moment in C.S. Lewis’s The Lion, the Witch and the Wardrobe when Lucy, Susan and Aslan come to a courtyard full of statues. Lucy cries out, “All those stone animals – and people, too! It’s – it’s like a museum!” Aslan breathes on the stone figures, and they change from colorless stone to colorful, moving – alive – figures:

For a second after Aslan had breathed upon him the stone lion looked just the same. Then a tiny streak of gold began to run along his white marble back – then it spread – then the color seemed to lick all over him as the flame licks all over a bit of paper – then, while his hindquarters were still obviously stone, the lion shook his mane and all the heavy, stone folds rippled into living hair. (1)

The Lion, the Witch and the Wardrobe.
Photo by Julie Diekmann. Used by permission.

I imagine the courtyard with tangles of ivy hanging down the walls, and in the open space, goldenrod, brambles, and tall grasses at least up to the statues’ waists. I imagine a similar overgrowth has overtaken the back wards of Mount Caramel chronic care hospital, which Sacks describes as an abyss of affliction. Instead of goldenrod, a stale yellow stench. Instead of ivy, long fingernails and whiskers. And statues everywhere.

The statues are post-encephalitic patients, the survivors of Encephalitis Lethargica and the subjects of Awakenings. They are frozen in odd positions in wheelchairs. Rose R. was frozen like someone in those roller coaster photos hawked at amusement parks – her head thrust back, her hands tight fists. Frances D.’s pose was like an elderly philosopher – her gaze was upward, beatific, one hand cupped and raised as if to emphasize a point.

And then, their color returned.Oliver Sacks treated them with L-DOPA, and slowly they began to speak, walk, reconnect with family members, dance, and work.

It is a real-life allegory, one not lost on Sacks (one gets the sense that not much is lost on him):

I want something of their lives, their presence, to be preserved and live for others, as exemplars of the human predicament and survival. This is the testimony, the only testimony, of a unique event – but one which may become an allegory for us all.

It does strike readers as an allegory, and it interweaves with other allegories; it’s impossible for me to write about Encephalitis Lethargica without thinking of stories I heard growing up. This bothers and intrigues me, and I want to explore why we crave metaphor, why I am quick to see allegories in Awakenings, and whether or not seeing real life as allegory is dangerous.

A Hopefully Not Too Somnolent Exploration of Metaphor

The metaphor of someone asleep for years who suddenly awakens is one of our cultural myths.Off the top of my head, I can think of Sleeping Beauty, Rip Van Winkle, Narnia, and that Mel Gibson movie Forever Young (which, okay, I watched probably 50 times in high school. I can probably recite whole scenes).

Why is this story represented in many different ways?

Metaphor is essential to our thinking. It’s how we get from everyday, concrete realities to things for which we may not have tangible proof.2 Imagine I’m trying to explain a forest to someone who has only seen the desert.I would begin with what the person knows.Cacti, maybe. We do the same with abstract or unseen realities.We look for temporal parallels to the eternal.

Because death bothers us, we constantly search for metaphors for death.My mother, seeking comfort after the death of both her mother and brother this past year, has been picturing death as a kind of birth.The way a baby resists birth because of the comfort and familiarity of the womb is also the way we want to cling to earth-life. I love this.

I’m guessing the same thing was going on with the Sleeping Beauty story. Isn’t this exactly what we want death to be?We want to wake up beautiful. We want to know we’ll still be ourselves.We want to be with people we love.When the powerful kiss of true love comes Sleeping Beauty’s way, she’s able to return to life, still pretty as a daisy, but now side by side with a man she loves.

If we are to see allegory in this fairy tale, we have to do the work of connecting the allegory to another narrative not explicitly given.3 When we think of people who have been asleep for decades waking up, we can see this as allegory, because sleep is so often a cultural metaphor for death.Sometimes it is sleep to the exclusion of waking, like the French Revolution’s credo, “death is eternal sleep,” which was meant to de-Christianize the republic.Or sleep as the preamble to waking, as when Jesus says about a dead girl, “she is sleeping.”

