Letters, p.75
Letters, page 75
With regard to the musical hallucinations, these are clearly “psychotized,” and yet one has to wonder whether they might have an organic kernel in her deafness and auditory deafferentation—the more so as B has now renounced or refused the use of hearing aids. (But she will not easily be persuaded to use them again, and might take any pressure to do so amiss.)
There have been trials of antipsychotic agents—these have not been effective so far, and may have produced some dyskinetic effects. […]
I cannot help wondering whether shock therapy might be useful here. I have memories of one or two patients with severe obsessive-psychotic depressions who were recalcitrant to all medication but greatly helped by shock therapy. But this is just a thought—I must leave it to my colleagues to weigh the matter.
I do hope this poor tormented woman, so undone by loss and bereavement, can be helped to return to a happier life.
Oliver Sacks MD, FRCP[*14]
To Georg Klein
Microbiologist
September 12, 2007
2 Horatio St., New York
Dear Georg,
I was delighted to get your letter. On your question, first, about Bartok (et al.) having Asperger’s: I suspect that there is very little solid evidence in any of these cases (the evidence, of course, would have to be historical and anecdotal, because none of them could be “tested”), and that this posthumous diagnosing comes partly from people with Asperger’s who are hungry for eminent exemplars, role models, etc. (It is similar with regard to Tourette’s syndrome. Mozart, for example, is considered to have Tourette’s, maybe autism too.) […]
On Seymour Benzer,[*15] I found your notes riveting, and kept pulling out my marker to highlight particular things. I am agog to see your essay on him—will it be translated into English (or, rather, when will it be?). I am happy to think I may have introduced the two of you at that conference in Berkeley. […] In regard to your specific question, I came away from an afternoon in Benzer’s lab feeling that insects were my “brothers”—that huge insights in (the genetics and molecular biology of human) behaviour could come from our little brothers, with their “100,000 transistor” brains (I also got this feeling, in relation to the “psychology” of insects when I visited Ralph Greenspan, at Neurosciences). And I get it from a lovely little Robert Frost poem—do you know it? called “A Considerable Speck.” The conservation of genes (not only throughout the animal kingdom, but all the kingdoms of life) seems to me one of the wonderful and startling (and yet, when one broods on it, right and inevitable) realizations of these last decades. I have especially thought of this in relation to conservation of a handful of visual genes, determining eyespots in protozoa, chloroplasts in plants, eyes of fascinatingly-different but “parallel” construction in seven or eight animal phyla. I have some of the same feeling with regard to Kandel’s wonderful studies of Aplysia (which you mention in your Benzer talk).
Speaking of Kandel, I have a new position at Columbia—a chair in clinical neurology & psychiatry, as well as being a “Columbia artist”[*16] (whatever this will mean). I have become close to Kandel, hope to see a lot more of him (we even saw a patient together), and of course Richard Axel is there as well. How this will work out, I don’t know—I have been a maverick, a nomad, a freelance, whatever, for the last forty years, and entering Academia in my 75th year seems a little daunting. But I think it could be a very rich and exciting new chapter of life—and one needs such feelings as one faces the losses and “lessnesses” which go with age.
* * *
—
With regard to my eye—since you ask about it—the situation is complex, but on the whole reassuring. Areas of melanoma have persisted despite radiation, but can be extinguished (it seems) by being lasered, cauterized, though this, of course, destroys the areas of retina overlying them. Unfortunately the tumor is close to enveloping the fovea, and so with lasering I have now lost a good deal of my central vision in this eye (and may lose it all). But other than the loss of stereoscopy this seems to matter remarkably little in functional terms—I can still drive, bicycle, walk, swim, read, write etc (and could even if the eye had to be enucleated). I have tried to suggest a “deal” with the melanoma: “You can have my eye, but leave the rest of me alone”—and can only hope that it will abide by this.
This has not stopped me working—and I have a new book (Musicophilia: Tales of Music and the Brain) coming out next month—I will send you a copy. […] I hope that you—both of you—continue in good health and spirits…and SWIMMING DAILY.
