Letters, p.5
Letters, page 5
Dear Ma and Pa and Auntie Len,
I have been remiss in writing, due to trying to do too many things in the same lifetime. […] Things are quieter with Grant[*45] away, though busier also, since I am starting to assist Bert Feinstein at the stereotaxic operations. I have now taken over the neurological work ups and follow ups on all patients and am designing various new rating techniques, both clinically and cinematographically, for evaluation of the operative results. The old anecdotal days of medicine are passing—“I once had a patient”—and one strives more and more to get results which can be “processed” statistically. In many hands this results in a nonsensical pseudo-quantification of evidence, and against this one must be on one’s guard.
I know quite a number of the house staff and attending staff now, and have even been known to play cribbage in the evenings. However I am still a dunce over card games, and intend to remain one. I have enough time-wasting activities to my credit already. Last Thursday was Thanksgiving (for the safe landing of the Pilgrim Fathers and the founding of White America), which is a sort of secular Xmas, with turkeys and ham and decorations etc. I went to no less than four massive dinners, one at Allinek’s (whose wife you delivered, Ma; they had some cousins there who were your patients in the East End, Pa),[*46] and at the parents Feinstein (where there was no ham in evidence, but stuffed cabbage balls and smoked salmon). Xmas has been largely taken over by Jews here, and I have heard Xmas trees referred to as Chanukah bushes in all seriousness. Which reminds me: you will be receiving a package of assorted American wonders around the start of the New Year.
The bike has done 800 miles since I bought it two weeks ago, and so is nearly run in.[*47] There is a speed limit all over the US of 65 mph, which is very frustrating: however one cannot really go faster if one tries, on account of the vast volume of traffic on the freeways—often almost bumper to bumper for hundreds of miles. Off the main roads however, there are enchanting country lanes, and winding mountain roads, and one can almost fancy oneself back in England, save for crimson succulent vegetation, which sometimes seems almost Martian. The weather has so far remained pretty good, save for a violent storm last week when, with the collusion of the house “mother” (who looks after us all in the Residency) I took my baby up to my bedroom, where it stood for a couple of days, leaking oil and fuming in the middle of the room. However this was received quite well at MZ, since it tied in with the notion of English students and house doctors they derive from our export films such as Carry On Nurse or Doctor in the House. I have taken to carrying a spare clutch cable, links for the chain, spare bulbs etc. for all long journeys, so that I never find myself helpless 200 miles from the nearest city. I will probably be going down to L.A. via the desert road in two or three weeks, and staying there for two or three working days, negotiating the future. I will come back by the superb coastal road. Both of these are comparatively slow compared with the freeway, but this would be boring and nightmarish, in turns.
The sun had a curious chromatic halo round it today, which probably foretells another storm. There was virtually no winter last year, or at least no rain, so this one is going to be hard, people prophesy.
I have a pile of discharge summaries to compose, which I shall do in solitude now, among the deserted electronic apparatus, its purity sullied by the cigar and bottle of beer I have brought in to solace my work with.
Then a quick work out, and to bed. And up at six thirty, if the weather holds, for a morning ride.
Do you remember a Somerset Maugham story about a man who had a spell cast on him by some jilted Island girl, and developed a fatal hiccough? One of our patients, a coffee baron, has had a hiccup for six days following operation, intractable to all the usual and some very unusual measures, and I fear may go the same way unless we block his phrenic[*48] or something. I suggested bringing in a good hypnotist: I wonder if this will work? Have you any experience of this as a major problem?
All my best, and write soon.
Love,
OLIVER
PS Could you send my large black pullover (the one which we had dyed), my blue and grey squared suit (“speckled”) and my new dark suit with waistcoat.