When I come to the nonfiction story of Awakenings, I can’t help but see it as an allegory, because the cultural narratives are already in place.Even though the stories are case studies, not morality plays, once factual narratives overlap with cultural narratives, allegory can be born.

Resurrectamine, St. Ignatius, and the Day to Day

Since Awakenings matches quite well with a few cultural narratives, there are several figurative ways to see the case studies. I’ll return to the story of Magda B. I discussed in the first installment.

For all those around her could see, Magda was dead – unable to speak or move. L-DOPA came along, and she was able to speak first in a monotone, then in a rich Viennese accent.She reconnected with her family, adapted to the drugs, and died peacefully, in her sleep.

“Dopamine is Resurrectamine,” said awakened patient Leonard L., and Magda’s case, indeed, seems like resurrection. To anyone passing through the dreary halls, Magda would have looked like a vegetable. wakened, she participates fully in all that life means.A gracious personality emerges.It reminds me of my minister’s oft-repeated words that God wants to make us more fully human.She is still fully herself when she dies and the case study ends.

Looking at the pictures of the post-encephalitic patients reminds me of another narrative. Platonic dualism, and St. Ignatius of Loyola‘s spiritual exercises telling us to see in our imaginations the “soul as a prisoner in this corruptible body.”4 Surely, this narrative seems plausible when we see people with personalities not dead only dormant, and they are held captive by their bodies – muscles that will not let them do all the things their souls long to do: speak or sing or clasp a relative’s hand.

I resist St. Ignatius’s picture of the captive soul because I don’t want to think of my body (its functions, limitations, sexuality, and many flaws) as an enemy I’ll soon win against.I want to see it as a gift.And it is important to see someone like Hester Y., who also views her imperfect body as a gift. She is able to ignore the tics that overtake her body. She sits in the eye of a storm, continuing to talk while the tics go on, appreciating what her body can do.She pays the tics no mind: they are strangers visiting a body she knows.As Sacks says, disease is not “a thing-in-itself, but parasitic on health and life and reality.”

Instead of advocating either of these narratives, Sacks most wants us to remember how to live. We, too, can experience a “return to one’s self . . . ‘rebirth,'” like the patients who are so eager to just talk to people around them, listen to music, take out their cobbler’s bench and return to their life’s work. The patients, he says, “show us the full quality – the zenith of real being (so rarely experienced by so many ‘healthy’ people); they show us what we have known – and almost forgotten.”

Hijacking Nonfiction?

My students at North Park University just read Awakenings. I asked them to fictionalize one of the case studies to draw attention to any allegorical aspects.Almost all of them had a very difficult time with that.It wasn’t just that I was asking them to perform a creative writing assignment that was fairly complex for freshmen.I may have been asking them to do something slightly immoral.

The case studies are human stories, and, yes they teach us.But what comes of seeing real live people as allegories?

If we approach nonfiction narratives – Awakenings, other nonfiction, the lives of people we hear about or read about in newspapers – and treat the allegory like the kernel of the story and discard, like a pistachio shell, the real lives of people, then I think we are definitely doing something dubious.

But seeing allegory in everyday lives may also make life something dually beautiful. Can we hold this in tension?While seeing allegory, can we remember to respect these lives?To appreciate them as we would appreciate a friend with whom we were having a late-night conversation, the debris of wine circling the bottoms of our glasses? Deriving wisdom from them, like we would listen and find meaning in the words of this friend? And yet also seeing a life as a story that extends far beyond that life, into eternal meanings?

We can do this. And if we read Awakenings we have to.The patient Leonard L. asks that we learn from him at the same time we appreciate him: “I am a living candle. I am consumed so that you may learn. New things will be seen in the light of my suffering.”

It is appropriate to tiptoe into the courtyards of suffering and rebirth and listen, watch, and learn.

1 Lewis, C.S., The Lion, The Witch and the Wardrobe. 1950. New York: Harper Collins, 1994: 167.

2 Crisp, Peter. “Allegory: conceptual metaphor in history.” Language & Literature 10, no. 1 (February 2001): 5. Academic Search Premier, EBSCOhost (accessed December 5, 2008): 5.

