Letters, p.39
Letters, page 39
On the other hand, with the disappearance of these old possessive-competitive tensions, I—we—found ourselves freer and more at-ease. It was a deep (and almost mystical) delight climbing up Mount Hood with you—the immensity, the spaciousness, the goodness of it all (and I love your new sensitivity, and communion with nature, whether it is feeling the great trees as friendly angel-spirits, or spotting new lichens, and knowing what’s edible. I have the feeling that you could live off the land, with the land, in a sort of peaceful, holy communion with it). And those lovely ancient baths, fed by generous Hot Springs: how right you are—it was indeed a Special Place, a Secret Place, a Holy Place, a Healing. You saw (how much you see!) the wound in my centre, my central maiming, which has been so overwhelming since that Norwegian experience: you saw what had happened, and what I needed: a true healer. And taking me with you, on that path on Mount Hood, was a deeply healing symbolic act—of a sort Kabbalists call Tikkun; somehow repeating the experience of a mountain path, but this time not alone but with an old and dear friend, and not destructively but humbly and holily, and not with a Bull but in the presence of friendly Trees. All this somehow exorcized the horror which has held me for three years, and broke the trauma, the ragged nightmare. I have felt much better, and specifically, surer-footed since that Monday evening—the terror, of slipping, of falling, of self-killing, I felt it going away in our walk.
There is some strange current between us—nothing we can ever (or even need to) “act on”: it has always been there, and will probably endure. I don’t even know what sort of words to use—it is a feeling beyond words, which is liable, perhaps, to get spoilt by words: it is certainly a sort of love, and a sort of communion, and it has something sexual about it, but in that mystic and sublime sense which Dante uses when he speaks of “the holy and glorious flesh,” and the flesh as Mystery, as the Word made Flesh. Something physical, something mystical, a sort of mystical sexuality. I cannot formulate it, I have already tried too much: suffice that it’s there—somehow mysterious and ordained—and that it makes for a mysterious flowing and contact, and can do so without tempting or teasing or tormenting us into anything merely and profanely physical which would be damaging, and somehow unnecessary as well. Perhaps I shouldn’t have said this—but I feel the need to—it’s part of the clear-sight, the reconciliation, the quietness, the acceptance, which mingles joy and sadness strangely. […]
I had a lovely experience in Toronto—it started well with a symbolic deed: a young man came up to me and said, “Oliver Sacks? I have been wanting to hug you!” and he did so forthwith. (He was chairman of the film committee of the APA,[*24] and said he couldn’t read Awakenings, or see the film, without wanting to hug me!). It was a lovely, genuine, spontaneous reaction, and—especially after the hateful coldness at UCLA, where I felt anything but hugged—it gave me a wonderful feeling of warmth and welcome, and this carried on into the meeting, where, in turn, feeling loved, I loved the audience back, and there was a marvellous discussion which was like an embrace. […]
Love,
Oliver
To R. E. Case[*25]
Correspondent
July 25, 1977
11 Central Parkway, Mt. Vernon, NY
Dear Dr. Case,
I have just received your most generous and thoughtful and thought-provoking letter […].
Questions of outlook and orientation in regard to medical education, no less than treatment, have been exercising me greatly at the present time—and it is a curious coincidence that your own letter should arrive right now. My feelings are at once passionate, ambiguous, and not fully resolved—and therefore […] I find it difficult to write on this matter, above all to write in a critical way. For this reason, among others, when I was recently asked to contribute a memoir or reminiscence to be included in a book called “My Medical School” after some weeks of vexation I had to decline, because I found Medical School deadly—a real murdering of the perceptions, the heart, and the mind—and I could have expressed and explored nothing except negative feelings. I feel that my Medical School (and it was one of the best in England) retarded and deformed my education and development, as a scientist, as a physician, and as a human being—and that it was this (among other things) which delayed my finding my own feet, defining myself as a physician and a person (and I think the person, the personal qualities, are pre-requisite for a physician, though perhaps not for a physicist) until I had “escaped” from Medical School, and the systematic idiocy which it imposed upon me—on all my contemporaries. There was a lack of intellectual excitement and wonder, and a lack of human feeling and concern: the nerve of astonishment—and compassion—was not nourished; sometimes, perhaps, it was almost killed. The sheer dullness of doctors—their lack of intellectual curiosity and passion, and their resistance to entering fully into the feelings of their patients, seems to me very much a reflection of miseducation—an education which reduces everything to “information” and “skills.” I think it is difficult, and rare, for physicians to surmount the mischiefs built into their training, the false ideas and emotions on which so much “Modern Medicine” is reared. I stress “modern” because I think that this is partly or largely a reflection of our age: unbridled technology and growth of information, and a loss of the leisure, the human dimensions, the sense of apprenticeship, which characterized medical education fifty years ago (for example, the education of my parents, who both became physicians during the First World War). I think there has been a rupture of a most ancient tradition—call it the Hippocratic tradition if you will—in which epistemology and ethics and education are inseparable. I by no means advocate a mere going-back to the past: our world has changed irreversibly this century; what I envisage as an almost desperate necessity is bringing all our new knowledge and concepts and skills into a human and humane tradition or, as Buber puts it, “humanizing technology before it dehumanizes us.”[*26] […]
For physicians, there must continually be a sort of “double” orientation, an exact and dispassionate grasp of the phenomena involved (which, in a sense, are impersonal, supra-personal, or sub-personal)—and this constitutes the Science of Medicine); and an empathic and compassionate grasp of the personal predicament involved—the intelligence of the heart no less than the mind. […]
No, I am afraid I cannot send you any articles etc. because I no longer write them—I only write letters (like this!), and—occasionally—books (I think of a book as a letter to everyone—at least to the sort of people I would like to correspond with). By the same token I fight shy of any public lectures or involvement, although I deeply appreciate your generosity in suggesting my name. But I am essentially a solitary physician-thinker-writer, and I have to work and publish in my own rather private and personal way. Your own series of lectures sounds profound and exciting.
