oliver sacks is ogling my cough-drops. It's a damp, altogether dreary morning in mid-December, and when he spies me pulling a small sack of Fisherman's Friends from my pocket I've just gotten over a bout with the flu. He asks, "Might I have one of those? They're quite addictive, aren't they?" For the rest of the interview he smacks away happily on several of the small lozenges, as content as a child with a lollipop.
There's an unstudied, childlike quality about Oliver Sacks that, in person, is enormously appealing. He wears tremendously mismatched outfits ("I have no clothes sense," he explains), greeting a visitor to his spacious Greenwich Village office in black trousers, a blue checked shirt that's haphazardly tucked-in, a bright red tie and gray running shoes. He pops up enthusiastically every minute or so to show a visitor an artifact, or a map, or an unusual plant as if the mementos of his life as the world's most peripatetic neurologist were in fact wonderful toys. Which, of course, they are. And he confesses that he eats the same things each day for breakfast and lunch (cereal with bananas) and dinner (fish with rice). He seems happy, alert, eternally curious.
Sacks' curiosity and compassion have led him to become one of the world's most rewarding writers about science, medicine and the vicissitudes of the human experience. His seven books which include "The Man Who Mistook His Wife for a Hat," "Awakenings" and "An Anthropologist on Mars" are largely case studies of patients with neurological dysfunction. Yet they are also potent and oddly charming meditations on what he has called "the wonder and horror which lurk behind life."
Sacks' new book, "The Island of the Colorblind," is a series of essays about his experiences in the Pacific Islands, including the isolated island of Pingelap, where a disproportionate number of natives have been born almost completely colorblind. (The book includes information about The Achromatopsia Network, a group that maintains a Web site devoted to sharing information about this kind of colorblindness.) Other essays in the book deal with Sacks' lifelong love of botany, and about how a favorite variety of cycad tree may have been responsible for a crippling disease on a separate Pacific island. "The Island of the Colorblind" is quintessential Sacks a compelling blend of case studies, medical and natural history and offhanded personal observation.
Sacks, 63, is a lifelong bachelor. He continues to practice neurology and is Clinical Professor of Neurology at the Albert Einstein College of Medicine. He lives on City Island in the Bronx, where he raises ferns and cycads, and swims nearly every day, except in winter, in Long Island Sound.
Because he seemed so intent, during our interview, on switching attention away from himself and onto various objects around him, I began by asking him what it was like, during his research for "The Island of the Colorblind," to have a film crew poking cameras in his face.
While you were researching your new book in the Pacific Islands, you had a BBC documentary film crew following you around. Did that alter your experience there?
Somewhat both positively and negatively. My usual contact with people is quiet and intimate and often very prolonged. I stutter and I stammer and I come back the next day as a sort of postscript, as a follow-up visit. The pen and notebook are my tools. So I did feel somewhat put off at first by the cameras. And so did the others. But on the other hand, the filming was so discreet that after a while one would forget.
You don't seem like a person who would watch much television even the BBC, if you could get it.
No, not much. I tend to watch "Star Trek." When it was on at eight on Mondays I would invariably get to it. And if anyone phoned me at that time they would find me very distant or withdrawn [laughs]. And they would wonder if I wasn't sort of hostile. But in fact I simply didn't want to be interrupted. I don't watch television much. On the other hand I am surrounded by radio. I think I probably come from a radio generation. I like background music. I like going to concerts partly so that I can sit at the back with a notebook and follow my own thoughts.
What sort of things do you write during a concert?
Well, curiously, I'm seeing if something comes to me as a connection. A friend and colleague of mine, whom I mentioned [in the book] in relation to colorblindness, saw me at Carnegie Hall recently, during a performance of Mozart's "Great Mass" and "Requiem," and I was writing in my notebook. And in fact I was writing about achromatopsia [colorblindness]. I tend to follow my own thoughts and at the same time to listen to the music. There's a passage in Nietzsche where he speaks of his love for Bizet, and how when he is at a concert Bizet will set him off on his own trains of thought. He says Bizet makes him a better philosopher. I find music, especially Mozart, very congenial to thinking.
You've written about patients with various neurological disorders who can be helped by music.
I think music is extremely powerful in all sorts of ways. I've seen this with my patients. I have had some Parkinsonian patients who have lost their internal tempo and melody and movement. I am trying to give them rhythm or melody in a kinetic way. I am very fascinated by music, and I think the neurology of music is very important and interesting.
I enjoyed the essay in your last book called "The Last Hippie" about a music fan whose range of cultural references ended in the 1960s or early 1970s because of memory loss. You didn't seem, in that essay, to have any real affinity for the Grateful Dead or any recent popular music. Do you enjoy any pop music?
