Monday, September 14, 2015

To clarify my thoughts

RIP Oliver Sacks, a British neurologist, whose books about patients with neurological conditions sold widely, largely because of his literary flare and his ability to make medical science accessible. Indeed, his books were so popular that, despite their rather obscure content, some were turned into plays and films. Sacks was an inveterate keeper of journals and notebooks, amassing more than 1,000. However, only one has ever been published in book form, the record of a short trip to Oaxaca, Mexico, with a group of fern lovers!

Sacks was born in London, the youngest of four children, in 1933. His father was a physician, and his mother was one of the country’s first female surgeons. During the war, he was sent with a brother to a boarding school in the Midlands. Thereafter, he attended St Paul’s School in London and Queen’s College, Oxford. He graduated in 1956 with a degree in physiology and biology, and then continued to study medicine, with an internship at Middlesex Hospital, completing this in 1960. Uncertain of his next move, he travelled to Canada, and then the US where he took a residency in neurology at Mt. Zion Hospital, San Francisco, and fellowships in neurology and psychiatry at University of California, Los Angeles.

Sacks then moved to New York, where, in 1966, he became professor of neurology at New York University School of Medicine, and consulting neurologist for Beth Abraham Hospital in the Bronx. At the latter, he recognized a group of patients, many of whom had spent decades in a frozen state, as survivors of sleepy sickness pandemic in the 1910s and 1920s. He treated them with a then-experimental drug, L-dopa, enabling them to come back to life. He published their stories in a 1973 book, Awakenings, which later inspired a play by Harold Pinter and a film starring Robert De Niro and Robin Williams.

From 1966 also, Sacks worked as: an instructor and later clinical professor of neurology at the Albert Einstein College of Medicine (until 2007); a neurological consultant to various nursing homes run by the Little Sisters of the Poor; and a consulting neurologist at Bronx Psychiatric Center. From 1992, he held an appointment at the New York University School of Medicine (to 2007). In 2007, he joined the faculty of Columbia University Medical Center as a professor of neurology and psychiatry; and from 2012, he returned to New York University School of Medicine as a professor of neurology and consulting neurologist at the epilepsy center.

After Awakenings, Sacks published more than half a dozen more books based on case histories of his patients - such as The Man Who Mistook His Wife for a Hat and The Mind’s Eye - as well as several autobiographical memoirs, including Uncle Tungsten: Memories of a Chemical Boyhood. In 2015, he published On the Move: A Life, which revealed for the first time personal details about his adult life: a somewhat wild youth, full of drugs, motorbikes and obsessive bodybuilding, followed by several decades of celibacy and living alone. In 2008, he began a relationship with the writer Bill Hayes. Towards the end of his life, he wrote movingly about his own health issues. He died two weeks ago on 30 August. Further biographical information is available from the Oliver Sacks website and Wikipedia, or from obituaries in The New York Times, The Guardian, The Independent, and The Eonomist.

Oliver Sacks was an obsessive diarist and note taker. A dozen years or so before his death, he assessed his collection of journals as totalling over 1,000. Yet they were all written for himself alone without a thought for publication. Here is Sacks himself, writing on the last-but-on page of his autobiography On the Move: ‘
They called me Inky as a boy, and I still seem to get as ink stained as I did seventy years ago. I started keeping journals when I was fourteen and at last count had nearly a thousand. They come in all shapes and sizes, from little pocket ones which I carry around with me to enormous tomes. I always keep a notebook by my bedside, for dreams as well as nighttime thoughts, and I try to have one by the swimming pool or the lakeside or the seashore; swimming too is very productive of thoughts which I must write, especially if they present themselves, as they sometimes do, in the form of whole sentences or paragraphs.

When writing my Leg book, I drew heavily on the detailed journals I had kept as a patient in 1974. Oaxaca Journal, too, relied heavily on my handwritten notebooks. But for the most part, I rarely look at the journals I have kept for the greater part of a lifetime. The act of writing is itself enough; it serves to clarify my thoughts and feelings. The act of writing is an integral part of my mental life; ideas emerge, are shaped, in the act of writing.