Enough said. My deepest thanks, and best regards,
[…]
Oliver Sacks
To Richard Lindenbaum
September 6, 1977
11 Central Parkway, Mt. Vernon, NY
Dear Dick,
[…] Such a sadness, and a release, has come from the death of Luria, which I heard about ten days ago (it was reported here, initially, but not in England). In a way which must sound absurd if not unintelligible to you, my “idealizations” are for “good fathers”—like Auden and Luria—who are set at a safe distance from reality. My in-a-way very intimate correspondence with Luria, over the last four years, was the most deeply affirmative experience of my life; and I would feel (as I think Gorki says of Tolstoy) “While this old man is here on earth I shall not be an orphan” (or something like this). I never saw this old man in Moscow whom I loved, and after some initial yearning and pining, no longer wanted to, and felt (as I think he did also) that we could give of our best, our most “ideal,” given (and only given) a distance between us. But, of course, it is absurd to press the comparison further; I wanted communication, even communion, but not conjugation. I knew, of course, that he was old and ill, but he was so vividly alive, imaginatively and emotionally, so vividly present to me, every day, many times a day (I would continually be saying to myself, at work: “Now what would Luria say of that? Must write to him instantly! Send him a tape!”) that I was utterly stunned by his death, and spent a couple of days absolutely howling, in a way I haven’t done since my mother’s death—and, to a much less extent, Auden’s. (I had become closer to Luria than I ever was to Auden, perhaps, partly, because we had so much to share.)
His death “unlocked” me, cleared my heart, cleared my mind—and suddenly I was able to go, to flow. When I found that there had been no news, or obituary, in England, I instantly felt that writing an obituary was the right thing to do, and, without the least hesitation, even a second thought, I sent a telegram to the Editor of The Times. When I tried to write the Obituary, my feelings overflowed—“feelings” is too narrow or sentimental a word; I flowed into an extended biographic-critical-lyrical essay, 20,000 words, almost a little book; and they poured out in a single sitting—I scarcely stirred from my chair until I was “finished.” I think it is probably good, because it came out in this way—very much the sort of way in which Awakenings came out (at least the impassioned part which I wrote straight after my mother’s death)—with a transparency and purity of feeling: genuine in feeling and thought, through and through (as opposed to my conflicted, ambiguous piece in ’73).[*27] It was an Act, an existential Act: an Act of Mourning, Remembering, Thanking, Farewell; and, in its way, an Act of Love. Whether this makes it essentially private I am not sure—I think, probably, it doesn’t, because so much of what I say is not just “my feelings,” but Truth, or at least a deep understanding, which others can share, of a rare and very significant human being, whom I could not help, again and again, comparing to Freud (and “neuro-analysis” to psycho-analysis, etc.). Only when I had done this could I write the Obituary. Eric[*28] phoned me this morning, to tell me it was printed—a bit cut—in yesterday’s Times (Sept 5) and I have just been down to the Foreign Papers Shop to get it. I am glad to see it. I have done the right thing. Most of my life is dominated by a feeling that I have done/am doing/may do the wrong thing, an almost perpetual sense of Crime and Sin. So the certainty of doing the right thing is very important—indeed it is the only time I can ever make a move. […]
To Samuel Sacks
September 24, 1977
11 Central Parkway, Mt. Vernon, NY
Dear Pop,
[…] Thank you for your lovely New Year’s telegram—and I hope you got mine. And that you had a good, festal New Year, and will really enjoy this New Year to come. […]
We had a very nice (“Sacks”) get-together at Rosh Hashanah here—the Capps, and their ramifications; and Jonathan,[*29] and Carmel[*30]—and Aubrey. It was odd and moving to see a Sacks Face, and hear a Sacks Voice, in so many different inflections and modulations. Perhaps I have been more aware of the Landau Face and Voice, and of these determining me, in me; but I had a vivid feeling, on Rosh Hashanah, of the other half, the Sacks patrimony in me. This was strengthened by a long talk with Aubrey, in which he spoke particularly of our grandfather, your father; and, afterwards, I borrowed a proof-copy of his autobiography,[*31] which so riveted me that I read it at one sitting (not easy, because it is about 700 pages long!). Beautifully, brilliantly, vividly written, it never loses its tone and pace, gives one a tremendous feeling of History—History lived. The only note of sadness—never explicit, but somehow present throughout, especially in the opening chapter on Boyhood—is a certain sense that he himself never had much say in the matter: that he was “chosen,” or “fated,” really from childhood, and that, to some extent, personal feelings and development, etc. had to be sacrificed to a certain Public role—although a very noble one, as Witness, Voice, Architect, and Historian—of age-old Jewish yearnings and plight, and the brand-new, yet so-long-awaited, State of Israel. But that’s how it is when one has a “Mission”: one’s personal life is sacrificed in a sense, but consecrated too. And now I think of it, these two words have the same root, indeed they are synonyms which have split-apart in meaning. The other pity—and something which must be exercising Aubrey now—is where he belongs in the present State of Israel, which, alas! has lost some of the selfless splendour of its first days, and is so riven by petty party politics and squabbles, which are so below, so inconceivable, to someone like Aubrey. One feels he is almost too big for present-day Israel. […]
I see quite a lot of Carmel—really very fond of her—please give my love to the indomitable Yitzhak, and of course to Lina, and Florrie, etc.