I did go along once to the Grateful Dead and I enjoyed it in a way. I was sort of given a seat behind the stage, and it gave me an impulse to dance. I sort of danced around for hours and enjoyed it. I loved the physical tonic, the rhythmic vitality. And although "Greg" [his patient in the essay] now thinks that I am a sort of Dead Head, alas I am not, and don't know much about their music. I had to sort of fake it as best I could. That is to say, I brought in people who knew more about pop music than I did. I went to "Tosca" on Friday, which was very pleasant. But I'm basically a Bach and Mozart person.
Did the Grateful Dead concert interest you as a communal experience? I ask because there's a nice moment in your new book where you take part in a traditional sakau ceremony on the Pacific Island of Pohnpei. You drink this root that's been pulped, and you describe yourself as getting slightly stoned. At other times, though, you've written about how you can rarely give in to moments like that you tend to remain aloof, objective.
There can be a combination of yielding to an experience and yet articulating it in a certain way. I think if it were just passivity alone it would rather frighten me. Now this may in fact be a strength or a weakness. I remember once I was with a friend in Japan, and we had all sorts of exotic experiences. He once said to me: "Stop thinking! Why can't you just give yourself to the total experience and not interrogate everything." And since he came from the Midwest, he compared me to one of these huge tractors which are always cogitating and turning things over. I think I felt, with the island experience, that I did yield to the perceptions and emotions strongly, and then I sought to give it some sort of intellectual coherence or backbone later.
How did you find Pingelap, the "island of the colorblind"? I know that in a previous book you'd written about an artist who suddenly became colorblind.
There was a sort of funny labyrinth of connections, which I've presented in a simplified form [in the book]. I had been in Guam the previous year, and for some reason I asked my friend and colleague John Steele in Guam if he knew of an island of the colorblind. The fact that I should ask such a questions shows that things had already been ruminating in my mind. And he said sure 1200 miles from here. And he told me about Pingelap. There was also some contact with an achromatopic woman in California who knew of another island of the colorblind off Denmark, this island of Fuur. So I rather suddenly found out about two islands of the colorblind. But there were no more achromatopes left on Fuur.
I am interested in isolates villages, valleys, places where some condition becomes excessively common. Some years ago I visited and wrote about this village in Northern Canada full of people with Tourette's [syndrome] Tourettesville. And I had written about Martha's Vineyard, which once had a very high concentration of deaf people. I've also heard of a village in Israel where a third of the population are deaf and the entire village signs. I've heard of a village in Italy where no one gets heart disease. I know some villages in Venezuela where there's a horrifying incidence of Huntington's chorea. I'm interested in this notion of a special place where some disease, some gift, some animal, some plant, some mineral, something is unique and strange. Often islands, because they are isolated, but they can also be some conceptual island like valleys or oases or ghettos or isolated places.
In this new book you combine your interest in neurology with your interest in botany. At first, they can seem like an odd combination.
I was just looking at a review of the English edition [of "The Island of the Colorblind"] by the director of Kew Gardens, and I was very delighted to see it. He says medicine and botany do seem an odd combination. Well, I guess it's partly fortuitous. I became a doctor rather late; my early passions were for the natural sciences. The idea of innumerable forms of life is something which excites me. I'm doing a scuba diving course at the moment. I am very fond of coral reefs and things. I do, I think, I partly regard various clinical conditions as forms of life. For example, I think of Tourette's as a form of life. One can also think of it as a medical condition with all sorts of symptoms and signs, but I think the whole center from which a Tourettic person lives can be different, and their values and their perspective. It really seems to me to be a mode of being, a form of life. I think botany and zoology give me that feeling strongly. Also, in something like a forest or a rain forest, I think there is a tremendous feeling of complexity and interconnectedness which strikes me as a sort of parallel to the way people are. For example, no one just has a migraine, say, because their migraine center is set off. Although migraines are specific and physiological, I think they are always embedded to some extent in the life of the person in their patented reaction, what they are exposed to outwardly and inwardly. So I think one has to look at a sort of an ecology of migraine.
It must be frustrating being so interested in the natural world, and to spend so much of your time in Manhattan.
My hospital in the Bronx, the Beth Abraham hospital, which is the "Awakenings" hospital, is right opposite the Botanical Garden. I go there when I can.
In "The Island of the Colorblind" you write that, as a child, you had visual migraines that brought on something like temporary colorblindness. Is this one reason you were attracted to this topic?