My journals are not written for others, nor do I usually look at them myself, but they are a special, indispensable form of talking to myself. The need to think on paper is not confined to notebooks. It spreads onto the backs of envelopes, menus, whatever scraps of paper are at hand. And 1 often transcribe quotations I like, writing or typing them on pieces of brightly colored paper and pinning them to a bulletin board. When I lived in City Island, my office was full of quotations, bound together with binder rings that I would hang to the curtain rods above my desk.’

In fact, Sacks did, during his lifetime, release a very few extracts for publication, including two articles for a magazine, and the diary he kept on a tour to Mexico to study ferns, published as Oaxaca Journal by National Geographic in 2001. Of this latter, Sacks says, on his website: ‘I have been an inveterate keeper of journals since I was fourteen, especially at times of adventure and crisis and travel. Here, for the first time, such a journal made its way to publication, not that much changed from the raw, handwritten journal that I kept during my fascinated nine days in Oaxaca.’

It is also worth reproducing Sack’s own introduction in the book (available to preview at Googlebooks), as it sheds more light on his diary habits.

‘I used to delight in the natural history journals of the nineteenth century, all of them blends of the personal and the scientific - especially Wallace’s The Malay Archipelago, Bate’s Naturalist on the River Amazons, and Spruce’s Notes of a Botanist, and the work which inspired them all (and Darwin too), Alexander von Humbolt’s Personal Narrative. It pleased me to think that Wallace, Bates, and Spruce were all crisscrossing in one another’s paths, leapfrogging, on the same stretch of the Amazon during the selfsame months of 1849, and to think that all of them were good friends. (They continued to correspond throughout their lives, and Wallace was to publish Spruce’s Notes after his death.)

They were all, in a sense, amateurs - self-educated, self-motivated, not part of an institution - and they lived, it sometimes seemed to me, in a halcyon world, a sort of Eden, not yet turbulent and troubled by the almost murderous rivalries which were soon to mark an increasingly professionalized world (the sort of rivalries so vividly portrayed in H. G. Wells’s story “The Moth”.

This sweet, unspoiled, preprofessional atmosphere, ruled by a sense of adventure and wonder rather than by egotism and a lust for priority and fame, still survives here and there, it seems to me, in certain natural history societies, and amateur societies of astronomers and archaeologists, whose quiet yet essential existences are virtually unknown to the public. It was the sense of such an atmosphere that drew me to the American Fern Society in the first place, and that incited me to go with them on their fern-tour to Oaxaca early in 2000. And it was the wish to explore this atmosphere which, in part, incited me to keep a journal there. There was much else, of course: my introduction to a people, a country, a culture, a history, of which I knew almost nothing - this was wonderful, an adventure in itself - and the fact that all journeys incite me to keep journals. Indeed I have been keeping them since the age of fourteen, and in the year and a half since my visit to Oaxaca, I have been in Greenland and Cuba, fossil hunting in Australia, and looking at a strange neurological condition in Guadeloupe - all of these travels have generated journals, too.

None of these journals has any pretension to comprehensiveness or authority; they are light, fragmentary, impressionistic, and, above all, personal.

Why do I keep journals? I do not know. Perhaps primarily to clarify my thoughts, to organise my impressions into a sort of narrative or story, and to do this in “real time,” and not in retrospect, or imaginatively transformed, as in an autobiography or novel. I write these journals with no thought of publication (journals which I kept in Canada and Alabama were only published, and that by chance, as articles in Antaeus, thirty years after they were written).

Should I have prettied up this journal, elaborated it, made it more systematic and coherent - as I was to do with my book-sized Micronesian and “leg” journals - or left it as written, as with my Canadian and Alabaman ones? I have, in fact, taken an intermediate course, adding a little (chocolate, rubber, things Mesoamerican), making little excursions of various sorts, but essentially keeping the journal as written. I have not even attempted to give it a proper title. It was Oaxaca Journal in my notebooks, and Oaxaca Journal it remains. December 2001’

And here is an extract (somewhat reduced) from the first (and undated) diary entry in Oaxaca Journal.

