A neurologist coloured with vision

11 Sep 2015 by Ryan O'Hare

This month the world of science mourned the passing of one of its most celebrated commentators on clinical conditions of the brain, as British neurologist and bestselling author Dr Oliver Sacks died at his New York home, aged 82.

This month the world of science mourned the passing of one of its most celebrated commentators on clinical conditions of the brain, as British neurologist and bestselling author Dr Oliver Sacks died at his New York home, aged 82.
Best known for his popular book, The man who mistook his wife for a hat, Dr Sacks was an explorer of the farthest reaches of the human brain, chronicling some of the rarest and strangest neurological conditions through his writings.
Born in London in 1933 into a large Jewish family, his father was a GP and his mother a surgeon, he studied medicine at Oxford University, before leaving for the United States in the early 1960s.
Accounts of this early period of his life depict him as something of a rebel – a motorcycle-riding, champion weight-lifter with a penchant for recreational drug use. It was a brief stint in the laboratory which marked a swift end to his career as a bench scientist and pushed him towards medical practice. In a 2005 interview with the Guardian he recalled: “It was my last attempt to be a real scientist. It was a disaster. So everything went wrong. I lost samples. I broke machines. Finally they said to me, ‘Sacks, you're a menace. Get out. Go see patients. They matter less.’”  
It was his subsequent experience in a New York hospital in the mid 1960s, observing and treating patients with ‘sleepy sickness’, which was the basis for his 1973 book Awakenings – decades later it would be the inspiration for an Oscar-winning film of the same name. The neurologist treated patients frozen in catatonic states with the drug L-dopa, waking them from their lethargy.
For the rest of his working life, Dr Sacks continued to bring some of the most bizarre neurological case histories to the fore, with reserves of compassion and understanding. He often delved deep into the world of visual processing, exploring the neurological basis of visual oddities in a number of his books.


"Dr Sacks was an explorer of the farthest reaches of the human brain."

His 1997 book, The island of the colorblind, focused on the Pacific atoll population of Pingelap, reported to have the world’s largest population of people with achromatopsia. Through the book – and associated documentary – Dr Sacks explained that a combination of geographical isolation, reluctance to marry outside of the community and periodic decimations of the Pingelap population from natural disasters was likely to have ensured that the normally rare genetic condition was far more prevalent. The resulting close genetic ancestry of the islanders meant that the prevalence of achromatopsia increased from a typical one in 40,000 to almost one in 12.
The neurologist explored the visual theme further in a later book, Hallucinations. In addition to providing a case study of a blind poet who suffered from Charles Bonnet Syndrome, the book also recounts his own adventures into the inner visual world, including self-induced psychedelic visions of patterns and colours facilitated by LSD and morphine.
In his later life Dr Sacks revealed his own brain to be something of a neurological oddity, admitting to struggling with a degree of prosopagnosia, an inability to recognise faces. Providing a glimpse into the world of the ‘face blind,’ he explained: “[Patients] may see a face clearly, but it doesn’t convey identity to them.” While in his recently published autobiography, On the move, the neurologist reflects on his experiences with his brother’s schizophrenia and growing as a gay man in a time in which homosexuality was still listed as a neurological disorder by the American Psychiatric Association.

Writing in a comment piece in the New York Times earlier this year, Dr Sacks describes his life-changing diagnosis of ocular melanoma nine years ago. He writes: “The radiation and lasering to remove the tumor ultimately left me blind in that eye. But though ocular melanomas metastasize in perhaps 50% of cases, given the particulars of my own case, the likelihood was much smaller. I am among the unlucky ones.” By this time the cancer had metastisised to his liver.
A video interview in 2010 sees Dr Sacks detail the impact his changing vision had on his life in the descriptive prose he was gifted with. “I find myself in a maddeningly flat world” he stated, describing his loss of stereoscopic vision and a lingering inability to make out stairs as anything other than a series of lines.
Dr Sacks remained active up to his death, continuing to write articles for the New York Times, playing piano and being visited in at his home in the Greenwich area of New York City. He died on August 30 in the company of close friends and family and his partner of eight years, writer Bill Hayes.
Before his death he established the Oliver Sacks Foundation, which aims to publish his remaining works and make them available for scholarly use. The nonprofit organisation states among its goals a vision to continue “working to reduce the stigma of mental and neurological illness, and supporting a humane approach to neurology and psychiatry.”
In an obituary published in Nature earlier this month, Dutch psychologist and author Douwe Draaisma wrote: “Sacks saw himself as a storyteller, not a theorist. He often said that he was happy to present the case material that others could use to devise grand theories [...] Although not the inventor of the neurological narrative, Oliver was certainly its culmination. For the coming decades, his legacy will be safe in the hearts and minds of millions of readers.”
Images: Luigi Novi, Douglas White

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