I think certainly my own visual migraines gave me a great ability to empathize with what the colorblind artist had. Sometimes in a visual migraine you can't make sense of what you see. You see it clearly, but you don't know what it is. You have a visual agnosia. But I don't know how much something like this helps one to imagine what it is like to be born colorblind, or born blind, or born deaf. Having visual migraines from a very early age was one of the things that interested me in the brain and in neurology. I would often lose sight to one side, and sometimes one can lose the idea of one side in a migraine, which can be a very, very strange thing. When I was young I was sort of terrified of these things. I asked my mother, who was a doctor herself and also had visual migraines. She was the first to explain to me that we are not just cameras we are not just given the visual world. We make it to some extent. I think I had an early drenching in visual things. With me [colorblindness] was a very brief, temporary thing, which would certainly give me a sense of loss and impoverishment and fear and horror.
Here's an entirely different question. You write in your new book, "I have a passion for monotony." And you've said elsewhere that you eat the same things for breakfast, lunch and dinner each day ...
[Hopping energetically out of his chair] Let me show you. [He takes me into his small office kitchen, where identical Tupperware containers hold the cereal he eats with bananas for breakfast and lunch each day.] And my refrigerator at home contains bags of fish and rice marked "Saturday," "Sunday," "Monday" ...
I bring this up because I'm wondering if being monotonous in some things allows you more freedom in others.
I think so. I am rather bad at decision in some ways. For example, decisions on what to eat. I am also an ex-320 pounder, having shed 120 pounds with great difficulty, so I find I need an obsessive regimen. I have no clothes taste, so one day I will tend to be mostly in gray, another day in red, another day in blue. In fact, about two minutes before you came I put on this red tie to add a bit of change. I go for a swim every morning. I always like to use locker 450 at the Chelsea [Health Club], and locker 77 at the New Rochelle Y. I mean, they are no different from any other lockers. But I think you are right. Some of these invariant things are basically so I can take off impulsively, which I do all the while. Like suddenly taking the ferry to Hoboken last Sunday, or taking off ambitiously to Micronesia. Also, I find myself thinking for some reason about T.S. Eliot saying that poets should dress like bank clerks a certain external unremarkableness so that one can have more freedom inside.
Is writing ever difficult for you? Do you worry, while you are having these experiences in, say, Micronesia, about being able to capture them on paper once you return?
Sometimes. Often I can't make sense of it. I mean, elemental things can't be described. Pain can't be described. Color can't be described for that matter. Part of my business is to try to describe the indescribable or the incommunicable. I think that with rage or jealousy or suspicion or joy, all of us have knowledge of these feelings and you can count on the reader's knowledge. But being Parkinsonian is not something which can be imagined. Which is a reason why I wondered how Robert De Niro and others would do it in the movie of "Awakenings." You can simulate some things because you can feel all the usual human emotions that are part of the human condition. But Parkinsonism is not a universal experience that way.
Were you pleased with the portrayals in "Awakenings"?
I was pleased with a great deal of it. I think in an uncanny way, De Niro did somehow feel his way into being Parkinsonian. So much so that sometimes when we were having dinner afterwards I would see his foot curl or he would be leaning to one side, as if he couldn't seem to get out of it. I think it was uncanny the way things were incorporated. At other levels I think things were sort of sentimentalized and simplified somewhat.
There have been three plays derived from your work, and an opera, and a movie. What is it like to see your work on stage or screen?
I don't get directly involved myself in any of these adaptations or whatever, but I am intrigued and grateful if other people's creative impulses, in different modes, gets going from my work. One of the most recent things I've seen, I don't know if you have seen the Brian Friel play "Molly Sweeney," but that was considerably inspired by my case history "To See and Not See." Friel dealt with it and brought so much of himself into this. It is clearly a sequel to his play, "Faith Healing," from 15 years before, and it's just a privilege to have another imagination use one's stuff in such an original way. I rather like the idea of all of these visions. Some of them are uncanny. When Harold Pinter wrote a play which derived from one of the "Awakenings" stories, I felt that had that patient been alive at the time, which she wasn't, she would have found it uncanny. She would have felt that he had somehow divined her state. It's very mysterious. Some rather unpleasing terms like "voyeurism" and "freak show" have been thrown around [in regard to my work] and I feel very vulnerable to them and hope they don't apply. Because I think I am moved essentially by a respect and wonder for what I see, which I want to share.
You mentioned reading a review of your book recently. Do negative reviews bother you?
Yes, they can sometimes bother me intensely. When my book "A Leg to Stand On" came out, there was an assasinatory review in England which bothered me so much that I stopped writing for three months. It was only after a deeply appreciating and encouraging review of the same book came out here [in the U.S.], by someone I intensely admired, that I felt relieved and affirmed enough that the rest of the "Man Who Mistook His Wife for a Hat" pieces, seven or eight, sort of rushed out in a matter of weeks. I think I am less sensitive now. But I have both been halted in my tracks by reviews and encouraged very much. I was very delighted by the review by the director of Kew in England, because I felt, "Here's a real botanist and a very eminent one." But what matters much more is whether there is something of substance, real.