Thank you
To Elsie and Samuel Sacks
February 2, 1961
[San Francisco]
Dear Ma and Pa,
I am glad you are both in good form. […] I was saddened, but not surprised, by your news of Michael’s relapse. The most impossible cross to bear is the awareness that someone near and dear to you has undergone a complete change of personality, of a destructive type: in a sense, almost any other sickness would be preferable. But I do not think it realistic to hope, at this stage, that Michael will ever be able to live more than a protected social life, with perhaps periods of having to be institutionalized. New and better drugs for controlling symptoms will undoubtedly appear on the market, but it is near certain that he has already undergone a good deal of irreparable change. Perhaps I am wrong to put this so crudely, but I think you will both be less torn if you cease to entertain extravagant hopes of his “getting well.”
Thank you, too, for news of other members of the family. I am, myself, a family man at one remove. That is, I like the awareness that I am part of a huge ramifying family, and to hear news of it: but I am happy to live out of the sphere of family feelings and pressures. […]
Let me tell you something about a conference at the University here last weekend, entitled “The Control of Mind,” to which Levin and Feinstein had invited us all[*49] ($25 times twelve: presumably tax deductible!), full of eminent people—neurologists, psychiatrists, historians, Jesuits, journalists, writers, philosophers etc., and destined to start an epoch, or at least start people thinking.
Wilder Penfield of Montreal (Nobel Laureate, etc.) started the ball rolling. Unfortunately, he has become mildly senile, so was rather disappointing. He was followed by Holger Hyden, a marvellous Swedish biochemist, who produced some very exciting results on the chemical bases of memory and learning, as well as intimating that he has some astonishing drug which can affect this directly. (This was taken up by an Irresponsible Press in a big way!) Hebb,[*50] also from Montreal, summarized his work on sensory deprivation and, by showing that we are almost entirely a product of our environments, demolished the Rousseau Natural Man very effectively. Aldous Huxley gave a tremendous after dinner speech on Education. I had never seen him before and was amazed by his height and cadaverous emaciation. […] Leaning forward, in intense concentration, he somewhat resembled Vesalius’ skeleton in meditation. However, his marvellous mind is as good as ever, served by a wit, a warmth, a memory and an eloquence that brought everyone to their feet more than once. On Sunday morning, the pharmacologists described some of the new psychotropic drugs and their social implications.[*51] […] On Monday, the journalists and politicians spoke, the computer men promised us moral intelligence in their machines, and the conference ended with a series of informal smaller groups. A very exciting weekend, I am very grateful to L and F for taking us all. Humdrum life seems rather tame now. […]
Write again soon, and remind Auntie Len that I am hoping to hear from her also.
Love,
Oliver
PS I have not smoked now for six weeks. I can’t say I miss it much.
* * *
—
In the spring of 1961, having taken the exams that would allow him to begin an official internship at Mount Zion on July 1, OS traded in his Norton Atlas motorbike for a secondhand BMW R69 and set out to travel across the United States.
To Elsie Sacks, Samuel Sacks, and Helena Landau
April 22, 1961
Lausanne School for Girls, Memphis, TN
Dear Ma, Pa, Auntie Len and All,
Finding myself, for the first time in two weeks, with a typewriter and some leisure, I thought I would let you know something of my trip. […]
I am typing from the unlikeliest of places, the Lausanne School for Girls! A friend of mine from Oxford days, who bears the splendid name of Walter Raleigh Coppedge, is headmaster here, a very astonishing evolution. He is, I find, a very good one too, which needs a good deal of courage in a place like Tennessee, where it is still illegal to teach the “false doctrine of evolution,” and where one is savagely slated by the press for any progressive idea. At present I am sitting outside, barefoot, in a pleasant Cowper-Dryden like woodland, with a lake to one side and the graceful school buildings to the other. As I write this sentence, Walter is conducting two grey-haired parents of a prospective student around the grounds, no doubt deflecting their gaze from the strange barefoot man who sits typing under a tree. The ground is covered with catkins and acorns, and if I can ignore the monstrously large ants and butterflies, I can easily imagine myself back in England for the nonce.