Love,
OLIVER
To Harvey Shapiro
Medical Director, Beth Abraham Hospital
November 10, 1977[*32]
11 Central Parkway, Mt. Vernon
Dear Dr. Shapiro,
I was somewhat distressed by our talk this afternoon, and I could see that you were as well. There is, indeed, no matter as emotionally charged—for anyone—as all questions relating to death. […]
As a person, as a physician, as a biologist, and as a man of religious consciousness, I have, of course, a reverence for life—indeed, it is the deepest feeling I have, and the root and spring of all other feelings. Moreover, it is not simply theoretical: as I mentioned to you, I have a power of seeing and bringing out life, potential, hope, in the most severely brain-damaged patients whom others have long since given up. Time and time again people are dumbfounded by this power, and say “Dr. Sacks, we never heard her talk before. Look she’s smiling! We never knew she had any feelings. It’s amazing how you bring people to life, etc.” Last Friday, I saved a man’s life by doing a tracheotomy with a table-knife—he had a seizure while eating, and aspirated a chicken-leg down his larynx. A couple of weeks ago, in a nursing home where I work, a patient had a coronary and immediately went into massive pulmonary oedema and shock—I worked on her, desperately, for two hours, brought her through at last, and now she is recovering quietly. I am a practising physician, and I do not speak theoretically of life and death. I am entirely for life, on the side of life—true life, personal life—whenever I see it.
I think you were hasty in comparing me to executioners in the death-camp, as you did, if only by implication; but I know that here, you were carried away somewhat, and—forgot yourself, and who you were speaking to; but realizing this, and the obvious excitement and anxiety which led you to invoke such a comparison, I overlook it. You forget, perhaps, that I lost most of my “extended” family in the death camps—as, very likely, you did as well. Neither of us could possibly be potential Eichmanns!
This is not the issue, at all. We are not speaking about killing the living, the truly living, the personal, the human…which, of course, is the ultimate atrocity.
What we are talking about is a rather terrible twilight zone which has only come into existence in the last thirty years, and which has no precedent in the entire history of humanity. Namely, our ability to maintain, even for decades, those who have the most severe and seemingly incorrigible brain damage—for example, those who are apparently cerebrally “dead,” and have flat EEG’s, etc. Such patients could not be “maintained” a few years ago, and the problem of what “Life” meant, in relation to them, did not arise. It is only in the last few years that we have developed the ability to keep such patients “alive”—if the term “alive” can legitimately be used of someone who has no detectable cerebral activity—or cerebral activity which does no more than maintain autonomic functions, and is apparently incapable of improvement.
Here the problem is not that of killing a conscious and personally-alive human being, as of the sense, and morality, of maintaining, by artificial means, a sort of “zombie”—someone who may be “essentially” dead, but who can be kept going as a sort of living corpse. This is a horrible and uncanny region—because one is dealing with what it means to be “half-alive” and “half-dead.” You extended my attitude, as you saw it, to the Death-Camps; I could extend your attitude, with similar unfairness, into a vision of a world where, if a man or a dog has been decapitated by injury, we might keep their hands (and bodies) alive, by perfusion. I do not say whether we should or should not—simply that this is a region which has no precedent in human experience, and which faces us all with problems which have no precedent, and where we cannot but be confused as to meaning and application of the classical and biblical injunctions, because no such situation was envisaged when they came into historical being. One can imagine a hospital entirely full of decerebrate patients maintained artificially—one can imagine a hospital or a city, or a world: this is the other side of the Death Camp vision. And one which some might consider scarcely less terrible, unholy, and obscene. These are very deep and frightening waters, and it is far from clear what course one should steer. But I do think that such matters do need discussion and “agonizing reappraisal.” But, of course, I fully realize that such matters are not for the chart![*33]
I wish we lived in a simpler and more innocent world!
Skip Notes
*1 Stent wrote an influential article entitled “Prematurity and Uniqueness in Scientific Discovery,” published in Scientific American in 1972.