Kate joins me in sending our love,
Oliver
To Henry Nicholls
Science Writer
September 24, 2007
2 Horatio St., New York
Dear Dr. Nicholls,
Many thanks for your letter—I am glad you will be writing about Chemistry sets,[*17] tho’ I fear it may be a lost cause.
1) I think that a personal experience of chemical reactions is crucial to get young children interested. The first experience might be (say) fireworks, on Guy Fawkes night, or seeing one’s mother remove a red-wine stain with salt, or bleaching—but then one has to experiment for oneself. I do not think that there can be any adequate substitute for having a chemistry set (or a little chemistry lab), and doing experiments oneself—thinking them out, taking responsibility for them—and (occasionally) facing risks too. Failing an active experience like this, the next best are demonstrations by a teacher or lecturer (as Humphry Davy used to do, and as are, perhaps, still done—are they?—in the Royal Institution, and in schools everywhere). Films (like the lovely—and very funny—little RSC film on putting bits of alkali metals, Li to Cs, in water) have their uses too; but none of these can be a full substitute for planning, doing, reflecting on, real experiments of one’s own.
2) Not in America, where there is a sort of Nursery atmosphere, and a hysteria about risks, insurance, etc. Maybe in England. It may be (this overlaps with the first point) that a virtual chemistry set could yield some excitements, develop skills, and, conceivably, a “nano-chemistry” set, where one is using milligrams or micrograms and not grams. […]
But if chemistry sets (or something equivalent) cannot come back, a certain realm of childhood, youthful fun, joy, thought, responsibility, etc may be lost for ever.
I may, of course, just be an old fogey consumed with nostalgia.
With best wishes—and do send me your piece!—
Oliver Sacks
PS Forgive typing.
To Neil Shubin
Paleontologist, Author of Your Inner Fish
October 31, 2007
2 Horatio St., New York
Dear Dr. Shubin,
I was thrilled when I read of the discovery of Tiktaalik[*18] a couple of years ago, and now (reading the proof copy of Your Inner Fish, which Dan Frank sent to me) I find it even more fascinating—and moving—as I read the full story, and how it fits into your life and work. Indeed I found every chapter of the book riveting—and am sending off a “blurb,” tho’ I fear it may not do justice to one of the most exciting books I have read this year. (Another, on the botanical side, was The Emerald Planet.)
My mother was a surgeon and comparative anatomist (her teacher was Wood Jones), and drummed into me, and into her students, that our own anatomy is unintelligible without a knowledge of the origins, and “precursors”—and how it becomes infinitely fascinating with such knowledge. I think the medical students in Chicago are very lucky to have you as a teacher, illuminating this for them.
Tho’ my own life is a clinical one now, I have never left my early interest in palaeontology—and a few years ago, on a visit to Australia, I went with Alex Ritchie on a “fossicking” expedition to the Devonian billabong of Canowindra—he, of course, was hoping for such a discovery as you and your colleagues were to make in Greenland—
I was intrigued by your remarks on hiccups (pp 186–189), and thought I would find reference here to what neurologists (perhaps mistakenly) call “branchial myoclonus.” (I once wrote a sentence or two about this in my Island book—see enclosed.)
Anyhow congratulations on conveying so vividly (and engagingly) a marvellous scientific adventure-story.
With kind regards,
Oliver Sacks
To Orrin Devinsky
December 6, 2007
2 Horatio St., New York
Dear Orrin,
I very much enjoyed my quiet Chanukah dinner with you all—thanks so much for letting me join you (I think Deborah does sprouts particularly deliciously!). The train back was uneventful—I fell into one of those strange half sleeps, both dreaming, and yet (at least intermittently) aware of everything—a sort of “doubled” consciousness.
Tho’ Deborah said it was sometimes too much, your girls’ adolescence is fascinating to an outsider—they seem to me, each time I see them, more and more individuated as young adults. I guess that’s what adolescence is.