3 Crisp, 8.

4 Ignatius of Loyola, The Spiritual Exercises of St. Ignatius. 1951. New York: Vintage Spiritual Classics, 2000: 22.

All other quotes are from Sacks, Oliver. Awakenings. 5th edition. New York: HarperPerennial, 1990.

What Ghosts Teach:
Oliver Sacks’s Awakenings, Part I

Book available on Amazon.com.

What could being asleep for fifty years, and then awakening, teach a person about life? You might tell me to Google Washington Irving or the Brothers Grimm and see what lessons they intended, but I am dead serious when I ask this question.

I ask it because in the early part of the 20th century, the disease Encephalitis Lethargica turned people into living statues for as long as Rip Van Winkle snoozed in the Catskills.

It was a Parkinsonian epidemic that killed nearly five million people by keeping them awake until they died or sending them into comas so deep nothing could rouse them. It kept a handful of survivors locked inside their bodies.

The survivors weren’t in comas, and they weren’t “vegetables.” The better metaphor is that they were ghosts. Like Scrooge in A Christmas Carol or Emily at the end of Our Town, they could watch life go by, but interaction was impossible. Although they could think, one patient described thoughts as if they were “a picture whipped out of its frame.”

They sat like ghosts in wheelchairs through the wars fought, depressions overcome, civil rights won, and leaders assassinated. And then, in 1969, neurologist Oliver Sacks treated a group of patients with L-DOPA, then an experimental drug. On a high dosage of the drug, these “ghosts” came to participate in life again, exhibiting not only mobility and speech, but also personalities that had, for fifty years, been reduced to shadows.

Sacks, their empathetic and uniquely perspicacious doctor, clearly had in mind questions of what it means to be human as he wrote, and this is one of the aspects that makes the case studies and reflections in his book, Awakenings, so compelling. Sacks has gained popular appeal by finding the human story in the neurological oddities he studies, in books like The Man Who Mistook His Wife for a Hat, Migraine, and An Anthropologist on Mars. Indeed, he introduces readers to aspects of the human condition that are beyond the edges of what many people experience. Awakenings is by no means new; it was published in 1973 and is considered a classic, and I urge you to pick it up if you haven’t already had the chance.

So, back to the original question. What can patients beyond the edges of commonplace experience teach us about being human? With a disease so peculiar and an author so perceptive, the lessons are legion. I’ll focus on just two.

Shout Back if You’re Listening

First, they teach that our yuckiest emotions are part of what makes us “awake.” Now, I know any good therapist could tell you that for a mere $25/week co-pay, but before you close the browser, consider the case study of Magda B. as an illustration of just how essential this is.

Other patients would react to their environments and shout out during extreme fits of Parkinsonism, but even when the hospital staff placed Magda next to a “mad, hostile dement,” who would curse, insult and even hit her, Mrs. B would sit placidly next to him, never registering the slightest agitation.

On small initial doses of L-DOPA, Magda still showed apathy. When she could first speak, she sounded like an automated phone system. When the dose was raised, the first signs of awakening Sacks noted were a distinct Viennese accent – far from a monotone – and anxiety. She was anxious that the drug was making her sleepless and nauseous. She had moved from a placid statue to a person invested in her own survival.

That sounds pretty sucky, eh? You wake up after fifty years and worry is one of your first emotions. But it’s part of the reason we were considered higher than rocks on the Great Chain of Being; acknowledging worry makes us alive.

After acknowledging anxiety, Magda continued to show rich, complex emotions. She was even able to mourn her husband who died only five years before she woke up.

Oliver Sacks says Magda was dropped “through a vacuum” from her mid-twenties to her sixties, and was still able to don with ease the “mantle of old age, ‘Grannie-hood.'” Likewise, even though she is dropped from numbed emotions to the need to express grief, she is able to make the move. She moves from stone-cold apathy to anxiety and mourning and finally to a graceful acceptance of herself and her lost years.