‘I am on my way to Oaxaca to meet up with some botanical friends for a fern foray, looking forward to a week away from New York’s icy winter. The plane itself - an AeroMexico flight - has an atmosphere quite unlike anything I’ve ever seen. We are scarcely off the ground before everyone gets up - chatting in the aisles, opening bags of food, breast-feeding babies - an instant social scene, like a Mexican cafe or market. One is already in Mexico as soon as one boards. [. . .]

My neighbor asks why I am visiting Mexico, and I tell him I am part of a botanical tour headed for Oaxaca, in the south. There are several of us on this plane from New York, and we will meet up with the others in Mexico City. Learning that this is my first visit to Mexico, he speaks glowingly of the country, and lends me his guidebook. I must be sure to visit the enormous tree in Oaxaca - it is thousands of years old, a famous natural wonder. Indeed, I say, I have known of this tree and seen old photos of it since I was a boy, and this is one of the things that has drawn me to Oaxaca. [. . .]

We have a leisurely three hours in Mexico City airport - lots of time before our connection to Oaxaca. [. . .]

5:25 p.m.: We taxi endlessly about the monstrous tarmac, joltingly, too joltingly for me to write. This giant city, God help it, has a population of 18 million (or 23 million, according to another estimate), one of the largest, dirtiest cities in the world.

5:30 p.m.: We’re off! As we rise above the smear of Mexico City, which seems to stretch from one horizon to the other, my companion suddenly says, “See that . . . that volcano? It is called Ixtaccihuatl. Its summit is always covered in snow. There, next to it, is Popocatépetl, its head in the clouds.” Suddenly, he is a different man, proud of his land, wanting to show it, explain it, to a stranger. It is an incredible view of Popocatépetl, its caldera nakedly visible and next to it a range of high peaks covered with snow. I am puzzled that these should be snow-covered, while the higher, volcanic cone is not - perhaps there is sufficient volcanic heat, even when it is not erupting, to melt the snow. With these amazing, magical peaks all around, one sees why the ancient Aztec capital of Tenochtitlán was established here, at 7,500 feet.

My companion (now on his second rum and coke, in which I join him) inquires why I have come to Mexico. Business? Tourism? “Neither, exactly,” I say. “Botany. A fern tour.” He is intrigued, speaks of his own fondness for ferns. “They say,” I add, “that Oaxaca has the richest fern population in Mexico.”

My companion is impressed. “But you will not confine yourself to ferns?” He speaks then, with eloquence and passion, of pre-Columbian times: the astonishing sophistication of the Maya in mathematics, astronomy, architecture; how they discovered zero long before the Greeks; the richness of their art and symbolism; and how the city of Tenochtitlán had more than 200,000 people. “More than London, Paris, more than any other city on Earth at the time, except the capital of the Chinese empire.” [. . .]

As we descend from the plane in Oaxaca city I can see John and Carol Mickel - my friends from the New York Botanical Garden - waiting in the airport. John is an expert on the ferns of the New World, of Mexico in particular. He has discovered more than sixty new species of fern in the province of Oaxaca alone and (with his younger colleague Joseph Beitel) described its seven hundred-odd species of fern in their book Pteridophyte Flora of Oaxaca, Mexico. He knows where each of these ferns is to be found - their sometimes secret, or shifting, locations - better than anyone. John has been to Oaxaca many times since his first trip in 1960, and it is he who has arranged this expedition for us.

While his special expertise lies in systematics, the business of identifying and classifying ferns, tracing their evolutionary relationships and affinities, he is, like all pteridologists, an all-round botanist and ecologist too, for one cannot study ferns in the wild without some understanding of why they grow where they do, and their relationship to other plants and animals, their habitats. Carol, his wife, is not a professional botanist, but her own enthusiasm, and her many years with John, have made her almost as knowledgeable as he is.’

Finally, Lawrence Weschler, author and ex-staff writer at The New Yorker, recently wrote, for Vanity Fair, a moving appreciation of Sacks, and included a number of his own diary entries about his friend.

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