Their showing me the dancing figures with your face, on the computer, and seeing all the images of my face, played a part in an odd dream I had this morning—when I seemed to be in a sort of gaudy gallery, with “pop-out” versions of my face all round me (one would pop out of the wall, then disappear, and then another, and another). And then I, apparently introducing “the Sacks show,” as I understood it to be, announced you: “that epilepsy Knight, Fleischman of the 5:30” (at this point, my alarm went off and terminated the dream). So—you are a “knight” of epilepsy, a valiant warrior battling the powers of ictal darkness and confusion. The “5:30” was the train we took, your train…but why “Fleischman”? My associations are with Flashman and Flash Gordon…and I had a phonecall yesterday from De Niro, in which he spoke of seeing Leon Fleisher at the Kennedy Center.
I am being too prolix, but it was a fun dream, and intriguing in its bringing together (and transforming) some of (what Freud called) “the residues of the day.”
* * *
—
I enclose the two letters [from prospective patients] I meant to give you last night—don’t know whether they are of any interest to you. Thank you for your two consults. J.B. sounds fascinating, and articulate, and colorful—even if she does have a little dementia. It sounds as if she may have a combination of peripheral and central factors, as with Z. I would like to see her. […]
I hope my scrawl is not too difficult to read!
Thanks,
Oliver
PS: I hope we can set up my bike on a stand, and I think I have (after your demonstration) to yield to an iPod, and perhaps combine it with cycling indoors.
To Bill Hayes
Writer, Author of The Anatomist
January 17, 2008
2 Horatio St., New York
Dear Mr. Hayes,
Thank you very much for your note.
I did read The Anatomist in proof, with great enjoyment and interest (my mother was an anatomist, and the first review I ever wrote, when I was eighteen, was a sort of essay on a just-published new edition of Gray’s Anatomy). I am very sorry I did not provide a “blurb”—I meant to, but it was a distracted time with interviews etc relating to my own new book,[*19] and I failed to do it, to do all sorts of needed things at the time.
But I am delighted by the advance praise the book did get, and the lovely review in last Sunday’s NY Times—all richly deserved. And I would be delighted to meet you when you are in NY next month.
My best,
Oliver
PS: I enjoyed yr. previous books too.
PPS: And I gave a proof of The Anatomist to my eye-surgeon, who has contributed 2 chapters on ocular anatomy etc. for the latest edition of Gray.
* * *
—
A few weeks later, on a trip to New York with a view to finding a job and moving there, Hayes met OS for a meal. Once back in San Francisco, Hayes sent OS drafts of a few essays he was working on. OS’s response to these, below, was never sent—perhaps he felt it was too personal since they had only recently met.
To Bill Hayes
February 29, 2008 [Not Sent]
2 Horatio St., New York
Dear Bill(y),
(I always find the informal variants more difficult to use—everyone called Stephen Jay Gould “Steve,” I called him “Stephen.”)
I was very moved by your letter and the two pieces—the “gym” one more than the London one (but this may just be that I read it first, and had got saturated with sympathetic grief myself, and could not take any more).[*20] Yes, writing in your own way, as time and occasion prompt, and without any hurry, or planning, or system, I think that your book may turn into a collection of such pieces, a sort of album of grief and loss, as they thrust up suddenly, in different ways and places.
I have not read Bowlby’s volumes for a long time, but they may well be the deepest study of these themes. (I seem too to recollect a book by Geoffrey Gorer?? called Death, Grief and Mourning…or perhaps I’m mistaken.) When Darwin lost his mother at the age of eight, he did not mourn, none of the family mourned, no mention of loss or expression of grief was “permitted.” And years later, when a close friend suffered a grievous loss, Darwin wrote a remarkable letter of sympathy, adding that he, however, had never known any (such) losses himself. On the other hand, the death of his favorite child darkened the rest of his life (and, besides much else, destroyed what vestiges of religious faith he still had).