My journey, in outline, has been as follows: first down to LA for the weekend. Then through California to Death Valley, which is tolerable this time of year (the ground temp. rises towards 200 in the summer).[*52] It reminded me very much of the Negev in certain ways, though is a great deal more spectacular: one can, for example, look up from Badwater (the lowest part of the world after the Dead Sea) to the highest mountains in America, less than a hundred miles away, and clearly visible in the still air. The air was anything but still when I was there—a huge hot shrivelling wind blew up from the valley, something like a monstrous hairdryer. From Death Valley I crossed into evil Nevada (no speed limit, no limit on anything: a bubble economy subsisting entirely on sale of liquor and gambling). My one evening in Las Vegas, mercifully perhaps, was truncated by a dust storm of grotesque violence, which twice blew me off the bike, filled my ears, eyes, nose, mouth, clothes with dust, and made me marvel that such a place of glittering twenty-first century skyscrapers as L.V. (mad and arbitrary in the middle of the desert) cannot protect itself against the elements when they really decide to “have a go.” I passed rapidly across bleak horrible Nevada (no wonder they set off the first A bomb in its deserts) to Arizona, where I spent about four days. For colours, and for geology, Arizona can have no equal on the earth. […] The Petrified Forest and the Painted Desert are amongst the most incredible natural phenomena I have seen—in fact, they reminded me of the cover pictures of some wild science-fiction magazine. From Arizona I passed into New Mexico, mostly a “mesa” (a high plateau desert) around 7000 ft. I mustn’t forget to mention the Grand Canyon, which inspired all the usual feelings. What engaged me more than the scenery of New Mexico were the Navajo Indians, who have a sixteen million acre reservation occupying a good part of N.M., Arizona, Utah and Colorado—they are the only tribe of Indians who are on the increase. […]
From New Mexico to Texas, which is ridiculous—for you can drive through a hundred miles of solid wheatland (no fields, hedges or any of our petty European partitions), and hardly see another human being. Fearfully, in New Mexico, I spent thirty valuable dollars (it broke my heart, but I am sure it was wisest) in buying a new back tyre and tube (I am carrying the old one as a spare—the poor bike is loaded with close to a hundred pounds of impediments!): I would hate to get a ripped tyre in the middle of one of these deserts. From Texas through Arkansas—sleepy Sunday state, where the men and animals resemble each other, and watched my passing with sleepy incurious eyes (and where, indeed, the sleepiest and Sundayest place of all was a village called London—population: 353, produce: Ozark Mountain peaches)—to Tennessee. […] Probably, I shall now go further South, to New Orleans[*53] […] and then wind my way along the coast, across Florida, and up the Eastern seaboard to Washington and New York, arriving there the first week in May. From there to Montreal and Toronto, and then back through the Northern States.
I have not yet heard about the State Boards etc. but will probably find information awaiting me at New York. I hope to be starting at Mount Zion in June or July (perhaps July, in preference, for this would give me a clear month to arrange, edit and type my new journal). Please let me know how things are with you back in London. If you write soon (i.e., if the answer will be back within a week), write directly to the YMCA, W. 63rd. St. N.Y. 23 and mark: TO AWAIT COLLECTION.
Keep well, and love to you all,
OLIVER
To Elsie and Samuel Sacks
[Received in London on June 24, 1961][*54]
[San Francisco]
Dear Ma and Pa,
Thank you very much for your letter, which came today.
First—before I forget—the best returns for your wedding anniversary on the 22nd: may you have many more before you.