Have you learned from reviews?
Oh yes. I am very glad for constructive reviews, which in a way warn me against sentimentality and against romancing things too much. Although there are other reviews which can infuriate as well as depress, because they really ask one to be something other than what one is. I think there was one review of "Colorblind" which was annoyed because it was not a textbook. Well, it's not a textbook. The first time I ever submitted anything to a publisher, which was a non-medical thing, something I wrote in my early 20s, it came back with a comment which finally came to: "You seem to be talented, but why don't you write like Hemingway?" Well, I suppose I write more like Sir Thomas Brown than Hemingway [laughs]. Elaboration and this and that is part of the way I am. Hemingway didn't have footnotes. Well, I do.
You've said a CD-ROM might be perfect to incorporate your footnotes. I also noticed that, in your new book, you write about how important the Internet has become for achromatopes to share information.
Kate had to explain to me what the Internet was. I still don't understand too well. Curiously, I heard something on the radio about how people with some odd disease, how they are able now to access information and other people with it. Certainly for some of these rare achromatopes, and one in 30,000 is pretty rare Tourette's and deafness and autism are one in a 1,000, so one in 30,000 is damn rare these are isolated, potentially lonely people and I think its very nice for them to be able to reach out and share their experiences. I know it's very important.
Does the Internet interest you as a tool?
It should, but it doesn't or I should say it doesn't yet. I need to get my apprenticeship. I probably haven't had enough exposure. About a year ago a cousin of mine did a series here with public television called "Heritage" and a CD-ROM version has been made of it. And I was very fascinated by how one could stop at any scene and sort of explore it. I don't know enough about the Internet although I am frightened of what I might call promiscuous intercourse. I get 10,000 letters a year and this is already too much for me. I don't have any e-mail and at the moment I am sort of keeping at a distance.
Many of those letters must be from people seeking your help. How do you decide which cases to take?
Kate and Juan [his other assistant] will remove the first 90 percent. But the other 10 percent ... I mean this pile [he points to a tray of letters] never goes away. Some of it is heartbreaking stuff. I just saw a letter this morning from someone with a strong family history of Creutzfeldt-Jakob disease. In England that will immediately strike a note because it's possibly connected with mad cow disease and all that. I do what I can to answer letters. There was a time where I answered every letter, and I was actually spending eight hours a day answering letters I didn't have any life left. If something interests me very much, and if I think I can do something which other people can't, then perhaps I will suggest to a person that we meet while saying I promise nothing, or I can promise nothing except attention. I will listen closely, and I will think, but whether this will get us anywhere I don't know.
I see that you work on a rather old typewriter.
I don't use a computer. Partly I am used to typing and writing. I am a two-finger typer, although a quick one. I type 80 words a minute. I am afraid, actually this may be this monotony thing. I never tried to touch-type; I thought it might interfere with my bizarre, old fashioned journalistic skill of two-finger typing, because both my fingertips are completely numb. I pound them and they are sometimes visibly, visibly bruised after a day of typing. But I noticed with correspondence that word-processed letters that come to me are often longer and less economic and less tightly organized than hand-written letters. I am afraid of that. I think the very slowness of handwriting and so forth, the very labor sometimes makes one think more. Although I find it quite difficult now to get spare parts for my typewriter. I also need a pre-1968 typewriter. I don't like the typewriters with the ball. There's sufficient weight with the key so that many potential errors don't become actual errors because of the inertia of the key. Whereas with an immediately responsive ball [errors occur].
Last question: When writing your books, do you give yourself deadlines?
I used to do so in the most merciless way. With "Migraine" there was a prehistory about having all sorts of difficulties I was told that I would regret it if I wrote it and this and that. What finally happened is that I gave myself a 10-day deadline on September the first, 1968. I said: "If I haven't finished by then, I will commit suicide." And that's a real deadline! [laughs] In fact what happened is, after a day or two, I so got into the delight and rhythm of writing that I forgot my deadline and in fact the book got written in nine days. It came out in a sort of rush. I don't think in terms of deadlines much, but things have their own tempo which can be a very cruel tempo. I mean we were all driven to exhaustion [on "The Island of the Colorblind"]. Kate kept saying, "Slow down, pace yourself, take a week off." I couldn't do it once the eruption had started. And now it's over and I feel sort of empty and vacuous. A postpartum. I'm not sure what comes next.