I have spent much of today with a friend who has also suffered a grievous loss (tho’ not as grievous as yours)—the departure of his wife, who suddenly decided to leave him after fifteen years of marriage. She took off, finally, yesterday, and Peter’s voice, when I spoke to him then, was sepulchral. But I was able, today, to persuade him to come to a mineral show, with friends; to have a swim; and to go to a reunion party (of our swim/triathlete group, now coachless).[*21] So, he was distracted for eight hours—which was exactly what was needed. What I am saying, I guess, is that I hope you permit yourself distraction—dinners with friends (yes, you do speak of this), going to movies, whatever—distractions as well as consolations.
At some level, I suppose, I cannot really feel what you (or Peter) feel—for I have never had a relationship of fifteen or seventeen years; or, for that matter, any “relationships” at all. This, alas!, is a “forbidden” area for me—although I am entirely sympathetic to (indeed wistful and perhaps envious about)[*22] other people’s relationships. This used to be a grief for me, but now solitude is so habitual that I scarcely mind it any more—and I do have, if not “relationships,” many friends to warm my life.
Before I forget I should thank you for the lovely photos as well, though my association is a neural rather than a vascular one—I think of how Nabokov compared trees in winter to the nervous systems of giants. Formally, I suppose, there is little to choose between vascular & neural arborizations.
I enjoyed meeting you too—look forward to seeing you again.
All my best,
Oliver
* * *
—
Hayes decided to move to New York a year later, and over time their relationship grew into a partnership that would last the rest of OS’s life.
To Christopher Payne
Photographer
September 3, 2008
2 Horatio St., New York
Dear Chris,
I have just read your own really beautiful Introduction to Asylum[*23]—indeed it is so good that I am now even more uncertain as to whether I have anything useful to say, tho’ I was especially struck by your paragraph about speaking to former employees—and how “through recollections filled with pride, humor and a sense of nostalgia, the empty buildings and vacant grounds came alive” (also, in the same para, how they felt the end of “patient labor” was so damaging to patients).
I have also read, in the last few days—was it you who recommended these?—The Discovery of the Asylum (Rothman), The Architecture of Madness (Yanni), and (most movingly for me) The Lives They Left Behind: Suitcases from a State Hospital Attic (Penney & Stastny).
But this read and said—what do I have to say?
I did spend 25 years working at Bronx State Hospital (1966–1990)—tho’ this, unlike the great State Hospitals you photographed, was built only in 1963—and designed to be a short-stay hospital not a residential or custodial one (but, of course, it had “chronic” wards, where patients from Pilgrim and elsewhere were transferred). I did spend a year on one (hideous) ward—but for the most part worked in the Clinic, and did not have that much to do with the Wards. It was clear, however, that they varied greatly in character—morally, in all respects: some were full of life and interaction and community and good care and doctoring—others (like the hideous Ward 23) the opposite.
My more intensive and intimate experiences, however, have been with Institutions other than State Hospitals—but with obvious analogies to these (and equally obvious differences), e.g. Beth Abraham Hospital in the Bronx (originally “Beth Abraham Home for the Incurable,” possibly even “BA Home for the Crippled and Dying”)—where I worked from 1966 to 2006. It was here, in 1969, that “Awakenings” occurred. BAH has not been pulled down, but its character has changed a good deal—it is much less a Home for patients with chronic/congenital neurological disease, as it was originally, and as it was for my first thirty years there, for now there has been a “de-institutionalization” of such patients (partly for budgetary reasons)—and the place is largely filled now with drug-addicts, and people for short-term rehabilitation after head injuries etc. I was VERY struck by the adverse effect, in BAH, of closing the Sheltered Workshop (because of “patient labor” laws)—for this had a special, happy, productive, social spirit, where patients could forget they were “patients,” and just become fellow-workers, and companions. I was very struck too by the closing of “the old wards,” the 32-bedded wards, which (amazingly) combined a sense of community with one of inviolable privacy (whether patients chose to close the curtains about their beds). When these were dissolved, in 1967, and replaced by 1-, 2-bedded rooms, much community was lost, and a new devastating sense of isolation and loneliness entered.