Second, before I forget again, here are some photos of me (one with the new bike)[*55] taken in New York; Auntie Len might like one of the close-ups. Tell me if you like them; as you see (genes, hormones, race, age, rage, depravity) my hair is getting very scanty, but my smile is as charming as ever. […]
The internship becomes, if anything, less tolerable daily. Not because of the “work,” but because one is treated like a shit or a menial or both, by the majority of the attending men. Having fifty masters (a consequence of being in a private hospital) is difficult at the best of times: many of them are second, third and fourth rate (this is not extenuated by there being a few very good men on), and one sees the grossest examples of medical incompetence and immorality daily. How MZ has achieved so high and desirable a status I can’t imagine: or, at least, I can—the others must be even worse. Surgical internship is particularly awful, for it consists of being “used” all day: sudden phone calls: “Doctor, you’ve been assigned to such and such a case: be up here in ten minutes.” The case to which you have been “assigned” is one you have probably never seen before, and will have no chance of seeing again, i.e. you are deprived of responsibility: as like as not, you will be a fifth assistant on a mastectomy, so you lack even the consolation of imagining yourself useful. Appalling mutual hostility obtains between the attending and house staff—which was epitomized in the savage lampoons of the annual “show” last week.
However, something can perhaps be “done” about all this. I hope so, for otherwise this will be the most miserable and useless period of life. I can write nothing at the moment, which adds to my fury, and have been eating pathologically—gained 24 lbs. in fifteen days. Incidentally, Pop, delighted to hear that you are becoming slim—don’t let this chance slip like all the others. […]
yours,
Oliver
To Elsie and Samuel Sacks
July 6, 1961
Mt. Zion Hospital, San Francisco
Dear Ma and Pa,
Thank you very much for your letters: your mammoth ones are rare, Pa, but well worth waiting for. This will be a slender reply, and a rather tardy one because I am in a mood of great vexation and uncertainty. […] I am not a good correspondent, because I speak and write at people rather than to them. […]
A new infuriating enactment of the State Boards now makes foreign doctors do yet an extra year of internship here; i.e., it really doesn’t want them in California. I am not sure that there is any way of evading this if I am to procure a Californian licence. Indeed, I am wondering: do I in fact want such a licence. I see this loathsome internship prolonged indefinitely, and to no purpose. I am discovering, in a far more intense degree than ever before (these were mere intimations) an extreme aversion to patients, sickness, hospitals and particularly doctors. I cannot imagine that private practice would be any pleasanter: first, I do not enjoy clinical responsibility and would probably betray it sporadically; second, I want leisure, and a lot of it; third, I am not very competitive. I am thinking of returning, here and now, without further waste of time and temper, to academic work, i.e. physiology. […] However, with Oxford in mind,[*56] I am also none too sanguine about this: I am probably too temperamental, too indolent, too clumsy and even too dishonest to make a good research worker. The only things I really enjoy are talking, lecturing (when I have the chance), reading and writing. It occurs to me (with the precedent of Charles Singer[*57] and many others in mind) to give thought to the subject of the history of medicine and science, and I shall be contacting the department at Cal in this subject. This way I might harness my long long education in science and biology and medicine with my other interests, and my ability to write, and make myself a reasonably pleasant and profitable life. The truth is, you know, I should never have become a doctor. However, I regret nothing: I have a great deal I can still capitalize on. By a curious telepathic coincidence, I was mentioning some of these thoughts to Grant Levin only yesterday, when I received a letter from Jonathan,[*58] beautifully written and full of realization of similar issues. Let me quote a sentence here and there: “I am, like Wells,[*59] enchanted by the prospect and paralysed by the reality of scientific research. The only place where any of us move nimbly or with grace is with ideas and words. Our love of science is utterly literary.” Looking towards the future, he says, “I now feel I am ready, equipped with an extraordinary biological education, to turn a powerful instrument into a region where I never dared imagine myself at home.” He thinks, utopianly, of some unit where psychology, sociology and neurology all meet. And I am thinking, in analogous terms, of scientific history and journalism. I don’t know what will finally become of either of us, but I feel that this turmoil is a healthy sign, even if it disturbs you a lot. It would really be a great shame and rather a waste to turn into a mediocre doctor with no love for medicine. However, do not get too alarmed: I shall do nothing rash, and nothing without careful advice and help from others. In the meantime, this internship will give me bread, bed and money (100 dollars a month, affluence!) while I brood and plan.