And what does she teach? She makes me wonder why the image of a woman in a wheelchair sitting next to an abusive psychotic and staring forward with utter tranquility is so close to what I expect of myself. I crave “unruffledness.” And where does it get me? In urban life, personal assaults on the dignity of people around me seldom register. In my personal life, I let questions of faith flicker in my mind for one second, then snuff them out.I would much rather pick up a book or get on Facebook than analyze why a conversation with my husband left us both feeling hurt. And I turn to stone. A woman who was only fully awake for a few years of her life has suddenly become my role model, because she learned to shout back.

Pitfalls of a Captive Audience

Second, when Magda embraces her new roles in life, one thing above all else supports her: her connection to people around her. She writes letters, catches up with her daughters, and entertains friends with her tales of her Viennese childhood. She has been inside herself far too long.

Rose R., a “Sleeping Beauty whose ‘awakening’ was unbearable to her,” showed a stark contrast to this. This patient, a flapper in the 1920’s, only wanted to talk about her memories when she awoke. After filling the ears of everyone around her, she asked for a tape recorder into which she could pour her memories of 1926. Soon, the tape recorder became her only audience, and indeed, her only friend. She would ask to be alone and talk to her tape recorder. She wouldn’t acknowledge anyone else.

In Magda’s case, talking to others was Dramamine for the lurching ride from the 20’s to the 60’s, since she had to catch up on decades in days. To Rose R., the medicine was a tape recorder. When she did not get outside herself, however, her body enclosed itself around her. It locked her in with overwhelming Parkinsonian tics that kept her “entranced” for the rest of her life.

To be fully awake, in this case, meant that Rose had to put the tape recorder away. It’s possible, when seeing Rose and Magda in stark contrast, that reconnecting with others may have helped Magda acclimate to a changed culture. Our daily acclimations are not like the ones Encephalitis Lethargica thrust on its patients, but they’re still rough. In light of this, what does true connection mean?

Why You Should Read the Book Even If You’ve Seen the Movie

Okay, so let’s say you saw the Robin Williams/Robert DeNiro Awakenings film from the 90’s. Why should you care about these case studies?

What struck me more than anything else when I re-watched the movie post-Sacks was its simplicity. It takes a story of human quirks, where each patient exhibits totally different symptoms during the epidemic and then shows a completely different course on L-DOPA, and homogenizes the patients to fit a classical film structure, complete with two love stories.

With the exception of Leonard (DeNiro), Robin Williams (the Dr. Sacks character) gives all the patients L-DOPA at the same time. In reality, Sacks was quite careful to evaluate patients on a case-by-case basis. In the film, they all wake up, they all start buzzing around the ward, and they all express fairly similar reactions of surprise, delight and loss. We watch Leonard’s descent into the tics that eventually overcame most of the patients in the book, and are assured that each patient is an individual who may react differently, but we aren’t shown their individuality. Granted, Robert DeNiro does an impeccable and moving job portraying Leonard’s character, especially when his tics take over. But the movie makes it seem like this is a simple disease, when in reality, it was, as Sacks wrote, “a Hydra with a thousand heads.”

As part of the simplicity, Hollywood sanitizes the case studies. There is very little drooling, there is no sweating; there are delusions, but no hallucinations. There is also no reference to masturbating. That’s right. One of the (many) reasons I scorn the love story between Leonard and a stroke-victim’s daughter is that in reality, Leonard was more like Crazy Uncle Teo in Fellini’s Amarcord, who, when his family briefly delivers him from a mental hospital, climbs up a tree and starts shouting, “I want a woman!” After years of being unable to express his sexuality, Leonard couldn’t make the graceful transition to having lunch with a woman at a cafeteria like director Penny Marshall wanted him to. Instead, he suggested that the hospital should send him a prostitute and masturbated for hours on end.

In Marshall’s sanitized version, mystery is lost to oversimplification, and the most fascinating truths are scrubbed away. If you want the truth of humans waking up after fifty years, a Hollywood formula doesn’t cut it. We’re much more intricate than that, and our complexity has much to teach.

All quotes are from Sacks, Oliver. Awakenings. 5th edition. New York: HarperPerennial, 1990.